Abdominal Viscera Flashcards
(128 cards)
1
Q
Derivatives of Foregut (celiac trunk)
A
Esophagus, stomach, duodenum, liver, gallbladder, spleen, pancreas
2
Q
Derivatives of Midgut (superior mesenteric artery)
A
- Duodenum (also part of foregut), jejunum, ileum, cecum and appendix, ascending colon, 2/3 of transverse colon
3
Q
Derivatives of Hindgut (inferior mesenteric artery)
A
1/3 transverse colon, descending and sigmoid colon, rectum and anal canal
4
Q
The thoracic esophagus pierces the diaphragm at ____
A
T10 (this is known as the esophageal hiatus)
5
Q
Where is the esophageal hiatus located
A
T10 (this is where thoracic esophagus pierces the diaphragm)
6
Q
The esophagus is slightly ____ of midline
A
left
7
Q
The esophagus is slightly left of midline and then turns sharply ____ to enter the stomach at the _____
A
left to enter the stomach at the cardiac orifice
8
Q
The cardiac orifice is located at about T____
A
T11
9
Q
The abdominal esophagus is about ____ cm
A
2.5cm
10
Q
The esophageal sphincter is physiologic, and not
A
well defined anatomically
11
Q
IVC passes through the diaphragm at ____
A
T8
12
Q
The Aorta passes through the diaphragm at
A
T12
13
Q
openings in the diaphragm are called ____
A
hiatuses
14
Q
What is a sliding hiatus hernia
A
- esophageal hiatus of diaphragm enlarges or weakens
- Abdominal esophagus and parts of the stomach (cardia and sometimes fundus) herniate into the thorax
15
Q
Paraesophageal hiatel hernia
A
- a defect in diaphragm next to the esophageal hiatus
- permits funds of stomach to herniate (not usually the esophagus)
16
Q
Left end of stomach is fixed at
A
T10-T11
17
Q
Right end of stomach is fixed at
A
L1-L2
18
Q
The stomach is located in the
A
left hypochondriac and epigastric regions
19
Q
Parts of stomach
A
- fundus
- cardiac part, cardiac orifice
- body
- pylorus
- pyloric antrum
- rugae
- pylorus (pyloric sphincter)
- Pyloric orifice
20
Q
The pyloric antrum is the entrance to the
A
pyloris
21
Q
What is the entrance to the duodenum
A
pyloric orifice
22
Q
Posterior to the stomach
A
- diaphragm
- spleen (posterior and lateral)
- left suprarenal gland
- upper left kidney
- pancreas
- left colic flexure
- left transverse colon
- Transverse mesocolon
23
Q
Anterior to the stomach
A
- anterior abdominal wall
- left costal margin
- left diaphragm
- left and quadrate lobes of the liver
24
Q
The _____ is located between the stomach and the large intestine
A
small intestine
25
the duodenum is in what quadrant
RUQ
26
The duodeno-jejunal flexure
LUQ
27
how long is the duodenum
10 inches long (12 finger-breadths)
28
The duodenum is located approximately at L_ and L__ vertebral bodies
L1 and L4
29
The duodenum starts at the ____ of the stomach and ends at the ___
pylorus and ends at the duodenal-jejunal junction
30
The duodenum can further be subdivided into __-parts. what are they
- 4
| - Superior, descending, horizontal, and ascending
31
The duodenum is secondarily retroperitoneal except for some of the ___ and ___ parts
1st and 4th (superior and ascending)
32
Covered anteriorly by peritoneum except where the _________ crosses the 2nd part (descending) of the duodenum
mesocolon of the transverse colon crosses
33
The 1st part (superior) of the duodenum is surrounded by the
hepatoduodenal ligament
34
The root of "the mesentery" begins at the _______
duodeno-jejunal flexure
35
Features of the 1st part (superior) duodenum
- starts at the pyloric sphincter
- about 2 inches long
- held in place by the hepatoduodenal ligament
- Portal vein, hepatic artery and bile duct are therefore posterior and superior to this part
- Duodenal bulb (widened area)
- The head of the pancreas is inferior to this part
36
Features of the 2nd part (descending) duodenum
- about 3 inches long
- all retroperitoneal (secondarily)
- The fundus of the gall bladder, right lobe of the liver, transverse colon are all anterior
- The right kidney and ureter are posterior
- the head of the pancreas is medial
- the bile and pancreatic ducts enter into the second part of the duodenum a the duodenal papilla
37
The bile and pancreatic ducts enter into the ___ part of the duodenum at the ____-
2nd (descending) part of duodenum at the major duodenal papilla
38
Features of the 3rd part (horizontal) duodenum
- Superior mesenteric artery and vein and the root of the mesentery cross the anterior surface of the 3rd part of the duodenum
- the head of the pancreas is superior
- The jejunum is anterior and inferior
39
Features of the 4th part (ascending) duodenum
- not covered by peritoneum
- the root of the mesentery and jejunum are anterior
- the left margin of the aorta and medial border of the psoas muscle are posterior
- the 4th part is held in place by the suspensory ligament (or muscle) of the duodenum (of Treitz)
- The suspensory ligament anchors the 4th part of the duodenum to the right crus of the diaphragm
40
____ and ____ occupy most of the peritoneal cavity of the abdomen and pelvis
jejunum and ileum
41
The jejunum and ileum are coiled and bout ___ feet long
20
42
The jejunum begins at _____ junction and the ileum ends at the _____ valve
duodenual-jejunal junction and the ileum ends at the oleo-cecal valve
43
The jejunum and the ileum are very mobile and held to posterior wall by
The mesentery
44
The jejunum and ileum are "framed" by the
large intestine
45
The jejunum and ileum are often called the
free small intestine
46
The jejunum is about ____ feet long
8-10
47
The jejunum is about _____ of the free small intestine
2/5
48
The jejunum has simple ____ arcades, long _____, and is more ____ than the ileum
vascular, long vasa recta, more vascular
49
The jejunum has a _____ diameter, is ___ , and has ____ plicae circularis than the ileum
greater, thicker, more
50
The ileum is about ____ feet long
10-12 feet long
51
The ileum is _____ of the free small intestine
3/5
52
The ileum has _____ vascular arcades, ____ vasa recta, and is _____ vascular than the jejunum
less
53
The ileum is ____ in diameter and ____ walled when compared to the ileum
smaller and thinner
54
The ileum has ____ plicae circularis than the jejunum
fewer
55
what is the most common congenital anomaly of the small intestine
Meckel's (ileal) diverticulum
56
Meckel's (ileal) diverticulum occurs in about ___% of the population
2%
57
Meckel's (ileal) diverticulum is about ___ feet form the ileocecal junction
2
58
Meckel's (ileal) diverticulum is on average about ___ inches long
2
59
Meckel's (ileal) diverticulum is a remnant of the _____ duct
vitelline
60
Meckel's (ileal) diverticulum is clinically difficult to distinguish from ____
appendicitis
61
"THE Mesentery" is about ___ cm long at the root. and it attaches the ___ and ___ to the ____
15cm, it attaches the jejunum and the ileum to the posterior body wall
62
"The mesentery" crosses
- LV1-2
- 3rd part of duodenum
- aorta
- IVC
- right ureter
- right gonadal vessels
- right psoas major
- ends at right S.I. Joint
63
The mesentery is made up of ___ layers of peritoneum with nerves, lymph nodes, vessels, fat, arteries and veins running between them
2
64
The mesentery is made up of 2 layers of peritoneum with _____, _____, _____, ____, ____ and ______ running between them
nerves, lymph nodes, vessels, fat, arteries, and veins
65
What are the regions of the Large intestine
- Cecum and vermiform appendix
- Ascending colon
- Right colic flexure
- Transverse colon
- Left colic flexure
- Descending colon
- Sigmoid colon
- Rectum and anal canal are in the pelvis
66
What are the functions of the large intestine
- fecal formation, transport and evacuation, water absorption and mucus secretion
67
______ are 3 bands of longitudinal muscle on the outside of the colon
Taeniae coli
68
The Tania coli converge at the root of the
appendix
69
The Tania coli produce _____ that slow the movement of ____
haustrae (sacculations), feces
70
Tags of fat, that are a characteristic of the large intestine
Appendices epiploicae (epiploic appendages)
71
Characteristics of the Cecum
- no epiploic appendages
- blind "pouch" inferiro to ileocecal orifice
- iliocolic valve is 2 folds that are not a true sphincter
- ileal papilla is a cone-like projection of the ileum into the cecum
- The opening for the appendix is inferior to the ideal papilla
72
is a cone-like projection of the ileum into the cecum
ileal papilla
73
The opening for the appendix is inferior to the
ileal papilla
74
The iliocolic valve is ___ folds that are not a
2 folds that are not a true sphincter
75
blind "pouch" inferior to ileocecal orifice
Cecum
76
The vermiform appendix is usually attached to the
posteromedial part of the cecum
77
The vermiform appendix is located at the junction of ______
3 taenia coli
78
The vermiform appendix is ____ cm long and supported by a ______
9-10 cm long and supported by a mesoappendix
79
Characteriestics of the ascending colon
- Right colic flexure (hepatic flexure)
| - secondarily retroperitoneal (usually) except the lowest part
80
Characteristics of the transverse colon
- left colic flexure (splenic flexure)
| - intraperitoneal (transverse mesocolon)
81
Characteristics of the Descending colon
- Secondarily retroperitoneal
82
Characteristics of the sigmoid colon
- Intraperitoneal (sigmoid mesocolon)
83
Location of the spleen
- left hypochondriac region
- Parallel left ribs 9,10, and 11
- midaxillary line, between stomach and diaphragm
84
What is the size of the spleen
about the size of the hand
85
Is the spleen normally palpable below the costal margin
no
86
Peritoneal relationships of the spleen
- covered by peritoneum
| - develops in the dorsal mesentery from mesoderm (gastrosplenic ligament and splenorenal ligament)
87
_____ is posterior to the spleen
diaphragm
88
____, ____, and _____ are anterior to the spleen
stomach, left colic flexure, and tail of the pancreas
89
The ____ and ____ are inferior to the spleen
left kidney and phrenicocolic ligmanet
90
Visceral surface of the spleen
- Hilum with gastrosplenic and splenorenal ligaments
| - There are colic, gastric and renal impressions on the visceral surface of the spleen
91
The pancreas is ______ retroperitoneal
secondarily
92
The pancreas is loaded at about L ___-L____
L1-L2
93
Parts of the pancreas
- Head- with uncinate process, in the duodenal curve
- Body- Triangular cross-section
- Neck- Triangular cross-section
- Tail- Some of the tail is located in the splenorenal ligament , anterior the hilus of the spleen
94
____ and ____ are posterior to the neck of the pancreas
Superior mesenteric artery and vein
95
____ and ___ run horizontally superior to or posterior to the body of the pancreas
Splenic vein and artery
96
The tail of the pancreas is against the _____
spleen
97
______ and _____ are posterior the body of the pancreas
Inferior vena cava and aorta
98
The duodenum is ___, ___ and ___ to the head of the pancreas
superior, right and inferior
99
The transverse colon lies ___ and ___ to the pancreas
anterior and inferior
100
The main or major pancreatic duct joins the bile duct and they enter the ____ part of the duodenum together through a common _______
2nd part (descending), common hepatopancreatic ampulla
101
The accessory pancreatic duct (if present) enters the duodenum at the more superior ______
minor duodenal papilla
102
The main or major pancreatic ducts joins the bile duct and they enter the 2nd part (descending) of the duodenum together through a common hepatopancreatic ampulla. This forms the ______
major duodenal papilla
103
most of the liver is loaded in the
Right upper quadrant
104
The smaller left lobe of the liver is located in the
left upper quadrant
105
lobes of the liver
- left
- right
- caudate
- quadrate
106
The ____ is a double layer of peritoneum that connects the liver to the anterior wall
falciform ligament
107
The diaphragmatic surface of the liver
- smooth and fits concavity of diaphragm
- peritoneum attaches the liver is to the anterior body wall and the peritoneum splits to encode a "bare area" of the liver
108
The bare area of the liver includes the area where the ____ is posterior to the liver and the _____ drain into it
IVC, Hepatic veins
109
The visceral surface of the liver
- ligamentum venosum
- ligamentum teres h.
- haptic fossa for gall bladder
- lobes of the liver (right, left, caudate, and quadrate)
110
The ligamentum venosum is between what two lobes of the liver
left lobe and Caudate
111
The ligamentum teres h. is between what two lobes of the liver
the left lobe and the quadrate
112
Visceral (posterior) surface of the liver features
- The porta hepatis
- Ligamentum teres
- ligamentum venosum
- Hepatic fossa for gall bladder
113
A transverse fissure between the caudate and quadrate lobes
Porta hepatis
114
The porta hepatis transmits the ______
portal triad
115
The portal triad is composed of
- hepatic artery (proper)
- Portal vein
- Bile duct
116
The ligamentum teres is in the edge of the ______
falciform
117
The ligamentum teres is the obliterated
umbilical vein
118
The ligamentum venous is the old
ductus venosus (used to connect the umbilical vein with the inferior vena cava)
119
The lesser omentum is composed of
hepatoduodenal and hepatogastric ligaments
120
The gallbladder lies in the _____
hepatic fossa
121
What is the lowest, widest part of the gallbladder
fundus
122
The fundus of the gallbladder contacts the anterior abdominal wall at the _______, ________
midclavicular line, 9th or 10th costal cartilage
123
The gallbladder is usually located on the ____ line
transpyloric line
124
Parts of the gallbladder
- fundus, body, neck
125
Exrahepatic bile passages
- right hepatic duct (R) and left hepatic duct (L), which together form the common hepatic duct
- cystic duct
- bile duct (common bile duct)
126
The common bile duct is formed from
the cystic and common hepatic ducts
127
The Bile duct runs in the
edge of the lesser omentum (hepatoduodenal ligament)
128
The bile duct goes posterior and inferior to the _____ part of the duodenum, posterior to the head of the pancreas, and enters the ___ part of the duodenum with the pancreatic duct
1st, 2nd
