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Block D - Digestion and Metabolism > Anatomy Lecture 4 -- Solid Organs > Flashcards

Anatomy Lecture 4 -- Solid Organs Flashcards

1
Q

3 solid organs of the abdomen

A
  • Spleen
  • Pancreas
  • Liver/ Gall bladder
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2
Q

Define the 1x3x5x7x8x9x11 rule

A

Anatomical proportions of the spleen

  • SIZE = 1” x 3” x 5”
  • WEIGHT = ~7 oz
  • Position = between 9th and 11th ribs
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3
Q

Define the precise location of the spleen

A
  • Between the 9th and 11th ribs
  • Left hand side
  • Between the stomach and splenic flexure of the colon (anteriorly) and the diaphragm (posteriorly)
  • In left hypochondriac region
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4
Q

From what do peritoneal reflections of the spleen develop?

A

Primitive dorsal mesentery

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5
Q

Describe the relationships of the spleen during the primitive embryonic stage

A

Located in the dorsal mesentery, which is perfectly in the dorsal midline between the aorta and the developing stomach

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6
Q

Ligaments connected to the spleen

A
  • Splenorenal ligament
  • Gastrosplenic ligament
  • Phrenicocolic ligament (diaphragm to splenic flexure; spleen rests on it but is not connected by it)
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7
Q

Surfaces of the spleen

A
  • Diaphragmatic surface
  • Visceral surface:
    • Gastric
    • Renal
    • Colic
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8
Q

What organs are related to the spleen by the gastric impression

A

Posterior left side of the stomach and tail of the pancreas

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9
Q

Organs related to the spleen by the renal impression

A

Upper, left anterior surface of the left kidney

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10
Q

Organs related to the spleen by the colic impression

A

Splenic flexure of the colon

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11
Q

Blood supply of the spleen

A

Splenic artery

Splenic vein

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12
Q

Describe the location of the splenic artery

A
  • From the celiac trunk
  • Larger, tortuous – posterior to the lesser sac and along the superior border of the pancreas
  • Travels through the lienorenal ligament to the spleen
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13
Q

Function of the splenic artery

A

Provide blood supply to the stomach (short gastric and left gastroepiploic arteries via the gastrosplenic ligament) and the spleen

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14
Q

Describe the location of the splenic vein

A
  • Travels on the posterior surface of the pancreas, below the artery
  • Joins with the superior mesenteric vein to form the portal vein
  • Usually receives the inferior mesenteric vein behind the body of the pancreas
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15
Q

Common cause of splenomegaly

A
  • Usualyl associated with increased workload (i.e. hemolytic anemias) –> response to hyperfunction
  • Therefore associated with any disease process that involves abnormal RBCs being destroyed in the spleen
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16
Q

2 common causes of splenomegaly unrelated to function

A
  • Congestion due to portal hypertension
  • Infiltration by leukemias and lymphomas
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17
Q

Treatment of splenomegaly

A

Removal (without any apparent ill effects)

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18
Q

4 functions of the spleen

A
  • Storage of RBCs
  • Destruction of worn-out RBCs
  • Removal of foreign material from the blood
  • Production of mononuclear leukocytes
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19
Q

COnsequence of losing one’s spleen

A

Not essential to life; liver and bone marrow can take over many of its functions = no apparent ill effects

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20
Q

5 parts of the pancreas

A
  • Head
  • Neck
  • Body
  • Tail
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21
Q

Describe the anatomical position of the pancreas head

A
  • Lies within the medial curve of the D2
  • Uncinate process elongation of inferior border to the left, crossed anteriorly by the superior mesenteric vessels
  • Posterior = IVC and bile duct
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22
Q

Describe the anatomical position of the pancreas neck

A
  • Left of the head
  • Superior = pylorus and origin of the celiac trunk
  • Posterior = origin of the portal vein
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23
Q

Describe the anatomical position of the pancreas body

A
  • Anterior = lesser sac, then stomach
  • Posterior = aorta, splenic vein and left kidney
  • Inferior = duodenal-jejunal junction
  • Superior = splenic artery
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24
Q

Describe the anatomical position of the pancreas tail

A
  • Left extremity
  • Extends to the hilum of the spleen in the lienorenal ligament
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25
Q

Define the ducts associated with the pancreas

A
  • Common bile duct (from liver and gall bladder)
  • Main pancreatic duct (of Wirsung)
  • Both join into the hepatopancreatic ampulla (ampulla of Vater)
26
Q

Sphincter associated with the pancreas

A

Sphincter of Oddi (or sphincter of ampulla)

27
Q

Define the sphincter of Oddi

A

A muscular valve that controls the flow of digestive juices (bile and pancreatic juice) through the ampulla of Vater into the second part of the duodenum

28
Q

Normal variation of the pancreatic ducts

A

Most people have one, but an additional accessory duct can occur = Duct of Santorini

29
Q

Where does the duct of Santorini empty to?

A

Straight to the duodenum at the minor duodenal papilla

30
Q

Draw out the blood supply of the pancreas

A
31
Q

Parts of the diaphragmatic surface of the liver (10)

A
32
Q

Parts of the visceral surface of the liver (12)

A
33
Q

Lobes of the liver

A
  • Right lobe
  • Left lobe
  • Quadrate lobe
  • Caudate lobe
34
Q

Number of functional segments of the liver

A

8

35
Q

What delineates each functional segment of the liver

A
  • Hepatic veins at the periphery of each segment
  • Center has branches of the portal veins, hepatic arteries and bile ducts
36
Q

2 ways to divide the lobes of the liver

A

Anatomical lobes

Functional lobes

37
Q

How to delineate anatomical lobes

A

Divide along the left-hand limb of the “H” and by the attachment of the falciform ligament on the diaphragmatic surface

38
Q

How to delineate functional lobes of the liver

A

Separated by a plane through the right hand limb of the “H” from the gall bladder to the sulcus of the inferior vena cava – defined by ductal and vascular anatomy

39
Q

Function of the gall bladder

A

Store bile

40
Q

3 parts of the gall bladder

A
  • Fundus
  • Body
  • Neck
41
Q

Valve of the gall bladder

A

Spiral folds

42
Q

Function of gall bladder spiral folds

A

Kelp keep the cystic duct open so bile can easily be diverted into the gall bladder when the distal end of the bile duct is closed by the sphincter of the bile duct of the hepatopancreatic duct

43
Q

Structures in the hepatoduodenal ligament

A
  • Proper hepatic artery
  • Portal vein
  • Bile duct
44
Q

Blood supply of the gall bladder (6 structures)

A
45
Q

Blood supply of the liver

A

IVC, 3 hepatic veins, hepatic artery, portal vein

46
Q

4 major veins of the portal system

A
  • Portal vein
  • Splenic vein
  • Inferior mesenteric vein
  • Superior mesenteric vein
47
Q

4 major vein types of the caval system

A
  • 11 intercostal veins
  • 1 subcostal vein (T12)
  • 4 lumber veins
  • Hepatic veins
48
Q

Define portocaval anastomoses

A

Areas where the veins of the portal and caval systems meet

49
Q

4 types of portocaval anastomoses

A
  1. Esophageal
  2. Paraumbilical
  3. Rectal
  4. Retroperitoneal
50
Q

Define paraumbilical veins

A

Small veins in the course of ligamentum teres and the medium umbilical ligament

51
Q

Define portocaval hypertension

A

High blood pressure in the portal vein system caused by liver disease

52
Q

Cause of consequences of portal hypertension

A

Blood being forced down alternate channels (esophageal and anorectal varices, or paraumbilical veins) by the increased resistance to flow through the systemic system rather than the portal system

53
Q

Parasympathetic innervation of the GIT

A
  • Vagus nerve
  • Pelvic splanchnic nerves
54
Q

What does the vagus nerve innervate?

A
  • Esophagus to the end of the proximal 2/3 of the transverse colon
  • (This is the point of the midgut/hindgut junction – occurs just before the splenic flexure of the transverse colon)
55
Q

What do the pelvic splanchinic nerves innervate?

A

Distal 1/3 of the transverse colon to the rectum

56
Q

Sympathetic innervation of the GIT

A
  • Thoracic splanchnic nerves
  • Lumbar splanchnic nerves
57
Q

List the thoarcic splanchnic nerves

A
  • Greater splanchnic nerve (T5 - 9)
  • Lesser splanchnic nerve (T9-10)
  • Lowest (least) splanchnic nerve (T12)
58
Q

Origin of lumbar splanchnic nerves

A

L1 - 2

59
Q

Location of sympathetic synapses for GIT

A

In the aortic, superior mesenteric or inferior mesenteric plexuses. Then, post-ganglionic fibers use the vessels to get to the organs

60
Q

Location of synapses for the parasympathetic innervation of the GIT

A

Pre-ganglionic fibers use the vessles to get to the organs AND THEN synapse in the wall of the organs

NOTE: No parasympathetic innervation for the spleen

61
Q

How does the right vagus nerve enter the abdomen?

A

Through the esophageal hiatus of the diaphragm as the posterior vagal trunk

62
Q

How does the left vagus nerve enter the abdomen?

A

Through the esophageal hiatus of the diaphragm as the anterior vagal trunk

Block D - Digestion and Metabolism (29 decks)

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