Term
| what are the bones of the abdominal wall? |
|
Definition
5 lumbar vertebrae and IV discs
Superior, expanded part of pelvic bones (greater pelvis)
12th rib
Anterior portion of 11th rib
Xiphoid process |
|
|
Term
| which muscles compose the abdominal wall posteriorly? |
|
Definition
Quadratus lumborum
Psoas major
Iliacus |
|
|
Term
| which muscles compose the abdominal wall anterolaterally? |
|
Definition
Transversus abdominis
Internal oblique
External oblique
Rectus abdominis |
|
|
Term
| what is the dermatome for the umbilicus? |
|
Definition
|
|
Term
| what region of the abdomen becomes pigmented in pregnant women? |
|
Definition
|
|
Term
| the transtubercular plane marks the formation of which vein? |
|
Definition
|
|
Term
| the supracristal plane marks the bifurcation of which artery? |
|
Definition
|
|
Term
| where is the transpyloric plane located? |
|
Definition
| at L1; superior mesenteric artery |
|
|
Term
| where is the subcostal plane located? |
|
Definition
| at L3; inferior mesenteric artery |
|
|
Term
| in what quadrant does appendicitis usually occur? |
|
Definition
|
|
Term
| where is mcburney's point located? |
|
Definition
| 1/3rd of the way up along a line from the right anterior superior iliac spine to the umbilicus |
|
|
Term
| what will happen if pressure is applied at mcburney's point in an individual with appendicitis? |
|
Definition
| Pressure here will cause maximum tenderness in a patient with acute appendicitis |
|
|
Term
| what are the layers of the abdominal wall from most superficial to deep? |
|
Definition
Skin
Superficial fascia (fatty layer) – Camper’s fascia
Deep fascia (membranous layer) – Scarpa’s fascia
Flat muscles:
External oblique
Internal oblique
Tranversus abdominis
Transversalis fascia
Extraperitoneal fascia
Peritoneum (parietal) – serous membrane that lines the peritoneal cavity |
|
|
Term
| can a surgeon suture camper's fascia? |
|
Definition
| no, but can suture scarpa fascia |
|
|
Term
| is campers fascia vascularized? |
|
Definition
|
|
Term
| which layer of fascia gives rise to the fundiform ligament of penis? (superficial or membranous) |
|
Definition
|
|
Term
| describe the anastomose of the paraumbilical veins |
|
Definition
Paraumbilical veins, which normally
drain into the portal vein,
anastomose with the
superficial epigastric veins which
normally drain into the
femoral vein.
If the portal vein is blocked, blood will drain through these vein anastomoses |
|
|
Term
|
Definition
Blockage of portal drainage,
as in portal hypertension, causes distension of the paraumbilical veins. Can also occur with blockage of inferior vena cava.
This looked like the head
of Medusa to early physicians
seen in alcoholics and people with cancer
blood uses portal drainage to get back to the heart |
|
|
Term
| is there a potential space between the membranous layer of the superficial fascia and the deep fascia over the external oblique muscle? |
|
Definition
|
|
Term
| describe what happens during urinary extravasation |
|
Definition
| blood or urine fills the scarpa's fascia with damage to the urethra |
|
|
Term
| what is the origin and insertion of the external oblique muscle? |
|
Definition
Origin
Outer surface of ribs 5-12
Insertion
Linea alba
Pubic tubercle
Anterior ½ of iliac crest
Free margin forms inguinal ligament
Aponeurotic fibers form external spermatic fascia |
|
|
Term
| true or false: the external oblique goes in the opposite direction as the internal oblique muscle |
|
Definition
|
|
Term
| what is the origin and insertion of the internal oblique muscle? |
|
Definition
Origin
Thoracolumbar fascia
Anterior 2/3 of iliac crest
Lateral ½ of inguinal ligament
Insertion
Inferior borders 10-12th ribs
Linea alba
Pecten pubis via conjoint tendon
Gives rise to cremaster muscle |
|
|
Term
| what is the origin and insertion of the transversus abdominis muscle? |
|
Definition
Origin
Inner surfaces of 7th-12th costal cartilages
Thoracolumbar fascia
Iliac crest
Lateral 1/3rd of inguinal ligament
Insertion
Linea alba
Pubic crest
Pecten pubis via conjoint tendon |
|
|
Term
| what is the function of the transversalis fascia? |
|
Definition
Helps form posterior wall of rectus sheath above arcuate line
Forms posterior wall of rectus sheath below arcuate line
Continues over spermatic cord as internal spermatic fascia |
|
|
Term
| why is pain associated with visceral disease and inflammation referred to the abdominal wall? |
|
Definition
| This is because visceral afferents enter the spinal cord with somatic afferents |
|
|
Term
| what is Hesselbach's triangle the site of? |
|
Definition
| direct inguinal hernias, which occur medial to the inferior epigastric vessels; region of weakness |
|
|
Term
| what suspends the gut tube from the posterior abdominal wall? |
|
Definition
|
|
Term
| what is the upper boundary of the abdominal cavity? |
|
Definition
|
|
Term
| what is the lower boundary of the abdominal cavity? |
|
Definition
| superior pelvic aperture or pelvic inlet |
|
|
Term
| the abdominal cavity extends to the _____ intercostal space to the pelvic inlet. |
|
Definition
|
|
Term
| what is the derivation of the greater omentum? |
|
Definition
| derived from the developing dorsal mesentery |
|
|
Term
| what are the subdivisions of the peritoneal cavity? |
|
Definition
| the greater sac and the omental butrrsa |
|
|
Term
| which subdivision of the peritoneal cavity accounts for most of the space in the peritoneal cavity? |
|
Definition
| the greater sac; it is entered once the parietal peritoneum has been penetrated |
|
|
Term
| the greater sac is continuous with the omental bursa through an opening termed? |
|
Definition
| the omental (epiploic) foramen |
|
|
Term
| what structures surround the omental foramen anteriorly? |
|
Definition
| portal vein, hepatic artery proper, and bile duct |
|
|
Term
| what structures surround the omental foramen posteriorly? |
|
Definition
|
|
Term
| the lesser omentum is derived from which mesentery? |
|
Definition
|
|
Term
| what are the attachment sites for the greater omentum? |
|
Definition
| the greater curvature of the stomach and the first part of the duodenum; becomes adherent to the peritoneum on the superior surface of the transverse colon and the anterior layer of the transverse mesocolon before arriving at the posterior abdominal wall |
|
|
Term
| what are the attachment sites of the lesser omentum? |
|
Definition
| the lesser curvature of the stomach and the first part of the duodenum to the inferior surface of the liver |
|
|
Term
| what are the 2 divisions of the lesser omentum? |
|
Definition
| hepatogastric and hepatoduodenal ligaments |
|
|
Term
| where does the hepatogastric ligament pass? |
|
Definition
| passes between the stomach and the liver |
|
|
Term
| what is peritoneum and what are the 2 types? |
|
Definition
A continuous, glistening, transparent serous membrane
Parietal peritoneum
Internal lining of the abdominopelvic cavity
Visceral peritoneum
invests the organs
forms mesenteries, omenta and ligaments
The layers form the peritoneal sac that encloses the peritoneal cavity
the viscera lie outside of the peritoneal cavity
Parietal peritoneum branches off wall to become mesentery and then visceral peritoneum |
|
|
Term
| both the parietal and visceral peritoneum consist of which type of epithelium? |
|
Definition
| mesothelium, simple squamous |
|
|
Term
| the parietal peritoneum has the same blood supply and innervation as what region? |
|
Definition
|
|
Term
| the visceral peritoneum has the same blood supply and innervation as which region? |
|
Definition
|
|
Term
| what ligament suspends the liver from the diaphragm? |
|
Definition
|
|
Term
| what can be found in the hepatoduodenal ligament? |
|
Definition
| bile duct, hepatic artery and portal vein |
|
|
Term
| what can happen as a result of ulceration of the posterior wall of the stomach or as a result of pancreatitis? |
|
Definition
| the omental bursa or lesser sac can fill with fluid |
|
|
Term
| true or false: viscera are outside the peritoneal cavity |
|
Definition
|
|
Term
| does the peritoneal normally contain a small amount of serous fluid? |
|
Definition
|
|
Term
| what are peritoneal/intraperitoneal organs? |
|
Definition
surrounded or nearly surrounded by visceral peritoneum
Ex: ileum |
|
|
Term
| what are retroperitoneal organs? |
|
Definition
only convered by peritoneum on their anterior surfaces
example: kidneys |
|
|
Term
| what are secondarily retroperitoneal organs? |
|
Definition
organs lose their mesenteries during development as they are pushed against the posterior body wall
example: ascending colon |
|
|
Term
|
Definition
| abnormal accumulation of fluid in the peritoneal cavity; fluid can be samples by paracentesis |
|
|
Term
| in the development of the peritoneum, the parietal/somatic mesoderm gives rise to what? |
|
Definition
| parietal peritoneum which lines abdominopelvic cavity |
|
|
Term
| in the development of the peritoneum, the visceral/splanchnic mesoderm gives rise and forms what structures? |
|
Definition
Gives rise to connective tissue and muscular parts of gut wall
Forms visceral peritoneum and mesenteries |
|
|
Term
| how are mesenteries formed in the development of the peritoneum? |
|
Definition
| formed by 2 layers of splanchnic mesoderm coming together |
|
|
Term
| where is the dorsal mesentery found in the developing peritoneum? |
|
Definition
| Extends from lower end of esophagus to the cloacal region of the hindgut |
|
|
Term
| where is the ventral mesentery found in the developing peritoneum? |
|
Definition
| Exists only in the region of the terminal part of the esophagus, the stomach, and the upper part of the duodenum |
|
|
Term
| what are the only adult remnants of the ventral mesentery? |
|
Definition
| falciform ligament and lesser omentum |
|
|
Term
| what does the falciform ligament contain? |
|
Definition
| Contains the ligamentum teres of the liver which is the obliterated left umbilical vein |
|
|
Term
| what does the dorsal mesentery carry? |
|
Definition
| blood vessels to and from the gut |
|
|
Term
| what are the remnants of the dorsal mesentery? |
|
Definition
| greater omentum, mesentery of the small intestines (mesentery proper) and sigmoid mesocolon |
|
|
Term
| what is the gastrocolic ligament? |
|
Definition
| portion of greater omentum attaching the greater curvature of the stomach to the transverse colon |
|
|
Term
| what is the gastrolienal ligament? |
|
Definition
| portion of greater omentum attaching the stomach to the spleen |
|
|
Term
| what is the lienorenal ligament? |
|
Definition
| portion of the greater omentum attaching the spleen to the left kidney |
|
|
Term
| describe the omental bursa |
|
Definition
Lies posterior to the stomach
Superior recess – limited by diaphragm and posterior layers of the coronary ligament of the liver
Inferior recess – potential space between the layers of the greater omentum
Function – allows free, smooth movement, of the stomach over the structures posterior and inferior to it |
|
|
Term
| what contributes to the formation of the omental bursa (lesser sac)? |
|
Definition
| Differential growth of the stomach, rotation of the stomach, and extensive growth of the dorsal mesogastrium (mesentery), which forms the greater omentum and related structures, contribute to the formation of the lesser sac |
|
|
Term
| true or false: the dorsal aspect of the stomach grows faster than the ventral aspect |
|
Definition
|
|
Term
| describe the rotation of the stomach as it develops |
|
Definition
As the stomach grows, it rotates slowly, 90° clockwise around its longitudinal axis
During rotation and growth, the cranial region moves to the left and inferiorly
The caudal region moves to the right and superiorly |
|
|
Term
| which artery supplies the foregut? |
|
Definition
|
|
Term
| which artery supplies the midgut? |
|
Definition
| the superior mesenteric artery |
|
|
Term
| which artery supplies the hindgut? |
|
Definition
|
|
Term
| which organs are supplied by branches of the celiac trunk? |
|
Definition
Lower esophagus
Stomach
Upper duodenum
Pancreas
Liver
Gallbladder |
|
|
Term
| which organs are supplied by braches of the superior mesenteric artery? |
|
Definition
Lower duodenum
Ileum
Jejunum
Cecum and appendix
Ascending colon
Proximal 2/3rds of transverse colon |
|
|
Term
| which organs are supplied by branches of the inferior mesenteric artery? |
|
Definition
Distal 1/3rd of the transverse colon
Descending colon
Sigmoid colon (rectosigmoid junction at S3)
Rectum
Upper part of anal canal |
|
|
Term
| where does the esophagus emerge? |
|
Definition
| emerges through the right crus of the diaphragm, usually at the level of vertebra T10, it passes from the esophageal hiatus to the cardial orifice of the stomach just left of the midline (T11) |
|
|
Term
| what is gastroesophageal reflux disorder (GERD)? |
|
Definition
Gastroesophageal reflux disorder is when an incompetent esophageal valve allows acid to rise into the esophagus.
In chronic cases, the lining of the esophagus can change or worse, become eroded |
|
|
Term
| what is barrett esophagus? |
|
Definition
Barrett esophagus is a metaplastic change of the esophageal epithelium from stratified squamous to simple columnar epithelium, like that of the intestines, secondary to gastroesophageal reflux.
The majority of people with Barrett esophagus are smokers and drinkers. |
|
|
Term
| what are esophageal varices? |
|
Definition
The esophageal veins are
a site where the caval venous
drainage anastomoses with the
portal venous drainage.
Portal hypertension cause dilation
of the esophageal veins. These
dilated and weakened varices are
prone to hemorrhage and is a
common cause of death in
persons with portal hypertension
Usually a sign of alcoholism |
|
|
Term
|
Definition
Formerly called cardiospasm
Onset 25-60 years
Men=women
Loss of myenteric neurons (Auerbach’s plexus) in lower the esophagus
Lower esophageal sphincter (LES) paralyzed in constricted state
Esophagus dilated |
|
|
Term
| describe the 2 vagal trunks which innervate the esophagus |
|
Definition
the anterior vagal trunk consists of several smaller trunks mostly coming from the left vagus nerve; rotation of the gut during development moves these trunks to the anterior surface of the esophagus
the posterior vagal trunk consists of a single trunk whose fibers mostly come from the right vagus nerve and rotational changes during development move this trunk to the posterior surface of the esophagus |
|
|
Term
| the first part of the duodenum is at what spinal level? |
|
Definition
|
|
Term
| the 3rd part of the duodenum is at what spinal level? |
|
Definition
|
|
Term
| the superior mesenteric artery and vein run over which organ? |
|
Definition
|
|
Term
| what marks the junction between foregut and midgut derived structures? |
|
Definition
|
|
Term
| describe obstructive jaundice due to pancreatic carcinoma |
|
Definition
Jaundice results from retention of bile
Bile pigments stain tissues such as the sclera (whites) of the eyes
Cancer of the head of the pancreas can often compress the bile duct or the hepatopancreatic ampulla (ampulla of Vater)
Associated with severe back pain
Large gallstone can also cause obstructive jaundice and so one must consider this as a possibility in the differential |
|
|
Term
| the spleen lies against which ribs? |
|
Definition
|
|
Term
| where is the spleen located? |
|
Definition
| on left side within greater sac, lies against 9th-11th ribs |
|
|
Term
| describe the location and function of the spleen in general |
|
Definition
NOT derived from the foregut
Immune organ
Highly vascular – filters blood
Located on left side within greater sac
It lies against the 9th-11th ribs
Clinical note: Trauma to these ribs can rupture the spleen causing profuse internal bleeding |
|
|
Term
| the greater curvature of the stomach is the point of attachment for what structures? |
|
Definition
| gastrosplenic ligament and the greater omentum |
|
|
Term
| what attaches to the lesser curvature of the stomach? |
|
Definition
|
|
Term
| which arteries supply the stomach? |
|
Definition
| left gastric, right gastric, right gastro-omental, left gastro-omental, posterior gastric |
|
|
Term
| what is the largest part of the gastrointestinal tract? |
|
Definition
|
|
Term
| where does the small intestine extend from? |
|
Definition
| extends from the pyloric orifice of the stomach to the ileocecal fold |
|
|
Term
| where is the superior part of the duodenum located? |
|
Definition
| extends from the pyloric orifice of the stomach to the neck of the gallbladder, is just to the right of the body of vertebra L1 |
|
|
Term
| in which section of the duodenum do most duodenal ulcers occur? |
|
Definition
|
|
Term
| where is the descending part of the duodenum located? |
|
Definition
| just to the right of the midline and extends from the neck of the gallbladder to the lower border of vertebra L3 |
|
|
Term
| where are the major and minor duodenal papilla located and what do they do? |
|
Definition
| located in the descending part of the duodenum; major- common entrance for the bile and prancreatic ducts; minor- entrance for the accessory pancreatic duct and the junction of the foregut and the midgut just below the major duodenal papilla |
|
|
Term
| which part of the duodenum is the longest section? |
|
Definition
|
|
Term
| what crosses the inferior part of the duodenum anteriorly? |
|
Definition
| the superior mesenteric artery and vein |
|
|
Term
| where does the ascending part of the duodenum terminate? |
|
Definition
| at the duodenojejunal flexure |
|
|
Term
| describe the small intestine in general |
|
Definition
Small intestine is 7 meters long
Duodenum, described above, is the initial portion of small intestine
Jejunum is the upper 2/5ths of the remainder
Mostly located in left upper quadrant
Ileum is lower (more distal) 3/5ths
Mostly in right lower quadrant
Suspended in abdominal cavity by mesentery |
|
|
Term
| the duodenojejunal flexure is surrounded by a fold of peritoneum containing muscle fibers called what? |
|
Definition
| ligament of Treitz (suspensory muscle ligament of duodenum) |
|
|
Term
| compare the jejunum to the ileum |
|
Definition
jejunum is characterized by numerous prominent folds that circle the lumen; has less prominent arterial arcades and longer vasa recta compared to ileum; blood supply from jejunal arteries from the superior mesenteric artery
the ileum has thinner walls, fewer and less prominent mucosal folds, shorter vasa recta, more mesenteric fat, and more arterial arcades; blood supply to the ileum is from the ileal arteries from the superior mesenteric artery and an ileal branch from the ileocolic artery (from superior mesenteric) |
|
|
Term
| what is the function of the large intestine? |
|
Definition
| absorbs fluid and salts from the gut contents, thus forming feces and consists of the cecum, appendix, colon, rectum and anal canal |
|
|
Term
| what are the 8 parts of the large intestine (colon)? |
|
Definition
1. Cecum
-Dilated saccular pouch in right iliac fossa
-appendix attached about 2cm below
2. ileocecal junction
3. Ascending colon
4. Transverse colon
5. Descending colon
6. Sigmoid colon
7. Rectum
8. Anal canal |
|
|
Term
| where is the appendix attached? |
|
Definition
| to the posteromedial wall of the cecum, just inferior to the end of the ileum |
|
|
Term
| describe the structure and function of the appendix |
|
Definition
| a narrow, hollow, blind-ended tube connected to the cecum; it has large aggregations of lymphoid tissue in its walls and is suspended from the terminal ileum by the mesoappendix which contains appendicular vessels |
|
|
Term
| is the location of the appendix static? |
|
Definition
| no it varies considerably |
|
|
Term
| people with appendicular problems describe pain near what region? |
|
Definition
| mcburney's point; the junction of the lateral and middle one-third of a line from the anterior superior iliac spine to the umbilicus |
|
|
Term
| which parts of the colon are secondarily retroperitoneal and which parts are intraperitoneal? |
|
Definition
| its ascending and descending segments are secondarily retroperitoneal and its transverse and sigmoid segments are intraperitoneal |
|
|
Term
| is the rectum retroperitoneal? |
|
Definition
|
|
Term
| what is the largest, most vascular visceral organ in the body? |
|
Definition
|
|
Term
| what are the 2 surfaces of the liver? |
|
Definition
| diaphragmatic (anterior, superior, and posterior) and visceral surface (inferior direction) |
|
|
Term
| which recesses are associated with the diaphragmatic surface of the liver? |
|
Definition
| the subphrenic and hepatorenal recess |
|
|
Term
| what does the subphrenic recess separate? |
|
Definition
| separates the diaphragmatic surface of the liver from the diaphragm and is divided into right and left areas by the falciform ligament, a structure derived from the ventral mesentery |
|
|
Term
| what is the hepatorenal recess? |
|
Definition
| a part of the peritoneal cavity on the right side between the liver and the right kidney and right suprarenal gland |
|
|
Term
| true or false: the subphrenic and hepatorenal recesses are continuous anteriorly |
|
Definition
|
|
Term
| the visceral surface of the liver is covered with visceral peritoneum except in what regions? |
|
Definition
| the fossa for the gallbladder and the porta hepatis (gateway to the liver) |
|
|
Term
| what is the bare area of the liver? |
|
Definition
| the site where original relationship with septum transversum is retained; small area where liver is up against diaphragm |
|
|
Term
| the ligamentum teres is derived from what structure? |
|
Definition
| obliterated left umbilical vein |
|
|
Term
| what are the 4 lobes of the liver? |
|
Definition
| right, left, quadrate, caudate |
|
|
Term
| describe the boundaries of the quadrate lobe of the liver |
|
Definition
| bounded on the left by the fissure for ligamentum teres and on the right by the fossa for the gallbladder; functionally it is related to the left lobe of the liver |
|
|
Term
| describe the boundaries of the caudate lobe of the liver |
|
Definition
| bounded on the left by the fissure for the ligamentum venosum and on the right by the groove for the inferior vena cava |
|
|
Term
| which arteries supply the liver? |
|
Definition
| the right and left hepatic arteries from the hepatic artery proper |
|
|
Term
| describe the characteristics of gallstones |
|
Definition
Gallstones common in Western society
Twice as likely in female than male
Americans have extraordinary rate of gallstones
Can remain asymptomatic
But, can cause severe epigastric or right upper quadrant pain
Pain can be referred to right shoulder (irritation of diaphragm)
Large gallstones can cause obstructive jaundice |
|
|
Term
| development of gallstones is _______ dependent in women |
|
Definition
|
|
Term
| what are brown pigment stones almost always associated with? |
|
Definition
| bacterial cholangitis; related to increased concentration of unconjugated bilirubin in bile |
|
|
Term
| the foregut receives sympathetic innervation from which spinal cord segments? |
|
Definition
|
|
Term
| pain afferents in the forgut run with the ______. |
|
Definition
| sympathetics; other afferents run with the parasympathetics (vagus) |
|
|
Term
| the midgut receives sympathetic innervation from which spinal cord segments? |
|
Definition
|
|
Term
| pain afferents in the midgut run with the _______. |
|
Definition
|
|
Term
| what is hirschsprung's disease? |
|
Definition
Also known as congenital aganglionic megacolon
There is a failure of neural crest cells to migrate into the distal colon
1:5000 births
Males affected more than females 4:1 |
|
|
Term
| what forms the portal vein? |
|
Definition
Formed when the splenic and superior mesenteric vein join posterior to the neck of the pancreas at the level of the L2 vertebra. It receives all the blood from the GI tract and spleen.
The blood from the kidneys does not drain into the portal vein. |
|
|
Term
| the hindgut receives sympathetic innervation from which spinal segments? |
|
Definition
|
|
Term
| pain afferents from the hindgut run with the _______. |
|
Definition
| sympathetics; other afferents run with the parasympathetics (pelvic splanchnics) |
|
|
Term
| the foregut and midgut derivatives receive parasympathetic innervation from which nerve? |
|
Definition
|
|
Term
| sympathetic supply to the foregut and midgut derivatives are from which nerves? |
|
Definition
|
|
Term
| hindgut derivatives receive parasympathetics from which nerves? sympathetics? |
|
Definition
parasympathetics- pelvic splanchnics
sympathetics- lumbar splanchnics |
|
|
Term
| describe referred pain in the abdomen |
|
Definition
Pain associated with visceral disease and inflammation is referred to the abdominal wall.
This is because visceral nociceptive (pain) afferents enter the spinal cord with somatic afferents.
All pain fibers run with the
sympathetic system and enter the spinal cord at the same segment that gives rise to the preganglionic efferents. |
|
|
Term
| describe the recto-anal watershed |
|
Definition
In this region of multiple
vascular supply, the lymphatics
follow the arteries.
The upper portion of the rectum
drains along the route of the
inferior mesenteric A. The middle
And lower portions drains back
toward the internal iliac arteries.
Below the pectinate line, drainage
is to the superficial inguinal nodes. |
|
|
Term
| what are the 4 sites of portal-caval anastomoses? |
|
Definition
esophageal veins, paraumilical veins, veins of anal canals, retroperitoneal veins
the first 2 are often associated with alcohol abuse and cirrhosis |
|
|
Term
| what is the function of the gallbladder? |
|
Definition
| receives, concentrates, and stores bile from the liver |
|
|
Term
| what artery supplies the gallbladder? |
|
Definition
| the cystic artery from the right hepatic artery (a branch of the hepatic artery proper) |
|
|
Term
| where does the pancreas lie? |
|
Definition
| lies mostly posterior to the stomach; it extends across the posterior abdominal wall from the duodenum, on the right, to the spleen, on the left. |
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Term
| true or false: the pancreas is secondarily retroperitoneal except for a small part of its tail and consists of a head, uncinate process, neck, body and tail |
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Definition
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Term
| in what region of the pancreas does the pancreatic duct join the bile duct? |
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Definition
| the lower part of the head |
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Term
| the joining of the pancreatic duct and the bile duct forms what? |
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Definition
| the hepatopancreaticampulla (ampulla of vater) |
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Term
| where is the spleen located? |
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Definition
| lies against the diaphragm, in the area of rib 9-10; it is therefore in the left upper quadrant of the abdomen |
|
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Term
| what structures are the spleen connected to? |
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Definition
| the greater curvature of the stomach (gastrosplenic ligament) and the left kidney (splenorenal ligament) |
|
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Term
| what is the splenic hilum? |
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Definition
| the entry point for the splenic vessels and occasionally the tail of the pancreas reaches this area |
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Term
| the arterial supply to the spleen is what artery? |
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Definition
| splenic artery from the celiac trunk |
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Term
| the right and left hepatic ducts combine to form which duct? |
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Definition
| the common hepatic duct; runs near the liver with the hepatic artery proper and portal vain in the free margin of the lesser omentum |
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Term
| what are the components of the posterior abdominal wall? |
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Definition
Five lumbar vertebrae
their intervertebral discs
Ribs 11 and 12
Posterior abdominal muscles
Posterior part of the diaphragm |
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Term
| true or false: the kidneys are surrounded by an incredible amount of fat; the fat serves as protection for the kidneys |
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Definition
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Term
| describe the attachments, innervation and action of the quadratus lumborum muscle |
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Definition
Superior attachment:
medial ½ of superior border of 12th rib and tips of lumbar transverse processes
Inferior attachment:
iliolumbar ligament and internal lip of the iliac crest
Innervation: T12-L4
Actions: bilaterally extends
Vertebral column, unilaterally flexes column, fixes ribs during inspiration |
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Term
| describe the attachments, innervation and action of the psoas major muscle |
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Definition
Superior attachment:
T12-L5 vertebrae and disks
Inferior attachment:
along with iliacus m, lesser trochanter of femur
Innervation:
anterior rami L1-L3
Action:
flexes thigh, also a trunk flexor |
|
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Term
| describe the attachments, action and innervation of the iliacus muscle |
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Definition
Superior attachment:
superior 2/3 of iliac fossa
Inferior attachment:
along with psoas major m,
lesser trochanter of femur
Action:
hip flexion
Innervation:
femoral nerve L2-L4 |
|
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Term
| what attaches the diaphragm to the vertebral column? |
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Definition
Diaphragm is attached to the vertebral column by the crura.
Right to L1-L3 and the intervening discs.
Gives rise to ligament or muscle of Treitz.
Left to L1-L2 and intervening discs.
Arcuate ligaments also attach diaphragm to posterior body wall.
Median attaches two crura.
Arches over aorta.
Medial is thickening of psoas major fascia.
Lateral is thickening of quadratus lumborum fascia. |
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Term
| describe the blood supply to the diaphragm |
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Definition
Abdominal surface
Inferior phrenic arteries
1st pair arteries off abdominal aorta
Thoracic surface
Pericardicophrenic arteries
Branches of musculophenic arteries
Small superior phrenic arteries off aorta |
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Term
| the genitofemoral nerve lies on the anterior surface of which muscle? |
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Definition
|
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Term
| where are the kidneys located? |
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Definition
Lie in the paravertebral gutters
Lie at level of T11-L3 with the right slightly lower than the left
Posterior surfaces associated with quadratus lumborum muscle and diaphragm |
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Term
| which nerves pass diagonally and laterally posterior to the kidneys? |
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Definition
| Subcostal, iliohypogastric and ilioinguinal nerves pass diagonally and laterally posterior to the kidneys |
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Term
| renal arteries come off between which vertebral levels? |
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Definition
| L1 and L2; arising just below the superior mesenteric artery |
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Term
| what vertebral level is the transpyloric plane located? |
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Definition
|
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Term
| typically, the renal artery gives off how many branches to the lobes of the kidney? |
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Definition
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Term
| the ureters in males pass into the pelvis at what region? |
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Definition
| the bifurcation of common iliac artery |
|
|
Term
| what passes under the uterine artery in females? |
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Definition
|
|
Term
| the pain of kidney stones is typically referred to which spinal levels? |
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Definition
|
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Term
| where are the adrenal (suprarenal) glands located? |
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Definition
positioned over the upper poles of the kidneys
Right adrenal lies behind the bare area of the liver
Left adrenal faces into the omental bursa
retroperitoneal |
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Term
| which nerve gives off fibers directly to the adrenal gland? |
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Definition
the greater splanchnic nerve
These preganglionic sympathetics synapse directly on neural
crest-derived cells in adrenal medulla. These chromaffin cells secrete epinephrine (80%) and norepinephrine (20%). |
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Term
| is there parasympathetic innervation to the adrenals? |
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Definition
|
|
Term
| does the adrenal cortex have any innervation? |
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Definition
|
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Term
| where is the cisterna chyli located? |
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Definition
| At the inferior end of the thoracic duct, at the level of the L1 and L2 vertebral bodies is the cisterna chyli. It is quite variable in size and shape and typically lies between the right crus of the diaphragm and the aorta. |
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Term
| Virtually all the deep lymphatic drainage inferior to the diaphragm and superficial drainage inferior to the umbilicus converge on the? |
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Definition
| commencement of the thoracic duct |
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Term
| all of the venous drainage from the digestive organs and the spleen enter what system? |
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Definition
| the portal venous system to e carried to the liver |
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Term
| the portal vein forms behind what region? |
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Definition
|
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Term
| what 2 veins form the portal vein? |
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Definition
| the superior mesenteric and splenc vein |
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|
Term
| at what vertebral level does the portal vein form? |
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Definition
| L1/L2; transpyloric plane is where it forms; anterior to the inferior vena cava and posterior to the neck of the pancreas |
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Term
| superior rectal veins drain back into which veins? |
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Definition
| superior mesenteric veins |
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