Lower Abdomen Flashcards
1
Q
What is the opening and exit of the stomach?
A
- cardiac orifice; entrance from esophagus
- pyloric sphincter; exit to duodenum
2
Q
What are the temporary folds within the body of the stomach?
A
Rugae
3
Q
What are the main functions of the stomach?
A
- mixing of the mass of food (bolus)
- beginning of enzymatic digestion
- chyme production
4
Q
Where does the small intestine begin?
A
pyloric orifice
5
Q
The first section of the small intestine, is retroperitoneal, and relatively immobile
A
duodenum
6
Q
The portions of the small intestine that are tethered to mesentery, but very mobile w/ combine length of 3 segments (20ft)
A
jejunum & ileum
7
Q
The _____ _____ are permanent folds within intestine, become more diffuse distally bc absorption of nutrients, so more prominent in jejunum
A
plicae circularis
8
Q
The ileum emptions into the cecum at the ________ junction
A
ileocecal
9
Q
What are the 4 parts of the duodenum and levels of vertebrae they are found?
A
- Superior part (L1)
- Descending part (L1+L2)
- Inferior part (L3)
- Ascending part (L3 + L2)
10
Q
The diameter of the intestine _______ distally bc of absorption through the tract
A
decreases
11
Q
The ______ ____ is long and the ____ ____ is short in jejunum
A
- vasa recta
- arterial arcades (close to SMA)
12
Q
The ___ ___ is long and the ___ ___ is short in the ileum
A
- arterial arcades
- vasa recta
13
Q
_____ _____ is a remnant of embryonic yolk sac that appears as a finger like pouch 1m proximal to ileocecal valve
A
Meckel’s (ideal) diverticulum
14
Q
What is the clinical significance of Meckel’s(ileal? diverticulum?
A
-may become inflamed and mimic appendicitis when digestive material is compacted and may develop own vasculature and drainage
15
Q
The _____ ____ “frames” small intestines and is divided into 5 segments and 2 flexures
A
Large Intestine (colon)
16
Q
What are the segments of the large intestine?
A
- Cecum (right after ileosecal junction)
- Ascending colon
- Transverse colon
- Descending colon
- Sigmoid colon
17
Q
What are the 2 flexures of the large intestine?
A
- Right Colic flexure (hepatic)
2. Left colic flexure (splenic)
18
Q
The ____ ____ is the point of parasympathetic exchange btw vagus and sacral?
A
L Colic Flexure
19
Q
The large intestine terminates into the ____
A
rectum
20
Q
The _____ ______ opens into cecum inferior to ileocecal orifice; commonly retroperitoneal
A
veriform appendix
21
Q
What type of mesentery covers the appendix and holds it in place?
A
Triangular mesentery = mesoappendix
22
Q
_____ is inflammation of the appendix and ______ is removal of the appendix
A
- appendicitis
- appendectomy
23
Q
Where does appendicitis cause vague pain in beginning stages?
A
- periumbilical region from afferent pain referred to T10 level
24
Q
Where does appendicitis cause severe pain in later stages?
A
- Right lower quadrant
25
______ causes the severe pain in the right lower quadrant during appendicitis?
- (peritinitis)- irritation of peritoneum of posterior abdominal wall
26
Pain is most severe during appendicitis over _____ _____ btw the _____ and ____
- spinoumbilical point
- ASIS
- umbilicus
27
What are the 3 smooth m. bands paralleling the length of the colon?
teniae coli
28
_____ ____ are outpouchings produced by teniae coli
haustra coli
29
___ _____ are fat tags found along the colon
epiploic appendages
30
What are the 3 main branches of the abdominal aorta and what regions of the abdomen do they supply?
- Celiac trunk- (foregut)
- Superior mesenteric artery (Midgut)
- Inferior mesenteric artery (Hindgut)
31
1st major branch of abd. aorta that supplies liver, gallbladder, esophagus, stomach, pancreas & spleen
Celiac trunk
32
What are the 3 main branches of the celiac trunk?
1. Common hepatic
2. L. gastric
3. Splenic aa.
33
What vertebral level is the celiac trunk found?
T12- superior to pyloric stomach
34
What is the second major branch of the abdominal aorta and 1 cm inferior of celiac?
Superior mesenteric artery (SMA)
35
The _____ sends 15-18 _______ aa to small intestine and supplies up to proximal 2/3 of transverse colon
- SMA
| - intestinal
36
What branches of SMA supply the small intestine up to the proximal 2/3 of transverse colon?
- ileocolic
- Right colic
- Middle colic
- Inferior pancreaticduodenal
37
What vertebral level is the SMA found?
L1
38
What is the 3rd major branch of the abdominal aorta?
Inferior mesenteric artery (IMA)
39
The IMA is found 5 cm superior to the ___ ____
aortic bifurcation
40
The IMA supplies colon from _____ ____ of transverse colon to superior rectum
distal 1/3
41
What are the branches of the inferior mesenteric artery?
- left colic
- sigmoid (4)
- superior rectal
42
What vertebral level is IMA found?
L3-L4 inferior to inferior part of duodenum which is found at L3
43
T/F There are variations of SMA & IMA branching but regions supplied are specific
True
44
Collateral circulation of the lower abdomen is supplied by which anastomoses?
colic branches
45
What artery is the consistent vascular arc around the colon?
marginal a. of Drummond
46
The gastroduodenal a gives off ______ ______ that anastomoses with _____ ____ from SMA
- superior pancreaticoduodenal aa.
| - inferior pancreaticoduodenal aa.
47
The gastroduodenal a is a branch of ____ ____
celiac trunk
48
The anastomosis of superior pancreaticoduodenal and inferior pancreaticoduodenal supply ______ of pancreas and duodenum
head
49
_______ supplies rest of pancreas with additional branches
splenic a.
50
Which paired artery comes off of abdominal aorta as lateral branches to enter the hilum of each kidney to supply it?
Renal artery (Left & Right)
51
The renal a. sends off branches to ______ glands and ______
- adrenal
| - ureters
52
_____ & aorta send other adrenal branches
- inferior phrenic a.
53
The ______ artery sends lateral branches of abdominal aorta inferior to renal artery
gonadal artery (left + right)
- ovarian (females)
- testicular (males)
54
The ______ artery crosses over ureters & iliac vessels and descends to pelvis to suppy ________
- ovarian aa.
| - ovaries
55
The ______ artery crosses over ureters & enters inguinal canal and descends into ____ to supply _____
- testicular aa.
- scrotum
- testes
56
How do you determine gonadal artery btw males and females?
- ovarian- goes into pelvic cavity and testicular aa. goes into scrotum
57
What vertebral region are the testicular or ovarian arteries found?
L2
58
What side of the gonadal artery is typically found to be superior to the other?
left gonadal artery
59
What is the largest vein in the body that begins at L5 level at the union of common _____ veins?
Inferior Vena Cava
| - iliac
60
The inferior vena cava returns ______ oxygenated blood from LL, most of the back, abdominal wall & __________ viscera to the ____ ____ of the heart
- poorly
- abdominopelvic viscera
- right atrium
61
The blood from the viscera drains via the _____ ______ _____
portal venous system
62
At what vertebral level does the aortic bifurcation occur?
L4- just superior to IVC
63
Which venous system is filtered in the liver?
portal bc nutrient rich unlike caval
64
The _____ vein is formed by the union of the splenic and superior mesenteric vv. (L2)
portal
65
The portal vein has venous return from what 4 things?
- spleen
- pancreas
- gall bladder
- abdominal gastrointestinal tract
66
What does the portal vein return to the liver then via IVC to the RA of heart?
nutrient rich, poorly oxygenated blood
67
How many portal caval anastomoses occur in the lower abdomen?
4
68
The portal gastric vv anastomoses with which caval vein?
esophageal
69
The caval epigastric vv anastomoses with which portal vein?
paraumbilical vv
70
The portal superior rectal vv anastomoses with which caval vein?
middle/ inferior rectal vv
71
The caval retroperitoneal vv anastomoses with which portal vein?
colic vv
72
What are the 4 portal veins involved in anastomoses with the caval veins?
- gastric
- paraumbilical
- superior rectal
- colic
73
What are the 4 caval veins involved in anastomoses with the portal veins?
- esophageal
- epigastric
- middle/inferior rectal
- retroperitoneal
74
Which portal veins (1-4) anastomose with caval veins (5-8)
1. Paraumbilical
2. Gastric
3. Superior rectal
4. Colic
5. Epigastric
6. Retroperitoneal
7. Esophageal
8. Middle/ Inferior rectal
1-5
2-7
3-8
4-6
75
T/F The portal system has valves
false, no valves
76
What is another word for caval?
systemic
77
Reversal of blood flow from the portal venous system to the caval venous system leads to _______
portal hypertension which restricts blood flow causing caval vv to become engorged
78
Dilated caval veins may become dilated and _________
varicose
79
Dilated esophageal vv produce ____ ___
esophageal varices
80
Dilated epigastric vv produce _____ _____
caput medusae
81
Dilated infr. & mid rectal vv produce ________
hemorrhoids
82
Varicose veins can lead to ______ rupture and severe ________
- vascular
| - hemorrhaging
83
What can rupture esophageal veins causing irritation and constant bleeding?
food bolus
84
The celiac plexus (prevertebral plexus) contains what 3 ganglia?
- celiac
- aorticorenal
- superior mesenteric
85
The aortic plexus contains what?
- inferior mesenteric ganglion
| - SMA & bifurcation
86
Where is the superior hypogastric plexus located?
- inferior to bifurcation of the abdominal aorta
87
The innervation to the viscera of the abdomen is via what nerve plexus?
Autonomic; parasympathetic/ sympathetic
88
At what vertebral levels do the sympathetic fibers that supply the abdomen originate?
T5-T12-L2 (3)
(thoracolumbar)
- T5-T12 (foregut + midgut)
- T12-L2 (hindgut)
89
At what vertebral levels do the parasympathetic fibers that supply the abdomen originate?
```
CN X (proximal) + S2-4 (distal)
(craniosacral)
```
90
CN X supplies?
most of abdomen to midgut/hindgut @ transverse colon
91
The preganglionic sympathetic splanchnic (T5-12)nn synapse in the ______ ganglia
collateral (para aortic)
92
Sympathetic splanchnic postganglionic fibers of the leave the collateral ganglia to reach _____ _____
effector organs
93
How do sympathetic splanchnic postganglionic fibers travel to effector organs?
n all main arterial branches ie celiac trunk, SMA, renal aa, IMA and all their branches
94
Where are the sympathetic cell bodies found?
Lateral horn T1-L2
95
The thoracic splanchnic nerves what three preganglionic sympathetic nerves?
- Greater splanchnic nerve (T5-9)
- Lesser splanchnic nerve (T10-11)
- Least splanchnic (T12)
96
Where do the thoracic splanchnic nerves synapse?
celiac plexus
97
Preganglionic sympathetic lumbar splanchnic nerves synapse in ____ ______ ganglia
inferior mesenteric
98
There is a postganglionic sympatheric connection between ganglia that allows ___ ____
cross talk
99
Preganlionic parasympathetic nerves from ______ travel on upper arterial branches ie celiac trunk, SMA, renal aa and their branches
CN X
100
Preganglionic parasympathetic nerves from _____ travel on lower arterial branches ie IMA and branches
S2-4
101
Preganglionic parasympathetic nerves synapse within ____ ____
effector organs
102
Thoracic and lumbar splachnic contain what types of nerve fibers?
preganglionic sympathetic
103
Pelvic splanchnic contain what types of nerve fibers?
preganglionic parasympathtic
104
____ ____ plexus travels w/ celiac branches
celiac canglion
105
___ ___ ___ plexus travels with SMA branches
superior mesenteric ganglion
106
____ ____ plexus travels with renal branches
aorticorenal ganglion
107
___ ___ ___ plexus travels with IMA branches
inferior mesenteric ganglion
108
Which of the 4 major autonomic ganglia receive thoracic splanchnic nn & CN X branches (preganglionic sympathetic)
- celiac
- superior mesenteric
- aorticorenal
109
Which of the 4 major autonomic ganglia receive lumbar splanchnic nn & S2-4 branches (preganglionic parasympathetic)
- inferior mesenteric ganglion
