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ANAT 380 > module 2B > Flashcards

module 2B Flashcards

1
Q

what is the abdominal esophagus

A
  • is one continuous muscular tube extending from the pharynx to the stomach
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2
Q

what can the abdominal esophagus divided into

A
  • cervical (head/neck)
  • thoracic
  • abdominal
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3
Q

what is the length of the abdominal esophagus

A

short (1-2.5 cm) in length beginning at the esophageal hiatus (T10) of the diaphagm and terminating at the stomach

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4
Q

where is the lower esophageal sphincter

A
  • distal end of the esophageal, between the abdominal esophagus and the stomach
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5
Q

what is the lower esophageal sphincter

A
  • smooth musclular “gateway”, the lower esophageal sphincter (LES)
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6
Q

what does the LES do?

A

prevent reflex of gastric content (acid, pepsin, etc.) into the esophagus
- INVOLUNTARY control, opening and closing as a bolus passes from the esophagus into the stomach

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7
Q

gastroesophageal reflux (GERD)

A
  • a weak or abnormal closure of the LES can result in regurgitation of stomach contents into the esophagus
  • the reflux of the corrosive stomach contents into the esophagus is experienced as a buring sensation
  • because its close to the heart buring is felt as “heartburn”
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8
Q

symptoms of gastroesopheal reflux

A
  • chest pain
  • nausea
  • and/or vomiting of reflux content
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9
Q

anatomy of the stomach

A

once the bolus has passed the lower esophageal sphincter (LES), the bolus enters the stomach
- the rugae (gastric fold) of the stomach allows expansion, accommodating the quantity of consumed foods

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10
Q

where is the pyloric sphincter

A

distal end of the stomach, where the stomach contents are emptied into the proximal part of the small intestines, the stomach walls narrow to form the pyloric orifice

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11
Q

analogous to the LES

A

the pylorus has a “gateway”, the pyloric sphincter,

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12
Q

what does the pyloric sphincter do

A

controls the movement of content from the stomach (chyme) into the duodenum
- under autonomic control

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13
Q

what is an endoscopy

A

is the insetion of a long, thin tube directly into the body to observe an internal organ in detail

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14
Q

what supplies blood to stomach

A
  • celiac truck–> right and left gastric arteries which anastomose at the lesser curvature
  • the right and left gastro-epiploic arteries anastomose at the greater curvature of the stomach
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15
Q

what supplies the lesser curvature

A

right and left gastric arteries

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16
Q

what supplies the greater curvature

A

right and left gastro-epiploic arteries

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17
Q

where are the small intestine

A

extends from the pyloric orifice to the ileocecal junction

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18
Q

what is the small intestine divided into

A
  • duodenum
  • jejunum
  • ileum
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19
Q

is the small intestine intraperitonela or retroperitoneal

A

most of it is intra except proximal part of the duodenum which retro

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20
Q

what is the shortest part of the small intestine

A

duodenum which runs from the pyloric orifice to the jejunum

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21
Q

what is the duodenum divided into?

A
  • superior (first part)
  • descending (second part)
  • horizontal (third part)
  • ascending (fourth part)
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22
Q

superior part of the duodenum

A

is the only portion of the duodenum that is intraperitoneal

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23
Q

what travels posterior of the superior part of the duodenum

A

bile duct and the gastroduodenal artery

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24
Q

descending (second part) of duodemun

A

runs vertically, passing anterior to the hilum of the right kidney

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25
Q

what does the descending second part contain

A

major duodenal papilla, which is the site where the hepatopancreatic ampulla drains into the duodenum

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26
Q

what is the hepatopancreatic ampulla

A

duct formed from the union of the common bile duct and the pancreatic duct

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27
Q

horizontal part of duodeum

A
  • transversely across the inferior vena cava and abdominal aorta, just inferior to the origin of the superior mesenteric artery and vein
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28
Q

what is superior mesenteric artery syndrome

A

compression of the duodenum between the aorta and the superior mesenteric artery

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29
Q

ascending fourth part of the duodenum

A
  • passes upward and to the left of the aorta, forming the duodenojejunal flexure
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30
Q

duodenojejunal flexure

A

anchored to the posterior abdominal wall by the fibromuscular suspensory ligament of the duodenum ligament of Treitz

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31
Q

ligament of treitz shortened

A

is shortened, compression of the horizontal section of the duodenum can result
- another cause for superior mesenteric artery syndrome

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32
Q

duodenum blood supply 1st and 2nd parts

A

supplied by gastroduodenal artery and its branch –> superior pancreaticoduodenal artery

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33
Q

duodenum blood supply 3rd and 4th part

A

supplied by the inferior pancreaticoduodenal artery branch of SMA

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34
Q

jejunum and ileum blood supply

A

supplied jejunal and ileal arteries, branches of the SMA
- both arteries form a series of anastomotic loops (arterial arcades) from which terminal straight branches (vasa recta) reach the intestinal wall

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35
Q

networks that supply the jejunum have ___ arcades along with ___ vasa recta

A

fewer, longer

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36
Q

networks that supply ilium have ____ arcades with ____ vasa recta

A

many, shorter

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37
Q

what is meckels diverticulum

A
  • outpouching of tissue in the distal ileum of the small intestine
  • sudden abdominal pain or asymptomatic
  • blood in the stool
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38
Q

what is primary function of the small intestine

A

absorption

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39
Q

outpouching

A

a bulging of the walls of the intestine to form a sac

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40
Q

about meckels diverticulum

A
  • birth defect
  • can become ulcerated, causing blood in the stool, and the pain confused with the pain from appendicitis
  • can cause intestinal obstruction resulting in vomiting and constipation
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41
Q

pain with meckels diverticulum

A

is referred to the epigastric and umbilical regions of the abdomen

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42
Q

features in the large intestine

A
  • teniae coli
  • haustra
  • epiploic (omental) appendages
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43
Q

teniae coli

A
  • three thickened bands of longitudinal muscle
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44
Q

haustra

A

segmented pouches or folds

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45
Q

epiploic (omental) appendages

A

fatty tags enclosed by peritoneum

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46
Q

Hirschsprung disease

A

disorder that occurs at birth when motor nerve cells, called the Auerbach’s plexus are absent in the muscles of the colon
- affect the colon making it difficult to pass stool

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47
Q

where does the ileum join the large intestines

A

at the cecum in the right inguinal region (lower right quadrant)

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48
Q

what is the opeing of the ileum into the cecum controlled by

A

ileocecal (ileocolic) valve

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49
Q

what is the cecum

A

is a blind-ended pouch lying in the right iliac regions (lower right quadrant) and is almost completely covered with peritoneum but has not mesentery (intraperitoneal structure)

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50
Q

intraperitoneal large intestines

A
  • cecum
  • transverse colon
  • sigmoid colon
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51
Q

retroperitoneal of large intestine

A
  • ascending colon
  • descending colon
  • rectum
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52
Q

what is the midgut portion of the large intestine supplied by

A

3 branches of the superior mesenteric artery
- ileocolic artery
- right colic artery
- middle colic artery

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53
Q

midgut ileocolic artery supplies what

A

ileocolic artery cecum to appendix)

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54
Q

midgut right colic artery supplies what

A

right colic artery (to ascending colon)

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55
Q

midgut middle colic artery supplies what

A

middle colic artery (to transverse colon)

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56
Q

what is the hindgut of the large intestine supplied by

A

branches of the inferior mesenteric artery
- left colic artery
- sigmoidal artery
- rectal artery

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57
Q

hindgut left colic artery supplies what

A

to descending colon

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58
Q

hindgut sigmoidal arteries supplies what

A

sigmoid colon

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59
Q

superior rectal supplies what of hindgut

A

rectum and upper anal canal

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60
Q

what forms the marginal artery

A

right, middle, left colic arteries

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61
Q

where does the marginal artery form

A

along the border of the colon that may allow important collateral circulation

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62
Q

mesenteric artery ischemia

A

is a condition resulting in the occlusion of the mesenteric arteries

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63
Q

effects of mesenteric artery ischemia

A
  • midgut affects
  • distal duodenum, jejunum, ileum, and colon
  • leading to tissue death: thus small intestines cannot function normally and bowel movements become disruptied, leading to nausea and vomiting
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64
Q

abdominal pain of mesenteric artery ischemia

A

typically abrupt and accompanied by abdominal tendernes

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65
Q

what does the venous drainage of the abdomen form

A

an elaborate plexus of veins to return deoxygenated blood to the heart

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66
Q

what are the 3 main veins that drain the gastrointestinal viscera

A
  1. splenic vein
  2. superior mesenteric vein
  3. inferior mesenteric vein
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67
Q

where do the splenic vein, SMV, or IMV drain to?

A

portal (hepatic portal) vein

68
Q

where does the splenic vein leave?

A

the spleen

69
Q

where does the splenic vein go

A

passes posterior to the pancreas to join the superior mesenteric vein

70
Q

what does the splenic vein drain?

A

spleen, lower esophagus, and part of the stomach and pancreas

71
Q

since the proximity of splenic vein to the pancreas what happens

A

various pancreatic conditions (tumors, infections) can compress the vein, leading to the formation of a thrombosis

72
Q

thrombosis

A

the formation of blood clot preventing blood from flowing normally within the circulatory system

73
Q

where does the superior mesenteric vein ascend

A

through the mesentery of the small intestine

74
Q

what does the SMV join

A

the splenic vein, posterior to the pancreas

75
Q

the names of the SMV tributaries (branches)

A

correspond to the branches of the superior mesenteric artery

76
Q

what is the mesenteric ischemia

A

is the occlusion of the superior of the inferior mesenteric vein, it is rare, it can be fatal due to the many veins it drains

77
Q

inferior mesenteric vein where does it ascend

A

on the left

78
Q

what does the IMV join

A

the splenic vein

79
Q

IMV tributes (branches)

A

correspond to the branches of the IMA

80
Q

what is mesenteric ischemia

A

results from the occlusion of the superior or inferior mesenteric vein

81
Q

what is more common in the SMV

A

mesenteric ischemia

82
Q

what does the hepatic portal vein do

A

carriers nutrient-rich deoxygenated blood from the digestive tract to the liver

83
Q

where is the hepatic portal vein formed

A

posterior to the pancreas

84
Q

how is the hepatic portal vein formed

A

by the union of the splenic and superior mesenteric veins

85
Q

where does the portal vein ascend

A

before entering the porta hepatis of the liver

86
Q

what is assessment of pulsatiliilty (rate of blow flow) of the portal vein used for

A

detecting early signs of cirrhosis

87
Q

porta hepatis

A

the porta hepatis is a deep fissure in the inferior surface of the liver through which neurovascular structures enter or leave the liver

88
Q

cirrhosis

A

a chronic disease of the liver marked by degeneration of cells, inflammation, and fibrous thickening of tissue
- typically result of alcoholism or hepatitis

89
Q

what is mesenteric ischemia

A

the partical or complete interruption of blood in the superior or inferior mesenteric artery resulting in abnormal bowel movements, abdominal pain, vomiting

90
Q

what is the best imaging technique to diagnose mesenteric ischemai

A

angiography
- as it is used to image the lumen of the vasculature
- helps see the blockage

91
Q

necrosis

A

the death of most or all of the cells in an organ or tissue due to disease, injury or failure of the blood supply

92
Q

about the liver

A
  • is the largest internal organ in the body
  • right and central upper abdomen
93
Q

inferior surface of the liver

A

is adjacent to abdominal viscera

94
Q

what are lobes of the liver divided by

A

the attachment of a fold of peritoneum
- falciform ligament

95
Q

what is the peritoneal cavity incompletely divided into

A

spaces and recesses (or fossae)

96
Q

what do the spaces and recessus important for

A

allow passage for infectious fluids from different compartments of the abdomen

97
Q

what are the 2 liver recesses

A
  • subphrenic recess
  • hepatorenal recess
98
Q

subphrenic recess

A

are superior extensions of the peritoneal cavity between the liver and diaphragm

99
Q

how many subprenic recesses are there

A

left and right

100
Q

what are the left and right subphrenic recess separated from

A

falciform ligament of the liver

101
Q

what is hepatorenal recess

A

is a deep recess in the peritoneal cavity on the right side between the liver and the right kidney

102
Q

how much cardiac output passes through the liver?

103
Q

how does cardiac output pass through the liver

A

delievered through the portal vein and 20% is delivered via the hepatic artery proper

104
Q

portal vein thrombosis : what is it

A

a blood clot is formed in the portal vein
- an occlusion in this vessel interrupts the flow of nutrient rich blood from the intestines to the liver

105
Q

symptoms of portal vein thrombosis

A

upper right abdominal pain, abdominal swelling, fever

106
Q

what does the gallbladder do?

A

receives, stores, and concentrates bile

107
Q

where is the fundus of the gallbladder

A

projects anteriorly from the inferior border of the liver
- the body projects posteriorly and narrows to the neck which is continuous with the cystic duct

108
Q

gallstones

A

are hardened deposits of bile that can form in the gallbladder
- biliary colic is spasmodic pain caused by an attempt to expel a gallstone

109
Q

when do gallstones cause pain?

A

when they obstruct the biliary ducts

110
Q

what is the biliary tree

A

the system of vessels that directs secretions from the liver, gallbladder, and pancreas through a series of ducts into the duodenum

111
Q

cholangitis

A

is an inflammatory condition of the biliary duct system, commonly caused by gallstones blocking a duct
- bile is sterile but due to the presence of gallstones, bacteria enters the biliary tree by a reverse ascent from the duodenum

112
Q

symptoms of cholangitis

A
  • pain in the right upper quadrant of the abdomen
  • fever
  • chills
  • nausea
  • vomiting
113
Q

what causes the blockage of the biliary duct system

A

presence of bacteria causes a block in the passageways leading to infection
- increased biliary pressure further spreads the infection into the hepatic veins leading to bacteremia

114
Q

bacteremia

A

presence of bacteria in the bloodstream

115
Q

location of the pancreas

A

lies transversely on the posterior abdominal wall, posterior to the stomach

116
Q

location of head of pancreas

A

sits in the concavity of the duodenum on the right side of the abdominal cavity
- has a medial projection, the uncinate process, lying deep to the superior mesenteric vessls and the origin of the portal vein

117
Q

location of the body pancreas

A

extends towards the left, passing behind the stomach and tapering to become the tail

118
Q

location of the tail of pancreas

A

abuts the medial side of the spleen

119
Q

what is pancreatitis

A

inflammation of the pancreas, can be caused by the presence of gallstones

120
Q

when do gallstones become problematic

A

when they block the common bile duct
- pancreatic enzymes are also blocked passing into the small intestine, forceing them into the pancreas

121
Q

pancreatitis : recycled enzymes

A

begin to irritate the cells of the pancreas causing the inflammation associated with pancreatitis

122
Q

symptoms of pancreatitis

A
  • upper abdominal pain
  • upper left quadrant pain
  • nausea/vomiting
  • fever
123
Q

location of the spleen

A
  • left upper quadrant of the abdomen
  • under the left dome of the diaphragm behind the stomach and anterior to ribs 9, 10, 11
124
Q

what is the largest lymphatic organ

125
Q

notches on the spleen

A
  • are on the anterior border
126
Q

what is on the medial surface of spleen

A

hilum (can be papated if swollen)

127
Q

what enters and exits the hilum of spleen

A
  • splenic artery
  • splenic vein
128
Q

splenomegaly

A
  • since spleen is on the left side pain with splenomegaly is also felt in the left upper abdomen
129
Q

where is pain felt with gallstones

A

is felt on the right, since the gallbladder sits in the right upper abdomen

130
Q

what is a common cause of splenomegaly

A

liver disease

131
Q

jaundice

A
  • skin, whites of eyes, and mucous membranes turn yellow because of a high level of bilirubin resulting from a dysfunctional liver
132
Q

relationships with the pancreas

A
  • nestles its head into the arms of the duodenum
  • the tail of the pancreas (left) is playing footsies with the spleen
133
Q

relationships with the common bile duct

A
  • passes through duodenum
  • proximal to the pancreas
134
Q

what are earliest signs of a tumor in the head of the pancreas

A

pain associated with the gallbladder because its compressed

135
Q

relationships with the duodenum

A
  • vessels of the superior mesenteric artery and abdominal aorta
  • duodenum is “sandwiched between the two at one point
136
Q

relationships with the liver

A
  • inferior to the diaphragm
  • bare surface of the liver touches the diaphragm
  • right dome of the diaphragm is higher than the left dome to accommodate the size of the liver
137
Q

where are the kidneys located

A

on the posterior abdominal wall on either side of the vertebral column

138
Q

what kidney is lower, why?

A

right kidney
- due to the position of the liver which lies superior to it

139
Q

what is posterior to the kidney

A

diaphragm as well as the costco diaphragmatic recesses of the pleural cavitiies

140
Q

how much do the contraction of the diaphragm move the kidneys

A

downward 2.5cm

141
Q

pyelonephritis

A
  • kidney infection typically caused by a bacterial infection of the bladder
  • infections from the bladder can travel to the kidney through the ureters
142
Q

acute pyelonephritis

A

is one of the most common bacterial infection in young adult women

143
Q

symptoms of pyelonephritis

A
  • flank pain
  • fever
144
Q

flank pain

A

is a sensation of discomfort, distress, or agnoy in the upper abdomen or back and sides
- this is the region between the hip bone (iliac bone) and lower rib cage

145
Q

what can diagnose pyelonephritis

A

urinalysis

146
Q

urinalysis

A

is a group of physical, chemical, microscopic tests
- tests detect and/or measure several substance in the urine, such as byproducts of normal and abnormal metabolism, cells, cellular fragments, bacteria

147
Q

what are ureters

A

muscular tubes that transport urine from the kidney to the bladder

148
Q

where does the ureter leave

A

the hilum of the kidney and descends vertically towards the pelvis
- during its descent, it passes anterior to the psoas muscle and the bifurcation of the common iliac artery and vein

149
Q

ureter stones what is it

A

also known as a ureteral stone, is a kidney stone that has moved from the kidney into another part of the urinary tract, obstructing the pathway of urine from the kidney to the bladder

150
Q

symptoms of ureter stones

A
  • severe, intermittent pain in the flank region
  • damage to the ureters can be detected as blood in the urine and pain when urinating
  • fever
  • nausea
  • vomiting
151
Q

passing of the ureter stones

A

stones may pass through the ureter, into the bladder, and eventually pass out of the body during urination

152
Q

too big of a stone

A

can get lodged in the ureter, block flow of urine and can be extremely painful

153
Q

where are the adrenal glands

A

lie on the upper poles of the kidneys

154
Q

shape of the right adrenal gland

A

is pyramidal

155
Q

shape of the left adrenal gland

A

is semilunar

156
Q

what are the suprarenal gland supplied by

A

the suprarenal artery as well as branches from the inferior phrenic and renal arteries

157
Q

adrenal gland tumor

A

pain associated with an adrenal gland tumor would be felt more superiorly relative to pain from pyelonephritis or a ureter stone

158
Q

symptoms of adrenal gland tumor

A

will indicate an imbalance/overproduction of hormones which can result in excessive hair growth and unusual acne

159
Q

blood supply of kidneys

A
  • receive blood from the right and left renal arteries (off the abdominal aorta) and 2nd lumbar vertebra
160
Q

accessory renal arteries

A
  • common and may arise from the aorta above or below the main renal artery and enter the kidney above or below the hilum
161
Q

where do the right and left renal veins travel

A

anterior to the renal arteries

162
Q

where does the left renal vein pass

A

under the SMA to drain into the INC

163
Q

what renal vein is longer and why

A

left because it has to cross the aorta to reach the IVC

164
Q

what is nutcracker syndrome

A

rare condition that occurs when the left renal vein becomes compressed between the abdominal aorta and the superior mesenteric artery

165
Q

symptoms of nutcracker syndrome

A

pressure increase in the renal vein can lead to blood and protein appearing in the urine
- flank pain
- abdominal pain

166
Q

what is the first course of action against acute pyelonephritis

A

antibiotics
- the type depends on whether or not the bacteria can be identific

ANAT 380 (9 decks)

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