Lower Abdomen Flashcards

1
Q

What is the entrance to the stomach from the esophagus?

A

Cardiac oriface

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2
Q

What is the exit from the stomach to the duodenum?

A

The pyloric sphincter

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3
Q

What is the primary function of the stomach?

A

Enzymatic digestion

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4
Q

Describe the mobility of the duodenum?

A

Fixed and relatively immobile

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5
Q

Describe the mobility of the jejunum and ilium?

A

Tethered but very mobile

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6
Q

What is the combined length of the three parts of the small intestine?

A

20 ft

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7
Q

What are the permanent folds within the small intestine called?

A

Plicae circularis

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8
Q

Describe the concentration of the plicae circularis in the proximal and distal portions of the small intestine?

A

Become fewer or more diffuse as we move distally

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9
Q

What is the ileocecal junction?

A

Where the ilium empties into the cecum

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10
Q

What allows the small intestine to be more compact and fit into the abdomen?

A

Tonic contraction

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11
Q

What part of the duodenum is intra versus retraperitoneal?

A

The duodenal cap is retroperitoneal and the rest of the duodenum is intraperitoneal

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12
Q

What vertebral level is the superior part of the duodenum?

A

L1

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13
Q

What vertebral level is the descending part of the duodenum?

A

L2-L3

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14
Q

What vertebral level is the inferior part of the duodenum?

A

L3

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15
Q

What vertebral level is the ascending part of the duodenum?

A

L3-L2

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16
Q

As we move proximal to distal in the jejunum and ilium what happens to the vasa recta?

A

They decrease in length

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17
Q

As we move proximal to distal in the jejunum and ilium what happens to the plica circularis?

A

They decrease in number

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18
Q

As we move proximal to distal in the jejunum and ilium what happens to the arterial arcades?

A

They increase in length and number

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19
Q

As we move proximal to distal in the jejunum and ilium what happens to fat accumulation?

A

It increases

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20
Q

As we move proximal to distal in the jejunum and ilium what happens regarding lymphatics?

A

They increase

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21
Q

If the jejunum and ilium section of the small intestine were divided into fifths, how long is each component?

A

Jejunum is proximal 2/5 and ilium is distal 3/5

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22
Q

Using the quadrant abdominal division, where are the jejunum and ilium located?

A

Jejunum is upper left and ilium is lower right

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23
Q

What is Meckel’s (ileal) diverticulum?

A

Remnant of the embryonic yolk sac

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24
Q

Where would Meckel’s diverticulum be found?

A

1 m proximal to ilieocecal valve

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25
Q

How many parts are there in the large intestine?

A

5 segments and 2 flexures

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26
Q

What are the 5 segments of the large intestine?

A

Cecum, ascending, transverse, descending, sigmoid

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27
Q

What are the two flexures of the large intestine called?

A

Right colic (hepatic), and left colic (splenic) flexures

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28
Q

How is the left colic flexure attached?

A

This part of the large intestine is attached to the diaphragm via splenocolic flexure

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29
Q

What are the right and left paracolic gutters?

A

These are depressions that are lateral to the ascending and descending segments of the large intestine, through which materials pass from one region of the peritoneal cavity to another

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30
Q

What are the teniae coli?

A

These are 3 smooth muscle bands paralleling the length of the colon

31
Q

What are the haustra coli?

A

These are outpouchings that are created by the teniae coli

32
Q

What are the epiploic appendages?

A

These are fat tags found along the colon (blobs of fat)

33
Q

The left branch of the middle colic artery anastomoses with what artery?

A

Inferior mesenteric artery

34
Q

How many arteries does the SMA send to the small intestine?

A

15 - 18

35
Q

How distal of the intestine does the SMA supply?

A

Up to the proximal 2/3 of the transverse colon

36
Q

Where is the IMA located on the aorta?

A

5 cm superior to the aortic bifurcation

37
Q

What part of the intestine does the IMA supply?

A

Starts at the distal 1/3 of the transverse colon and supplies to rectum

38
Q

What are the three main branches of the IMA?

A

Left colic, sigmoid (4), and superior rectal

39
Q

Where do the middle colic and left colic arteries anastomose?

A

At the marginal arteries

40
Q

Why do anastomoses exist between colic branches?

A

For collateral circulation, this forms consistent vascular arc around the colon

41
Q

The renal arteries are branches of what artery?

A

Lateral branches of abdominal aorta, lateral to SMA

42
Q

The renal arteries send branches off to what two other structures?

A

Adrenal glands and ureters

43
Q

What artery do the ovarian and the testicular arteries come from?

A

The gonadal artery which is a lateral branch of the aorta (inferior to the renal artery

44
Q

Explain the path ovarian arteries must cross to supply the ovaries.

A

They will cross over the ureters and the iliac vessels, and descend into pelvis to supply the ovaries

45
Q

Explain the path testicular arteries must cross to supply the testes.

A

Cross over ureters and enters inguinal canal, then descends into scrotum to supply the testes

46
Q

The gonadal arteries will descend along what muscle?

A

The psoas muscle

47
Q

Where does the inferior vena cava start?

A

Begins at the L5 level at the union of common iliac veins

48
Q

What areas of the body does the IVC drain?

A

LL, most of the back, abdominal wall, and abdominal pelvic viscera, and nutrient rich blood from the portal venous system.

49
Q

Where is the portal vein started?

A

By the union of the splenic and the superior mesenteric veins

50
Q

The portal vein has venous return from what viscera?

A

Spleen, gallbladder, pancreas, abdominal gastrointestinal tract

51
Q

What are the 4 portal-caval anastomoses?

A

Gastric vv. and esophageal vv.,
paraumbilical vv. and epigastric vv.,
superior rectal vv. and middle/inferior rectal vv.,
colic vv. and retroperitoneal vv.

52
Q

Of the gastric and esophageal vv, which is portal and which is caval?

A

Gastric vv. is portal

esophageal vv. is caval

53
Q

Of the paraumbilical and epigastric vv. which is portal and which is caval?

A

paraumbilical vv. is portal

epigastric vv. is caval

54
Q

Of the superior rectal and middle/inferior rectal vv. which is portal and which is caval?

A

Superior rectal vv. is portal

middle/inferior rectal vv. is caval

55
Q

Of the colic vv. and retroperitoneal vv. which is portal and which is caval?

A

Colic vv. is portal

retroperitoneal vv. is caval

56
Q

The portal venous system is missing what structure that other venous systems have?

A

Valves, the portal system relies solely on pressure

57
Q

Dilated esophageal vv. produce what?

A

esophageal varices

58
Q

Dilated epigastric vv. produce what?

A

caput medusae

59
Q

Dilated inferior/middle rectal vv. produces what?

A

hemorrhoids

60
Q

The sympathetic nervous system has what other name?

A

Thoracolumbar (T1-L2)

61
Q

Where are the parasympathetic nerves located?

A

Cranial and S2-S4

62
Q

Innervation to the viscera of the abdomen is via what?

A

Autonomic n. plexus

63
Q

What vertebral levels innervates the entire abdomen?

A

T5 - L2

64
Q

What is cranial nerve ten?

A

Vagus nerve

65
Q

Preganglionic splanchnic nn synapse where?

A

In collateral ganglia

66
Q

Postganglionic fibers leave collateral ganglia to reach what?

A

Effector organs

67
Q

Post synaptic fibers travel on all what?

A

Main arterial branches

68
Q

T10 - T11 are sympathetic chain nerve exceptions, where do they synapse?

A

At SMA collateral ganglion

69
Q

T12 is a sympathetic chain nerve exception, where does this nerve synapse?

A

Renal or para-aortic

70
Q

Preganglionic nerves from CN X travel on what?

A

Upper arterial branches (celiac trunk, SMA, renal aa., and all their branches)

71
Q

Preganglionic nerves from S2-S4 travel on what?

A

Lower arterial branches (IMA and branches)

72
Q

Where are the cell bodies in the parasympathetic nerves of the abdomen?

A

In the walls of the organs that they innvervate

73
Q

What are the four major autonomic ganglia and their associated plexus?

A

Celiac ganglion, superior mesenteric ganglion, aorticorenal ganglion, inferior mesenteric ganglion

74
Q

Postganglionic and what term are interchangeable?

A

Postsynaptic