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91 Cards in this Set
- Front
- Back
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From the liver where does the falciform ligament attach?
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along the anterior abdominal wall to the umbilicus
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Where does most water reabsorption occur in the GI tract?
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ascending colon
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What forms the portal vein?
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the merger of the superior mesenteric v and splenic v
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What muscle at the pharyngeal esophogeal junction causes cervical constriction of the esophagus?
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cricopharyngeus
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What causes the constriction in the mid esophagus?
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The left main bronchus and the arch of the aorta cross the esophagus and can impinge it
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In the superior third of the esophagus what type of muscle is present? What about the middle and lower?
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1) voluntary striated muscle
2) mixed in middle 3) smooth muscle |
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What diaphragmatic crus does the esophagus pass through? What vertebral level? What side of mid-line?
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right crus at T10 slightly to left
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Where does the esophagus terminate? What rib and vertebral level?
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Ends in cardial orifice of stomach at 7th costal cartilage and T11
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Where is the esophageal nerve plexus located?
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lower esophagus
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What ligament is attached to the esophageal hiatus in diaphragm and the esophagus? what is its function?
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phrenicoesophageal ligament allows independent movement of diaphragm and esophagus during respiration and swallowing
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What covers the anterior esophagus?
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peritoneum of greater sac
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What organ does the esophagus have a groove on in the abdominal cavity?
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the posterior surface (visceral) of liver
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What covers the posterior surface of the esophagus?
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peritoneum for omental bursa
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Where is the esophagogastric junction?
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T11 at tip of xiphoid process
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Where is the Z-line?
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at the esophagogastric junction where the stratified squamous epithelium transitions to gastric mucosa
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What arteries supplies the abdominal esophagus? Where do these arteries branch from?
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1) the left gastric from celiac.
2) left inferior phrenic artery |
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Where do the submucosal veins drain form the inferior esophagus?
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via the left gastric vein to the portal system and into the systemic system via esophageal veins entering the azygous veins
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A person with lower esophageal cancer will have metastisis to what lymph nodes?
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left gastric nodes to the celiac nodes
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What forms the lower esophageal plexus?
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Vagus nerves and greater splanchnic nerves
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How many liters of food is the stomach capable of holding?
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2-3 liters
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In the supine position what quadrants does the stomach primarily lie in?
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In the right and left or in the epigastric, umibilical, and left hypochondrium
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In the supine position where does the cardial orifice lie?
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the 6th left costal cartilage at T11
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In the supine position where does the fundus lie?
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posterior to 6th left rib in MCL
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What level is the transpyloric plane? What part of stomach is at this point?
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At L1 is the pylorus
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A puncture at the level of the 8th costal cartilage on the rectus abdominus would hit what?
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The pylorus
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When a person is standing what vertebral levels does the pylorus fluctuate in?
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T2-4
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Where is the angular insicure of the stomach?
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inferior portion of lesser curvature at junction of body and pylorus
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What rib level marks the beginning of the greater curvature of the stomach?
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begins at the 5th intercostal space and passes to level of 9th or 10th intercostal space
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What color is normal gastric mucosa? Where is this not true?
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the gastric mucosa is reddish brown but is pink in the pylorus
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When the 2 layers of the lesser omentum wrap the stomach what do they become?
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the greater omentum at greater curvature of stomach
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What is the stomach related to anteriorly?
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the diaphragm, left lobe of liver, and anterior abdominal wall
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What is the stomach related to posteriorly?
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The pancreas and omental bursa
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What forms most of the anterior wall of the omental bursa?
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the posterior surface of the stomach
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What is related to the stomach inferiorly?
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transverse colon
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Where does all of the arterial to the stomach branch from?
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the celiac trunk
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What do surgeons use a mark to identify the pylorus?
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the prepyloric vein which ascends to the right gastric vein
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where do the right and left gastric veins to?
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the hepatic portal vein
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where do short gastric and left gastro-omental veins drain?
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The splenic vein
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Where does the right gastro-omental vein drain?
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the SMV
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What lymph nodes are on the stomach?
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the gastric and gastro-omental which drain to celiac nodes
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Cancer in the superior 2/3 of the stomach will metastisize to what lymph nodes?
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the gastric nodes.
Note: the fundus and superior body can drain to pancreaticosplenic nodes |
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Lymph from the right inferior 1/3 of the stomach drains to what?
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right gastro-omental nodes to pyloric nodes
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Lymph from the left inferior 1/3 of the stomach (greater curvature) drains to what?
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pancreaticoduodenal nodes
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Where does the anterior vagal nerve run?
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as a single branch toward lesser curvature of stomach where it gives off hepatic and duodenal branches?
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How does the vagal nerve get to the liver and gall bladder?
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via the hepatoduodenal ligament
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Does the right or left vagal nerve run on the anterior part of the stomach?
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the left is anterior and the right is posterior
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What does the posterior vagal branch give rise to?
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supplies parts of anterior and posterior surfaces of stomach then gives off branch to celiac plexus and later gives off posterior gastric branches
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What is the sympthatetic supply to the stomach? via what nerve?
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T6-9 via the greater splanchnic
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What does the celiac trunk give rise to?
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common hepatic, left gastric and splenic a.
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Is the left gastric a. peritoneal or retroperitoneal? what does it supply?
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1) retro.
2) supplies the distal esophagus and lesser curvature. anastomosis with right gastric |
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Is the splenic a. peritoneal or retroperitoneal? what ligament does it run through? what does it supply?
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1) retro
2) splenorenal ligament 3) body of pancreas, spleen, greater curvature and posterior body of stomach |
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What is the relation of the pancreas to the splenic a.?
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artery is on superior border of pancreas
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Where does the posterior gastric arise? Is it retroperitoneal or peritoneal? What ligament does it enter?
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1) splenic a.
2) retroperitoneal 3) gastrophrenic ligament |
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Where does the left gastro-omental come from? What ligament does it run in?
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1) splenic a.
2) runs in gastrosplenic ligament to anastomose with rt gastro-omental ligament 3) |
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Where do the short gastric a. arise? what do they supply? what ligament do they run in?
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1) the splenic a.
2) fundus of stomach 3) gastrosplenic ligament |
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Where does the hepatic a. arise? What ligament does it run through and how does it get there?
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1) from common hepatic when it gives rise to right gastro-omental a.
2) passes retroperitoneally to reach hepatoduodenal ligament |
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What arteries does the common hepatic artery give rise to?
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the hepatic a., gastroduodenal a.
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where does the cystic a. branch from? Within what ligament? With in what triangle?
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1) right hepatic a.
2) hepatoduodenal lig 3) triangle of Calot |
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The gastroduodenal artery is a branch of what? Is it posterior or anterior to gastroduodenal junction? Is it retroperitoneal?
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1) common hepatic artery
2) posterior 3) runs retroperitoneal |
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What does the gastroduodenal a. give rise to?
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superior pancreaticoduodenal a. and the right gastro-omental a.
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What is another name for the gastro-omental artery?
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gastroepiploic a.
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What ligament does the right gastroepiploic a. run in?
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the greater omentum to anastomose with left gastroepiploic
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What artery bifurcates around the pancreatic head to anastomose with other arteries? What is it a branch from? What does it supply?
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1) superior pancreaticoduodenal
a. 2) gastroduodenal a. from hepatic a. 3) proximal duodenum and superior part of pancreatic head |
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Where does the inferior pancreaticoduodenal a. arise? What does it supply? where does it terminate?
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1) SMA
2) distal duodenum and pancreatic head 3) runs anteriorly and posteriorly around pancreatic head to anastomose with superior pancreaticoduodenal a. |
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At what vertebral level is the duodenojejunal junction?
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L2 just left of midline
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Is the duodenum peritonal or retroperitoneal?
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both
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Where is the first part of the duodenum located?
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the superior part is at the body of L1
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What vertebral levels does the descending part of the duodenum lie at?
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L1-L3
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What vertebral level is the inferior or 3rd part of duodenum at?
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L3
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The ascending duodenum begins where rises to what level?
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begins at L3 and ends at L2
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What is the first part of the superior duodenum called?
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the ampulla (duodenal cap)
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What part of the superior duodenum is retroperitoneal?
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distal 3 cm
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What organs overlap the superior portion of the duodenum?
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the liver and gallbladder
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A lesion at the proximal part of the duodenum risks damage to what ligament?
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hepatoduodenal
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An ulcer on the posteromedial wall of the duodenum could jeopardize what structures?
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bile and main pancreatic duct
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The descending duodenum is considered ____?
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retroperitoneal
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The inferior duodenum passes over the IVC at what vertebral level?
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L3
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What vessels pass anterior to the inferior part of the duodenum?
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SMA and SMV
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What is superior to the inferior part of the duodenum?
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pancreatic head and uncinate process
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An ulcer on the posteromedial wall of the duodenum could jeopardize what structures?
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bile and main pancreatic duct
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The descending duodenum is considered ____?
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retroperitoneal
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The inferior duodenum passes over the IVC at what vertebral level?
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L3
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What vessels pass anterior to the inferior part of the duodenum?
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SMA and SMV
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What is superior to the inferior part of the duodenum?
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pancreatic head and uncinate process
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List all the structures that are posterior to the inferior part of the duodenum?
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IVC, aorta, right psoas major, right testicular and ovarian vessels
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What is the function of the ligament of Treitz? Where does it originate?
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1) support the duodenojejunal flexure and widen it to ease food through
2) contains muscle from diaphragm where it attaches and SMC from duodenum |
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What artery supplies the duodenum proximal to the entry of the bile duct? distal to it? Where do the arteries lie?
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1) superior pancreaticoduodenal a.
2) inferior pancreaticoduodenal a. 3) between head of pancreas and duodenum |
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Do the veins of the duodenum drain to the SMV or the IVC?
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SMV
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The anterior lymph vessels of the duodenum drain to what?
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pancreaticoduodenal lymph nodes which drain to the pyloric lymph nodes
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Where do the posterior lymphatic vessels of the duodenum drain?
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to the superior mesenteric lymph nodes which go to the celiac nodes
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Which nerves supply both parasymp and sympathetic stim?
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vagus and greater and lesser splanchnic
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