Anatomy- Abdomen Part 1

Front 1

Where is the transpyloric plane? (vert. level also)

Back 1

1. 1/2 way between jugular nutch and pubic symphysis
2. L1

Front 2

Where is the subcostal plane? (vert. level also)

Back 2

1. lowest part of the costal margin
2. L2

Front 3

At what level is the umbilical plane?

Back 3

L3

Front 4

Where is the transtubercular plane? (vert. level also)

Back 4

1. tubercles on the iliac crest
2. L4

Front 5

The abdomen is split into sections by what planes?

Back 5

1. transpyloric plane
2. subcostal plane
3. umbilical plane
4. transtubercular plane

Front 6

Clinically what do these regions refer to:
1. iliac region
2. hypogastrium
3. back of lumbar region, in angle between R12 and midline

Back 6

1. iliac fossa
2. suprapubic region
3. renal angle

Front 7

The foregut, midgut, and hindgut have their own arteries which are?

Back 7

1. coeliac
2. superior mesenteric
3. inferior mesenteric arteries

Front 8

The peritoneal cavity is divided into what?

Back 8

1. a main cavity or greater sac
2. omental bursa or lesser sac

Front 9

The omental bursa has an opening facing to the right called what?

Back 9

1. epiploic foramen (of Winslow)

Front 10

Where does the omental bursa lie?

Back 10

mainly behind the liver and the stomach

Front 11

Where does the lesser omentum extend?

Back 11

extends from the lesser curvature of the stomach to the liver

Front 12

Where does the upper recess of the omental bursa lie?

Back 12

1. posterior to the lesser omentum and the caudate lobe of the liver

Front 13

The greater omentum is what and what does it hang from?

Back 13

1. an apron of peritoneum, fat and blood vessels
2. hanging from the greater curvature of the stomach

Front 14

If you reflect the greater omentum what will you see embedded in its posterior surface?

Back 14

1. the transverse colon

Front 15

Describe the layers of the greater omentum and what they cover and where they run.

Back 15

1. a double layer of peritoneum
2. covering the front and back of the stomach
3. hanging down from the greater curvature and folded back on itself at the lower border

Front 16

What is the transverse mesocolon?

Back 16

the mesentery between the transverse colon and the posterior abdominal wall

Front 17

What is above the transverse mesocolon?

Back 17

the posterior wall of the lesser sac is formed by the "stomach bed"

Front 18

What are the left boundaries of the epiploic foramen?

Back 18

1. lienorenal ligament
2. gastrosplenic ligament

Front 19

What is the lienorenal ligament?

Back 19

ligament from the kidney to the spleen

Front 20

What is the gastrosplenic ligament?

Back 20

ligament from the spleen to the stomach

Front 21

Above the level of the spleen what replaces the lienorenal and gastrosplenic ligament?

Back 21

gastrophrenic ligament

Front 22

Below the level of the spleen what replaces the lienorenal and gastrosplenic ligament?

Back 22

left edge of the greater omentum

Front 23

The dorsal mesentery of the embryonic foregut is also called what?

Back 23

1. dorsal mesogastrium

Front 24

The gastrophrenic, gastrosplenic, and lienorenal ligaments are all parts of what?

Back 24

The same folded, double layered peritoneum (dorsal mesentery of the embryonic foregut)

Front 25

After rotation of the gut and return to the abdomen, both duodenum and pancreas (except for the tail end) become what? What are they refered to as when this happens?

Back 25

1. become fused to the dorsal abdominal wall
2. become retroperitoneal

Front 26

What does the ventral mesogastrium form?

Back 26

1. lesser omentum
2. falciform ligament
3. triangular ligament
4. coronary ligament

Front 27

The first part of the duodenum is attached to what? What is it in terms of mobility?

Back 27

1. lesser omentum
2. is mobile

Front 28

Aside from the first part of the duodenum, what is the rest considered?

Back 28

retroperitoneal

Front 29

What is the path of the second part of the duodenum?

Back 29

1. descends vertically down to L3

Front 30

What marks the junction between the foregut and midgut?

Back 30

1. the opening of the common bile duct into the duodenum

Front 31

What is the path of the 3rd part of the duodenum?

Back 31

1. crosses the midline horizontally

Front 32

What is the path of the 4th part of the duodenum?

Back 32

1. ascends to the left of midline to the level of L2

Front 33

Where is the head of the pancreas in relationship to the duodenum?

Back 33

1. enclosed in the C-shaped duodenum

Front 34

What does the 2nd part of the duodenum overlie?

Back 34

1. hilum of right kidney (renal pelvis and renal vessels)

Front 35

What does the tail of the pancreas cross over?

Back 35

1. the hilum of the left kidney

Front 36

Where are the renal glands in relation to the kidney? Where is the right one in relation to the inferior vena cava?

Back 36

1. adrenal glands sit on top of kidneys
2. right one is posterior to the inferior vena cava

Front 37

Where does the aorta lie in relation to the vert.? Where does the inferior vena cava lie in relation to the aorta?

Back 37

1. aorta lies midline in contact with the vert. bodies
2. inferior vena cava is to the right of the aorta

Front 38

What does the beginning of the transverse colon cross over? Once it crosses these structures what does it become suspended by?

Back 38

1. right kidney and 2nd part of the duodenum
2. transverse mesocolon

Front 39

Where does the spleen sit in relation to the kidneys? How does the pancreas attach to the spleen? What is the spleen enclosed by?

Back 39

1. spleen sits on upper lateral portion of the left kidney
2. tail of pancreas attaches to the spleen's hilum by the lienorenal ligament
3. spleen is enclosed by peritoneum

Front 40

Where does the coeliac artery arise? How many branches does it have?

Back 40

1. just above the upper border of the pancreas
2. immediately has 3 branches

Front 41

What are the 3 branches of the coeliac artery?

Back 41

1. left gastric artery
2. splenic artery
3. common hepatic artery

Front 42

What is the path of the left gastric artery from the coeliac artery?

Back 42

1. climbs toward the esophagus, turns anteriorly and inserts itself in the layers of the lesser omentum(giving out esophageal branches)
2. runs onto the lesser curvature of the stomach and anastomoses with the right gastric artery

Front 43

What is the path of the splenic artery from the coeliac artery? What are its branches?

Back 43

1. runs along the upper border of the pancreas into the lienorenal ligament and the hilum of the spleen
2. short gastric and left gastroepiploic arteries

Front 44

The common hepatic artery passes to the right from the coeliac artery and gives out what branches?

Back 44

1. proper hepatic artery
2. right gastric artery
3. gastroduodenal artery

Front 45

What is the path of the proper hepatic artery? What are its branches?

Back 45

1. turns superiorly into the free border of the lesser omentum and passes to the liver
2. right hepatic artery(gives rise to cystic artery, and left hepatic artery

Front 46

What is the path of the right gastric artery? What may it also arise from?

Back 46

1. passes to the lesser curvature of the stomach and anastomoses with the left gastric artery
2. may also arise from proper hepatic artery

Front 47

What is the path of the gastroduodenal artery? What does it divide into?

Back 47

1. runs to the 1st part of the duodenum and divides when it reaches its lower border
2. right gastroepiploic artery and the superior pancreaticoduodenal artery

Front 48

After branching off of what, the right gastroepiploic arteries follow what structure?

Back 48

1. branch from gastroduodenal artery
2. follow greater curvature of the stomach

Front 49

What does the superior pancreaticoduodenal artery branch off of? What is its path? What does it supply/anastomose with? Why is this a significant anastomoses?

Back 49

1. gastroduodenal artery
2. runs down between the pancreas and duodenum
3. supplies and anastomoses the inferior pancreaticoduodenal artery
4. significant anastomoses between foregut and midgut

Front 50

What does the inferior pancreaticoduodenal artery arise from?

Back 50

superior mesenteric artery

Front 51

Where does the superior mesenteric artery arise? What is its path?

Back 51

1. posterior to the pancreas
2. emerges at the lower border of this organ and crosses the third part of the duodenum

Front 52

The superior mesenteric artery and the abdominal aorta form a nutcracker by enclosing what structures?

Back 52

1. left renal vein
2. 3rd part of the duodenum

Front 53

The pancreas sends what posterior to the superior mesenteric artery?

Back 53

uccinate process

Front 54

Where does the superior mesenteric vein lie?

Back 54

1. to the right of the artery and passes posterior to the pancreas

Front 55

The superior mesenteric vein is joined by what? Where does this structure lie before joining the SMV?

Back 55

1. splenic vein
2. lies inferior to the splenic artery and thus posterior to the pancreas

Front 56

When the superior mesenteric vein and the splenic vein join what do they form and where does this structure lie?

Back 56

1. portal vein
2. lies posterior to the pancreas and the first part of the duodenum

Front 57

Explain the blood mixing of the splenic and superior mesenteric veins as they join to form the portal vein?

Back 57

1. there is little blood mixing when they join

Front 58

The right side of the portal vein receives blood from what and the left side receives blood from what?

Back 58

1. right- superior mesenteric vein
2. left- splenic and inferior mesenteric veins

Front 59

In the case of ingested liver poisons, their absorption from the small intestines leads to what?

Back 59

1. absorption from small intestines into tributaries of the superior mesenteric vein with results in a greater concentration of the poison in the right side of the liver (which will show toxic changes while the left may remain normal)

Front 60

Body as temple of the HS

Back 60

1Corinthians 6
19 Or do you not know that your body is a temple of the Holy Spirit within you, whom you have from God? You are not your own,

Front 61

What path does the portal vein take to reach the liver?

Back 61

1. travels in the free border of the lesser omentum, posterior to the hepatic artery

Front 62

What is the portal vein anterior to and what separates the two structures?

Back 62

1. anterior to the inferior vena cava
2. separated from it by the epiploic foramen

Front 63

Are there valves in the portal vein?

Back 63

NO

Front 64

What does the common bile duct lie within when it leaves the liver? What are its relationships at this point?

Back 64

1. lies within the free border of the lesser omentum
2. lies to the right of the hepatic artery and anterior to the portal vein

Front 65

Where does the common bile duct run and where does it open up? With what other structure does it open up?

Back 65

1. runs posterior to the first part of the duodenum and the head of the pancreas
2. opens into the second part of the duodenum
3. opens with the main pancreatic duct

Front 66

What nerves innervate the liver?

Back 66

1. sympathetic branches from the celiac plexus
2. hepatic branches from the anterior vagal and posterior vagal trunks

Front 67

How do the sympathetic branches reach the liver?

Back 67

1. from the celiac plexus they follow the hepatic arteries and the portal vein to the liver

Front 68

How do the hepatic branches from the anterior vagal and posterior vagal trunks reach the liver?

Back 68

1. run in the lesser omentum to reach the hepatic plexus

Front 69

The sympathetic and vagal fibers end on what structures related to the liver?

Back 69

1. gallbladder
2. extra and intrahepatic ducts

Front 70

What will a vagotomy lead to in relation to the gallbladder?

Back 70

1. will lead to enlargement of the gallbladder and slow its emptying

Front 71

What is the function and path of the visceral afferents in the context of innervation of the liver?

Back 71

1. sense pain
2. -join the celiac plexus, the the thoracic splanchnic nerves
-enter the spinal cord at levels T6-T9

Front 72

Where is pain from the gallbladder referred to?

Back 72

Referred to the region of ribs 6-9 extending to the inferior angle of the scapula on the right side

Front 73

The inferior mesenteric artery is hidden by what? Where does it emerge and what does it give branches to?

Back 73

1. hidden by 3rd part of duodenum
2. emerges inferior to it
3. gives off branches for the supply of the hindgut

Front 74

Where do the testicular or ovarian arteries emerge?

Back 74

posterior to the duodenum

Front 75

Where do the inferior phrenic arteries emerge? Where does the right one lie?

Back 75

1. emerge superior to the coeliac artery
2. right one lies posterior to the inferior vena cava

Front 76

Where does the inferior mesenteric artery run? What does it join?

Back 76

1. leaves the left side of the IMA, running superiorly and alongside the fourth part of the duodenum, posterior to the pancreas
2. joins the splenic vein

Front 77

What makes up the stomach bed?

Back 77

1. omental bursa
2. pancreas
3. upper part of the left kidney and the suprarenal gland
4. coeliac artery and coeliac ganglia
5. spleen

Front 78

What veins anastomose on the esophagus?

Back 78

1. esophageal veins form the left gastric veins and the esophageal branches of the azygos veins

Front 79

What is the name for the anastomoses of veins on the esophagus? What can happen to them in disorders such as esophageal varices?

Back 79

1. form a portal-systemic anastomoses
2. may become swollen in portal obstruction and bleed (esophageal varicies)

Front 80

Where is the anastomoses of esophageal veins located?

Back 80

1. near the cardiac orifice of the stomach

Front 81

What are the parts of the stomach?

Back 81

1. fundus
2. body
3. pylorus

Front 82

What level does the fundus of the stomach rise to?

Back 82

1. 5th intercostal space

Front 83

What innervates the stomach?

Back 83

1. vagal fibers
2. sympathetic branches from the celiac plexus, which receives fibers from the greater splanchnic nerve, T6-9

Front 84

What arteries supply the greater omentum?

Back 84

right and left gastroepiploic arteries

Front 85

What is the function of the greater omentum?

Back 85

1. policeman of the abdomen
2. forms adhesions in case of inflammation, sealing off the danger area and preventing generalized peritonitis

Front 86

What is the liver divided into? What is also contained on the right side?

Back 86

1. right and left lobe
2. caudate lobe and quadrate lobe

Front 87

Where is the lesser omentum attached to the liver?

Back 87

at the fissure for the ligamentum venosum

Front 88

What is the ligamentum venosum?

Back 88

a remnant of the ductus venosus which connects the left branch of the portal vein to the inferior vena cava

Front 89

Where is the inferior vena cava in relation to the liver on its path to where? What is the IVC considered at this point in relation to the peritoneum?

Back 89

1. it is deeply embedded in the liver
2. before passing through the central tendon of the diaphragm
3. considered retroperitoneal

Front 90

What is the function of the gallbladder and where does it lie?

Back 90

1. reservoir for bile
2. lies in a groove under the liver

Front 91

How does the gallbladder join the hepatic ducts from the liver and what do they all form?

Back 91

1. has a cystic duct that joins with the common hepatic duct
2. all form the common bile duct

Front 92

What supplies blood to the gallbladder and what does this vessel branch from?

Back 92

1. cystic artery
2. comes from the right branch of the hepatic artery

Front 93

What supplies blood to the pancreas?

Back 93

1. splenic artery and its branch called the greater pancreatic artery

Front 94

The main pancreatic ducts opens with the common bile duct into what (specific structure)? This structure is closed by what?

Back 94

1. ampulla of Vater
2. sphincter of Oddi

Front 95

What innervates the pancreas?

Back 95

1. celiac and superior mesenteric plexuses

Front 96

Where is pain in the pancreas referred to?

Back 96

referred to T6-10 dermatomes

Front 97

Where does the spleen lie in relation to ribs and what does this mean for its anterior aspect?

Back 97

1. lays opposite ribs 9-11
2. has notches on its anterior aspect due to the ribs

Front 98

What type of innervation is present in the spleen?

Back 98

purely sympathetic

Front 99

What causes caput medusae?

Back 99

enlargement of the paraumbilical veins running with the ligamentum teres and uniting portal veins with veins of the anterior abdominal wall

Front 100

What are the areas of portal systemic anastomoses?

Back 100

1. esophageal
2. paraumbilical veins
3. in the anal canal
4. in the region of the bare area of the liver by the diaphragm

Front 101

What veins anastomose near the bare area of the liver?

Back 101

1. anastomoses between small veins of the portal system and veins of the diaphragm or of the posterior abdominal wall