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Gross Anatomy Block 2 > Stomach, Liver, Biliary Ducts, Spleen And Celiac Trunk > Flashcards

Stomach, Liver, Biliary Ducts, Spleen And Celiac Trunk Flashcards

1
Q

What regions of the abdomen is the stomach located?

A

Left hypochondriac, epigastric and umbilical regions

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2
Q

3 functions of the stomach

A
  1. Stores food
  2. Mixes food with gastric secretions to form semi-fluid mass (chyme)
  3. Controls rate of delivery of chyme to small intestine
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3
Q

2 borders of the stomach and their location

A

Lesser curvature- shorter and on the right

Greater curvature- longer and on the left

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4
Q

What is the incisura angularis?

A

Indentation in lower part of lesser curvature

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5
Q

Stomach as two orifices. Name them

A

Cardial and pyloric

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6
Q

Cardial orifice:

  1. Location
  2. Function
  3. Sphincter?
  4. Major anti-reflux mechanism?
A
  1. Indentation between left border of esophagus and fundus of stomach
  2. Communicates esophagus with stomach
  3. No (backflow is controlled by sphincter on esophagus)
  4. Tonic contractions of smooth muscle in wall of lower esophagus/circle fibers of esophageal hiatus of diaphragm
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7
Q

Pyloric orifice

  1. Function
  2. Sphincter?
  3. Formed by?
A
  1. Communicates stomach with duodenum
  2. Yes, pyloric sphincter
  3. Thickening of circular muscle layer of stomach
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8
Q

4 parts of the stomach and their location

A

Cardia- immediately adjacent to cardial orifice
Fundus- (dome shaped), upper part of stomach— usually full of gas
Body- extends from level of cardial notch to level of angular notch
Pyloric part- (funnel shaped), extends from angular notch to pyloric orifice — proximal wider part is pyloric antrum; distal, narrower part is pyloric canal

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9
Q

4 anterior relations of the stomach

A

Anterior abdominal wall, left costal margin, diaphragm, and left lobe of liver

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10
Q

7 posterior relations of the stomach (5 organs, 1 artery, 1 gland)

A

Diaphragm, spleen, upper part of left kidney, pancreas, transverse mesocolon, splenic artery and left suprarenal gland

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11
Q

Lesser omentum gives off what two ligaments

A

Hepatogastric ligament (wider and thinner) and hepatoduodenumal ligament

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12
Q

What does the hepatogastric ligament connect

A

Extends from liver to lesser curvature of the stomach

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13
Q

What does the hepatoduodenumal ligament connect

A

Extends from liver to first part of the duodenum

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14
Q

Where are the muscles that form the stomach bed located?

A

Small recess of peritoneal cavity called the omental bursa/lesser sac

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15
Q

Greater omentum is located between

A

Anterior abdominal wall and loops of small intestine

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16
Q

What is the transverse mesocolon is made from?

Structural function?

A

Fold of peritoneum

It is how the transverse colon is attached to posterior abdominal wall

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17
Q

Abdominal Aorta

  1. Begins at what level?
  2. Runs between?
  3. Terminates at what level?
A
  1. T12
  2. Lumbar vertebrae and parietal peritoneum (retroperitoneal structure) and to left of IVC
  3. L4 by dividing into right and left common iliac arteries
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18
Q

Before abdominal aorta divides it gives off branches. Branches are divided into what 4 groups?

A

Visceral branches: paired and unpaired

Parietal branches: paired and unpaired

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19
Q

Name the 3 unpaired visceral branches

Originate from where on abdominal aorta?

Supply?

A

Celiac trunk, superior and inferior mesenteric artery

Anterior aspect

GI tract

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20
Q

Name the 3 paired visceral branches

A

Middle suprarenal arteries, renal arteries and gonadal (testicular/ovarian) arteries

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21
Q

Name the 1 unpaired parietal branch?

A

Median sacral artery

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22
Q

Name the 2 paired parietal branches?

A

Inferior phrenic arteries and lumbar arteries (4 pairs)

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23
Q

Unpaired visceral artery: Celiac trunk

  1. Originates from?
  2. Where does it lie?
  3. (Immediately) Divides into what 3 branches
A
  1. Abdominal aorta at T12 (or upper body of L1)
  2. Posterior to stomach and lesser sac
  3. Left gastric artery, splenic artery, and common hepatic artery
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24
Q 
Left gastric artery
~1. Smallest branch of ?
2. Location of where it passes
3. Gives off what branches?
4. Anastomoses with ?
A
  1. Celiac trunk
  2. Superiorly and to the left toward cardial region of stomach, posterior to lesser sac, branches, then descends along lesser curvature of stomach
  3. Esophageal branches (passes through esophageal hiatus of diaphragm to supply lower part of esophagus)
  4. Right gastric artery
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25
Q 
Splenic artery
~1. Branch of?
2. Where does it run?
3. Enters what ligament, where?
4. 4 branches of splenic artery?
A
  1. Celiac trunk
  2. To the left along superior border of pancreas, posterior to stomach and lesser sac
  3. Enters splenorenal ligament upon reaching the left kidney and runs to hilum of spleen
  4. Left gastroepiploic (gastroomental) artery, short gastric arteries, numerous pancreatic branches, and terminal branches
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26
Q

Splenic artery branches locations

  1. Left gastroepiploic
  2. Short gastric arteries
  3. Terminal branches
A
  1. Originates near hilum of spleen, reaches greater curvature of stomach in gastrosplenic ligament and runs along greater curvature (left to right) - anastomoses with right gastroepiploic artery
  2. Originates near hilum of spleen, reaches stomach in gastrosplenic ligament and supplies fundus of stomach
  3. Originates near hilum of spleen
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27
Q

Common hepatic artery
~1. Branch of
2. Course and where it divides/what it divides into

A
  1. Celiac trunk
  2. Runs anteriorly and to the right to reach superior aspect of duodenum, where it divides into proper hepatic artery and gastroduodenal artery
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28
Q 
Proper hepatic artery
~1. Branch of
2. Course?
3. Location within lesser omentum?
4. Usually gives rise to what artery? What is its course?
A
  1. Common hepatic artery
  2. Ascends between 2 layers of hepatoduodenal ligament toward hilum of liver (porta hepatis), divides into right and left branches that enter liver through porta hepatis. ~right branch usually gives off cystic artery
  3. Anterior to hepatic portal vein and to the left of common bile duct
  4. Right gastric artery; descends to pyloric end of stomach, runs to left along lesser curvature of stomach and anastomoses with left gastric artery
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29
Q

What artery supplies the gallbladder?

A

Cystic artery (given off by right branch of proper hepatic artery)

30
Q

Gastroduodenal artery
~1. Branch of
2. Course?
3. Branches?

A
  1. Common hepatic artery
  2. Descends posterior to duodenum
  3. 2 superior pancreaticoduodenal arteries (anterior and posterior) and right gastroepiploic (gastroomental) artery
31
Q
  1. Right gastroepiploic artery course and anastomose?

2. Superior pancreaticoduodenal arteries supply and anastomose?

A
  1. Runs along greater curvature of stomach (right to left); anastomoses with left gastroepiploic artery
  2. Supply duodenum and head of pancreas, anastomose with inferior pancreaticoduodenal arteries
32
Q

Inferior pancreaticoduodenal arteries are branches of

A

Superior mesenteric artery

33
Q

Clinical relevance of gastroduodenal artery

A

Ulcer in posterior wall of the first part of duodenum can potentially eat up the wall of the gastroduodenal artery and cause massive hemorrhage (can also asffect posterior superior pancreaticoduodenal artery)

34
Q

The following are arteries that supply the stomach. Name what it is a branch of

  1. Left gastric artery
  2. Right gastric artery
  3. Left gastroepiploic artery
  4. Right gastroepiploic artery
  5. Short gastric arteries
A
  1. Celiac trunk
  2. Proper hepatic artery
  3. Splenic artery
  4. Gastroduodenal artery
  5. Splenic artery
35
Q

All arteries of stomach are accompanied by veins of the same name—> all venous blood from stomach drains into?

A

Hepatic portal vein (directly or indirectly)

36
Q

Function of hepatic portal vein

A

To bring nutrient rich blood into the liver (collects all the blood from organs)

37
Q

All lymph from stomach drains into what lymph nodes? Where is there location?

A

Celiac lymph nodes located around origin of celiac trunk

38
Q

Preaortic lymph nodes (anterior to abdominal aorta) collect lymph from? Where does lymph go next?

A

Celiac and superior and inferior mesenteric arteries; then goes to lateral aortic or lumbar lymph nodes (located on sides of abdominal aorta)

39
Q

Nerve supply of stomach:

  1. Preganglionic parasympathetic fibers?
  2. Postganglionic parasympathetic fibers?
  3. Preganglionic sympathetic fibers & postganglionic sympathetic fibers
A
  1. From vagus nerve
  2. Within gastric wall
  3. From T6-T9- travel in greater splanchnic nerves to reach celiac ganglia. Celiac ganglia give rise to postganglionic sympathetic fibers with form plexuses around arteries that supply stomach
40
Q
  1. Sympathetic fibers cause?

2. Parasympathetic fibers cause?

A
  1. Constriction of gastric vasculature/pyloric sphincter and are inhibitory to gastric musculature
  2. Stimulate secretion of gastric glands and contraction of gastric musculature. Inhibit pyloric sphincter
41
Q

Which abdominal regions is the liver located in?

A

Right hypochondriac, epigastric, and left hypochondriac regions

42
Q
  1. What are the two surfaces of the liver
  2. Where are they located
  3. How are they separated?
A
  1. Diaphragmatic and visceral
  2. Diaphragmatic- undersurface of diaphragm; visceral- molded to adjacent organs
  3. Anteriorly by sharp border, can’t tell posteriorly
43
Q

Visceral surface has grooves shaped like an H. What are each part of the H/what do they contain?

A

Cross bar- porta hepatis (contains right/left hepatic ducts, branches of proper hepatic artery and portal vein, autonomic nerves and hepatic lymph nodes/vessels)
L side- (left sagittal fissure) formed anteriorly by fissure for round ligament of liver; posteriorly by fissure for ligamentum venosum
R side- (right sagittal fissure) formed anteriorly by fossa for gallbladder; posteriorly by groove for IVC

44
Q

Intrauterine life: what vein carries blood from placenta

A

Umbilical vein - either carries it to join portal vein or bypasses liver and goes to IVC via ductus venosus

45
Q

At birth, what do the umbilical vein and ductus venosus become?

A

Umbilical- round ligament of the liver; ductus venosus- ligamentum venosum

46
Q

Differentiate between the two lobes of the liver

A

Quadrate lobe- located anterior to porta hepatis (between gallbladder and round ligament of the liver)

Caudate lobe- posterior to porta hepatis (between IVC and ligamentum venosum)

47
Q
  1. Blood supply/bile collection for right liver?

2. Left liver?

A
  1. Right hepatic artery and right branch of portal vein; bile is collected by right hepatic duct
  2. Left hepatic artery and left branch of portal vein; bile is collected by left hepatic duct
48
Q

Right and left parts of liver are separated by?

Further subdivided into?

A

Main portal fissure (line connecting IVC and gallbladder) Right and left parts are further divided into segements I-VIII

49
Q

Falciform ligament

  1. Connects what two things
  2. Forms boundary between?
  3. Inferior margin contains
  4. What happens with this ligament posteriorly?
A
  1. 2 layered peritoneal fold that connects diaphragmatic surface of liver and anterior abdominal wall above umbilicus
  2. Right and left lobes
  3. Round ligament of liver
  4. Its 2 layers separate and become superior layer of coronary ligament
50
Q

What is the bare area of the liver?

A

Space between the superior and inferior layers of the coronary ligament where there is no peritoneum

51
Q

What is formed when left and right ends of coronary ligament join

A

Right and left triangular ligaments

52
Q

Lesser omentum connects?

A

Visceral surface of liver to lesser curvature of stomach and duodenum

53
Q

Liver receives blood from what two sources?

Which has oxygenated/deoxygenated blood

A

Proper hepatic artery (30% of blood-oxygenated)

Hepatic portal vein (70% of blood- deoxygenated, but rich in nutrients)

54
Q

Process hepatic veins go through to drain into IVC

A

Hepatic veins join and form progressively larger veins-> eventually 3 large hepatic veins (right,left,middle) are formed and these are intersegmental and drain into IVC

(Hepatic veins are only structures that leave the liver without going through the porta hepatis)

55
Q

Which veins collect arterial and venous blood that run through the sinusoids?

A

Central veins

56
Q

Liver produces ~1/2 of all body lymph. Drains into which nodes?

A

Celiac lymph nodes

57
Q

Nerve supply:

  1. Hepatic plexus originates from
  2. Postganglionic sympathetic fibers
  3. Preganglionic fibers
A
  1. Celiac plexus
  2. Celiac ganglia
  3. T6-T9 and reach celiac ganglia via greater splanchnic nerves
58
Q

Bile is produced by ___

Formation of ducts?

A

Hepatocytes
Small bile ducts (within liver) -> join -> eventually form 2 large ducts (right and left hepatic ducts) -> exit liver (via porta hepatis) -> join to form common hepatic duct -> joined by cystic duct (from gallbladder) to form common bile duct

59
Q

Location of common bile duct

A

Initially within hepatoduodenal ligament, then passes posterior to duodenum and posterior to head of pancreas

60
Q

Clinical significance of common bile duct

A

Can be compressed by tumors of head of pancreas (usually discovered late) results in jaundice then death

61
Q

Common bile duct is usually joined by ___ to form

A

Main pancreatic duct; form short, dilated chamber embedded in duodenal wall

62
Q

Gallbladder:

  1. Location
  2. Function
A
  1. Visceral surface of liver

2. Stores bile and concentrates it by absorbing water

63
Q

3 parts/location of gallbladder

A
  1. Fundus- tip of right 9th costal cartilage
  2. Body- contacts visceral surface of liver superiorly and transverse colon/duodenum inferiorly
  3. Narrow, directed toward porta hepatis; continuous with cystic duct
64
Q

What is the cystohepatic triangle? What is it limited by

A

Area where cystic artery is found; limited by cystic duct, common hepatic duct, and inferior surface of liver

65
Q

What can inflammation of the gallbladder lead to?

A

Development of adhesions between gallbladder and duodenum or transverse colon; formation of abnormal fistulas between gallbladder and these parts of intestines

66
Q

What is the largest lymphoid organ of the body

A

Spleen

67
Q

Spleen is located in which abdominal region?

What is clinically significant about its location

A

Left hypochondriac

Completely sheltered by lower ribs so lacerations of spleen can result from fractured ribs

68
Q

Functions of the spleen

A

Eliminates old/damaged blood cells, filters antigens from blood and contributes to immune response against such antigens

69
Q

Hilum of spleen is connected to which two organs? By which two ligaments?
What arteries are contained in these ligaments?

A

Stomach= gastrosplenic ligament (contains short gastric arteries and veins and left gastroepiploic artery and vein)
Left kidney= splenorenal ligament (contains splenic artery and vein and tail of pancreas)

70
Q

Venous drainage of spleen

A

Splenic vein -> joins superior mesenteric vein to form portal vein

Gross Anatomy Block 2 (8 decks)

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