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Anatomy Flashcards

(161 cards)

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1
Q

Epigastric

A

Upper middle ninth

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2
Q

Hypochondrium

A

Left and right upper ninths

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3
Q

Umbilical

A

Middle ninth

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4
Q

Flank

A

Left and right middle ninths

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5
Q

Pubic

A

Lower middle ninth

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6
Q

Groin

A

Left and right lower ninths

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7
Q

9 layers of abdominal wall from skin to abdominal cavity

A 
Skin
Campers fascia
Scarpas fascia
External oblique muscle
Internal oblique muscle
Transversus abdominis
Transversalis fascia
Extraperitoneal fascia
Parietal peritoneum
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8
Q

Superior boundary of abdomen

A

Diaphragm and inferior thoracic aperture

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9
Q

Inferior boundary of abdomen

A

Iliac crest, inguinal ligament and pelvic inlet

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10
Q

Posterior boundary of abdomen

A

Lumbar vertebral column, psoas major, quadratum lumborum

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11
Q

Lateral and anterior boundary of abdomen

A

Abdominal wall muscles

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12
Q

Above the bellybutton, the fascia present is:

A

Campers fascia only

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13
Q

Below the bellybutton, the fascia present is:

A

Campers and Scarpas fascia

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14
Q

Campers fascia

A

Thick, fatty superficial layer of the anterior abdominal wall

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15
Q

Scarpas fascia

A

Deep membranous layer of fascia

Deep to Campers fascia, superficial to external oblique muscle

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16
Q

Rectus abdominis origin

A

Pubic tubercle, crest and symphysis

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17
Q

Rectus abdominis insertion

A

Costal cartilage of ribs 5 - 7 and xiphoid process

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18
Q

Rectus abdominis actions

A

Flexes trunk

Supports and compresses abdominal wall

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19
Q

Rectus abdominis innervation

A

Anterior rami of thoracic spinal nerves

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20
Q

Rectus abdominis fibre direction

A

Directly down

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21
Q

External oblique origin

A

Ribs 5 - 12

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22
Q

External oblique insertion

A

Iliac crest and linea alba

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23
Q

Aponeurosis of external oblique muscle

A

From xiphoid process of sternum to pubic symphysis. Lower border forms inguinal ligament.

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24
Q

External oblique actions

A

Flexes trunk
Turns to opposite side
Bends to same side

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25
External oblique innervation
Anterior rami of thoracic spinal nerves
26
External oblique fibre direction
Infero-medial
27
Linea alba
Fibrous structure that runs down the midline of the abdomen in humans and other vertebrates
28
Internal oblique origin
Thoracolumbar fascia, inguinal ligament and iliac crest
29
Internal oblique insertion
Ribs 9 - 12, linea alba and pubis
30
Internal oblique actions
Flexes trunk | Bends and turns trunk to the same side
31
Internal oblique innnervation
Anterior rami of thoracic spinal nerves | Some L1
32
Internal oblique fibre direction
Supero-medial
33
Transversus abdominis origin
Thoracolumbar fascia, iliac crest, inguinal ligament and costal cartilage of ribs 7 - 12
34
Transversus abdominis insertion
Linea alba, pubic crest and pectineal line
35
Transversus abdominis actions
Supports abdominal wall
36
Transversus abdominis innervation
Anterior rami of thoracic spinal nerves | Some L1
37
Transversus abdominis fibre direction
Transverse
38
Below the arcuate line there is no:
Posterior rectus sheath behind rectus abdominis | Instead covered posteriorly by transversalis fascia and parietal peritoneum
39
The superior epigastric artery comes from:
The internal thoracic artery
40
The inferior epigastric artery comes from:
The external iliac artery
41
Position of superior and inferior epigastric arteries
Deep longitudinally to rectus abdominis, on top of transversalis fascia and within the rectus sheath Eventually form an anastamosis
42
The thoracoepigastric veins drain into:
The axillary vein
43
The superficial epigastric veins drain into:
The femoral vein
44
The axillary vein drains:
The superior abdomen
45
The femoral vein drains:
The inferior abdomen
46
Abdominal nerve position
Travel in neurovascular plane between internal oblique and transversus abdominis muscles
47
Skin, muscles and parietal peritoneum innervation
T7 - T12 intercostal and L1 iliohypogastric spinal nerves
48
Important landmark of the T10 dermatome
Umbilicus
49
Important landmark of the T4 dermatome
Nipple
50
In general, the superior lymphatics follow:
Veins
51
In general, the inferior lymphatics follow:
Arteries
52
Visceral peritoneum covers:
Organs (abdominal viscera)
53
Parietal peritoneum:
Lines the body wall
54
Between the two peritoneum layers you can find:
A small amount of serous fluid to prevent friction during movement
55
Mesentery is formed by:
The visceral peritoneum folding back in on itself, forming an anchor to the posterior body wall
56
Function of mesentery
Anchorage | Passage of blood vessels and nerves in and out
57
Parietal peritoneum sensation
Sensitive to pain, touch, temperature and pressure Thoracic and lumbar somatic nerves supply body wall Phrenic nerve supplies near diaphragm Obturator nerve supplies near pelvis
58
Visceral and mesentery sensation
Sensitive to stretch by autonomic nervous system
59
GI tract is suspended by:
Multiple mesenteries
60
Midgut and hindgut is suspended by:
Dorsal mesentery only
61
Foregut is suspended by:
Both ventral and dorsal mesenteries
62
Greater sac
Peritoneal cavity proper
63
Lesser sac
Behind lesser omentum and stomach | Formed by rotation of foregut structures which drags the lesser omentum round to create a pocket
64
The opening to the lesser sac is called:
The foramen of Winslow
65
Boundaries of the foramen of Winslow
Anterior: the free edge of the lesser omentum containing the portal triad Posterior: the IVC
66
3 intraperitoneal areas suspended by mesenteries
Jejunum to terminal ileum - mesentery Transverse colon - transverse mesentery Sigmoid colon - sigmoid mesocolon
67
Paracolic gutter
Peritoneal sulci lateral to the ascending/descending colons | Create a pathway for fluids to migrate around the abdomen
68
Clinical significance of paracolic gutter
Different positions of the body can affect fluid migration which can cause pain to present in different regions distant from the affected organ A sitting position causes fluid to migrate down towards appendix, a spine position causes fluid to migrate into lesser sac
69
Abdominal aorta branches
Celiac trunk at T12/L1 level Superior mesenteric artery at L1 level Inferior mesenteric artery at L3 level Bifurcation at L4 leading to left and right common iliac arteries
70
3 branches from the celiac trunk
Left gastric artery Splenic artery Common hepatic artery
71
Injury to foregut localises pain at the:
Epigastric region
72
Components of the foregut
``` Distal oesophagus Stomach Liver Gall bladder Proximal 1/3 of duodenum Pancreas ```
73
Foregut blood supply
Branches of the celiac trunk
74
Foregut venous drainage
The portal vein
75
Foregut innervation
Celiac plexus at T12
76
Foregut lymphatics
Pre-aortic nodes at T12 (celiac nodes)
77
Fundus location
Ribs 5/6
78
Oesophagus location
Costal cartilage 7/8
79
Pylorus location
L1 verterbral level
80
Lesser curvature arterial supply
Left gastric - celiac trunk | Right gastric - common hepatic artery
81
Greater curvature arterial supply
Left gastro-omental - splenic | Right gastro-omental - gastroduodenal and common hepatic arteries
82
Fundus arterial supply
Splenic artery
83
Duodenal structure
Originates from pyloric region of stomach and wraps around head of pancreas. Then crosses back over IVC and aorta and ascends to duodenojejunal flexure. Mostly retroperiotoneal except for the very first part
84
Duodenal blood supply
Part celiac trunk, part super mesenteric artery Superior half = superior pancreaticoduodenal branches from gastroduodenal artery of celiac origin Inferior half = inferior pancreaticoduodenal branches from superior mesenteric artery
85
Duodenal innervation
Superior half: celiac plexus at T12 | Inferior half: superior mesenteric plexus at L1
86
Duodenal venous drainage
Superior half: direct to portal vein | Inferior half: superior mesenteric vein
87
Duodenal lymphatic drainage
Superior half: Pre-aortic celiac nodes at T12 | Inferior half: Pre-aortic superior mesenteric nodes at T1
88
Ampulla of Vater
Union of common bile duct and main pancreatic duct which drains into descending duodenum
89
Major duodenal papilla
Enters through wall of descending duodenum | Controls bile flor from liver and pancreatic juice from pancreas into the duodenum via the Sphincter of Oddi
90
Sphincter of Oddi
Clamps off major duodenal papilla to stop bile constantly dripping in
91
Midgut refers to pain in the:
Umbilical region
92
Components of midgut
``` Distal 1/2 duodenum Jejunum Ileum Caecum Appendix Ascending colon Proximal 2/3 transverse colon ```
93
Neurovascular structures of midgut
Arterial: branches of SMA Venous: SMV Innervation: SM plexus at L1 Lymphatics: Pre-aortic nodes at L1
94
Small intestine anatomy
About 6 m long Suspended from body wall by mesentery, fan shaped folds of peritoneum enclosing the gut tube allowing ingress and egress of vessels, nerves and lymphatics
95
Haustra
Sacculations of the large intestine wall
96
Appendices epiplociae
Pouches of peritoneum in the large intestine filled with fat that can get inflamed
97
Teniae coli
Longitudinal muscles of the large intestine wall collected into 3 bands that can contract, pulling the colon into haustra coli
98
Caecum and appendix region
Right groin
99
Large intestine is found in all gut regions except:
Umbilical
100
3 flexures of large intestine
Hepatic Splenic Sigmoid colon
101
Regions that flexures are found in
Hepatic - Right hypochondrium Splenic - Left hypochondrium Sigmoid colon - Left groin
102
Superior mesenteric arteries supplying the large intestine
Caecum/appendix: caecal and appendicualr arteries respectively, both from ileocolic artery Ascending colon: right colic artery Proximal 2/3 transverse colon: middle colic and marginal arteries
103
Inferior mesenteric arteries supplying the large intestine
Distal 1/3 transverse colon: marginal and left colic arteries Descending colon: left colic artery Sigmoid colon: sigmoid artery
104
Marginal artery
Anastomotic point between SMA and IMA
105
Neurovascular structures of hindgut
Arterial supply: branches of IMA at L3 Innervation: IM plexus at L3 Venous: IMV Lymphatics: pre-aortic inferior mesenteric nodes at L3
106
Sigmoid colon becomes rectum at:
S3 vertebral level
107
Stool is held in the:
Transverse folds of the rectum
108
Rectal peritoneum
1st 1/3: Covered in visceral peritoneum 2nd 1/3: Peritoneum on anterior surface only 3rd 1/3: Infraperitoneal
109
Arterial supply of rectum
Superior rectal branches of IMA at L3 Middle rectal branch of internal iliac artery Inferior rectal branch of internal pudendal
110
Venous drainage of rectum
Superior rectal vein ----> IMV ----> portal vein | Middle and inferior rectal veins ----> internal iliac vein ----> common iliac artery ----> IVC
111
Innervation of rectum
Proximal 1/3: IMP at L3 | Distal 2/3: Inferior/superior hypogastric plexus
112
Lymphatics of rectum
Proximal 1/3: to pre-aortic nodes at L3 | Distal 2/3: to internal iliac nodes
113
Parasympathetic nerve supply of the gut
Vagus nerve | Pelvic splanchnic nerves S2-4
114
Sympathetic nerve supply of the gut
Thoracic, lumbar and sacral splanchnic nerves from T5-L2 sympathetic ganglia
115
Foregut autonomic supply
Plexus: Celiac SNS: Greater splanchnic T5-9 PSNS: Vagus X
116
Midgut autonomic supply
Plexus: Superior mesenteric SNS: Lesser splanchnic T10-11 PSNS: Vagus X
117
Aorticorenal autonomic supply
Plexus: Renal SNS: Least splanchnic T12 PSNS: Vagus X
118
Hindgut autonomic supply
Plexus: Inferior mesenteric and superior hypogastric SNS: Lumbar/sacral splanchnic fibres L1-2 PSNS: Pelvic splanchnic S2-4
119
Pelvic organs autonomic supply
Plexus: Inferior and superior hypogastric SNS: Sacral splanchnic L1-2 PSNS: Pelvic splanchnic S2-4
120
Location of liver
Right hypochondrium, extends into epigastric region
121
Superior boundary of liver
Ribs 5/6
122
Gall bladder location
9th costal cartilage level, affixed to bottom of liver
123
Gross morphology of liver
2 lobes on anterior surface separated by falciform ligament 4 lobes on posterior surface: back of left and right lobes, caudate lobe in middle and quadrate lobe below (continuation of right lobe) Gall bladder between quadrate lobe and right lobe on posterior surface, IVC between caudate lobe and bare area above right lobe
124
Bare area of liver
Only part of the liver not intraperitoneal. Functions to anchor liver to diaphragm
125
Quadrate lobe
Anatomically part of right lobe but separated from the rest of the lobe by the gall bladder, therefore considered its own area
126
Falciform ligament
Separates right and left lobes on anterior surface. Remnant connecting to body wall containing ligamentum teres
127
Ligamentum teres
Runs inside and extends out of the falciform ligament. Embryological remnant of umbilical cord.
128
Porta hepatis
Doorway to liver Free edge of lesser omentum attaches here Portal triad runs through here
129
Portal triad
Portal vein Hepatic artery Common hepatic duct
130
The liver is covered in visceral peritoneum except for:
Bare area and fossa for gall bladder
131
6 peritoneal ligaments
``` Right triangular ligament Anterior coronary ligament Left triangular ligament Falciform ligament Posterior coronary ligament Hepatoduodenal ligament ```
132
Pouch of Morison
Space that separates the liver from the right kidney, normally not filled with fluid
133
Blood supply to liver
25% hepatic artery proper supplies oxygenated blood | 75% portal vein supplies nutrient rich blood
134
Venous drainage of liver
Arterial and venous blood conducted to central vein of each liver lobule by sinusoids, then central veins drain to left, right and central hepatic veins, then directly into IVC
135
Liver segments
Determined by position of hepatic and portal veins Caudate lobe is I, rest numbered clockwise from top right corner Falciform ligament separates lobes II and III from rest of liver No arterial communications between right and left halves 2 x portal veins 3 x hepatic veins
136
Lymphatic drainage of liver
Lymph from liver about 1/3 total body lymph | Nodes at porta hepatis to celiac nodes at T12
137
ANS of liver
Visceral supply from celiac plexus | PSNS via vagus nerve, SNS from greater splanchnic nerves T5-9
138
Pain in liver
Referred to epigastric region | Small amount via diaphragm to right shoulder/chest (C3-5)
139
Gross morphology of gallbladder
Fundus hangs below liver Body contacts visceral surface of liver Neck joins cystic duct Covered in visceral peritoneum
140
Biliary tree
Bile secreted by liver, stored by gallbladder When released, bile flows down cystic duct into common hepatic duct where it is joined by main pancreatic duct Drained via bile duct which bifurcates past cystic duct into left and right hepatic ducts
141
Hepatopancreatic ampulla of Vater
Formed by the union of the pancreatic duct and common bile duct Opens into duodenum via sphincter of Oddi
142
Neurovascular structures of gallbladder
Arterial supply: cystic artery from right hepatic artery Venous drainage: cystic vein into portal vein Innveration: ANS via celiac plexus, pain referred to epigastric region Lymphatics: cystic nodes to hepatic nodes to celiac nodes at T12
143
Gallstones
Crystalline bodies made from bile components Cholesterol = green or yellow/white Pigment stones = small, dark calcium or bilirubin stones
144
5 areas of pancreas
``` Head - in concavity of duodenum Ulcinate process - wraps behind SM vessels Neck - anterior to SM vessel origins Body Tail - passes into splenorenal ligament ```
145
The tail of the pancreas is in contact with:
The hilus of the spleen
146
Main pancreatic duct
From tail to Ampulla of Vater Joined by bile duct Enters descending duodenum via Sphnicter of Oddi (major duodenal papilla)
147
Accessory pancreatic duct
Not always present | Drains into upper part of head then into duodenum (minor duodenal papilla)
148
Arterial supply of pancreas
Common hepatic artery and splenic artery (from coeliac trunk origin) Superior mesenteric artery
149
6 specific arteries that supply pancreas
Anterior superior pancreaticoduodenal Posterior superior pancreticoduodenal Dorsal pancreatic Great pancreatic Anterior inferior pancreaticoduodenal Posterior inferior pancreaticoduodenal
150
Venous and lymphatic drainage of pancreas
Always flows back through splenic or SMV into liver through portal vein then IVC Lymph drains to coeliac nodes and SM nodes
151
ANS for pancreas
Coeliac and SM plexi Greater and lesser splanchnic nerves Vagus nerve Pain referred to epigastric region
152
Spleen position
Inferior to ribs 9-11 in left hypochondrium
153
Splenorenal ligament
To left kidney | Carries splenic vessels and pancreas tail
154
Spleen vessels
``` Splenic artery from coeliac axis Splenic vein to portal vein Lymph drains to coeliac nodes ANS: coeliac plexus - vagus and greater splanchnic Pain to epigastric region ```
155
2 surfaces of spleen
Diaphragmatic | Visceral
156
2 poles of spleen
Upper | Lower
157
3 areas of spleen
Gastric Colic Renal
158
2 splenic ligaments
Spenorenal: splenic vessels, tail of pancreas Gastrosplenic: short gastric vessels and gastro-omental vessels
159
Splenic rule of odd numbers
1 x 3 x 5 inches 7 ounces Found under ribs 9-11
160
3 main porto-systemic shunts
Bottom 1/3 of oesophagus Around umbilicus Anus
161
Trans-pyloric plane | 12 key areas
``` L1 Midway between suprasternal notch and pubic symphysis 1st part duodenum Pylorus Hila of kidneys Neck of pancreas SMA origin PV origin Fundus of gallbladder Tip of 9th costal cartilage Transverse mesocolon origin Colic flexures Spleen End of spinal cord ```

Digestive (9 decks)

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