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84 Cards in this Set
- Front
- Back
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Name the 8 layers of the lateral abdominal wall from superficial to deep
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1. Skin
2. superficial fascia 3. external obliques 4. internal obliques 5. transversus abdominis 6. transversalis fascia 7. extraperitoneal tissue 8. peritoneum |
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Name 9 major retroperitoneal organs/parts
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1. pancreas (except bulb)
2. aorta 3. IVC 4. kidneys/ureters 5. adrenals 6. pancreas (except tail) 7. colon - descending 8. colon - ascending 9. rectum |
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What is contained in the adult derivative of the fetal vein?
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ligamentum teres
(in the FALCIFORM ligament - connects the liver to the abdominal wall) |
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What is the surgical significance of the hepatoduodenal ligament?
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It connects the greater and lesser sacs; may be accessed through the omental foramen to control bleeding because it contains the portal triad
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What is the portal triad?
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hepatic artery
portal vein common bile duct |
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What may be cut during surgery to access the lesser sac?
What does it connect? What does it contain? |
- Gastrohepatic ligament
- Connects liver to lesser curvature of stomach - Gastric arteries |
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In what structure are the gastroepiploic arteries contained?
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Gastrocolic ligament (part of greater omentum; conects greater curvature to transverse colon))
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In what structure are the short gastric vessels contained?
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Gastrosplenic ligament (connects greater curvature of stomach to spleen)
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In what structure are the splenic artery and vein contained?
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Splenorenal ligament (connects spleen to posterior abdominal wall)
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What are the layers of the digestive tract from inside to outside, including the enteric nervous plexuses
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1. Lumen
2. Mucosa - epithelium (absorption) - lamina propria (support) - muscularis mucosae (motility) 3. Submucosa - submucosal (Meissner's) plexus 4. Muscularis externa - inner circular layer - outer longitudinal layer 5. Serosa/adventitia |
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Name the 8 layers of the lateral abdominal wall from superficial to deep
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1. Skin
2. superficial fascia 3. external obliques 4. internal obliques 5. transversus abdominis 6. transversalis fascia 7. extraperitoneal tissue 8. peritoneum |
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Name 9 major retroperitoneal organs/parts
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1. pancreas (except bulb)
2. aorta 3. IVC 4. kidneys/ureters 5. adrenals 6. pancreas (except tail) 7. colon - descending 8. colon - ascending 9. rectum |
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What is contained in the adult derivative of the fetal vein?
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ligamentum teres
(in the FALCIFORM ligament - connects the liver to the abdominal wall) |
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What is the surgical significance of the hepatoduodenal ligament?
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It connects the greater and lesser sacs; may be accessed through the omental foramen to control bleeding because it contains the portal triad
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What is the portal triad?
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hepatic artery
portal vein common bile duct |
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What may be cut during surgery to access the lesser sac?
What does it connect? What does it contain? |
- Gastrohepatic ligament
- Connects liver to lesser curvature of stomach - Gastric arteries |
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In what structure are the gastroepiploic arteries contained?
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Gastrocolic ligament (part of greater omentum; conects greater curvature to transverse colon))
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In what structure are the short gastric vessels contained?
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Gastrosplenic ligament (connects greater curvature of stomach to spleen)
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In what structure are the splenic artery and vein contained?
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Splenorenal ligament (connects spleen to posterior abdominal wall)
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What are the layers of the digestive tract from inside to outside, including the enteric nervous plexuses
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1. Lumen
2. Mucosa - epithelium (absorption) - lamina propria (support) - muscularis mucosae (motility) 3. Submucosa - submucosal (Meissner's) plexus 4. Muscularis externa - inner circular layer - outer longitudinal layer 5. Serosa/adventitia |
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Where are Peyer's patches (lymphoid tissue) found?
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In the lamina propria and submucosa of the ILEUM
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Which section of intestine has crypts but no villi?
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colon
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What is the basal electric rhythm of the stomach?
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3 waves/min
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What is the basal electric rhythm of the dudoenum?
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12 waves/min
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What is the basal electric rhythm of the ileum?
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9 waves/min
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Where is nonkeratinized stratified squamous epithelium found?
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esophagus
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Where are villi and microvilli found?
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small bowel:
dudoenum > jejunum > ileum |
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Where are Brunner's glands found?
What do they do? |
duodenum
secrete alkaline/mucous fluid |
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Where are crypts of Lieberkuhn found?
What do they do? |
Small and large intestine
Contain stem cells and secrete enzymes (maltase, sucrase, peptidases) |
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Where are the most goblet cells found in the small intestine?
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jejunum
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Where are plicae circulares found?
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jejunum, ileum
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What differentiates the ileum from the jejunum?
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Presence of Peyer's patches (lymphoid tissue)
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Meissner's plexus:
- Where is it? - What does it do? - What kind of neurons does it contain? |
- In the submucosa
- regulates secretions, blood flow, absorption - cell bodies of parasympathetic terminal effector neurons |
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Auerbach's plexus:
- Where is it? - What does it do? - What kind of neurons does it contain? |
- between in the inner (circular) and outer (longitudinal) layers of the muscularis externa
- coordinates motility along gut wall - cell bodies of parasympathetic terminal effector neurons |
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What type of muscle is found in the upper 1/3 of the esophagus?
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striated
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What type of muscle is found in the middle 1/3 of the esophagus?
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striated and smooth
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What type of muscle is found in the middle 1/3 of the esophagus?
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smooth
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At what spinal cord level does the celiac artery branch off the abdominal aorta?
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T12
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At what spinal cord level does the superior mesenteric artery branch off the abdominal aorta?
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L1
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At what spinal cord level does the renal artery branch off the abdominal aorta?
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L2
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At what spinal cord level do the testicular/ovarian arteries branch off the abdominal aorta?
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L3
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At what spinal cord level abdominal aorta bifurcate into the right and left iliac arteries?
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L4
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At what spinal cord level does the inferior mesenteric artery branch off the abdominal aorta?
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L3
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Stomach to proximal duodenum, liver, gallbladder, pancreas
- blood supply? - embryologic origin? - parasympathetic innervation? |
- celiac artery
- foregut - vagus |
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Spleen
- blood supply? - embryologic origin? - parasympathetic innervation? |
- celiac artery
- mesoderm - vagus |
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Distal duodenum to proximal 2/3 of transverse colon
- blood supply? - embryologic origin? - parasympathetic innervation? |
- superior mesenteric artery
- midgut - vagus |
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Distal 1/3 of transverse color to upper portion of rectum
- blood supply? - embryologic origin? - parasympathetic innervation? |
- inferior mesenteric artery
- hindgut - pelvic |
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What arteries supply the lesser curvature of the stomach?
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LEFT GASTRIC artery (branch of celiac)
RIGHT GASTRIC artery (branch of common hepatic, branch of celiac) |
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What artery supplies the duodenal bulb?
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SUPERIOR PANCREATICODUODENAL artery (branch of gastroduodenal, branch of common hepatic, branch of celiac)
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What arteries supply the greater curvature of the stomach?
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RIGHT GASTROEPIPLOIC (branch of gastrodudoenal, branch of common hepatic, branch of celiac)
LEFT GASTROEPIPLOIC (branch of splenic, branch of celiac) |
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What arteries supply the fundus of the stomach?
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SHORT GASTRICS (branches of splenic, branch of celiac)
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What arteries supply the liver?
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HEPATIC ARTERY --> RIGHT HEPATIC, LEFT HEPATIC
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What artery supplies the gall bladder?
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CYSTIC ARTERY (branch of hepatic, branch of common hepatic, branch of celiac)
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Superior pancreaticoduodenal (celiac) has collateral circulation with _____
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Inferior pancreaticoduodenal (SMA)
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Superior epigastric artery (internal thoracic) has collateral circulation with _______ and ___________
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Internal mammary (subclavian) and
inferior epigastric (external iliac) |
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Middle colic artery (SMA) has collateral circulation with ________
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left colic artery (IMA)
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Superior rectal artery (IMA) has collateral circulation with ___________
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middle rectal artery (internal iliac)
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Portosystemic anastamoses between which vessels produces esophageal varices?
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left gastric vein (portal) and esophageal vein (systemic)
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Portosystemic anastamoses between which vessels produces caput medusae?
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paraumbilical vein (portal) and superficial and inferior epigastric veins (systemic)
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Portosystemic anastamoses between which vessels produces internal hemorrhoids?
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superior rectal vein (portal) and middle and inferior rectal veins (systemic)
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What anastamoses can be surgically created to relieve portal hypertension?
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1. connect spleinc vein (portal) to renal vein (systemic)
2. connect portal vein to IVC |
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Embryologic origin above pectinate line?
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hindgut
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Embryological origin below pectinate line?
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ectoderm
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Type of hemorrhoids above and below pectinate line?
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above: internal (non-painful)
below: external (painful - inferior rectal nerve) |
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Type of cancer above and below pectinate line?
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above: adenocarcinoma
below: squamous cell carcinoma |
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Arterial supply above and below pectinate line?
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above: superior rectal artery (IMA)
below: inferior rectal artery (internal pudendal) |
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Venous drainage above and below pectinate line?
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above: superior rectal vein --> IMV (portal)
below: inferior rectal vein --> internal pudendal vein (systemic) |
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What is the space of Disse?
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lymphatic drainage in liver
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What zone is most susceptible to viral hepatitis?
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periportal zone (Zone I)
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What zone is most sensitive to ischemia and toxic injury?
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pericentral vein (Zone III)
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Which zone contains the P450 system?
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pericentral vein (Zone III)
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Which zone is the site of development of alcoholic hepatitis?
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pericentral vein (Zone III)
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what is the relationship between the sphincter of Oddi and the ampulla of Vater?
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sphincter surrounds ampulla (lumen of duct)
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What structures are contained in the femoral triangle?
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Nerve
Artery Vein Empty space Lymphatic (deep inguinal) |
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What are the borders of the femoral triangle?
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Superior: inguinal ligament
Inferolateral: sartorius muscle Medial: adductor longus muscle |
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What is contained in the femoral sheath (fascial tube below inguinal ligament)?
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Artery
Vein Empty space Lymphatic (deep inguinal) |
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"hourglass stomach"
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sliding hiatal hernia
(stomach --> esophageal hiatus of diaphragm @ T10 --> GE junction displaced) |
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Normal GE junction; cardia of stomach moves into thorax
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paraesophageal hernia (less common)
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Where does a direct inguinal hernia protrude?
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Hasselbach's triangle:
medial to inferior epigastric vessels lateral to medial umbilical ligament through abdominal wall |
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Where does an indirect inguinal hernia protrude
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In internal (deep) inguinal ring:
lateral to inferior epigastric arteries |
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Etiology of indirect inguinal hernia in an infant?
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Failure of processus vaginalis to close; follows path of spermatic cord --> scrotum
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What is the difference between an indirect and direct inguinal hernia regarding the layers of spermatic fascia that cover them?
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Indirect - covered by all 3 layers (external, cremasteric, internal)
Direct - covered only by external fascia |
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What is the leading cause of bowel incarceration?
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femoral hernia (more common in women)
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Where does a femoral hernia protrude?
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In the femoral canal (below inguinal ligament, inferolateral to pubic tubercle
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