Abdominal organs and abdomen Flashcards
(33 cards)
Name the parts of the stomach
-Cardia (connects stomach to oesophagus)
-Body
-Fundus
-Pylorus (connects pylorus to duodenum with pyloric sphincter)
Stomach also has a greater and lesser curvature.
Describe the duodenum
-4 parts which form a c shape around the head of the pancreas
-The 2nd, 3rd and 4th parts are all retroperitoneal
-First part ascends from gastroduodenal junction
-Second part descends in curve around head of pancreas
-Third part runs transversely to the left
-4th part ascends upwards and to the left to terminate in DJ flexure
- Superior
- Descending
- Inferior
- Ascending
Into which part of the duodenum does the CBD enter?
-Enters posteromedial wall of the 2nd part of the duodenum in the ampulla of vater (flow of bile is regulated by the sphicter of oddi)
How can you tell the difference between the jejunum and ileum?
-Jejunum: thicker wall, greater diameter, valvulae conniventes become thicker more proximally
-jejunum: longer vasa recta, fewer arterial arcades
-Mesentery of jejunum is thinner
How can you tell the difference between large and small bowel on an abdominal radiograph?
-Large bowel: haustra, only go 1/3rd of way accross bowel
-Small bowel: valvulae conniventes, go all the way accross the lumen
-Small bowel is central, large bowel peripheral
During surgery:
-Large bowel can be distinguished by appendices epiploicae and taeniae coli
How many parts does the pancreas have?
-Uncinate process
-Head
-Neck
-Body
-Tail
What are the functions of the pancreas?
Endocrine
-alpha cells: glucagon
-Beta cells: insulin
-Delta cells: somatostatin
Exocrine (pancreatic acini)
-Amylase
-Lipase
-Trypsinogen
Describe the blood supply to the pancreas and the venous drainage
-Head:
—> superior pancreaticoduodenal (gastroduodenal)
—> inferior pancreaticoduodenal (SMA)
Body and tail
—> splenic artery
Venous drainage:
–> follows arterial supply: mesenteric veins, portal veins, splenic vein
What are the three main divisions of the coeliac axis?
-Left gastric artery
-Common hepatic artery
-Splenic artery
Describe blood supply to stomach
Lesser curvature
–> Left gastric (coeliac trunk)
–> Right gastric (Common hepatic
Greater curvature
–> left gastroepiploic (splenic)
–> right gastroepiploic (gastroduodenal)
Fundus and posterior:
–> short and posterior gastric arteries from splenic
Describe the gastro-epiploic (gastro-omental) arteries
-Left gastro-omental artery is largest branch of splenic
-Right gastro-omental is from gastroduodenal, which is from common hepatic.
-Both give off gastric branches that supply anterior and posterior surface of stomach, and omental branches that supply greater omentum
Which artery can bleed due to erosion by a duodenal ulcer?
Gastroduodenal (supplies 1st and 2nd parts duodenum)
Rarely ulcer in 3rd/4th part of duodenum could cause pancreaticoduodenal artery to bleed
What is a meckel’s diverticulum? What complications can it cause?
Remnant of the vittelo-intestinal duct (connects midgut to the yolk sac)
Rule of 2s:
-2% of the population
-Twice as common in men as women
-2 inches long
-2 feet from ileocaecal valve
Complications:
–> acute inflammation (can mimic appendicitis)
–>Ulceration and bleeding (ectopic gastric mucosa)
–> perforation
–> intussusception
–> obstruction
–> littre’s hernia: hernia containing meckel’s diverticulum, found most frequently in inguinal region
–> tumours can occur in meckel’s diverticulum
Where are the kidneys found?
-Vertebral level T12-L3
-Hilum is at L1 (transpyloric plane)
-Right kidney is normally around 1 inch lower than the left
-Kidneys are retroperitoneal structures surrounded by perinephric fat and gerota’s fascia
What are the relations of the kidney>
Posterior:
–> diaphragm
–> psoas major, quadratus lumborum, transversus abdominis
–> 12th rib (11th left side)
–> nerves top to bottom: subcostal (T12), iliohypogastric and ilioinguinal (L1)
Anteiror:
Both
–> Suprarenal gland
–> colic flexure
–> small intestine (jejunum left, duodenum right)
Left:
–> Spleen
–> Stomach
–> Pancreas
Right:
–> Liver
Where do the suprarenal glands lie:
antero-superiorly to kidney, in separate compartment of encompassing gerota’s fascia
What are the layers of the adrenal gland?
Each adrenal gland has a medulla surrounded by outer cortex. Medulla secretes adrenaline and noradrenaline
Cortex is divided into 3 layers (GFR from superficial to deep)
-Zona glomerulosa (produces mineralocorticoid: aldosterone)
-Zona fasciculata: produces mineralocorticoid (cortisol)
-Zona reticularis (produces androgens)
What organs are palpable in the normal abdomen
-Aorta
-Upper pole of right kidney in some individuals
-Liver and spleen can be felt in pathology
Name surface markings of:
1. the neck of the pancreas
2. The liver
3. The gallbladder
4. The spleen
- L1 transpyloric plane
- Runs superiorly along the nipple line to the left 5th intercostal space mid-clavicular line, inferiorly along right 10th rib
- 9th costal cartilage, mid clavicular line
- Lies behind 9th, 10th and 11th rib. Susceptible to blunt chest wall and abdominal trauma
Identify the branches of the aorta
Anterior branches
-Coeliac axis (T12)
-SMA (L1)
-IMA (L3)
Lateral/posterior branches:
-T12: inferior phrenic, middle suprarenal
-L1-2: renal arteries
-L1-L4: lumbar arteries
-L2: gonadal arteries
-L4: divides into common iliacs, median sacral given off
Surface markings of abdominal aorta
-Enters abdomen at T12 through diagphragm
-Runs in retroperitoneal space
-Bifurcates at L4 into common iliacs, gives off median sacral
What is this investigation?
Ct aortogram. It is a form of digital subtraction angiography
What branch is this?
Splenic artery
What artery is this?
SMA
