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Anatomy Quiz 5
Block 3
131
Anatomy
Professional
12/04/2011

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Term
How far does the diaphragm rise on each side?
Definition
Right dome- 5th rib

Left dome- 5th intercostal space
Term
What organs are protected by the lower ribs so can be injured in fractures of the lower ribs?
Definition
liver and spleen
Term
What is in the R upper quadrant?
Definition
liver (right lobe), gallbladder, stomach (pylorus), duodenum (parts 1-3), pancreas (head), R suprarenal gland, R kidney, R colic (hepatic) flexure, ascending colon (superior part), transverse colon (right half)
Term
What is in the R lower quadrant?
Definition
cecum, vermiform appendix, most of ileum, ascending colon (inferior part), R ovary, R uterine tube, R ureter (abdominal part), R spermatic cord (abdominal part), Uterus (if enlarged), urinary bladder (if very full)
Term
What is in the L upper quadrant?
Definition
liver (left lobe), spleen, stomach, jejunum and proximal ileum, pancreas (body and tail), L kidney, L suprarenal gland, L colic (splenic) flexure, transverse colon (L half), descending colon (superior part)
Term
What are the 9 regions of the abdomen?
Definition
divided by 2 vertical midclavicular planes, 2 horizontal planes: subcostal plane thru 10th costal cartilage (transpyloric plane) and transtubercular plane thru tubercles of iliac crest (level of Lv5)

Midline regions- epigastric, umbilical, hypogastric (pubic)

Lateral regions- hypochondrac , lateral (flank), inguinal (groin)
Term
What consists of the abdominal wall proper?
Definition
5 lumbar vertebrae P and wings (alae) or ilia L
Term
What is in the superficial fascia of the anterolateral abdominal wall?
Definition
cutaneous nerves, including lateral/anterior cutaneous branches of thoracoabdominal nerves (T7-11- pain from disease of lower thoracic wall may be referred to abdomen, T10 innervates umbilicus), subcostal nerve (T12), iliohypogastric and ilioinguinal nerves (L1)
Term
What are the arteries of the anterolateral abdominal wall?
Definition
Superficial vessels branches of femoral artery- superficial epigastric arteries and superficial circumflex iliac arteries
Term
What are the arteries of the abdominal wall as deeper vessels?
Definition
inferior epigastric (external iliac) and superior epigastric (internal thoracic) which anastomosis as potential source of collateral circulation, deep circumflex iliac artery from external iliac artery
Term
What are the collateral routes for return of blood to the hear if inferior/superior vena cava is obstructed?
Definition
caval-caval shunts
Term
What are the 2 anastomoseses to return blood to the heart if inferior/superior vena cava is obstructed?
Definition
first-superficial epigastric vein (femoral vein) with lateral thoracic vein (axillary vein) to form thoracoepigastric vein

second- inferior epigastric vein (external iliac) with superior epigastric vein (brachiocephalic) w/in rectus sheath
Term
What is the lymphatic drainage from the anterolateral abdominal wall?
Definition
superficial lymphatic vessels above umbilicus draining mainly upward to axillary lymph nodes and below umbilicus downward to superficial inguinal lymph nodes, deep lymphatic vessels accompanying deep veins of abdominal wall
Term
What are the 2 layers of the superficial fascia inferior at level of the umbilicus?
Definition
superficial fatty layer- Camper's fascia, deep membraneous- Scarpa's fascia
Term
What is Scarpa's fascia continous with and what can this cause?
Definition
superficial penile fascia, dartos fascia of scrotum, and Colles' fascia of perineum- extravasated urine from ruptured penile urethra may spread upward into the A abdominal wall (doesn't spread to thigh because Scarpa's fascia fuses w/ fascia lata of thigh just below the inguinal ligament)
Term
What are the 3 muscles on each side of the anterolateral abdominal wall and what do they develop from?
Definition
external oblique, internal oblique, and transversus abdominis; develop from same 3 layers of hypomere in embryo as 3 layers of the intercostal muscles of the thoracic wall
Term
Where does the external oblique muscle originate and insert?
Definition
arises from lower 8 ribs and courses inferomedially, has posterior fibers inserting into iliac crest and A has broad external oblique aponeurosis that helps form A layer of rectus sheath
Term
What is the linea alba?
Definition
where aponeurotic fibers intersect w/ fibers from other side
Term
Where is the external oblique aponeurosis?
Definition
Between anterior superior iliac spine and pubic tubercle, forms inguinal ligament, spermatic cord lies in shallow gutter formed by inguinal ligament
Term
Where does the internal oblique muscle originate and insert?
Definition
arises from thoracolumbar fascia, iliac crest, and lateral 1/2 of inguinal ligament, fiber course superomedially at R angle to external oblique and continue into internal oblique aponeurosis
Term
What do the inferior fibers of the internal oblique join to form the conjoint tendon (falx inguinalis)?
Definition
deeper transversus abdominis muscle, tendon arches over spermatic cord to attach into pubic crest and pecten pubis
Term
What separates the two sides of the rectus abdominis muscle? What is it bounded by?
Definition
linea alba- no major nerves/BVs corss so can do surgical incisions here

linea semilunaris which is more obvious in thin/muscular individuals
Term
How is the rectus sheath different above and below the arcuate line?
Definition
Above- the internal oblique aponeurosis splitting to contribute to both A/P layers

Below- all 3 aponeuorses passing A to rectus abdominis, P surface is in contact with transversalis fascia
Term
What are the functions of the anterolateral abdominal muscles?
Definition
support/protection of organs (involuntary spasms may occur due to inflammation that irritates nerve supply (appendicitis) or palpation w/ cold hands), relaxation/contraction in breathing, increase intra-abdominal pressure (micturition-emptying bladder, defection, coughing/sneezing, parturition-giving birth), movement (flexion of trunk-bilateral contraction, lateral felxion-one side contracts/ipsilateral, rotation of trunk-one internal oblique and contralateral external oblique to side of internal oblique)
Term
What is in the inguinal region?
Definition
area of weakness, contains inguinal canal- transmits large spermatic cord or round ligament of uterus
extends inferomedially from deep inguinal ring to superficial inguinal ring w/in external oblique aponeurosis
Term
What are the boundaries of the inguinal canal?
Definition
anterior wall- external oblique aponeurosis w/ reinforcement laterally from internal oblique aponeurosis
posterior wall- transversalis fascia reinforced medially by conjoint tendon
roof- arching fibers of internal oblique and trasversus abdominis
floor- inguinal ligament reinforced medially by lacunar ligament
Term
What is a hernia and where does it occur in the abdominal region?
Definition
hernia- protrusion of an organ/other structure from its normal anatomic enclosure
may be through congenital or acquired defect in abdominal wall (external hernia) or through internal opening (internal hernia)
msot occur in inguinal, umbilical, or epigastric region
Term
What are the 2 types of hernias?
Definition
follow path of testis (indirect inguinal hernia-leaves abdominal cavity lateral to inferior epigastric artery) or push directly though weak area of abdominal wall more medially (direct inguinal hernia)
Term
What causes an indirect inguinal hernia?
Definition
follows the path of embryonic descent of testis through inguinal canal and exits the superficial inguinal ring, is due to persistance of evagination of peritoneum on each side (processus vaginalis)
considered congenital since its a persistent processus vaginalis, may be in women if have peritoneal pouch (canal of Nuck)
Term
What are the 3 fascial coverings of the spermatic cord?
Definition
internal spermatic fascia (from transversalis fascia), cremasteric fascia (from internal oblique muscle), external spermatic fascia (from external oblique aponeurosis)
Term
What is the risk associated with an indirect inguinal hernia?
Definition
significant risk of becoming entrapped (incarceration) w/bowel obstruction and possible loss of blood supply (strangulation)
Term
Where does the direct inguinal hernia leave?
Definition
abdominal cavity medial to inferior epigastric artery, pushes directly into inguinal canal through or around a weak conjoint tendon, protrudes through inguinal (Hesselbach's) triangle formed by inferior epigastric artery laterally, rectus abdominis meidally, and inguinal ligament inferiorly
Term
What are the characteristics of a direct inguinal hernia?
Definition
has hernial sac formed by transversalis fascia, fains outer covering by external spermatic fascia as it protrudes though superficial inguinal ring, less likely to descend into scrotum than an indirect inguinal hernia, classfied as acquired lesion
Term
What are the factors that oppose inguinal hernia formation?
Definition
contraction of internal oblique/transversus abdomins muscle fibers(indirect), pressure of posterior wall of inguinal canal toward the anterior wall (indirect), location of conjoint tendon (direct)
Term
What is omphalocele?
Definition
severe congenital hernia- due to failure of bowel to return to body cavity following its normal embryonic herniation, covered by amnion
Term
What is gastroschisis?
Definition
due to herniation of abdominal contents through the body wall lateral to umbilicus into amniotic cavity, viscera are NOT covered by amnion
Term
What are incisional hernias?
Definition
protrusions of omentum or organs thru sites of surgical incisions, may result from improper healing of abdominal wall following surgery or from weakness of abdominal wall muscles following the cutting of their motor nerve supply
Term
What does the digestive system consist of?
Definition
oral cavity, pharynx, esophagus, stomach, SI, LI, accessory digestive organs: salivary glands, liver, gallbladder, pancreas
Term
What kind of muscle makes up the esophagus?
Definition
upper 1/3 skeletal, middle 1/3 mixed, lower 1/3 smooth
Term
where is the lower esophageal sphincter located?
Definition
at esophageal hiatus of diaphragm
Term
what are the 3 constrictions of the esophagus?
Definition
cervical- caused by upper esophageal spincter at pharyngoesophgeal junction
thoracic- caused by arch of aorta and left main bronchus
diaphragmatic- caused by lower esophageal spincter at the esophageal hiatus of diaphragm
Term
What is achalasia?
Definition
esophageal motility disorder, may cause absence of esophageal peristalsis and failure of lower esophageal sphincter to relax, signs/symptoms result from absence of autonomic ganglion cells w/in wall of esophagus, pt experiences dysphagia w/ possible regurgitation and chest pain (bird beak)
Term
What happens in Barrett's esophagus?
Definition
stratified squamous epithelium undergoes metaplastic change into columnar epithelium, columnar epithelium is prone to ulceration and strictures may develop causing obstruction; the metaplastic epithelium may undergo malignant transformation into adenocarcinoma
Term
What are the 4 parts of the stomach?
Definition
cardia/cardiac region- at gastroesophageal junction
fundus- dilated superolateral part below L dome of diaphragm
body-major part
pyloric part- funnel shaped, which consists of wide pyloric antrum leading into narrow pyloric canal
Term
What indicates the junction of the body and pyloric part?
Definition
angular incisure, also has lesser curvature on top and greater curvature on bottom
Term
What increase the SA in the small intestine?
Definition
circular folds (plicae circulares) of mucosa-submucosa, villi, microvilli
Term
Where is the C shaped loop of the duodenum?
Definition
around head of pancreas, continuous w/ jejunum at duodenojejunal junction
Term
What are the 4 parts of the duodenum?
Definition
superior, descending, inferior/horizontal, ascending
Term
What is the most frequent location of peptic ulcers?
Definition
duodenal cap/ampulla- in superior part of duodenum
Term
What structure enters the descending part of the duodenum?
Definition
receives common bile duct carrying bile and main pancreatic duct carrying pancreatic enzymes (join in common chamber-hepatopancreatic ampulla-which drains into duodenum at major duodenal papilla)
Term
Where can the superior mesenteric artery/vein be compressed/obstructed following sudden weight loss?
Definition
inferior/horizontal part (superior mesenteric artery syndrome)
Term
What suspends the duodenojejunal junction?
Definition
suspensory muscle of the duodenum (ligament of Treitz) from diaphragm, junction b/w upper GI bleeding and lower GI bleeding which have different clinical characteristics
Term
What do the jejunum and ileum look like in a barium swallow?
Definition
feathery appearance of jejunum due to numerous large mucosal-submucosal folds (plicae circulares) in wall, smooth walls of distal ileum
Term
What is the embryonic remnant attached to the ileum?
Definition
ileal (Merkel's) diverticulum- remnant of embryonic vitelline duct (yolk stalk), contains all layers normally found in intestinal wall, may contain ectopic gastric or pancreatic tissue and cause hemorrhage, bowel obstruction, perforation, and/or pain (mimic appendicitis)
Term
How is the large intestine distinguished from the small intestine?
Definition
omental appendices (small fatty projections), teniae coli (3 bands of longitundinal smooth muscle), haustra (sacculations)
Term
What are the parts of the large intestine?
Definition
cecum, appendix, colon (ascending, transverse, descending, sigmoid), rectum, anal canal
Term
What does the appendix suspend from?
Definition
cecum, inferior to ileocecal junction
Term
Define: intussusception, volvulus, gallstone ileus
Definition
intussusception: telescoping of proximal segment of intestine into a more distal part
volvulus- twisting of intestine of itself
gallstone ileus- gallstone blocks ileocecal junction
Term
What is the appendix?
Definition
intestinal diverticulum that contains lymphoid tissue, variable in postion- most commonly retrocecal
Term
What causes appendicits? What can happen if it isn't removed?
Definition
occlusion of lumen or infection, may become gangrenous or perforate causing peritonititis
Term
What are the 4 parts of the colon?
Definition
ascending, transverse, descending, sigmoid
Term
Where does the ascending colon meet the transverse colon? Where does the transverse colon meet the descending colon?
Definition
right colic (hepatic) flexure, left colic (splenic) flexure
Term
Where are the rectum and anal canal located?
Definition
pelvis (rectum) and perineum (anal canal)
Term
What are the digestive system accessory organs?
Definition
salivary glands, liver, gallbladder, pancreas
Term
What are the functions of the liver?
Definition
production of bile, storage of glycogen, receives all nutrients absorbed by alimentray tract except lipids
Term
What are the fissures dividing the anatomical lobes of the liver?
Definition
left sagittal fissure formed by fissure of the round ligament of the lvier (ligamentum teres hepatis) and fissure for the ligamentum venosum (right lobe includes quadrate and caudate lobes)
Term
What divides the functional (portal) lobes?
Definition
imaginary right sagittal fissure passing through gallbladder fossa and fossa of I vena cava on visceral side
each lobe receives its own branch of the hepatic artery and portal vein and is drained of bile by its own hepatic duct (together the portal triad)
Term
What is in the portal triad and where does it enter?
Definition
branch of each of the proper hepatic artery and portal vein along with bile duct
structures enter visceral surface of liver at transverse fissure, porta hepatis
Term
What is the arrangement of the portal triad?
Definition
traverses hepatoduodenal ligament, bile duct is located anteriorly on R, proper hepatic artery is A on L, portal vein is located posterior to these 2 structures
Term
What can cause cirrhosis?
Definition
chronic alcoholism, hepatitis B and C
Term
What are the parts of the gallbladder?
Definition
fundus- blunt end that project from inferior border of liver at tip of R 9th costal cartilage
body- main portion, in contact w/ visceral surface of liver, duodenum, and transverse colon
neck- narrow tapering end that usually makes S-shaped turn to become continuous with cystic duct
Term
Define: cholelithiasis, cholecystitis, fistula, cholecystenteric fistula, gallstone ileus
Definition
cholelithiasis- gallstones
cholecystitis- gallstones obstruct passage of bile and cause inflammation
fistula-opening
cholecystenteric fistula- opening that develops in superior part of duodenum or transverse colon
gallstone ileus- gallstone in small intestine that may obstruct ileocecal valve
Term
What are the ducts that carry bile?
Definition
Common hepatic duct (from liver, formed by union of R and L hepatic ducts from lobes of liver), cystic duct (bile from gallbladder), common bile duct (union of cystic duct and common hepatic duct, joins main pancreatic duct at hepatopancreatic ampulla to drain into duodenum)
Term
Where does the pancreas lie?
Definition
transversely across vertebrae L1-2
Term
What are the 4 parts of the pancrea?
Definition
head- lies w/in C shaped concavity of duodenum
neck- pancreas overlying the superior mesenteric artery and vein
body- longest part
tail- closely related to spleen
Term
What are the 2 ducts of the pancreas?
Definition
main pancreatic duct- begins at tail and runs through body, neck, and head and joins w/ bile duct at hepatopancreatic ampulla to drain at major duodenal papilla
accessory pancreatic duct- drains part of the head of the pancreas
Term
Where does cancer of the pancreas usually happen and what does this cause?
Definition
head of pancreas, may obstruct bile duct causing jaundice- symptoms include painless jaundice and severe pain radiating to mid to lower back
Term
When does cancer in body and tail of the pancreas occur?
Definition
not until metastasis has occured, 4th leading cause of cancer death in US
Term
Why is the peritoneal cavity not closed in females?
Definition
vagina, uterus, and uterine tubes connect to peritoneal cavity- the uterine tubes open into peritoneal cavity providing pathway for spread of infection
Term
Define: ascites, paracentesis
Definition
ascites- peritoneal fluid accumulates
paracentesis- removal of excess fluid
Term
What is peritonitis?
Definition
infections of peritoneum
Term
Why do we prop up a patient with bacterial peritonitis?
Definition
usually fluid flows superiorly towards diaphragm and is rapidly absorbed, propped up so that infected fluid flows downward into pelvic cavity where absorption is slower, likelihood of infection spreading though diaphragm to pleura from subphrenic space is reduced
Term
When do adhesions (fibrous bridges) develop and what do they cause?
Definition
may result from peritonitis due to trauma or infection, may cause chronic pain and bowel/uterine tube obstruction
Term
Define: intraperitoneal, retroperitoneal
Definition
intraperitoneal- invaginating the peritoneal sac from behind and suspended form the body wall by double layer peritoneum (mesentery)
retroperitoneal- located posterior to peritoneum
Term
What is associated with intraperitoneal organs?
Definition
covering of visceral peritoneum, suspended by mesentery, peritoneum lining body wall is parietal peritoneum
Term
What are the intraperitoneal organs?
Definition
abdominal esophagus, stomach and proximal duodenum (duodenal cap), jejunum and ileus, cecum, transverse colon, sigmoid colon, liver and gallbladder, tail of pancreas, spleen
Term
What are the retroperitoneal organs?
Definition
duodenum (except duodenal cap), ascending colon, descending colon, pancreas (except tail), kidneys and ureters, abdominal aorta, inferior vena cava
Term
What are the 3 structures formed by double layers of peritoneum?
Definition
mesenteries, omenta (connect sotmach and proximal duodenum to other organs), peritoneal ligaments (connect abdominal organs to each other or to abdominal wall)
Term
Where does the omentum attach?
Definition
greater omentum-suspended from greater curvature of stomach
lesser omentum-connecting lesser curvature (hepatogastric ligament) and proximal duodenum (hepatoduodenal ligametn) to liver
Term
What is the function of the greater omenutum?
Definition
moves to wall off infections w/in peritoneal cavity keeping them localized to prevent generalized peritonitis
Term
Where are the greater and lesser sacs of the peritoneal cavity?
Definition
greater- main larger part
lesser (omental bursa)- lies posterior to stomach and lesser omentum
Term
How do the greater sac and omental bursa communicate?
Definition
through omental (epiploic) foramen
Term
What is the omental foramen bounded by?
Definition
anteriorly-hepatoduodenal ligament (forms free right edge of lesser omentum)
posteriorly-inferior vena cava
superiorly- caudate lobe of liver
inferiorly- superior (first) part of the duodenum
Term
What disease state happens at the omental foramen?
Definition
internal hernia when a loop of small intestine becomes entrapped w/in it, since none of the boundaries of the foramen can be incised the swollen intestine must be decompressed with a needle to free it
Term
What is the greater sac divided by and into what compartments?
Definition
subdivided by transverse colon and transverse mesocolon

supracolic compartment- contains stomach, liver, spleen
infracolic compartment- contains small intestine, ascending colon, descending colon (infracolic compartment subdivided by mesentery of small intestie into R and L infracolic space)
Term
How does the abdominal cavity communiate with the pelvic cavity providing pathways for the spread of infection/cancer?
Definition
right paracolic gutter-lateral to ascending colon, connects supracolic compartmetn and pelvic cavity
left paracolic gutter- lateral to descending colon
Term
Where is the heptorenal recess (Morison's pouch) and how does it communicate with other spaces?
Definition
located b/w right lobe of liver and right kidney; communicates medially with omental bursa through omental foramen and anteriorly with subphrenic recess b/w liver and diaphragm (common site for abscesses)
Term
What are the derivatives of the embryonic gut supplied by in terms of arteries?
Definition
supplied by unpaired ventral branches of abdominal aorta

caudal foregut- celiac trunk (celiac artery)
midgut- superior mesenteric artery
hindgut- inferior mesenteric artery
Term
What does the embryonic caudal foregut form?
Definition
abdominal portion of esophagus, stomach, duodenum as far as its union w/ bile and pancreatic ducts, liver and gallbladder, pancreas
Term
What are the branches of the celiac trunk that supply derivatives of the caudal foregut?
Definition
left gastric artery, splenic artery (left gastro-omental, short gastric), common hepatic artery (gastroduodenal-right gastro-omental, superior pancreaticoduodenal; proper hepatic-right hepatic/cystic, left hepatic)
Term
What do the left gastric and splenic arteries supply?
Definition
Left gastric- supplies stomach and lower esophagus
splenic artery- supplies neck, body, and tail of pancreas; spleen, sends branches to stomach
Term
What do the branches of the common hepatic artery (gastroduodenal and proper hepatic) supply?
Definition
gastroduodenal- supplies sotmach, head of pancreas, duodenum
proper hepatic- supplies liver, gallbladder; sends right gastric branch to somtach, right hepatic artery gives off cystic artery to the gallbladder
Term
What are the aberrant/accessory arteries that may occur?
Definition
abberant right hepatic artery branching from superior mesenteric artery
abberent left hepatic artery branching from left gastric artery
Term
What structures does the midgut form?
Definition
duodenum distal to its union w/ bile and pancreatic ducts, jejunum and ileum, cecum and appendix, ascending colon, right 2/3 of transverse colon
Term
What are the branches of the superior mesenteric artery that supply the midgut?
Definition
inferior pancreaticoduodenal

intestinal branches of jejunal and ileal arteries

middle colic-right and left branches

right colic-ascending and descending branches

ileocolic- appendicular artery, A/P cecal branches, ascending and ileal branches
Term
What do the branches of the superior mesenteric artery supply?
Definition
inferior pancreaticoduodenal- head of pancreas, duodenum

intestinal branches- jejunum and ileum

middle colic- transverse colon

right colic- ascending colon

ileocolic- terminal ileun, cecum, ascending colon- gives off appendicular artery to appendix
Term
What does the hindgut form?
Definition
L 1/3 of transverse colon, descending colon, sigmoid colon, rectum and upper anal canal
Term
What are the branches of the inferior mesenteric artery that supply hindgut?
Definition
left colic artery- ascending and descending branches

sigmoid arteries

superior rectal artery
Term
What do the branches of the inferior mesenteric artery supply?
Definition
left colic artery- descending colon

sigmoid arteries- sigmoid colon

superior rectal artery- rectum and anal canal
Term
What is the marginal artery formed by? What can it be used for?
Definition
parallel to wall of large intestine, formed by branches of ileocolic, right colic, middle colic, left colic arteries; may become dilated to provide collateral circulation during slow occlusion of superior or inferior mesenteric arteries and may allow ligation of inferior
Term
What is in the left colic (splenic) flexure in terms of vasculature?
Definition
"watershed area" where anastomoses b/w branches of middle and left colic arteries to form marginal artery may be absent or insufficient therefore systemic hypotension or inferior mesenteric artery stenosis may result in ischemia and infarction (ischemic bowel disease)
Term
Where does blood from the GI system and spleen drain?
Definition
into hepatic portal vein for transport to liver; different from rest of body which passes direct tribuitaries to vena cava
Term
What is the hepatic portal vein formed by? What drains blood into the inferior vena cava?
Definition
hepatic portal vein- formed posterior to neck of pancreas by union of superior mesenteric vein and splenic vein, inferior mesenteric drains into splenic

hepatic veins drain blood from liver into inferior vena cava
Term
Where is the spleen located? Why is it associated with GI system even though it isn't a part of the digestive system?
Definition
located deep to left lower ribs 9-11 with long axis parallel to rib 10

considered with digestive system because of its proximity and shared blood supply
Term
What is the vasculature of the spleen?
Definition
supplied by splenic artery (celiac trunk) may develop aneurysm in pregnant women who smoke causing aneurysm rupture

drained by splenic vein which joins w/ superior mesentic vein to form portal veins, inferior mesenteric drains tinto splenic vein
Term
Where is pain referred in issues with the spleen? How can it be ruptured?
Definition
left shoulder via phrenic nerve

blunt trauma to abdomen, may be lacerated with fractures of lower left ribs
Term
What recess is located near the spleen and is important in a splenic needle biopsy?
Definition
costodiaphragmatic recess which descends to level of 10th rib in midaxillary line, be careful not to enter or can cause pleuritis
Term
What are the ganglia and plexuses form from the esophagus to anus?
Definition
intrinsic ganglia and nerve plexuses that form enteric nervous system- capable of independently maintaining function of digestive tract but activities influenced by sympathetic/parasympathetic nervous sytems
Term
What are the main intrinsic nerve plexuses that form enteric NS?
Definition
submucous (Meissener's)w/in submucosa, myenteric (Auerbach's) w/in muscularis externa
Term
What does the sympathetic nervous innervation of abdominal organ consist of?
Definition
preganglionic nerve fibers that reach prevertebral ganglia through abdomniopelvic splanchnic nerves, postganglionic nerve fibers from nerve cell bodies w/in prevertebral ganglia that follow arteries to organs
Term
At what origins along the abdominal aorta are the prevertebral ganglia found?
Definition
celiac trunk- celiac ganglia

superior mesenteric artery- superior mesentic ganglion

inferior mesenteric artery- inferior mesenteric ganglion

renal arteries- aorticorenal ganglia
Term
What are the splanchnic nerves that carry preganglionic sympathetic nerve fibers from cell bodies w/in the IMLCC to prevertebral ganglia?
Definition
thoracic splanchnic nerves- greater (T5-9), lesser (T10-11), least (T12)
lumbar splanchnic nerves (L1-2, occasionally L1-3)
Term
What do the 2 division of the splanchnic nerves supply?
Definition
thoracic (preganglionic) splanchnic nerves- foregut (celiac trunk) and midgut (superior mesenteric artery)

lumbar (preganglionic) splanchnic nerve- hindgut (inferior mesenteric artery)
Term
Since the autonomic fibers to visceral organs follow blood vessels, what do they supply?
Definition
celiac ganglia nerve fibers- foregut derivatives: stomach, proximal duodenum, liver, gallbladder, pancreas, spleen

aorticorenal ganglia- renal artery branches to kidneys and renal glands

superior mesenteric ganlia- midgut derivatives: distal duodenum, jejunum and ileum, cecum and appendix, ascending and transverse colon

inferior mesenteric ganglia- hindgut derivatives: descending colon, sigmoid colon, rectum, upper anal canal
Term
What does the sympathetic NS do?
Definition
vasoconstriction in blood vessels of viscera, reduced glandular secretion, reduced peristalsis
Term
Where does preganglionic parasympathetic innervation of abdominal organs come from?
Definition
vagus nerve (CN X) which innervates foregut/midgut derivatives

pelvic splanchnic (S2-4) which innervates hindgut derivatives
Term
What structures does the vagus nerve provide parasympathetic innervation?
Definition
foregut and midgut derivatives- distal esophagus, stomach, liver, gallbladder, pancreas, duodenum, jejunum, ileum, ascending colon, transverse colon
Term
What strucutures does the pelvic splanchnic nerves innervate?
Definition
hindgut: descending colon, sigmoid colon, rectum, upper anal canal (only splanchnic nerve that carry parasympathetic fibers)
Term
What do parasympathetic fibers do?
Definition
increase glandular secretion, increase peristalsis, inhibit pyloric sphincter
Term
What accompany the sympathetic nerves, carrying pain?
Definition
visceral afferent fibers
Term
Where would irritation of phrenic nerve be referred?
Definition
to ipsilateral shoulder, phrenic nerve (C3,4,5) enter same spinal cord segments as supraclavicular nerves (C3,4) which supply cutaneous innervation to the shoulder
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