Lower Abdomen 2

Question 1

What are the abdominal organs?

Answer 1

Stomach
Duodenum
Transverse Colon 
Ascending Colon
Descending Colon
Jejunum
Ileum
Cecum
Sigmoid Colon
Appendix
Rectum
Anal Canal

Question 2

What is the entrance to the stomach from the esophagus?

Answer 2

Cardiac orifice

Question 3

What is the exits from the stomach to the duodenum?

Answer 3

Pyloric sphincter

Question 4

What is the stomach lined with?

Answer 4

Rugae - temporary folds within the body of the stomach

Question 5

What are the parts of the small intestine?

Answer 5

1) Duodenum - fixed & relatively immobile
2) Jejunum & ileum
- tethered, but very mobile
- combined length of 3 segments ~20 ft.
3) Plicae Circularis
- permanent folds within intestine
- become more diffuse distally
- Ileum empties into cecum at ileocecal junction

Question 6

What are the sections of the Duodeunum?

Answer 6

Superior part, descending part, inferior part, ascending part

Question 7

What is Meckel’s (ileal) diverticulum and where is it?

Answer 7

It’s a remnant of the embryonic yolk stalk, and it’s in the ileum

It appears as a finger like pouch, it’s located 1 m proximal to ileocecal valve, may become inflamed & mimic appendicitis

Question 8

What is another name for the colon?

Answer 8

Large intestine

Question 9

What are the five segment of the colon?

Answer 9

Cecum, Asc, Trans, Desc, Sigmoid

Question 10

What are the 2 flexures of the colon?

Answer 10

The Right Colic (Hepatic) flexure and the Left Colic (Splenic) flexure

Question 11

Where does the colon terminate?

Answer 11

into the rectum

Question 12

What does the veriform appendix open into? Where is it?

Answer 12

the cecum, inferior to the ileocecal orifice

commonly retrocecal but varies considerably

Question 13

What is the mesoappendix?

Answer 13

a swatch of triangular mesentery between the ileum and appendix

Question 14

What are the symptoms of appendicitis?

Answer 14

• Vague pain begins in the periumbilical region (it’s afferent pain referred to T10 level)
• Severe pain later from R. lower quadrant (from irritation of peritoneum of posterior abdominal wall)
• Pain is most severe over spinoumbilical point between the ASIS & umbilicus

Question 15

The colon frames the ____

Answer 15

small intestines

Question 16

What are the specializations of the colon?

Answer 16

1) Teniae coli - 2 smooth m. bands paralleling length of colon
2) Haustra coli - outpouchings produced by teenier coli
3) Epiploic appendages - fat tags found along the colon

Question 17

What is the arterial supply of the upper abdomen?

Answer 17

Celiac trunk - 1st major br. of abdominal aorta - it supplies liver gallbladder, esophagus, stomach, pancreas & spleen - it has 3 main branches:

1) Common hepatic
2) L. gastic
3) Splenic aa.

Question 18

What is the arterial supply of lower abdomen?

Answer 18

1) Superior Mesenteric A. - 2nd major branch of abdominal aorta - ~1 cm inferior of celiac - it sends 15-18 intestinal aa. to small intestine - supplies up to proximal 2/3 of transverse colon via ileocolic, R. colic & middle colic
2) Inferior mesenteric A. - 3rd major branch of abdominal aorta - ~5 cm superior to aortic bifurcation - supplies colon from distal 1/3 of transverse colon via L. colic, sigmoid (4) & superior rectal
* Variations of SMA & IMA branching exist.
* Anastomoses between colic branch for collateral circulation, these form a consistent vascular arc around the colon via marginal a. of Drummond

Question 19

What are the Pancreatic Arteries?

Answer 19

Gastroduodenal a. gives off Superior
pancreaticoduodenal aa.
• SMA gives off Inferior pancreaticoduodenal aa.
(they anastomose and supply head of pancreas & duodenum)
• Splenic a. supplies rest of pancreas with additional branches

Question 20

What are the renal arteries?

Answer 20

ateral branches of abdominal aorta (lateral to SMA)
• Enter hilum of each kidney to supply it
• sends off brs. to adrenal glands and ureters
• other adrenal branches from inferior phrenic aa & aorta


Question 21

What are the gonadal arteries?

Answer 21

Gonadal Aa.
•  lateral branches of abdominal aorta (inf. to renal aa.)
•  Ovarian aa (♀)
–  crosses over ureters &
iliac vessels
–  descends to pelvis to supply ovaries
•  Testicular aa. (♂)
–  crosses over ureters &
enters inguinal canal
–  descends into scrotum to supply testes

Question 22

What is the venous drainage of the abdomen?

Answer 22

1) Inferior Vena Cava
–  largest vein in body
–  begins at ~L5 level
»  at union of common iliac vv.
–  returns poorly oxygenated blood from LL, most of the back, abdominal wall, & abdominopelvic viscera
–  to the RA of heart
–  Blood from viscera
»  via Portal venous system

2) Portal Vein
–  Formed by union of splenic and superior mesenteric vv. (L2)
–  Venous return from:
»  Spleen
»  Pancreas
»  Gallbladder
»  Abdominal gastrointestinal tract
–  Returns nutrient rich, poorly oxygenated blood to the liver
–  Then via IVC to the RA of heart

Question 23

What are Portal-Caval Anastomoses?

Answer 23

4 anastomoses: portal & caval vv
–  gastric vv & esophageal vv
–  paraumbilical vv & epigastric vv
–  superior rectal vv & middle/ inferior rectal vv
–  colic vv & retroperitoneal vv

*Portal venous system has no valves
• reversal of blood flow into caval vv is possible
-portal hyper tension restricts blood flow
– causes caval vv to become engorged
– may become dilated & varicose