Which layers of the thoracolumbar fascia is the quadratus muslce contained in?
Ant and middle layers
The oesophageal opening into the stomach is called the ...?
What is the hilum of the liver called?
The porta hepatis
The tail of the pancreas leads to what?
Do all unpaired structured of the GIT have mesentery?
No. The did originally but some structure had theirs reabsorbed - these are the secondary retroperitoneal structures
Where does the superior mesenteric artery come off the aorta?
1cm below the celiac trunk
Between which muscles does the neuro-vascular plane lie?
Internal oblique and transversus abdominis
What lies inbetween the right and caudate lobes of the liver?
What is the ucinate process?
The "tongue" off the head of the pancreas
What structures are from the midgut?
Second half of the duodenum
Jejunum and ileum
Ascending and transverse colon
What feature in the jejunum reflects that there is more absorption there cf to the ileum?
Greater mucosal folding
All unpaired structures of the GIT are derived from what?
The primative tube
The fundus of the stomach usually contains what?
What are the three major mesentery's
The transverse mesocolon
Upon which muscle do the kidneys sit?
With which muscle does the ureter travel in the abdomen?
The psoas muscle
The diaphragmatic surface of the liver is separated into two lobes by what
The falciform ligament
Where does the superior mesenteric artery run?
Along the root of The mesentary
What is the gastroesophageal junction?
Transition point between oesophagus and stomach
What is the major duodenal papilla?
Point of insertion for the bile and pancreatic duct
Is the pancreas retro or intraperitoneal?
In what order do the vessels of the kidneys sit (from anterior to posterior)
Vein > Artery > Renal pelvis
Which is longer the jejunum or ileum?
LNs from abdo structures are situated where?
On and beside the aorta
What structure does the pyloric area of the stomach make?
How does bile enter the gallbladder?
When the sphincter is closed it backs up into the common bile duct (not the pancreatic) and drains into the gallbladder
What does the cystic duct drain?
The gall bladder
Is the hepatic vein in the hilum of the liver?
At what level does the oesophagus travel through the diaphragm?
Parasympathetic innervation is from the vagus for which structures?
What is the significance of the narrowings the ureter?
Kidney stones can stop there
What is the function of the quadratus lumborum?
Lateral flexor of the spine
Stabiliser of the hip
Which of the liver's lobes is the biggest?
What veins drain the abdominal wall?
IVC and portal vein
What does the renal sinus contain?
What does the spleenic artery supply?
Left gastroepiploic artery
What is the difference in the rectus sheath between the superior and anterior part?
Superiorly it completely surrounds the rectus abdominis (external's aponeurosis infront, internal split and transersus behind). But inferiorly all three aponeurosis are ant to the rectus muscle and behind is the arcuate line.
T/F all the duodenum is intraperitoneal
False, only the first inch is intraperitoneal, the rest is retroperitoneal
What is the function of the pyloric sphincter?
Controls food exiting from the stomach
Name the secondary retroperitoneal structures
Ascending and descending colon
Where does the ileum insert into the large intestine?
Where do ganglia for the hindgut come from?
Where is pain from unpair abdo structures down from midway along the sigmoid colon to the anus referred to?
In which part of the stomach do the left and right gastric arteries run?
Lesser curvature of the stomach
What is the course of the splenic artery?
Along the pancreas, behind the stomach and into hilum of spleen
What is the origin and insertion of the quadratus luborum?
O: Transverse process and 12th rib
I: Post aspect of the iliac crest
What is the course of the greater omentum?
Starts on the greater curvature of the stomach
Extends over the transverse colon and small intestine
Folded backwards at the bottom and travels back to over the transverse colon and towards to post abdo wall
What are epiploic appendages?
Fat tags that hang from the colon
What is the minor duodenal papilla for?
Opening for the accessory pancreatic duct
What demarcates the diaphragmatic and visceral surface of the liver?
Inferior margin of the liver
How do the spleenic vein and inferior mesenteric vein drain into the portal vein?
The inferior mesenteric vein joins the spleen vein and they drain into the superior mesenteric vein which becomes the portal vein
What are the haustra of the large intestine?
The collections/bulges that are divided by folds
Most of the pancreas is behind which GIT structure?
Where are the oblique muscle aponeurotic?
In what direct do the pyramid of the kidney's medulla point?
Towards the hilum
Which has more fat in its mesentery, the jejunum or the ileum?
What structures form the inguinal canal?
Floor: inguinal ligament
Roof: is the arching fibres of the internal oblique and the transversus abdominis
How is the stomach divided?
Pylori (pyloric antrum then canal)
Parasympathetic innervation is from the pelvic splanchnics for which GIT structures?
Which artery supply the hindgut?
Inferior mesenteric artery
Where does the celiac trunk branch from the aorta?
What is the falciform ligament?
A double fold of peritoneum
What is bad about liver fibrosis for the hepatic venous system?
Fibrosis impedes blood flow > increased pressure in an otherwise low pressure system > Veins that are alternate routes enlarge
What are the lobes of the liver?
Name the paired structures of the abdomen?
What is the length of the oesophagus in the abdomen?
1/2 an inch
Which parts of the colon are retroperitoneal?
The ascending and descending
The horizontal part of the duodenum runs between which muscles?
Right to left psoas muscles
In which part of the duodenum do the bile and pancreatic duct insert?
The middle part that runs downwards
Around which organ does the duodenum line?
Head of the pancreas
T/F Part of the greater omentum and transverse mesocolon attach to the post abdo wall at the same place. If so, where?
Above and behind the transverse colon
Where are sympathetic ganglia located?
Around unpaired branches of aorta and renal arteries
What is the name of the membrane that surrounds the post abdo wall muscles?
Where are the cisterna chyli located? What comes from them?
Just below the diaphragm
What are the origins, course and insertions of the internal oblique muscle?
Origin: Thoracolumbar fascia, ant 2/3 of the of iliac crest, connective tissue deep to the lateral third of the linguinal ligament
Courses towards the linea alba
Insertions: Interferior borders of costal margin, linea alba, pubic crest via the conjoint tendon
Which is darker in colour, the cortex or medulla of the kidney?
What is the difference between parietal peritoneum and visceral peritoneum?
Visceral peritoneum surrounds organs while parietal peritoneum lines cavity walls
Which quadrant is the spleen in?
Which renal artery has a shorter trip to the its kidney?
What is special about the free edge of the lesser omentum?
It contains the portal vein, hepatic artery and ducts
It demarcates the foramen of Winslow (omental foramen)
Where does the inferior mesenteric artery arise from the aorta?
What is the common bile duct joined by?
The pancreatic duct
What lies inbetween the right and quadratus lobe of the liver?
The gall bladder
Why do psoas abscesses end in the inguinal area?
Because when they burst through the vertebrae they can't break through the thoracolumbar fascia
Describe the passage of the testis during development
Start at the extra peritoneal fat in the poster lumbar region inside the abdominal cavity
Travel to the deep ring which is located in the aponeurosis of the transversis abdominis, half way between the ASIS and the pubic tubercle, a finger's width above the inguinal ligament
Enter the inguinal canal
Travel down the canal and out the superficial ring (the triangle structure)
Go into the scotum
Which arteries run along the greater omentum of the stomach?
Left and right gastroepiploic
What is the name of the tubes that transports urine from the kidneys to the bladder?
On which side of the body is the splenic flexture?
What are the origins, course and insertions of the transversus abdominis
Internal/underlap of the costal margin, thoracolumnar fascia, illiac crest and lateral 1/3 of the inguinal ligament.
Inserts into the linea alba and joins with the internal oblique to insert in the pubic crest via the conjoint tendon
How do the vessels of the jejunal mesentery differ from the vessels of the ileum's mesentery?
There are fewer arterial arcades but longer vasa recta
Apart from making the fatty apron, where else does the greater omentum go?
One part goes lateral over the spleen
The other goes superio-lateral straight to the post abdo wall
What is contained in the porta hepatis?
Portal vein (behind)
Proper hepatic artery and common hepatic ducts (infront)
(nerves and lymphatics)
What are the part of the small intestine?
What does the gastroduodenal artery do and supply?
Travel down behind the duodenum
Supplies the head of pancreas, first part of duodenum and greater curvature of stomach (via R gastroepiploic)
The preaortic LNs and paraaortic LNs form trunk and collect at what?
The liver receives blood from the other organs via what vein?
What are ganglia for foregut structures derived from?
T/F The appendix most commonly extends into the pelvis
False, 65% lie retrocecal
What is the name of the gastric folds on the stomach?
Which side of the stomach is the greater curvature?
Foregut structures are supplied which arteries?
Which structures are derived from the hindgut?
Descending sigmoid colon
What point demarcates the end of body of the stomach?
What is the origin and insertion of the iliacus muscle?
O: Iliac fossa
I: Conjoint tendon of the lesser trochanter of the femur
What are the 3 branches of the celiac trunk
Common hepatic artery
Left gastric a.
How is the pancreas divided?
Head > Neck > Body > Tail
What is mesentery?
Name for a double fold of parietal peritoneum
T/F there is perirenal fat outside the renal fascia
False, it is inbetween the kidney's fibrous capsule and the renal fascia
What is the course of the left gastric a.
Branches off the celiac trunk
Goes up and left
Onto the superior aspect of the lesser curvature of the stomach and travel down that
What is a hiatal hernia?
When the stomach herniates through the diaphragm
Into how many segmental arteries do the renal arteries split?
Name the foregut structures
First part and half of the second part of duodenum
T/F the duodenum is attached to the right psoas muscle via fibrous tissue
False, it's attached to the left
A what point is the greater and lesser sack continuous?
Foramen of Winslow/Epiploic foramen
Which renal vein has the shortest route to the IVC?
Where are the kidneys in relation to the vertebral column?
T12 to L3
What is the origins and course of the lesser omentum?
Lesser curvature and first part of duodenum to the under surface of the liver.
Once at the liver it splits and surrounds it
What is the of the course inferior mesenteric a. and what does supply?
Turns left and down towards the iliac fossa
It gives off left colic branch for descending colon and sigmoid colic branch for the sigmoid colon
Becomes the superior rectal artery
T/F the jejunum is intraperitoneal while the ileum is retroperitoneal
False, both are intraperitoneal
What is the ligamentum teres?
A round ligament at the end of the falciform ligament that used to transmit blood from placenta to the fetus
What are the intraperitoneal structures?
Jejunum and ileum
Transverse and sigmoid colon
Caecum and appendix
What is attached the lesser curvature of the stomach?
What does the common hepatic artery split into?
Proper hepatic artery
How is the structure of the psoas minor similar to other evolutionary declining muscles?
The majority of its course is tendon
Where is the lesser sack?
Behind the stomach and liver
What is the function of the psoas muscle?
Where will pain from unpaired abdo viscera from top to mid sigmoid colon be refered to?
Midline of the anterior abdominal wall
What does The mesentery supply?
Jejunun and ileum
Where are the tendenous intersections of the rectus abdominis located?
Level of the xiphoid process and umbilicus and one inbetween
What nerves supply the abdominal wall?
T7-11 of the thoracoabdominal
Apart from the liver, where does the falciform ligament connect to?
The ant. abdominal wall
Where is the base of The mesentery?
Post. abdo wall from the duodenum to start of ascending colon, over the aorta, IVC and R ureter on the R psoas
What does the proper hepatic artery do and supply?
Turn up and travel in the lesser omentum
Supplies the liver (via L and R hepatic arteries) and the gall bladder (via cystic artery)
What is the inguinal ligament?
Thickened, undercurving, fibrosus band of the posterior border of the external oblique muscle. Spans from the ASIS to the pubic tubercle. Has a triangular opening before it beds down and attaches to the puberic crest
Where do ganglia for the midgut come from?
Where is the cortex located within the kidney?
In what position is the duodenum in the abdomen?
It overlying the lumbar vertebral column
Which vein (being joined by others) becomes the portal vein?
Superior mesenteric vein
What the colonic flextures?
Directional changes in the colon, ie hepatic flexture is where the ascending become the transverse
What is the name of LNs that receive lymph from unpaired organs?
What is the shape and where is the base of the sigmoid mesocolon?
Small V shape
Base is over the division of the L common illiac artery
Which ducts make up the common bile duct?
The common hepatic duct and the cytic duct
Which artery supplies the midgut?
Superior mesenteric artery
Where does the psoas major lie?
In the paravertebral gutter (between the body and transverse process of lumbar vertabrae)
The adrenal gland on top of which kidney is described as cresent shaped?
What are omenta?
Double folds of peritoneum that connect organs
From where do paraaortic LNs receive lymph?
Where are there narrowings in the oesophagus?
Upper oesophageal sphincter
Aortic arch, LMB
How many major calyces generally branch off the renal pelvis?
From outside to in, what are the layers of the abdominal wall?
Superficial fascia - fatty and membraneous layer
External, internal and transversus abdominis muscle/rectus abdominis
What are in origins and insertions of the rectus abdoninis?
Origin: anterior surface of the 5th,6th and 7th ribs
Attaches to the pubic crest and tubercle
What is the size of the kidney?
What is the angular notch?
An angle at the base of the less curvature of the stomach
T/F the right renal artery travels over the IVC?
False, it travels behind the IVC - generally arteries travel behind veins
What are tenia (in the L intestine)
Strips of muscle
What are the origins, insertions and course of the external obliques?
Origin: External surfaces of the 5th-12th ribs, overlaps the costal margin
Course: Fibres are is the front pocket conformation
Insertion: Linea alba, Anterior aspect of the iliac crest, pubic tubercle
Which arteries supply the abdominal wall?
Which ant. abdo muscles originate from the thoracolumbar fascia?
Where in the duodenum do most peptic ulcers occur?
The first part that runs posterior
How many minor calyces branch off the major calyces?
Generally where do the ant abdominal muscles start and finish?
Linear alba, Illiac crest, ASIS (anterior superior iliac spine), pubic crest and pubic tubercle
For the most part of it's course the greater omentum is made up of how many layers?
T/F the erector spinae muscle is contained the thoracolumbar fascia
What landmarks make up the boarder (top and bottom) of the post abdo wall?
Post. iliac crest
What are the 3 muscles on the post abdo wall?
Psoas major (and minor)
Where the aorta and IVC sit in relation to each other in the abdomen?
Aorta to the left of the IVC
At level does the aorta split into the L and R common iliac arteries?
What branches does the superior mesenteric artery give off? What do they supply?
Inferior pancreaticduodenal artery - last part of the duodenum
Jejunal and ileal arteries
Middle colic a. - transverse colon
Right colic a. - ascending colon
Ileocolic a. - ileum, cecum and appendix
Where are the three point of narrowing the ureter?
At its origin in the renal pelvis
When is travels over the pelvis brim
When inserts into the bladder
Where does the base of the transverse mesocolon run?
Over the middle of the duodenum, head and body of the pancreas
What does the left gastric a. supply?
Lesser curvature of stomach
The abdo aorta must supply three groups of structures, what are they?
Unpaired structures of the GIT
Paired structures in the retroperitoneum
Which ribs is the spleen close to?
9, 10 and 11
Which kidney is lower, R or L?
R - because of the liver
In which quadrant is the stomach located?
What is the name of the divisions of the renal pelvis?
What shape does the duodenum make?
How does pain in appendicitis progress?
Starts as dull localised pain (due to stretching of visceral peritoneum)
If inflammatory continues and parietal peritoneum is impinged on then the pain becomes sharp and localised
What are the parts of the gallbladder?
The fundus >
Neck (continuous with the cytic duct)
What is between the caudate and quadratus lobe and the left lobe?
The ligamentum venosum and the ligamentum teres
Does the internal oblique have any free edges?
Where does peritoneum receive it nervous supply?
The structures it supplies
Where does the psoas origin and insert
O: T12 to L1
I: Lesser trochanter of the femur
What vessel drains blood from the liver into the IVC?