Thorax: Abdominal Viscera II

Question 1

liver: location

Answer 1

• R hypochondrium and epigastric region -> L hypochondrium

Question 2

liver: surface projection

Answer 2

• deep to rib 7 -11 on R side and crosses midline to L nipple
• inf border follows R costal margin

Question 3

liver: surfaces

Answer 3

• diaphragmatic (ant/ sup/ post)

- visceral

Question 4

liver: recesses

Answer 4

• subphrenic

- hepatorenal

Question 5

liver: visceral surface related to (9)

Answer 5

• esophagus
• stomach
• sup part of duodenum
• lesser omentum
• gallbladder
• R colic flexure
• R transverse colon
• R kidney/ suprarenal gland

Question 6

liver: list lobes

Answer 6

• R/ L
• caudate
• quadrate

Question 7

liver: ligaments

Answer 7

• round (ligamentum teres) lig
• falciform
• 2x triangular (L/R)
• ligamentum venosum
• coronary lig

Question 8

liver: blood supply

Answer 8

• dual
• portal vein (70%)
• hepatic aa (30%)

Question 9

portal-systemic anastomoses: portal v. communicates w systemic venous vessels at

Answer 9

• esophagus (btw esophageal v)
• rectum (btw rectal v)
• umbilicus (around umbilical v)

Question 10

porta hepatis vs portal triad:

Answer 10

porta hepatis:

• only 1
• incl proper hepatic aa., portal v. and common bile duct

portal triad:

• many in liver cells
• hepatic portal v, bile/hepatic duct, hepatic aa.

Question 11

eg. cirrhosis:

Answer 11

• blocked blood flow= necrosis of tissue
• fatty cysts
• lumpy surface
• scarring

Question 12

gallbladder: function

Answer 12

• stores and concentrates bile

Question 13

gallbladder: parts and features

Answer 13

• fundus (tup of 9th costal cartilage in MCL)
• body
• neck (mucosal folds forming spiral valve)

Question 14

bile ducts: features

Answer 14

• produced by hepatocytes -> bile canaliculi -> interlobular bile ducts
• R and L hepatic ducts = common hepatic duct

common hepatic duct + cystic duct = bile duct

Question 15

pancreas: exocrine portion

Answer 15

• proteases
• amylase
• lipases

Question 16

pancreas: endocrine portion

Answer 16

islets of Langerhan:

• glucagon
• insulin
• somatostatin
• pancreatic polypeptides

Question 17

pancreas: location

Answer 17

• across post abdominal wall from duodenal curvature to hilum of spleen
• post to stomach
• transverse mesocolon attaches to ant margin

Question 18

pancreas: retro or intra?

Answer 18

• retro

Question 19

pancreas: parts

Answer 19

• head
• uncinate process
• body
• tail
• neck

Question 20

pancreas: main pancreatic duct

Answer 20

• originates in tail of pancreas
• head of pancreas joins bile duct = hepatopanceatic ampula (Vater)
• enters 2nd part of duodenum at major duodenal papilla

Question 21

pancreas: circular layer of muscle forms sphincter

Answer 21

sphincter of Oddi

Question 22

pancreas: accessory pancreatic duct

Answer 22

• superior to ostium of main pancreatic duct

- minor duodenal papilla

Question 23

eg. pancreatitis

Answer 23

• blockage at distal end of ampulla by gallstone
• neither bile/ pancreatic juices can exit
• back flow of bile -> main pancreatic duct

Question 24

spleen: location

Answer 24

• L hypchondrium again diaphragm btw ribs 9-10

Question 25

spleen: features

Answer 25

- intraperitoneal organ | - diaphragmatic and visceral surfaces

Question 26

spleen: blood supply

Answer 26

celiac trunk -> splenic aa. branch

Question 27

spleen: function

Answer 27

- lymphocyte proliferation/ immune surveillance and response prenatally: - haematopoietic (produces RBC) postnatally: - destroying RBC - recylcing Fe, globin - blood reservoir (provide small transfusion)

Question 28

thoracic splanchnic nerves: name them

Answer 28

- greater - lesser - least splanchnic

Question 29

thoracic splanchnic nerves: great SN

Answer 29

- T5-T9 ganglia and traverse to celiac ganglion

Question 30

thoracic splanchnic nerves: lesser SN

Answer 30

- arise T9- T10/11 ganglia | - traverse to aortico-renal ganglion

Question 31

thoracic splanchnic nerves: least SN

Answer 31

- T12 ganglion traverse to renal plexus

Question 32

parasympathetic innervation: vagus n

Answer 32

- CN X | - through esophageal hiatus = ant/ post esophageal plexuses

Question 33

parasympathetic innervation: pelvic splanchnic n

Answer 33

- S2-S4 spinal cord levels | - PSY inn to hindgut

Question 34

enteric nervous system: list nerves

Answer 34

- submucosal plexus | - myenteric plexus

Question 35

enteric nervous system: submucosal plexus

Answer 35

- sensory cells communicate w myenteric plexus | - motor fibres stimulate gland/ mucosal secretion of fluids into lumen

Question 36

enteric nervous system: myenteric plexus

Answer 36

- neurons which regulate enzyme output of adjacent organs

Question 37

enteric nervous system: function

Answer 37

regulates: - motility - local blood flow - fluid flow - control gastic/ pancreatic secretions - control enteroendocrine secretion

Question 38

sympathetic stimulation: effects

Answer 38

- decrease motility - decrease intestinal secretion - increase sphincter contraction - increase vessel contraction (vasoconstriction)

Question 39

parasympathetic stimulation: effects

Answer 39

- increase motility - increase intestinal secretion - decrease sphincter contraction - decrease vessel contraction (vasodilation)

Question 40

eg. Hirsprung's disease

Answer 40

- aganglionic colon (lack or loss of ganglia in distal colon) - less control

Question 41

transpyloric plan: location

Answer 41

- L1 vertebra, 9th costal cartilages

Question 42

transpyloric plan: features

Answer 42

- beginning of duodenum - end of 4th part of duodenum - hilum of L kidney - neck of pancreas - origin of SMA

Question 43

referred visceral pain: epigastric region

Answer 43

foregut

Question 44

referred visceral pain: umbilical region

Answer 44

midgut

Question 45

referred visceral pain: pubic region

Answer 45

hindgut