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Anatomy Exam III > Abdomen > Flashcards

Abdomen Flashcards

1
Q

Peritoneum

A

Serous membrane w/ two layers
1. parietal
2. visceral
Between layers peritoneal cavity w/ serous fluid

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2
Q

Greater sac

A

accounts most of the space in peritoneal cavity

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3
Q

Lesser sac (Omental bursa)

A

small space posterior to the lesser momentum, stomach, liver and inside greater momentum; sac is created by stomach rotation and growth of liver

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4
Q

Communication between greater and lesser sac

A

Epiploic foramen (foramen of Winslow’s)

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5
Q

Peritoneal cavity

A

Males: closed cavity
Females: fallopian tube open into cavity

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6
Q

Peritoneal fold: stomach

A

lesser and greater omentum

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7
Q

Peritoneal fold: small intestine

A

mesentery

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8
Q

Peritoneal fold: large intestine

A

mesoappenix, transverse mesocolon, sigmoid mesocolon

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9
Q

Intraperitoneal organs

A

stomach, 1st part of duodenum, jejunum, ileum, appendix, transverse colon, sigmoid colon, liver, spleen

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10
Q

Retroperitoneal organs (SADPUCKER)

A

Suprarenal glands, aorta, duodenum 2-4, pancreas, ureter, colon, kidney, esophagus and rectum

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11
Q

Ligament

A

double layer of peritoneum connects an organ with another or anterior abdominal wall

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12
Q

Mesentery

A

double layer of peritoneum result from the invagination of the peritoneum by the intestine

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13
Q

Omentum

A

double layer of peritoneum passing from the stomach and first part of the duodeunm to adjacent organs

greater omentum –> greater curvature
lesser omentum –> lesser curvature

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14
Q

Nerve supply: Parietal peritoneum

A

somatic nerves of the overlying muscles and skin

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15
Q

Nerve supply: Visceral peritoneum

A

Autonomic nerves with the underlying viscera (does not receive somatic (pain) but receives sympathetic (stretch, tension))

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16
Q

Blood supply: foregut

A

celiac trunk (T12)

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17
Q

Blood supply: midgut

A

superior mesenteric artery (L1)

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18
Q

Blood supply: hindgut

A

inferior mesenteric artery (L3)

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19
Q

Organs arising from foregut

A

stomach, liver, gallbladder, pancreas, 1st half of duodenum

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20
Q

Organs arising from midgut

A

2nd half of duodenum, jejunum, ileum, cecum, ascending colon, 2/3 transverse colon

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21
Q

Organs arising from hindgut

A

L 1/3 transverse colon, descending colon, sigmoid colon, rectum

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22
Q

Stomach dilation can occur because of…

A

rugae (folds in the mucosa)

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23
Q

Stomach bed

A

Structures posterior to the stomach separated by lesser sac
Speen
4 L (L kidney, L suprarenal, L colic flexure, L crus of diaphragm)
4 T (transverse colon, mesocolon, body of pancreas, splenic artery)

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24
Q

Hepatogastric ligament

A

Porta hepatis of liver to lesser curvature of stomach

lesser omentum - ventral mesentery

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25
Q

Hepatoduodenal ligament

A

Porta hepatis of liver to the 1st part of duodenum

lesser omentum - ventral mesentery

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26
Q

Greater omentum

A 
Dorsal mesentery 
Policeman of the abdomen 
-gastrosplenic
-gastrcolic
-splenorenal
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27
Q

Fissures of the liver

A
  1. Fissure for ligamentum venosum (from ductus venous)
  2. Fissure for ligamentum teres (round ligament)
  3. Foss of gall bladder
  4. Fissure for IVC
  5. Porta Hepatis
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28
Q

Porta Hepatis

A

lies transversely between the quadrate and caudate lobes

Structures: portal vein, hepatic artery, hepatic duct (from posterior to anterior)

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29
Q

Anatomical lobes of liver

A

Right lobe contains caudate and quadrate divided by falciform ligament, fissure for ligamentum theres and venosum

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30
Q

Function lobes of liver

A

Left lobe contains caudate and quadrate (division based on blood supply) divided by fossa of gallbladder and IVC

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31
Q

Physiological blood supply to the liver

A

Hepatic artery: 25% blod and 50% oxygen demand

Portal vein: 75% of blood and 50% oxygen demand

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32
Q

Sphincter of Oddi

A

Layer of circular muscle surrounding the lower end of bile duct, pancreatic duct and ampulla controlling the flow of bile and pancreatic secretions

33
Q

Location of the fundus of gall bladder

A

meeting point between the right line semilunaris and the 9th right costal cartilage (sight of tenderness for gall bladder inflammation)

34
Q

Common site for gall bladder stones

A

Hartmann’s pouch - posteromedial wall, neck of the gallbladder

35
Q

Venous drainage of the liver

A

sinusoids–>central veins–>hepatic v. –> IVC

36
Q

Vessels transmitted within gastrosplenic ligament?

A

short gastric and gastro-omental

37
Q

Location of the spleen

A

Left posterior, very close to 9,10,11 ribs, wedged between stomach and left kidney

38
Q

Duodenum

A

C shaped tube surrounding head of pancreas; pylorus to duodenojejunal flexure

1st part: lies at L1, peritoneal, attached to the greater and lesser omentum, duodenal cap –> duodenal ulcers
2n part: lies from L2-3, retroperitoneal, receives major and minor duodenal papilla
3rd: lies at L3, retroperitoneal
4th: lies from L3-2, retroperitoneal, duodenojejunal flexure tethered by the ligament of treitz

39
Q

Divisions of the SMA

A 
inferior pancreaticoduodenal
middle colic
right colic
ileocolic (appendicular, ileal)
Ilieal/ jejunal (12+)
40
Q

SMA

A

artery of the midgut
arises from abdominal aroma at L1
runs right toward iliac fossa
all branches to the right except jejunal and ileal

41
Q

IMA

A 
artery of handgun
arises from the abdominal aorta at L3
runs left towards iliac fossa
all branches to the left
ends by becoming superior rectal artery (once it crosses the left common iliac artery)
42
Q

Divisions of IMA

A

Left colic
Sigmoid arteries (2-3)
Superior rectal artery

43
Q

Anatomies between the GI arteries

A
  1. Pancreaticoduodenal (superior from celiac trunk, inferior from SMA)
  2. Marginal artery (between SMA and IMA)
44
Q

Pancreatic ducts

A
  1. main pancreatic duct (of Wirsung) joins the common bile duct and empties into the hepatopancreatic ampulla (ampulla of Vater)- 2nd part of duodenum
  2. accessory pancreatic duct- drains the uncinate process at the min papilla, proximal to the main papilla
45
Q

Appendices epiploicae (omental appendices)

A

small pouches filled with fat, absent in cecum, appendix and rectum (CAR)

46
Q

Taeniae coli

A

outer longitudinal muscle layer is thickened to form three bands which are shorter than the outer layers, they begin at the base of appendix and end at sigmoid colon

47
Q

Sacculations (haustra)

A

between the taeniae coli the colon bulges outwards forming three rows of pouches

48
Q

Peritoneal folds: Cecum

A

retroperitoneal

49
Q

Peritoneal folds: appendix

A

mesoappendix

50
Q

Peritoneal folds: ascending colon

A

retroperitoneal

51
Q

Peritoneal folds: transverse colon

A

transverse mesocolon

52
Q

Peritoneal folds: descending colon

A

retroperitoneal

53
Q

Peritoneal folds: sigmoid colon

A

sigmoid mesocolon

54
Q

Peritoneal folds: rectum

A

retroperitoneal

55
Q

Ileocecal valve

A

guards the ideal opening into the cecum; valve has 2 lips; opening to appendix lies two cm below

56
Q

Appendix

A

blind ending tube, rich in lymphoid tissue, suspended by mesoappendix; the three taeniae coli meet at the base of the appendix

57
Q

Acute appendicitis

A

acute inflammation of the appendix due to viral or bacterial infection; infection of the appendix may result in thrombosis of the appendicular artery (branch of ileocolic artery) which may lead to perforation of the appendix

58
Q

McBurney’s point

A

the point of maximum tenderness in acute appendicitis ; lies opposite the junction of lateral and middle thirds of a line joining the Rt ASIS to the umbilicus; pain from the appendix enter the spinal cord through T10 segment so pain of acute appendicitis is refereed to the umbilicus region

59
Q

Meckel’s diverticulum (syndrome of Two’s)

A

2 ft from IC valve, 2 inches long, 2% of population, 2% are symptomatic, 2 types of ectopic tissue (gastric and pancreatic), 2 years of age at clinical presentation, and 2x more common in boys

Inflammation of Meckel’s diverticulum

60
Q

Most common appendix

A

pelvic appendix

61
Q

Portal vein anastomes

A
  1. gastric and esophageal (azygos)
  2. paraumbilical and epigastric (iliac vein)
  3. s. rectal and inferior rectal (rectal vein)
62
Q

Liver cirrhosis effect on portal vein

A

Portal hypertension leads to increased pressure in tributaries, dilation of veins becoming fragile will causing bleeding at anastomes

  1. inferior esophagus bleeding
  2. inferior rectum bleeding
  3. caput medusae (varices around navel)
63
Q

Parasympathetic innervation on the gut

A

Foregut and midgut- vagus nerves

Hindgut- pelvic spanchnic nerves (S2,3,4)

64
Q

Sympathetic innervation on the gut

A

Foregut and midgut- thoracic splanchnic nerves (greater, lesser, least)
Hindgut- lumbar splanchnic nerves

65
Q

Three splanchnic nerves

A 
Greater = T5-T9
Lesser = T10-T11
Least = T12
66
Q

Layers of the posterior abdominal wall

A
  1. Bony layer: iliac bone, lumbar vertebrae, last 2 ribs
  2. Muscle layer
  3. Fascia
  4. Visceral layer: kidney, ureter, suprarenal, abdominal aorta, IVC
  5. Partial peritoneal layer
67
Q

Diaphragm openings

A

T8- IVC
T10- Esophagus
T12- Aorta

“i ate ten eggs at noon”

68
Q

Regions of the diaphragm

A

Right and left copula (right is higher due to liver)

Central tendon

69
Q

Origin of the diaphragm

A

sternal: xiphoid process
costal part: lower 6 costal cartilages
vertebral (lumbar): 2 crura and 5 ligaments

70
Q

Vertebral origin of the diaphragm

A

Right crus: upper three bodies of lumbar vertebrae, forms esophageal hiatus, forms the suspensory ligament of duodenum
Left crus: arises from bodies of upper 2 lumbar

Median arcuate ligament: unites crura across aorta, forming aortic hiatus
Medial arcuate ligament: tendinous arch across the upper part of posts major
Lateral arcuate ligament: tendinous arch across the quadrates lumborum

71
Q

Lumbar plexus: T12

A

subcostal nerve

runs in front of quadratus lumborum

72
Q

Lumbar plexus: L1

A

Iliohypogastric nerve
Ilioinguinal nerve

runs in front of quadratus lumborum and pierce internal oblique to run between it and external oblique

73
Q

Lumbar plexus: L1, L2

A

genitofemoral

pierces posas major

74
Q

Lumbar plexus: L2, L3

A

lateral cutaneus thigh

lateral to psoas major

75
Q

Lumbar plexus: L2,3,4

A

Femoral nerve- between iliac and psoas major

Obturator nerve- white round glistening, medial to psoas major

76
Q

Sites of constriction of ureter

A

Ureter may be obstructed by renal calculi (kidney stones) in three areas:

  1. Uretero-pelvic junction- where it joins the renal pelvis
  2. Pelvic inlet- crosses the pelvic brim over the distal end of the common iliac artery
  3. Ureterovesicular junction- enters the wall of the urinary bladder (narrowest point of the ureter)
77
Q

Arteries to the suprarenal gland

A
  1. Superior suprarenal artery from the inferior phrenic artery
  2. Middle suprarenal artery from abdominal aorta
  3. inferior suprarenal artery from the renal artery
78
Q

Suprarenal drainage

A

Right empties into the IVC

Left empties into the left renal vein

79
Q

Cisterna chyli

A

lower dilated lymphatic sac at the end of the thoracic duct and lies just to the right and posterior to the aorta, usually between two crura of the diaphragm

formed by the intestinal and lumbar lymph trunks, narrows superiorly and gives the thoracic duct

Anatomy Exam III (8 decks)

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