[Anatomy] Abdominal Contents

Front 1

abdominal cavity

Back 1

space bounded by the abdominal wall; separated from thoracic cavity by diaphragm; continuous with pelvic cavity inferiorly (“abdominopelvic cavity”)

Front 2

peritoneum

Back 2

serous membrane that lines the walls and organs of the abdominal cavity; two continuous parts: parietal and visceral peritoneum

Front 3

parietal peritoneum

Back 3

lines the internal aspect of the abdominopelvic wall; sensory innervation via nerves of the abdominal wall; pain tends to be acute (can be localized)

Front 4

visceral peritoneum

Back 4

invests the organs; lacks innervation

Front 5

peritoneal cavity

Back 5

potential space between the parietal and visceral peritoneum; contains thin layer of fluid that keeps surfaces moist and lubricated; does not contain organs

Front 6

ascites

Back 6

excess fluid in the peritoneal cavity; can be caused by infections, metastasis of cancer cells, and perforations of the GI tract

Front 7

peritoneal cavity - males vs. females

Back 7

closed in males; open in females, as there is a communication with the outside world via the uterine tubes, uterus, and vagina

Front 8

retroperitoneal space

Back 8

located between the parietal peritoneum and the muscles of the abdominal wall; contains fat, vessels (e.g. abdominal aorta, IVC) and some organs (e.g., kidneys; primarily retroperitoneal organs)

Front 9

ontogeny of gut tube

Back 9

as the abdominal organs develop from the embryonic gut tube, they become invested in visceral peritoneum; form intraperitoneal organs aand secondarily retroperitoneal organs

Front 10

intraperitoneal organs

Back 10

completely enclosed by the visceral peritoneum; these organs are mobile (e.g., stomach)

Front 11

primarily retroperitoneal

Back 11

organs occupying the retroperitoneal space

Front 12

secondarily retroperitoneal

Back 12

entirely enclosed by visceral peritoneum early in development, but came to be pushed up against the posterior abdominal wall, losing their mobility (e.g., ascending colon)

Front 13

messenteries (aka ligaments)

Back 13

two layers of peritoneum that suspend an intraperitoneal organ from the body wall or another organ; nerves and vessels travel between the two layers to reach the organs

Front 14

omenta

Back 14

mesenteries associated with the stomach; greater and lesser

Front 15

greater omentum

Back 15

extends from the greater curvature of stomach and proximal duodenum; forms adhesions to wall off inflamed organs, protecting adjacent viscera

Front 16

lesser omentum

Back 16

extends from lesser curvature of stomach/proximal duodenum to the liver; composed of hepatogastric ligament and the hepatoduodenal ligament

Front 17

hepatogastric ligament

Back 17

between stomach and liver

Front 18

hepatoduodenal ligament

Back 18

between duodenum and liver; contains the portal triad

Front 19

portal triad

Back 19

contains portal vein, proper hepatic artery, bile duct ; found in hepatoduodenal ligament of lesser omentum

Front 20

greater sac

Back 20

larger sac of peritoneal cavity that extends from diaphragm to pelvic region

Front 21

lesser sac

Back 21

aka omental bursa; smaller sac that is posterior to the stomach and lesser omentum

Front 22

omental foramen

Back 22

aka epiploic foramen; opening deep to the hepatoduodenal ligament that allows for communication between the greater and lesser sacs

Front 23

divisions of gut tube

Back 23

foregut, midgut, hindgut; organs derived from the same division share a common blood supply and route of venous and lymphatic drainage

Front 24

foregut derivatives

Back 24

pharynx, esophagus, stomach, proximal duodenum, liver, gallbladder, pancreas

Front 25

foregut blood supply

Back 25

celiac trunk

Front 26

foregut venous drainage

Back 26

gastric veins, splenic vein

Front 27

foregut lymphatics

Back 27

celiac lymph nodes

Front 28

esophagus

Back 28

primarily a thoracic organ; passes through esophageal hiatus of diaphragm (T10); abdominal portion is intraperitoneal and only 1-1.5 cm long

Front 29

acid reflux

Back 29

regurgitation of stomach contents into the thoracic esophagus; prevented by the contraction of the diaphragm (functions as sphincter)

Front 30

hiatal hernias

Back 30

hernias of abdominal esophagus and proximal stomach through the esophageal hiatus, into the thoracic cavity.

Front 31

stomach

Back 31

intraperitoneal; typically located in the left upper quadrant, occupying transpyloric plane; highly variable in shape and distribution; parts: lesser/greater curvature, cardia, fundus, body, pyloric portion, rugae

Front 32

lesser curvature

Back 32

superior concave margin; associated with lesser omentum

Front 33

greater curvature

Back 33

inferior convex margin; associated with greater omentum

Front 34

cardia

Back 34

narrow proximal region

Front 35

fundus

Back 35

dome of the stomach; located inferior to left dome of the diaphragm; distinguishable in x-rays due to typical presence of a radiolucent gas bubble

Front 36

pyloric portion

Back 36

wide pyloric antrum; narrow pyloric canal; muscular pyloric sphincter

Front 37

pyloric sphincter

Back 37

located at the L1 vertebral level (transpyloric plane); circular smooth muscle; controls release of stomach contents into duodenum

Front 38

rugae

Back 38

internal folds of gastric mucosa

Front 39

gastric ulcers

Back 39

the mucosal lining of the stomach becomes eroded; usually treated with antibiotics; treatments also include vagotomies

Front 40

proximal duodenum

Back 40

located in the right upper quadrant; four parts

Front 41

superior (1st) part of duodenum

Back 41

intraperitoneal (associated with hepatoduodenal ligament); lies on the transpyloric plane (L1)

Front 42

descending (2nd) part of duodenum (include location)

Back 42

secondarily retroperitoneal; runs parallel to (and just to the right of) IVC; curves around head of pancreas; contains major/minor duodenal papilla

Front 43

major duodenal papilla

Back 43

found in descending (2nd) part of duodenum; contains opening of the hepatopancreatic ampulla

Front 44

hepatopancreatic ampulla

Back 44

fused bile duct and main pancreatic duct; opening found in major duodenal papilla of 2nd part of duodenum

Front 45

minor duodenal papilla

Back 45

located superior to the major papilla in 2nd duodenum; associated with accessory pancreatic duct

Front 46

pancreas

Back 46

secondarily retroperitoneal; located in right upper and left upper quadrants; located posterior to stomach, between duodenum on right and spleen on left; contains head (surrounded by 2nd part of the duodenum), body, tail (in contact with hilum of the spleen), pancreatic duct, accessory pancreatic duct

Front 47

pancreatic duct

Back 47

courses from the tail to the head of the pancreas; smooth muscle sphincter of the pancreatic duct; merges with bile duct to form hepatopancreatic ampulla (>2nd duodenum)

Front 48

liver

Back 48

intraperitoneal; covered with peritoneum except at bare area, adjacent to diaphragm; located mostly in right upper quadrant, deep to ribs 7-11; extends partially into left upper quadrant; located just inferior to the diaphragm; has falciform and hepatoduodenal ligament

Front 49

falciform ligament

Back 49

attaches liver to the anterior abdominal wall; round ligament of liver found in inferior margin

Front 50

lobes of liver

Back 50

right lobe, left lobe, caudate lobe, quadrate lobe (C & Q seen in posterior view only)

Front 51

segments of liver

Back 51

8 Segments; each supplied by a branch of the left or right hepatic artery and portal vein; each drained by a branch of the left or right hepatic duct; hepatic veins lie intersegmentally, eventually draining into the IVC

Front 52

bile duct pathways

Back 52

left and right hepatic ducts > common hepatic duct > cystic duct > bile duct

bile duct > pancreatic duct > hepatoduodenal ampulla > major duodenal papilla

Front 53

gallbladder

Back 53

located in the right upper quadrant; store bile when bile duct sphincter

Front 54

bare area of liver

Back 54

part of liver uncovered by peritoneum, adjacent to diaphragm

Front 55

bile duct sphincter

Back 55

bile duct has a smooth muscle sphincter associated with it; when contracted, this sphincter forces the bile back into the cystic duct and gallbladder, where it is stored

Front 56

spleen

Back 56

intraperitoneal; located in the left upper quadrant, deep to ribs 9-11; typically the size of a fist; lies just inferior to the diaphragm and is in close proximity to the left kidney, tail of the pancreas, and stomach

Front 57

splenomegaly

Back 57

enlargement of the spleen due to disease; can result in the spleen being palpable inferior to the left costal margin

Front 58

hilium

Back 58

where vessels/nerves enter/exit the spleen; tail of pancreas is in contact with hilum

Front 59

abdominal aorta

Back 59

extends from the aortic hiatus of diaphragm (T12) to its bifurcation into left and right common iliac arteries (L4)

Front 60

paired branches of abdominal aorta

Back 60

supply primarily retroperitoneal organs (e.g., kidneys, suprarenal glands) and gonads

Front 61

unpaired branches of abdominal aorta

Back 61

supply the abdominal organs; celiac trunk (T12); superior mesenteric artery (SMA, L1); inferior mesenteric artery (IMA, L3)

Front 62

celiac trunk branches

Back 62

supply foregut derivatives and spleen; 3 branches emerge immediately: left gastric artery, splenic artery, common hepatic artery

Front 63

left gastric artery

Back 63

branch of celiac trunk; courses along lesser curvature (in lesser omentum); feeds to esophageal arteries

Front 64

splenic artery

Back 64

branches off celiac trunk; tortuous course posterior to the body and tail of the pancreas; splits into short gastric arteries and left gastro-omental artery (courses along greater curvature in greater omentum)

Front 65

common hepatic artery

Back 65

branches off celiac trunk; splits into proper hepatic and gastroduodenal artery

Front 66

proper hepatic artery

Back 66

branches from common hepatic artery; courses in hepatoduodenal ligament; part of portal triad; splits into right gastric artery and right and left hepatic arteries

Front 67

right gastric artery

Back 67

branches from proper hepatic artery; courses along lesser curvature (in lesser omentum); anastomoses with left gastric artery

Front 68

right and left hepatic arteries

Back 68

branches from proper hepatic artery; terminal branches of proper hepatic artery that supply the liver; cystic artery usually arises from the right hepatic a.

Front 69

gastroduodenal artery

Back 69

branches from common hepatic artery; courses posterior to the 1st duodenum; branches into right gastro-omental artery and anterior and posterior superior pancreaticoduodenal arteries
(which anastomose with APIPA)

Front 70

right gastro-omental artery

Back 70

branches from gastroduodenal artery; courses along greater curvature (in greater omentum); anastomoses with left gastro-omental artery

Front 71

left gastro-omental artery

Back 71

branches from splenic artery; courses along greater curvature (in greater omentum); anastamoses with right gastro-omental

Front 72

caval (systemic) system of abdomen

Back 72

these veins drain structures in the retroperitoneal space, parallel to the paired branches of the aorta, and drain into the inferior vena cava (IVC)

Front 73

portal system

Back 73

has three main tributaries:
splenic vein, superior mesenteric vein, inferior mesenteric vein; oxygen poor/nutrient rich blood from the abdominal organs eventually drains into the portal vein, which enters the liver; liver detoxifies /processes the blood, which then empties into the IVC via the hepatic veins (part of the caval system of veins);

Front 74

what are portal-caval anastomoses?

Back 74

portal system vessels have no valves so can flow either direction; anastomoses between portal and caval vessels provide alternative routes for venous circulation if blood flow through the liver is obstructed (portal hypertension)

Front 75

areas of portal-caval anastomoses (4)

Back 75

umbilicus; distal esophagus; colon (ascending/descending); rectum / Anus

Front 76

portal-caval anastomoses around the distal esophagus

Back 76

esophageal veins drain into either the azygos system (caval) or left gastric vein (portal); dilated esophageal varices can rupture, resulting in potentially fatal bleeding

Front 77

portal system in foregut

Back 77

there is no ‘celiac vein’ but otherwise, the veins course alongside and share the names of the arteries

Front 78

portal vein

Back 78

part of portal triad that courses in hepatoduodenal ligament; tributaries: cystic veins, R/L gastric veins, splenic vein (short gastric veins, L gastro-omental vein), superior mesenteric vein (R gastro-omental vein, APSPV)

Front 79

fetal circulation in abdomen

Back 79

oxygen rich blood enters the fetus via the umbilical vein;
oxygen rich blood then bypasses the liver via the ductus venosus; oxygen poor blood leaves the fetus via the umbilical arteries

Front 80

foregut lymphatics

Back 80

lymph drains to the celiac lymph nodes; lymph then travels to the chyle cistern, and onto the thoracic duct

Front 81

foregut parasympathetic innervation

Back 81

Preganglionic cell bodies: brain (CN X); Preganglionic fibers: vagus nn. ; Postganglionic cell bodies and fibers: walls of organs

Front 82

foregut sympathetic innervation

Back 82

Preganglionic CB: lateral horn of the thoracic spinal cord; Preganglionic fibers: ventral root > spinal nerve > white ramus communicans > sympathetic trunk > greater splanchnic nerve (T5-T9); postganglionic CB: celiac ganglion; postganglionic fibers: follow arterial branches to their organ targets

Front 83

foregut visceral pain innervation

Back 83

follow the sympathetic pathways back to the spinal cord; foregut visceral pain is typically referred to the area at and inferior to the costal margin

Front 84

round ligament of liver

Back 84

adult remnant of umbilical vein; found in the inferior margin of the falciform ligament

Front 85

medial umbilical ligaments

Back 85

adult remnants of umbilical arteries