Lower Abdomen Flashcards
The inferior portion of the duodenum is at what vertebral level? It is anterior to ___ & ____ and posterior to ___ & ____?
L3; IVC and aorta; SMA and SMV
What is the length difference between jejunum and ileum (hint: out of 5/5)?
Jejunum is about 2/5, ileum about 3/5
Which structure is a remnant of the embryonic yolk stalk that can mimic appendicitis when inflamed?
Meckel’s ileal diverticulum
Which of the colic flexures is more acute?
The L colic (splenic)
In anatomical directional terms, how does the splenic flexure differ from the hepatic flexure?
It is more superior and posterior within the body
Where does vague pain from appendicitis begin and at what vertebral level?
The periumbilical region; referred pain from T10 level
After vague pain, appendicitis causes more point specific pain where?
R. lower quadrant; from irritation of peritoneum of posterior abdominal wall
Where is the most severe pinpoint pain from appendicitis?
Over the spinoumbilical point between the ASIS and umbilicus
Which two segments of the LI are intraperitoneal?
The transverse and sigmoid
Name a means by which the celiac trunk and SMA are connected (hint: it is a pancreatic anastomosis).
Through the anastomosis of the superior pancreaticoduodenal (celiac) and the inferior pancreaticoduodenal (SMA)
The renal arteries exit the aorta very close to which other vessel?
The SMA
What are the first paired arteries off of the abdominal aorta?
The inferior phrenic
At what vertebral level does the IVC begin?
L5
How is the blood from the viscera returned to the heart?
Through the portal venous system THEN to the IVC; so that the liver can filter
How is the portal vein formed and at what vertebral level?
Union of the splenic v and SMV; L2
Where does the IMV drain into?
The splenic; because it is on the left side
Name the 4 portal-caval anastomoses.
1.Gastric (portal) and Esophageal (caval) 2.Paraumbilical (portal) and epigastric (caval) 3.Superior rectal (portal) and middle/inferior rectal (caval) 4.colic (portal) and retroperitoneal (caval)
What is caput medusa?
Distended and engorged paraumbilical or epigastric vv (often resulting from cirrhosis)
Dilation of which vessels produce hemorrhoids?
The inferior and middle rectal vv.
Sympathetic fibers originate from which vertebral level?
T5-L2; aka thoracolumbar
Parasympathetic fibers originate from which vertebral level?
CNX & S2-S4; aka craniosacral
Where do sympatheric postganglionic fibers travel to reach their effector organs?
Along all main arterial branches; celiac trunk, SMA, renal aa, IMA, and their branches
What are the 4 collateral ganglion where the abdominal preganglionic sympathetic fibers synapse?
1.Celiac ganglion 2.Aorticorenal ganglion 3.SM ganglion 4.IM ganglion
The greater splanchnic n originates from which vertebral level(s) and synapses in which collateral ganglion?
T5-T9; Celiac ganglion
The lesser splanchnic n originates from which vertebral level(s) and synapses in which collateral ganglion?
T10-T11; SMA ganglion
The least splanchnic n originates from which vertebral level(s) and synapses in which collateral ganglion?
T12; Aorticorenal ganglion
The lumbar splanchic nn originate from which vertebral level(s) and synapse in which collateral ganglion?
L1-L2; IMA ganglion
The preganglionic nerves from CNX (parasympathetic) travel on which arterial branches?
Celiac trunk, SMA, renal aa, and all their branches
The nerve fibers from the vagus n (CNX) innervate which derivative(s) of the abdomen (foregut, midgut, or hindgut)?
Foregut and midgut
The preganglionic fibers from S2-S4 travel on which arterial branches?
IMA and its branches
The nerve fibers from S2-S4 supply which derivative(s) of the abdomen (foregut, midgut, hindgut)?
The hindgut
Where does the vagus nerve stop innervating (give an exact point)?
The proximal 2/3 of the transverse colon
Which plexus(es)/trunk(s) do the vagal nerve fibers form?
Anterior/posterior vagal trunks, celiac plexus, SM plexus, and aorticorenal plexus
Which plexus(es) do the sacral nn (S2-S4) form?
IM plexus
