Term
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Definition
| Has the tranpyloric plane which includes the hilum of the kidneys, celiac artery above, origin of the superior mesenteric artery, renal artery below, the body of the pancreas, pylorus, duodenal-jejunal flexure below and inferior. |
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Term
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Definition
| Beginning of the thoracic duct (as the cysterna chyli) and the azygos vein, the end of the spinal cord and beginning of the cauda equine. |
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Term
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Definition
| The subcostal plane, Inferior Mesenteric Artery, Horizontal part of duodenum, inferior poles of the left and right kidneys. |
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Term
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Definition
| The umbilical plane which has the umbilicus, the highest point of the iliac crest, the bifurcation of the abdominal aorta, the beginning of the common iliac arteries. |
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Term
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Definition
| Has the transtubercular plane which has the arcuate line and iliac tubercles, and is where the common iliac vein begins and IVC begins. |
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Term
| Vasculature (a's & v's) of the esophagus (2) |
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Definition
It is supplied by the left gastric and the left inferior phrenic artery
Veins
a. Systemic and Portal Venous Anastomosis:
Submucosal veins of the esophagus drain through the left gastric vein to the portal venous system
Submucosal veins also drain through the esophageal veins into azygos vein into the systemic venous system.
b. Esophageal varices: Submucosal veins drain the systemic and portal systems forming an anastomosis. With portal hypertension blood can’t pass through the hepatic portal vein into the liver so the blood volume increases in the submucosal veins creating esophageal varices, which can be life-threatening. |
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Term
| Abdominal Region Locations of the Stomach |
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Definition
| Left hypochondriac, Epigastric and Umbilical region |
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Term
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Definition
Convex - curves outward (top of a dome)
Concave - curves inward (roof of a dome, cervical vertabrae, lordosis - the fat lord lives in a cave) |
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Term
| Which part of the stomach is not intraperitoneal? |
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Definition
| The greater curvature is not covered with peritoneum where the greater omentum is attached. |
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Term
| Arteries of the foregut, midgut, and hindgut |
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Definition
Foregut - Celiac Trunk
Midgut - Superior Mesenteric
Hindgut - Inferior Mesenteric |
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Term
| Anastomoses (2) and blood supply of the stomach |
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Definition
Right gastric (from hepatic) and left gastric (from celiac trunk)
The right and left gastro-omental arteries anastomose along the greater curvature in greater omentum
The upper body and fundus also receive blood supply from the short and posterior gastric arteries. |
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Term
| Veins that constitute the hepatic portal vein |
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Definition
| Mainly the Superior Mesenteric and Splenic, but also the right and left gastric |
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Term
| What veins drain into the splenic vein? |
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Definition
| short gastric veins, left gastroepiploic vein, pancreatic veins, inferior mesenteric vein |
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Term
| What veins drain into the superior mesenteric vein? |
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Definition
| Only the right gastro-omental vein drains into it, it is mostly formed from the return of the superior mesenteric artery |
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Term
| Lymphatic drainage of the stomach and spleen |
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Definition
| Splenic nodes and left gastric nodes (upper) and left gastric epiploic and pylroic nodes (lower) will all ultimately go to the celiac lymph nodes which lead to the cisterna chyli. |
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Term
| Discuss the effects of the sympathetics on the GI tract |
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Definition
Parasympathetic: from vagus nerve (CNX) Which enters at the esophageal hiatus (T10). Increases blood flow to the GI tract and releases neurotransmitters during the cephalic phase of digestion.
Sympathetic: greater splanchnic nerve (T6-T9 to plexus). Decreases blood flow to the GI tract. |
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Term
| Regional locations of the small intestine |
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Definition
| Mostly in the Umbilical (jejeunum) and epigastric regions, also in the hypogastric (ileum) |
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Term
| 4 parts of the duodenum in order |
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Definition
| Superior, Descending, Inferior/Horizontal, Ascending |
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Term
| Identify the location and clinical significance of the duodenal cap |
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Definition
| The duodenal cap is the superior portion of the duodenum, which is also called the ampulla/duodenal bulb of the duodenum. This is the most common site of duodenal ulcer. This is where the pylorus meets the duodenum. |
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Term
| Superior Part of the Duodenum length and features (3) |
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Definition
5 cm
The greater omentum and the hepatoduodenal ligament (part of lesser omentum) attach here. The proximal 2cm of this portion is the most movable part of the duodenum. The distal part has no mesentery and is immobile/retroperitoneal. It starts at the pylorus and ends at the neck of the gallbladder. |
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Term
| Descending Part of the Duodenum length and features (6) |
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Definition
10 cm.
Significant because it has the hepato-pancreatic ampulla. It starts at the neck of the gallbladder and ends lower L3.
Hepato-pancreatic ampulla/Sphincter of Odi: The pancreatic and bile duct enter at the hepato-pancreatic ampulla. It enters at 2nd part of duodenum.
This is where the major papilla is (The duodenal papilla lies inferiorly). The foregut derivatives end at this level.
Inferior duodenal flexure: It turns to become horizontal at this point |
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Term
| Retroperitoneal Structures (9) |
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Definition
| Kidneys, Adrenal Glands, Head of Pancreas, Aorta, IVC, Ureters, Bladder, Rectum, Esophagus, Duodenum except for cap |
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Term
| Secondary Retroperitoneal Organs (4) |
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Definition
| Duodenum, Ascending & Descending Colons, Tail of Pancreas |
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Term
| Folds inside the duodenum |
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Definition
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Term
| Muscle lines on the outsides of the colon |
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Definition
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Term
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Definition
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Term
| Fat Junk hanging off the colon |
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Definition
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Term
| Supplies (blood to) the transverse colon |
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Definition
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Term
| Supplies (blood to) the ascending colon |
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Definition
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Term
| Supplies the cecum and arises from the right side of the superior mesenteric artery |
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Definition
| Ileocolic/cecal artery/vein |
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Term
| Horizontal Part of duodenum length and features (3) |
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Definition
10 cm.
This lies across the L3 vertebrae from L3 to the left side of the aorta at L3.
Physically retroperitoneal with this part of the duodenum. |
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Term
| Horizontal Duodenum Relations Posterior, Anterior, and Inferior structures |
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Definition
Posterior to: Superior mesenteric vessels, root of mesentery, transverse colon, mesocolon, coils of small intestine
Anterior to: IVC, aorta, psoas major, right ureter, right gonadal vessels, inferior mesenteric artery
Inferior to: Head of pancreas |
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Term
| Ascending part of duodenum length and features (3) |
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Definition
2-3 cm.
The duodeno-jejunal flexure is attached to the diaphragm (right crus) via Treitz ligament (is a peritoneal fold) |
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Term
| Blood supply to the duodenum (2) - Logically why would this be 2? |
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Definition
Superior pancreaticoduodenal artery ← Gastroduodenal ← common hepatic ← celiac trunk
Inferior pancreaticoduodenal artery ←Superior mesenteric artery
Has both foregut and midgut parts. |
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Term
| Lymphatic drainage of the duodenum (3 --> 1) |
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Definition
Anteriorly lymph drains into pancreaticoduodenal lymph nodes, and pyloric lymph nodes.
Posteriorly lymph drains to the superior mesenteric lymph nodes.
These all then drain into the celiac lymph nodes, which drain into the cisterna chyli. |
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Term
| Innervation of duodenum (3) |
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Definition
Sympa: Greater (T8 & 9) and lesser splanchnic (T10)
Para: Vagus |
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Term
| General (quadrant) locations of the Jejeunum and Ileum |
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Definition
| Most of the jejunum is in the left upper quadrant and the ileum is in the right lower quadrant. |
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Term
| Differentiating the Jejeunum from the Ileum |
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Definition
Jejunum: Has thicker walls, greater diameter, only creates 1 or 2 arcades and they don’t anastomose, and it lies in umbilical region.
Ileum: the mesentery is thicker with more fat, the arcades are shorter and more complex and don’t anastomose, and it lies in the hypogastric region. |
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Term
| Is the small intestine intra, retro, or secondary retroperitoneal? |
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Definition
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Term
| Three branches of the superior mesenteric artery |
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Definition
| middle colic, right colic, and ilio-colic/cecal |
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Term
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Definition
| Anastomotic loops made up of the intestinal branches of the superior mesenteric artery and give rise to the vasa recti (straight arteries) |
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Term
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Definition
| the straight arteries; tiny arteries that come off of the arcades to supply the small intestine |
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Term
| Innervation of the small intestine |
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Definition
Same as duodenum;
Sympathetic: Greater and lesser splanchnic nerves (T8-T10)
Parasympathetic: Vagus nerve |
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Term
| What besides size determines the difference between the small and large intestine? |
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Definition
It is distinguished by the presence of omental/epiploic appendices, except at the rectum)
Size of the large intestine is inconsistent and can be as large as the small intestine |
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Term
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Definition
| Omental appendices are fat, small omentum-like projections |
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Term
| Large intestine parts - intra, retro, or secondary peritoneal |
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Definition
Ascending/Descending colon: secondary retroperitoneal
Intraperitoneal:
Transverse: intraperitoneal (largest segment of large intestine 40-50cm)
Sigmoid colon
Cecum does not have a mesentery but it is still an intraperitoneal organ because it extends from ascending colon. |
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Term
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Definition
| In the right lower quadrant; marks the base of the appendix as well as the point at which the incision is made for an appendectomy |
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Term
| What parts of the intestines are 2° Retroperitoneal? |
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Definition
| The ascending and descending colons |
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Term
| Ascending colon length and features |
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Definition
15cm.
It is the second part of the large intestine (after cecum) and the first part of the colon. Receives blood supply from iliocecal and R. colic arteries. |
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Term
| Hepatic/Right Colic Flexure |
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Definition
| Lower than the splenic flexure. The ascending colon turns to the left to become the transverse colon. |
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Term
| Name the viscera that are physically related (close to?) to the right/hepatic flexure and those that are related to the left/splenic flexure |
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Definition
Hepatic flexure (R): Related to the R.kidney, duodenum, gallbladder and liver.
Splenic flexure (L): Related to the L. kidney, spleen, pancreas, stomach, and diaphragm (via phrenico-colic ligament). |
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Term
| Transverse Colon length and features (4) |
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Definition
50 cm.
Located between flexures. It is the most mobile and is the longest part of the colon. It is attached to the greater omentum between the two flexures.
It receives blood supply from the middle/right/left colic arteries. |
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Term
| Splenic/Left Colic Flexure |
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Definition
| The transverse colon turns downward to become the descending colon at this curve. |
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Term
| Descending colon length and features (3) |
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Definition
25cm.
Deeper than ascending, has loose mesentery.
It receives blood supply from the left colic and superior sigmoid arteries. |
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Term
| Sigmoid Colon features (5) |
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Definition
Intraperitoneal because it has mesentery. Characterized by an S shape. It connects the descending colon to the rectum. When the sigmoid colon meets the rectum at the rectosigmoid junction, this also marks the end of the taenia coli.
It receives blood supply from the left colic and sigmoid arteries. |
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Term
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Definition
| The colon, which is part of the large intestine, does not include the anal canal and cecum. |
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Term
| Identify all the abdominal viscera draining into the Portal Hepatic Vein |
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Definition
| Basically everything except for the kidneys |
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Term
| Lymphatic drainage of the large intestine (2; logical) |
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Definition
The lymph vessels of the transverse and ascending colon end in the superior mesenteric nodes.
The lymph vessels of the descending and sigmoid colon end in the inferior mesenteric nodes. Both sets lead to cysterna chyli. |
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Term
| Large intestine Innervation (sympathetics) |
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Definition
1. Ascending Colon, Cecum, Appendix
Sympathetic. –Celiac and Superior Mesenteric plexus
Parasympathetic- Vagus. Thoracoabdominal and pelvic splanchnic nerves (distal 1/3 of transverse to rectum; S2-4).
2.Transverse colon
Sympathetic: Superior and Inferior Mesenteric Plexuses as well as hypogastric plexus.
Parasympathetic is also coming these plexuses, and vagus nerve ends here.
3. Descending. And Sigmoid Colon
Sympathetic: Inferior mesenteric plexuse and hypogastric plexus.
Parasympathetic: pelvic splanchnic nerves/S2-S4 spinal nerves. |
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Term
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Definition
| In the pelvic diaphragm; composed of the coccygeus and levator ani muscles; creates the pelvic floor. |
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Term
| Anal Canal (perineum) features (2) |
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Definition
Begins at the pelvic diaphragm; includes the
Ischio-rectal Fossa - fat filled area on both sides of anal canal. A dangerous area because infections can travel into this area. Innervated by the pudendal nerve. |
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Term
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Definition
Fat filled area on both sides of anal canal; A dangerous area as infections can travel into this area.
Innervated by the pudendal nerve. |
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Term
| Muscles of chewing are all innervated by what nerve? |
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Definition
| Trigeminal Nerve - V3 specifically |
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Term
| Muscles of mastication (4) |
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Definition
The masseter
The temporalis
The medial pterygoid
The lateral pterygoid |
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Term
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Definition
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Term
| All of the infrahyoid muscles (includes which 4) are innervated by? |
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Definition
| All of the infrahyoid muscles are innervated by ansa cervicalis from the cervical plexus(C1-3) EXCEPT for the thyrohyoid muscle, which is innervated by only C1 fibres travelling with the Hypoglossal Nerve (CN XII). |
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Term
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Definition
Anterior - V3
Posterior - Facial (CN7) |
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Term
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Definition
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Term
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Definition
Rectus Abdominus T7-T12
Thoraco Abdominal Nerve T7-T11
Subcostal Nerve T-12 (for all)
Other abdominal muscles T7-T12, L1 |
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Term
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Definition
| demarcates the lower limit of the posterior layer of the rectus sheath |
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Term
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Definition
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Term
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Definition
| Attaches transverse colon to posterior abdominal wall |
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Term
| 4 duodenum parts vertebral levels |
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Definition
Duodenal Cap - L1
Descending - L2
Horizontal - L3
Ascending - L2 |
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Term
| The boundaries of the inguinal canal are (6) |
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Definition
• Deep: deep inguinal ring
• Superficial: superficial inguinal ring
• Anterior: aponeurosis of the external oblique muscle
• Inferior (floor): inguinal ligament and lacunar ligament
• Superior (roof): the arching fibers of the internal oblique and transversus abdominis muscles
• Posterior: transversalis fascia laterally and conjoint tendon medially |
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Term
| Transverse Abdominus Muscle Attachments |
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Definition
Internal surfaces of the costal cartilages of ribs 7-12, the thoracolumbar fascia, the iliac crest, and the lateral third of the inguinal ligament.
The distal attachments of the transversus abdominis muscle are the linea alba, the pubic crest, and the pecten pubis. |
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Term
| Internal Oblique Rib Attachment & Distal Attachments |
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Definition
ribs 10-12
linea alba, the pubic crest, and the pecten pubis |
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Term
| External Oblique Rib Attachment & Distal Attachments |
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Definition
The proximal attachments of the external oblique muscle are the external surfaces of ribs 5-12
Linea alba, pubic tubercle, and anterior half of the iliac crest |
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Term
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Definition
A network of nerve fibers innervating most of the palate, larynx, and pharynx
It is located on the surface of the middle pharyngeal constrictor muscle |
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