Organs Flashcards
At what level does the oesophagus join the cardiac orifice of the stomach?
T11
How is the food transported in the oesophagus?
peristalsis
What are the lymphatic drainage of the oesophagus?
Superior third - deep cervical lymph nodes
Middle third - superior and posterior mediastinal nodes
Lower third - left gastric and celiac nodes
Arterial supply of oesophagus - thoracic and abdominal
thoracic - inferior thyroid artery
Abdominal - left gastric artery
What arteries supply the greater curvature?
short gastric arteries,
the right gastro-omental (branch of gastroduodenal artery from the common hepatic artery)and left gastro-omental arteries (from splenic artery from coeliac trunk)
What ligament does the lesser curvature attach to?
hepatogastric ligament
What arteries supplies the lesser curvature?
left gastric artery, right gastric branch of the hepatic artery from coeliac trunk
What does the greater omentum attach to?
transverse colon
What does the lesser omentum attach to?
liver
Where does the right and left gastric vein drain into?
hepatic portal vein
Where does the short gastric vein, left and right gastro-omental veins drain into?
superior mesenteric vein
What is the parasympathetic nerve supply of the stomach?
anterior and posterior vagal trunks, derived from the vagus nerve - relax pyloric sphincter
What is the sympathetic nerve supply of the stomach?
Celiac/solar plexus from the T6-T9 spinal cord segments
Lymphatic drainage of the stomach?
into the gastric and gastro-omental lymph nodes which connects to the coeliac lymph nodes
What part of the duodenum receives pancreatic juices and bile?
descending (L1-L3)
What are 2 sources of arterial supply of duodenum?
1) Proximal to the major duodenal papilla - supplied by gastroduodenal artery (from coeliac trunk).
2) Distal to the major duodenal papilla - by inferior pancreaticoduodenal artery (branch of superior mesenteric)
Lymphatic drainage of duodenum
pancreatoduodnal and superior mesenteric nodes
lymphatic drainage of jejunum and lleum
superior mesenteric nodes
What is the ileocaecal valve?
separation of small and large intestines - landmark for colonoscopy. Also a closed loop obstruction can occur here.
What is the lymphatic drainage of cecum and appendix?
ileocolic lymph nodes
What is the embryonic origin of cecum and appendix?
Midgut
What is the most common position of the appendix?
retrocecal
What are the 4 characteristics of the larger intestines?
- omental appendices
- teniae coli
- haustra
- wider diameter
Embryological origin of large intestines
Ascending colon and proximal 2/3 of the transverse colon – derived from the midgut.
Distal 1/3 of the transverse colon, descending colon and sigmoid colon – derived from the hindgut.
Arterial supply of large intestines
Mid-gut derived: superior mesenteric artery - ileocolic and right colic arteries
Hindgut-derived: inferior mesenteric artery. - left colic arteries and sigmoid arteries
Venous drainage of large intestines
ascending and transverse: superior mesenteric vein
descending and sigmoid: inferior mesenteric vein
BOTH EMPTIES INTO HEPATIC PORTAL VEIN
Innervation of large intestines
midgut: superior mesenteric plexus
Hindgut: inferior mesenteric plexus (parasympathetic was pelvic spalnchnic nerve and sympathetic was lumbar splanchnic nerves)
Where does the superior and inferior mesenteric nodes drain into?
intestinal lymph trunk - cisterna Chyli- thoracic duct
What level does the rectum begin
S3
What is the function of the ampulla in rectum? what flexure helps with faecal continence?
relaxes to accumulate and temporarily store faeces until defecation.
Anorectal flexure also helps with faecal continence
What plexus are involved in the sympathetic and parasympathetic nervous supply of the rectum?
sympathetic: superior and inferior hypogastric plexuses
Parasympathetic: pelvic spalnchin nerves (S2-4)
What are the 2 surfaces of the liver?
1) Diaphragmatic surface - the anterosuperior surface
2) Visceral surface - posteroinferior surface
Where are the caudate and quadrate lobes of the liver?
Caudate - upper aspect
quadrate - lower aspect
Where in the abdomen is the liver predominantly located?
Right hypochondrium
What does the hepatic portal vein do?
supplies the liver with partially deoxygenated blood, carrying nutrients absorbed from the small intestines.
What causes portal hypertension?
Blockage in the veins due to pathological conditions such as liver cirrhosis and Schistosomiasis
Pre-hepatic causes: embolis
hepatic- cirrhosis
post-hepatic: right heart failure
What are the sites of anastomosis between the portal and systemic venous circulation?
1) Oesophageal - between oesophageal branches of the left gastric vein and of the azygos vein.
2) Rectal – between superior rectal and middle/inferior rectal veins.
3) Para-umbilical – between para-umbilical and superficial epigastric veins
What are the clinical consequences of portal hypertension?
- Varices: lead to hemmorids
- Ascites
- Splenomegaly
- toxins are not filtered
At what vertebral level do the two common iliac veins unite to form IVC?
L5
What supply the sensory, sympathetic and parasympathetic innervation to the gall bladder?
- Sympathetic and sensory: Coeliac plexus
- Parasympathetic: Vagus (causes secretion of bile)
Whats the part of the pancreas that is intraperitoneal?
tail
What is the clinical significance of “vascular segments” of the spleen?
allows for subtotal splenectomy
What fascia encloses the adrenal glands and kidneys?
perinephric (or renal) fascia
Where is the adrenal cortex derived from? what are the layers and what hormones are produced and secreted from each?
Derived from the embryonic mesoderm.
1) Zona glomerulosa - aldosterone
2) Zona fasciculate - Cortiicosteroid
3) Zona reticularis - androgen e.g. DHES
Where is the adrenal medulla derived from and what hormone is produced and secreted?
derived from the ectodermal neural crest cells.
produce and release adrenaline (epinephrin)
Where does the left and right adrenal vein drain into?
Right - inferior vena cava
left- left renal vein
Innervation of adrenal glands?
Coeliac plexus and greater splanchnic nerves.
Sympathetic innervation to the adrenal medulla is via myelinated pre-synaptic fibres, mainly from the T10 to L1 spinal cord segments.
What is the best description of the shape of the left adrenal gland?
semi-lunar
What is the best description on the shape of the right adrenal gland?
pyramidal
What level does the kidney sit? and why is the right kidney lower?
T12 to L3
Right kidney sits lower due to the presence of liver.
What are the layers of the kidney (deep to superficial)?
- Renal capsule: tough fibrous capsule.
- Peri- renal fat: collection of extraperitoneal fat.
- Renal fascia (also known as Gerota’s fascia or perirenal fascia): encloses the kidneys and the suprarenal glands.
- Pararenal fat: mainly located on the posterolateral aspect of the kidney.
Where is the original embryological site of kidney?
pelvis
Where does the lymph of the kidney drain?
para-aortic nodes (or lateral aortic)
