Abdomen IV

Question 1

What are the borders of the lesser omentum

Answer 1

Posteriorly: inferior vena cava
Anteriorly: lesser curvature of stomach
Superiorly: liver
Inferiorly: pancreas

Question 2

The stomach is supplied by which artery

Answer 2

The celiac trunk

Question 3

Where does bile enter the digestive tract?

Answer 3

In the second part of the duodenum

Question 4

What are the two causes of inflammation of the abdomen

Answer 4

Either fluid accumulation corresponding to liver disease, and eczema of lower limbs. Or pregnancy.

Question 5

Where is the liver

Answer 5

In the right hypochondrium, left hypochondrium, and epigastric region

Question 6

How much does the liver weigh? What was it’s embryological function?

Answer 6

1.5kg, it had hematopoietic function

Question 7

What structures enter the hilum of the liver

Answer 7

The portal triad which consists of the hepatic portal vein (rich in nutrients and CO2), the hepatic artery (small), and the lymphatic vessels (is how lipids enter the liver)

Question 8

What are the 3 faces of the liver, and what is it’s relationship with peritoneum

Answer 8

The liver has the visceral surface, the diaphragmatic surface and the bare area of the liver.
The liver is intraperitoneal except the hilum and the bare area

Question 9

What structure is inbetween the diaphragmatic and visceral surface of the liver

Answer 9

The inferior anterior margin of the liver. Which is normally smooth, but can be bumpy in serosis

Question 10

How are the subphrenic and hepatorenal recesses formed

Answer 10

The subphrenic recess of formed by the reflection of the peritoneum onto the anterior diaphragmatic surface of the liver and the inferior surface of the diaphragm.
The hepatorenal recess is formed by the reflection of the diaphragm onto the visceral surface of the liver and the surface (head of the right kidney). Note that this is a virtual space which is made of 4 layers (2 peritoneum, glissons capsule, kidney capsule)

Question 11

The falciform ligament function is

Answer 11

The attachment of the liver onto the surface of the diaphragm

Question 12

Function of coronary ligament is?

Answer 12

It has 2 parts the anterior, and posterior . Look at slide 52 of abdomen 3

Question 13

The right and left lobe of the liver are divided by

Answer 13

The ligamentum teres (the round ligament)

Question 14

What are the impressions on the visceral surface of the liver

Answer 14

Left: gastric and esophageal
Right: colic and renal

Question 15

What are the lobes of the liver

Answer 15

The caudate lobe ( is posterior) the quadrate lobe (anterior) ,Left lobe, right lobe

Question 16

Explain the arterial supply of the liver, venous drainage?

Answer 16

The celiac trunck gives rise to the hepatic artery which enters the hilum with the porta hepatis. Drained by the portal vein

Question 17

How many lobules can the lover be divided into?

Answer 17

8

Question 18

How is the hepatic vein formed

Answer 18

All the central veins (in the center of the hexagonal lobule) connect and form the right/left/middle hepatic vein. This eventually blends into the inferior vena cava

Question 19

How does bile enter the duodenum

Answer 19

All the bile ducts combine to form the left and right hepatic ducts. These join to form the common hepatic duct. This merges with the cystic duct to form the common bile duct (boyden). This now merges with the pancreatic duct (wirsung) to form the hepatopancreatic ampulla (vater) (sphincter of oddi). It enters the duodenum through the major duodenal papilla

Question 20

What is the arterial supply of the gall bladder, venous?

Answer 20

It’s from the cystic artery of the hepatic artery. Through portal vein

Question 21

What is the pancreas? What are it’s sections? What is its purpose?

Answer 21

It is a gland, which is 80% exoxrine secretions that help directions of lipids, and 20 % endocrine. It is in the posterior left hypochondrium, and the epigastrium. It forms the posterior wall of the lesser sac.
It has a head, an uncinate process, neck, body, tail (reaches the hilum of the spleen) . It is retroperitoneal.
The vessels running behind it are the IVC and the aorta.

Question 22

What is the arterial supply and venous drainage of the pancreas

Answer 22

The celiac trunck and the superior mesentaric artery.Note that when the have a cancer in the pancreas we feel no pain as there is no pancreatitis( inflammation of pancreas due to bile presence)

Question 23

What kind of organ is the spleen? Where is It? What is its function?

Answer 23

It is intraperitoneal, in the left hypochondrium. Is in a vertical plane, destroys RBC and stores blood.

Question 24

Innervation of the spleen

Answer 24

By the splenic artery ( from celiac trunk)

Question 25

Talk about the abdominal aorta

Answer 25

It starts at T12 and ends at L4, it runs along the left side of the vertebral column. It becomes the common iliac artery.

Question 26

Talk about the IVC

Answer 26

Starts at L5, from the common iliac vein. And runs along the right of the vertebral column.

Question 27

Where are the kidneys, what’s their relationship to the peritoneum,

Answer 27

They are in the posterior abdominal wall, are covered by peritoneum only on certain parts of the anterior surface. It contacts the psoas major (medially) and quadratus lumborum and transversus abdominus muscles(laterally). GO TO SLIDE 4 of abdomen 4

Question 28

Explain the renal fascia

Answer 28

The endoabdominal fascia gives a branch in the posterior region which then splits into 2 forming the renal fascia. The posterior renal fascia attaches to the fascia of the quadratus lumborum. The anterior renal fascia jpns to the anterior facia on the other side. The fat surrounded by the renal fascia is called perinephric fat. The fat in the posterior region delimited by the posterior renal fascia and the fascia of the quadratus lumborum is called paranephric fat.