Flashcards
Abdomen continued
Flashcards do conjunto (200)
- 1Into what set of lymph nodes does lymph from around the stomach drain into?Coeliac lymph nodes
- 2How is the stomach innervated?Via sympathetic nerve supply from T6-T9 passing to the coeliac plexus via the greater splanchnic nerves and distributed as a plexus around the gastric and gastro-omental arteries
- 3What is found anteriorly related to the stomach?Anterior abdominal wall, diaphragm and left lobe of the liver
- 4What is found related posteriorly to the stomach?Omental bursa and pancreas
- 5What is the stomach bed?The structures that the stomach rests on when a person is in the supine position?
- 6What is the name given to the junction between the ileum and the caecum?Ileocaeccal junction
- 7What part of the small intestine is the shortest? Approx how long is it?Duodenum (25cm)
- 8What are the four parts of the duodenum in order that they occur in?1. Superior part
2. Descending
3. Inferior
4. Ascending - 9At what level is the superior part of the duodenum found?Anterolateral to body of L1 vertebra
- 10At what levels is the descending part of the duodenum found?Vertically down L2 and L3 vertebra
- 11What structure does the descending part of the duodenum curve around?Head of the pancreas
- 12Where is the descending part of the duodenum found in relation to the IVC?To the right and parallel
- 13What two structures empty contents into the descending part of the duodenum? What collective vessel do they pass the contents through?1. Bile duct
2. Main pancreatic ducts
Empty into hepatopancreatic ampulla - 14What two major blood vessels does the inferior part of the duodenum pass anterior to?IVC and aorta
- 15What two major blood vessels does the inferior part of the duodenum pass posterior to?Superior mesenteric artery and vein
- 16At what level does the inferior part of the duodenum cross the aorta and IVC?L3
- 17What part of the duodenum is the longest?Descending
- 18What is the superior-most level that the ascending part of the duodenum reaches? Where is this in relation to the midline?Superior border of L2 vertebra.
2-3 cm to left of midline - 19What is the name given to the junction between the duodenum and jejunum?Duodenojejunal flexure
- 20What supports the duodenojejunal junction?Suspensory muscle of the duodenum (ligament of Treitz)
- 21Where is the suspensory ligament of the duodenum found in relation to the pancreas and splenic vein?Posterior
- 22What is the name given to the initial free-part of the duodenum (2cm)?Ampulla (duodenal cap)
- 23Why is the majority of the duodenum immobile?It is retroperitoneal and has no mesentery
- 24What is the typical surface markings of the cardial orifice of the stomach in the supine position?Posterior to 6th left costal cartilage, 2-4cm left of median plane at T10/T11
- 25What is the typical surface markings of the fundus of the stomach in the supine position?Posterior to the 5th left rib in the midclavicular plane
- 26What is the typical surface markings of the greater curvature of the stomach in the supine position?Passes inferiorly to the right to reach 10th costal cartilage and turns medially to reach pyloric antrum.
- 27What are the typical surface markings of the pyloric part of the stomach in the supine position?At the level of the 9th costal cartilage (L1 vertebra)
- 28At what level might the pylorus of the stomach be found in the supine position?L2 - L4
- 29How might the stomach be orientated in a person with a slender, asthenic physique?Low and vertically placed
- 30What is the cause between the transition in blood supply that occurs along the duodenum? Approximately where does this transition occur?Embryological site of the junction between the foregut and the midgut.
Along the descending duodenum approximately where the hepatopancreatic ampulla joins. - 31What arteries supply the proximal part of the duodenum?Gastroduodenal artery and its branch the superior pancreaticoduodenal artery (from coeliac trunk)
- 32What artery supplies the distal part of the duodenum and alimentary canal (to the point of the left colic flexure)?Superior mesenteric artery
- 33What artery are the third and fourth parts of the duodenum supplied by?Inferior pancreaticoduodenal artery (branch of superior mesenteric artery)
- 34Approximately how long is jejunum and ileum combined within a cadaver?6 -7 m
- 35At what level is the duodenojejunal junction found?L2 vertebra (left side)
- 36List some structures that the root of the mesentery of the small intestine crosses.Ascending and inferior parts of the duodenum, aorta, IVC, right ureter, right psoas major mm., right testicular and ovarian vessels.
- 37What artery supplies the jejunum and ileum?Superior mesenteric artery
- 38What is the name given to the loops/arches of arterial vessels that are found within the mesentery of the small intestine?Arterial arcades
- 39What is the name given to the small straight arteries that are found within the mesentery of the small intestine?Vasa recta
- 40What major vein drains the mesentery of the small intestine?Superior mesenteric vein
- 41What two major veins unite to form the hepatic portal vein?1. Superior mesenteric vein
2. Splenic vein - 42Describe the orientation of the SMV in relation to the SMA in the root if the mesentery?SMV is anterior and to the right of the SMA
- 43What name is given to the specialised lymphatic vessels found in the villi of the small intestine?Lacteals
- 44What are the three groups of lymph nodes that receive lymph from the small intestine?1. Juxta-intestinal lymph nodes
2. Mesenteric lymph nodes
3. Central superior lymph nodes - 45Where are the junta-intestinal lymph nodes located?Close to the intestinal wall
- 46Where are the mesenteric lymph nodes located?Around the arterial arcades within the mesentery
- 47Where are the central superior lymph nodes located?Proximal part of the SMA
- 48Where do lymphatic vessels from the terminal ileum drain to?Follow the ideal branch of the ileocolic artery and drain into the ileocolic nodes
- 49At what level does the SMA arise from the aorta?L1
- 50At what level does the inferior mesenteric artery arise from the aorta?L3
- 51What are the branches of the SMA?1. Intestinal
2. Middle colic
3. Right colic
4. Ileocolic - 52What structures does the ileocolic artery supply?1. Ileum
2. Caecum
3. Ascending colon
4. Appendix (via appendicular branch) - 53What is the terminal branch of the SMA?Ileocolic artery
- 54What are the branches of the inferior mesenteric artery?1. Left colic
2. Sigmoid branches
3. Superior recta; - 55What is the name given to the areas of mesentery found between the vasa recta?Windows
- 56How does the jejunum and ileum differ in colour?Jejunum: deeper red
Ileum: paler pink - 57What is the name given to the circular folds found within the small intestine?Plicae circulares
- 58How do the circular folds within the jejunum and ileum compare?Circular folds are large, tall and abundant in jejunum. They are low and sparse in the ileum and absent in its most distal part.
- 59Are the vasa recta found to be longer in the mesentery of the jejunum or the ileum?Jejunum
- 60Which is more highly vascularised: the jejunum or the ileum?Jejunum
- 61Generally what is the effect of sympathetic innervation on digestion within the GI tract?Reduces secretion and motility, vasoconstrictor directing blood elsewhere.
- 62From which spinal root values do the pre-synaptic sympathetic fibres supplying the mesentery of the small intestine originate? Through which nerves do they pass to the periarterial plexuses around the SMA?T8-T10
Thoracic abdominopelvic splanchnic nerves - 63Name the two plexuses found in the intestinal wall of the small intestine.1. Myenteric
2. Submucous - 64List the parts of the large intestine.1. Appendix
2. Caecum
3. Ascending colon
4. Transverse colon
5. Descending colon
6. Sigmoid colon
7. Rectum
8. Anal canal - 65Name the longitudinal muscles associated with the large intestine.Teniae coli
- 66What is the name of the sacculations that are formed by the teniae coli?Haustra
- 67What is the name given to the fatty projections of the large colon?Omental appendices
- 68What is the name of the mesentery associated with the appendix?Meso-appendix
- 69What surface markings usually demarcate the base of the appendix?Spina-Umbilical or McBurney point:
a point 1/3 of the way along oblique line from the right ASIS to the umbilicus. - 70What artery supplies the caecum?Ileocolic artery
- 71What artery supplies the appendix?Appendicular artery (branch of ileocolic artery)
- 72To which lymph nodes does lymph from the caecum and appendix drain to?Lymph nodes in the meso-appendix and ileocolic lymph nodes along the ileocolic artery. This then will enter the superior mesenteric lymph nodes.
- 73From what spinal level do sympathetic nerve fibres that supply the caecum and appendix originate?T10-T12
- 74What separates the ascending colon from the anterolateral abdominal wall?Greater omentum
- 75What arteries and vein supply/drain the ascending colon?Ileocolic, right colic arteries/veins
(+ middle colic) - 76Describe the lymphatic drainage from the ascending colon.Lymph flows to epicolic and paracolic lymph nodes which then pass to the ileocolic and right colic lymph nodes and finally to the superior mesenteric lymph nodes.
- 77What plexus supplies the nerves to the ascending colon?Superior mesenteric plexus
- 78How does the position and nature of the left colic flexure differs from the right colic flexure?Left colic flexure is usually more superior and more acute. It is less mobile.
- 79What structure lies anterior to the inferior part of the left kidney?Left colic flexure of transverse colon.
- 80What attaches the left colic flexure to the diaphragm?Phrenicocolic ligament
- 81What arteries supply the transverse colon?Middle colic artery
(right & left colic arteries via anastomoses) - 82Describe the lymphatic drainage of the transverse colon.Middle colic lymph nodes and then into the superior mesenteric lymph nodes.
- 83At what level does the sigmoid colon join the rectum?Third sacral segment
- 84What parts of the large intestine typically have a mesentery?1. Appendix
2. Transverse colon
3. Sigmoid colon - 85Where is the point of transition between blood supply within the large intestine? What does it switch from and to?At left colic flexure.
SMA to inferior mesenteric artery - 86What arteries supply the descending and sigmoid colon?1. Left colic artery
2. Sigmoid artery
(branches of IMA) - 87The arteries supplying the colon form a continuous anastomotic channel, what is the name given to this?Marginal artery
- 88What is the importance of the marginal artery of the colon?May provide important collateral circulation
- 89Into which vein does the inferior mesenteric vein usually flow?Splenic vein
- 90Describe the lymphatic drainage of the descending and sigmoid colon.Drains to epicolic and paracolic lymph nodes and from there to intermediate colic lymph nodes along the left colic artery. Then into inferior mesenteric lymph nodes.
- 91Describe the sympathetic nerve supply to the descending and sigmoid colon.Lumbar abdominopelvic splanchic nerves towards inferior mesenteric ganglia. Then via periarterial plexus on the IMA.
- 92At what level does the rectum begin?S3
- 93Is the spleen described as intraperitoneal or retroperitoneal?Intraperitoneal: mobile
- 94What is the general name given to the site of entry/exit of vessels into the spleen?Hilum
- 95What surface markings demarcate the site of the spleen?Ribs 9 - 11
- 96What is the usual length and width of the spleen?Length: 12cm
Width: 7cm - 97What connects the spleen to the stomach?Gastrosplenic ligament
- 98What connects the spleen to the left kidney?Splenorenal ligament
- 99What vessels are found within the gastrosplenic ligament?Short gastric vessels
Left gastro-omental vessels - 100What are the three areas of the visceral surface of the spleen (based on what they contact)?1. Gastric
2. Renal
3. Colic - 101Where does the splenic vein unite with the SMV to form the hepatic portal vein?Behind the neck of the pancreas
- 102From which plexus are the nerves of the spleen derived?Coeliac plexus
- 103What lymph nodes are associated with splenic lymphatic drainage?Pancreaticosplenic lymph nodes
- 104What level is the neck of the pancreas found at?L1/L2 vertebrae in the transpyloric plane
- 105Is the pancreas described as intraperitoneal or retroperitoneal?Retroperitoneal
- 106Which pancreatic cells are responsible for exocrine secretions into the duodenum?Acinar cells
- 107Which pancreatic cells are responsible for endocrine secretions into the blood circulation?islets of Langerhans
- 108What are the four (/five) parts of the pancreas?1. Head (+uncinate process)
2. Neck
3. Body
4. Tail - 109The uncinate process of the pancreas is found posterior to what major artery?Superior mesenteric artery
- 110What vessels groove the posterior surface of the neck of the pancreas?1. Superior mesenteric artery and vein
2. Origin of hepatic portal vein (most superiorly) - 111What organ is the tail of the pancreas closely associated with?Spleen (at hilum)
- 112Where does the main pancreatic duct originate and terminate?Originates: tail of pancreas
Terminates: hepatopancreatic ampulla as merges with bile duct - 113Through which structure does the hepatopancreatic ampulla enter the duodenum?Major duodenal papilla
- 114What two vessels unite to form the hepatopancreatic ampulla?1. Main pancreatic duct
2. Common bile duct - 115What list the three sphincters associated with the hepatopancreatic ampulla region.1. Sphincter of the bile duct
2. Sphincter of the pancreatic duct
3. Hepatopancreatic sphincter (sphincter of Oddi) - 116What is the function of the sphincter of the pancreatic duct?Prevents reflux of bile into pancreatic duct
- 117What is the function of the sphincter of Oddi?Prevents duodenal content from entering hepatopancreatic ampulla
- 118Through which structure does the accessory pancreatic duct enter the duodenum?Minor duodenal papilla
- 119From which part of the pancreas does the accessory pancreatic duct usually drain?Uncinate process and inferior part of head of pancreas
- 120What artery (and its branches) supplies the majority of the pancreas?Splenic artery
- 121What arteries supply the head of the pancreas?1. Anterior and posterior superior pancreaticoduodenal arteries (branches of gastroduodenal artery)
2. Anterior and posterior inferior pancreaticoduodenal arteries (branches of SMA) - 122What vein primarily drains the pancreas?Splenic vein
- 123What lymph nodes drain lymph from the pancreas? In turn which larger lymph nodes do they drain into?1. Pancreaticosplenic nodes (mostly)
2. Pyloric lymph nodes
Drain to superior mesenteric or coeliac lymph nodes - 124What sets of nerves innervate the pancreas? Through which plexuses do they unite?1. Vagus nerve
2. Abdominopelvic splanchnic nerves
Unite at coeliac and superior mesenteric plexuses. - 125What type of autonomic innervation is secretomotor in the pancreas?Parasympathetic
- 126What is the primary control mechanism of pancreatic secretion?Hormonal: secretin and cholecystokinin (from duodenum and proximal intestine)
- 127How do visceral afferent fibres from the pancreas travel to the spinal cord?Accompany sympathetic fibres
- 128What is the average weight of the liver?1500g
- 129Every substance absorbed by the GI tract is delivered first to the liver, except for what substance?Lipids
- 130The inferior border of the liver separates what two surfaces?1. Diaphragmatic
2. Visceral - 131What name is given to the superior extension of peritoneal cavity found between the anterior and superior surfaces of the liver and the diaphragm?Subphrenic recess
- 132What separates the subphrenic recess into right and left?Falciform ligament
- 133What is the name given to superior extension of peritoneal cavity between the right posterior surface of the liver and the right kidney and suprarenal gland?Hepatorenal recess
- 134What name is given to the area of peritoneal cavity found inferior to the liver?Subhepatic space
- 135Where is the diaphragmatic surface of the liver not covered with peritoneum? What does it lie in contact with?Bare area of the liver, lies in contact with the diaphragm
- 136Where is the visceral surface of the liver not covered by peritoneum?1. Bed of the gallbladder
2. Porta hepatis - 137What passes through the port hepatis?1. Hepatic artery
2. Hepatic portal vein
3. Hepatic nerve plexus
4. Hepatic ducts
5. Lymphatic vessels - 138List the areas of the visceral surface of the liver to which it is related to other structures.1. Gastric area
2. Pyloric area
3. Duodenal area
4. Attachment of lesser omentum
5. Fossa for gallbladder
6. Colic area (right colic flexure etc..)
7. Renal and suprarenal areas - 139What is the surface anatomy of the normal position of the liver?Underlying ribs 7-11 on right side, crossing midline towards left nipple
- 140What action might allow a patient's liver to be palpated?Inspiration
- 141What are the four anatomical lobes of the liver?1. Right
2. Left
3. Caudate
4. Quadrate - 142What divides the large right lobe from the smaller left lobe (division based on blood supply and glandular secretion)?Falciform ligament
Left sagittal (umbilical) fissure - 143Are the quadrate and caudate lobe generally classified as part of the right or left lobe of the liver?Right
- 144What form the boundaries of the caudate lobe on the visceral surface of the liver?1. Medial: Left sagittal fissure
2. Inferior: Porta hepatis
3. Lateral: Right sagittal fissure - 145What structures form the groove of right sagittal fissure?1. Fossa for gallbladder
2. IVC - 146What structures form the groove of the left sagittal fissure?1. Round ligament of the liver (ligamentum teres)
2. Ligamentum venosum (ductus venosum) - 147What is the round ligament of the liver a remnant of?Remnant of the umbilical vein (carried well-oxygenated blood from placenta to foetus)
- 148What is the ligamentum venosum a remnant of?Foetal ductus venosum (shunted blood from umbilical vein to IVC
- 149What demarcates the division between the right and left livers (portal lobes)?Plane of the middle hepatic vein (sagittal plane passing through gallbladder fossa and IVC fossa on the visceral surface and an imaginary line over the diaphragmatic surface).
- 150What does the left liver contain?1. Left lobe
2. Caudate lobe
3. Most of quadrate lobe - 151How many hepatic segments are there?8
- 152What defines the divisions of the hepatic segments?Tertiary branches of the right and left hepatic arteries, hepatic portal veins and hepatic ducts.
- 153What defines the difference between right and left livers?Blood supply and glandular secretion
- 154What veins pass between hepatic segments?Intersegmental hepatic veins
- 155What % of blood to the liver is supplied by each of its respective blood sources?Hepatic portal vein: 75-80%
Hepatic artery: 20-25% - 156Where does the hepatic artery and hepatic portal vein divide?At/ near porta hepatis
- 157What is the hepatic artery a branch of?Coeliac trunk
- 158What three major veins are found between segments of the liver and drain blood?Right hepatic vein
Left hepatic vein
Middle hepatic vein - 159Where do the hepatic veins open into the IVC?Just inferior to the diaphragm
- 160What proportion of the lymph received by the thoracic duct originates from the liver?1/4 to 1/2
- 161Where are the two types of lymphatic vessels of the liver located?Superficial vessels: fibrous capsule of liver (Glisson capsule)
Deep lymphatics: accompany branches of portal triad and hepatic veins - 162To which lymph nodes does lymph darin from the anterior aspect of the diaphragmatic and visceral surfaces of the liver and deep lymphatics accompanying branches of the portal triad?Hepatic lymph nodes along hepatic vessels within lesser omentum. From there into the coeliac lymph nodes.
- 163Into which significant structure might lymph from the coeliac lymph nodes drain into?Cisterna chyli (inferior end of thoracic duct)
- 164Into which lymph nodes does lymph drain from the posterior aspects of the diaphragmatic and visceral surfaces of the liver?Drain towards bare area to phrenic lymph nodes or join deep lymphatics following hepatic veins to IVC to pass through diaphragm an enter posterior mediastinal lymph nodes.
- 165Where might efferent lymphatics of the posterior mediastinal lymph nodes drain to?Right lymphatic duct and thoracic duct
- 166List three other possible routes of lymphatic drainage of the liver.1. Left gastric nodes
2. Along falciform ligament to parasternal lymph nodes
3. Along round ligament to anterior abdominal wall - 167What is the largest derivative of the coeliac plexus?Hepatic nerve plexus
- 168What is the nerve supply to the liver?Hepatic nerve plexus
- 169What does the hepatic nerve plexus consist of?Sympathetic: coeliac plexus
Parasympathetic: anterior and posterior vagal trunks - 170What is found in the thickened free border of the falciform ligament?Ligamentum teres (round ligament of the liver)
- 171Where is the most inferior attachment of the falciform ligament on the surface of the liver?Hepatic notch
- 172What do the folds of the falciform ligament become at the superior border of the liver?Coronary ligament
- 173What name is given to the right and left extensions of the coronary ligament of the liver?Right and left triangular ligament
- 174What do the hepatocytes secrete bile into?Bile canaliculi
- 175Describe the course taken by bile to reach the bile duct.Secreted by hepatocytes, flows into bile canaliculi and then to interlobular biliary ducts. This follows to the corresponding right or left hepatic duct of the right and left liver and through the common hepatic duct leaving the liver. This goes on to become the bile duct.
- 176What two structures unite to form the common hepatic duct?Right and left hepatic ducts
- 177What two structures unite to form the bile duct?1. Common hepatic duct
2. Cystic duct - 178Where does the bile duct form?Free edge of the lesser omentum
- 179How does the bile duct reach the pancreas?Passes posterior to the superior part of the duodenum, forms a groove on the posterior surface of the head of the pancreas.
- 180What always the movement of excess bile to enter the cystic duct and therefore the gallbladder?The contraction of the sphincter of the bile duct (choledochal). Bile backs up and passes into cystic duct.
- 181What arteries supply the parts of the bile duct?Retroduodenal part: posterior superior pancreaticoduodenal artery and gastroduodenal artery
Proximal part: cystic artery
Middle part: right hepatic artery - 182What is the cystic artery a branch of?Right hepatic artery
- 183How is blood drained from the bile duct?Proximal part: veins drain directly to liver
Distal part: posterior superior pancreaticoduodenal vein (empties to hepatic portal vein) - 184Where does lymph from the bile duct drain to?1. Cystic lymph node (near neck of gallbladder)
2. Node of the omental foramen
3. Hepatic lymph nodes
Pass to coeliac lymph nodes - 185Roughly how long is the gallbladder?7-10 cm
- 186What are the three parts of the gallbladder?1. Fundus
2. Body
3. Neck - 187What is the surface marking for the fundus of the gallbladder?Right 9th costal cartilage in the midclavicular line
- 188What structures does the body of the fundus lie in contact with?Liver, transverse colon, superior part of duodenum
- 189What name is given to the specialised structure of the mucosa of the neck of the gallbladder?Spiral fold
- 190What is the function of the spiral fold?Maintains the opening cystic duct allowing flow of bile in either direction depending on what is required.
- 191How long is the cystic duct?About 4cm
- 192Where does the cystic artery tend to arise?From the right hepatic artery in the cystohepatic triangle (of Calot): triangle between cystic duct and hepatic duct.
- 193What artery supplies the gallbladder and cystic duct?Cystic artery
- 194What is the lymphatic drainage of the gallbladder?Often passes to cystic lymph nodes at the neck of the gallbladder then to hepatic lymph nodes.
All tend to pass to coeliac lymph nodes - 195Describe the nerve supply to the gallbladder and cystic duct?Sympathetic and visceral afferent periarterial innervation on the cystic artery originating from the coeliac nerve plexus. Parasympathetic via vagus nerve. Somatic afferent via right phrenic nerve.
- 196What stimulates contraction of the gallbladder?Hormonally stimulated.
- 197What name is given to the non contractile capillaries of the liver?Venous sinusoids
- 198Describe the portosystemic anastomosis that occurs in the abdominal oesophagus.Between oesophageal veins draining into the azygos vein (systemic) and oesophageal veins of the left gastric vein (portal)
- 199What occurs when the veins in the abdominal oesophageal portosystemic anastomosis are dilated?Oesophageal varices
- 200Describe the portosystemic anastomosis that occurs in the rectum.Between inferior and middle rectal veins draining to the IVC (systemic) and the superior rectal vein draining to the IMV (portal)
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- Year 1 Anatomy & SF2 FlashCards sobre Abdomen continued, criado por Lou Clark em 02-10-2016.
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- Lou Clark
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