Unit 4: The Abdomen and Pelvis Flashcards
what composes the liver and the hepatic portal system?
- liver (right, left, caudate, quadrate lobes)
- falciform ligament
- common hepatic artery
- hepatic vein
- portal vein
- right and left hepatic ducts
- cystic duct
- common bile duct
- gall bladder
what does the celiac trunk branch into?
- common hepatic artery
- splenic artery
- left gastric artery
what does the right gastric artery branch off of?
common hepatic artery
what does the common hepatic artery supply and what vertebral level does it originate?
- supplies the liver
- T12
what vertebral body does the celiac trunk originate at and supply?
- T12
- supplies foregut
what do the hepatic veins drain and at what vertebral level do they drain into the IVC?
- drain blood from liver
- drain into IVC at T8 (at IVC hiatus)
what is the function of the portal vein?
delivers oxygen-poor nutrient-rich blood to the liver
what veins does the portal vein collect blood from?
- superior mesenteric vein
- inferior mesenteric vein
- splenic vein
- gastric veins
- cystic vein (from gall bladder and cystic duct)
what are the functions of the right and left hepatic ducts?
carry bile from right and left lobes of liver; drain into common hepatic duct
what is the function of the cystic duct?
carries bile from gall bladder; joins with common hepatic duct to form common bile duct
what is the function of the common bile duct?
passage for bile into the hepatopancreatic ampulla
where is the gall bladder and what is its function?
- sits on inferior surface of right lobe of liver
- stores bile
what are the lobes of the liver?
- right lobe (larger than left)
- left lobe
- caudate lobe (superior)
- quadrate lobe (inferior)
what is the function of the falciform ligament?
separates right and left lobes of liver
where is the head of the pancreas?
- encircled by C-shaped duodenum
what is the hepatopancreatic ampulla and where does it travel?
- combination of common bile duct and pancreatic duct
- exits the head of the pancreas through the major duodenal papilla (sphincter of Oddi)
where is the tail of the pancreas?
- neighbours splenic hilum and left colic (splenic) flexure
- passes transversely anterior to the aorta and L2 vertebral body
- anterior surface covered in peritoneum
what is the pancreatic duct?
originates in the tail of the pancreas; joins common bile duct to form hepatopancreatic ampulla
where is the splenic artery and what does it supply?
- branches off celiac trunk @ T12
- squiggly, travels superior to pancreas
- supplies spleen, pancreas, and little stomach
what is the cardiac orifice?
distal opening of the esophagus
what is the cardia?
most proximal region of the stomach
what is the fundus of the stomach and how does it appear on CT?
superior portion of stomach; appears hypodense on CT because usually empty (air-filled)
what is the pylorus?
most distal part of the stomach; where chyme lies before dumped into duodenum
what is the function of the pyloric valve (and pyloric sphincter)?
prevents backflow from duodenum into stomach
what is the lesser curvature of the stomach?
superior, short, concave border of stomach; attachment for lesser omentum
what is the greater curvature of the stomach?
inferior, long, convex border of the stomach; attachment for greater omentum
what is the duodenum?
most proximal division of the small intestine; ends at duodenojejunal flexure
what is the jejunum?
second part of the small intestine, begins at duodenojejunal flexure
what is the ileum?
last part of the small intestine, terminates at the ileocecal junction
what is the mesentary and where is it?
- continuation of visceral and parietal peritoneum
- tethers organs (stomach, SI, pancreas, spleen) to posterior abdominal wall
- lies deep to greater omentum
what is the cecum?
proximal portion of the large intestine, continuous with the ascending colon
- connected to ileum by ileocecal valve
what is the appendix?
distal to the cecum, filled with lymphoid tissue (possible role in bacteria growth and development for gut microbiome)
- pouch
how does the colon travel?
- ascending colon on right side, turns into transverse colon and reflects left at right colic (hepatic) flexure, which is just inferior to the liver
- transverse colon runs from right colic flexure to left colic (splenic flexure) which is near the spleen
- descending colon on left side and turns into sigmoid colon at sigmoid flexure (at left iliac crest) to S3
- becomes rectum and then anus
what vertebral level is the rectum at?
S3
what are tenia coli?
thin ribbon of longitudinal muscle along large intestine
what does the superior mesenteric artery supply and at what vertebral level does it branch off the aorta?
- supplies duodenum to proximal 2/3s of transverse colon + pancreas; midgut
- L1
what does the inferior mesenteric artery supply and what vertebral level does it branch off the aorta?
- supplies distal 1/3 of transverse colon to rectum; hindgut
- L3
what are the suprarenal (adrenal) glands?
- sit on top of each kidney
- divided into cortex and medulla
what is the function of the suprarenal (adrenal) cortex?
secretes corticosteroids and androgens into the bloodstream
what is the function of the suprarenal (adrenal) medulla?
comprised of nervous tissue; functions like sympathetic ganglion (products epinephrine)
what level do the renal arteries branch off the abdominal aorta?
L2
what is the renal hilum?
medial aspect of the kidneys where the renal arteries, veins, nerves, and ureters enter
what is the function of the ureters?
carry urine to the urinary bladder from the renal pelvis
- travels in the retroperitoneal cavity
what is the function of the renal cortex?
contains majority of the nephron (primary site of filtration)
- outer portion of kidney
what is the function of the renal medulla?
contains the renal pyramids
what is the function of the renal capsule?
encloses the kidney
what are the renal columns?
space between pyramids
what are the renal pyramids?
within the medulla, triangular structures
what are the renal papillae?
apex of renal pyramids
- open to expel filtrate into the centre of the kidney
what are the minor renal calyces?
what renal papillae open into and are surrounded by
- merge to form the major renal calyx
how does urine travel after the minor renal calyces?
- major renal calyx
- renal pelvis
- ureter
what is the renal corpuscle?
where blood is filtered and filtrate enters the nephron
- made of the glomerulus (capillaries) and Bowman’s capsule
what is the function of the proximal convoluted tubule?
responsible for reabsorption and secretion of solutes and water
what is the function of the distal convoluted tubule?
regulates ECF and electrolyte homeostasis
what are the collecting tubules?
last part of nephron where filtrate becomes urine
what are the muscles of the abdominal wall?
- external obliques
- internal obliques
- transverse abdominus
- rectus abdominus
- quadratus lumborum
what are the OIAs of the external obliques?
O: ribs 5-12
I: iliac crest, inguinal ligament, linea alba, pubic tubercle
A: bilaterally - anterior flexion of the trunk and compression of the abdomen
unilaterally - lateral flexion of the trunk and rotation to the opposite side
what are the OIAs of the internal obliques?
O: iliac crest, inguinal ligament, thoracolumbar fascia
I: ribs 10-12, pectineal line, linea alba/abdominal aponeurosis
A: bilaterally - anterior flexion of the trunk and compression of the abdomen
unilaterally - lateral flexion of the trunk and rotation to the same side
what are the OIAs of transverse abdominus (corset muscle)?
O: iliac crest, thoracolumbar fascia, costal cartilages of ribs 7-12
I: abdominal aponeurosis
A: compression
what are the OIAs of rectus abdominus?
O: pubic crest and symphysis
I: costal cartilages 5-7, xiphoid process
A: flexion of the trunk
what are the OIAs of quadratus lumborum?
O: iliac crest
I: transverse processes of L1-L5, rib 12
A: extension of the trunk + lateral flexion, stability
what are the os coxae and how are they connected?
hip bones
- connected anteriorly by the pubic symphysis
- connected posteriorly by the sacrum
what bones compose the bony pelvis?
- sacrum
- coccyx
- bilateral os coxae
what are the landmarks of the ilium?
- iliac crest
- posterior superior iliac spine
- posterior inferior iliac spine
- anterior superior iliac spine
- anterior inferior iliac spine
- iliac fossa
- acetabulum
- acetabular notch
- greater sciatic notch
what is the function of the iliac crest?
attachment for internal oblique, transverse abdominus and external oblique (+ lat dorsi)
what landmark is colloquially known as the hip?
anterior superior iliac spine
what is the acetabulum?
cup-like fossa formed by all 3 os coxae bones; articulates with femur to form hip joint
what is the acetabular notch?
discontinuation of labrum and lunate surface of acetabulum (incomplete part of circle)
what is the greater sciatic notch?
between PIIS and ischium; forms the greater sciatic foramen
what are the landmarks of the ischium?
- ischial tuberosity
- body of ischium
- ramus of ischium
- obturator foramen
what bone of the os coxae bears weight while sitting?
ischium
what is the ischial tuberosity known as?
sit bones