Flashcards in Lecture 12 DA Deck (40):
What can be found at the iliocaecal junction?
The iliocaecal opening is found. Inferiorly is the caecuma and appendix. Above is the ascending colon.
What are the names of the 6 regions of the colon?
It begins with the ascending colon. Inferior to it is the caecum and appendix. The ascending colon becomes the transverse colon at the hepatic flexure. The transverse colon becomes the descending colon at the splenic flexure. Descending colon becomes the sigmoidal colon as it enters the pelvis. It becomes the rectum past the rectosigmoidal junction.
What direction are the muscles of the colon? What are the outer muscles called?
The inner muscles are circular, while the outermost are longitudinal. The outermost form 3 distinct bands called tenia coli.
What are haustra, and how are they formed?
They are pouch-like structures on the colon, caused by the tenia coli.
What are the fat pads hanging off the haustra called?
What direction does the verbiform appendix have? What is its histology?
The appendix is found at the merge of the three tenia coli bands. The appendix extends downwards into the pelvis, called pelvic appendix. In some people, it may extend upward instead, called retrocaecal appendix. It has mostly lymph nodes.
What happens to the colon at the hepatic flexure?
It goes from ascending to transverse colon.
What happens at the splenic flexure?
It goes from transverse to descending colon.
What is the caecum?
Blind ending pouch, below the iliocaecal junction.
What happen to tenia coli at the rectosigmoidal junction?
They fan out to become a continuous muscle.
Where is the liver found?
It fills the upper right quadrant, above the right costal margin.
What are the surfaces of the liver?
It has a smooth diaphragmatic surface, and an impressioned visceral surface.
What is the falciform ligament?
It connects the left and right liver. The right lobe is bigger.
Which lobe of the liver is bigger?
What does the falciform ligament attach the liver to?
To the anterior abdominal wall.
What is found at the base of the falciform ligament?
The ligamentum teres hepatis, which once had a vascular bundle for foetal (gosh darnit jimmeh), originating from the umbilicus.
Describe the lobes found on the visceral surface of the liver.
Rather than being split up-down for 2 lobes, itthe visceral surface is split by a H, for 4 lobes. There is still a left and right, but the upper quadrant within the H is known as the caudate lobe, while the lower quadrant is known as quadrate lobe.
Categorise the liver by lobes, in terms of functionality.
Functional left liver = caudate + quadrate + left lobe.
Functional right liver = right lobe + gall bladder.
Where is the gall bladder found relative to the liver?
It is found on the liver's quadrate lobe. Its duct is found on the right.
Where does the liver drain?
Direct to the IVC.
Describe the vessels of the liver.
On the left, the proper hepatic artery is found, splits into the left and right hepatic artery.
It is followed by the common hepatic duct.
Behind both of these is the portal vein, which supplies blood from the gastrointestinal circulation to the liver (ie. products of digestion). It does NOT drain the liver.
What is the porta hepatis?
Hilum of the liver.
What is found at the porta hepatis?
The proper hepatic artery, it hasn't branched yet, but does so when it enters the liver. It is found on the left.
Followed by common cystic duct,
Behind both, the portal vein.
Where is the IVC relative to the liver?
It is embedded within the liver superiorly, between the caudate and left lobes. The hepatic vein drains direct to the IVC.
What connects the lesser curvature of the stomach to the liver?
The lesser omentum.
What connects the greater curvature of the stomach to the transverse colon?
The greater omentum.
How does the cystic duct reach the duodenum?
The duodenum leaves the mesentery, and as it does, a space is found. The cystic duct travels down this space, and the portal vein travels up. A double folded mesentery connects it to the liver.
Describe the regions of the gall bladder.
Fundus - inferiorly
Neck - Superiorly, becomes the spiral cystic duct
Describe the cystic duct system.
The left and right hepatic duct merge to become the common hepatic duct. The spiral and common hepatic duct merge to form the common cystic duct.
The common cystic duct tucks behind the first part of the duodenum and enters the second part. This occurs at a C-shaped junction. Pancreatic duct enters here too.
What is the major duodenal papilla?
It is where the common cystic and pancreatic duct enter the duodenum. It has a complex sphincter, which releases after a fatty meal. Otherwise, it remains closed, and fluid backtracks and concentrates in the gall pladder.
Is the gall bladder completely enclosed by the liver?
No, the fundus dips below the liver slightly, at the right lobe.
Describe the regions of the pancreas from medial to lateral.
Where is the head of the pancreas found?
The head is found at the C-shaped junction of the duodenum, which curves around the head.
What is the unsinate process? Why is it important?
It is a projection off the head of the pancreas, and is a landmark for the sueprior mesentery artery.
Where is the neck and body of the pancreas found? What do they overlie?
They both overlie the inferior stomach. The neck also overlies the superior mesentery vessels.
The body is found superior to the duodeno-jejunal flexure.
Where is the tail of the pancreas found?
It is found directly medial to the hilum of the spleen.
What shape is the spleen? What happens to it with age?
It is fist sized and oval shaped. It atrophies with age.
The spleen has a smooth and visceral surface. Describe the visceral surface.
Inferiorly, it has a colic surface, found by the colic flexure.
The superior margin is notched, on the lateral side (due to ribs).
Where is the hilum of the spleen found?
It is superior to he colic surface.