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61 Cards in this Set
- Front
- Back
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Where does the abdominal esophagus originate and terminate?
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Abdominal esophagus extends from the esophageal hiatus in the diaphragm to the stomach; only a few cm long.
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Where is the esophageal hiatus?
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In the diaphragm's right crus, @ T10, to the left of the midsagittal plane of the body.
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Where is the abdominal esophagus with respect to the liver?
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It lies posterior to the left lobe of the liver.
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What is the right border of the abdominal esophagus continuous with?
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The lesser curvature of the stomach.
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What nerves are associated with the abdominal esophagus?
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The anterior (left) and posterior (right) trunks of the vagus (from the thorax) lie on it.
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What are the smooth muscle components of the abdominal esophagus?
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Outer layer of longitudinal smooth muscle, underlain by a circular layer of smooth muscle.
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Typically, what shape is the stomach?
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J-shaped
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How is the stomach oriented in the abdomen?
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It lies obliquely across the supra colic compartment of the abdomen.
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What organ partially overlies the stomach?
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The stomach is partly overlain by the left lobe of the liver.
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How distensible is the stomach?
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Extremely-in some individuals standing erect, a full stomach can extend into the greater pelvis.
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What is the cardiac orifice of the stomach?
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A narrow ring around the esophageal opening-prevents reflux of stomach contents into esophagus.
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What is the fundus of the stomach?
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Dome of the stomach-separated from the abdominal esophagus by the cardiac notch.
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Where does the fundus lie with respect to the diaphragm?
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The fundus lies within the left dome of the diaphragm.
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Where is the body of the stomach?
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Inferior to the fundus; the body comprises most of the stomach.
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Tell me about the pyloric part of the stomach.
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Shaped like a funnel, the wider portion is the pyloric antrum and the narrower is the pyloric canal.
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Where is the pylorus, you med-school minion?
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It's the last part of the stomach, ring-shaped and internally-thickened by a circular muscle layer (pyloric sphincter). The sphincter regulates the passage of food from stomach to duodenum.
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How many muscle layers does the stomach have?
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Three:
Outer longitudinal layer Inner circular layer Innermost oblique layer |
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What are rugae?
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Broad, non-permanent folds inside the stomach that disappear when the stomach fills (no magic here-allow for distention).
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What abdominal structures are posterior to the stomach?
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1. diaphragm
2. spleen 3. left kidney (superior part) 4. pancreas 5. left suprarenal gland |
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What is the first part of the small intestine?
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duodenum
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What shape is the duodenum?
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Roughly C-shaped.
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Is the duodenum intra- or retroperitoneal?
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It's mostly retroperitoneal.
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What is nestled up alongside the duodenum? Where?
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The pancreas is located in the concave surface of the duodenum.
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Why do we love the duodenum so?
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It receives bile and pancreatic juices; yummy!
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What have you been told about plicae circulates?
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They're the permanent folds lining the internal surface of the duodenum
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What are the four segments of the duodenum? QUICKLY!
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Four segments, each lying t right angles to the next:
1. superior 2. descending 3. horizontal 4. ascending |
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What direction does the superior duodenum run?
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Posteriorly and to the right, reaching the right side of the vertebral bodies
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At what vertebral level is the superior duodenum?
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L1
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What runs posterior to the superior duodenum?
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Bile duct
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What is anterior to the superior duodenum?
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Gallbladder
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Where is the descending duodenum?
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Runs along the right side of the vertebral column to the level of L3.
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What empties into the descending duodenum?
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Bile duct and pancreatic duct empty into the descending duodenum.
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Where in the descending duodenum do the bile duct and pancreatic duct empty?
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~2/3 of the way down; the hepatopancreatic ampulla open into the duodenum through the major duodenal papilla.
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Where does the major duodenal papilla lie?
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At the superior part of a distinctive, longitudinally running fold.
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Where is the horizontal part of the duodenum?
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@ the level of L3, horizontal part runs horizontally across the anterior surface of the IVC and the abdominal aorta.
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Where is the ascending part of the duodenum?
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It ascends just to the left of the abdominal aorta up to the level of L2, then bends and becomes the jejunum (@ the duodenojejunal flexure)
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Where does the spleen lie?
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In the left, posterior part of the abdominal cavity, just anterior to the diaphragm and to the superior part of the left kidney. It's posterior to the stomach and colon (@ left colic flexure).
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What organ often touches the spleen? Lol
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The tip of the tail of the pancreas-so be careful next time you're surgically removing one.
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How is the spleen usually oriented? Where is it in relation to ribs?
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Horizontally; lies parallel to 9th, 10th, and 11th left ribs (separated from them by the diaphragm and costodiaphragmatic recess of pleural cavity)
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Describe the curvature of the spleen.
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Spleen has a convex posterior surface and a flat or concave anterior surface.
It has a notched superior margin. |
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Where do blood vessels enter/leave the spleen?
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@ the hills, on its anterior surface.
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What supports the jejunum and ileum?
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mesentery
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How do you tell the jejunum and ileum apart?
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1. Jejunum has thicker walls, larger total diameter, and is pinker than the ileum.
2. There's less fat in the mesentery of the jejunum. 3. The pattern of blood vessels differs. 4. Internal plicae circulares are most abundant in the jejunum. 5. Wall of the ileum has Peyer's patches. 6. Ileum is continuous with the cecum (right iliac fossa) |
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What is the cecum?
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A blind pouch, into which both the ileum and appendix open.
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What do you of the ileocecal orifice?
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The ileocecal orifice is an elevated horizontal slit, defined by two raised edges of the mucosa (frenula-prevent reflux of feces into ileum). The ileocecal orifice is surrounded by the ileocecal valve.
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Where does the vermiform appendix open from?
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The poster-medial wall of the cecum.
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Where does the vermiform appendix generally lie?
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Tucked up in a pouch posterior to the cecum (retrocecal pouch) in ~60% of individuals.
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What comprises the retrocecal pouch?
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A retrocecal fold of peritoneum and the mesentery of the terminal ileum.
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Where is the second most common position for the appendix?
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Iliac fossa-appendix extends down into lesser pelvis (~30% of people)
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WTF is a mesoappendix?
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Well minion, I'm glad you asked... The mesoappendix is the mesentery of the appendix, it hangs inferiorly from the terminal ileum. The artery to the appendix lies in the free edge of this space.
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You're wandering around the bustling town of Moscow when, to your surprise, someone screams out: "AAARRGGHHHH-My appendix is exploding-cut it out!" Where do you make your incision?
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McBurney's Point: 1/3 of the way along a line from the right anterior superior iliac spine to the umbilicus. BTW, check your local statutes-not sure if this scenario is covered under Good Samaritan Laws.
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What are taeniae coli?
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"Ribbons" They are thickenings of the longitudinal muscle of the large intestine-3 narrow bands, spaced 120 degrees from each other.
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What are haustrau?
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Sacculations of the wall of the colon.
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What are omental appendices (epiploic appendices)?
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Small pouches of visceral peritoneum, filled with fat, hanging from the outside of the colon.
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What are diverticula?
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pouches of mucosa (inner layer) that have herniated out through the outer layers of the intestinal wall-usually involves the sigmoid colon
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What "fixes" the ascending and descending colon?
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Paraverterbral gutters
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What is the largest part of the colon?
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Transverse colon-it can droop to varying degrees, sometimes reaching the pelvis
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Where does the right colic (hepatic) flexure occur?
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ascending to transverse-occurs at the inferior border of the right kidney (L3)
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Where does the left colic (splenic) flexure occur?
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transverse to descending-inferior border of the spleen (L1)
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Where does the descending colon join the sigmoid colon?
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left iliac fossa
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Where does the sigmoid colon extend to posteriorly?
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The S-shaped sigmoid colon extends posteriorly into the lesser/true pelvis to become the rectum anterior to the third piece of the sacrum.
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