Nov 18 - Abdomen II: Abdominal Viscera Flashcards

1
Q

What does the gastrointestinal tract (GI) consist of (for the purposes of this section)?

A

The esophagus, the stomach, the small intestine and the large intestine (colon). Sometimes the term GI is used to refer to all structures from mouth to anus

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2
Q

What is the esophagus?

A

Long, muscular tube that carries food from the oral cavity to the stomach (peristalsis). It extends through the posterior mediastinum, and passes through the diaphragm (at T10) to reach the stomach

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3
Q

Where is the stomach?

A

It is located in the left hypochondriac and epigastric regions

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4
Q

Name the parts of the stomach

A

The cardia, the fundus, the cardiac notch, the body, the pyloric antrum, the pyloric canal

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5
Q

Describe the cardia

A

It is the area surrounding the opening of the esophagus

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6
Q

Describe the fundus

A

It is located beneath the left dome of the diaphragm (above the cardia) and it is usually filled with air

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7
Q

What is the cardiac notch?

A

The angle between the esophagus and fundus

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8
Q

Describe the body of the stomach

A

It is located between the fundus and the pyloric antrum

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9
Q

Describe the pyloric antrum

A

It is the funnel shaped region of the stomach between the body and pyloric canal

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10
Q

Describe the pyloric canal

A

It’s narrower than the antrum, contains the pyloric sphincter aka pylorus

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11
Q

What happens if the cardiac notch becomes larger?

A

The closer mechanism becomes much weaker (reflux)

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12
Q

Describe the internal structure of the stomach

A

It is highly ridged. These mucosal folds are called rugae

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13
Q

What is the pyloric sphincter?

A

It is a thick band of muscle that controls the passage of stomach contents into the duodenum. It can be compromised during surgery

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14
Q

What is the pH of the stomach?

A

Between 2 and 3

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15
Q

What is the small intestine?

A

It is the main site of nutrient absorption. It is approximately 7 metres in length in an adult. The small intestine consists of the duodenum, the jejunum and the ileum

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16
Q

Describe the duodenum

A

It’s about 25 cm in length and divided into four parts: the superior, descending, horizontal and ascending duodenum

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17
Q

Describe the superior duodenum

A

It lies anterolateral to the body of the L1 vertebra

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18
Q

Describe the descending duodenum

A

It descends along the right side of the L1-L3 vertebrae. It is the location of the major duodenal papilla, entrance of the bile duct and the pancreatic duct

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19
Q

Describe the horizontal duodenum

A

It crosses the L3 vertebrae

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20
Q

Describe the ascending duodenum

A

It begins at the left of the L3 vertebrae, ascending to the superior border of the L2 vertebrae

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21
Q

Describe the jejunum and ileum

A

They are suspended from the posterior abdominal wall by the mesentery, very mobile. There is no distinct border between the jejunum and the ileum. Generally the jejunum is found in the left upper quadrant, ileum in the right lower quadrant

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22
Q

Jejunum and ileum differences: colour

A

Jejunum is deeper red and ileum is pale pink

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23
Q

Jejunum and ileum differences: wall thickness

A

Jejunum: thick
Ileum: thin

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24
Q

Jejunum and ileum differences: vascularity

A

Jejunum: more vascular
Ileum: less vascular

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25
Q

Jejunum and ileum differences: vasa recta (blood vessels in mesentery)

A

Jejunum: long
Ileum: short

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26
Q

Jejunum and ileum differences: arcades (also blood vessels in mesentery)

A

Jejunum: a few large loops
Ileum: lots of short loops

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27
Q

Jejunum and ileum differences: fat in mesentery

A

Jejunum: less
Ileum: more

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28
Q

Jejunum and ileum differences: plicae circulares (internal circular folds)

A

Jejunum: lots of prominent folds, tightly bunched
Ileum: sparse, absent in the distal part of the ileum

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29
Q

Jejunum and ileum differences: Peyer’s patches (lymphoid nodules)

A

Jejunum: few
Ileum: many

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30
Q

Describe the large intestine

A

It extends from the ileocecal junction to the anus - 1.5 m long. It consists of the cecum, ascending, transverse, descending and sigmoid colon, rectum and anal canal. It re-absorbs water and electrolytes

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31
Q

Describe the left colic flexure

A

Aka the splenic flexure. It’s a watershed region; it receives blood supply from the superior and inferior mesenteric arteries

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32
Q

Name three distinguishing features of the large intestine

A

Teniae coli, the haustra and the epiploic appendages

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33
Q

What are the teniae coli?

A

3 longitudinal bands of muscle

34
Q

What are haustra?

A

Sacculations found along the length of the large intestine. They are formed by the action of the teniae coli (like elastic band on sweatpants). They are dependant on the peristalsis.

35
Q

What are epiploic appendages

A

Small peritoneal pouches filled with fat

36
Q

What is the cecum?

A

The first part of the large intestine. It is continuous with the ascending colon. It’s the point where the ileum meets the large intestine

37
Q

What is the vermiform appendix

A

It is a blind-ended tube (worm shaped). It’s usually found posterior to the cecum (retrocecal). There is not true function; it’s the site of appendicitis

38
Q

What is the liver?

A

It’s the largest solid organ in the body, and also the most vascularized

39
Q

What are the functions of the liver?

A

Major metabolic organ (fats, proteins and carbohydrates)
Glycogen synthesis and storage
Production of bile (fat digestion)
Detoxification of blood (excretion of bilirubin, metabolism of alcohol and other drugs)

40
Q

Name the four lobes of the liver

A

The right and left lobes, the quadrate lobe (next to the gallbladder and the caudate lobe (next to the inferior vena cava)

41
Q

What is the liver covered with?

A

Visceral peritoneal

42
Q

What is the inferior part of the falciform ligament?

A

A duct system important to foetuses

43
Q

Describe bile production

A

Bile is produced in the liver and is secreted into the common hepatic duct. The gallbladder stores and concentrates the bile

44
Q

What happens when the gallbladder contracts?

A

It expels bile through the cystic duct, and into the common bile duct and it enters the duodenum where it helps emulsify fats

45
Q

What is the pancreas?

A

Flat, leaf-shaped gland. It is retroperitoneal. It has both endocrine and exocrine functions

46
Q

Describe the endocrine function of the pancreas

A

It produces hormones that regulate blood sugar - insuline and glucagon

47
Q

Describe the exocrine function of the pancreas

A

It produces digestive enzymes - trypsin, chymotrypsin (aka, pancreatic juice)

48
Q

What is the pancreatic duct?

A

It collects the digestive enzymes produced by the pancreas and secretes them into the duodenum. The pancreatic duct and the common bile duct meet and open into the duodenum at the duodenal papilla

49
Q

Where is the spleen?

A

It is located in the far upper left quadrant of the abdomen, right against the diaphragm, shielded by the ribs

50
Q

What are the functions of the spleen?

A

Lymphatic organ - filters blood to remove old erythrocytes
Immune organ - contains B and T lymphocytes
Stores about 230 ml of blood

51
Q

What happens if you remove the spleen?

A

The liver will take over most of the duties

52
Q

Name the three unpaired branches of the abdominal aorta that supplies the abdominal viscera

A

The celiac trunk, the superior and inferior mesenteric artery

53
Q

What organs are supplied by the celiac trunk?

A

The stomach, the spleen, the liver, the pancreas, and part of the duodenum

54
Q

What organs are supplied by the superior mesenteric artery?

A

The remainder of the duodenum, the jejunum, the ileum, the cecum and appendix, the ascending colon, part of the transverse colon

55
Q

What organs are supplied by the inferior mesenteric artery?

A

The remainder of the transverse colon, the descending colon, the sigmoid colon and the rectum

56
Q

Name the main branches of the celiac trunk

A

The left gastric artery, the splenic artery, the common hepatic artery

57
Q

What does the left gastric artery supply?

A

The lesser curvature of the stomach

58
Q

What does the splenic artery supply?

A

The spleen

59
Q

Name a branch of the splenic artery. What does it supply?

A

The left gastro-omental artery; it supplies the greater curvature of the stomach

60
Q

Name the 2 branches of the common hepatic artery

A

The hepatic artery proper and the gastroduodenal artery

61
Q

What does the hepatic artery proper supply?

A

The liver

62
Q

Name a branch of the hepatic artery proper. What does it supply?

A

The right gastric artery; it supplies the the lesser curvature of the stomach

63
Q

Name the branches of the gastroduodenal

A

The right gastro-omental and superior pancreaticoduodenal arteries

64
Q

What does the right gastro-omental artery supply?

A

The greater curvature of the stomach

65
Q

What does the superior pancreaticoduodenal artery supply?

A

The pancreas and the duodenum

66
Q

Name the branches of the superior mesenteric artery within the small intestine

A

The inferior pancreaticoduodenal artery, the jejunal and ileal arteries and the vasa recta

67
Q

What does the inferior pancreaticoduodenal artery supply?

A

It supplies the pancreas and the duodenum (distal to the duodenal papilla)

68
Q

Describe the jejunal and ileal arteries

A

They form arcades (loops) within the mesentery

69
Q

Describe the vasa recta

A

Straight arteries that enter the intestinal wall

70
Q

Name the branches of the superior mesenteric artery within the large intestine

A

Ileocolic artery, the right colic artery and the middle colic artery

71
Q

What does the ileocolic artery supply?

A

The distal ileum, the cecum, the appendix, the ascending colon

72
Q

What does the right colic artery supply?

A

The ascending colon

73
Q

What does the middle colic artery supply?

A

The 2/3 of the transverse colon

74
Q

Name the branches of the inferior mesenteric artery

A

The left colic artery, the sigmoid arteries, the superior rectal artery

75
Q

What does the left colic artery supply?

A

The remaining 1/3 of the transverse colon and the descending colon

76
Q

What do the sigmoid arteries supply?

A

The descending colon and the sigmoid colon

77
Q

What does the superior rectal artery supply?

A

The rectum

78
Q

What is the hepatic portal vein?

A

Large vein (8 cm long), formed by the union of the splenic and superior mesenteric veins

79
Q

What is the function of the hepatic portal vein?

A

It drains blood from the unpaired abdominal organs and conveys it to the liver for processing of nutrients and removal of toxins

80
Q

Name the organs that eventually drain into the hepatic portal vein

A

The stomach, the spleen, the pancreas, the gallbladder, the small intestine and the large intestine