11-5 Abdomen I

Question 1

List the 6 layers of the ANTERIOR Abdominal Wall

[Outside——>in]

Answer 1

1. SKIN
2. Superficial Fascia [ Superficial Camper’s vs. Deep Scarpa’s]
3. Muscles [ 2 groups of (3 m.) ]
4. Transversalis fascia
5. Xtraperitoneal connective tissue
6. Peritoneum

Question 2

A: Describe the 2 layers of Abdominal Wall FASCIA

B: Where are these layers found in regards to the umbilicus?

Answer 2

1. [Superficial Camper’s Fascia]= FATTY & eventually turns into [SubQ Dartos Scrotum muscle] below
   vs.
2. ## [DEEP Scarpa’s Fascia] = membranous fascia continuous with [Colles’ Perineum Fascia]B: THESE 2 FASCIA LAYERS are found BELOW UMBILICUS! (above umbilicus = fat)

Question 3

A: There are 2 groups of( __ muscles each) in the Abdominal Wall Muscle Region . List the Groups & muscles in each

B: What is the Order of muscles from Flank to organs

Answer 3

A: Abdominal Wall = 2 groups of (3 MUSCLES EACH)

º 3 Anterolateral m. = (EXTernal Oblique / internal Oblique / Transversus abdominis)

B: EXTernal Oblique—->internal Oblique–>[Transversus abdominis]—>Transversalis Fascia

Question 4

• *EXTernal Oblique m.**
  1. Origin

2. Insertion [3]
3. Innervation
4. Main Actions [2]

Answer 4

• *EXTernal Oblique m.**
  1. O: Ribs 5-12

2. i:< Linea alba + ANT iliac crest + pubic tubercle >
3. [6 inferior Thoracic n. Ventral rami]
4. Compresses & supports abdomen / Flexes & rotates trunk

Question 5

• *internal Oblique m.**
  1. Origin [2]

2. Insertion [2]
3. Innervation [2]
4. Main Actions [2]

Answer 5

• *internal Oblique m.**
  1. O: [ iliac crest + inguinal ligament]

2. i: [Ribs + Linea alba ]
3. 1st lumbar n. & [6 inferior Thoracic n. Ventral rami]
4. Compresses abdomen / Flexes & rotates trunk

Question 6

• *Pyramidalis m.**
  1. Origin [2]

2. Insertion
3. Innervation
4. Main Actions

Answer 6

• *Pyramidalis m.**
  1. O: [ Rectus abdominis m. + Pubis ]

2. i: Linea alba
3. iLiohypogastric nerve
4. Tenses Linea alba

Question 7

• *Rectus abdominis m.**
  1. Origin [2]

2. Insertion
3. Innervation
4. Main Actions [2]

Answer 7

• *Rectus abdominis m.**
  1. O: pubic crest + Pubic symphysis

2. i: [Xiphoid process + costal cartilages 5-7 ]
3. [6 inferior Thoracic n. Ventral rami]
4. Flexes trunk + Compresses abdominal viscera

Question 8

• *Transversus abdominis m.**
  1. Origin [4]

2. Insertion [3]
3. Innervation
4. Main Actions

Answer 8

• *Transversus abdominis m.**
  1. O: [costal cartilages 7-12] + [iliac crest] + [inguinal ligament] + [thoracolumbar fascia]

2. i: Linea alba + pecten pubis + pubic crest
3. [6 inferior Thoracic n. Ventral rami]
4. Compresses & supports abdomen

Question 9

A: Cremaster muscle [4]

B: How is this muscle related to the Spermatic cord?

Answer 9

• Made from lower fibers of INTERNAL OBLIQUE m.
• innervated by [Genitofemoral n.>genital branch]
• Inserts @ Pubic Tubercle
• functions to suspend testes & is important in CREMASTERIC REFLEX

B: Cremaster m. fibers descend on Spermatic cord and forms loops around it!

Question 10

1) What is the Rectus Sheath
2) What 3 groups are found in it?

3) In regards to WALLS of the Sheath: [Front vs. back]
A: What things are found ABOVE arcuate line?
B: What things are found beloww arcuate line?

Answer 10

1) Aponeurotic sheath formed from combined aponeuroses from [EXTernal oblique], internal oblique & [Transverse abd m.]

2)
A: 2 muscles= [Rectus abdominis / Pyramidalis]

B: 2 vessels= [SUP/inf epigastric vessels]

3)
Above Arcuate:
ºFront=Aponeuroses of EXT/internal Oblique m.
ºBack = Aponeuroses of internal Oblique m. & transverse abdominis m.

below arcuate:
ºfront= Aponueroses of EXT/internal Oblique m. AND transverse abdominis m.

ºback = Rectus abdominis contacting [transversalis fascia]

Question 11

Rectus abdominis m. are related to 3 lines. Name and Describe them

Answer 11

1. Linea Alba = tendon raphe between 2 rectus abdominis m. formed by fused aponeuroses from EXT oblique , internal oblique & transverse abd m.
   - Extends from Xiphoid process to pubic symphysis
2. Linea Semilunaris= curved line along lateral rectus abdominis
3. Arcuate Line = Crescent-shaped line marking the bottom ending limit of POST layer rectus sheath course—>ALL RECTUS SHEATH START RUNNING ANTERIOR TO RECTUS ABDOMINIS (vs. being split) AND [inf. epigastric a.] ascends & enters sheath

Question 12

A: What are the 3 Key things to remember regarding Embryological Testis Descent

B: What other major pelvic events are occurring at this time?

Answer 12

A: 1. By 26 weeks testes have descended retroperitoneally (eXTernal to peritoneum) from SUP lumbar region

2. Extends from SUP lumbar region–>POST abd wall
   - —>deep inguinal rings
3. it drags its vessels & nerves from POST abd wall
   ———– —————- —————— ————- ————– ——–
   B: at same time..fetal pelvis enlarges & body/trunk of embryo elongates

Question 13

B: B: Processus vaginalis
————————————————————————————
C: How are these 2 related?

Answer 13

B: Pv= diverticulum/out pouch of peritoneum that develops IN FRONT of the gubernaculum
————————————————————————————
C: GT forms path thru ANT abd wall so Pv can follow during inguinal canal formation —> it Guides Testicle decent and Anchors Testicle to scrotum

Question 14

A: When the testis and ____ ____ descend, they are ensheathed by ___ ____ of the abd wall.

B: Describe these 3 abd wall sheaths

Answer 14

A: When the testis and DUCTUS DEFERENS descend, they are ensheathed by FASCIAL EXTENSIONS of the abd wall.

B:

1. transversalis fascia —becomes—->[ internal spermatic fascia]
2. internal oblique m.—->cremasteric muscle
3. EXTernal oblique aponeurosis—-> [EXTernal spermatic fascia]

Question 15

Embryologically, how does the [tunica vaginalis] form? [2]

Answer 15

1st: Testes in scrotum projects into distal end of [processus vaginalis] 1st….
2nd: Then, in PERINATAL PERIOD, the connecting stalk between processus normally obliterates—–> leaves remaining white serous membrane[tunica vaginalis] that covers front & sides of testes

Question 16

1) Inguinal Canal [4]

2) how is this related to pathway of descent of testes?

Answer 16

1)
ºOblique passage right above inguinal ligament
º4 cm long & directed downward, forward & medially (Like EXTernal oblique)
ºLarger in Males
ºStarts at [Deep inguinal ring] & ENDS at [Superficial inguinal ring]

2) inside[Deep]—>Out/superficial = pathway of descent of testes

Question 17

Boundaries of inguinal canal

1: ANTERIOR [2]
2: POSTERIOR [2]
3: Roof [2]
4: FLoor

Answer 17

• inguinal canal*
  1: ANT=EXT oblique aponeurosis & internal oblique

2: POST= Transversalis fascia & Conjoint tendon
3: Roof= [low arched fibers of internal oblique] & [ HIGH ARCHED Transversus abdominis]
4: FLoor= Inguinal Ligament

Question 18

Describe these Inguinal Canal structures
A: Transversalis Fascia [3]

B: Deep Inguinal Ring

Answer 18

A: TF= ºHas deep inguinal ring & lines [transversus abdominis m.] inner surface
ºforms POST canal wall
ºrepresented in scrotum as [internal spermatic fascia]
————————————————————————————
Deep inguinal Ring
B: 1. oval opening in [transversalis fascia] that laterally shares inguinal triangle space with [inf epigastric vessels]

2. Male Spermatic cord (female uterine round ligament)
   , [Genitofemoral n.>genital branch] & Cremastric m. pass thru

Question 19

1) Where is the [_____ Inguinal Triangle]/what are its boundaries?
A: Medially
B: Laterally
C: Inferiorly

2) What is the clinical significance of this area?

Answer 19

1) [Hesselbach’s Inguinal Triangle]
A: MEDIAL= linea semilunaris (lateral Rectus abdominis m.)
B: LATERALLY=lateral umbilical fold (formed by inf epigastric vessels)
C: INFERIORLY= Inguinal Ligament

2) MOST COMMON SITE FOR DIRECT INGUINAL HERNIA = area of potential weakness

Question 20

A: MOST [Transversus Abdominis m.] fibers run TRANSVERSE except for which fibers?

B: What is the Conjoint Tendon? What does this tendon do once its formed?

C: Why are [Transversus Abdominis m.] fibers NOT found in the scrotum?

Answer 20

A: MOST [Transversus Abdominis m.] (TA) fibers run Transverse EXCEPT FIBERS ORGINATING FROM INGUINAL LIGAMENT= High Arching Fibers

B: ºconjoint tendon= fusion tendon made of [TA inguinal ligament High Arching Fibers ] & [internal oblique inguinal ligament low arching fibers]
ºBy descending behind it Conjoint Tendon SUPPORTS superficial inguinal ring so it itself can b attached to pubic crest & pectineal line

C: becuz it also has fibers originating from Inguinal Ligament (which are High Arching vs. transverse) = not represented in Scrotum

Question 21

“Raise your hands to the sky”
A: MOST [Internal Oblique m.] fibers run ______, forward & medially except for which fibers?

B: How is the [Internal Oblique m.] related to the Male Spermatic Cord or female round ligament ?

C: Is this muscle represented in the Scrotum?

Answer 21

A: MOST [Internal Oblique m.] fibers run UPWARD, forward & medially EXCEPT FIBERS ORGINATING FROM INGUINAL LIGAMENT= loww arching fibers

B: [internal oblique inguinal ligament-low arching fibers] has a TRIPLE RELATION (ANT vs. above vs. POST) to MSC & FrL

C: YES, [Internal Oblique m.] is inside scrotum as CREMASTER MUSCLE

Question 22

“put your hand in ur pocket”

A: [EXTernal Oblique m.] fibers contain which important structure & and which direction do they run? [3]

B: Is this muscle represented in the Scrotum?

C: [EXTernal Oblique m.] forms the ___[ANT/POST] wall of Inguinal canal. What forms the roof of the Inguinal Canal?

Answer 22

A: [EXTernal Oblique m.] =
ºcontains SUPERFICIAL INGUINAL RING
ºruns DOWNWARD, forward & medially

B: YES, represented in Scrotum as [EXTernal spermatic Fascia]

C: [EXTernal Oblique m.] forms ANT wall of Inguinal Canal …while the combo[ Transversus abdominis + Internal Oblique] forms the Roof

Question 23

Inguinal ligament

Answer 23

ºinf. border of [EXTernal Oblique m.] AND [Hesselbach’s Inguinal Triangle space]

ºForms Floor of Inguinal CANAL

ºGives origin to “Arched Fibers” of [Transversus Abdominis] and [internal oblique m.]

ºgives off [LACUNAR LIGAMENT]= triangular posterior extension from medial end of Inguinal ligament

Question 24

• Superficial inguinal ring*
  1. Location

2. What structure Supports this ring
3. What important structure passes THRU this ring
4. Explain the route pathway of the [ iLioinguinal nerve] thru the Superficial inguinal ring [4]

Answer 24

• Superficial inguinal ring*
  1. Triangular opening INSIDE [EXTernal oblique m.] aponeurosis superolateral to pubic crest. Sides are medial & lateral crura

2. Supported Posteriorly by Conjoint Tendon
3. Spermatic Cord in males (round ligament of uterus in females) & iLioinguinal n. passes thru
4. iLioinguinal n. pierces [Transversus abdominis]—>runs between it and [internal oblique]—>then pierces lower [internal oblique] –>to enter inguinal canal and EXit out of Superficial inguinal ring

Question 25

A: SPERMATIC CORD B: What are its 3 coverings C: What are the 3 Arteries D: What are the 3 Veins E: What are the 3 Nerves

Answer 25

A: group of smaller cords tht meet at deep inguinal ring & transverses down the inguinal canal to POST border of testis at Scrotum B: 1-External spermatic fascia(from EXTernal oblique m.) 2-[Cremaster m. & fascia] (from internal oblique) 3-Internal Spermatic fascia (transversalis fascia) C: 1- Testicular / Cremastric / Vas Artery D: Vas Deferens / [pampiniform Venous plexus] / [Vestige of processus Vaginalis] E: [Genitofemoral n.>genital branch], [sympathetic plexus around testicular a. ] , [sympathetic plexus around a. of vas]

Question 26

A: What is an Inguinal Hernia ? B: What are the 2 different types?

Answer 26

A: ºProtrusion of abdominal contents (usually intestine) into peritoneum sac into inguinal region ºMore common in Males due to larger canal ---------------------------------------------------------------------------------- B: Indirect (passess thru deep ring, inguinal canal & superficial ring) AND MORE COMMON vs. Direct = occurs thru weakened abdominal wall muscles DIRECTLY into POST wall of inguinal canal/inguinal triangle

Question 27

Describe InDirect inguinal Hernia [4]

Answer 27

- Passes thru deep ring, inguinal canal & superficial ring - MORE COMMON and early age onset - Is CONGENITAL & associated w/persistence of processus vaginalis - DESCENDS into Scrotum/labium majus & lies lateral to [inf epigastric a.]

Question 28

Describe DIRECT inguinal Hernia

Answer 28

* occurs thru weakened abdominal wall muscles DIRECTLY thru POST wall of inguinal canal...thru inguinal triangle * not common for it to reach scrotum * ACQUIRED hernia & Medial to [inf epigastric a.]

Question 29

A: There are __ Umbilical fold made in the suprapubic region that are literally just raises of the _____ _____. B: Describe these Suprapubic Fold

Answer 29

A: There are 5 Umbilical Folds made in the suprapubic region that are literally just raises of the PARIETAL PERITONEUM 1 median umbilical fold = raised by [fibrosed Urachus ligament] ---> (median umbilical ligament) 2 MEDIAL umbilical folds = raised by [obliterated umbilical a.]--->(MEDIAL umbilical ligament) 2 Lateral umbilical ligaments = raised by [inf. epigastric a.] on its way to rectus sheath

Question 30

The Peritoneum is a ___membrane with 2 layers (____ & ______). Between these layers is the peritoneal cavity which is filled with ____ ____ and functions to________ B: The Peritoneal cavity is subdivided into 2 different Sacs. Describe these Sacs [1] vs. [3] C: How do these 2 Sacs communicate with each other?

Answer 30

The Peritoneum is a SEROUS membrane with 2 diff layers (PARIETAL vs. VISCERAL). Between these layers is a peritoneal cavity filled with SEROUS FLUID & functions to ALLOW VISCERA TO MOVE ---------------------------------------------------------------------------- B: Greater Sac= MOST of space inside peritoneal cavity. As you open cadaver peritoneum = Greater sac vs. [Lesser Omental bursa Sac] = ºsmall space BEHIND lesser omentum & stomach but INSIDE Greater Omentum. ºcontinuous to greater omentum via [Omental Epiploic foramen] ºEmbryologically Formed because stomach rotation & liver growth ---------------------------------------------------------------------------- C: 2 sacs communicate via [Epiploic Foramen of Winslow's]

Question 31

Describe the Parietal Layer [2] vs. visceral layer of the Peritoneum

Answer 31

**PERITONEUM** ºParietal Layer = 1. lines ANT / POST / lateral abdominal walls 2. inf. surface of Diaphragm & pelvic cavity vs. 2) visceral layer= leaves body wall to SURROUND abd viscera

Question 32

A: The ____ ____is hung by the Dorsal Mesentery(Double layer Peritoneum) from the ____ ____ _____ B: Where is the Ventral Mesentery found and what happens to it during development? C: What forms the small intestine and part Large Intestine? D: In Males the Peritoneal Cavity is _____[Open/closed] while in females the Peritoneal Cavity ____________

Answer 32

A: The GUT TUBE is hung by Dorsal Mesentery(Double layer Peritoneum) from POST ABD WALL B: Ventral Mesentery is found ONLY ABOVE UMBILICUS and is divided by Liver into lesser omentum & falciform ligament during development C: MID-GUT LOOP rotates to form small intestine and part Large Intestine D: In Males Peritoneal Cavity is CLOSED, while in females Peritoneal Cavity OPENS UP INTO FALLOPIAN TUBES

Question 33

A: The Peritoneum exits POST abd wall in the form of 4 ______ ____ . B: Name These 4 structures and their corresponding GI parts C: Describe these folds

Answer 33

A: The Peritoneum exits POST abd wall in the form of 4 PERITONEAL FOLDS ---------------------------------------------------------------------------- B: 1) Greatr/lesser omentum = Stomach 2) Mesentery = Small intestine 3) Meso-colon = Mesoappendix / Transverse & Sigmoid Mesocolon 4) Falciform Ligament {used to be Ventral Mesentery} = Liver or Spleen - --------------------------------------------------------------------------- C: 1: Greatr/lesser omentum-->Double layer peritoneum passing from Stomach & 1st part Duodenum TO adjacent organs 2: Mesentery-->Double layer peritoneum which results from invagination by intestine 4: Ligament--->Double layer peritoneum connecting [organ TO organ] or [organ TO ANT abd wall] {ex.Falciform}

Question 34

A: What are the organs that develop ON Posterior Abd Wall and BEHIND Visceral peritoneum? B: What is a common name for this Muscle Group?

Answer 34

A: S A D P U C K E R 1. Suprarenal "adrenal" glands 2. Aorta 3. Duodenum < 2nd/3rd parts > 4. Pancreas 5. Ureter 6. Colon & Cecum 7. Kidneys 8. Esophagus 9. Rectum B: ^ ^ ^ RETROPERITONEAL MUSCLES ^ ^ ^

Question 35

A: NERVE supply for Parietal peritoneum. List an example ------------------------------------------------------------------------------- B: NERVE supply for Visceral peritoneum B2: State the 2 exceptions for Visceral peritoneum innervation

Answer 35

A: Parietal= SOMATIC nerves of overlying muscles/skin Ex: [Diaphragmatic Parietal peritoneum] by phrenic N. ---------------------------------------------------------------------------- B: Visceral= AUTONOMIC n. with underlying viscera 1. Visceral peritoneum doesn't have somatic innervation = Visceral doesn't interpret pain! 2. Visceral peritoneum DOES receive AUTONOMIC Sympathetic innervation = sensitive to stretch/tension/ischemia

Question 36

A- The GUT TUBE is divided into __ parts with all Different Blood Supply. List Blood supply for each part B-Describe these Arteries as a group [2] C-List the FIRST Organ you should see at the beginning of each GUT TUBE part "AKA the Boundaries"

Answer 36

A-GUT TUBE is divided into 3 parts with all Different Blood Supply. 1. Foregut alternative routes for arterial supply ------------------------------------------------------------------------------- C- 1. Foregut = Liver & stomach 2. Midgut = 2nd half of Duodenum 3. Hindgut = L end 1/3 of Transverse Colon

Question 37

A: What Organs are found in the Hindgut? [4] B: What Artery are they supplied by and what is its daughter arteries? [3]

Answer 37

1. L 1/3 Transverse Colon 2. Descending Coon 3. Sigmoid colon 4. Rectum B: < inf mesenteric a. L3 > ºL colic ºSigmoid branches ºSUPErior rectal

Question 38

A: What Organs are found in the FOREgut? [6] B: What Artery are they supplied by and what is its daughter arteries? [3] --------------------------------------------------------------------------------- C: What are the daughter arteries of the SUPerior mesenteric a.? [3] and What does this a. supply?

Answer 38

1. Stomach 2. Liver 3. Gallbladder 4. Pancreas 5. Spleen 6. 1st half duodenum B: ºSplenic ºL gastric ºCommon hepatic --------------------------------------------------------------------------------- C: SUPerior mesenteric a. --> iLeocolic / R & middle colic = supplies MiDgut

Question 39

The STOMACH has __borders, ___sacs, __ surfaces and ____ends. Describe it's composition [4] 2) Describe the Stomach mucosa and list its blood supply 3) The stomach bed is separated from structures behind stomach by ____ ____. What are these structures? [9]

Answer 39

STOMACH has 2 borders [with 2 Omenta], 2 sacs, 2 surfaces and 2 ends (Cardiac vs. pyloric) . ºComposed of Cardia / Fundus / Body / Pylorus(antrum, canal, sphincter) --------------------------------------------------------------------------------- 2) Stomach mucosa is thrown into [rugae folds] -->dilation freedom --------------------------------------------------------------------------------- 3) Stomach bed separated from POST structures by LESSER SAC. POST stomach structures include..... *Spleen * = L kidney/L suprarenal/L colic flexure/[L diaphragm crus] * = T colon/T mesocolon/ [pancreas body] /splenic a.

Question 40

1. The _____ _______ is continuous with the Lesser omentum. 2. Describe the Lesser omentum [3] 3. What 3 structures are found in Free border of Lesser omentum?

Answer 40

1. VENTRAL MESENTERY is continuous with Lesser Omentum 2.Lesser Omentum: ºDouble layer peritoneum extending from [Liver porta hepatis] ---> lesser curvature of stomach & 1st part duodenum ºConsist of Hepatogastric & Hepatoduodenal ligaments ºFormed from 2 R layers of VENTRAL MESENTERY becoming continuous in R free margin (epiploic foramen still present) 3. * bile duct * hepatic artery * portal vein

Question 41

A. The _____ _______ is continuous with the GREATER Omentum. B. Describe the GREATER Omentum C. What 4 structures does it consist of? D. What is special about this GREATER Omentum?

Answer 41

A: DORSAL MESENTERY is continuous with Greater Omentum B: GREATER Omentum: ºDouble layer peritoneum hanging down from Greater curvature of stomach---->covers transverse colon & other abd viscera C: * Gastrosplenic * Gastrophrenic * Gastrocolic * [lienorenal/splenorenal] D: ACTS AS ABDOMINAL POLICEMAN = sequesters dz

Question 42

*LIVER* = ____ gland in human body 1: What is the liver derived from? 2: Name its blood supply 3: Explain the peritoneum coverage for the liver 4: The Liver has __ peritoneal folds, ___ surfaces and __ fissures 5. Describe the __ Peritoneal ligament folds 6: List the ___ Liver surfaces

Answer 42

* LIVER* = LARGEST gLand in humans 1. liver derived from FOREgut 2. [Celiac Trunk a. T12 >hepatic] 3. MOST of liver is covered by peritoneum EXCEPT "bare area" which lies between upper & lower coronary ligaments 4. Liver has 5 PERITONEAL FOLDS, 5 Surfaces & 5 Fissures{H-shaped} --------------------------------------------------------------------------------- 5.PERITONEAL FOLDS= º4 FOLDS attached to diaphragm & abd wall by (Coronary / Falciform / R&L triangular LIGAMENTS) º1 FOLD attached to Stomach by lesser omentum --------------------------------------------------------------------------------- 6. 5 Liver Surfaces = (ANT / POST / R / SUP/ [inf-visceral] )

Question 43

A: LIVER has ___ Fissures that are __-Shaped. Name each Fissure & what each transmit B: What is the Portal triad and how is it related to these fissures?

Answer 43

Liver has 5 FISSURES that are H-SHAPED combined 1. Porta Hepatis = horizontally found between [inf quadrate lobe] and [SUP CAUDATE LOBE] = transmits Portal Triad 2. Ligamentum venosum= transmits ductus venosus 3. Round Ligamentum teres = transmits obliterated umbilical vein 4. Gall bladder Fossa= transmits Gallbladder 5. IVC Fissure= inf Vena Cava --------------------------------------------------------------------------------- B: Portal Triad= 3 vessels arrnged FRONT to back as: < DAV > tht transmit [Porta Hepatis Fissure] & Perfuse Liver ``` D= hepatic DUCT {in FRONT} A= hepatic ARTERY V= portal VEIN ```

Question 44

1: What are the 4 Lobes of the Liver --------------------------------------------------------------------------------- 2A: What 3 structures divide Liver into R & L ANATOMICAL lobes? 2B: Anatomically The [inf quadrate lobe] & [SUP CAUDATE LOBE] are housed on which side? --------------------------------------------------------------------------------- 3A: What 2 structure divide Liver into R & L FUNCTIONAL lobes? 3B: Functionally The [inf quadrate lobe] & [SUP CAUDATE LOBE] are housed on which side? Why is this?

Answer 44

1: ( R / L / [SUP CAUDATE] / [inf quadrate] ) --------------------------------------------------------------------------------- 2A: {Falciform ligament / Round Ligamentum teres / Ligamentum venosum} 2B: Anatomically: [inf quadrate lobe]&[SUP CAUDATE LOBE]--->are on right side! --------------------------------------------------------------------------------- 3A: {Gallbladder Fossa / IVC Fissure} 3B: FUNCTIONALLY: [inf quadrate lobe]&[SUP CAUDATE LOBE]--->are on L SIDE because this is side they're PERFUSED ON

Question 45

A: Describe the Venous pathway from the Liver to Heart [4] --------------------------------------------------------------------------------- B: Physiologically Describe [% Blood] vs. [% Oxygen demand] housed in the hepatic ARTERY vs. portal VEIN

Answer 45

A: blood sinusoids-->Central veins------>HEPatic Veins----->IVC --------------------------------------------------------------------------------- B: *hepatic ARTERY= 25%Blood + 50% Oxygen Demand **portal VEIN= 75%Blood + 50% Oxygen Demand

Question 46

1) Explain the Order of Path for the Biliary "___" System starting with the Liver [6] 2) Where is the Sphincter of Oddi and what is its job?

Answer 46

1: [R / L hepatic ducts]-->Common Hepatic Duct----(cystic duct interjects)---->CBD Common bile duct----(main pancreatic duct interjects)----->[Ampulla of Vater] opens on major duodenal papillae -2nd part duodenum 2: circular m. surrounding lower bile duct, pancreatic duct & [Ampulla of Vater] = controls bile flow & pancreatic secretions

Question 47

The Gallbladder is a ___shaped sac with 3 parts [__ vs. ___vs. ____] Describe these 3 parts

Answer 47

Gallbladder = PEAR SHAPED SAC w/3 parts 1. FUNDUS = lies at meeting point between Semilunaris & [9th R costal cartilage] = MAX site of tenderness during acute cholecystitis 2. BODY= lies in Gallbladder Fossa on inf Liver surface 3. NECK= Houses [Hartmann's Pouch] on its posteromedial wall--->common site for Gallbladder STONES

Question 48

The Celiac Trunk a. is a short artery that stems from ____ _____ at ___ vertebrae. Celiac Trunk perfuses the _____. It has 3 Daughter Arteries [L gastric / Splenic /Common Hepatic] Describe the L gastric a. daughter [3]

Answer 48

Celiac Trunk a. is a short artery stemming from ABDOMINAL AORTA at T12 vertebrae. Celiac Trunk perfuses the FOREGUT. Has 3 Daughter Arteries [L gastric / Splenic / Common Hepatic] L Gastric: 1. Points UPWARD & slides into lesser omentum 2. Branches to (Esophagus + Stomach) 3. Ends by anastomosing with R GASTRIC a. at lesser curvature of stomach

Question 49

The Celiac Trunk a. is a short artery that stems from ____ _____ at ___ vertebrae. Celiac Trunk perfuses the _____. It has 3 Daughter Arteries [L gastric / Splenic /Common Hepatic] B: Describe the Splenic a. daughter[4] C: Describe this arteries Branches to Stomach

Answer 49

Celiac Trunk a. is a short artery stemming from ABDOMINAL AORTA at T12 vertebrae. Celiac Trunk perfuses the FOREGUT. Has 3 Daughter Arteries [L gastric / Splenic / Common Hepatic] --------------------------------------------------------------------------------- Splenic Tortuous a. : 1. Points TO LEFT & is VERRRY TORTUOUS/SQUIGGLY 2. Branches to (Stomach + spleen + pancreas) 3. Runs along SUP pancreas border & ENDS in [lienorenal ligament] by giving spleen 5-6 terminal branch 4. Has [L gastroepiploic a.] that ends by anastomosing with [R gastroepiploic a.] at Greater Curvature of stomach --------------------------------------------------------------------------------- C: branches to stomach--->short gastric a. and [L gastroepiploic a.] = BOTH run in [gastrosplenic ligament]

Question 50

The Celiac Trunk a. is a short artery that stems from ____ _____ at ___ vertebrae. Celiac Trunk perfuses the _____. It has 3 Daughter Arteries [L gastric / Splenic /Common Hepatic] B: Describe the Common Hepatic a. daughter [2] C: This Artery FIRST gives off the _____ granddaughter a.(which has which 2 products of its own?) Common Hepatic then creates _____ _____ and then [R/L Hepatic A. (which goes to ____organ) D: What PARENT artery does the R Gastric a. come from E: Supraduodenal artery

Answer 50

Celiac Trunk a. is a short artery stemming from ABDOMINAL AORTA at T12 vertebrae. Celiac Trunk perfuses the FOREGUT. Has 3 Daughter Arteries [L gastric / Splenic / Common Hepatic] --------------------------------------------------------------------------------- B: Common Hepatic a. 1. Points TO RIGHT 2. Branches to (Stomach + duodenum + Liver) --------------------------------------------------------------------------------- C: 1st:Common Hepatic---->Gastroduodenal = [SUP PANCREATICODUODENAL] + [R GASTROMENTAL] 2ND: Common Hepatic--->Hepatic Proper ---->R/L hepatic a.------>cystic artery branch (to Gallbladder) D:Hepatic proper----> R Gastric a. --------------------------------------------------------------------------------- E: Supraduodenal a. is a branch of common hepatic that may arise from either [Gastroduodenal a.] OR [Hepatic Proper a.]

Question 51

1) What is the SPLEEN? 2) Where is it located? 3) Describe its 2 Surfaces 4) Name the 3 Areas and their order 5) What is its Blood Supply [Arterial vs. Venous] ? 6) Why is the [Splenic Tortuous Artery] so..Tortuous?

Answer 51

1) Spleen= Lrge lymphoid organ related to hematopoiesis 2) wedged between stomach & L kidney (connected by gastrosplenic & Lienorenal ligaments) --------------------------------------------------------------------------------- 3) A: Diaphragmatic= separates spleen from L lung & Ribs 9-11 B: Visceral=CONTAINS HILUM which transmits splenic vessels & originates stomach/kidney attchmnt ligaments 4) ºColic = Front and lateral ºGastric = Behind and medial --------------------------------------------------------------------------------- 5) [Arterial]: Celiac trunk--->Splenic Tortuous Artery [Venous]: Splenic vein receives [inf mesenteric vein] and then combines with [SUP mesenteric vein] to create Portal Vein---->Spleen - -------------------------------------------------------------------------------- 6) accommodates variable Stomach Distention