Lower Abdomen

Question 1

Lower abdomen

Answer 1

Stomach
Large intestine
Small intestine

Question 2

Stomach

Answer 2

Cardiac orifice
Pyloric sphincter
Body
Fundus
Lined with rugae= expansion and movement

Question 3

Small intestine

Answer 3

Duodenum -‘fixed and immobile because part retroperitoneal
Jejunum and ileum
-tethered by Mesentery proper
-intraperitoneal
-combined length 20 ft
- plicae circularis will have permanent folds to increase surface area
-becomes more diffuse distally, absorption decreases

Question 4

Ileocecal junction

Answer 4

Where the ilium meets the cecum of the large intestine

Question 5

Duodenum

Answer 5

Superior- intraperitoneal, L1 level
Descending- retroperitoneal L2-L3 level, c shaped
Inferior- posterior to SMA but anterior to the aorta, L3
Ascending- goes to duodenal jejunal junction held by ligament of triats– region where it becomes intraperitoneal

Question 6

Jejunum

Answer 6

Wall are thicker
Plicae circularis more prominent 
Vasa recta longer
Arterial arcades shorter
2/5
Supplied by SMA

Question 7

Ileum

Answer 7

Thinner walls
Less plicae circularis
Short vasa recta
Long arterial arcades
3/5
Supplied by SMA

Question 8

Meckels diverticulum

Answer 8

Remnants of embryonic yolk stalk
Appears as finger like pouch
1 m proximal to ileocecal valve
May become inflamed
Fistula is the example

Question 9

Large intestine

Answer 9

5 segments and 2 flexures
Cecum ascending  transverse descending sigmoid 
Terminates into rectum 
R colic or hepatic flexure
L colic or splenic flexure

Question 10

Veriform appendix

Answer 10

Opens into cecum inferior to ileocecal orifice
Triangular Mesentery = mesoappendix
Commonly retro Cecil but varies considerably
Inflammation possible when food gets stuck

Question 11

Appendicitis

Answer 11

Vague pain in the peri umbilical
From T10 level
R lower quadrant hurts next with point irritation of peritoneum
Pain most severe in ASIS and umbilicus

Question 12

Colon

Answer 12

Teniae coli-3 smooth muscle bands paralleling the length of the colon
Haustra coli- outpouching produced by teniae coli
Epiploic appendages- fat tags found along colon

Question 13

Superior mesenteric artery

Answer 13

Midgut
2nd major branch of aorta
15-18 intestinal branches
Ileocolic branch
Right colic branch
Middle colic branch
Inferior pancreaticoduodenal

Question 14

Inferior mesenteric

Answer 14

3 red major branch
Hind gut
Supplies colon from distal 1/3 of transverse colon
Left colic
Sigmoid -4
Superior rectal

Question 15

Marginal artery of Drummond

Answer 15

Cross the transverse colon which anastomoses with the SMA to IMA

Question 16

Pancreatic anastomoses

Answer 16

Superior pancreaticoduodenal from gastroduodenal
Inferior pancreaticoduodenal from SMA

Anastomoses to supple pancreas and duodenum

Splenic arteries supply rest of pancreas

Question 17

Renal arteries

Answer 17

About same level as SMA
Enter hi lim of each kidney
Have branches to adrenal gland

Question 18

Gonadal Arteries

Answer 18

Lateral branches of abdominal aorta
Inferior to renal arteries
Males pass thru inguinal canal and descend into scrotum
Females travels to ovaries
Ovarian or testicular arteries

Question 19

Portal vein

Answer 19

Splenic vein– inferior mesenteric
Superior mesenteric
Then through the liver and into IVC

Drains: spleen pancreas gallbladder abdominal gastrointestinal tract

Question 20

Portal caval anastomoses

Answer 20

Gastric veins portal and esophageal veins caval
Paraumbilical veins portal and epigastric veins caval
Superior rectal vein portal and inferior rectal vein caval
Colic vein portal and retroperitoneal vein caval

Question 21

Sympathetic abdomen

Answer 21

Preganglionic splanchnic n synapse in collateral ganglia
Postganlionic fibers leave ganglia to reach effectors
T5-L2
1. Ascending synapse
2. Synapse at level of exit
3. Descend the synapse
4. Pass without synapsing, find a collateral ganglia

Question 22

Sympathetic plexus

Answer 22

Greater splanchnic nerve- celiac ganglion, T5-T9
Lesser splanchnic nerve- SMA ganglion, T10-T11
Least splanchnic nerve- aorticorenal ganglion, T12
Lumbar splanchnic nerve- IMA ganglion, L1-L2

Question 23

Parasympathetic abdomen

Answer 23

Preganlionic from CNX travel on upper arterial branches, vagus nerve
-celiac, SMA,renal,
Preganglionic from S2-S4 travel on lower arterial branches
-IMA
SYNAPSES ON THE EFFECTOR ORGAN

Question 24

Parasympathetic plexus

Answer 24

Vagus nerve or CNX contributes to 
Celiac ganglion
Superior mesenteric ganglion
Aorticorenal ganglion
Sacral nerves contribute to
Inferior mesenteric ganglion