Thorax: Abdominal Viscera II Flashcards
liver: location
- R hypochondrium and epigastric region -> L hypochondrium
liver: surface projection
- deep to rib 7 -11 on R side and crosses midline to L nipple
- inf border follows R costal margin
liver: surfaces
- diaphragmatic (ant/ sup/ post)
- visceral
liver: recesses
- subphrenic
- hepatorenal
liver: visceral surface related to (9)
- esophagus
- stomach
- sup part of duodenum
- lesser omentum
- gallbladder
- R colic flexure
- R transverse colon
- R kidney/ suprarenal gland
liver: list lobes
- R/ L
- caudate
- quadrate
liver: ligaments
- round (ligamentum teres) lig
- falciform
- 2x triangular (L/R)
- ligamentum venosum
- coronary lig
liver: blood supply
- dual
- portal vein (70%)
- hepatic aa (30%)
portal-systemic anastomoses: portal v. communicates w systemic venous vessels at
- esophagus (btw esophageal v)
- rectum (btw rectal v)
- umbilicus (around umbilical v)
porta hepatis vs portal triad:
porta hepatis:
- only 1
- incl proper hepatic aa., portal v. and common bile duct
portal triad:
- many in liver cells
- hepatic portal v, bile/hepatic duct, hepatic aa.
eg. cirrhosis:
- blocked blood flow= necrosis of tissue
- fatty cysts
- lumpy surface
- scarring
gallbladder: function
- stores and concentrates bile
gallbladder: parts and features
- fundus (tup of 9th costal cartilage in MCL)
- body
- neck (mucosal folds forming spiral valve)
bile ducts: features
- produced by hepatocytes -> bile canaliculi -> interlobular bile ducts
- R and L hepatic ducts = common hepatic duct
common hepatic duct + cystic duct = bile duct
pancreas: exocrine portion
- proteases
- amylase
- lipases
pancreas: endocrine portion
islets of Langerhan:
- glucagon
- insulin
- somatostatin
- pancreatic polypeptides
pancreas: location
- across post abdominal wall from duodenal curvature to hilum of spleen
- post to stomach
- transverse mesocolon attaches to ant margin
pancreas: retro or intra?
- retro
pancreas: parts
- head
- uncinate process
- body
- tail
- neck
pancreas: main pancreatic duct
- originates in tail of pancreas
- head of pancreas joins bile duct = hepatopanceatic ampula (Vater)
- enters 2nd part of duodenum at major duodenal papilla
pancreas: circular layer of muscle forms sphincter
sphincter of Oddi
pancreas: accessory pancreatic duct
- superior to ostium of main pancreatic duct
- minor duodenal papilla
eg. pancreatitis
- blockage at distal end of ampulla by gallstone
- neither bile/ pancreatic juices can exit
- back flow of bile -> main pancreatic duct
spleen: location
- L hypchondrium again diaphragm btw ribs 9-10
spleen: features
- intraperitoneal organ
- diaphragmatic and visceral surfaces
spleen: blood supply
celiac trunk -> splenic aa. branch
spleen: function
- lymphocyte proliferation/ immune surveillance and response
prenatally:
- haematopoietic (produces RBC)
postnatally:
- destroying RBC
- recylcing Fe, globin
- blood reservoir (provide small transfusion)
thoracic splanchnic nerves: name them
- greater
- lesser
- least splanchnic
thoracic splanchnic nerves: great SN
- T5-T9 ganglia and traverse to celiac ganglion
thoracic splanchnic nerves: lesser SN
- arise T9- T10/11 ganglia
- traverse to aortico-renal ganglion
thoracic splanchnic nerves: least SN
- T12 ganglion traverse to renal plexus
parasympathetic innervation: vagus n
- CN X
- through esophageal hiatus = ant/ post esophageal plexuses
parasympathetic innervation: pelvic splanchnic n
- S2-S4 spinal cord levels
- PSY inn to hindgut
enteric nervous system: list nerves
- submucosal plexus
- myenteric plexus
enteric nervous system: submucosal plexus
- sensory cells communicate w myenteric plexus
- motor fibres stimulate gland/ mucosal secretion of fluids into lumen
enteric nervous system: myenteric plexus
- neurons which regulate enzyme output of adjacent organs
enteric nervous system: function
regulates:
- motility
- local blood flow
- fluid flow
- control gastic/ pancreatic secretions
- control enteroendocrine secretion
sympathetic stimulation: effects
- decrease motility
- decrease intestinal secretion
- increase sphincter contraction
- increase vessel contraction (vasoconstriction)
parasympathetic stimulation: effects
- increase motility
- increase intestinal secretion
- decrease sphincter contraction
- decrease vessel contraction (vasodilation)
eg. Hirsprung’s disease
- aganglionic colon (lack or loss of ganglia in distal colon)
- less control
transpyloric plan: location
- L1 vertebra, 9th costal cartilages
transpyloric plan: features
- beginning of duodenum
- end of 4th part of duodenum
- hilum of L kidney
- neck of pancreas
- origin of SMA
referred visceral pain: epigastric region
foregut
referred visceral pain: umbilical region
midgut
referred visceral pain: pubic region
hindgut
