SM_129b: Structure of the Abdomen Flashcards
Surface of abdomen can be divided into ____ quadrants or ____ regions
Surface of abdomen can be divided into four quadrants or nine regions
Abdominal foregut artery is the ____ with its ____, ____, and ____ branches
Abdominal foregut artery is the celiac trunk with its left gastric, common hepatic, and splenic branches
Midgut artery is the ____ with its ____, ____, and ____ branches
Midgut artery is the superior mesenteric artery with its ileocolic, right colic, and middle colic branches
Hindgut artery is the ____ with its ____, ____, and ____ branches
Hindgut artery is the inferior mesenteric artery with its left colic, sigmoid, and superior rectal branches
GI smooth muscle and glands are innervated by ____
GI smooth muscle and glands are innervated by parasympathetic neurons (craniosacral outflow)
- Vagus nerve: foregut and midgut
- Pelvic splanchnic nerves: hindgut
GI arterial smooth muscle is innervated by ____
GI arterial smooth muscle is innervated by sympathetic neurons (thoracolumbar outflow)
Thoracic and lumbar splanchnic nerves
GI visceral sensory fibers travel with ____
GI visceral sensory fibers travel with all autonomic nerves
Visceral sensory spinal segment innervation is T1 for ____
Visceral sensory spinal segment innervation is T1 for ____ middle esophagus
Visceral sensory spinal segment innervation is T7-9 for ____
Visceral sensory spinal segment innervation is T7-9 for stomach
Visceral sensory spinal segment innervation is T10 for ____
Visceral sensory spinal segment innervation is T10 for appendix/cecum
Visceral sensory spinal segment innervation is T11 for ____
Visceral sensory spinal segment innervation is T11 for right colic flexure
Visceral sensory spinal segment innervation is L1 for ____
Visceral sensory spinal segment innervation is L1 for left colic flexure
Visceral sensory spinal segment innervation is L5 for ____
Visceral sensory spinal segment innervation is L5 for sigmoid colon
Four lobes of liver are _____, _____, _____, and _____
Four lobes of liver are left, right, and caudate and quadrate
- Posterior: left, right, caudate
- Anterior: quadrate
Four lobes of liver are divided by the ____
Four lobes of liver are divided by the H-shaped fissures with the porta hepatitis (where structures enter and leave the liver) in the cross bar of the H
- Adult structures (gall bladder, IVC) are in the right limb of H
- Embryonic derivatives (ligamentum teres and ligamentum venosum) are in the left lumb of the H
Portal system of veins drains blood from GI capillaries into the ____
Portal system of veins drains blood from GI capillaries into the liver sinusoids
With obstruction of portal blood flow, portal blood passes into ____
With obstruction of portal blood flow, portal blood passes into veins of the caval system at important sites of anastomoses where veins are dilated which are the esophagus, anterior abdominal wall (caput medusa), and rectum (hemorrhoids)
Body and tail of pancreas and accessory pancreatic duct develop from the ____
Body and tail of pancreas and accessory pancreatic duct develop from the dorsal pancreatic bud
Head and main pancreatic duct develop from the ____ that must slide around the duodenum to join the dorsal bud
Head and main pancreatic duct develop from the ventral bud that must slide around the duodenum to join the dorsal bud
____ drapes over the transverse colon to cover the intestines
Greater omentum (part of the dorsal mesogastrium) drapes over the transverse colon to cover the intestines
_____ contains the portal triad (bile duct, hepatic artery proper, and portal vein) and overlies the epicloic foramen
Lesser omentum (hepatogastric and hepatoduodenal ligaments) contains the portal triad (bile duct, hepatic artery proper, and portal vein) and overlies the epicloic foramen
Portal triad is ____, ____, and ____ is within the ____
Portal triad is bile duct, hepatic artery proper, and portal vein is within the lesser omentum
___ is the entry into the lesser peritoneal sac behind the stomach
Epiploic foramen is the entry into the lesser peritoneal sac behind the stomach
Routes for the pasage of peritoneal fluid / blood are ____, ____, and ____
Routes for the pasage of peritoneal fluid / blood are Morrison’s pouch (hepatorenal recess), paracolic gutters, and left side of dorsal mesointestine
(can accumulate more readily in more restricted spaces above the phrenicocolic ligament in the left foregut, within the lesser sac, and to the right of the dorsal mesointestine within the loop of the midgut)
Surgical resection of the cardiac part of the stomach near the esophagus would require ligation of branches from ____
Surgical resection of the cardiac part of the stomach near the esophagus would require ligation of branches from the left gastric artery
Chronic low blood pressure could result in ischemia (low perfusion) with possible necrosis (tissue death) of bowel in locations of anastamosis between branches of the three large arteries of foregut, midgut, and hindgut. ____ would most likely be in jeopardy.
Chronic low blood pressure could result in ischemia (low perfusion) with possible necrosis (tissue death) of bowel in locations of anastamosis between branches of the three large arteries of foregut, midgut, and hindgut. Left colic flexure would most likely be in jeopardy.
Describe functions of the dorsal pancreatic bud
Dorsal pancreatic bud
- Gives rise to the body and tail of the pancreas
- Gives rise to the pancreatic duct
Describe functions of the ventral pancreatic bud
Describe functions of the ventral pancreatic bud
- Gives rise to the major pancreatic duct
- Is a bud off the liver bud
- Slides around the duodenum to fuse with the other bud
- Its ducr is in the major duodenal papilla
- It joins the common bile duct
With portal obstruction and hypertension, blood in the portal system of veins will reverse flow and dilate anastomoses with systemic veins that drain into the inferior or superior vena cava. This will occur in the ____, ____, and ____
With portal obstruction and hypertension, blood in the portal system of veins will reverse flow and dilate anastomoses with systemic veins that drain into the inferior or superior vena cava. This will occur in the anterior abdominal wall, esophagus, and rectum
Patient with pain in T10 dermatoma may have pathology in ____
Patient with pain in T10 dermatoma may have pathology in appendix
If neural crest cells do not migrate into the celiac ganglion, ___ would be diminished
If neural crest cells do not migrate into the celiac ganglion, arterial mucle tone would be diminished
Tumors in the posterior right lobe of the liver extending into the caudate lobe might affect the ____
Tumors in the posterior right lobe of the liver extending into the caudate lobe might affect the inferior vena cava
Fluid from ____ can pass most easily from the abdominal cavity (greater peritoneal sac) into the pelvic cavity
Fluid from left paracolic gutter can pass most easily from the abdominal cavity (greater peritoneal sac) into the pelvic cavity
Tumor in the head of the pancreas might compress the ____ artery
Tumor in the head of the pancreas might compress the superior mesenteric artery
A patient has an accumulation of peritoneal fluid in the lesser peritoneal sac. Look for the ___ when inserting a drainage canula into the epiploic foramen to enter the lesser sac.
A patient has an accumulation of peritoneal fluid in the lesser peritoneal sac. Look for the hepatoduodenal ligament when inserting a drainage canula into the epiploic foramen to enter the lesser sac.
Midline abdominal regions are ____, ____, and ____
Midline abdominal regions are epigastric, umbilical, and suprapubic
Left and right regions of the abdomen are ____, ____, and ____
Left and right regions of the abdomen are hypochondriac, lumbar, and inguinal
Appendix is located at ____
Appendix is located at McBurney’s point
(1/3 from anterior superior iliac spine to navel)
____ can compress the left renal vein
Superior mesenteric artery can compress the left renal vein
Spleen spans from ribs ___ and right kidney is ____ than left kidney
Spleen spans from ribs 9-11 and right kidney is lower than left kidney (mostly below rib 12)
____ and ____ provide sympathetic innervation into the autonomic (enteric) plexus via collateral ganglia
Thoracic and lumbar splanchnic nerves provide sympathetic innervation into the autonomic (enteric) plexus via collateral ganglia
Parasympathetics in the vagus synapse in ____, while sympathetics in thoracic and lumbar splanchnics synapse in ____
Parasympathetics in the vagus synapse in wall of intestine (enteric plexus), while sympathetics in thoracic and lumbar splanchnics synapse in collateral ganglia
____ plexus is a parasympathetic synapse for smooth muscle contraction
Auerbach’s plexus is a parasympathetic synapse for smooth muscle contraction
____ plexus is a parasympathetic synapse for glandular secretion and muscularis mucosae
Meissner’s (submucosal) plexus is a parasympathetic synapse for glandular secretion and muscularis mucosae
Describe visceral sensory spinal cord segments
Visceral sensory spinal cord segments
- T1: heart ventricles
- T7-9: stomach
- T10: appendix
- T12: right colic flexure
- L1: left colic flexure
- L2: upper sigmoid colon
____ is an intense sensation carried by general sensory neurons in the body wall (spinal nerves) including the parietal peritoneum
Somatic pain is an intense sensation carried by general sensory neurons in the body wall (spinal nerves) including the parietal peritoneum
____ is mostly dull sensation carried by visceral sensory neurons in splanchnopleure derivatives in the gut
Visceral sensation is mostly dull sensation carried by visceral sensory neurons in splanchnopleure derivatives in the gut
____ originates in one location and is felt in another supplied by the same spinal segment
Referred pain / sensation originates in one location and is felt in another supplied by the same spinal segment
Arterial and venous portal blood mix in ___ in the liver lobules, while hepatic veins drain into the ___
Arterial and venous portal blood mix in sinusoids in the liver lobules, while hepatic veins drain into the IVC
____ brings veinous blood from GI capillaries to liver sinusoids
Hepatic portal system brings veinous blood from GI capillaries to liver sinusoids
(portal vein, superior mesenteric vein, splenic vein, and inferior mesenteric vein)
____, ____, and ____ are important sites of venous porta-caval anastamosis
Left gastric veins, para-umbilical veins, and superior rectal veins are important sites of venous porta-caval anastamosis
Clinical signs of portal hypertension are ____, ____, and ____
Clinical signs of portal hypertension are esophageal varices, caput medussa on abdominal wall, and hemorrhoids
- Left gastric veins: esophageal varices
- Caput medussa on abdominal wall: para-umbilical veins
- Superior rectal veins: hemorrhoids
In pancreatic development, ventral bud swings around the ___ to join the dorsal bud
In pancreatic development, ventral bud swings around the duodenum to join the dorsal bud
____ becomes the head with the main pancreatic duct
Ventral bud becomes the head with the main pancreatic duct
____ becomes the body and tail and accessory pancreatic duct
Dorsal bud becomes the body and tail and accessory pancreatic duct
____ constricting the duodenum results when the ventral bud envelops the gut tube during migration
Anular pancreas constricting the duodenum results when the ventral bud envelops the gut tube during migration
- Most common pancreatic congenital defect is failure of fusion of the two buds -> accessory duct becomes major duct
Gall stones can blcok both the common bile duct and the major pancreatic duct at the ____ and ____
Gall stones can blcok both the common bile duct and the major pancreatic duct at the sphincter of Oddi and major duodenal papilla
(bile can back up in pancreas -> pancreatitis and severe perinotitis)
Gall bladder touches the ____, ____, ____, and ____
Gall bladder touches the anterior abdominal wall, liver, transverse colon, and duodenum
Describe paracolic gutters and fluid routes
Paracolic gutters and fluid routes
- 4 gutters: two paracolic and one one each side of dorsal mesointestine
- 2 enclosed spaces: to the left of the foregut and right of the dorsal mesointestine
Descrieb the mesenteries and greater and lesser peritoneal sacs
Mesenteries and greater and lesser peritoneal sacs
