Abdomen Flashcards
(158 cards)
1
Q
where is the posterior abdominal wall located? (2)
A
- behind abdominal organs
- extends from vertebral volumn to posterior aspects of abdominal cavity
2
Q
what are the muscles included in the PAW? (4)
A
- psoas major
- psoas minor
- iliacus
- quadratus lumborum
3
Q
what are the main parts of the PAW? (5)
A
- muscles
- vertebrae
- thoracloumbar fascia
- blood vessels
- nerves
4
Q
what is thoracolumbar fascia? (2)
A
- strong connective tissues structure that covers the muscles of the lower back and forms a sheet
- provides stability
5
Q
retroperitoneal organs (2) vs intraperitoneal organs (2)
A
retroperitoneal:
* anchored to PAW
* lies behind parietal peritoneum
Intraperitoneal:
* anterior to PAW
* suspended within peritoneal cavity by mesentery
6
Q
the two types of extraperitoneal organs:
A
- rertoperitoneal
- sub periotteal
7
Q
what is a sub peritoneal organ?
A
- an organ beneath the peritoneum of the abominal cavity
8
Q
types of mesentery’s of the abdomen: (4)
A
- SI mesentery = the mesentery
- transverse colon mesentery = mesa colon
- sigmoid colon mesentery = sigmoid colon
- stomach mesentery = greater and lesser omentum
9
Q
what is a secondary retroperitoneal organ? (3)
A
- an organ that originally had a mesentery
- was intrapertioneal
- due to enlarging of other organs in evolution (e.g. the SI), has become pushed against the PAW
10
Q
examples of secondary retroperitoneal organs: (3)
A
- ascending colon
- descending colon
- duodenum
11
Q
what is the lesser sac of the abdominal peritoneum also known as?
A
- omental bursa
12
Q
what are the 2 main parts of the lesser sac?
A
- superior recess
- inferior recess
13
Q
what are the 3 divisions of the gut?
A
- foregut
- midgut
- hindgut
14
Q
what does the foregut contain? (6)
A
- oeseophagus
- stomach
- liver
- gallbladder
- pancreas
- first part of duodenum
15
Q
what does the midgut contain? (7)
A
- second part of duodenum
- jejuunum
- ileum
- cecum
- appedix
- ascending colon
- first 2-thirds of transverse colon
16
Q
what does the hindgut contain? (5)
A
- last 1/3 of transverse colon
- descending colon
- sigmoid colon
- rectum
- upper part of anal canal
17
Q
what is the trunk that supplys to the foregut?
A
- coeliac trunk
18
Q
what are the branches of the coeliac trunk? (3)
A
- left gastric artery
- splenic artery
- common hepatic artery
19
Q
what does the left gastric artery supply? (2)
A
- the lesser curvature of the stomach
- lower part of oesophagus
20
Q
what does the splenic artery supply? (3)
A
- spleen
- part of stomach
- part of pancreas
21
Q
what does the common hepatic artery divide into and supply? (2)
A
- proper hepatic artery - liver
- gastroduodenal artery - first part of duodenum
22
Q
where vertebral evel is the coeliac trunk found?
A
T12
23
Q
what does the proper hepatic artery further split into, and supply (4)?
A
- right gastric artery - lesser curvature of stomach
- cystic artery - gall bladder
- left hepatic artery - liver
- right heptic artery - liver
24
Q
what does the gstroduodenal artery further split into and supply (3)?
A
- supra duodenal artery - superior aspect of duodenum
- right gastroepiploic artery - inferior greater curvature of stomach
- superior pancreatic duodenal artery - duodenum and pancreas
25
what boundary does the pelvid brim/pelvic inlet mark?
* boundary between abdominal and pelvic cavities
26
what is the omentum? (2)
* two folds of peritoneum, that line the abdominal cavity and abdominal organs
* plats role in supporting and protecting abdominal organs
27
the greater omentum: (origin, location and role)
* hangs down from greater curavture of stomach
* drapes over abominal organs
* contains lymph nodes and immune cells to respond to infections and inflammation
28
why is the greater omentum known as the policeman of the abdomen?
* it can migrate to areas of inflammation to help contain infections or seal off injured areas
29
what ligaments are there in the greater omentum, and what they connect: (3)
* gastrocolic ligament - greater curvature of stomach and transverse colon
* gastrosplenic ligament - stomach to spleen
* gastrophrenic ligament - stomach to diaphragm
30
what does the gastrocolic ligament contain?
* blood vessels, nerves and lymphatic vessels to stomach and transverse colon
31
the lesser omentum location (2)
* extends from lesser curvature of stomach and proximal duodenum
* to the liver
32
the two ligaments of the lesser omentum:
* hepatogastric ligament - liver and lesser curvature of stomach
* hepatoduodenal ligament - liver to first part of duodenum
33
what important structure does the lesser omentum contain?
* the portal triad
34
how is the foregut attachment different from the rest of the GI tract?
* attached at the back **and front** to abdominal wall by 2 double folds of peritoneum
35
what are the attachments that connect the foregut to the abdominal wall called?
* Dorsal mesogastrium = back
* ventral mesogatrium front
36
what is the epiploic foramen? (2)
* the only opening in the peritoneum that connects the greater and lesser sac
* located posterior to free edge of lesser omentum - the bit that connects the liver to lesser curvature of stomach
37
how does the epiploic foramen form? (2)
* duodenum is stuck against liver
* leaves small section of lower free boarder of lesser omentum
38
what are the 3 arteries that supply the GI tract, and which part:
* foregut - coeliac artery
* midgut - superior mesenteric artery
* hindgut - inferior mesenteric artery
39
what are the peritoneal attachments of the liver also referred to as?
ligaments
40
what are the peritoneal attachments of the liver? (4)
* falciform ligament
* coronary ligament
* right triangular ligament
* left triangular ligament
41
# origin, insertion, anterior boarder, posterior boarder, what it contains
the falciform ligament: (5)
* origin - diaphragm
* insertion - highest part of liver, down to hepatic notch
* anterior boarder attaches to abdominal wall
* posterior boarder hangs free
* contains ligamentum teres
42
what does the falciform ligament line of attachment do?
* divide the liver into the left (smaller) and right (larger) lobes
43
what is the ligamentum teres
* a remnant of the foetal umbilical vein
44
the coronary ligament: (2)
* located on superior posterior part of liver
* surrounds front of inferior vena cava
45
the right and left triangular ligaments: (2)
* formed where the anterior and posterior layers of the coronary ligament meet on the left and right side
* attaches to the right/left lobe of liver
46
the stomach position relative to the costal margin:
* more than half of stomach lies above level of costal margin
47
the junctions of the stomach: (2)
* gastro-esophageal junction - where oesophageus meets stomach
* pyloric junction - where stomach meets duodenum
48
what is the most superior part of the somach called?
* the fundus
49
what is the narrow part of the stomach called?
* the pyloric antrum
50
the walls of the GI tract: (2)
* outer layer of smooth muscle
* inner layer of mucosa
51
difference between mucosa in the fundus and pyloric antrum of the stomach: (2)
* fundus = smooth
* pyloric antrum = prominent longitudinal folds known as ruggae
52
which of the two sphincters of the stomach is more effective?
* pyloric sphincter
53
what is the biliary system?
* a network of ducts and structures (organs) that play a crucial role in production, storage and transportation of bile
54
what does the biliary system include? (7)
* lliver
* gallbladder
* common bile duct
* pancreatic duct
* amupulla of Vater
* Hepatic ducts
* Cystic ducts
55
what are ampulla of Vater? (3)
* smal opening
* where the common bile duct and pancreatic duct
* enter the duodenum
56
what do hepatic ducts do?
* carry bile away from liver
57
what do cystic ducts do? (2)
* connect gallbladder to common hepatic duct
* allows flow of bile from gallbladder to common bile duct
58
where does the common bile duct end up? (2)
* duodenum
* enters at the duodenal papilla
59
what 2 structures enter the duodenum at the duodenal papilla?
* common bile duct
* pancreatic duct
60
main functions of the spleen? (2)
* blood filtration - removees old/damaged RBCs from blood stream and also debris
* immune response - contains WBCs, lymphocytes and macrophages
61
# ligaments
what are the two folds of peritoneum that connect to the spleen?
* gastrosplenic ligament - at the front, connects to stomach
* Lienorenal ligament - at the back, loose connection to left kidney
62
what vessels supplies the spleen, and where they enter the spleen?
* splenic blood vessels
* hilum of spleen
63
what is the hilum of the spleen?
* refers where the blood vessels, nerves and lymphatic vessels enter ane exit organs (spleen in this case)
64
the superior and inferior boundary of the abdominal cavity:
* superior - diaphragm
* inferior - pelvic inlet
65
what is peritonitis?
* inflammation of the peritoneum
66
the three components of the portal triad and their position:
* bile duct - anterior right
* hepatic duct - anterior left
* portal vein - posterior
67
the boundaries of the epiploic foramen: (4)
* anterior - hepatoduodenal ligament
* posterior = IVC
* superior = liver
* inferior = 1st part of duodenum
68
what is splenomegaly?
* enlargement of the spleen
69
what is the large intestine mesentery called?
* mesacolon
70
divisions of the splenic artery that supply the stomach: (2)
* short gastric artery - fundus of stomach
* left gastro-epiploic artery - greater curvature of stomach
71
the common hepatic artery branches that supply the stomach: (2)
gastroduodenal artery
* right gastroduodenal artery - greater curvature of stomach
hepatic artery proper:
* right gastric artery - lesser curvature of the stomach
72
what are the specific branches of the coeliac truk that supply the stomach: (5)
* left gastric artery
* right gastric artery
* left gastro-epiploic artery
* right gastro-epiploic artery
* short gastric artery
73
what level does the bifurcation of the aorta occur?
T12
74
the steps of hepatic circulation: (11)
1. heart
2. arteries
3. arterioles
4. capillary 1 - lamina propria
5. venules
6. veins (hepatic portal system)
7. venules
8. capillary 2 - hepatic sinusoids
9. venules
10. veins
11. heart
75
3 the features tha distinguish the large from small intestine, and what are they?
1. appendices epiploicae - fatty projections
2. taenia coli - 3 bands of longitudinal layers of smooth muscles of the wall
3. haustria - sacculations of the wall between the taenia coli
76
what are the jejunum and ileum?
* jejunum - middle section of SI
* ileum - final section of SI
77
differences of jejunum compared to ileum: (3)
jejunum is:
* wider
* thicker wall
* large, tall and closely packed **pilcae circulares**
78
what are pilcae circulares, and 2 major functions?
* folds of mucous membrane found in the SI
* slows down movement of chyme (food)
* increases SA
79
at what vertebral level does the superior mesenteric artery branch off?
L1
80
what does the superior mesenteric artery give rise to to the SI? (2)
* the jejunal and ileal branches
81
what do the jejunal and ileal branches give rise to? (2)
* vasa recta - short striaght arteries
* arterial arcades
82
which branch has more arterial arcades, the jejunum or ileal branch?
* ileum
83
in which branch are the vasa recta shorter, jejunum or ileum?
* ileum
84
blood supply from the superior mesenteric artery to the LI: (3)
* middle colic
* right colic
* ilio colic
85
the branches of the superior mesenteric artery: (6)
1. inferior pancreatic duodenal artery
2. jejunal branches
3. ileal branches
4. middle colic
5. right colic
6. ileocolic
86
# 4 for iliocolic
what do the right, middle and ilio-colic artery supply?
* right - ascending colon
* middle - transverse colon
* iliocolic - terminal ileum, appendix, cecum and part of ascending colon
87
where does the inferior mesenteric artery arise, vertebral level?
L3
88
what does the inferior mesenteric artery give rise to? (3)
* left colic artery
* sigmoid arteries
* superior rectal artery
89
# two branches
what does the left colic artery supply? (3)
* ascending branch - distal transverse colon & upper ascending colon
* descending branch - lower descending colon
90
what do the branches of the left colic artery anastomose with?
* ascending branch - middle colic artery
* descending branch - sigmoid artery
91
how many sigmoid arteries are there?
* varies from 2-4
92
what do the sigmoid arteries supply? (1)
* sigmoid colon
93
what do the branches of the sigmoid arteries anastomose with? (2)
* left colic artery
* superior rectal artery
94
what does ths superior rectal artery supply?
upper rectum
95
what does the superior rectal artery anastomose with? (2)
* middle and inferior rectal arteries
96
what is the first branch of the inferior mesenteric artery?
* the superior rectal artery
97
where do the gastroc veins drain blood from and to?
* lesser curvature of the stomach
* portal vein
98
where do the gastroepiploic veins drain blood to? (2)
* portal and splenic vein
99
what vein drains all the midgut organs?
* superior mesenteric vein
100
the 3 primary tissues where blood drains to both hepatic portal system and caval veins?
* oesophagus
* rectum
* anterior abdominal wall
101
the primary portal and caval vein of the oesophageal region:
* portal - left gastric vein to HPV
* cval - oesophageal vein to azygous vein
102
# 4 for each - pathway
the primary portal and caval vein of the rectum region:
portal:
* superior rectal vein
* to inferior mesenteric vein
* into splenic vein
* into HPV
caval:
* middle/inferior veins
* into internal iliac vein
* into common iliac vein
* into IVC
103
the primary portal (1) and caval vein (4) of the anterior abdominal wall
Portal:
* periumbilical veins to HPV
Caval:
* superficial epigastric vein
* into femoral vein
* into external iliac vein
* into common iliac vein
104
where do the sympathetic nerves supplying the abdomen originate at the vertebral level: (2)
* T5-T12
* L1-L3
105
what is the parasympathetic supply to the abdomen?
* the vagus nerve
106
where does the aorta bificate?
* L4
107
what is the aortic plexus that surrounds the coeliac trunk?
* the coeliac plexus
108
what aortic plexus surrounds the superior mesenteric artery:
* superior mesenteric plexus
109
what aortic plexus surrounds he inferior mesenteric artery?
* the inferior mesenteric plexus
110
what aortic plexus surrounds the bifurcation of the aorta?
* the superior hypogastric plexus
111
what aortic plexus surrounds the internal iliac artery?
* the inferior hypogastric plexus (2 of them)
112
what two of the plexuses are connected and how?
* superior and inferior hypogastric plexus
* by hypogastric nerves
113
what are the 3 pre aortic ganglia where the abdominal nerves from the sympathetic chain go? and which thoracic nerves from which vertebrae go to which:
* the coeliac ganglia - T5-T9
* the superior mesenteric ganglia - T19-T12
* the inferior mesenteric ganglia - L1-L3
114
what are the main sympathetic nerves of the abdomen? (4)
* the greater, lesser, least & lumbar splanchnic nerves
115
the main parasympathetic nerves of the abdomen: (2)
* vagus nerve
* pelvic splanchnic nerves
116
where do the pelvic splanchnic nerves arise?
S2-S4
117
which parasympathetic nerve supplies which part of the abdomen:
* vagus nerve - foregut and midgut
* pelvic splanchnic nerves - hindgut
118
what is the cecum? (2)
* the side passage at the beginning of the alrge intestine
* hangs downward in right iliac fossa
118
what are the 2 branches of the portal vein?
* superior mesenteric
* splenic
119
boarders of the spleen: (5)
* anterior - stomach
* posterior - diaphragm
* inferior - left colic flexure
* superior - diaphragm
* medially - left kidney
120
the 4 main sections of the aorta:
* ascending aorta
* aortic arch
* thoracic aorta
* abdominal aorta
121
the abdominal aorta: where it begins, ends, position to IVC,
* begins at T12
* ends at L4
* lies to left of IVC
122
what does the superior mesenteric artery supply (the region)? (2)
* intestine - from duodenum up to first 2/3s of colon
* head of pancreas
123
the inferior mesenteric artery supply: (2)
* rest of colon, last 1/3
* rectum
124
the 3 large paired **lateral**branches of the abdominal aorta:
* suprarenal
* renal
* gonadal
125
what is the biggest branch of the paired branches of the abdominal aorta?
* the renal
126
what are the 5 paired **abdominal wall** branches of the aorta?
* inferior phrenic branch
* 4 lumbar branches
127
nmeumonic to remeber the 6 branches of the lumbar plexus:
* **I **(twice)
* **G**et
* **L**aid
* **O**n
* **F**ridays
128
what are the 6 nerves of the lumbar plexus:
* Iliohypogastric
* Ilioinguinal
* Gentiofemoral
* Lateral femoralcutaneous
* Obturator
* Femoral nerve
129
within what muscle does the lumbar plexus form?
* the psoas major muscle
130
where the nerves leave the psoas major muscle
* Anterior - genitofemoral nerve
* medial - obturator nerve
* Laterally - the other 4
131
what are the two parts of the diaphragm?
* aponeurotic part
* muscular part
132
what is the aponeurotic part of the diaphragm? (2)
* the central part
* the ligament part
133
what is the 3 sections of the muscular part of the diaphragm, and there specific attachments?
* sternal part - xiphoid process
* costal part - inferior 6 costal cartilages and ribs (6-12)
* lumbar part - L1-L3
134
what are the arcuate ligaments of the diaphragm? (3)
* median arcuate ligament
* medial arcuate ligament
* lateral arcuate ligament
135
what nerves innervate the peripheral part of the diaphragm?
* the lower 6/7 intercostal nerves and subcostal nerves
136
the blood supply of the adrenal glands: superior, middle, and inferior
* Superior - the inferior phrenic artery
* Middle - aorta
* Inferior - renal artery
137
difference in the shapes of the adrenal glands:
* right - pyramidal shaped
* left - crescentic shaped
138
which kidney lies slightly superior and why?
* left
* due to presence of liver
139
what vertebral level are the kidneys located?
* T12-L3
140
what are ureters? (4)
* muscular ducts
* transport urine from kidney to urinary bladder
* retroperiotneal structures
* pass over pelvic brim at bifurcation of common iliac arteries
141
what are the narrowing sites along the ureters?
* constriction potential sites
142
how many constriction potential sites are there along the ureters, and where are they:
Three
1. junction of ureters and renal pelvis
2. where ureter crosses pelvic brim
3. during passage through wall of urinary bladder
143
what does the iliohypogastric nerve innervate? (2)
* muscles of anterior abdominal wall
* skin of suprapubic region
144
what does the ilioinguinal nerve innervate? (4)
* muscles of anterior abdominal wall
* skin of anteriormedial part of thigh
* skin of scrotum and root of penis
* skin of labia and root of clitoris
145
what does the lateral femoral cutaneous nerve supply? (1)
* anterolateral part of thigh
146
the branches of the genitofemoral nerve: (2)
* genial branch
* femoral branch
147
what does the genial branch supply (3)
* cremaster muscle
* skin of anterior scrotum
* skin of labia majora
148
what does the femoral branch of the genitofemoral nerve supply?
* skin of upper and anterior thigh
149
lymphatic drainage from the alientary tract, liver, spleen & pancreas: (2)
* pre-aortic lymph nodes: coeliac, superior & inferior mesenteric nodes
* intestinal lymphatic trunk
150
lymphatic drainage from the PAW, kidneys, ureters & testes (2)
* lumbar lymph nodes
* lumbar lymphatic trunks
151
what are the layers of the anterior abdominal wall from superficial to deep? (6)
1. skin
2. superficial fascia
3. muscles
4. transversalis fascia
5. extraperitoneal fat
6. parietal peritoneum
152
what can the superficial fascia be divided into? (2)
* campers fascia - fatty layer
* Sarcpa.s fascia - membranous layer
153
origin and insertion of the inguinal ligament
* origin - ASIS
* insertion - pubic tubercle
154
function of the inguinal ligament (2)
* forms base of inguinal canal
* supports abdominal wall
155
what is the deep fascia of the anterior abdominal wall:
the transversalis fascia
156
what is the transversalis fascia function: (2)
* structural support
* forms part of inguinal canal
157
