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Semester 4: Nutrition and Metabolism > Anatomy Topic 4 Case 2 > Flashcards

Anatomy Topic 4 Case 2 Flashcards

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1
Q

What is the peritoneum?

A
  • Membrane that lines the abdominal cavity and covers much of the viscera
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2
Q

Identify the two layers of peritoneum

A
  • Parietal peritoneum lines the walls of the abdominal cavity
  • Visceral peritoneum covers the organs
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3
Q

How are abdominal viscera suspended in the peritoneal cavity?

A
  • Mesenteries
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4
Q

What is the difference between intraperitoneal and extraperitoneal organs?

A
  • Intraperitoneal organs are located within the peritoneal cavity
  • Retroperitoneal organs are located outside of the peritoneum with only one surface in contact with the peritoneum
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5
Q

What is the greater sac and where does it extent between?

A
  • Largest space in peritoneal cavity, deep to parietal peritoneum
  • Beginning superiorly at the diaphragm and continuing inferiorly into the pelvic cavity
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6
Q

What is the omental bursa and where is it located?

A
  • Smaller subdivision of the peritoneal cavity

- Located posterior to the stomach and liver

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7
Q

How is the omental bursa continuous with the greater sac?

A
  • Through the omental foramen
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8
Q

Identify the structures surrounding the omental foramen

A
  • Portal vein and hepatic artery proper
  • Bile duct anteriorly
  • Inferior vena cave posteriorly
  • Caudate lobe of the liver superiorly
  • First part of the duodenum inferiorly
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9
Q

What is the purpose of peritoneal fluid in the peritoneal cavity?

A
  • Lubricates movement of the viscera suspended in the abdominal cavity
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10
Q

Identify an advantage and a disadvantage of the large surface area of the peritoneal cavity

A
  • Can be used for administering certain types of treatments and a number of procedures e.g. ventriculoperitoneal shunts for obstructive hydrocephalus.
  • Facilitates the spread of disease through the peritoneal cavity and over the bowel and visceral surfaces.
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11
Q

Identify three types of peritoneal folds

A
  • Omenta
  • Mesenteries
  • Ligaments
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12
Q

Identify two roles of peritoneal folds

A
  • Contain nerves and vessels

- Maintain proper positioning of viscera

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13
Q

What is the embryological origin of the greater omentum?

A
  • Dorsal mesentery
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14
Q

What are the attachments of the greater omentum?

A
  • Greater curvature of the stomach and first part of the duodenum.
  • After descending it turns posteriorly and ascends
  • Where it becomes adherent to superior surface of transverse colon
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15
Q

Which vessels are positioned between the two layers of the greater omentum?

A
  • Right and left gastro-omental vessels
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16
Q

What does thickening of the greater omentum indicate?

A
  • Metastasis
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17
Q

What is the embryological origin of the lesser omentum?

A
  • Ventral mesentery
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18
Q

What are the attachments of the lesser omentum?

A
  • Lesser curvature of stomach
  • First part of duodenum,
  • inferior surface of liver
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19
Q

Identify the two ligaments of the lesser omentum

A
  • Hepatogastric ligament between liver and stomach

- Hepatoduodenal ligament between liver and duodenum

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20
Q

What is the anatomical significance of the hepatoduodenal ligament?

A
  • Ends laterally as a free margin

- Which serves as the anterior border of the omental foramen

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21
Q

What is enclosed within the free edge of the hepatoduodenal ligament?

A
  • Hepatic artery proper
  • Bile duct
  • Portal vein
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22
Q

What are mesenteries?

A
  • Peritoneal folds that attach viscera to the posterior abdominal wall
  • That allow some movement and provide a conduit of vessels, nerves and lymphatics
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23
Q

Identify the embryological origin of the mesenteries?

A
  • Dorsal mesentery
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24
Q

What is the mesentery?

A
  • Large, fan shaped, double-layered fold of peritoneum

- That connects the jejunum and ileum to posterior abdominal wall

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25
What is are the superior and inferior attachments of the mesentery?
- Superior: duodenojejunal junction | - Inferior: Ileocecal junction
26
What is the transverse mesocolon?
- Double layered fold of peritoneum that connects the transverse colon to the posterior abdominal wall
27
What is the anterior layer of the transverse mesocolon adherent to?
- Posterior layer of greater omentum
28
What is the sigmoid mesocolon?
- V-shaped peritoneal fold - That attaches the sigmoid colon to the abdominal wall - Wit the apex of the V near the left common iliac artery - Left limb along the medial border of the left psoas muscle - Right limb descending into pelvis at level L3
29
What are ligaments?
- Two layers of peritoneum that connect two organs to each other or an organ to the body wall
30
Identify the four parts of the stomach
- Cardia - Fundus - Body - Pyloric part
31
Identify the different parts of the pyloric part of the stomach
- Pyloric antrum - Pyloric canal - Pylorus
32
Identify the different parts of the pylorus
- Pyloric constriction - Pyloric sphincter - Pyloric orifice
33
At which vertebral level is the pylroic orifice located?
- Lower border of L1 (transpyloric plane)
34
Identify which artery the left gastric artery arises from and the part of the stomach that it supplies
- Branches from coeliac trunk | - Lower third of oesophagus + upper right part of stomach
35
Identify which artery the right gastric artery arises from and the part of the stomach that it supplies
- Hepatic artery proper | - Lower right part of stomach
36
Identify which artery the short gastric arteries arises from and the part of the stomach that it supplies
- Splenic artery | - Fundus
37
Identify which artery the left gastro-omental artery arises from and the part of the stomach that it supplies
- Splenic artery | - Upper part of greater curvature
38
Identify which artery the right gastro-omental artery arises from and the part of the stomach that it supplies
- Gastroduodenal branch of hepatic artery proper | - Lower part of greater curvature
39
Which vessel do the left and right gastric veins drain into?
- Directly into portal vein
40
Which vessel do the short gastric veins drain into?
- Splenic vein
41
Which vessel do the left-gastro-omental veins drain into?
- Splenic vein
42
Which vessel do the right-gastro-omental veins drain into?
- Superior mesenteric vein
43
Outline the lymphatic drainage of the stomach
- Left and right gastric nodes - Left and right gastro-omental nodes - Short gastric nodes - Into coeliac nodes around the root of the coeliac artery on the posterior abdominal wall
44
Outline the parasympathetic nerve supply to the stomach
- Anterior and posterior vagal trunks - Anterior vagal trunk gives off a large pyloric branch - Posterior vagal trunk passes to coeliac and superior mesenteric plexuses
45
Outline the sympathetic nerve supply to the stomach
- Preganglionic fibre from T6 - Passes through white ramus communicans into sympathetic trunk - Synapses with coeliac ganglion - Gives off postganglionic neuron which accompanies branches of coeliac trunk to supply stomach
46
Identify the histological layers of the stomach
- Mucosa composed of gastric pits - Muscularis mucosae - Submucosa - Inner oblique muscle layer - Inner circular layer - Outer longitudinal layer
47
Identify five types of cells of gastric glands and their function
- Neck mucus cells, secrete mucus - Parietal cells, secrete gastric acid and intrinsic factor - Chief cells, secrete pepsinogen - Stem cells, replace old cells - Neuroendocrine cells, secrete hormones (e.g. G cells that secrete gastrin)
48
Identify the structure of a gastric parietal cell
- Plasma membrane forms canaliculi that extent throughout the cytoplasm - Which consists of membrane bound vesicles which include a proton pump
49
Identify the mucosal transition at the pyloric sphincter
- From glandular secretory type | - To villous absorptive type
50
What are Brunner's glands?
- Mucus-secreting glands - Located exclusively in submucosa of duodenum - Secrete a thin, alkaline mucus
51
Identify the three anterior branches of the abdominal aorta and the region of the primitive gut tube that each supplies
- Coeliac trunk (foregut) - Superior mesenteric artery (midgut) - Inferior mesenteric artery (hindgut)
52
Identify the contents of the foregut
- Abdominal oesophagus - Stomach - Spleen - Duodenum - Liver - Gallbladder
53
Identify the contents of the midgut
- Jejunum - Ileum - Cecum - Appendix - Ascending colon - Right 2/3 of transverse colon
54
Identify the contents of the hindgut
- Left 1/3 of transverse colon - Descending colon - Sigmoid colon - Rectum - Upper part of anal canal
55
Identify the three branches of the coeliac trunk
- Left gastric artery - Splenic artery - Common hepatic artery
56
Outline the course taken by the left gastric artery and identify its branches
- Ascends to the cardioesophageal junction - Sends oesophageal branches to the abdominal oesophagus which anastomose with oesophageal branches of thoracic aorta - Turns right and descends along lesser curvature to anastomose with right gastric artery
57
Outline the course taken by the splenic artery and identify its branches
- Travels along superior border of pancreas - Gives off branches to supply neck, body and tail of pancreas - Passes in splenorenal ligament and enters hilum of spleen - Gives off short gastric artery and left gastro-omental artery which anastomoses with right gastro-omental artery
58
Outline the course taken by the common hepatic artery and identify its branches
- Runs to the right and divides into hepatic artery proper and gastroduodenal artery
59
Outline the course of the hepatic artery proper and identify its branches
- Ascends toward liver in free edge of lesser omentum - Runs to left of bile duct and anterior to portal vein - Divides into right and left hepatic artery - Right hepatic artery gives of cystic artery
60
Outline the course of the gastroduodenal artery and identify its branches
- Gives off supraduodenal artery and posterior superior pancreaticoduodenal artery - Descends posterior to superior part of duodenum - Gives off its terminal branches, right gastro-omental and anterior superior pancreaticoduodenal artery
61
Which veins unite to form the portal vein? At which vertebral level does this occur?
- Splenic vein and superior mesenteric vein | - L2
62
Outline the course of the portal vein
- Ascends towards liver - Enters the right margin of the lesser omentum - Divides into right and left branches which enter liver parenchyma
63
Identify three tributaries of the portal vein and what they drain
- Right and left gastric veins (draining lesser curvature and abdominal oesophagus) - Cystic veins (draining gallbladder) - Para-umbilical vein (anterior abdominal wall)
64
Outline the course of the splenic vein
- Leaves hilum of spleen - Passes right through splenorenal ligament - Passes over pan - Joins superior mesenteric vein to form portal vein
65
Identify four tributaries of the splenic vein and what they drain
- Short gastric veins (fundus) - Left gastro-omental vein (greater curvature) - Pancreatic veins (body and tail of pancreas) - Inferior mesenteric vein
66
What do the coeliac nodes drain into?
- Cisterna chyli
67
What are the sympathetic trunks
- Two parallel nerve cords that descend on either side of the vertebral column
68
Describe the positioning of the sympathetic trunks as they descend through the thorax and abdomen
- Posterior to carotid sheath - Anterior to neck of ribs in upper thorax - Lateral aspect of vertebral bodies in lower thorax - Anterolateral to lumbar bodies continuing into pelvis
69
How many of the each of the different types of ganglia are there in the sympathetic trunks?
- 3 cervical - 11 thoracic - 4 lumbar - 4 sacral - Ganglion impar anterior to coccyx
70
How are the ganglia and trunk connected to adjacent spinal nerves?
- Grey rami communicantes
71
How are the ganglia and trunk connected in the region of T1-L2?
- White rami communicantes
72
What are splanchnic nerves?
- Pass from sympathetic trunk | - To sympathetic ganglia
73
Identify the three types of thoracic splanchnic nerve, from where they arise and to which ganglion they travel to
- Greater: 5-9th thoracic ganglia to coeliac ganglion - Lesser: 10-11th thoracic ganglia to aorticorenal ganglion - Least: 12th thoracic ganglia to renal plexus
74
To which nerve plexus do lumbar splanchnic nerves pass to?
- Prevertebral plexus
75
To which nerve plexus do pelvic splanchnic nerves pass to?
- Inferior hypogastric plexus (extension of prevertebral plexus in pelvis)
76
Why are pelvic splanchnic nerves unique?
- They carry parasympathetic fibres - Meaning they do not originate from sympathetic trunk - Rather, they arise from anterior rami of S2 to S4
77
What do the pelvic splanchnic nerves innervate?
- Distal 1/3 of transverse colon - Descending colon - Sigmoid colon
78
What is the abdominal prevertebral plexus?
- Collection of nerve fibres that surrounds the abdominal aorta
79
Identify the three major divisions of the abdominal prevertebral plexus
- Coeliac plexus - Aortic plexus - Superior hypogastric plexus
80
Identify the ganglia associated with the coeliac plexus
- Two coeliac ganglia - One superior mesenteric ganglion - Two aorticorenal ganglia
81
Identify the ganglia associated with the aortic plexus
- Inferior mesenteric ganglion
82
Identify the ganglia associated with the superior hypogastric plexus
- Numerous small ganglia
83
Identify fibres to the abdominal prevertebral plexus
- Preganglionic parasympathetic fibres from vagus nerve | - Preganglionic sympathetic fibres from splanchnic nerves
84
Identify two sources of parasympathetic innervation to the abdominal viscera
- Vagus nerves which give off vagal trunks which give off branches containing preganglionic parasympathetic fibres to prevertebral plexus - Pelvic splanchnic nerves, carrying preganglionic parasympathetic fibres from S2-S4 to hypogastric plexus
85
Identify two two plexuses of the enteric nervous system, where they are located and what they control
- Myenteric plexus between outer longitudinal and inner muscular layers, controlling GI movements - Submucosal plexus in submucosa controlling GI secretions and local blood flow
86
Which regions of the abdomen is the stomach located in?
- Left hypochdonrium - Epigastric region - Umbilical region

Semester 4: Nutrition and Metabolism (17 decks)

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