D1 Anatomy chapter 4 test 3 Flashcards
(167 cards)
1
Q
What level is the Transpyloric plane?
A
lower aspect of L1
2
Q
Name some landmarks of the Transpyloric sphincter
A
Passes sternum at 9th costal cartilage, Crosses C shaped duodenum, through body of pancreas, passes through parts of hila of kidneys
3
Q
name the 3 main arteries of gastrointestinal system
A
celiac trunk, superior mesenteric a. , inferior mesenteric a.
4
Q
celiac trunk branch level and what it supplies
A
upper border of L1, supplies the foregut
5
Q
superior mesenteric a. level and what it supplies
A
lower border L1, supplies the midgut
6
Q
inferior mesenteric a. level and what it supplies
A
L3, supplies the hindgut
7
Q
what does the left renal vein drain?
A
kidney, suprarenal gland, gonad on same side
8
Q
left common iliac vein
A
crosses L5 to join right common iliac vein to form inferior vena cava
9
Q
what does the inferior vena cava drain?
A
lower limbs, pelvis, perineum, and some abdominal wall
10
Q
describe the venous drain system of the gastrointestinal system
A
blood from abdominal parts of the gastro intestinal system and spleen have to pass a second vascular bed in the liver before returning to the heart
11
Q
pathway GI tract, pancreas, Gallbladder and spleen into liver
A
enter via hepatic portal vein which distributes blood to small endothelieal-lined sinusoids which form a vascular exchange in the liver
12
Q
pathway out of the liver
A
blood collects in hepatic veins that drain into inferior vena cava just before it enters the diaphragm
13
Q
Innervation of skin, muscles, parietal peritoneum and anterolateral abdominal wall
A
T7-L1
14
Q
describe these nerves branching?
A
a lateral cutaneous branch and end as a anterior cutaneous branch
15
Q
T7-T11 pathway spinal nerves
A
leave intercostal spaces passing deep to costal cartilages and continue onto the anterolateral abdominal wall between internal oblique and transversus abdominis muscles
16
Q
T7-T11 pathway continued
A
They pass deep to lateral edge of rectus sheath. Near midline they pass through the abdominus and sheath to supply the skin.
17
Q
T12 pathway
A
“subcostal nerve” follows same pathway as intercostals
18
Q
L1 pathway
A
” Iliohypogastric, ilio-inguinal nerve”. Originates from lumbar plexus
19
Q
what does T7-T9 supply
A
skin from xiphoid process to just above umbilicus
20
Q
what does T10 supply?
A
skin around umbilicus
21
Q
T11, T12, L1 supplies?
A
skin just below umbilicus to pubic region
22
Q
Ilio-inguinal nerve supplies?
A
anterior surface of scrotum or labia majora and small cutaneous regions of thigh
23
Q
what does musculophrenic artery supply(superficially)?
A
superior part of abdominal wall ( remember its a branch of the internal thoracic artery)
24
Q
what does the superficial epigastric artery supply? (superficially)
A
medially inferior part of abdominal wall
25
what does the superficial circumflex iliac artery supply(superficially)?
lateral inferior part of abdominal wall
26
what do the superficial epigastric and superficial circumflex iliac arteries branch from??
femoral artery
27
branches of 10th, 11th intercostal aa. and subcoastal artery (deep)
lateral part of wall
28
inferior epigastric artery( deep)?
inferior medial part of wall
29
deep circumflex iliac artery (deep)
lateral, deep wall
30
which vessel does the inferior epigastric and deep circumflex arteries branch from?
external iliac artery
31
where do the superior and inferior epigastric arteries anastamose?
posterior to rectus abdominis muscle
32
superficial lymphatics above umbilicus go where?
superior direction to axillary nodes
33
superficial lymphatics below umbilicus go where?
inferior to superficial inguinal nodes
34
deep lymphatics go where
follow deep arteries back to parasternal nodes along internal thoracic artery, lumbar nodes along aorta, and external iliac nodes along external iliac artery
35
where do the omenta develop from?
original dorsal and ventral mesenteries which suspend the GI tract
36
Omenta consists of what?
2 layers of peritoneum which pass from stomach and first part of duodenum to other viscera
37
Greater omentum is derived from
dorsal mesentery
38
lesser omentum is derived from
ventral mesentery
39
what does greater omentum attach to?
greater curvature of stomach, first part of duodenum
40
where else does it attach?
to peritoneum of superior surface of transverse colon, then posterior abdominal wall
41
what is between the 2 folds of the omentum?
right and left gastro-omental vessels ( veins and arteries)
42
where does lesser omentum attach?
lesser curvature of stomach to inferior surface of liver
43
name the two parts of lesser omentum
medial hepatogastric ligament, lateral hepatoduodenal ligament
44
hepatogastric ligament attaches what to what
liver to stomach
45
hepatoduodenal attaches what to what?
liver to duodenum
46
what is enclosed in the free edge by liver of hepatoduodenal lig.?
hepatic artery proper, bile duct, portal vein
47
what are mesenteries defined as?
peritoneal folds that attach viscera to posterior abdominal wall
48
name the 3 mesenteries
mesentery, transverse mesocolon, sigmoid mesocolon
49
what are mesenteries derived from?
the dorsal mesentary
50
Mesentary attaches what to what
jejunum and ilieum to posterior abdominal wall
51
superior/inferior attachement of mesentary
sup. - duodenojejunal junction
| inf. -ileocecal junction
52
what is between the two peritoneal layers of mesentery?
veins, nerves, arteries, lymphatics that supply the Jejunum and ileum
53
what does transverse mesocolon attach?
transverse colon to posterior abdominal wall
54
where does the T mesocolon come out ?
above head and body of pancreas
55
the anterior layer of Transverse colon is adherent to what?
greater omentum
56
Sigmoid mesocolon resembles what letter and attaches what to what?
inverted V shape. attaches sigmoid colon to posterior abdominal wall
57
about where is the apex of the V?
near division of left common iliac artery
58
Left leg of V follows by what?
medial border of psoas major muscle
59
right leg of V follows by what?
descends into pelvis and ends near S3
60
what are peritoneal ligaments?
2 layers of peritoneum that connect 2 organs together or to wall
61
where does the esophagus enter the abdomen?
T10 , right crus of diaphragm
62
how do the anterior vagal trunk and posterior vagal trunk get positioned?
rotation of gut during development.
63
anterior vagal trunk is derived from what?
left vagus trunk
64
posterior vagal trunk is derived from what?
right vagus trunk
65
arterial supply of the abdominal esophagus
by esophageal branches from left gastric artery ( celiac trunk), and left inferior phrenic artery ( from abdominal aorta)
66
stomach is in what regions
epigastric, umbilical, and left hypochondrium regions
67
name the 4 regions of stomach
cardia, fundus, body, pyloric part
68
where is the pylorus?
most distal part of pyloric part
69
where is the transpyloric plane?
lower border of L2 , this is where you find the pyloris
70
gasteriosplenic ligament
attaches spleen to stomach. ( part of greater omentum)
71
what makes the cardiac notch?
the esophagus entering the stomach
72
what is the angular incisures?
bend of lesser curvature
73
5 arteries that supply stomach
left/ gastric artery, lef/right gastro-omental arteries, posterior gastric artery
74
how long is the small intestine?
6-7m long, from pyloric orfice to ileocecal fold
75
how long is duodenum
20-25 cm long and has largest lumen of small intestine
76
all of duodenum is retroperitoneal except what part
the very beginning that attaches to the hepatoduodenal ligament
77
superior part of duodenum extends from where to where
pyloric orfice of stomach to neck of gallbladder at L1
78
where do most duodenal ulcers occur?
superior part
79
where is descending part of duodenum
neck of gallbladder to lower border of L3
80
what does it touch?
transverse colon, kidney, head of pancreas
81
name the two papilla and where they are
major and minor duodenal papilla, major is below
82
inferior part of duodenum crosses what
its the longest part of duodenum , crosses inferior vena cava, aorta, and vertebral column
83
about how high the the ascending duodenum reach?
L2, terminates at duodenojejunal flexure
84
what supports the duodenojejunal flexure?
suspensory muscle (lig.) of duodenum. ( ligament of treitz)
85
what portion of small intestine is jejunum?
2/5
86
plicae circulares of jejunum
prominent mucosal folds
87
arterial supply of jejunum
jejunal arteries from superior mesenteric artery
88
ileum is what proportion of small intestine?
3/5, it has less mucosal folds than jejunum
89
ileocecal fold
where cecum and ileum meet, it may prevent reflux and regulate passage of contents
90
arterial supply of ileum
ilial arteries from superior mesenteric artery and ileal branch from ileocolic artery
91
how long is large intestine? what does it do
1.5m in adults, absorbs salts and fluid
92
name the anatomy of large intestine
ascending colon, right colic flexure, transverse colon, left colic flexure, descending colon, sigmoid colon
93
what are omental appendicies?
peritoneal covered accumulations of fat
94
what is taenieae coli?
longitudinal smooth muscle
95
haustra of colon
little segments of colon
96
which segments of colon are retroperitoneal?
ascending and descending
97
which parts are intraperitoneal?
transverse and sigmoid
98
describe right and left paracolic gutters
between colon and wall of ascending and descending segments. Material can pass from one region of cavity to another. It is blood free since vessels are on medial side of colon
99
where does sigmoid colon begin
above pelvic inlet and goes to S3, its supported by sigmoid mesocolon
100
appendix is attached to what wall of the cecum?
posterolateral wall
101
what holds the appendix up?
mesoappendix which also has blood vessels
102
name the positions the appendix can be in
pre-ileal, post-ileal, subcecal, retrocecal, pelvic
103
what areas of liver are not covered with visceral peritoneum ?
gallbladder fossa, porta hepatis
104
what enters and exits the porta hepatis?
enters- hepatic arteries, and portal vein.
| Exits- hepatic ducts
105
falciform ligament
attaches liver to anterior abdominal wall
106
right and left triangular ligaments
connect diaphragm to liver
107
anterior coronary ligament
heart to liver
108
where is caudate and quadrate lobes?
quadrate visible anteriorly
| caudate is posterior
109
quadrate lobe is functionally like what lobe?
left
110
caudate is functionally like what lobe?
none
111
what supplies the liver
right and left hepatic artery proper
112
arterial supply for gallbladder
cystic artery from right hepatic artery
113
pancreas
secondarily retroperitoneal. has head, neck, body, tail, uncitate process
114
describe duct system for bile
R/L hepatic ducts to common hepatic duct, cystic duct combines to form bile duct which combines with pancreatic duct
115
development of spleen
developes as part of vascular system in part of dorsal mesentery that suspends the developing stomach in wall
116
where is spleen in adults?
between rib 9 and 10
117
what attaches spleen to greater curvature of stomach?
gastrosplenic ligament
118
what connects the spleen to left kidney?
splenophrenic ligament
119
what supplies the spleen with blood?
splenic artery
120
what are the terminal branches of the descending aorta?
the 2 common iliac arteries
121
celiac trunk supplies what
foregut
122
superior mesenteric artery supplies what
midgut
123
inferior mesenteric artery supplies what
hindgut
124
what is the foregut?
abdominal esophagus to major duodenal papilla. ( includes everything between stomach, duodenum, liver, pancreas, gallbladder)
125
midgut consists of ....
begins inferior to major duodenal papilla and ends at Junction between proximal 2/3 and distal1/3 of transverse colon ( includes duodenum, jejunum, ileum, cecum, appendix, ascending colon & right 2/3's transverse colon)
126
hindgut consists of...
starts and left colic flexure and ends at mid-anal canal. ( includes left 1/3 transverse colon- upper part of anal canal
127
where is the celiac trunk?
immediately below aortic hiatus so L1
128
what does celiac trunk split into?
left gastric a., splenic a. , common hepatic arteries
129
left gastric artery pathway
ascends to cardioesophageal junction, sends esophageal branches upward, anastomoses with right gastric a. from common hepatic artery
130
splenic artery pathway ( largest)
travels through spleenorenal ligament , gives off many branches in neck, body, tail of pancreas, anastomoses with left gastro-omental a. which anastomoses with right gastro-omental a.
131
branches of common hepatic a
right gastric a, common hepatic artery, gastroduodenal a.
132
branching of hepatic artery proper
ascends in lesser omentum, branches into right/left hepatic arteries and cystic artery
133
Gastroduodenal artery
divides into anterior and posterior superior pancreaticoduodenal arteries
134
which artery gives off the right gastro-omental artery?
anterior superior gastroduodenal artery
135
what does the anterior/posterior superior pancreaticoduodenal arteries supply?
head of pancreas and duodenum
136
what does the anterior/posterior pancreaticoduodenal arteries anastamose with?
anterior/ posterior inferior pancreaticoduodenal arteries
137
what do the anterior/ posterior inferior pancreaticoduodenal arteries converge in to?
the inferior pancreaticoduodenal artery
138
where does the inferior pancreaticoduodenal artery come out from?
superior mesenteric artery
139
where does the superior mesenteric artery arise?
lower L1
140
what branches off the superior mesenteric artery
inferior pancreaticoduodental artery, jejunal and ileal arteries, right, middle, and ileocolic arteries
141
what does the middle, right, and ileocolic arteries supply?
terminal ileum to first 2/3rds of transverse colon
142
what does the inferior pancreaticoduodenal artery turn into?
anterior/ posterior inferior pancreaticoduodenal arteries
143
jejunal and ilial arteries come off which side of superior mesenteric a?
left
144
middle colic artery
enters transverse colon and branches into right and left branches
145
what doe the branches anastamose with?
right branch with right colic artery, left branch with colic artery
146
right colic artery
supplies ascending colon, divides into ascending/descending branches
147
where do these branches anastamose?
ascending with middle colic a. , descending with ileocolic a.
148
ileocolic artery
anastomoses with right colic artery
149
what vertebral level can you find the inferior mesenteric artery?
around L3
150
what does it branch into?
left colic artery, sigmoid arteries, superior rectal artery
151
whats special about left colic artery?
ascends retroperitonealy
152
whats special about superior rectal artery?
terminal branch of inf. mesenteric a. Found at S3
153
where do all of the abdominal lymphatics eventually end up?
pre-aortic lymph nodes
154
where are the pre-aortic nodes found?
by the 3 main branches of aorta
155
1st route lymph can take
celiac trunk drains into celiac nodes which also receive from other 2 main branches. Then it enters Cysterna chyli
156
2nd route of lymph
superior mesenteric artery drains in superior mesenteric nodes which also receives from inferior mesenteric a. then drains into celiac nodes
157
3rd route
inferior mesenteric artery drains into inferior mesenteric nodes then drains into superior mesenteric nodes
158
innervation of abdominal viscera is by what
extrinsic and intrinsic components
159
extrinsic innervation
receives motor impulses from CNS and sends sensory to CNS
160
Intrinsic innervation
involves regulation of digestive tract by a self sufficient network of sensory and motor neurons
161
some organs that receive extrinsic innervation of abdomen
spleen, GI tract, pancreas, gallbladder, liver
162
the 2 interconnected plexuses of the enteric system do what
coordinate contraction and relaxation of smooth muscle and regulate secretions and blood flow
163
what is the ganglian impar?
ganglion at bottom of coccyx
164
how many ganglion in cervical region?
3
165
thoracic region?
11/12
166
lumbar?
4
167
sacral?
4/5
