Abdominal Viscera Flashcards
(100 cards)
1
Q
What organs make up the foregut?
A
- esophagus
- stomach
- duodenum
- liver
- gallbladder
- spleen
- pancreas
2
Q
Which organs make up the midgut?
A
- duodenum
- jejunum
- ileum
- cecum and appendix
- ascending colon
- 2/3 of transverse colon
3
Q
Which organs make up the hindgut?
A
- 1/3 tranverse colon
- descending colon
- sigmoid colon
- rectum and anal canal
4
Q
At what vertebra level does the thoracic esophagus pierce the diaphragm?
A
- T10
- through the esophageal hiatus
- slightly left of midline
5
Q
What does the esophagus do once it courses through the esophageal hiatus?
A
- Turns sharply left to enter the stomach at the cardiac orifice.
- about T11
- abdominal esophagus is 2.5 cm long
- the esophageal sphincter is physiologic, not well-defined anatomically
6
Q
At which vertebral levels do structures pass through the diaphragm?
A
- T8 - IVC
- T10 - esophagus
- T12 - aorta
7
Q
What is a “sliding” hiatal hernia?
A
- esophageal hiatus of diaphragm enlarges or weakens
- abdominal esophagus and parts of the stomach (cardia and sometimes fundus) herniate into the thorax
** no CT image in slides **
8
Q
What is a paraesophageal hiatal hernia?
A
- defect in diaphragm next to the esophageal hiatus
- permits fundus of stomach to herniate (not usually the esophagus)
** has CT image in slides of it **
9
Q
In which quadrants of the abdomin is the stomach located in?
A
- left hypochondriac region
- left epigastric region
10
Q
Which plane transverses through the stomach to separate it between the left hypochondriac and epigastric regions?
A
transpyloric plane
11
Q
What vertebral region is the left end of the stomach fixed at?
A
T10-11
12
Q
What vertebral level is the right end of the stomach fixed at?
A
L1-2
13
Q
What is the pyloric antrum of the stomach?
A
entrance to the pylorus
14
Q
What is the pyloric orifice of the stomach?
A
entrance to the duodenum
15
Q
What makes up the muscularis externa of the stomach going from superficial to deep?
A
- outer longitudinal layer
- middle circular layer
- inner oblique fibers
16
Q
Which layer of the stomach muscularis externa is circular?
A
middle circular layer
17
Q
What is found 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
18
Q
What is found in relation to the anterior of the stomach?
A
- anterior abdominal wall
- left costal margin
- left diaphragm
- left and quadrate lobes of the liver
19
Q
Is the left and quadrate lobes of the liver found on the anterior or posterior side of the stomach?
A
anterior relationship
20
Q
Which portion of the diaphragm has an anterior relationship with the stomach?
A
left diaphragm
21
Q
What organs is the small intestine located between?
A
between stomach and large intestine
22
Q
How long is the duodenum?
A
10 inches long
23
Q
What are the four parts of the duodenum?
A
- superior
- descending
- horizontal
- ascending
24
Q
The duodenum is located approximately at which vertebral vertebra?
A
L1 to L4
25
Which ligament suspends the duodenum to the right crus of the diaphragm?
suspensory ligament of duodenum
26
Is the duodenum a retroperitoneal structure?
Yes - seondarily retroperitoneal
\*\*except for some of the 1st and 4th parts\*\*
27
What is the anterior portion of the duodenum covered by?
Covered anteriorly by peritoneum except where the mesocolon of the transverse colon crosses the 2nd part.
28
What is the first part of the duodenum surrounded by?
hepatoduodenal ligament
29
Where does the root of the mesentery begin?
At the duodeno-jejunal flexure.
30
Which vessels are found posterior and superior to the 1st part of the duodenum?
* portal vein
* hepatic artery
* bile duct
31
Is the head of the pancreas inferior or superior to the 1st part of the duodenum?
inferior
32
Where are the fundus of the gallbladder, right lobe of the liver, and transverse colon located in respect to the 2nd part of the duodenum?
anterior
33
Is the 2nd part of the duodenum all retroperitoneal?
YES
34
Where is the kidney and ureter located in respect to the 2nd part of the duodenum?
posterior
35
True or False:
The bile and pancreatic ducts enter into the second part of the duodenum at the major duodenal papilla.
True
36
Is the head of the pancreas located medially or superiorly to the 2nd part of the duodenum?
medial
37
What major vessels cross the anterior surface of the 3rd part of the duodenum?
superior mesenteric artery and vein; and the root of the mesentery
38
Where is the head of the pancreas located with respect to the 3rd part of the duodenum?
superior
39
Where is the jejunum located with respect to the 3rd part of the duodenum?
anterior and inferior
40
Is the 4th part of the duodenum covered by peritoneum?
NO
41
Where is the root of the mesentery and jejunum located with respect to the 4th part of the duodenum?
anterior
42
What muscle and major vessel is found posterior to the 4th part of the duodenum?
* left margin of aorta
* medial border of psoas muscle
43
What ligament holds the 4th part of the duodenum in place?
Suspensory Ligament (or muscle) of the duodenum (of Treitz).
44
True or False:
The suspensory ligament of the duodenum is of muscular origin, not viceral or mesenteric.
True
45
Which parts of the small intestine occupy most of the peritoneal cavity of the abdomen and pelvis?
jejunum and ileum
46
How long is the jejunum and ileum, combined?
20 feet
47
What holds the jejunum and ileum to the posterior wall of the abdomin?
mesentery
48
What is another name for the jejunum and ileum?
"free" small intestine
49
Compare and Contrast the jejunum and ileum.
* Length:
* jejunum -\> 8-10 feet long
* ileum -\> 10-12 feet long
* Portion of "free" intestine:
* jejunum -\> 2/5
* ileum -\> 3/5
* Vascular arcades:
* jejunum -\> _simple_ vascular arcades, **_long vasa recta_**, **more vascular**
* ileum -\> _compound_ vascular arcades, **_shorter vasa recta_**, **less vascular**
* Size:
* jejunum -\> greater diameter, thicker, **_more plicae circularis_**
* ileum -\> smaller diameter, thinner wall, **_fewer plicae circualris_**
50
What is the most common congenital anomaly of the small intestine?
Meckel's (ileal) diverticulum
\*\* in the ileum \*\*
51
Where does Mecke's (ileal) diverticulum typically occur?
* About 2 feet from the ileo-cecal junction.
* Occurs in 2% of population
* Average about 2 inches long
* Rmenant of the vitelline duct
* Clinically difficult to distinguish from appendicitis
* May contain other types of tissue
52
How long is the mesentery at the root?
15 cm (6-7 inches)
53
What does the mesentery attach to the posterior abdominal wall?
jejunum and ileum
54
What does the mesentery cross?
* L 1-2
* 3rd part of duodenum
* aorta
* IVC
* right ureter
* right gonadal vessels
* right psoas major
* ends at right S.I. joint
55
What runs in between the mesentery (2 layers of peritoneum)?
* nerves
* lymph nodes and vessels
* fat
* arteries
* veins
56
How long is the mesentery at it's intestinal border?
20 feet
57
Where is the rectum and anal canal located?
in the pelvis
58
Is the large intestine highly mobile?
yes
59
What are the functions of the large intestine?
* fecal formation
* transport
* evacuation
* water absorption
* mucus secretion
60
What are taenia coli?
3 bands of longitudinal muscle on the outside of the colon.
* they converge at root of appendix
* they produce haustrae (sacculations) that slow the movement of feces
61
What are appendices spiploicae (epiploic appendages)?
* tags of fat
* characteristic of the large intestine
62
Does the cecum have epiploic appendages?
no
63
Is the iliocolic valve a true sphincter?
NO - 2 folds that are not a true sphincter.
64
What is the ileal papilla?
a cone-like projection of the ileum into the cecum
65
Where is the opening for the appendix located in relation to the ileal papilla?
inferior
66
Which parts of the colon are secondarily retroperitoneal?
* ascending colon
* descending colon
67
Which parts of the colon are intraperitoneal?
* transverse colon (transverse mesocolon)
* sigmoid colon (sigmoid mesocolon)
68
What is the size, shape, and location of the spleen?
* left hypochondriac region
* parallels left ribs 9, 10, and 11
* midaxillary line, between stomach and diaphragm
* about the size of a hand
* normally not palpable below the costal margin
69
What are the peritoneal relationships of the spleen?
* covered by peritoneum
* develops in the dorsal mesentery from mesoderm
* gastrosplenic ligament
* splenorenal ligament
70
What are the relation of the spleen with other organs of the abdominal cavity?
* diaphragm is posterior
* stomach, left colic flexure and tail of pancreas are anterior to the spleen
71
Does the spleen have a diaphragmatic surface?
yes - smooth against diaphragm
72
Where are the left kidney and phrenicocolic ligament in relation to the spleen?
inferior to spleen
73
What impressions are found on the visceral surface of the spleen?
* colic
* gastric
* renal
74
Which two ligaments are found in the hilum of the spleen?
* gastrosplenic
* splenorenal
75
Is the pancreas seondarily or primarily retroperitoneal?
Secondarily Retroperitoneal
76
Is some of the tail of the pancreas located in the splenorenal ligament?
yes
77
Is the tail of the pancreas anterior or posterior to the hilus of the spleen?
anterior
78
What are the relationships of the pancreas to other organs in the abdominal cavity?
* superior mesenteric artery and vein are posterior to the neck
* splenic vein and artery run horizontally superior to or posterior to the body
* the tail is against the spleen
* inferior vena cava and aorta are posterior to the body
* stomach is anterior to the spleen
* duodenum is superior, right and inferior to the head
* transverse colon lies anterior and inferior to the pancreas
79
What joins the bile duct at the hepatopancreatic ampulla?
main or major pancreatic duct
80
Where does the accessory pancreatic duct enter the duodenum?
more superior minor duodenal papilla
81
Where does the main pancreatic duct and bile duct empty into the 2nd part of the duodenum?
major duodenal papilla
82
Where is most of the liver located?
right upper quadrant
83
Where is the smaller left lobe of the liver located?
left upper quadrant
84
What are the 4 lobes of the liver?
* right lobe
* left lobe
* quadrate lobe
* caudate lobe
85
What is the falciform ligament?
Is a double layer of peritoneum that connects liver to the anterior wall.
86
What connects the liver to the anterior abdominal wall?
Falciform ligament - which is a double layer of peritoneum.
87
What does the peritoneum that attaches the liver to the anterior body wall split to enclose?
"bare area" of the liver
88
What does the bare area include?
Area where IVC is posterior to liver and hepatic veins drain into it.
89
Which ligament borders the left and anterior side of the caudate lobe?
ligamentum venosum
90
Which ligament boarders the left side of the quadrate lobe?
ligamentum teres (round ligament)
* in the edge of the falciform
* obliterated umbilical vein
91
What is the porta hepatis?
* transverse fissure between caudate and quadrate lobes
* transmits the portal triad
* hepatic artery (proper)
* portal vein
* bile duct
92
Which ligament is the obliterated umbilical vein?
ligamentum teres
93
Which ligament is the "old" ductus venosus?
* ligamentum venosum
* used to connect the umbilical vein with the inferior vena cava
94
What did the ductus venosus connect before it became the ligamentum venosum?
umbilical vein with inferior vena cava
95
What are the peritoneal attachments of the liver?
* falciform ligament with ligamentum teres
* lesser omentum with hepatoduodenal and hepatogastric ligaments
96
Where does the gall bladder and biliary tract lie?
hepatic fossa
97
Where does the gallbladder contact the anterior abdominal wall at?
Midclavicular line - 9th or 10th costal cartilage.
98
Is the gallbladder typically located on the transpyloric line?
Yes
99
What forms the bile duct and where does it course?
* Bile Duct: formed from cystic and common hepatic ducts.
* Runs in the edge of the lesser omentum (hepatoduodenal ligament).
* Goes posterior and inferior to the 1st part of the duodenum, posterior to the head of the pancreas, enters the 2nd part of the duodenum with the pancreatic duct.
100
