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Anatomy Exam 2 > Lower Abdomen > Flashcards

Lower Abdomen Flashcards

1
Q

Describe a Meckel’s (ileal) diverticulum

A
  • remnant of embryonic yolk stalk
  • appears as a finger like pouch
  • located ~1 m proximal to ileocecal valve
  • May become inflamed & mimic appendicitis
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2
Q

Describe the vermiform appendix.

A
  • Opens into cecum inferior to ileocecal orifice
  • triangular mesentary = mesoappendix
  • Commonly retrocecal, but varies considerably
  • Appendicitis & Appendectomy
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3
Q

Describe the progression of pain associated with the progression of appendicitis.

A
  • Vague pain begins in the periumbilical region
    • from afferent pain referred to T10 level
  • Severe pain later from R. lower quadrant
    • from irritation of peritoneum of posterior abdominal wall
  • Pain most severe over spinoumbilical point between the ASIS & umbilicus
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4
Q

Describe the arterial supply of the lower abdomen.

A
  • Celiac Trunk
  • Superior Mesenteric A
  • Inferior Mesenteric A
  • Pancreatic A
  • Renal Aa.
  • Gonadal Aa.
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5
Q

Describe common variations of the arterial supply of the lower abdomen

A
  • Variations of SMA & IMA
    • Pattern of SMA & IMA branching is variable
  • Anastomoses exist between colic branches for collateral circulation
    • These form a consistent vascular arc around colon via marginal a. of Drummond
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6
Q

Describe the venous drainage of the abdomen

A
  • Inferior Vena Cava
  • Portal Vein
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7
Q

Explain the difference between the portal system of veins and the caval system of veins

A

Portal system

  • has no valves
  • directs blood from the GI tract to the liver
  • low pressure system caval system

Caval system

  • IVC returns blood to heart from lower limbs, pelvis and abdomen
  • valves
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8
Q

Describe the portal-caval anastomoses

A

4 anastomoses: portal & caval vv

  • gastric vv & esophageal vv
  • paraumbilical vv & epigastric vv
  • superior rectal vv & middle/inferior rectal vv
  • colic vv & retroperitoneal vv
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9
Q

Compare and contrast the sympathetic and parasympathetic innervation of the abdomen

A

parasympathetics

  • synapse within effector organs

sympathetics

  • synapse in collateral ganglia
  • post ganglionic fibers leave to reach effector organs
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10
Q

Describe the various autonomic ganglia and plexuses of the abdomen

A

4 major autonomic ganglia and plexuses

  • Celiac ganglion
    • plexus travels with celiac brs.
  • Superior mesenteric ganglion
    • plexus travels with SMA brs.
  • Aorticorenal ganglion
    • plexus travels with renal brs.
  • Inferior mesenteric ganglion
    • plexus travels with IMA brs.

1st 3 receive thoracic splanchnic nn & CN X brs 4th receives lumbar splanchnic nn & S2-S4 brs

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11
Q

Radiographic Anatomy, Abdomen #7

A

(Stomach & Duodenum)

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12
Q

Radiographic Anatomy, Abdomen #10

A

(Colon, Large intestine)

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13
Q

Radiographic Anatomy, Abdomen #20

A

(Superior Mesenteric Artery)

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14
Q

Radiographic Anatomy, Abdomen #21

A

(Inferior Mesenteric Artery)

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15
Q

Describe the stomach

A
  • Cardiac orifice
    • entrance from esophagus
  • Pyloric sphincter
    • exit to duodenum
  • Lined with Rugae
    • temporary folds within the body of the stomach
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16
Q

Describe the small intestine

A
  • Duodenum
    • fixed & relatively immobile
  • Jejunum & ileum
    • tethered, but very mobile
    • combined length of 3 segments~20 ft.
  • Plicae Circularis
    • permanent folds within intestine
    • become more diffuse distally
    • Ileum empties into cecum at ileocecal junction
17
Q

Describe how vasa recta and arterial arcades help distinguish parts of the intestine

A
  • in the small intestine
  • help differentiate ileum and jejenum
  • ileum
    • vasa recta are long and arterial arcades are short and less branched
  • jejenum
    • vasa recta are shorter and arterial aracades are larger and more branched
18
Q

Describe the large intestine

A
  • aka colon
  • 5 segments & 2 flexures
  • Terminates into Rectum
  • ‘Frames’ small intestines
  • Segments
    • Cecum
    • Ascending colon
    • Transverse colon
    • Descending colon
    • Sigmoid colon
  • Flexures
    • R. colic (hepatic)
    • L. colic (splenic)
19
Q

Describe the colon and it’s specializations

A
  • frames the intestines
  • Teniae coli
    • 3 smooth m. bands paralleling length of colon
  • Haustra coli
    • outpouchings produced by teniae coli
  • Epiploic appendages
    • fat tags found along the colon
20
Q

Describe the Celiac Trunk

A
  • 1st major br. of Abdominal aorta
  • Supplies liver, gallbladder, esophagus, stomach, pancreas & spleen
  • 3 main branches
    • Common hepatic a
    • L. gastric a
    • Splenic a
21
Q

Describe the Superior Mesenteric A.

A
  • 2nd major branch of abdominal aorta
    • ~1 cm inferior of celiac
    • sends 15-18 intestinal aa to small intestine
  • supplies up to proximal 2/3 of transverse colon
    • via ileocolic, R. colic & middle colic
22
Q

Describe the Inferior Mesenteric A.

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
23
Q

Describe the Pancreatic Arteries and where they anastomose

A
  • Gastroduodenal a. gives off Superior pancreaticoduodenal aa.
  • SMA gives off Inferior pancreaticoduodenal aa.
  • Anastomose and supply head of pancreas & duodenum
  • Splenic a. supplies rest of pancreas with additional branches
24
Q

Describe the Renal Aa

A
  • lateral 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
25
Q

Describe the Gonadal Aa

A
  • 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
26
Q

Describe the Inferior Vena Cava

A
  • 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
27
Q

Describe the Portal Vein

A
  • Formed by union of splenic and superior mesenteric vv. (L2)
  • Venous return from
    • Spleen
    • Pancreas
    • Gall bladder
    • Abdominal gastrointestinal tract
  • Returns nutrient rich, poorly oxygenated blood to the liver
  • Then via IVC to the RA of heart
28
Q

Describe the clinical significance of the portal-caval anastomoses

A
  • Portal venous system has no valves
    • reversal of blood flow into caval vv is possible
  • portal hypertension restricts blood flow
    • causes caval vv to become engorged
    • may them become dilated & varicose
29
Q

Describe the clinical significance of Portal-Caval Anastomoses and dilated Caval Veins

A
  • Dilated espophageal vv
    • produce esophageal varices
  • Dilated epigastric vv.
    • produce caput medusae
  • Dilated infr. & mid. rectal vv
    • produce hemorrhoids

Note: These can lead to vascular rupture & severe hemorrhaging.

Caput medusae- distended and engorged paraumbilical vv. Often resulting from cirrhosis

30
Q

Describe the nerve supply of the abdomen

A
  • Innervation to viscera is via autonomic n. plexuses
  • Sympathetic fibers
    • originate from T5-L2(3) thoracolumbar
  • Parasympathetic fibers
    • originate from CN X & S2-4 craniosacral
31
Q

Describe the sympathetics of the abdomen

A
  • Preganglionic splanchnic nn
    • synapse in collateral ganglia
  • Postganglionic fibers
    • leave ganglia to reach effector organs
  • post-synaptic fibers travel on all main arterial branches
    • celiac trunk, SMA, renal aa, IMA and all their branches
32
Q

Describe the parasympathetics of the abdomen

A
  • Preganglionic nerves from CN X travel on upper arterial branches
    • celiac trunk, SMA, renal aa, and all their branches
  • Preganglionic nerves from S2-S4
    • travel on lower arterial branches IMA and branches
    • Synapses occur within effector organs

Anatomy Exam 2 (13 decks)

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