Vascular Supply, Retroperitoneal Viscera and Posterior Abdominal Wall Flashcards
(188 cards)
1
Q
Foregut: Artery, Parasympathetic innervation, Vertebral level, and Structures supplied
A
Celiac
Vagus
T12/L1
esophagus to upper duodenum
2
Q
Hindgut: Artery, Parasympathetic innervation, Vertebral level, and Structures supplied
A
IMA
Pelvic splanchnic nerve
L3
Distal 1/3 of transverse colon to anal above pectinate line
3
Q
Midgut: Artery, Parasympathetic innervation, Vertebral level, and Structures supplied
A
SMA
Vagus
L1
Lower duodenum to proximal 2/3 of transverse colon
4
Q
Arteries supplying GI structures are ____
A
single and branch anteriorly
5
Q
Compress transverse (third) portion of duodenum
A
Superior mesenteric artery syndrome
6
Q
Two areas of colon that have dual blood supply from distal arterial branches (watershed regions) - susceptible in colonic ischemia
A
- Splenic flexure - SMA and IMA
2. Rectosigmoid junction - last sigmoid arterial branch from the IMA and superior rectal artery
7
Q
Arises from the front of the abdominal aorta immediately below the aortic hiatus of the diaphragm, between the right and left crura.
A
Celiac Trunk
8
Q
Branches of celiac trunk
A
left gastric artery,
splenic artery,
common hepatic arteries
9
Q
Is the smallest branch of the celiac trunk
Runs upward and to the left toward the cardia, giving rise to __ and __ branches and then turns to the right and runs along the lesser curvature within the lesser omentum to anastomose with the right gastric artery
A
Left Gastric Artery
Esophageal and hepatic
10
Q
Is the largest branch of the celiac trunk and runs a highly tortuous course along the superior border of the pancreas and enters the lienorenal ligament.
A
Splenic Artery
11
Q
Branches of splenic artery
A
dorsal pancreatic artery short gastric arteries left gastroepiploic (gastro-omental) artery
12
Q
Pass through the lienogastric ligament to reach the fundus of the stomach
A
short gastric arteries
13
Q
Reaches the greater omentum through the lienogastric ligament and runs along the greater curvature of the stomach to distribute to the stomach and greater omentum
A
left gastroepiploic (gastro-omental) artery
14
Q
Runs to the right along the upper border of the pancreas and divides into the proper hepatic artery, the gastroduodenal artery, and possibly the right gastric artery.
A
Common Hepatic Artery
15
Q
Branches of Common Hepatic Artery
A
proper hepatic artery,
gastroduodenal artery, and possibly
right gastric artery
16
Q
Ascends in the free edge of the lesser omentum and divides, near the porta hepatis, into the left and right hepatic arteries
A
Proper Hepatic Artery
17
Q
Ascends in the free edge of the lesser omentum and divides, near the porta hepatis, into the left and right hepatic arteries
A
Proper Hepatic Artery
18
Q
Gives rise, near its beginning, to the right gastric artery
A
Proper Hepatic Artery
19
Q
What is the origin branch of cystic artery in the cystohepatic triangle of Calot?
A
right hepatic artery
20
Q
Arises from the proper hepatic or common hepatic artery, runs to the pylorus and then along the lesser curvature of the stomach, and anastomoses with the left gastric artery.
A
Right Gastric Artery
21
Q
Descends behind the first part of the duodenum, giving off the supraduodenal artery to its superior aspect and a few retroduodenal arteries to its inferior aspect.
A
Gastroduodenal Artery
22
Q
Two major branches of Gastroduodenal Artery
A
right gastroepiploic (gastro-omental) artery superior pancreaticoduodenal artery
23
Q
Runs to the left along the greater curvature of the stomach, supplying the stomach and the greater omentum.
A
right gastroepiploic (gastro-omental) artery
24
Q
Passes between the duodenum and the head of the pancreas and further divides into the anterior-superior pancreaticoduodenal artery and the posterior-superior pancreaticoduodenal artery.
A
superior pancreaticoduodenal artery
25
It is a temporary cross-clamping (intermittent soft vascular clamping) of the hepatoduodenal ligament containing portal triads at the foramen of Winslow for control of hepatic bleeding during liver surgery or donor hepatectomy for living donor liver transplantation.
Pringle maneuver
26
* Arises from the aorta behind the neck of the pancreas.
* Descends across the uncinate process of the pancreas and the third part of the duodenum and then enters the root of the mesentery behind the transverse colon to run to the right iliac fossa.
Superior Mesenteric Artery
27
Passes to the right and divides into the anterior-inferior pancreaticoduodenal artery and the posterior-inferior pancreaticoduodenal artery, which anastomose with the corresponding branches of the superior pancreaticoduodenal artery.
Inferior Pancreaticoduodenal Artery
28
Branches of SMA
```
Inferior Pancreaticoduodenal Artery
Middle Colic Artery
Right Colic Artery
Ileocolic Artery
Intestinal Arteries
```
29
Enters the transverse mesocolon and divides into the right branch, which anastomoses with the right colic artery, and the left branch, which anastomoses with the ascending branch of the left colic artery. The branches of the mesenteric arteries form an anastomotic channel, the marginal artery, along the large intestine.
Middle Colic Artery
30
Arteries supplying non-GI structures are ______
paired and branch laterally and posteriorly
31
* Arises from the superior mesenteric artery or the ileocolic artery.
* Runs to the right behind the peritoneum and divides into ascending and descending branches, distributing to the ascending colon
Right Colic Artery
32
• Descends behind the peritoneum toward the right iliac fossa and ends by dividing into the ascending colic artery, which anastomoses with the right colic artery, anterior and posterior cecal arteries, the appendicular artery, and ileal branches.
Ileocolic Artery
33
* Are 12 to 15 in number and supply the jejunum and ileum.
| * Branch and anastomose to form a series of arcades in the mesentery.
Intestinal Arteries
34
It is caused by a thrombus, an embolus, atherosclerosis, an aortic aneurysm, a tumor in the uncinate process of the pancreas, compression by the third part of the duodenum, or surgical scar tissue.
Superior mesenteric artery obstruction
35
• Passes to the left behind the peritoneum and distributes to the descending and sigmoid colons and the upper portion of the rectum.
Inferior Mesenteric Artery
36
Branches of Inferior Mesenteric Artery
Left Colic Artery
Sigmoid Arteries
Superior Rectal Artery
37
Runs to the left behind the peritoneum toward the descending colon and divides into ascending and descending branches.
Left Colic Artery
38
Are two to three in number, run toward the sigmoid colon in its mesentery, and divide into ascending and descending branches.
Sigmoid Arteries
39
Is the termination of the inferior mesenteric artery, descends into the pelvis, divides into two branches that follow the sides of the rectum, and anastomoses with the middle and inferior rectal arteries.
Superior Rectal Artery
40
Arterial supply of right 2/3 of transverse colon
right and middle colic arteries of SMA
41
Arterial supply of left 1/3 of transverse colon
left colic artery from IMA
42
Venous drainage of transverse colon
veins of corresponding arterial supply
43
Arterial supply of rectum
Superior rectal artery - IMA
Middle rectal artery - internal iliac artery
Inferior rectal artery - internal pudendal artery
44
A system of vessels in which blood collected from one capillary bed (of intestine) passes through the portal vein and then through a second capillary network (liver sinusoids) before reaching the IVC (systemic circulation).
Hepatic Portal Venous System
45
Formed by the union of the splenic vein and the superior mesenteric vein posterior to the neck of the pancreas.
Portal Vein
46
Drains the abdominal part of the gut, spleen, pancreas, and gallbladder and is 8 cm (3.2 in.) long
Portal Vein
47
Carries three times as much blood as the hepatic artery and maintains a higher blood pressure than in the IVC
Portal Vein
48
It results from liver cirrhosis or thrombosis in the portal vein, forming esophageal varices, caput medusae, and hemorrhoids.
Portal hypertension
49
* Accompanies the superior mesenteric artery on its right side in the root of the mesentery
* Crosses the third part of the duodenum and the uncinate process of the pancreas and terminates posterior to the neck of the pancreas by joining the splenic vein, thereby forming the portal vein.
* Has tributaries that are some of the veins that accompany the branches of the superior mesenteric artery
Superior Mesenteric Vein
50
* Is formed by the union of tributaries from the spleen.
| * Receives the short gastric, left gastroepiploic, and pancreatic veins.
Splenic Vein
51
Formed by the union of the superior rectal and sigmoid veins.
Inferior Mesenteric Vein
52
What does the inferior mesenteric vein receive?
Left colic vein
53
Where does inferior mesenteric vein drain?
Usually into the splenic vein
May drain into the superior mesenteric vein
Junction of superior mesenteric and splenic veins
54
Has esophageal tributaries that anastomose with the esophageal veins of the azygos system at the lower part of the esophagus and thereby enter the systemic venous system.
Left Gastric (Coronary) Vein
55
* Are found in the falciform ligament and are virtually closed; however, they dilate in portal hypertension
* Connect the left branch of the portal vein with the small subcutaneous veins in the region of the umbilicus, which are radicles of the superior epigastric, inferior epigastric, thoracoepigastric, and superficial epigastric veins.
Paraumbilical Veins
56
Important Portal-Caval (Systemic Anastomoses)
LGV & EVAS 1. The left gastric vein and the esophageal vein of the azygos system.
SRV & MIRV 2. The superior rectal vein and the middle and inferior rectal veins.
PUV & REV 3. The paraumbilical veins and radicles of the epigastric (superficial and inferior) veins.
• Spider angiomata - patients with liver cirrhosis
RV - RSG Veins4. The retroperitoneal veins draining the colon and twigs of the renal, suprarenal, and gonadal veins.
57
* Consist of the right, middle, and left hepatic veins that lie in the intersegmental planes and converge on the IVC.
* Have no valves, and the middle and left veins frequently unite before entering the vena cava.
Hepatic Veins
58
It is an occlusion of the hepatic veins and results in high pressure in the veins, causing hepatomegaly, upper right abdominal pain, ascites, mild jaundice, and eventually portal hypertension and liver failure.
Budd-Chiari syndrome
59
Retroperitoneal structures
```
SAD PUCKER
Suprarenal (adrenal) glands
Aorta and IVC
Duodenum (2nd through 4th part)
Pancreas (except tail)
Ureters
Colon (ascending and descending)
Kidneys
Esophagus (thoracic portion)
Rectum (partially)
```
60
Remnant urachus
Median Umbilical Fold
61
Remnant of umbilical arteries
Medial Umbilical Fold
62
Lodges inferior epigastric arteries
Lateral Umbilical Fold
63
Is retroperitoneal and extends from T12 to L3 vertebrae in the erect position.
Kidney
64
Where is the right and left kidney related to?
right kidney - rib 12 posteriorly
| left kidney - ribs 11 and 12 posteriorly
65
What invests and surrounds the kidney?
invested by a firm, fibrous renal capsule
| surrounded by the renal fascia
65
Lies in the perinephric space between the renal capsule and renal fascia
perirenal (perinephric) fat
66
Lies external to the renal fascia
pararenal (paranephric) fat
67
Where does ureter, renal vessels, and nerves enter or leave the kidney?
hilus-on its medial border
68
What are the functional units of kidney?
Nephrons (1 to 2 million in each kidney)
69
What consists the nephron?
renal corpuscle (found only in the cortex),
proximal convoluted tubule,
Henle loop,
distal convoluted tubule.
70
What are the arterial segments in kidney with surgical importance?
superior, anterosuperior, anteroinferior, inferior, and posterior segments
71
Functions of kidney
```
Produce urine
Excrete urine
Regulate salt, ion (electrolyte), and water balance
Produce erythropoietin
Produces renin
```
72
What produces renin in the kidney?
juxtaglomerular cells
73
It increases blood pressure and volume and stimulates aldosterone production by the suprarenal cortex, thereby regulating the salt, ion, and water balance between the blood and urine.
angiotensin Il
74
Physiologic process involved in renin of the kidney
RAAS - renin, angiotensin, aldosterone system
75
Forms the outer part of the kidney and also projects into the medullary region between the renal pyramids as renal columns.
Cortex
76
Contains renal corpuscles and proximal and distal convoluted tubules.
Cortex
77
Contains renal corpuscles and proximal and distal convoluted tubules.
Cortex
78
What consists the renal corpuscle?
glomerulus (a tuft of capillaries) surrounded by a
| glomerular (Bowman) capsule, which is the invaginated blind end of the nephron
79
Forms the inner part of the kidney and consists of 8 to 12 renal pyramids (of Malpighi)
Medulla
80
What contains the renal pyramids (of Malpighi)?
```
straight tubules (Henle loops)
collecting tubules
```
81
An apex of the renal pyramid which fits into the cup-shaped minor calyx on which the collecting tubules open (10 to 25 openings).
renal papilla
82
Receive urine from the collecting tubules and empty into two or three major calyces.
Minor Calyces
83
Where do major calyces empty into?
renal pelvis - upper dilated portion of the ureter
84
It is formed by combination of a high level of calcium with oxalate, phosphate, urea, uric acid, and cystine.
Kidney stone (renal calculus or nephrolith)
85
Bilateral kidney stones
End stage kidney failure
86
Nephrolithiasis if in ureter?
ureterolithiasis
87
Smallest size of stone passing through ureter to bladder?
0.5 cm
88
Is a retroperitoneal muscular tube that begins with the renal pelvis, extending from the kidney to the urinary bladder
Ureter
89
What is the junction of ureter and renal pelvis?
ureteropelvic junction
90
Where is the junction where ureter enters the wall of the urinary bladder?
ureterovesicular junction (least diameter for passage)
91
Receives blood from the aorta and from the renal, gonadal, common, and internal iliac, umbilical, superior and inferior vesical, and middle rectal arteries.
Ureter
92
Is innervated by the lumbar (sympathetic) and pelvic (parasympathetic) splanchnic nerves.
Ureter
93
Where are the ureteric constrictions?
1. Ureteropelvic junction
2. Crossing of external/ common iliac artery
3. Ureterovesicle junction
94
It occurs by renal calculi or kidney stones where the ureter joins the renal pelvis, where it crosses the pelvic brim, or where it enters the wall of the urinary bladder.
Obstruction of the ureter
95
It is a fluid-filled enlargement of the renal pelvis and calyces as a result of obstruction of the ureter.
Hydronephrosis
96
Is a retroperitoneal organ lying on the superomedial aspect of the kidney. It is surrounded by a capsule and renal fascia.
Suprarenal (Adrenal) Gland
97
Shape of Suprarenal (Adrenal) Gland on the right and left
pyramidal - right
| semilunar - left
98
Part of Suprarenal gland that produces three types of steroid hormones
cortex
99
The outer zona glomerulosa produces?
mineralocorticoids: aldosterones (salt steroids)
100
The middle zona fasciculata produces?
glucocorticoids: cortisol and corticosterone ('energy' steroids)
101
The inner zona reticularis produces?
androgens: testosterone, DHEA, androstenedione ('sex' steroids)
102
Part of suprarenal gland that is derived from embryonic neural crest cells, receives preganglionic sympathetic nerve fibers directly, and secretes epinephrine and norepinephrine
Medulla
103
Where is medulla of suprarenal gland derived?
embryonic neural crest cells
104
What are arterial supply of suprarenal gland?
superior suprarenal artery from the inferior phrenic artery,
middle suprarenal artery from the abdominal aorta,
inferior suprarenal artery from the renal artery
105
What drains the suprarenal gland?
suprarenal vein, which empties into the IVC on the right and the renal vein on the left.
106
Passes through the aortic hiatus in the diaphragm at the level of T12, descends anterior to the vertebral bodies
Aorta
107
What are the bifurcations of aorta and at what level?
right and left common iliac arteries anterior to L4
108
Arise from the aorta immediately below the aortic hiatus, supply the diaphragm, and give rise to the superior suprarenal arteries.
Inferior Phrenic Arteries
109
Arise from the aorta and run laterally on the crura of the diaphragm just superior to the renal arteries
Middle Suprarenal Arteries
110
Arise from the aorta inferior to the origin of the super mesenteric artery. The right artery is longer and a little lower than the left and passes posterior to the IVC; the left artery passes posterior to the left renal vein.
Renal Arteries
111
What are branches of renal arteries?
inferior suprarenal artery
| ureteric artery
112
Descend retroperitoneally and run laterally on the psoas major muscle and across the ureter.
Testicular or Ovarian Arteries
113
Accompanies the ductus deferens into the scrotum, where it supplies the spermatic cord, epididymis, and testis.
testicular artery
114
It enters the suspensory ligament of the ovary, supplies the ovary, and anastomoses with the ovarian branch of the uterine artery.
ovarian artery
115
* Consist of four or five pairs that arise from the back of the aorta.
* Run posterior to the sympathetic trunk, the IVC (on the right side), the psoas major muscle, the lumbar plexus, and the quadratus lumborum
* Divide into smaller anterior branches (to supply adjacent muscles) and larger posterior branches, which accompany the dorsal primary rami of the corresponding spinal nerves and divide into spinal and muscular branches.
Lumbar arteries
116
* Arises from the back of the aorta, just above its bifurcations descends on the front of the sacrum, and ends in the coccygeal body
* Supplies the rectum and anal cane, and anastomoses with the lateral sacral and superior and inferior rectal arteries,
Middle Sacral Artery
117
Is formed on the right side of L5 by the union of the two common iliac veins, below the bifurcation of the aorta.
Inferior Vena Cava
118
Is longer than the abdominal aorta and ascends along the right side of the aorta.
IVC
119
Passes through the opening for the IVC in the central tendon of the diaphragm at the level of?
T8
120
IVC receives the right gonadal, suprarenal, and inferior phrenic veins. Where do these veins drain in the left?
Left renal vein
121
Also receives the three (left, middle, and right) hepatic veins and right and left renal veins.
IVC
122
Is the lower dilated end of the thoracic duct and lies just to the right and posterior to the aorta. usually between two crura of the diaphragm.
Cisterna Chyli
123
What forms Cisterna Chyli?
intestinal and lumbar lymph trunks
124
Include the celiac, superior mesenteric, and inferior mesenteric nodes; drain the lymph from the GI tract, spleen, pancreas, gallbladder, and liver; and their efferent vessels form the intestinal trunk.
Preaortic Nodes
125
• Drain lymph from the kidneys, suprarenal glands, testes or ovaries uterus, and uterine tubes; receive lymph from the common, internal, or external iliac; and their efferent vessels form the right and left lumbar trunks.
Para-aortic, Lumbar, or Lateral Aortic Lymph Nodes
126
* Is formed by the union of the ventral rami of the first three lumbar nerves and a part of the fourth lumbar nerve.
* Lies anterior to the transverse processes of the lumbar vertebrae within the substance of the psoas muscle.
Lumbar Plexus
127
Runs behind the lateral lumbocostal arch and in front of the quadratus lumborum. Penetrates the transverse abdominal muscle to run between it and the internal oblique muscle.
Subcostal Nerve (T12)
128
What does the Subcostal Nerve (T12) innervate?
external oblique, internal oblique, transverse, rectus abdominis, and pyramidalis muscles
129
* Emerges from the lateral border of the psoas muscle and runs in front of the quadratus lumborum.
* Pierces the transverse abdominal muscle near the iliac crest to run between this muscle and the internal oblique muscle.
* Pierces the internal oblique muscle and then continues medially deep to the external oblique muscle.
Iliohypogastric Nerve (L1)
130
What does Iliohypogastric Nerve (L1) innervate?
internal oblique and transverse muscles of the abdomen
skin above the pubis - anterior cutaneous branch
skin of gluteal region - lateral cutaneous branch
131
Runs in front of the quadratus lumborum, piercing the transverse and then the internal oblique muscle to run between the internal and external oblique aponeuroses.
Ilioinguinal Nerve (L1)
132
What does Ilioinguinal Nerve (L1) accompany?
spermatic cord (or the round ligament of the uterus)
133
What does ilioinguinal nerve (L1) innervate?
internal oblique and transverse muscles
| upper medial part of the thigh - femoral cutaneous branches + anterior scrotal or labial branches
134
Emerges on the front of the psoas muscle and descends on its anterior surface.
Genitofemoral Nerve (L1-L2)
135
Genitofemoral Nerve (L1-L2) divides into what branch which enters the inguinal canal through the deep inguinal ring to reach the spermatic cord and supply the cremaster muscle and the scrotum (or labium majus)?
genital branch
136
Genitofemoral Nerve (L1-L2) divides into what branch which supplies the skin of the femoral triangle?
femoral branch
137
Emerges from the lateral side of the psoas muscle and runs in front of the iliacus and behind the inguinal ligament.
Lateral Femoral Cutaneous Nerve (L2-L3)
138
Innervates the skin of the anterior and lateral thigh.
Lateral Femoral Cutaneous Nerve (L2-L3)
139
* Emerges from the lateral border of the psoas major and descends in the psoas and iliacus. groove between
* Enters the femoral triangle deep to the inguinal ligament and lateral to the femoral vessels, outside the femoral sheath, and divides into numerous branches.
Femoral Nerve (L2-L4)
140
Innervates the skin of the thigh and leg, the muscles of the front of the thigh, and the hip and knee joints, quadriceps femoris, pectineus, and sartorius muscles
Femoral Nerve (L2-L4)
141
What are the branches of Femoral Nerve (L2-L4)?
anterior femoral cutaneous nerve
| saphenous nerve
142
Arises from the second, third, and fourth lumbar nerves and descends along the medial border of the psoas muscle. It runs forward on the lateral wall of the pelvis and enters the thigh through the obturator foramen.
Obturator Nerve (L2-L4)
143
* Is present in approximately 9% of the population.
* Descends medial to the psoas muscle, passes over the superior pubic ramus, and supplies the hip joint and the pectineus muscle.
Accessory Obturator Nerve (L3-L4)
143
* Is present in approximately 9% of the population.
* Descends medial to the psoas muscle, passes over the superior pubic ramus, and supplies the hip joint and the pectineus muscle.
Accessory Obturator Nerve (L3-L4)
144
• Is formed by the lower part of the fourth lumbar nerve and all of the fifth lumbar nerve, which enters into the formation of the sacral plexus.
Lumbosacral Trunk (L4-L5)
145
What are the Autonomic Nerves in the Abdomen?
Autonomic Ganglia
Splanchnic Nerves
Autonomic Plexuses
Enteric Division
146
* Are composed primarily of ascending and descending preganglionic sympathetic general visceral efferent (GVE) fibers and general visceral afferent (GVA) fibers with cell bodies located in the dorsal root ganglia.
* Also contain cell bodies of the postganglionic sympathetic fibers.
Sympathetic Chain (Paravertebral) Ganglia
147
* Include the celiac, superior mesenteric, aorticorenal, and inferior mesenteric ganglia, usually located near the origin of the respective arteries.
* Are formed by cell bodies of the postganglionic sympathetic fibers.
Collateral (Prevertebral) Ganglia
148
How do Collateral (Prevertebral) Ganglia receive preganglionic sympathetic fibers?
greater, lesser, and least splanchnic nerves
149
* Are also called aortic bodies, Zuckerkandl bodies, organs of Zuckerkandl, or aortic glomera.
* Are small masses of chromaffin cells found near the sympathetic chain ganglia along the abdominal aorta and serve as chemoreceptors responsive to lack of oxygen, excess of carbon dioxide, and increased hydrogen ion concentration that help to control respiration.
Para-aortic Bodies
150
What are the Autonomic Ganglia?
Sympathetic Chain (Paravertebral) Ganglia
Collateral (Prevertebral) Ganglia
Para-aortic Bodies
151
Contain preganglionic sympathetic (GVE) fibers, with cell bodies located in the lateral horn (intermediolateral cell column) of the spinal cord, and GVA fibers, with cell bodies located in the dorsal root ganglia.
Thoracic Splanchnic Nerves
152
Where do greater splanchnic nerve, lesser splanchnic nerve, least splanchnic nerve enter/join?
greater splanchnic nerve enters the celiac ganglion
lesser splanchnic nerve enters the aorticorenal ganglion
least splanchnic nerve joins the renal plexus
153
* Arise from the lumbar sympathetic trunks and join the celiac, mesenteric, aortic, and superior hypogastric plexuses.
* Contain preganglionic sympathetic and GVA fibers.
Lumbar Splanchnic Nerves
154
What are the splanchnic nerves?
Thoracic Splanchnic Nerves
| Lumbar Splanchnic Nerves
155
Is formed by splanchnic nerves and branches from the vagus nerves.
Celiac Plexus
156
Is formed by splanchnic nerves and branches from the vagus nerves.
Celiac Plexus
157
What does Celiac Plexus contain and form along the branches of the celiac trunk?
celiac ganglia
| subsidiary plexuses
158
Is also called the solar plexus.
Celiac Plexus
159
The combined nerve plexus of the celiac and superior mesenteric plexuses.
Solar plexus
160
* Extends from the celiac plexus along the front of the aorta,
* Extends its branches along the arteries and forms plexuses that are named accordingly superior mesenteric, testicular (or ovarian), and interior mesenteric.
Aortic Plexus
161
* Extends from the celiac plexus along the front of the aorta,
* Extends its branches along the arteries and forms plexuses that are named accordingly superior mesenteric, testicular (or ovarian), and interior mesenteric.
Aortic Plexus
162
What does Aortic Plexus form just below the bifurcation of the aorta?
superior hypogastric plexus
163
What are autonomic plexuses?
Celiac Plexus
Aortic Plexus
Superior and Inferior Hypogastric Plexuses
164
Have sympathetic nerves that inhibit GI motility and secretion and constrict GI sphincters; parasympathetic nerves stimulate GI motility and secretion and relax GI sphincters.
Enteric Division
165
Located chiefly between the longitudinal and circular muscle layers of enteric division responsible for GI motility
myenteric (Auerbach) plexus
166
Located in the submucosa of enteric division which has secretory function.
submucosal (Meissner) plexus
167
Arises from the xiphoid process (sternal part), lower six costal cartilages (costal part), medial and lateral lumbocostal arches (lumbar part)
Diaphragm
168
Diaphragm
Right crus:__
Left crus:__
Right crus: L1 - L3
| Left crus: L1 - L2
169
Diaphragm inserts into the ___ and is the principal muscle of inspiration.
central tendon
170
Where does the central part and peripheral part of diaphragm receive sensory fibers?
central part: phrenic nerve
| peripheral part: intercostal nerves
171
Where does the central part and peripheral part of diaphragm receive sensory fibers?
central part: phrenic nerve
| peripheral part: intercostal nerves
172
* Receives blood from the musculophrenic, pericardiophrenic, superior phrenic, and inferior phrenic arteries.
* Descends when it contracts, causing an increase in thoracic volume by increasing the vertical diameter of the thoracic cavity and thus decreasing intrathoracic pressure
Diaphragm
173
* Receives blood from the musculophrenic, pericardiophrenic, superior phrenic, and inferior phrenic arteries.
* Descends when it contracts, causing an increase in thoracic volume by increasing the vertical diameter of the thoracic cavity and thus decreasing intrathoracic pressure
* Ascends when it relaxes, causing a decrease in thoracic volume with an increased thoracic pressure.
Diaphragm
174
Extends from the body of L1 to the transverse process of L1 and passes over the psoas muscle and the sympathetic trunk.
Medial Arcuate Ligament (Medial Lumbocostal Arch)
175
Extends from the transverse process of L1 to rib 12 and passes over the quadratus lumborum.
Lateral Arcuate Ligament (Lateral Lumbocostal Arch)
176
Lies in the central tendon of the diaphragm at the level of T8 and transmits the IVC and occasionally the right phrenic nerve.
Vena Caval Hiatus (Vena Caval Foramen)
177
Lies in the muscular part of the diaphragm (right crus) at the level of T10 and transmits the esophagus and anterior and posterior trunks of the vagus nerves.
Esophageal Hiatus
178
Lies behind or between two crura at the level of T12 and transmits the aorta, thoracic duct, azygos vein, and occasionally greater splanchnic nerve.
Aortic Hiatus
179
Action of iliacus and psoas muscles
Flexes thigh on trunk
180
Origin of iliopsoas muscle
Iliacus: iliac fossa of hipbone
Psoas: Transverse processes, intervertebral disks T12-L5 & T12-L1
181
Insertion of iliopsoas muscle
lesser trochanter of femur
182
Nerve supply of iliopsoas muscle
Femoral nerve
| Psoas: Lumbar plexus
183
Origin of Quadratus Lumborum
Iliac crest, Transverse process L3-L5, iliolumbar ligament
184
Insertion of Quadratus Lumborum
12th rib
185
Nerve supply of Quadratus Lumborum
Lumbar plexus
186
Action of Quadratus Lumborum
Depresses rib 12, flexes trunk laterally
