Upper Abdomen Anatomy Lecture Powerpoint Flashcards
amber man
Right/left abdominal quadrants from superior to inferior
Hypochondriac
Lumbar
Iliac
Right iliac fossa pain is associated with….
- acute appendicitis
- ruptured ovarian cyst
- ruptured ectopic pregnancy
- PID
Left iliac fossa pain is associated with….
- acute diverticulitis
- ruptured ovarian cyst
- ruptured ectopic pregnency
- PID
Right and left lumbar pain is associated with….
- Renal colic
- Acute pyelnephritis
Hypogastric pain is associated with….
- Acute urinary retention
- Ruptured ectopic
- Ruptured ovarian cyst
Umbilical pain is associated with…
- Acute pancreatitis
- small bowel obstruction
Epigastric pain is associated with….
-Acute peptic ulcer, acute pancreatitis
Left hypochondriac pain is associated with…
- Splenic infarction
- basal pneumonia
Right hypochondriac pain is associated with…
-Acute cholecystitis
Alimentary canal components
Mouth, pharynx, esophagus, stomach, small intestine, large intestine, rectum
Accessory digestive organ components
Teeth, tongue, gallbladder, salivary glands, liver, pancreas
4 general layers of all the GI tract and characteristics of them
1) Mucosa (innermost layer stratified squamous epithelium containing mucosal glands, lamina propria, muscularis mucosae)
2) submucosa (connective tissue housing vascular, lymphatic, and nerve supply)
3) Muscularis externa (inner circular and outer longitudinal layer of smooth muscle with peristaltic like activity)
4) serosa/adventitia (connective tissue, serosa reduces friction as a viceral peritoneum, adventitia anchors organ
Myenteric plexus
Nervous system located in the muscularis externa between layers that receives innervation from autonomic nerve fibers (such as vagus?) to activate contractile/peristaltic activity
Important difference between adventitia and serosa when it comes to pathology
Adventitia anchors one organ to another and thus can spread infection or cancer more easily than a thick serosa which functions to avoid friction
Intraperitoneal organs have serosa or adventitia?
Serosa
Retroperitoneal organs have serosa or adventitia?
Adventitia
Visceral peritoneum
A thick layer of serosa that lines the organs of most digestive organs
Parietal peritoneum
A thick layer of serosa that lines the body cavity wall
Retroperitoneal organs are ____ than intra
Less protected
Mesentary
Double layered peritoneum that attaches the intestine to the posterior abdominal wall and hold them in place like an apron, as well as provides a path for blood vessels and lymphatics and nerves
Retroperitoneal organs and what they have around them
Pancreas, portions of large itnestine, kidneys, do not have mesentary and contain peritoneum on anterior side only (high risk of trauma)
Submucosal plexus
Regulates activity of glands and smooth muscle via autonomic imput to enteric nervous system
Intrinsic tongue muscles
Confined to tongue to allow it to change shape for speech and swallowing
Extrinsic tongue muscles
Extend from bone to allow tongue to protrude, retract, and move side to side
Lingual frenulum
Fold of mucosa that secures tongue to floor of mouth and limits posterior movement
3 phases of swallowing (yes, this is completely diff than HEENT’s philosophy)
1) Buccal phase - ingested into mouth and chewed and moved to back of throat
2) pharyngeal phase - reaches pharynx, pharyngeal constrictors move to esophagus and down
3) Esophageal phase - enters lower esophageal sphincter and goes into stomach
Histology of esophagus
Nonkeratnizied stratified squamous epi
Lower esophageal spinchter
Located at the cardiac oriface of the abdominal cavity where esophagus meets stomach, physiologic spinchter that acts as a valve along with diaphragm to close when food not being swallowed, important in preventing reflux
Areas of the stomach
- cardiac (entrance from esophagus
- fundus (superior rounded portion)
- body (majority
- pyloric (region where exits into duodenum)
Stomach muscularis externa
3 layers, longitudinal, circular, oblique
Rugae
Folds of mucosa and submucosa that the stomach collapses into when empty
Pyloric sphincter
A physiological sphincter between the exit of the stomach and the entrance into the duodenum
General gastric bypass surgery involves….
…removal of most of stomach and duodenum to reroute small portion of stomach straight to jejunum preventing eating too much and absorption
Stomach function
Store swallowed food, mix with digetive juices and break up food for absorption into small intestine, very little actual absorption except for a few drugs such as aspirin
Parietal cells
Secrete HCl and intrinsic factor into stomach
Chief cells
Secrete pepsinogen into stomach
Intrinsic factor
Required for B12 absorption in small intestine, secreted by parietal cells into stomach, without it results in macrocytic anemia
Neuroendocrine/G cells
Secrete gastrin, histamine, and somatostatin into stomach
Histamine function in stomach
Facilitate acid production by parietal cells
Somatostatin function in stomach
Inhibit acid secretion, helpful to increase pH before entrance into duodenum
Gastrin function
Regulate gastric acid and motility of stomach
3 phases of gastric secretion
1) Cephalic - brain receives stimulation to get sttomach ready for food reception
2) gastric - HCl, pepsin, muscularis contractions
3) Intestinal - duodenal enzymes slow emptying of stomach to prevent too much food at once as well as icnrease pH
Arteries of the esophagus (3)
1) Inferior thyroid artery provides upper esophageal spincter
2) thoracic aorta and bronchial arteries supply thoracic esophagus
3) left gastric artery and left splenic artery supply lower esophageal spincter
We rarely see infarction of esophagus. Why?
Recurrent blood supply from multiple branches throughout the body
Veins of the esophagus (3)
1) upper 1/3 by inferior thyroid vein
2) middle 1/3 by azygous vein
3) gastric veins into portal system (THIS IS KEY, conection between portal and systemic venous system, can see varices)
Caput medusa
The appearance of several distended abdominal veins typically from portal hypertension and accumulation of peritoneal fluid characteristic of end stage cirrhosis
