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76 Cards in this Set
- Front
- Back
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Branches of Celiac Trunk?
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Left Gastric
Splenic Common hepatic |
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Branches off the Left Gastric Artery?
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1) Left gastric goes into hepatogastric ligament supplies lesser curvature of stomach
2) 2 esophogeal branches -> lower esophogus |
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Branches off Splenic Artery?
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1) Short Gastric Artery -> through gastrosplenic ligament -> Supplies fundus and upper body of stomach
2) Left Gastro-omental a -> Runs along and supplies greater curvature of omentum and greater curvature of stomach |
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Branches of Common Hepatic Artery?
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1) Proper hepatic
2) Gastroduodenal |
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3 Branches of Proper Hepatic Artery?
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i. Right Gastric – lesser curvature, hepatogastric ligament. anastomoses with left gastric artery (1st branch off celiac trunk)
ii. Right Hepatic Artery- iii. Left Hepatic Artery |
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3 Branches of gastroduodenal Artery?
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i. Right Gastro-omental – supplies greater omentum and anastomoses with left gastro-omental artery (from splenic artery)
ii. Anterior Superior Pancreaticoduodenal artery – iii. Posterior Superior Pancreaticoduodenal artery - |
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Layers of Wall of Stomach
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Serosa (outermost)
outer longitudinal muscle inner cirular muscle innermost oblique |
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2 Inner Structures of Stomach
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Rugae - mucosa and submucosa folds
Gastric Canal - rugae running parallel to lesser curvature |
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Incisures on Stonach
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Cardiac Incisure - between esophogus and fundus
Angular Incisure - Lowest point of lesser curvature |
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4 Regions of Stomach
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Cardiac - junction in esophogus
Fundus - above gastro-esoph junction Corpus (body) Pyloric Region |
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3 Impressions on surface of spleen
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Gastric
Renal Colic |
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Big 3 things traveling through Hepatoduodenal ligament
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Hepatic Artery
Portal Vein Bile Duct |
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Gall Bladder Topography
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Fundus
Body Neck Cystic Duct |
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What makes up Cystohepatic Triangle (Calot)?
2) What normally passees through here? |
Visceral surface of liver
Common Hepatic Duct Cystic Duct 2) Cystic Artery |
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Sacral promontory
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the anatomical term for the superior most portion of the sacrum. It marks part of the border of the pelvic inlet.
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Termination Point of greater splanchnic nerves?
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celiac ganglia
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Termination point of lesser splanchnic nerves?
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Aorticorenal ganglia.
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Regions of Stomach
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Cardiac
Fundus Corpus (body) Pyloric Region |
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Incisure between esophogus and fundus?
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Cardiac Incisure
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Incisure at lowest point of lesser curvature?
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Angular Incisure
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Rugae running parallel to lesser curvature in stomach?
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Gastric canal
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What is the function of the gastric canal of stomach?
Clinical relevance of gastric canal? |
It directs fluids along lesser curvature of stomach.
If hazardous liquid is ingested then damage will be along the lesser curvature of stomach. So look here for ulcer. |
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What ribs is the spleen associated with?
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left ribs 9-11. Long axis parallels 10th rib.
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What visceral impressions are on spleen?
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gastric impression
renal impression colic impression |
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1) Porta Hepatis
2) How does "the triad" entering porta hepatis reach it? |
1) Fancy name for hilum of liver
2) Via hepatoduodenal ligament |
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What are the big 3 in the porta hepatis?
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hepatic artery
portal vein common bile duct |
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What is the Omental (epiploic) Foramen between?
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Hepatoduodenal Ligament and IVC
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Where is the line for anatomical division of Right and Left lobes of liver?
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Falciform Ligament
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Where is the line for Functional division of Right and Left lobes of liver?
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Roughly by a line through gall bladder bed and IVC
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How are functional units of the liver defined?
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By arterial supply and biliary drainage
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Regions of Gall Bladder?
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Fundus
Body Neck Cystic duct |
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Relations of 'Big Three' within the hepatoduodenal ligament?
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Portal Vein - posterior
Proper Hepatic Artery - anterior / left Common Bile Duct - Anterior / Right |
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What and where does cystic artery originate?
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Right hepatic artery becomes cystic artery as it passes posterior to common hepatic duct.
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What makes up Cystohepatic triangle (calot)?
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Visceral surface of liver
common hepatic duct cystic duct |
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What drains into intestinal trunk of cisterna chyli?
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Celiac and superior mesenteric nodes
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Where do left gastro-omental lymph nodes drain to?
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pancreatosplenic nodes -> celiac nodes
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Where do right gastro-omental lymph nodes drain to?
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plyoric nodes -> celiac nodes
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Where does left gastro-omental vein drain?
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splenic --> portal
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Where does right gastro-omental vein drain?
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SMV --> Portal vein (too low for portal vein)
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Where do right, left, and middle (often drains to left hepatic v) hepatic vv drain to?
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Directly to IVC
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What parts of duodenum are retroperitoneal (have bare areas)?
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2, 3, and 4
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Name the 4 regions of duodenum?
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1) Superior
2) Descending 3) Horizontal 4) Ascending |
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Portion of pancreas that is posterior to superior mesenteric vessels?
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Uncinate process
uncinate means "hook" |
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Where do superior mesenteric vessels cross duodenum? Anterior or posterior?
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The pass anterior to 3rd part of duodenum
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Relation of superior mesenteric vessels to pancreas?
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They are posterior to the neck of pancreas and anterior to uncinate process of pancreas
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3 things posterior to 1st part of duodenum?
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portal vein
common bile duct gastroduodenal artery |
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2 things posterior to 2nd part of duodenum?
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right renal pelvis and vessels
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what 2 things are posterior to the 3rd part of the duodenum?
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IVC and Aorta
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What attaches the duodenaljejunal flexure to the body wall?
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Ligament of Treitz
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Duodenal bulb / cap?
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in superior portion of duodenum, the 1st portion to receive food from stomach
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Major duodenal papilla?
where is it located? |
entrance of common bile duct and pancreatic ducts
Located on the medial and posterior wall of the 2nd part of duodenum |
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Minor duodenal papilla?
where is it located? |
Entrance of accessory pancreatic duct
Located 1-2 cm superior to major duodenal papilla |
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Hepatopancreatic ampulla (Vater):
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lumen common to both ducts (common bile duct and pancreatic duct)
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Hepatopancreatic sphincter (Oddi):
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surrounds both ducts (common bile duct and pancreatic duct)
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Sphincter of pancreatic duct:
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prevents intrusion of bile
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Common bile duct sphincter:
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forces bile to accumulate in gall bladder; relaxes to release bile into duodenum
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What is the clinical relevance of duodenal bulb?
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Tells you when you are in small intestines. Radiologist.
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What two structures does the posterior superior pancreaticoduodenal pass between?
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Passes anterior to common bile duct and posterior to first part of duodenum
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What arteries supply the 1st part of duodenum and where do they originate?
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1) Supraduodenal aa (from common hepatic a or gastroduodenal a)
2) Retroduodenal aa - multiple arteries that come off gastroduodenal artery as is passes posterior to 1st part of duodenum |
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What forms the the inferior pancreatic artery?
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The anastamoses of Dorsal pancreatic a, Great pancreatic a, and Caudal pancreatic aa
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4 potential sites of Portal-Caval Anastomoses:
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1) Esophogus
2) Paraumbilical 3) Rectal 4) Retroperitoneal |
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Manifestations of portal hypertension (6)?
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1. splenomegaly
2. esophogeal varacies 3. hemorrhoids 4. caput medusae - "head of madusa" umbilicus veins buldge 5. hepatomegaly 6. ascites - build up of fluid in peritoneal cavity |
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Anterior relations of both kidneys (2)?
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Colon
Small Intestine |
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Anterior Relations of Right Kidneys (2)?
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Liver
Duodenum |
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Anterior Relations of Left Kidneys (3)?
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Stomach
Pancreas Spleen |
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Posterior Relations of Kidneys (4)?
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Psoas major and minor
Quadratus Lumborum Transversus Abdominus Diaphram |
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Trace the flow from kidney's medulla to the ureters?
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Medulla
Pyramid Renal Papilla Minor Calyx Major Calyx Renal Pelvis Ureter |
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What are the posterior/anterior relations of structures in the renal hilus?
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Vein - most anterior
Artery Pelvis (renal pelvis) - most posterior |
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If doing surgery on kidney where would you enter and why?
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Avascular line (Brodl)
it has no vascularization |
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Where do the ureters enter the pelvic brim?
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At bifurcation of common iliac arteries
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Constriction sites of ureters or sites where kidney stone may get lodges?
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Junction with renal pelvis
pelvic brim wall of bladder |
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5 sources of ureter vascular supply?
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Renal a
Gonadal a aorta common illiac internal iliac |
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Arterial supply of suprarenal glands?
Where are they from? |
1) Superior suprarenal arteries (from inferior phrenic arteries)
2) Middle Suprarenal arteries (directly off aorta) 3) Inferior suprarenal arteries (from renal arteries) |
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At closest proximation: what is the relation of the ureter to bifurcation of common iliac vessels?
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Anterior
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At closest proximation: what is the relation of the Psoas major to kidneys?
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medial and posterior
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At closest proximation: what is the relation of the Gonadal vessels to ureters at the iliac bifurcation?
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anterior and lateral
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