Abdominal Viscera and Collateral Circulation Flashcards
(68 cards)
1
Q
The two curvatures of the stomach and their derivation:
A
- lesser curvature (ventral side of foregut before rotation)
- greater curvature (dorsal side of foregut before rotation)
2
Q
Lesser omentum attachment and derivation:
A
- attachment: lesser curvature of stomach
- derivation: ventral mesentery of stomach
3
Q
The two parts of the lesser omentum:
A
- hepatoduodenal ligament
- hepatogastric ligament
4
Q
Derivatives of the stomach dorsal mesentery:
A
- gastrosplenic ligament
- greater omentum
5
Q
Label all:
A
6
Q
Label:
A
greater omentum
(arises from dorsal mesentery)
7
Q
What structure is attached/fused to the posterior side of the greater omentum?
A
transverse colon
8
Q
Label A and B:
A
- A = transverse mesocolon
- B = greater omentum
9
Q
Greater Peritoneal Sac:
A
- All of the peritoneal cavity except for the lesser sac (omental bursa).
10
Q
The greater peritoneal sac is subdivided into what two compartments?
A
- supracolic compartment
- above transverse colon and greater omentum (fused).
- infracolic compartment
- below transverse colon and greater omentum (fused).
11
Q
The boundary between the supracolic compartment and infracolic compartment is:
A
- transverse mesocolon and greater omentum (which are fused together).
12
Q
The three compartments of the peritoneal cavity:
A
- lesser sac
- supracolic (part of greater sac)
- infracolic (part of great sac)
13
Q
What part of the greater omentum stretches from the greater curvature of the stomach to the level of the transverse colon?
A
gastrocolic ligament
14
Q
Gastrocolic ligament:
A
- the part of the greater omentum above the transverse colon.
- a surgical entry into the lesser sac.
15
Q
Label:
A
16
Q
Contents of Supracolic compartment:
A
stomach, liver and spleen
17
Q
Contents of Infracolic compartment:
A
small intestine, ascending colon, descending colon
18
Q
The lesser sac communicates with greater sac via:
A
epiploic foramen
(foramen of Winslow)
19
Q
The foregut gives rise to what organs?
A
PEG LSD
- Pancreas
- Esophagus
- Gallbladder
- Liver
- Stomach
- Duodenum (1, 2P parts)
20
Q
The midgut gives rise to what organs?
A
JAILED CAT
- Jejunum
- Appendix
- ILEum
- Duodenum (2D, 3, 4, parts)
- Cecum
- Ascending colon
- Transverse colon (proximal 2/3)
21
Q
The hindgut gives rise to what organs?
A
DESCENDING RATS
- DESCENDING colon
- Rectum
- Anal canal (upper part)
- Transverse colon (distal 1/3)
- Sigmoid colon
22
Q
Celiac trunk is the blood supply to:
A
foregut and spleen
PEG LSD + spleen
23
Q
Superior mesenteric artery is the blood supply to:
A
midgut + head of pancreas
JAILED CAT + head of pancreas
24
Q
Inferior mesenteric artery is the blood supply to:
A
hindgut
DESCENDING RTS
25
The three branches of the celiac trunk:
1. left gastric artery
2. splenic artery
3. common hepatic artery
26
Branches of the left gastric artery:
1. esophageal artery
27
Branches of the splenic artery:
1. short gastric artery
2. left gastroomental artery
28
Branches of the common hepatic artery:
1. proper hepatic artery
2. gastroduodenal artery
29
Branches of the proper hepatic artery:
* left hepatic artery
* right hepatic artery
* right gastric artery
30
Blood supply to the gallbladder and the origin of this artery:
cystic artery
branch of right hepatic artery
31
First branch of the superior mesenteric artery:
inferior pancreaticoduodenal artery
32
Branches of the superior mesenteric artery:
1. inferior pancreaticoduodenal artery
2. middle colic artery
3. right colic artery
4. ileocolic artery
5. jejunal arteries
6. ileal arteries
33
Blood supply to the appendix and its derivation:
* appendicular artery
* from ileocolic artery, from SMA
34
Label all:
35
Aorta ends (bifurcates) at what vertebral level?
L4
36
Inferior mesenteric artery branches off the aorta at what vertebral level?
L3
37
Branches of inferior mesenteric artery (3):
1. left colic artery
2. sigmoid artery
3. superior rectal artery
38
Label all:
39
What arteries branch and anastomose to form the Marginal Artery of Drummond (5)?
1. Right colic a.
2. Left colic a.
3. Middle colic a.
4. Ileocolic a.
5. Sigmoid aa.
40
What arteries connect the Marginal Artery of Drummond to the colon?
* Vasa recta
* end arteries;
* do not anastomose with one another
41
What arteries have to be obstructed in order to create an area of ischemic bowel?
* vasa recta
* obstructing branches of SMA or IMA will not lead to ischemic bowel since they all anastomose to form the marginal artery of Drummond.
42
Where does diverticulitis occur in the colon?
* points where the vasa recta penetrate the colon wall
* “weak-points”
43
The two venous systems of the abdomen:
1. inferior vena cava
2. portal vein
44
What two veins come together to form the portal vein?
1. splenic vein
2. superior mesenteric vein
45
What vein drains into the splenic vein?
* inferior mesenteric vein
46
The IVC drains what organs of the abdomen?
* originally retroperitoneal organs
* (primary retroperitoneal organs)
47
The portal vein drains what organs of the abdomen?
* originally peritoneal organs
* (primary peritoneal and secondary retroperitoneal)
48
The spleen drains into what venous system of the abdomen?
portal venous system
49
Pathway of portal venous system drainage to the heart:
1. splenic, superior mesenteric, inferior mesenteric veins
2. hepatic portal vein
3. venous sinusoids in liver
4. hepatic veins
5. inferior vena cava
6. heart
50
Portocaval anastomoses in the rectum:
* Superior rectal vein (portal) → middle rectal vein (caval) and inferior rectal vein (caval).
* **in the wall of rectum.**
51
Does the portal venous system have valves?
no; pressure gradient is based on pressure.
52
What will cause retrograde flow of blood in the portal venous system so that it drains in the IVC?
liver obstruction / portal hyperstension
53
What three veins of the rectum are susceptible to hemorrhoids in the setting of portal hypertension:
1. superior rectal vein
2. middle rectal vein
3. inferior rectal vein
* due to anastomoses between portal and caval venous systems.
54
Portocaval anastomoses in the esophagus:
* Esophageal branch of left gastric vein (portal) to esophageal vein (caval) to azygos vein (caval).
55
Esophageal varices result from the anastomosis of what veins?
* Esophageal branch of left gastric vein (portal) to esophageal vein (caval) to azygos vein (caval).
56
Portocaval anastomoses in the umbilical region:
paraumbilical veins (portal) → epigastric veins (caval)
57
Caput medussae may arise from:
* Portocaval anastomoses in the umbilical region:
* paraumbilical veins (portal) to epigastric veins (caval).
58
Lymphatic drainage of the abdomen:
1. preaortic channels
2. paraaortic channels
3. cysterna chylae
4. thoracic duct
59
Cysterna chylae is responsible for what lymphatic drainage:
all lymphatic drainage below the diaphragm
60
Label all:
61
Primary arterial supply to descending colon, which would have to be resected with the ascending colon in the setting of colon cancer:
* inferior mesenteric artery
* left colic artery
* LYMPH NODES FOLLOW VASCULATURE
62
Primary arterial supply to ascending colon, which would have to be resected with the descending colon in the setting of colon cancer:
* right colic artery
* middle colic artery
* ileocolic artery
* LYMPH NODES FOLLOW VASCULATURE
63
Draw the celiac trunk and its branches:
64
Draw the superior mesenteric artery and its branches:
65
Draw inferior mesenteric artery:
66
Draw marginal artery of drummond:
67
Draw IVC drainage in abdomen:
68
Draw portal vein drainage in abdomen:
