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310 Cards in this Set
- Front
- Back
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What are the boundaries of the abdominal cavity?
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diaphragm, pelvic brim, vertebrae, discs, paravertebral musculature, thoracolumbar fascia
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What lines divide the abdomen into 9 regions?
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R/L midclavicular lines, subcostal plane, intertubercular plane
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In general, what are the layers of the abdominal cavity from superficial to deep?
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skin, superficial superficial fascia, superficial deep fascia, (deep investing fascia, muscle) x3, endoabdominal fascia/transversalis fascia, extraperitoneal fascia, parietal peritoneum
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The pyramidalis is located (anterior/posterior) to rectus abdominus (when present).
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anterior
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What is the function of the anterolateral wall muscles when the glottis is open? When the glottis is closed?
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pushes superiorly on diaphragm to assist with forcible expiration, assists in evacuating pelvic organs
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Hyperpigmentation of the _____ _____ may occur during the 2nd trimester of pregnancy. What is this called?
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Linea Alba, linea nigra
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What is the innervation of the external oblique? Internal oblique? transversus abdominus?
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Anterior primary rami of T7-T12 & L1
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What innervates rectus abdominus?
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Anterior primary rami of T7-T12
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What is the function of the oblique muscles?
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flexes trunk, rotate trunk, compress and support abdominal viscera
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What is the function of the transversus abdominus?
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compresses and supports abdominal viscera
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What is the function of the rectus abdominus?
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flexes trunk, small contribution to compressing and supporting abdominal viscera
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Where is the neurovascular plane within the anterolateral wall muscles?
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between the internal oblique and the transversus abdominus
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What nerves run in the neurovascular plane of the anterolateral abdominal wall?
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anterior primary rami of T7-T11 (thoracoabdominal nn), subcostal n, iliohypogastric n, ilioinguinal n
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What vascular structures run in the neurovascular plane within the anterolateral abdominal wall?
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T10-T11 intercostal aa & vv, subcostal a & v, lumbar aa & vv, deep circumflex iliac aa & vv
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Where is the extraperitoneal fat located?
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between the transversalis/endoabdominal fascia and the parietal peritoneum
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The parietal peritoneum is richly innervated with _______ traveling in ________________________.
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GSAs, anterior primary rami of segmental spinal nerves
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What sensations to the GSAs of the parietal peritoneum convey?
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irritation and pain (easily localizable)
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Where does the posterior portion of the rectus sheath end?
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arcuate line
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What is the anterior rectus sheath composed of (superior portion)?
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aponeuroses of EAO and anterior 1/2 of the IAO
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What is the posterior rectus sheath composed of (inferiorly)?
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transversalis fascia, extraperitoneal fascia, parietal peritoneum
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The superior and inferior epigastric vessels are ensheathed within...
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the rectus sheath (posteriorly)
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What is the significance of the semilunar line?
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Where anterior and posterior rectus sheath aponeuroses fuse
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What does the median peritoneal fold contain?
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some tributaries of paraumbilical venous network, median umbilical ligament (remnant of the urachus)
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What do the medial peritoneal folds contain?
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medial umbilical ligaments (remnants of umbilical arteries)
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What do the lateral peritoneal folds contain?
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inferior epigastric arteries and veins
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What are the borders of the medial inguinal fossae?
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semilunar line, inferior epigastric vessels, inguinal ligament
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Which type of hernias occur in the medial inguinal fossa?
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direct inguinal hernias
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Where are the lateral inguinal fossae located?
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lateral to the lateral peritoneal folds
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Which type of hernias occur in the lateral inguinal fossa?
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indirect inguinal hernias
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What innervates quadratus lumborum?
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anterior primary rami of T12, L1-L4
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What is the action of quadratus lumborum?
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B- stabilize 12th rib during inspiration, flexes lumbar spine
U- lateral flexion of VC |
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What innervates psoas major?
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lumbar nerve plexus via anterior primary rami of L2-L4
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What is the action of psoas major?
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with trunk fixed- flexes femur
with thigh fixed- U: lateral flexion of VC B: tilt trunk anteriorly |
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What innervates iliacus?
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femoral nerve arising from anterior primary rami of L2-L4
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What is the action of iliacus?
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flexes femur and flexes trunk at hip, stabilizes hip joint
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Where does the iliopsoas insert?
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lesser trochanter
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What covers the quadratus lumborum anteriorly?
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anterior layer of thoracolumbar fascia
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The anterior layer of the thoracolumbar fascia represents the _________ boundary of the ___________ cavity.
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posterior, retroperitoneal
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From what does the superior epigastric artery arise?
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internal thoracic artery
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What does the superior epigastric artery supply?
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rectus abdominus and superior part of anterolateral wall
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From what does the inferior epigastric artery arise?
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external iliac artery
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What does the inferior epigastric artery supply?
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rectus abdominus and medial part of anterolateral abdominal wall
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Where do the superior and inferior epigastric arteries anastomose?
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umbilical region
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From what does the musculophrenic artery arise? What does it supply?
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internal thoracic artery, supplies numerous branches in anterior abdominal wall and diaphragm
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From what do the posterior intercostal, subcostal, and lumbar arteries arise? What do they supply?
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aorta, enter neurovascular plane to segmentally supply anterior abdominal wall
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From what does the deep circumflex iliac artery arise? What does it supply? With what does it anastomose?
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external iliac artery, supplies deep inguinal region, inferior intercostal arteries
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From what does the superficial epigastric artery arise? What do they supply? With what do they anastomose?
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femoral artery, superficial inguinal region, inferior intercostal arteries
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What do the thyroepigastric veins link?
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link femoral v and superficial epigastric v of the inguinal region with the lateral thoracic v and the axillary v
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What does the paraumbilical venous network link?
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hepatic portal vein, inferior epigastric vein, superior epigastric vein
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An enlarged paraumbilical anastomoses due to portal hypertension is known as...
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caput medusa
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The superficial supraumbilical region drains lymphatically to which nodes?
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axillary
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The superficial infraumbilical region drains lymphatically to which nodes?
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superficial inguinal nodes
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To where do the deep lymphatic vessels drain?
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lateral aortic nodes, external iliac nodes
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The thoracoabdominal nn contain GSEs to? GSAs from?
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anterior abdominal mm & rectus abdominus skeletal mm. from skin of anterior abdomen and perimeter of diaphragm, from underlying parietal peritoneum
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The subcostal n contains GSEs to? GSAs from?
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inferior EAO. from skin over ASIS and skin over hip, from underlying parietal peritoneum
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The iliohypogastric branch contains GSEs to? GSAs from?
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IAO & TA. from skin of hypogastric region, skin over iliac crest, IAO and TA, from underlying parietal peritoneum
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The ilioinguinal branch contains GSEs to? GSAs from?
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IAO and TA. from skin of anterior scrotum or labia majora, mons pubis and adjacent superior medial thigh
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The genitofemoral n contains GSEs to? GSAs from?
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femoral branch doesn't carry GSEs, genital branch to cremaster muscle. femoral branch from skin of anterior thigh, genital branch from skin of anterior scrotum or labia majora, mons pubis
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The lateral femoral cutaneous n contains GSAs from?
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skin of lateral thigh
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All abdominal wall nerves contain _________________________. No abdominal wall nerves contain _________________________.
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sympathetic postganglionic GVEs, parasympathetic GVEs
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The pathways of the cremasteric reflex are carried by what nerves?
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GSAs by ilioinguinal n, GSEs by genital brach of genitofemoral n.
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The epigastric region can have referred pain from...
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distal esophagus, stomach, duodenum
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The hypochondriac region can have referred pain from...
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L- stomach, spleen
R- late gall bladder |
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The interscapular area can have referred pain from...
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stomach
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The R shoulder can have referred pain from...
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duodenum
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The periumbilical region can have referred pain from...
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jejunum and ilium, early appendix
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The inferior epigastric region can have referred pain from...
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pancreas
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The flanks can have referred pain from...
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superior- spleen
entire- kidneys/ureters |
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The hypogastric region can have referred pain from...
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proximal large intestine
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The L lower quadrant can have referred pain from...
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distal large intestine
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The R lower quadrant can have referred pain from...
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late appendix
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The genitals and inguinal region can have referred pain from...
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kidneys/ureters
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What organs can be found in the RUQ?
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R kidney, R suprarenal gland, R lobe of liver, gallbladder, head of pancreas, distal portions of stomach, proximal small intestine, portions of large intestine
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What organs can be found in the LUQ?
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L kidney, L suprarenal gland, L lobe of liver, spleen, body and tail of pancreas, most of stomach, portions of small intestine, portions of large intestine
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What organs can be found in the RLQ?
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portions of small intestine, proximal portions of large intestine, vermiform appendix, abdominal part of R ureter, urinary bladder (when very full), R ovary, R uterine tube, uterus (in pregnancy), abdominal part of R spermatic cord
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What organs can be found in the LLQ?
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much of small intestine, distal portion of large intestine, abdominal part of L ureter, urinary bladder (when very full), L ovary, L uterine tube, uterus (in pregnancy), abdominal part of L spermatic cord
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What forms the medial boundary of the femoral ring?
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lacunar ligament
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The inguinal ligament passes from ______ to _______.
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ASIS, pubic tubercle
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The pectineal ligament is the __________ border of the femoral canal
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posterior
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The deep inguinal ring is an oval opening in the _________ fascia.
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transversalis
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Where is the superficial inguinal ring located in relation to the pubic tubercle?
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superolaterally
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What wall of the inguinal canal does the conjoin tendon reinforce? What is it made of?
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medial portion of posterior wall, fusion of IAO and TA aponeuroses as they form the anterior wall of the rectus sheath
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What are the boundaries of the inguinal canal?
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inferior- inguinal ligament and lacunar ligament
superior- arched fibers of IAO & TA anterior- EAO aponeurosis posterior- transversalis fascia |
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The ilioinguinal nerve passes through _______________ and supplies __________________.
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Inguinal canal. Skin sensation from scrotum or labia majora, mons pubis and adjacent superior medial thigh
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What are the coverings of the spermatic cord (superficial to deep)?
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skin, external spermatic fascia, cremasteric muscle and fascia, internal spermatic fascia
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What are the boundaries of Hesselbach's triangle?
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inferior- inguinal ligament
lateral- inferior epigastric vessels medial- lateral edge of RA mucle |
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List the structures within the spermatic cord.
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blood vessels, lymphatic vessels, nerves, ductus deferens
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In a direct hernia, the protrusion passes ________ to inferior epigasatric vessels.
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medial
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An indirect hernia enters the inguinal canal at...
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the deep ring
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Femoral hernias are the most common hernia in ____________.
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females
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Blood supply to structures in the foregut comes from...
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Celiac trunk
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Pain from structures in the foregut localizes in...
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epigastric region
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The foregut rotates ______________ during development.
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90 degrees clockwise
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Rotation of the stomach during development creates the __________ sac
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lesser
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Blood supply to structures of the midgut comes from...
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superior mesenteric artery
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The midgut rotates _______________ during development.
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90 degrees counterclockwise, then another 180 degrees counterclockwise
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The physiological midgut hernia retracts around the ____ week
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11th
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Pain from structures of the midgut localizes in...
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periumbilical area
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Blood supply to the structures of the hindgut comes from...
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inferior mesenteric artery
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Pain from structures of the hindgut localizes in...
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hypogastric region
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What structures in the abdomen arise from the foregut?
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esophagus, stomach, liver, gallbladder, bile ducts, pancreas, proximal duodenum
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What structures in the abdomen arise from the midgut?
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duodenum, jejunum, ileum, cecum, appendix, ascending colon, proximal 2/3 of the transverse colon
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What structures in the abdomen arise from the hindgut?
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distal 1/3 of the transverse colon, sigmoid colon, recum, proximal portion of the anal canal
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What anomaly of the foregut causes distention and projectile vomiting in a newborn?
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hypertrophic pyloric stenosis
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What is a congenital omphalocele?
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when the midgut loop fails to return into the abdominal cavity
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What is gastroschisis?
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defect in the ventral abdominal wall allowing protrusion of the viscera without involving the umbilical cord
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What midgut anomaly can cause misdiagnosis of appendicitis?
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malrotation
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A congenital ileal diverticulum (Meckel diverticulum) can mimic what condition (often leading to misdiagnosis)?
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appendicitis
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What is the term for when the anal membrane fails to perforate?
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Imperforate anus
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The greater sac and lesser sac communicate through the...
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epiploic foramen
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The subphrenic and subhepatic recesses can be found in the ____________ compartment, a division of the _______ sac.
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supracolic, greater
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What is the most frequently infected area of the abdomen?
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Pouch of Morison (formed by subhepatic recess and hepatorenal recess)
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The paracolic gutters are found in the _________ compartment of the ________ sac.
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infracolic, greater
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Which of the infracolic spaces communicates with the pelvic cavity?
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left
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What are the boundaries of the epiploic foramen?
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ant- hepatoduodenal ligament
post- IVC superior- caudate lobe of liver inferior- first part of duodenum |
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Mesentery is...
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a double layer of peritoneum
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Fusion fascia is created when the dorsal mesentery of the ascending and descending colon fuse to...
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parietal peritoneum of posterior abdominal wall
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Truly retroperitoneal organs have never been invested by...
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dorsal nor ventral mesentery
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What structures are retroperitoneal?
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kidneys, suprarenal glands, ureters, abdominal aorta, autonomic nerve plexuses associated with aorta, IVC, sympathetic trunks, inferior 1/3 of rectum
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The retroperitoneal sac is found posterior to __________________ and anterior to _________________.
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peritoneal sac, anterior layer of retroperitoneal fascia
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What is a secondary retroperitoneal organ?
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organ that had a mesentery but lost it by the end of fetal development.
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What are the secondary retroperitoneal organs?
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head, neck, & body of pancreas, duodenum from aborad 1/2 of the first part to just before the duodenojejunal flexure, ascending colon, descending colon
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What are the component visceral ligaments of the greater omentum?
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gastrocolic ligament, gastrophrenic ligament, gastrosplenic ligament, splenorenal ligament
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What are the component visceral ligaments of the lesser omentum?
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hepatogastric ligament, hepatoduodenal ligament
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What is included in the portal triad?
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common bile duct, proper hepatic artery, hepatic portal vein
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The round ligament of the liver is the remnant of what fetal structure?
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umbilical vein
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What ligaments border the bare area of the liver?
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coronary ligaments and the triangular ligaments
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What structures pass through the aortic hiatus?
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aorta, thoracic duct/cisterna chyli, azygous vein, hemiazygous vein
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The abdominal aorta ends as it bifurcates into the ________________ at the ____ level
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R&L common iliac arteries L4
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The inferior vena cava is formed at level ____ by the ________________.
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L5 confluence of R&L common iliac veins
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What defines a portal system?
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Blood passing from one capillary bed to another before returning to the right atrium
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The hepatic portal vein is formed by the confluence of what 2 veins?
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splenic vein and superior mesenteric vein
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The hepatic portal vein brahces into an expanded capillary network within the liver called the _________________________.
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hepatic venous sinusoids
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The inferior mesentery vein is typically a tributary of...
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splenic v
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What are the 3 major lymph trunks that empty into the cysterna chyli?
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intestinal trunk, R lumbar trunk, L lumbar trunk
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Enlargement of the signal lymph node is significant of disease in what structures?
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foregut derived structures
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Parasympathetic innervation to the foregut and midgut is via...? The hindgut?
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vagus nn, pelvic splanchnic nn from S2-S4
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The anterior vagal trunk arborizes in the peritoneal cavity to innervate _____________ structures.
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foregut
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The ____________ vagal trunk arborizes to innervate foregut and midgut structures.
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posterior
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Preganglionic sympathetics destined for the digestive tub arise from _____ pass through the ___________________ without synapsing and form __________________________ nerves.
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T5-L2, sympathetic chain ganglia, greater, lesser, least, lumbar splanchnic nn
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No visceral pain is referred to the __________ dermatomes
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L3-S1
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Where is the gut tube pain line?
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imaginary line in the mid-sigmoid colon.
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Proximal to the gut tube pain line most gut pain is carried along...
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GVAs that accompany sympathetic pathways (enter T5-L2)
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Distal to the gut tube pain line most gut pain is carried along...
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GVAs that accompany parasympathetic pathways (enter S2-S4)
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GVAs that accompany sympathetic pathways convey pain originating as..
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chemical irritation or mechanical distention
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GVAs that accompany parasympathetic pathways convey sensations of..
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nausea and/or hunger and are sensitive to distention with poor localization
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What ligament attaches the esophagus to the diaphragm?
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phrenicoesophageal ligament
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The characteristic separation at the esophagogastric juction is know as the...
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Z-line
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The transpyloric plane is located at what vertebral level?
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L1
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What supplies blood to the lesser curvature of the stomach? From what vessels do these originate?
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L Gastric a. from celiac trunk
R Gastric a from common hepatic a |
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What supplies blood to the greater curvature of the stomach? From what vessels do these originate?
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R gastro-omental a (terminal brach of gastroduodenal a) from common hepatic a
L gastro-omental a from distal splenic artery short gastric aa from distal splenic a |
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The L&R gastric vv drain into the..
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hepatic portal v
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The short gastric vv and the left gastro-omental v drain into the...
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splenic v
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The R gastro-omental v drains into the...
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superior mesenteric v
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Lymphatic drainage from the stomach goes to...
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the celiac nodes
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Presynaptic sympathetic GVEs to the stomach originate from_____ and course in ________________ to the _______ ganglia
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T6-T9, greater splanchnic nn, celiac ganglia
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GVAs that accompany sympathetic GVEs to the stomach will refer pain to...
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epigastric region, L hypochondriac regions, interscapular region
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Which part of the stomach is innervated by both the anterior and posterior vagal trunks?
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anterior portion
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Hiatal hernias are a result of weakening of ...
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R crus and phrenicoesophageal ligament
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The spleen is not a derivative of...
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the gut
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What is the function of the spleen?
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largest lymphatic organ. Filters worn out blood cells and reacts immunologically to blood antigens
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The spleen is located in the _______ sac between the ____________ and __________.
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greater, diaphragm, stomach
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The spleen is located in the _______ _________ quadrant
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left upper
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Spleen enlargement is a sign of what diseases? What is enlargement of the spleen called?
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mononeucleosis or leukemia, splenomegaly
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The spleen is typically located approximately between ribs...
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8-11
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What organs contact the spleen's visceral surface?
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stomach, L kidney, splenic flexure of large intestine
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Through what part of the spleen does the neurovasculature enter/exit?
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hilum
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What ligaments are part of the spleen's mesentery?
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gastrosplenic ligament, splenorenal ligament
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What organ touches the spleen without an intervening layer of peritoneum?
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tail of pancreas
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Which ligament contains the arterial supply to the spleen?
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splenorenal ligament
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What are the branches of the splenic artery?
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short gastric aa and left gastroepiploic aa
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What drains into the splenic vein?
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pancreatic veins and IMV
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The splenic vein drains into...
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the SMV
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Describe the lymphatic drainage of the spleen.
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Splenic lymph vessels drain to the pancreaticosplenic nodes, to the celiac nodes, to the intestinal trunk, to the cisterna chyli, to the thoracic duct
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Where do presynaptic sympathetic GVEs to the spleen originate?
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T6-T8
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Presynaptic sympathetic GVEs to the spleen course in the ______________ nerve to the _______ ganglia.
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greater splanchnic, celiac
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Postsynaptic sympathetic GVEs to the spleen course with the _______ artery.
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Splenic
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Visceral pain referred from the spleen localizes in...
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left hypochondriac and superior flank regions (T6-T8 dermatomes)
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Somatic pain referred form the spleen is perceived in...
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the L shoulder
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The duodenum is secondary retroperitoneal except...
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the orad 1/2 of the 1st part and the last few millimeters before the duodenojejunal junction
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The duodenum receives...
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bile from common bile duct
pancreatic juices from pancreatic duct |
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Which part of the superior duodenum has a mesentery?
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ampulla of duodenum
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The descending part of the duodenum accounts for __% of its total length
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40
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The common bile duct and the main pancreatic duct usually join to form... which empties into the...
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hepatopancreatic ampulla, major duodenal papilla
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The superior mesenteric vessels are located (anterior/posterior) to the horizontal part of the duodenum.
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Anterior
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What is the function of the suspensory ligament of the duodenum? Where is it located?
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secures the end of the ascending portion of the duodenum. Runs from the duodenojejunal flexure to the diaphragm
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What are the types of duodenal fossae?
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superior, inferior, paraduodenal
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The foregut derived duodenum gets its blood supply from the... the midgut derived duodenum from...
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celiac trunk (gastroduodenal---> superior pancreaticoduodenal), SMA (inferior pancreaticoduodenal)
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Presynaptic sympathetic GVEs to the duodenum originate from...
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T7/8-T12
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Presynaptic sympathetic GVEs to the duodenum course in the ___________ nerves and terminate in ____________ ganglia.
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greater, lesser, and least
Celiac and SM |
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Which vagal trunk contributes more parasympathetics to the duodenum?
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posterior
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Duodenal ulcers refer pain to...
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midepigastric region, dermatome of T7-T8
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A perforated duodenal ulcer can present like...
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appendicitis
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A serious consequence of a perforated duodenal ulcer can erode the ______________ artery, referring pain to ________________.
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gastroduodenal, R shoulder
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Which part of the pancreas lies within the transpyloric plane?
|
neck
|
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What mesentery attaches to the anterior surface of the pancreas?
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transverse mesocolon
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The pancreas is attached to the posterior wall via _______ ________ to the ____________ _____.
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fusion fascia, extraperitoneal fat/fascia
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What is the process that projects inferiorly from the head of the pancreas?
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uncinate process
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What vessels join at the posterior surface of the pancreas?
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splenic v and SMV to form hepatic portal vein
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What part of the pancreas forms the stomach bed?
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body
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The main pancreatic duct typically joins with the common bile duct to form... which opens into the...
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hepatopancreatic ampulla, major duodenal papilla
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What is the arterial supply to the head and neck of the pancreas?
|
Celiac trunk-- gastroduodenal a-- superior pancreaticoduodenal aa, SMA-- inferior pancreaticoduodenal aa
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What is the arterial supply to the body and tail of the pancreas?
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splenic artery
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The body and tail of the pancreas have lymphatic drainage to the... the head and neck to the...
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pancreaticosplenic nodes-- celiac nodes,
pancreaticoduodenal nodes |
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Where do presynaptic sympathetics to the pancreas originate?
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T6-T9
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Presynaptic sympathetics to the pancreas travel in the ________ nerves and terminate in the ______________ ganglia.
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greater splanchnic, celiac ganglia and SM ganglia
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Pain from the pancreas is carried by ____ that accompany _____________ GVEs and refers pain to __________________.
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GVAs, sympathetic, inferior epigastric regions contained within the T6-T9 dermatomes
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The liver is derived from the...
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foregut
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What is glisson's capsule? What does it extend into?
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CT that ensheaths the entire liver including the bare area, porta hepatis
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Most of the liver is found in the ______ quadrant deep to ribs _______.
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RUQ, 7-11
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What is the remnant of the umbilical vein?
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ligamentum teres
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What makes an impression on the liver?
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gallbladder, fissure for the ligamentum teres, porta hepatis
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What are the 3 parts to the liver based on a functional classification scheme?
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right, left, posterior
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Segments of the liver are determined based upon...
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blood supply
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What separates the functional R&L parts of liver?
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Cantlie line on diaphragmatic surface, R saggital fissure on visceral surface
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The posterior part of the liver is the same as the ___________ lobe.
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caudate
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The quadrate lobe is located in the _________ part of the liver.
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left
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Which structure of the portal triad is located most posterior?
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hepatic portal vein
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The hepatic portal vein is formed by the confluence of...
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splenic vein and SMV
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The proper hepatic artery is a branch of...
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common hepatic artery from the celiac trunk
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What portion of blood to the liver comes from the hepatic arteries?
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20-30%
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Cleansed and modified blood from the liver flows to ______________ veins which form the ___________ veins.
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collecting, hepatic
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Blockage of the liver causes blood to take advantage of...
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portacaval venous anastomoses
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What are the major sites of portal-systemic venous anastomoses?
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esophageal, paraumbilical, retroperitnoneal, rectal
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Esophageal or gastric varices, caput medusa sign, and rectal varices are signs of....
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portal hypertension
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Most lymphatic drainage from the liver enters the __________ nodes.
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celiac
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What can enlarged signal lymph nodes indicate?
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liver, stomach, or pancreatic cancer
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Presynaptic sympathetic GVEs for the liver originate in...
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T6-T9
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Presynaptic sympathetic GVEs for the liver travel in ____________ nerves and synapse in ________ ganglia.
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greater splanchnic, celiac
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Presynaptic parasympathetic GVEs for the liver travel in ________________ then pass through the ____________ plexus.
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anterior and posterior vagal trunks, celiac
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Visceral pain from the liver refers to...
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T6-T9 dermatome (epigastric or R hypochondriac region)
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Somatic pain from the liver refers to...
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R shoulder
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The position of the gallbladder can be approximated at...
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subcostal margin and the linea semilunaris
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What are the parts of the gallbladder?
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fundus, body, neck
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The right and left hepatic ducts join to form...
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common hepatic duct
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The common hepatic duct and the ___________ _________ from the gallbladder join to form...
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cystic duct, common bile duct
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What is the sphincter of the hepaticopancreatic ampulla?
|
sphincter of oddi
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What artery supplies the gallbladder? From what does it originate?
|
cystic artery, R hepatic artery
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At what vertebral level does the jejunum start?
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L2
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What artery supplies the jejunum and ileum?
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SMA
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____________ _____________ give rise to the straight __________ _________ to supply the small intestine.
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Arterial arcades, vasa recta
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Presynaptic sympathetics innervating the jejunum and ileum originate in...
|
T8-T12
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Presynaptic sympathetics innervating the jejunum and ileum travel in _______________ nerves and synapse in ____________ ganglia.
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greater lesser and least splanchnic nerves, SM ganglia
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Preganglioniic parasympathetics to the ileum and jejunum travel through which plexus?
|
celiac and SM
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Visceral pain from the jejunum and ileum refers to...
|
T8-T12 periumbilical region
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What is located at the junction of the ascending colon and the transverse colon? At the transverse colon and the descending colon?
|
hepatic flexure, splenic flexure
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Sacculations of the large intestine are called...
|
haustra
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_________ __________ are most numerous in the transverse and sigmoid colons.
|
omental appendices
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Which segments of the large intestine are intraperitoneal?
|
cecum, appendix, transverse, sigmoid
|
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What segments of the colon are secondary retroperitoneal?
|
ascending colon, descending colon, rectum
|
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What valve enters the cecum?
|
ileocecal valve
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What is the most common location of the appendix?
|
retrocecal recess
|
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The R paracolic gutter permits communication between...
|
pelvic cavity and hepatorenal recess
|
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What is volvulus?
|
A condition in which the ascending colon has a short mesentery which allows it to twist upon itself
|
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The transverse colon is (anterior/posterior) to the second part of the duodenum
|
anterior
|
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The inferior pole of the spleen rests on what mesentery?
|
phrenicocolic ligament
|
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What connects the transverse colon to the posterior abdominal wall?
|
transverse mesocolon
|
|
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Which part of the colon can often be palpated? Why?
|
descending due to presence of solid fecal matter
|
|
|
What disease of the large intestine can present with LLQ pain?
|
diverticulitis
|
|
|
The recto-sigmoid junction is just anterior to what vertebrae?
|
S3
|
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|
What courses along the floor of the intersigmoid recess?
|
L ureter
|
|
|
What is the arterial supply to the colon?
|
SMA supplies cecum, appendix, ascending colon and proximal 1/2-2/3 of transverse colon, IMA supplies distal 1/2-1/3 of transverse colon, descending colon, rectum, and proximal anal canal
|
|
|
Describe the origins of the appendicular a.
|
from posterior cecal brach of the ileocolic a of the SMA
|
|
|
Describe the origins of the cecal a?
|
anterior and posterior cecal aa from the ileocolic a from SMA
|
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The ascending colon is supplied arterially by
|
ileocolic a and right colic a (of SMA)
|
|
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The transverse colon is supplied arterially by
|
prox 2/3 from midddle colic a of SMA, distal 1/3 from left colic a of IMA
|
|
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The descending colon is supplied arterially by
|
left colic a and sigmoidal aa of IMA
|
|
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The sigmoid colon is supplied arterially by
|
sigmoidal aa of IMA
|
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The marginal artery forms an arterial-arterial anastomoses between...
|
SMA and IMA
|
|
|
The SMV and IMV are part of what system?
|
hepatic portal system
|
|
|
Describe the lymphatic drainage of the colon.
|
epicolic nodes to the paracolic nodes to the mesocolic nodes to the nodes at the origins of SMA and IMA to intestinal trunks to cysterna chyli
|
|
|
Presynaptic sympathetic GVEs to the large intestine originate in...
|
T8-T12 for prox colon
T12 & L1-2 for distal colon |
|
|
Presynaptic sympathetic GVEs to the colon travel in _________ nerves and synapse in ___________ ganglia.
|
greater, lesser, least, and lumbar splanchnics, primarily the SM ganglia (except lumbar splanchnics synapse in IM ganglia)
|
|
|
Parasympathetic innervation to the proximal colon comes from... the distal colon?
|
posterior vagal trunks, S2-S4 to pelvic splanchnic nerves
|
|
|
Preganglionic parasympathetic fibers in pelvic splanchnic nerves run through which plexuses?
|
R/L inferior hypogastric
R/L hypogastric nn superior hypogastric plexus inferior mesenteric plexus |
|
|
GVAs of the proximal colon (to prox 1/2 of sigmoid) refer pain to...
|
hypogastric regions contained within T10-T12 dermatomes or to LLQ within L1-L2 dermatomes (for prox sigmoid colon)
|
|
|
GVAs from the distal colon (after prox 1/2 of sigmoid) refer pain to...
|
perineal region (S2-S4 dermatomes)
|
|
|
What is the shape of the R suprarenal gland? The L?
|
R-pyramidal
L-semilunar |
|
|
The suprarenal glands are (inside/outside) the renal fascia?
|
inside
|
|
|
What are the parts of the suprarenal glands?
|
cortex (outside), medulla (inside)
|
|
|
What is the blood supply to the suprarenal glands?
|
superior suprarenal aa (from prox inferior phrenic aa), middle suprarenal a (from AA), inferior suprarenal a (from renal a)
|
|
|
Where do the suprarenal veins empty?
|
L- L renal v
R- IVC |
|
|
How do preganglionic sympathetic fibers reach the suprarenal cortex?
|
via greater splanchnic n and the celiac ganglion & plexus & aorticorenal gland and plexus
|
|
|
Postganglionic sympathetic fibers to the suprarenal cortex emerge from what ganglia?
|
celiac and aorticorenal
|
|
|
How do preganglionic sympathetic fibers reach the suprarenal medulla?
|
Via greater, lesser, least splanchnic nerves passing through celiac and aorticorenal ganglia without synapse
|
|
|
Postganglionic sympathetic fibers within the suprarenal medulla, when stimulated, release...
|
catecholamines into suprarenal vv
|
|
|
Which kidney is higher?
|
Left
|
|
|
From what fetal structure are the kidneys formed?
|
metanephroi
|
|
|
What is it called when a fetus is born with only one kidney?
|
renal agenesis
|
|
|
What is it called when one kidney resides in the pelvic cavity?
|
pelvic kidney
|
|
|
What is it called when the inferior poles of the kidneys fuse?
|
horseshoe kidney
|
|
|
What rib, when fractured, can damage the kidney?
|
12th
|
|
|
Describe the layers of kidney fascia from deep to superficial.
|
Renal sinus, renal capsule, perirenal fat, renal fascia, pararenal fat
|
|
|
Pararenal fat is a specific subvolume of which fascia?
|
extraperitoneal fat/fascia
|
|
|
What is at the apex of the renal pyramids?
|
renal papilla
|
|
|
Describe the path of urine from interior of kidney to bladder.
|
minor calyces to major calyces, infundibulum, renal pelvis, ureter, bladder
|
|
|
Where do the main arteries to the kidney arise?
|
renal arteries arise from AA
|
|
|
Which is more anterior, renal arteries or renal veins?
|
renal veins
|
|
|
Which renal vein crosses anterior to the AA?
|
L renal vein
|
|
|
Describe the lymphatic drainage of the kidneys.
|
lumbar nodes to lumbar trunk to cysterna chyli to thoracic duct
|
|
|
Presynaptic sympathetic GVEs to the kidneys arise from...
|
T10-L1
|
|
|
Presynaptic sympathetic GVEs to the kidneys travel in _________ n to __________ ganglia.
|
lesser and least splanchnic, aorticorenal
|
|
|
Presynaptic parasympathetic GVEs to the kidney travel in what plexuses?
|
celiac and aorticorenal plexuses
|
|
|
GVAs from the kidneys refer pain to...
|
flank regions within the T10-L1 dermatomes
|
|
|
The ureters pass (anterior/posterior) to the psoas muscles and (anterior/posterior) to the gonadal vessels.
|
anterior, posterior
|
|
|
Where are the constrictions of the ureters?
|
UPJ, crossing of iliac vessels, ureterovesical junction
|
|
|
The ureters receive presynaptic sympathetic GVEs from.... via...
|
T11-T12, lesser, least, lumbar, sacral splanchnic nn
|
|
|
Postsynaptic sympathetic GVEs to the ureters travel in which plexuses?
|
aoriticorenal, superior hypogastric, inferior hypogastric
|
|
|
What attaches the bladder to the anterior abdominal wall?
|
median umbilical ligament
|
|
|
What is the most anterior point of the bladder?
|
apex
|
