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M1: Anatomy and Embryology Lecture BW > Block 2: Abdomen, Gray's Review > Flashcards

Block 2: Abdomen, Gray's Review Flashcards

1
Q

Omental Bursa

  1. alternate name
  2. location
A

aka lesser sac

space posterior to the stomach and the liver

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2
Q

What connects the omental bursa to the rest of the greater sac?

A

omental foramen

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3
Q

Hepatorenal Space

  1. alternate name
  2. location
A

space/pouch of Morrison

separates the liver from the R kidney

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4
Q

Subphrenic Recess

A

separates the diaphragmatic surface of the liver from the diaphragm

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5
Q

Falciform Ligament

A

separates the subphrenic region into R and L components

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6
Q

What is directly posterior to the omental foramen?

A

Inferior vena cava

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7
Q

What are the borders of the omental foramen?

A
  1. visceral peritoneum of the liver.
  2. inferior: peritoneum covering the IVC
  3. anteriorly: hepatoduodenal ligament
  4. inferiorly: duodenum peritoneum
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8
Q

Fundic Region of the Stomach

A

area above the cardial orifice

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9
Q

What arteries lie on the fundus?

A

short gastric arteries

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10
Q

Ileum

  1. location
  2. what is it?
A

location: in the RLQ
what: distal 3/5 of the small intestines

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11
Q

Transverse Mesocolon

A

fold of the peritoneum that connects the transverse colon to the posterior abdominal wall

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12
Q

Gastrosplenic Ligament

A

connects the stomach to the spleen

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13
Q

Rectouterine Pouch

  1. location
  2. alternate name
A

location: space between the uterus and the rectum

alternate name: Pouch of Douglas

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14
Q

Paracolic Gutter

A

space b/w the colon and the abdominal wall

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15
Q

Retroperitoneal meaning

A

between the abdominal wall and the peritoneal cavity, embedded in mesentery

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16
Q

Which of the following organs is retroperitoneal?

jejunum 
stomach 
descending colon 
transverse colon 
appendix
A

descending colon

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17
Q

Processus Vaginalis

A

a tubular extension of the peritoneal cavity

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18
Q

Darto’s Fascia

A

a layer of camper’s fascia that continues into the scrotum and forms specialized fascial layer containing smooth munscle fibers

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19
Q

Hypospadias

  1. what is it?
  2. what’s the cause?
A

what: urethra opens on the ventral side of the penis
cause: DHT deficiency

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20
Q

Epispadias

  1. what is it?
  2. what’s the cause
A

what: urethra opens on the dorsal side of the penis
cause: genital tubercle developing more dorsally

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21
Q

Hydrocele

A

peritoneal fluid passing through the patent processus vaginalis into the tunica vaginalis

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22
Q

Descending colon innervation

A

innervated by the parasympathetic nerves from S2-S4 and visceral afferents

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23
Q

Duodenum Innervation

A

duodenum innervated by the vagus nerve, which innervates the GI tract up to the L colic flexure

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24
Q

Liver innervation

A

sympathetic innervation:
celiac ganglion
parasympathetic: vagus nerve

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25
Q

What does hematuria or hematemesis indicate?

A

it indicates bleeding within the gastrointestinal tract

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26
Q

SMA location in respect to the L renal vein

A

SMA lies superior and anteriorly to the L renal vein

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27
Q

What are the differences between the L and R renal veins, L and R testicular veins, & L and R suprarenal veins

A

IVC leads to the L renal vein, then L testicular vein, then L suprarenal vein

IVC leads directly to the R testicular vein, then the R suprarenal vein

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28
Q

List the normal points of ureteric constriction (3)

A
  1. close to the divergence of the common iliac vessels
  2. where the ureters enter the bladder
  3. pelvic-ureteric junction (where the renal pelvis meets the ureter)
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29
Q

paraesophageal hernia

A

characterized by herniation of the stomach into the mediastinum

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30
Q

sliding hernia

A

the gastroesophageal junction is displaced

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31
Q

By which rib does the kidney lie?

A

the 12th rib

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32
Q

Spleen Location (rib wise)

A

rib 9-11, under the liver

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33
Q

Liver Location (side of the body & ribs)

A

R side of the body, ribs 5-10

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34
Q

Pancreas Location (adjacent organs & ribs)

A

located in the middle of the body, medial to the kidneys at rib 11-12

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35
Q

What artery crosses the ureter?

A

uterine artery

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36
Q

Gallstone Ileus

A

a rare small bowel obstruction caused by a gallstone being lodged within the ileum of the small intestine

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37
Q

Psoas Sign

what is it?
alternative name?
indicates?

A

what: sign that indicates the irritation to the iliopsoas group of hip flexors in the abdomen

alternative name: Cope’s Psoas Test

Indicates: the inflamed appendix is retrocecal in position

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38
Q

List the layers of fat/tissue surrounding the kidney

A

(in order): Renal capsule, perinephric fat, renal fascia, perinephric fat

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39
Q

Varices

A

large, dilated veins

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40
Q

What is the result of portal venous pressure increase?

A

varices can occur at the sites of portosystemic anastomoses, pooling usually accumulates there

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41
Q

What are the sites of portosystemic anastomoses?

A
  1. varices @ anorectal junction

2. esophageal varices @ gastroesophageal junction

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42
Q

IMA supplies the

A

hindgut (distal 1/3 of the TC, descending colon, sigmoid colon, and rectum)

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43
Q

What is the connection b/w the SMA and the IMA?

A

anastamoses b/w middle colic (derived from the SMA) & L colic artery (derived from the IMA)

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44
Q

What system of veins do the esophageal veins arise from?

A

caval, particularly from the azygous system of veins

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45
Q

What is the consequence of cirrhosis of the liver on the portal venous system?

A

cirrhosis means the portal system doesn’t properly do its job; the portal venous flow will back up to the systemic flow, and will pool at areas of the portal-caval anastamoses

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46
Q

Where do aortic aneurysms usually occur?

A

below the bifurcation of the abdominal aorta

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47
Q

What do aortic aneurysms lead to?

A

increases in pressure, marked pulsation

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48
Q

Caput Medusae

A

systemic vessels that radiate from paraumbilical veins enlarge and become visible on the abdominal wall

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49
Q

What is the cause of caput medusae?

A

caused by severely elevated portal venous pressure

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50
Q

Paralytic Ileus

A

obstruction of the intestines due to the paralysis of he intestinal muscles

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51
Q

Borborygmi

A

Bowel Sounds

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52
Q

Borborygmi and Bowel Obstruction

A

bowel obstructions initially characterized by increased Borborygmi, usually immediately follows mechanical obstruction.

As the muscle tires, bowel sounds become reduced or absent

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53
Q

Nutcracker Syndrome

A

the duodenum lies between the aorta and the SMA with a normal 45 degree angle. when that angle diminishes to less than 20 degrees, the transverse colon can get entrapped, leading to partial SBO symptoms

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54
Q

SMA main branches (3)

A

middle colic
r colic
ileocolic

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55
Q

Ileocolic branches to

A

ileal branch

cecal branch

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56
Q

What arteries supply the head of the pancreas?

A

the pancreaticoduodenal arteries

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57
Q

How does the portal vein arise?

A

from the junction of the splenic and the superior mesenteric veins

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58
Q

posthepatic jaundice

A

obstruction of the biliary tree that causes jaundice

59
Q

What causes yellow eyes and jaundice?

A

reversal of flow of the bile into the blood stream

60
Q

The tail of the pancreas is supplied by

A

the splenic artery (anteriorly ad posteriorly)

61
Q

Duodenum is supplied by

A

superior and inferior anterior & posterior pancreaticdoduodenal arteries

62
Q

Gallbladder is supplied by

A

the cystic artery

63
Q

Kidney is supplied by

A

the R and L renal arteries

64
Q

Gastroduodenal artery branches from the

A

common hepatic artery

65
Q

Transverse Mesocolon

A

fold of the peritoneum that connects the transverse colon to the posterior abdominal wall

66
Q

What ligament connects the stomach to the spleen?

A

gastrosplenic

67
Q

What is the omental foramen bound by?

A

the portal triad and the IVC

68
Q

Processus Vaginalis

A

parietal peritoneum that precedes the testes in men, labia majora in women, as it “migrates” from upper lumbar wall to abdomen

69
Q

Patent Processus Vaginalis

A

processus vaginalis fails to obliterate like it should

70
Q

Cryptorchism

A

undescended testicles

71
Q

Chordee

A

head of the penis turns downward

72
Q

Direct Inguinal Hernia

A

herniated sac enters the ingunial canal through the posterior wall of the inguinal canal

73
Q

Indirect Inguinal Hernia

A

herniated sac enters through the deep inguinal ring

74
Q

Inguinal canal contents

A

Both: genital branch of genitofemoral nerve
Women: round ligament of the uterus
Men: Spermatic Cord

75
Q

What are the contents of the spermatic cord?

A
  1. testicular, cremasteric & deferential arteries
  2. pampiniform plexus of testicular nerve
  3. genital branch of genitofemoral nerve
  4. cremasteric nerve
  5. testicular sympathetic plexus
76
Q

Chromaffin cells

A

modified postganglionic sympathetic neurons that release norepinephrine & epinephrine that passes into the adrenal glands

77
Q

What are chromaffin cells derivedfrom?

A

neural crest cells

78
Q

What are the walls of the spermatic cord?

A

internal spermatic fascia
cremasteric fascia
external spermatic fascia

79
Q

Internal spermatic fascia

A

deepest layer of spermatic cord

arises from the transveraslis fascia

80
Q

Cremasteric Fascia

A

associated w/ the cremaster muscle

middle layer, originating from internal oblique muscle and its fascial coverings

81
Q

External spermatic fascia

A

derived from the external oblique aponeurosis

82
Q

Canalization failure leads to

A

atresia

83
Q

What happens if the inferior end of the vaginal plate fails to canalize?

A

results in an imperforate hymen

84
Q

Vaginal Plates are formed by

A

fusion of sinovaginal bulbs

85
Q

What does the vaginal plate give rise to?

A

lumen of the vagina

86
Q

What happens if the sinovaginal bulbs don’t develop?

A

absence of Vagina

87
Q

Persistent urachus

A

results from an abnormal fistula between the bladder and the umbilicus, leading to urine leaking from the external abdominal wall

88
Q

Ureteric Bud

A

responsible for development of the ureter

89
Q

What happens if the ureteric bud fails to branch?

A

results in 1 ureter being attached to 2 kidneys

90
Q

What happens if there’s incomplete division of the ureteric bud?

A

double ureter and supernumerary kidney

91
Q

Supernumerary Kidney

A

additional/accessory kidney

92
Q

What happens if the ureteric buds fail to form?

A

no ureters will be present

93
Q

What is the fate of the processus vaginalis?

A

it is supposed to terminate, giving rise to the tunica vaginalis

94
Q

True Hermaphroditism

A

presence of testicular and ovarian tissue

95
Q

Pseudohermaphroditism

A

errors in sexual differentiation lead to contrasting phenotypes

96
Q

Atresia

A

a blind ending pouch

97
Q

Subhepatic Cecum

A

failure of cecal buds to descend

98
Q

Consequence of sub-hepatic cecum

A

absence of an ascending colon

99
Q

Midgut Volvulus

A

improperly positioned and incompletely fixed intestines that leads to twisting of the midgut

100
Q

Why is midgut volvulus an issue?

A

the intestines rotate around the vasculature that supplies them

101
Q

Hirchsprung Disease

A

lack of autonomic ganglion cells in the myenteric plexus distal to the colon leads to an enlarged colon (megacolon)

102
Q

What causes megacolon?

A

failure of neural crest cells to migrate to the walls of the colon

103
Q

Anal Agenesis

A

incomplete separation of the cloaca

104
Q

Rectal Atresia

A

rectal and anal canals are not connected due to incomplete or absence of canalization

105
Q

What is the most common site of Meckel’s Diverticulum?

A

ileum

106
Q

Meckel’s Diverticulum

alternate name
clinical correlate
remnant of

A

aka: congenital ileum diverticulum

may become enflamed and mimic appendicitis symptoms

remnant of omphaloenteric duct (yolk sac)

107
Q

How does Meckel’s Diverticulum look?

A

a fingerlike projection of ileum

108
Q

Umbilical Hernia

A

intestines return to abdominal cavity and later herniate through an imperfect umbilicus

109
Q

What protrudes in an umbilical hernia?

A

greater omentum & small intesitnes

110
Q

Rule of 2’s

A

common for Meckel’s Diverticulum

2% of popualtion 
2 ft proximal from ileocecal jx 
2 inches long 
2x as often in males 
may contain 2 types of ectopic tissue 
may be associated with 2 clinical conditions
111
Q

Types of ectopic tissue associated w/ Meckel’s Diverticulum

A

gastric mucosa

pancreatic tissue

112
Q

Hypertrophied Pyloric Sphinter is the result of

A

thickened pyloric sphincter muscle that narrows the sphincter, blocking material from leaving the stomach

113
Q

Duodenal stenois vomitus

A

has bile

114
Q

Duodenal atresia vomitus

A

usually immediately after birth

115
Q

Incomplete Recanalization is most likely to occur in which part of the duodenum?

A

distal 3rd portion

116
Q

Incomplete recanalization of the duodenum is caused by

A

duodenal stenosis

partial occlusion of the lumen of the duodenum

117
Q

Duodenal Atresia

A

complete occlusion of the duodenal lumen that is the result of a failed reformation of the lumen fo the duodenum

118
Q

Double Bubble

A

distended, air filled stomach usually associated w/ duodenal atresia

119
Q

Meckel’s Diverticulum is a remnant of

A

omphaloenteric duct

120
Q

Malrotation of the Midgut

A

the intestine doesn’t rotate as it re-enters the abdomen, so the small intestine lies on the R side and the large intestine lies on the L side

121
Q

Gastrochisis

A

extension of abdominal contents that is the result of incomplete lateral fold closure

122
Q

Gastrochisis results in

A

epigastric hernia with viscera that protrude into the amniotic cavity & are covered with amniotic fludi

123
Q

Imperforate Anus

A

anal canal ends blindly or there may be an ectopic anus or anoperineal fistula

124
Q

Anoperineal Fistula

A

abnormal passage of anus into pernieum

125
Q

Anal Stenosis

A

anus is in normal position but the anus and the canal are narrow

126
Q

Anal stenosis is the result of

A

dorsal deviation of the urorectal septum as it grows caudally

127
Q

What happens if the anal membrane does not perforate?

A

develop imperforate anus

128
Q

What causes anal agenesis?

A

incomplete separation of the cloaca by the urorectal septum

129
Q

McBurney’s Point

A

most common location of the appedix at the cecum

130
Q

What are the fascial layers of McBurney’s point

A

aponeurosis of external abdominal oblique muscle

internal oblique muscle

transversus abdominis muscle

transversalis fascia

parietal peritoneum

131
Q

achalasia

A

failure of the smooth muscle of the esophagus to relax, leading to lower esophageal sphincter remaining closed

132
Q

The veriform appendix is best located by tracing and following what?

A

taeniae coli of ascending colon

133
Q

In adults, the urachus is represented as

A

median umbilical ligament

134
Q

Urachus

A

a thick cord remnant of allantois that extends from urinary bladder to umbilicus

135
Q

Why is Meckel’s Diverticulum prone to infection?

A

b/c the diverticulum may contain fecal material that can become infected

136
Q

Duodenal Atresia presents w/:

A

distended epigastrium biliius vomiting

double bubble sign

137
Q

Omphaloenteric Fistula

A

abnormal connection between umbilical surface and terminal ileal lumen

138
Q

Down syndrome is associated with what issue?

A

increased instance of duodenal atresia

139
Q

What is the most superior portion where ureters can be contstricted?

A

ureteropelvic junction

140
Q

Pancreas Innervation

A

vagus, celiac ganglion and pancreatic plexus

141
Q

List the dermatome levels of the abdomen and what they effect

A

T7-T9: skin from xiphoid process to above umbilicus
T10: skin around the umbilicus
T11-L1: supply the skin below the umbilicus to and including the pubic region
L1: anterior surface of scrotum or labia majora, small cutaneous branch to the thigh

142
Q

How would metastatic cells anywhere in the GI tract be spread? Where would they go first?

A

how: through the portal venous system

where 1st: to the liver

the liver (portal vein) receives all blood from the gastrointestinal system.

143
Q

Anorectal Agenesis

A

rectum ends blindly

M1: Anatomy and Embryology Lecture BW (37 decks)

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