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Anatomy of... > Abdomen > Flashcards

Abdomen Flashcards

1
Q

List the nine regions of the abdomen

A

Going superoinferiorly:
- Right and left hypochondriac, and epigastic
- right and left lumbar regions* *, umbilical
- right and left iliac or inguinal, hypogastric/pubic

Hector {} isabel every unceasing hour

Hypogastric = pubic, iliac = inguinal
NOTE: lumbar is superior to iliac/inguinal
NOTE 2: umbilicus at level of L3/4* *, can be used to divide left right upper lower quadrants
NOTE 3: abdominal cavity bordered superiorly by diaphargm(extends up to 4th intercostal space), continous with pelvic, hence “abdominpelvic”

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2
Q

What could be sources of pain in the epigastric region?

A
  • could be originating from abdominal cavity organs, muscles, or further posterior i.e. retroperitoneal (oesophagus, reflux)
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3
Q

Examples of DDx for reflux or GERD

A
  • heart burn
  • ‘stitch’ or muscle pain
  • peptic ulcer/stomach pain
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4
Q

What could be sources of pain in hypogastric region?

A
  • Bladder pain
    -uti
    -diverticulitis
    -apendicitis
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5
Q

What could be sources of pain in right iliac region?

A
  • appendicitis ^[1]
  • reproductive organs in female (ovary, fallopian tubes) ^[2]

1- unless situs inversus
2- if reproductive in origin would expect pain on contralateral side

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6
Q

Describe the divisions of the abdominal cavity

A

The abdominal cavity is one of three ventral body cavities.
It is located between the diaphragm and pelvic inlet or brim.
The dome shaped diaphragm forms the roof, thus the abdominal cavity extends into the thoracic space, up to the 4th intercostal space.

The abdominal cavity does not have a floor.
The abdominal cavity is continuous with the pelvic cavity below it, at the pelvic brim. THe combined space is sometimes referred to as the abdominpelvic cavity.

The abdominal wall is supporting by the greater pelvis, and also receives support posteriorly from the lumbar verterbrae, and it is surrounded by the abdominal wall.

Muscles are the mainstay of the abdominal wall.

The abdominal cavity contains most digestive organs, spleen, adrenal glands, kidneys and ureters.

There are nine regions and four quadrants of the abdomen:

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7
Q

Describe the contents of the regions of the abdominal cavity

A
  • right hypochondriac:
    The liver
    The gallbladder
    The small intestine
    The ascending colon
    The transverse colon
    The right kidney
  • epigastric: stomach liver pancreas dudoenum spleen adrenal glands
    The esophagus
    The stomach
    The liver
    The spleen
    The pancreas
    The right and left kidneys
    The right and left ureters
    The right and left suprarenal glands
    The small intestine
    The transverse colon
  • left hypochondriac:
    The stomach
    The top of the left lobe of the liver
    The left kidney
    The spleen
    The tail of the pancreas
    Parts of the small intestine
    The transverse colon
    The descending colon
  • right lumbar
    The tip of the liver
    The gallbladder
    The small intestine
    The ascending colon
    The right kidney
  • umbilicalThe stomach
    The pancreas
    The small intestine
    The transverse colon
    The medial extremities of right and left kidneys
    The right and left ureters
    The cisterna chyli
  • left lumbar
    A portion of the small intestine
    A part of the descending colon
    The tip of the left kidney
  • right iliac
    The small intestine
    The appendix
    The cecum
    The ascending colon
    The right ovary and right fallopian tube in females.
  • hypogastric or suprapubic
    The small intestine
    The sigmoid colon
    The rectum
    The urinary bladder
    The right and left ureters
    The uterus, the right and left ovaries and the fallopian tubes can be found in females
    The ductus deferens, seminal vesicles and prostate in males
  • left iliac
    Part of the small intestine
    The descending colon
    The sigmoid colon
    The left ovary and the left fallopian tube in females.
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8
Q

Describe the contents of the quadrants of the abdominal cavity

A

RUQ: liver right lobe, gallbladder, pylorus of stomach, right colic or hepatic flexure, duodenum, head of pancreas, right adrenal gland, right kidney, ascending colon, R transverse colon

LUQ:liver left lobe, spleen, stomach, jejunum and ileum, L colic or hepatic flexure, body or tail of pancreas, left adrenal gland and left kidney, L transverse colon, descending superior colon

RLQ: caecum, appendix, ileum, ascending inferior colon, R ovary, R uterine canal, ureter R, uterus, urinary bladder, R spermatic cord

LLQ: urinary bladder, L uterine canal, uterus, L spermatic cord, descending inferior colon, L ovary, ureter L

SEE ALSO radiopedia surfaca anatomy diagram

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9
Q

Describe the divisions of the gastrointestinal tract

A

The gastrointestinal tract, also known as the digestive tract, can be divided into three main regions based on embryological origin: the foregut, midgut, and hindgut.

Foregut: The foregut encompasses the upper part of the gastrointestinal tract and includes the mouth, pharynx, esophagus, stomach, and the first part of the duodenum.

Midgut: The midgut is the middle portion of the gastrointestinal tract and includes the remaining parts of the small intestine (distals 2/3s of duodenum, jejunum and ileum) and the first two-thirds of the large intestine (cecum, appendix and ascending colon, proximal 1/3 transverse colon).

Hindgut: The hindgut comprises the remaining parts of the large intestine, including the transverse colon, descending colon, sigmoid colon, rectum, and anus.

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10
Q

Which is higher, the right or left dome of the diaphragm?

A

Right dome is higher, i.e. more superior, in order to accommodate the liver.

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11
Q

Which is higher, the right or left kidney?

A

The left kidney sits higher i.e. more superior than the right, as the right kidney sits inferior to the right lobe of the liver

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12
Q

List the surface anatomy features of the abdomen

A
  • vertical: midclavicular tom id inguinal, lateral to 9th costal cartilage tip (marks costal margin)
  • subcotal lae: joinig lower most bonty points of rib cage usually between 10 cotal cartilage
  • umbilicus: L3/4: abdominal aorta branches at L4; common hernia site; enter perinuem for laparoscopy– identify problems
  • transtubercukar: joining two tubercles or iliac crest, L5 - iliac veins confluence
  • linea alba: cut no innervation, access abdomen in surgery
  • pubic tubercle
  • pubic sympysis
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13
Q

List and briefly describe the layers of the abdominal wall

A
  • skin
  • subcutaneous fat
  • superficial fascia: fatty and fibrous layers
  • rectus abdominis (and sometimes pyramidalis) (surrounded by rectus sheath, formed by aponeuroses of transverus abdominis, external and internal obliques)
  • external oblique
  • internal oblique
  • transcerus abdominis
  • transversalis fascia (and extraperitoneal fat)– retroperitoneal organs located here
  • parietal peritoneum (perceptible, shiny)
  • visceral peritoneum (1 cell layer thick, imperceptible)
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14
Q

Describe the organisation of the peritoneum - parietal/visceral

A

Parietal peritoneum first, shiny, perceptible; folds (Reflections = visceral peritoneum second ( 1 cell layer thick, imperceptible)

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15
Q

Describe anatomy of liver

A

right left, caudate (which is superior to ), quadrate lobe; ligaments: right and left coronary ligs, triangular hold liver in place, continuations of coronary, flciform anchors ant abdo wall and diaph, teres – round ligament, remnant of umbilical vein; lesser omentum.; lig venosum remnant of ductum venosum

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16
Q

Describe the blood supply of the liver

A

see portal triad (hepatic portal vein, haptic artery, hepatic duct); also has hepatic vein

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17
Q

Describe the anatomy of the biliary system/tree

A
  • hepatocytes
  • biliary canaliculi c(commences at level, dilated space between hepatocytes adjacent) – coalesce to form
  • interlobal canals, link up to form
  • right and left hepatic ducts
  • common heaptic ducy
  • links with cystic duct to form common bile duct
  • links for a brief stretch with pancreatic duct to form ampulla of Vater
  • end, sphicter of Oddi, enters duodenum via greater dudoneal papilla

aim: intraheppatic biliary tract designed to transport bile from hepatocutes to extrahepatic biliary tree

aalso lesser duodenal papilla, receives from accesssory pancreatic duct

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18
Q

Describe the location and the morphology of the pancreas

A

Head body and tail
Head in RUQ, body and tail in LUQ

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19
Q

Summarise the structure of the stomach

A

Pylorus in RUQ

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20
Q

Define duodenum, jejunum and ileum

A

The small intestine is divided into the duodenum, jejunum, and ileum. Together these can extend up to six meters in length. All three parts are covered with the greater omentum anteriorly. The duodenum has both intraperitoneal and retroperitoneal parts, while the jejunum and ileum are entirely intraperitoneal organs.

Duodenum: extends from the pyloric sphincter of the stomach, wraps around the head of the pancreas in a C-shape and ends at duodenojejunal flexure. This flexure is attached to the posterior abdominal wall by a peritoneal fold called the suspensory muscle (ligament) of duodenum, also called the ligament of Treitz.

superior (duodenal bulb/ampulla), descending, horizontal and ascending. Among several features of the duodenum, we’ll list the two most important:

The superior part (duodenal bulb/ampulla) is the only intraperitoneal part, as the hepatoduodenal ligament and greater omentum attach to it. 
The descending part of the duodenum has an opening called the major duodenal papilla (tubercle of Vater). The papilla contains the hepatopancreatic sphincter (sphincter of Oddi, Glissons’ sphincter) which regulates the emptying of the bile from the hepatopancreatic ampulla.

Jejunum:
The jejunum is the second part of the small intestine. It begins at the duodenojejunal flexure and is found in the upper left quadrant of the abdomen. The jejunum is entirely intraperitoneal as the mesentery proper attaches it to the posterior abdominal wall.

There is no clear line of demarcation between the jejunum and ileum, but there are some anatomical and histological differences

The ileum is the last and longest part of the small intestine. It is found in the lower right quadrant of the abdomen, although the terminal ileum can extend into the pelvic cavity. The ileum terminates at the ileal orifice (ileocecal junction) where the cecum of the large intestine begins.

Arteries: celiac trunk, superior mesenteric artery
Veins: hepatic portal vein, superior mesenteric vein

Innervation

Parasympathetic: vagus nerve (CN X) (through the submucosal (Meissner’s) and myenteric (Auerbach’s) nervous plexuses)
Sympathetic: Thoracic splanchnic nerves

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21
Q

Differentiate between the duodenum, jejunum, and ileumm function

A

The main functions of the small intestine are secretion and absorption. The epithelial cells of the small intestine secrete enzymes which digest chyme into the smallest particles, making them available for absorption. Concurrently the duodenum functions to mix food with bile and pancreatic enzymes to continue the digestion of carbohydrates, fats, and proteins.

Concerning absorption, carbohydrates and proteins are absorbed in the duodenum and jejunum respectively. The jejunum also functions to absorb most fats. The ileum function involves absorption of vitamin B12, bile salts and all digestion products which were not absorbed in duodenum and jejunum. All three small intestine segments absorb water and electrolytes.

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22
Q

Name the ligaments of the liver and briefly describe them

A

ligaments: right and left coronary ligs, triangular hold liver in place, continuations of coronary, flciform anchors ant abdo wall and diaph, teres – round ligament, remnant of umbilical vein; lesser omentum.; lig venosum remnant of ductum venosum

23
Q

Describe and list the components of the biliary system

A
  • hepatocytes
  • biliary canaliculi c(commences at level, dilated space between hepatocytes adjacent) – coalesce to form
  • interlobal canals, link up to form
  • right and left hepatic ducts
  • common heaptic ducy
  • links with cystic duct to form common bile duct
  • links for a brief stretch with pancreatic duct to form ampulla of Vater
  • end, sphicter of Oddi, enters duodenum via greater dudoneal papilla

aim: intraheppatic biliary tract designed to transport bile from hepatocutes to extrahepatic biliary tree

24
Q

Differentiate between the parts of the large intestine

A
  • cecum: The cecum is the first part of the large intestine, lying in the right iliac fossa of the abdomen. The cecum is intraperitoneal with various folds and pockets (retrocecal peritoneal recesses) surrounding it.
  • The vermiform appendix is a blind lymphoid pouch located in the right iliac fossa which arises from the cecum. These two parts of the large intestine are connected by the meso-appendix. The appendix has a role in the maintenance of gut flora and mucosal immunity.
  • ascending: The ascending colon travels through the right iliac fossa, right flank, and right hypochondriac region. It ends at the right colic (hepatic) flexure. The ascending colon is retroperitoneal and it is connected to the posterior abdominal wall by the Toldt’s fascia. A deep vertical groove or recess (right paracolic gutter) lies between the ascending colon and the lateral abdominal wall. The ascending colon is heavily involved in fluid and electrolyte reabsorption
  • transverse : It extends between the right and left colic (splenic) flexures, spanning the right hypochondriac, epigastric and left hypochondriac regions of the abdomen. The greater curvature of the stomach and gastrocolic ligament are superior to the transverse colon, while the greater omentum hangs over and extends inferiorly to it.

The transverse colon is intraperitoneal. A peritoneal mesentery (transverse mesocolon) attaches it to the posterior wall of the omental bursa.

  • descending:
    extends between the left colic flexure and sigmoid colon. It travels through the left hypochondriac region, left flank and left iliac fossa. The left paracolic gutter is located between the descending colon and the lateral abdominal wall.

This part of the colon is retroperitoneal. Toldt’s fascia fixes the descending colon to the posterior abdominal wall.

  • sigmoid
    The S-shaped sigmoid colon travels from the left iliac fossa until the third sacral vertebra (rectosigmoid junction). This part of the colon is intraperitoneal. It is connected to the pelvic wall by the sigmoid mesocolon.

Midgut: superior mesenteric artery
Hindgut: inferior mesenteric artery

25
Q

Define the caecum, colon, appendix and rectum

A
  • caecum: The cecum is the first part of the large intestine, lying in the right iliac fossa of the abdomen. The cecum is intraperitoneal
  • colon: he portion of the large intestine located between the cecum and rectum is termed the colon. It consists of four parts; ascending, transverse, descending, and sigmoid. The main functions of the colon include fluid and electrolyte reabsorption.
  • appendix: The vermiform appendix is a blind lymphoid pouch located in the right iliac fossa which arises from the cecum. These two parts of the large intestine are connected by the meso-appendix. The appendix has a role in the maintenance of gut flora and mucosal immunity.
  • rectum: The rectum stretches between the rectosigmoid junction and the anal canal. The typical characteristics of the large intestine (taenia coli, haustra, epiploic appendages) change or even terminate at the rectum. The roles of the rectum include temporary storage of fecal matter and defecation.
26
Q

Describe the greater and lesser omentum

A
  • The greater omentum is a two-leaflet hammock of fibro-fatty tissue that extends from the greater curvature of the stomach to the transverse colon. It spans the width of the abdomen laterally and reaches the pelvis inferiorly.
  • It is the larger of the two peritoneal folds/omenta
  • apron like
  • he greater omentum contains large amounts of fat
  • supplied by gastroomental arteries, right is branch of gastrodudenal, off common hepatic, left off spelnic

prevents the parietal and visceral peritoneum of the abdominal cavity from adhering to each other. For example, it prevents the parietal peritoneum lining the anterior abdominal wall from sticking to the visceral peritoneum of the ileum. It is very mobile

Lesser, also one of two omenta
The lesser omentum extends from the lesser curvature of the stomach and duodenal bulb (first part of duodenum) to the liver. One of its roles is to separate the greater sac from the omental bursa. The lesser omentum consists of two ligaments: medially located hepatogastric ligament, and laterally located hepatoduodenal ligament.
The lesser omentum transports the arteries for the lesser curvature of the stomach; the right and left gastric arteries. , r and l gastric veins follow same direction as arteries; vesceal vagus branches and hepatic astric lymph nodes also pass through

27
Q

Describe the greater and lesser curvature

A

Greater:
Lesser:

28
Q

Describe and distinguish between haustra, and taeniae coli

A

The haustra of the colon (singular haustrum) are the small pouches caused by sacculation, which give the colon its segmented appearance. The taenia coli runs the length of the large intestine. Because the taenia coli is shorter than the intestine, the colon becomes sacculated i.e. has sac like expanisons between the taenia, forming the haustra.

29
Q

List the major retroperitoneal organs

A

Suprarenal glands or adrenal glands
Aorta and IVC
Duodenum
Pancreas tail
Ureter
Colon - ascending and descending
Kidneys
Esophagus
Rectum

30
Q

Differentiate between the male and female pelvis

A
  • female: outlet wider, cavity wide and shallow, inelt round
  • male: inlet heart shape, prominent projecting promontory and prominant medially projecting ischial spines, cavity narow and deep, outlet smaller
31
Q

Describe blood supply to foregut, midgut and hindgut

A

Foregut = mouth to duodenum
Midgut = duodenum to 2/3rd transverse colon
Hindgut = distal 1/3 rd transverse colon to anus

Anterior
1. Coeliac Trunk (foregut)
2. Superior Mesenteric a. (midgut)
3. Inferior Mesenteric a. (hindgut)
Lateral (pairs)
1. Inferior phrenic a.
2. Adrenal a.
3. Renal a.
4. Gonadal a.
Posterior
1. Lumbar a. (4x pairs)
2. Median Sacral a.
Terminal
1. Common Iliac (left, right)

32
Q

Describe the bony landmarks associated with the abdomen

A

The bony landmarks of the abdominopelvic cavity are the spine and pelvic bones.
Spine posterioir
pelvic inferolateral

33
Q

Describe the non-bony landmarks of the abdomen

A

costal margins, xiphoid process, rectus abdominal muscle, linea alba, umbilicus, iliac crest, inguinal ligament, and symphysis pubis

34
Q

Describe different body shapes and explain their relevance to clinical practice

A

Important to be aware of your patient’s usual or typical body shape.
Consider: is this what the patient looks like?

Examples:
- a typically obese patient presents with redundant skin sagging–> indicative weight loss, underlying condition

35
Q

Describe the layers of the abdominal wall

A

Ant:
- skin
- subcutaneous fat
- superficial fascia: camper’s and scamper’s
- linea alba
- rectus sheath
- rectus abdomiinis
- external obl
- internal obl
- transverus abdmonis
- transversalis fascia
- partietal
- visceral

36
Q

Describe the contents of the inguinal canal

A

he contents of the inguinal canal in males consist of the spermatic cord (with the genital branch of the genitofemoral nerve) and the ilioinguinal nerve. For females, the contents include the round ligament, genital branch of the genitofemoral nerve, and the ilioinguinal nerve

37
Q

Define hernia

A

Protrusion i.e. of abdominal contents

38
Q

Briefly describe the types of hernia

A
  • Epigastric hernia: - between rectus abdominis - from xiphoid to umbilicus - Umbilical hernia: - through umbilicus - Inguinal: - direct inguinal hernia: weakness of all muscular layers/Hesselbach triangle - indirect: through inguinal canal -Femoral hernia: - through femoral, below inguinal - Obturator hernia: - through obturator canal - Spigelian hernia: - weakness of muscle layers - medial border is lateral edge of rectus abdominis - Incisional hernia:
39
Q

Describe innervation to viscera and wall of abdominal region

A

Sympathetic innervation of the abdominal viscera is derived from two sources: the thoracic and lumbar splanchnic nerves (g, less, least); lumbar. The parasympathetics are supplied either by the left and right vagus nerves or by the pelvic splanchnic nerves.

40
Q

Explain the general division of the blood supply to the abdomen

A

aorta:
- celic:
- left gastric, splenic and common hepatic arteries.
- The left gastric artery is the smallest of the three branches. It ascends across the diaphragm, giving rise to oesophageal branches, before continuing anteriorly along the lesser curvature of the stomach. Here, it anastomoses with the right gastric artery.
- Splenic Artery

The splenic artery arises from the coeliac trunk just inferior to the left gastric artery. It then travels left towards the spleen, running posterior to the stomach and along the superior margin of the pancreas. During its course, it is contained within the splenorenal ligament. It terminates into five branches which supply the segments of the spleen.

In addition to supplying the spleen, the splenic artery also gives rise to several important vessels:

Left gastroepiploic: supplies the greater curvature of the stomach. Anastomoses with the right gastroepiploic artery.

Short gastrics: 5-7 small branches supplying the fundus of the stomach.

Pancreatic branches: supply the body and tail of the pancreas.

The splenic artery has a tortuous appearance (similar to the facial branch of the external carotid artery) and thus is easily identifiable from other nearby vessels.
- Common Hepatic Artery

The common hepatic artery is the sole arterial supply to the liver and the only branch of the coeliac artery to pass to the right.

As it travels past the superior aspect of the duodenum, it divides into its two terminal branches – the proper hepatic and gastroduodenal arteries. Each of these arteries has multiple branches and variation in the arrangement of these branches is common.

Proper Hepatic

The proper hepatic artery ascends through the lesser omentum towards the liver. It gives rise to:

Right gastric: supplies the pylorus and lesser curvature of the stomach.

Right and left hepatic: divide inferior to the porta hepatis and supply their respective lobes of the liver.

Cystic: branch of the right hepatic artery – supplies the gall bladder.

Gastroduodenal

The gastroduodenal artery descends posterior to the superior portion of the duodenum. Its branches are:

Right gastroepiploic: supplies the greater curvature of the stomach. Found between the layers of the greater omentum, which it also supplies.

Superior pancreaticoduodenal: divides into an anterior and posterior branch, which supplies the head of the pancreas.
  • superior
    The superior mesenteric artery (SMA) is a major artery of the abdomen. It arises from the abdominal aorta, and supplies arterial blood to the organs of the midgut – which spans from the major duodenal papilla (of the duodenum) to the proximal 2/3 of the transverse colon.

he superior mesenteric artery then gives rise to various branches that supply the small intestines, cecum, ascending and part of the transverse colon

Inferior Pancreaticoduodenal Artery
Jejunal and Ileal Arteries:
pass between the layers of the mesentery and form anastomotic arcades – from which smaller, straight arteries (known as the “vasa recta”) arise to supply the organs

Middle and Right Colic Arteries

The right and middle colic arteries arise from the right side of the superior mesenteric artery to supply the colon:

Middle colic artery –  supplies the transverse colon.

Right colic artery – supplies the ascending colon.

Ileocolic Artery

The ileocolic artery is the final major branch of the superior mesenteric artery. It passes inferiorly and to the right, giving rise to branches to the ascending colon, appendix, cecum, and ileum. In cases of appendectomy, the appendicular artery is ligated.

  • inferior

It arises at L3, near the inferior border of the duodenum, 3-4 cm above where the aorta bifurcates into the common iliac arteries.

As the artery arises from the aorta, it descends anteriorly to its parent vessel, before moving to the left side. It is a retroperitoneal structure – situated behind the peritoneum.
here are three major branches that arise from the IMA – the left colic artery, sigmoid artery and superior rectal artery.

bifurcates at L4/5 into r and l common iliac

nb Stomach

The stomach is the only organ to receive arterial supply from the three branches of the coeliac trunk (left gastric, splenic and common hepatic arteries).

This is achieved through a system of anastomoses along the greater (gastroepiploic arteries) and lesser (gastric arteries) curvatures of the stomach.

also pancreatic duodenal arcade: supe and inf, for head

clin:
Peptic ulcers in the stomach and duodenum have potential to cause significant gastrointestinal bleeding if they erode into neighbouring arteries (usually the gastroduodenal artery).
or trunk compress syndrome

cclusion of the SMA restricts blood flow to the midgut, resulting in intestinal ischaemia. It is more common in the elderly, and most usually presents with abdominal pain. The most useful investigation in this scenario is CT scan of the abdomen.

41
Q

Name the major peritoneal ligaments and the funciton/position of mesenterium

A

Peritoneal ligaments are folds of peritoneum that are used to connect viscera to viscera or the abdominal wall.

e.g. hepatic ligaments: falciform, round, coronary, R and L triangular, hep-duo, he-gastric

Mesentery:
The mesentery is an organ that attaches the intestines to the posterior abdominal wall and is formed by the double fold of peritoneum. It helps in storing fat and allowing blood vessels, lymphatics, and nerves to supply the intestines, among other functions.

42
Q

Describe portal circulation

A

The hepatic portal vein is an important and unique vein that receives blood from structures of the abdomen and transports it into the liver for filtration and processing. This vein is part of the hepatic portal system that receives all of the blood draining from the abdominal digestive tract, as well as from the pancreas, gallbladder, and spleen.

superior mesenteric + splenic -> portal vein -> enters the liver -> divides into portal venules -> venules empty into hepatic sinusoids -> sinusoids drain into central veins -> central veins drain into hepatic veins -> hepatic veins drain into inferior vena cava

Portal hypertension is defined as an increase in blood pressure in the portal vein, and is a major complication of liver disease (most commonly cirrhosis, often from excessive alcohol consumption). Notable characteristics of chronic liver disease can include:

ascites
esophageal varices
spider nevi
caput medusae
palmar erythema
43
Q

Describe the location of the transumbilical plane

A

Between L3 and L4- intervertebral disc

very close to bifurcation of abdo aorta

n.bl4/l5

44
Q

Peritoneal or intraperitoneal organs

A

sigmoid colon (suspended by mesentery, visible after removal of greater omentum)
spleen
stomach
liver
jejunum (suspended by mesentery, visible after removal of greater omentum)
ileum (suspended by mesentery, visible after removal of greater omentum)
1st part of duodenum
transvere colon (transverse mesocolon)

45
Q

List some clinical consequences of abdominal regions

A

Grey-Turner’s sign is a redness or bruising that can be seen on the right lumbar region after a period of 24 to 48 hours, indicating a retroperitoneal hemorrhage. Its presence is significant because it can be predictive of severe hemorrhagic pancreatitis, abdominal injury or even metastatic cancer. Cullen’s sign is a discoloration of the skin around the umbilicus and points to a peritoneal hemorrhage.

46
Q

Describe the contents of the portal triad

A

The portal triad is contained within the hepatoduodenal ligament and contains the portal vein (posterolateral, bringing nutrient rich blood from GIT), hepatic artery (medial), and bile ducts (lateral)

47
Q

Describe the function of the portal vein

A

The portal vein or hepatic portal vein (HPV) is a blood vessel that carries blood from the gastrointestinal tract, gallbladder, pancreas and spleen to the liver. This blood contains nutrients and toxins extracted from digested contents.

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48
Q

DEFINE Peritoneum, parietal and visceral; distinguish between intra- and retroperitoneal organs

A

Peritoneum

The abdominal wall and the abdominal organs are lined by a thin serous membrane called the peritoneum. Peritoneum consists of two layers; parietal peritoneum that covers the abdominal wall, and visceral peritoneum which covers the viscera. There is a potential space between these two layers called the peritoneal cavity.

Depending on how they are lined with visceral peritoneum, abdominal organs are divided into intraperitoneal or retroperitoneal. Intraperitoneal organs are completely wrapped in peritoneum. Their peritoneal covering is continuous with peritoneal folds called mesenteries. A mesentery suspends an intraperitoneal organ from the abdominal wall and carries its neurovascular bundle. Mesenteries are named according to the organ they suspend. For example, the mesentery of the transverse colon is called the transverse mesocolon. Retroperitoneal organs are located posteriorly to the peritoneum, and only their anterior surfaces are covered with peritoneum. They do not have a mesentery.

49
Q

Describe the peritoneal cavity

A

the peritoneal cavity is the space between the parietal and visceral peritoneal layers. It is divided into two spaces that communicate with each other; the greater sac and the lesser sac (omental bursa). The greater sac is the larger of the two spaces. It extends from the diaphragm to the pelvic cavity. It is divided into two compartments by the transverse mesocolon.

The supracolic compartment, which is above the transverse mesocolon, contains the stomach, liver and spleen. 
The infracolic compartment lies below the transverse mesocolon and mostly contains the small and large intestines.

The omental bursa, also called the lesser sac, is located posteriorly to the stomach and the lesser omentum (which will be discussed later), and anteriorly to the pancreas and duodenum. The function of the omental bursa is to allow unrestricted movement of the stomach. The greater sac and omental bursa communicate with each other through an opening called the omental foramen (also called the foramen omentale or epiploic foramen).

50
Q

define omenta

A

Omenta are the fused peritoneal folds that connect the stomach and duodenum with other abdominal organs. There are two omenta, the greater omentum and the lesser omentum.

51
Q

List muscles of levator ani

A

Pubococcygeus Iliococcygeus Puborectalis

52
Q

List muscle of posterior abdominal wall

A

Psoas major Iliacus Quadratus lumborum (and lumbar vertebrae = posterior wall)
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53
Q

Define pelvis location and function

A

Pelvis is located inferior to the abdomen. It is a transitional area between the trunk and lower limbs It is funnel shaped The pelvic floor is formed by the pelvic diaphragm. Functions of the pelvis include: - supporting the body weight and pass weight to free lower limbs, distribute the weight to lower limbs - protect pelvic organs (lower GIT, urinary tract, internal genital organs) - attachments for muscles Pelvis or pelvic girdle is comprised of : - right and left coxae - sacrum -coccyx Can be divided in: - false/greater -true/lesser

54
Q

Distinguish between direct and indirect inguinal hernias

A

Inguinal hernias account for 75% of all abdominal wall hernias. The incidence of inguinal hernias has a bimodal distribution, with peaks around age 5 and after age 70. Two-thirds of these hernias are indirect, making an indirect hernia the most common groin hernia in both males and females. Males account for about 90% of all inguinal hernias and females about 10%.

An indirect hernia occurs when abdominal contents protrude through the internal inguinal ring and into the inguinal canal. This occurs lateral to the inferior epigastric vessels. The hernia contents may extend into the scrotum. A direct inguinal hernia is protrusion of abdominal contents through the transversalis fascia within Hesselbach’s triangle. The borders of Hesselbach’s triangle are the inferior epigastric vessels superolaterally, the rectus sheath medially, and inguinal ligament inferiorly.

Anatomy of... (15 decks)

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