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Regional Gross Anatomy > Region 3 - Abdominal Viscera > Flashcards

Region 3 - Abdominal Viscera Flashcards

1
Q

What organs make up the foregut?

A 
Distal oesophagus
Stomach
Liver
Spleen
Proximal duodenum
Part of pancreas
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2
Q

What aortic branch supplies the foregut? What vertebral level is it at?

A

Coeliac axis

T12

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3
Q

Where does lymph from the foregut drain?

A

Pre-aortic coeliac nodes at T12

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4
Q

What is the morphology of the gastric wall from external to internal?

A 
Serosa
Muscularis externa:
- Outer longitudinal
- Middle circular
- Inner oblique
Submucosa
Mucosa
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5
Q

What is the inside of the stomach folded into when empty?

A

Rugae

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6
Q

Approximately, at what level, does the oesophagus enter the stomach?

A

5th-6th ribs

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7
Q

What is the approximate level of the trans-pyloric plane?

A

Rib 8/L1 level

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8
Q

What is the region of the stomach that is the superior opening?

A

Cardia

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9
Q

What is the dilated superior part of the stomach?

A

Fundus

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10
Q

What is a feature of the lesser curvature that when drawn with a perpendicular line down from it to the greater curvature, makes up the boundary of the pyloric region?

A

Angular notch

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11
Q

What is the arterial supply to the lesser curvature of the stomach? Where do these arteries originate from?

A

Left gastric artery (from coeliac axis)

Right gastric artery (from common hepatic; from coeliac axis)

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12
Q

What is the arterial supply to the fundus of the stomach? Where does it originate?

A

Short gastric artery (from splenic artery; from coeliac axis)

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13
Q

What is the arterial supply to the greater curvature of the stomach? Where do these originate?

A

Left gastro-omental artery (from splenic; from coeliac axis)

Right gastro-omental artery (from gastroduodenal; from common hepatic; from coeliac axis)

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14
Q

Where do the left and right gastric veins drain?

A

Hepatic portal vein

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15
Q

Where does the left gastro-omental vein drain to?

A

Splenic vein -> Portal vein

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16
Q

Where does the right gastro-omental vein drain to?

A

Superior mesenteric vein -> Portal vein

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17
Q

Where does the short gastric vein drain to?

A

Splenic vein -> Portal vein

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18
Q

What is the name for the collection of lymph structures around the entrance of the stomach?

A

Cardiac ring

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19
Q

What local lymph nodes drain to the coeliac nodes?

A 
Gastro-omental
Gastric
Pyloric
Pancreaticosplenic
Pancreaticoduodenal
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20
Q

What provides PNS innervation to the stomach?

A

Anterior and posterior vagal trunks

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21
Q

What provides SNS innervation to the stomach?

A

Greater splanchnic (T5-T9) nerves via coeliac plexus

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22
Q

How long is the duodenum?

A

~25cm

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23
Q

What is the only part of the duodenum that is intraperitoneal?

A

1st part

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24
Q

What is the name given to the folds on the inner surface of the duodenum?

A

Plicae circulares

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25
Q

What is the ampulla of Vater?

A

Hepatopancreatic ampulla; union of:

  • Common bile duct
  • Pancreatic duct
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26
Q

What is the opening of the ampulla of Vater called?

A

Major duodenal papilla

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27
Q

What sphincter controls the flow of bile and pancreatic fluids into the duodenum? What type of muscle is it?

A

Sphincter of Oddi/Hepatopancreatic sphincter

Smooth muscle

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28
Q

Where does the duodenum lie?

A

Just right of midline

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29
Q

Where does the 1st part of the duodenum lie in relation to the vertebral column?

A

Anterolateral to L1

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30
Q

Where does the 2nd part of the duodenum lie in relation to the vertebral column?

A

Descends along right sides of L1-L3

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31
Q

Where does the 3rd part of the duodenum lie in relation to the vertebral column?

A

Crosses L3 to left side

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32
Q

Where does the 4th part of the duodenum lie in relation to the vertebral column?

A

Rises up to left of L2

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33
Q

Where is the duodenal-jejunal junction located?

A

3cm left of midline

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34
Q

What is the arterial supply of the proximal part of the duodenum?

A

Superior pancreaticoduodenal artery (from gastroduodenal; from common hepatic; from coeliac axis)

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35
Q

What is the arterial supply of the distal part of the duodenum?

A

Inferior pancreaticoduodenal artery (from superior mesenteric artery)

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36
Q

What provides SNS innervation to the duodenum?

A

Greater and lesser splanchnic nerves (via coeliac and superior mesenteric plexuses)

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37
Q

What provides PNS innervation to the duodenum?

A

Anterior and posterior vagal trunks

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38
Q

Where does pain from the duodenum go?

A

Epigastric region

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39
Q

What local nodes drain the proximal duodenum?

A

Pancreaticoduodenal
Gastroduodenal
Pyloric

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40
Q

Where does lymph from the proximal duodenum drain to?

A

Pre-aortic coeliac nodes at T12

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41
Q

What local nodes drain the distal duodenum?

A

Pancreaticoduodenal

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42
Q

Where does lymph from the distal duodenum drain to?

A

Pre-aortic superior mesenteric nodes at L1

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43
Q

What separates the left and right lobes of the liver and attaches it to the anterior abdominal wall? What forms it?

A

Falciform ligament

Peritoneum folds back on itself

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44
Q

What connects the left posterior part of the upper surface of the liver to the diaphragm?

A

Left triangular ligament

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45
Q

What connects the right posterior part of the upper surface of the liver (bare area) to the diaphragm?

A

Right triangular ligament

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46
Q

What does the coronary ligament form from and form into?

A

From falciform ligament

To right triangular ligament

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47
Q

Where does the falciform ligament pass to?

A

Umbilicus

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48
Q

What does the falciform ligament contain?

A

Remnants of umbilical vein - Ligamentum teres

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49
Q

What structures are present at the porta hepatis, besides the portal triad?

A

Right and left hepatic ducts
ANS fibres
Lymph nodes

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50
Q

What structures are not present at the porta hepatis? Why?

A

Hepatic veins

They are inside liver and drain directly to IVC

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51
Q

What is most of the anterior surface of the liver covered by?

A

Ribs

Costal cartilages

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52
Q

What is the rough level of the gallbladder?

A

Level of right 9th costal cartilage

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53
Q

What structures are associated with the posterior aspect of the liver?

A 
Oesophagus
Stomach
Duodenum
Right colic flexure
Right kidney
Right suprarenal gland
Gallbladder
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54
Q

What part of the liver is not covered in visceral peritoneum and why?

A 
Bare area (right posterior)
Diaphragm
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55
Q

What is the blood supply to the liver?

A

30% from hepatic artery

70% from portal vein

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56
Q

What is the route of arterial and venous blood in the liver?

A

Travels to sinusoids -> Central vein of each lobe -> Right and left hepatic veins (~4) -> IVC

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57
Q

What fraction of the total bodily lymph does the liver produce?

A

1/3 to 1/2

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58
Q

Where does most lymph from the liver drain to?

A

Coeliac nodes

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59
Q

Where can a small amount of hepatic lymph drain to?

A

Posterior mediastinum (via diaphragm)

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60
Q

Where does liver pain present?

A

Epigastric

Radiates to right shoulder via diaphragm

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61
Q

What organ secretes bile?

A

Liver

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62
Q

Where is bile stored?

A

Gallbladder

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63
Q

How long is the common bile duct?

A

~8cm

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64
Q

What makes up the common bile duct?

A

Common hepatic duct (right + left hepatic ducts)

Cystic duct

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65
Q

What part of the gallbladder joins the cystic duct?

A

Neck

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66
Q

What stimulates the gallbladder to contract and release bile?

A

Fat in duodenum -> CCK release from small intestine mucosa

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67
Q

What is the purpose of bile?

A

Emulsifies fat

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68
Q

What is the arterial supply of the gallbladder?

A

Cystic artery (from right hepatic; from hepatic artery proper; from common hepatic; from coeliac axis)

69
Q

What is the venous drainage of the gallbladder?

A

Cystic vein -> Portal vein

70
Q

Where does gallbladder pain present?

A

Epigastric

71
Q

What is the main component of green or yellow/white gallstones?

A

Cholesterol

72
Q

What colour are pigment stones and what salts make them up?

A

Dark (and small)

Bilirubin and calcium

73
Q

Where does the head of the pancreas lie?

A

Concavity of duodenum

74
Q

Where does the uncinate process of the pancreas lie?

A

Behind superior mesenteric vessels

75
Q

What does the neck of the pancreas lie anterior to?

A

Origin of superior mesenteric artery

76
Q

In what direction does the body of the pancreas run in?

A

Superolaterally

77
Q

What does the tail of the pancreas run in and what does it contact?

A

Lienorenal ligament

Hilus of spleen

78
Q

What lies anterior to the pancreas?

A

Transverse colon

Stomach

79
Q

Where does the main duct in the pancreas run from and to?

A

From tail

To ampulla of Vater

80
Q

What is the arterial supply of the pancreas?

A

Dorsal pancreatic artery (from splenic)
Superior pancreaticoduodenal artery (from gastroduodenal; from common hepatic)
Inferior pancreaticoduodenal artery (from sup. mesenteric)

81
Q

What is the venous drainage of the pancreas?

A

Splenic vein and sup. mesenteric vein -> Portal vein

82
Q

Where does pancreatic lymph drain to?

A

Coeliac (T12) and superior mesenteric (L1) pre-aortic nodes

83
Q

Where does the spleen lie?

A

Inferior to ribs 9-11 in left hypochondrium

Posterior to stomach

84
Q

What does the gastrosplenic ligament carry?

A

Short gastric vessels

Gastro-omental vessels

85
Q

What does the lienorenal ligament carry?

A

Splenic vessels

Tail of pancrease

86
Q

Where is the midgut?

A

From halfway along duodenum to 2/3 of transverse colon

87
Q

How long is the jejunum and ileum?

A

~6m

Proximal 2/5 is jejunum

88
Q

Which is paler; Jejunum or Ileum?

A

Ileum

89
Q

The walls of which is thicker with more plicae circularis; Jejunum or Ileum?

A

Jejunum

90
Q

The bore of which is wider; Jejunum or Ileum?

A

Jejunum

91
Q

Which has more mesenteric vessel branches from 3-4 arcades; Jejunum or Ileum??

A

Ileum

92
Q

In which does most of the adipose tissue lie near the root of the mesentery; Jejunum or Ileum?

A

Jejunum

93
Q

Which has numerous Peyer’s patches; Jejunum or Ileum??

A

Ileum

94
Q

Apart from ileal branches, what supplies the lower ileum?

A

Ileocolic artery

95
Q

Where does pain from the jejunum and ileum present?

A

Umbilical region

96
Q

What are haustra?

A

Sacculations of the colonic wall

97
Q

What is the name for the fatty tags on the large intestine?

A

Appendices epiplociae

98
Q

What are the longitudinal muscles on the large intestine and how many bands are there?

A

Teniae coli

3 bands

99
Q

What is the arterial supply to the caecum?

A

Caecal arteries (from ileocolic; from superior mesenteric)

100
Q

Where does the tip of the appendix often lie?

A

Retroperitoneal

101
Q

Where is the appendix (surface anatomy)?

A

Right iliac region

1/3 of the way along line from ASIS to umbilicus

102
Q

What is the arterial supply to the appendix?

A

Appendicular artery (terminal branch of ileocolic; from superior mesenteric)

103
Q

What is the venous drainage of the appendix?

A

Posterior caecal vein

104
Q

How long is the ascending colon?

A

~15cm

105
Q

What muscles is the ascending colon related to?

A

Iliacus

Qudratus lumborum

106
Q

What nerves is the ascending colon related to?

A

Ilioinguinal and iliohypogastric nerves

107
Q

What is the arterial supply of the ascending colon?

A

Ileocolic and right colic arteries (from superior mesenteric)

108
Q

How long is the transverse colon?

A

~38cm

109
Q

What does the transverse colon hang from?

A

Transverse mesocolon

110
Q

What hangs the left colic flexure from the diaphragm?

A

Phrenicocolic ligament

111
Q

What is the arterial supply to the transverse colon?

A

Proximal 2/3rds:
- Middle colic artery (from superior mesenteric)
Distal 1/3rd:
- Left colic artery (from inferior mesenteric)
Both anastomose by the marginal artery of Drummond (in transverse mesocolon)

112
Q

What is the nerve supply to the transverse colon?

A 
Superior mesenteric plexus:
- SNS from chain
- PNS from vagus (prox. 2/3rds)
Inferior mesenteric plexus:
- SNS from chain
- PNS from pelvic splanchnic (S2-S4) nn. to distal 1/3rd
113
Q

How long is the descending colon?

A

~25cm

114
Q

What nerves is the descending colon related to?

A

Femoral
Iliohypogastric
Ilioinguinal

115
Q

What muscles is the descending colon related to?

A

Psoas

Quadratus lumborum

116
Q

What is the arterial supply to the descending colon?

A

Left colic and sigmoid arteries (from inferior mesenteric)

117
Q

What is the nerve supply to the descending colon?

A

SNS from inferior mesenteric plexus

PNS from pelvic splanchnic nerves

118
Q

How long is the sigmoid colon?

A

~25-38cm

119
Q

Where does the sigmoid colon run?

A

From pelvic brim (in front of left external iliac artery)

To 3rd sacral vertebra

120
Q

What attaches the sigmoid colon to the posterior pelvic wall?

A

Pelvic mesocolon

121
Q

What is the arterial supply of the sigmoid colon?

A

Sigmoid artery (from inferior mesenteric)

122
Q

What is the innervation of the sigmoid colon?

A

Inferior hypogastric plexus

  • SNS from sacral splanchnic nerves
  • PNS from pelvic splanchnic nerves
123
Q

How long is the rectum?

A

~13cm

124
Q

Where does the rectum run?

A

From 3rd sacral vertebra

To 2cm anterior to tip of coccyx

125
Q

What is the arterial supply to the rectum?

A

Superior rectal artery (from inf. mesenteric)
Middle rectal artery (from internal iliac)
Inferior rectal artery (from internal pudendal)

126
Q

What is the venous drainage of the rectum?

A

Superior 1/3rd:
- Superior rectal vein into portal system via inferior mesenteric vein
Inferior 2/3rds:
- Middle and inferior rectal veins
- Drain to internal iliac and internal pudendal

127
Q

Where does lymph from the rectum drain?

A

Upper:
- Inferior mesenteric (L3) pre-aortic nodes
Lower:
- Internal iliac nodes

128
Q

What are primary retroperitoneal structures?

A

Develop posterior to peritoneum and stay that way

129
Q

What are the primary retroperitoneal structures?

A

Kidneys and ureters (and associated vessels/nerves)
Suprarenal glands (and associated vessels/nerves)
Aorta
IVC

130
Q

What are secondary retroperitoneal structures?

A

Become covered in peritoneum by end of development

131
Q

What are the secondary retroperitoneal structures?

A

Most of duodenum
Pancreas
Ascending and descending colon
Upper 2/3rds rectum

132
Q

What are the dimensions of a kidney?

A

~10-12cm long

~6-8cm wide

133
Q

What is the rough vertebral level of a kidney?

A

L1 (right is usually lower due to liver)

134
Q

What structures lie anterior to the right kidney?

A

Suprarenal gland
Liver
2nd part of duodenum
Right colic flexure

135
Q

What structures lie posterior to the right kidney?

A 
Diaphragm
Rib 12
Psoas
Quadratus lumborum
Transversus abdominis
Subcostal nerve
136
Q

What structures lie anterior to the left kidney?

A 
Suprarenal gland
Spleen
Stomach
Pancreas
Left colic flexure
Jejunum
137
Q

What structures lie posterior to the left kidney?

A 
Diaphragm
Ribs 11 and 12
Psoas
Quadratus lumborum
Transversus abdominis
Subcostal nerve
138
Q

What is present at the renal hila?

A

Renal vein
Branches of renal arteries
(Lymph and sympathetic fibres)

139
Q

What renal artery variants are common?

A

Supernumerary renal arteries

Polar arteries

140
Q

What parts of the filtration system are in the renal cortex?

A

Glomeruli

141
Q

What parts of the filtration system are in the renal medullary pyramids?

A

Loop of Henle

Collecting ducts

142
Q

What part of the kidney is the part where the medullary pyramids empty into the minor calyces?

A

Renal papillae

143
Q

Where does the right renal artery lie in relation to the IVC?

A

Posterior

144
Q

What do the segmental branches of the renal arteries branch into within the kidney?

A

Lobar
Interlobar
Arcuate
Afferent glomerular arterioles

145
Q

Where do the renal veins drain?

A

IVC

146
Q

Where does renal lymph drain?

A

Lateral para-aortic nodes around renal arteries at L1

147
Q

What is the nerve supply to the kidney?

A

From renal sympathetic plexus

Afferent fibres to T10-T12

148
Q

What structures does the left renal vein pass behind?

A

Splenic vein

Body of pancreas

149
Q

What veins drain to the left renal vein?

A

Left gonadal vein

Left suprarenal veins

150
Q

What structure does the right renal vein pass behind?

A

Descending duodenum (2nd part)

151
Q

What muscle do the ureters run on the surface of?

A

Psoas muscle

152
Q

What bifurcation does the ureter cross?

A

Common iliac (anterior to sacro-iliac joint)

153
Q

What pelvic structure does the ureter move towards?

A

Ischial spine

154
Q

What surface of the bladder does the ureter enter via and at what structure?

A

Inferior surface

Trigone

155
Q

What propels urine through the ureter?

A

Contractions of ureter wall

Glomerular filtration pressure

156
Q

Where are the ureteric constrictions?

A

Ureteropelvic junction
Pelvic brim (common iliac bifurcation)
Ureterovesical junction

157
Q

What is the arterial supply to the ureter?

A

Renal arteries
Gonadal arteries
Superior vesical arteries

158
Q

Where does lymph from the ureters drain?

A

Lateral para-aortic nodes (L1)

Iliac nodes

159
Q

Where does the innervation to the ureters arise?

A

Renal, gonadal and hypogastric plexuses

160
Q

What spinal levels do afferent fibres from the ureters enter?

A

L1 and L2

161
Q

What colour is the suprarenal cortex?

A

Yello

162
Q

What does the suprarenal cortex produce and what do these control?

A 
Corticoids:
- Fluid
- Electrolytes
Glucocorticoids:
- Carbohydrates
- Fats
- Proteins
163
Q

What colour is the suprarenal medulla?

A

Brown

164
Q

What does the suprarenal medulla produce?

A

Adrenaline and noradrenaline

165
Q

What is the arterial supply to the suprarenal glands?

A

Suprarenal branches of:

  • Inferior phrenic arteries
  • Aorta
  • Renal arteries
166
Q

What is the venous drainage of the suprarenal glands?

A

Single vein on each side:

  • Right suprarenal vein to IVC
  • Left suprarenal vein to renal vein
167
Q

What shape is the right adrenal gland and where does it lie?

A

Pyramidal

Behind right lobe of liver

168
Q

What shape is the left adrenal gland and where does it lie?

A 
Crescenteric
Behind:
- Pancreas
- Stomach
- Lesser sac
169
Q

What is the nerve supply to the suprarenal glands?

A

Preganglionic SNS from (greater) splanchnic nerves (usually ending in medulla)

Regional Gross Anatomy (14 decks)

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