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Gross Anatomy 2 > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

The liver lies mostly in which abdominal regions?

A

right hypochondrium and epigastric region

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2
Q

The spleen, funds and body of stomach lie mostly in which abdominal region?

A

left hypochondrium

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3
Q

Between what two layers of the abdomen would a extravasation of urine happen? What gender is it more common in? What causes it?

A

Between Scarpa’s facia and deep fascia of abdomen, more common in men, and trauma of spongy urethra

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4
Q

What comprises the rectus sheath

A

aponeuroses of the external oblique, internal oblique, and transversus abdominis

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5
Q

What structures does the rectus sheath enclose?

A

rectus abdominis, pyramidalis muscle, superior and inferior epigastric arteries and veins, and anterior primary rami of lower 6 thoracic nerves

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6
Q

What 4 vessels supply blood to anterior abdominal wall?

A

Superior and Inferior Epigastric, lumbar arteries, and deep circumflex iliac artery

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7
Q

Innervation of anterior abdominal wall

A

Lower 6 thoracic nerves

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8
Q

What forms the inguinal ligament and where does it extend to?

A

lower edge of the external oblique aponeurosis, and extends from ASIS to pubic tubercle

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9
Q

Is there a difference in diameter of inguinal canal between sexes? And what travels through it?

A

Yes, larger in males. Spermatic cord (males) Round ligament of uterus (female) and ilioinguinal nerve (both sexes)

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10
Q

What forms the conjoint tendon?

A

aponeuroses of internal oblique and transversus abdominis

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11
Q

What forms the anterior and posterior walls of inguinal canal?

A

Anterior: aponeurosis of external oblique, Posterior: conjoint tendon and transversalis fascia

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12
Q

What forms roof and floor of inguinal canal

A

roof: arching fibers internal oblique and transversus abdominis, floor: inguinal and lacunar ligaments

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13
Q

True or false, the superficial inguinal ring is made of three crura

A

false, made of two; lateral and medial crus

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14
Q

What forms the inguinal triangle?

A

Medially: rectus abdominis, Laterally: inferior epigastric vessels, Inferiorly: inguinal ligament

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15
Q

What is notable clinically about the inguinal triangle?

A

Area of potential weakness where direct inguinal hernias occur

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16
Q

In a child what direction is the inguinal canal facing?

A

much less oblique like in adult, more vertical

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17
Q

Why does the inguinal canal face obliquely in adults?

A

It strengthens the canal by being compressed by muscles

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18
Q

Are inguinal hernias more common in one sex? If so, why?

A

Yes, males. The males canal is larger in diameter for the spermatic cord

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19
Q

What is a indirect inguinal hernia? Where does it pass the inferior epigastric vessels?

A

Hernia that passes through deep inguinal ring, through canal, through superficial inguinal ring into groin region. Passes laterally to inferior epigastric vessels

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20
Q

How is a indirect inguinal hernia acquired? What percentage do indirect inguinal hernia account for?

A

Can be congenital or acquired through forced passage, 75%

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21
Q

What is a direct inguinal hernia? Where does it pass the inferior epigastric arteries? What percentage do direct inguinal hernias account for?

A

Punches directly through posterior wall of canal, bypassing deep inguinal ring (causes abdominal bulging)

Passes medially to vessels

25%

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22
Q

Are femoral hernias more common in men or women?

A

Women

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23
Q

The external spermatic fascia is derived from what?

A

external oblique aponeurosis

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24
Q

The cremasteric fascia is derived from what? How is it recognized

A

internal oblique muscle; bundles of muscle fibers

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25
Q

What are the bundles of muscle fibers in the cremasteric fascia collectively known as?

A

Cremaster muscle

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26
Q

What is the function of the cremaster muscle?

A

Control temperature of sperm

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27
Q

What is the internal spermatic fascia derived from?

A

trasversalis fascia

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28
Q

What is the ductus deferens

A

muscular duct which transports sperm from epididymis to ejaculatory duct

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29
Q

What is the pampiniform plexus of veins?

A

extensive network of veins, bulk of spermatic cord. Join at deep inguinal ring to form testicular vein

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30
Q

True or false, the ilioinguinal nerve runs through inguinal canal and superficial inguinal ring, accompanying the spermatic cord which it is a part of

A

False, it does accompany the spermatic cord, but it is not a part of it

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31
Q

What are the two branches of the iliolinguinal nerve?

A

Femoral branch, and Anterior scrotal or anterior labial nerves

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32
Q

What does the femoral branch of the iliolinguinal nerve supply?

A

upper medial thigh

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33
Q

What does the anterior scrotal or anterior labial nerve supply?

A

root of the penis and anterior part of scrotum, or mons pubis and anterior part of labia majora

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34
Q

Does the scrotum contain fat? Why or why not?

A

No, because fat is an insulator and would make controlling temp of sperm difficult

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35
Q

The dartos muscle is a continuation of what structures of abdominal cavity, and how does it differ from the cremaster muscle?

A

subcutaneous tissue, superficial and deep fascia, and it is smooth muscle not skeletal like cremaster

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36
Q

What is the tunica vaginalis? What are it’s layers

A 
Serous covering of testes; 
Parietal layer (superficial)
Visceral layer (deep, firmly adhered to testes and epididymis)
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37
Q

What is hydrocele

A

Accumulation of fluid with cavity of tunica vaginalis

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38
Q

What are the two functions of testes

A

production of spermatozoa and secretion of androgens

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39
Q

What is the Tunica Albuginea

A

fibrous outer covering of testes, deep to visceral layer of tunica vaginalis

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40
Q

Inside each lobule of the testes the seminiferous tubules have what function?

A

Produce sperm

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41
Q

Describe the path of sperm from production in the seminiferous tubules to the ductus deferens

A

Sperm enter a net like structure called the rete testis via the straight tubules; then enter the head of the epididymis via the efferent ductules, then travel down the body of the epididymis to the tail finally to the ductus deferens

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42
Q

What is the function of the epididymis

A

Store sperm until they are mature

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43
Q

Lymphatically, where do the testes drain into? Does it differ from where the scrotum drains?

A

Testes drain into lumbar nodes, and yes the scrotum drains into superficial inguinal nodes

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44
Q

What causes decent of the testes

A

Release of testosterone

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45
Q

Where do the testes develop before decent

A

lumbar region of abdomen

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46
Q

Where and when do the testes usually descend?

A

Through the inguinal canal, and usually just before birth

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47
Q

What is the gubernaculum testis and what is it’s function

A

Ligament present in fetus, connects the testis to scrotum. Contracts to pull testis down though inguinal canal

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48
Q

What is cryptorchidism? How is it treated? Unilateral or bilateral?

A

Undescended testes at birth, treated with testosterone. Usually unilateral

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49
Q

What is the peritoneum?

A

Smooth membrane which lines abdominal cavity

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50
Q

What are the two layers of peritoneum?

A

Parietal (covering abdominal walls) and Visceral (covering abdominal organs)

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51
Q

What are two common types of individuals who would be susceptible to infection of the peritoneal cavity?

A

Immunocompromised women, and women who gave birth in unsanitary conditions

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52
Q

Is the peritoneal cavity closed in both sexes?

A

No, in males it is but in females the uterine tubes travel through it (infections of vagina can enter peritoneal cavity this way)

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53
Q

What are retroperitoneal organs and what is one example of one

A

organs lying posterior to the peritoneum (covered only on anterior side of organ; example: kidneys

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54
Q

What is Ascites

A

Accumulation of fluid in the peritoneal cavity

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55
Q

Is the peritoneum absorbent? How can this play a role clinically?

A

Yes, highly absorbent.

Because of absorbency, rabies vaccine is given here, and kidney dialysis performed here

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56
Q

What causes ascites

A

malnutrition, congestive heart failure, liver failure, kidney failure, peritonitis

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57
Q

What is peritonitis

A

Inflammation of the peritoneum

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58
Q

What causes peritonitis

A

Trauma, inflammation bowl diseases (ruptured appendix), vaginal infections, perforated ulcers

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59
Q

Can adhesions occur in peritonitis?

A

Yes and often do

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60
Q

The parietal peritoneum is supplied by nerves of adjacent body such as:

A

Phrenic nerve, intercostal nerves, subcostal nerves, iliohypogastric nerve, ilioinguinal nerve

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61
Q

Is the parietal peritoneum sensitive to pain?

A

Yes, extremely

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62
Q

The visceral peritoneum is supplied by what nerves?

A

The autonomic nerves that travel with organs it invests

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63
Q

Is the visceral peritoneum sensitive to pain?

A

No

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64
Q

What is the Omentum?

A

Broad apron like reflection of peritoneum

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65
Q

The greater omentum has three parts which are:

A

Gastrophrenic ligament, Gastrosplenic ligament, and Gastrocolic ligament.

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66
Q

Why is the greater omentum often referred to as the “Abdominal Policeman”

A

Because it is very mobile and often attaches itself to areas of infection on nearby organs

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67
Q

What are the two parts of the lesser omentum

A

hepatogastric ligament and hepaoduodenal ligament

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68
Q

What does the general term of mesentery mean?

A

any double layer of peritoneum that connects portion of intestine to the body wall

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69
Q

What does the specific term of mesentery mean?

A

double layer of peritoneum that connects jejunum and ileum to body wall

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70
Q

What is the specific term of mesentery often referred to as?

A

mesentery proper

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71
Q

The omental bursa (lesser sac) is a closed sac except for where?

A

Where it connects to the greater sac through the omental foramen

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72
Q

How many divisions are in the greater sac? Are the spaces clinically significant?

A

5 (6 including hepatorneal recess which is an extension of sub hepatic) and yes, they channel and compartmentalize peritoneal fluid and infectious processes

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73
Q

What makes up the foregut (embryological)

A

distal esophagus, stomach and part of duodenum

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74
Q

What makes up the midgut (embryological)

A

entrance of bild duct and second part duodenum, ends with right 2/3 transverse colon

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75
Q

What makes up the hind gut (embryological)

A

Left 1/3 transverse colon, and upper part anal canal

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76
Q

Why are the three embryological divisions of the gastrointestinal tract important (foregut, midgut, and hind gut)

A

The adult derivatives share a unified blood supply and autonomic nerve supply

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77
Q

What is the blood supply of the foregut

A

branches of the celiac trunk

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78
Q

What is the blood supply of the midgut

A

branches of the superior mesenteric artery

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79
Q

What is the blood supply of the hind gut

A

branches of the inferior mesenteric artery

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80
Q

What is the sympathetic innervation of the foregut?

A

greater splanchnic nerves (T5-T9) and lesser splanchnic nerves (T10-T11)

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81
Q

What is the sympathetic innervation of the midgut

A

greater splanchnic nerves (T5-T9) and lesser splanchnic nerves (T10-T11)

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82
Q

What is the sympathetic innervation of the hind gut?

A

Lumbar splanchnic nerves (L1-L2)

83
Q

What is the parasympathetic innervation of the foregut and midgut?

A

Vagus nerve

84
Q

What is the parasympathetic innervation of the hind gut?

A

Pelvic splanchnic nerves (S2-S4)

85
Q

What does sympathetic activation do to your gastrointestinal tract?

A

decreases motility and tone/contracts sphincters

86
Q

What does parasympathetic activation do to your gastrointestinal tract?

A

Increases motility and tone/relaxes sphincters

87
Q

What are the four major layers of the gut wall?

A

Mucosa, Submucosa, Muscularis Externa, and Serosa

88
Q

Which layer of the gut wall is responsible for peristalsis?

A

Muscularis Externa

89
Q

What are the two subunits of the Muscularis Externa?

A

Inner Circular Layer of muscle and Outer Longitudinal Layer of muscle

90
Q

The Visceral peritoneum of the gut wall is referred to as what?

A

Serosa (One of the four major layers of gut)

91
Q

True or false, the enteric nervous system is dependent on the CNS?

A

False, it is semi-independent

92
Q

What are the two plexus’ of the enteric nervous system

A

Submucosal plexus and Myenteric plexus

93
Q

What does the submucosal plexus of the enteric nervous system control?

A

muscularis mucosae, and mucus secreting glands

94
Q

What does the myenteric plexus of the enteric nervous system control?

A

smooth muscle that causes peristalsis

95
Q

What are the only two things the stomach can absorb?

A

alcohol and drugs

96
Q

The cardinal orifice of the stomach is the opening between what two structures?

A

esophagus and stomach

97
Q

The Pyloric orifice of the stomach is the opening between what two structures

A

stomach and duodenum

98
Q

What is congenital hypertrophic pyloric stenosis

A

A tumor like increase in size of the pyloric sphincter which reduces the pyloric canal

99
Q

Is congenital hypertrophic pyloric stenosis more common in one sex? And what does it cause?

A

Yes in males, and projectile vomiting

100
Q

What is pylorospasm

A

Spasmodic contraction of pyloric sphincter causing difficulty of food passing from stomach to duodenum

101
Q

What is a gastric ulcer

A

Crater like depression in mucosa of stomach

102
Q

Explain how a healthy stomach avoids gastric ulcers from the presence of stomach acid?

A

Healthy stomach secretes viscous alkaline mucus which protects the stomach

103
Q

What causes gastric ulcers

A

Excessive acid secretion (stress related) or Inadequate mucus barrier (usually related to presence of bacteria

104
Q

Blood supply of the stomach comes from what artery’s branches

A

Celiac trunk

105
Q

The C shape of the duodenum surrounds what structure?

A

Head of the pancreas

106
Q

Name four parts of duodenum

A

Superior part, descending part, Horizontal part, Ascending part

107
Q

What is Crohn’s disease?

A

An inflammatory disease which commonly affects distal ileum and adjacent colon but can affect part of digestive tract

108
Q

Does Crohn’s disease affect all parts of the intestine? If so, how

A

Yes, causes thickening and ulcerations

109
Q

What are some symptomatic results in a patient with Crohn’s

A

pain, diarrhea, and malabsorption

110
Q

What is the etiology of Crohn’s

A

unknown, believed to be auto-immune

111
Q

Adjustments of lower thoracics may relieve some symptoms in a patient with Crohn’s disease, why?

A

Innervation of small intestine is autonomic (Vagus, and greater and lesser splanchnic nerves)

112
Q

What is the cecum

A

blind pouch found below ileocecal junction

113
Q

What is the appendix?

A

Narrow muscular tube which contains lymphoid tissue

114
Q

Is the position of the appendix variable? If so, where most common

A

Yes, retrocecal

115
Q

The large intestine outside of absorbing water has what secondary function

A

involved in synthesis of some vitamins requiring bacterial action like Vitamin K

116
Q

What is the ileal fold?

A

Two flaps that surround the junction of ileum and cecum.

117
Q

When the ileal fold closes what structure is formed?

A

frenula

118
Q

What is appendicitis

A

Inflammation of appendix (most common intra-abdominal inflammatory condition)

119
Q

If appendicitis is left untreated and the appendix ruptures, what could result?

A

Peritonitis

120
Q

What can cause appendicitis

A

Obstruction of lumen (lymphoid hyperplasia or fecal impaction)

121
Q

What are the four parts of the colon

A

Ascending, transverse, descending and sigmoid

122
Q

Describe Pyloric antrum

A

wide proximal part

123
Q

Describe pyloric canal

A

narrow distal part

124
Q

True or False the celiac trunk is the first unpaired branch of abdominal aorta

A

True

125
Q

The left gastric artery is a branch of what?

A

Celiac trunk

126
Q

Name the two branches off the left gastric artery

A

Esophageal and gastric

127
Q

What is the largest branch of the celiac trunk

A

Splenic artery

128
Q

The splenic artery gives off what branches/arteries

A

Pancreatic branches, short gastric arteries, and left gastro-omental artery

129
Q

The common hepatic artery is a branch of what?

A

Celiac trunk

130
Q

The gastroduodenal, surpaduodenal, right gastro-omental, and superior pancreaticodeodenal artery are all branches of what?

A

Common Hepatic artery

131
Q

What are the four branches of the Hepatic artery proper

A

Right and Left Hepatic arteries, Right gastric artery, and the cystic artery (‘cyst’ mean bladder)

132
Q

The absorption of nutrients happens almost exclusively in what organ?

A

Small intestine

133
Q

Specifically what part of the small intestine is responsible for most nutrient uptake?

A

Jejunum

134
Q

What is the ileum’s responsibility

A

absorb fat soluble vitamins, B12, and bile salts

135
Q

What happens in the plicae circulares (circular folds in small intestine)

A

Area of lots of absorption, slow passage of materials

136
Q

What is the function of peyers patches in the small intestine

A

immune defense

137
Q

What is the innervation of the jejunum and ileum

A

superior mesenteric plexus

138
Q

What is ileal (Meckel’s) diverticulum

A

Common malformation of digestive tract, has finger like pouch project from distal ileum

139
Q

What other condition’s symptoms does ileal (Meckel’s) diverticulum often mimic

A

appendicitis

140
Q

What parts of the large intestine are retroperitoneal and which are intraperitoneal

A

Retroperitoneal: Ascending and Descending colon.
Intraperitoneal: Transverse and Sigmoid colon.

141
Q

What are the taeniae coli?

A

Narrow bands of muscle seen in cecum and ascending colon

142
Q

What are haustra of colon

A

sacculations or outpouchings

143
Q

What are omental appendices

A

small masses of fat covered with visceral peritoneum extending from colon

144
Q

What is diverticulosis? Who is it common in? Is it more common in one area of colon?

A

Heriniations of mucosa of colon through muscular layer (without inflammation).
Common people over 40.
Yes, Sigmoid

145
Q

If diverticulosis becomes inflamed what is it called? What are the symptoms? What is it related to and are there dietary restrictions?

A

Diverticulitis
Diarrhea, abdominal pain
Related to a low fiber diet, and yes; cannot eat food with little seeds (can get caught in out pouches)

146
Q

What is ulcerative colitis? What are some symptoms?

A

Severe inflammation/ulceration of rectum and lower colon

Abdominal pain and diarrhea

147
Q

What is irritable bowel syndrome? Etiology?

A

“Spasmodic Colon” causes pain and diarrhea with no inflammation
Etiology is unknown though believed to be stressed related

148
Q

Where does the marginal artery run and what empties into it?

A

Runs from cecum to sigmoid colon

All branches of superior and inferior mesenteric arteries empty into it

149
Q

What is the innervation of colon from cecum to right 2/3 of transverse colon

A

superior mesenteric plexus

150
Q

What is the innervation of left 1/3 transverse colon to anal canal?

A

inferior mesenteric plexus and hypogastric plexus

151
Q

What are the two venous systems within the trunk?

A

Portal and Caval

152
Q

What does the portal venous system drain?

A

Drains gastrointestinal tract, spleen, pancreas, and gallbladder

153
Q

What is the portal vein formed of and where does the union happen?

A

Union of splenic vein and superior mesenteric vein

Happens behind head of pancreas

154
Q

Name the four tributaries of the portal vein

A

Splenic vein, superior mesenteric vein, left gastric vein, and paraumbilical veins

155
Q

What is true for all of the tributaries of the portal vein except the paraumbilical vein

A

All of them accompany arteries of the same name

156
Q

What is cirrhosis of the liver? As a result what happens to the liver?

A

Destruction of hepatic cells which are replaced by fibrous tissue or fat
Liver becomes hard

157
Q

What happens to the portal vein in cirrhosis of liver

A

tends to become constricted at porta hepatis

158
Q

What are the causes of cirrhosis of liver

A

Alcoholism, hepatitis, chronic obstruction of bile duct, and congestive heart failure

159
Q

What is portal hypertension? What often causes it?

A

Abnormal elevation of pressure within the portal system

Often due to constriction of the portal vein at the porta hepatis due to cirrhosis of the liver

160
Q

Does the portal system have valves? Does this cause complications?

A

No it doesn’t, and yes; in portal hypertension flow is reversed bypassing the liver into the caval system
This causes the veins in this area to varicose

161
Q

In portal hypertension, if blood backs up into esophageal region what is the obstructive sign

A

Esophageal varices (varicose veins of esophagus) can rupture and be fatal

162
Q

In portal hypertension, if blood backs up around umbilicus (superficial veins of abdominal wall) what is the obstructive sign

A

“medusa” pronounced snake like veins around umbilicus

163
Q

In portal hypertension, if blood backs up around rectum or anal canal what is the obstructive sign?

A

hemorrhoids

164
Q

Damage to the liver can cause what disease?

A

Jaundice

165
Q

What causes the yellowing of skin in jaundice?

A

Release of bilirubin (bile pigments)

166
Q

What is the largest visceral organ and largest gland of the body?

A

The liver

167
Q

What are four main functions of the liver

A

Bile secretion,
metabolism of proteins, fats, and carbs,
storage of glycogen, vitamins and iron
Detoxification

168
Q

What are the two surfaces of the liver

A

Diaphragmatic and Visceral

169
Q

What are the three structures located in the porta hepatis

A

common hepatic duct
hepatic artery proper
portal vein

170
Q

What are the four anatomical lobes of the liver

A

The right and left lobe of the liver, Quadrate and Caudate lobes

171
Q

Do the anatomical lobes correspond to function of liver?

A

No, only descriptive. The functional halves correspond to function

172
Q

The left and right functional halves of the liver have 8 hepatic segments how do they correspond to the left and right halves?

A

Hepatic segments I-IV in left functional half

Hepatic segments V-VIII in right functional half

173
Q

What is the bare area of the liver? Where is it located?

A

only area of liver not covered with visceral peritoneum

posterior aspect of diaphragmatic surface-liver maintains contact with diaphragm in this area

174
Q

What ligament forms the borders of the bare area of liver

A

coronary ligament

175
Q

What is the blood supply of the liver?

A

portal vein and hepatic artery

176
Q

What is the innervation of the liver?

A

hepatic plexus which is an extension of celiac plexus

177
Q

What is the function of the gallbladder? What hormone stimulates it

A

Stores bile and concentrates it by absorbing water
it contracts to expel bile into duodenum when food arrives
Contraction stimulated b cholecystokinin (CCK)

178
Q

What is the blood supply of the gallbladder?

A

right hepatic artery

179
Q

What is the innervation of the gallbladder?

A

celiac plexus

180
Q

Name the 6 ducts of the biliary duct system

A

right and left hepatic ducts, common hepatic duct, cystic duct, hepatopancreatic ampulla, and bile duct

181
Q

What are gallstones? What are they composed of?

A

hard masses formed by solidification of bile constituents

mainly composed of cholesterol crystals

182
Q

Where do gallstones typically get stuck?

A

hepatopancreatic ampulla because it is narrowest point in biliary passage

183
Q

What happens if gallstone blocks biliary duct and causes back up of bile

A

acute pancreatitis

184
Q

What area of spine will pain often be referred to in diseases involving liver, gallbladder, or stomach

A

T8-T12

185
Q

A gallbladder attack most commonly causes pain where?

A

in right upper quadrant of abdomen

186
Q

True or false the pancreas is both an exocrine and endocrine gland

A

true

187
Q

What is the exocrine function of the pancreas

A

secretion of digestive enzymes

188
Q

What is the endocrine function of the pancreas

A

secretion of hormones insulin and glucagon

189
Q

What duct drains the neck, body and tail of the pancreas

A

Pancreatic duct

190
Q

What duct drains the head and uncinate process of the pancreas

A

accessory pancreatic duct

191
Q

What are the three vessels supplying the pancreas

A

pancreatic branches of splenic artery, superior and inferior pancreaticoduodenal artery

192
Q

What is the innervation of pancreas

A

celiac plexus

193
Q

What can cause rupture of pancreas?

A

Forceful compression of abdomen in auto accident

194
Q

What are three main functions of spleen

A

Produces lymphocytes
Removes worn out RBC and other cellular debris
Stores RBC

195
Q

True or false the spleen is an endocrine organ?

A

False, it is a lymphatic organ

196
Q

What are the three surfaces on the visceral surface of the spleen

A

Gastric surface
Colic surface
Renal surface

197
Q

What is the blood supply of the spleen?

A

Splenic artery and Splenic vein

198
Q

What is the innervation of spleen?

A

celiac plexus

199
Q

What is the most frequently injured abdominal organ?

A

Spleen

200
Q

What organ is vulnerable to blows to left hyochondrium

A

Spleen

201
Q

What happens when spleen ruptures and how does it happen?

A

Hemorrhage and shock

trauma

202
Q

In what cases is the spleen more fragile to rupture

A

Mononucleosis
Malaria
Sickle cell anemia
Septicemia (blood poisoning)

203
Q

When spleen is removed, what organ takes over role of destroying old RBC

A

Liver

Gross Anatomy 2 (2 decks)

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