What is the Cardiac orifice?
Entry into the stomach from esophagus
What is the Pyloric sphincter?
Exit from the stomach to the duodenum.
The Stomach is lined with ________.
Rugae (temporary folds within the body of the stomach)
The _________ of the small intestine is characterized as fixed and relatively immobile.
Duodenum
The ____________ of the small intestines is characterized as tethered, but very mobile and is combines of 3 segments (each around 20ft)
Jejunum & Ileum
What is the Plicae Circularis and where is it?
Permeant folds within the intestine that become more diffuse distally.
The _______ empties into the _______ at the ileocecal junction.
- Ileum
- Cecum
The Duodenum is divided into 4 parts what are they?
- Superior part
- Descending part
- Inferior part
- Ascending part
- Shaped like a circle hook
What is Meckel’s (ileal) diverticulum? Clinical notes?
is a remnant of embryonic yolk stalk that appears as a finger like pouch.
- Located approx. 1 m proximal to ileocecal valve.
- CLINICAL NOTE = May become inflamed and mimic appendicitis.
The Large intestine is divided into……
5 segments and 2 flexures
- Cecum
- Asc. colon
- Transverse colon
- Desc. Colon
- Sigmoid colon (empties into rectum)
- Right colic (hepatic) Flexure
- Left Colic (Splenic Flexure
The large intestine terminates where?
rectum
The appendix opens into the _______.
cecum inferior to ileocecal orifice.
Triangular mesentery between appendix and Ileum is called what?
Mesoappendix
Clinical notes on the appendix?
Appendicitis
- Vague pain begins in periumbilical region from afferent pain referred to T10 level.
- Severe pain later from R. Lower quadrant.
- Pain most severe over spinoumbilical point between the ASIS & Umbilicus
Differences between the arterial supply in the ileum and jejenum is what?
Jejunum = longer vas recta & shorter arterial arcades.
Ileum = Shorter vas recta & longer arterial arcades.
What is the Teniae coli?
Specialized region of colon = 3 smooth muscle bands paralleling the length of the colon.
What is the Haustra coli?
Specialized area of colon = outpouchings produced by teenier coli.
What is the Epiploic appendages?
Specialized region of colon = Fat tags found along the colon.
Describe basic arterial supply to lower abdomen, then draw it!
Abdominal artery feeds celiac trunk (superior), Superior mesenteric artery (middle) and Inferior mesenteric artery (Inferior)
What is the first major branch of the abdominal aorta?
Celiac Trunk
What does the celiac trunk supply and what are the branches?
*Supplies liver, gallbladder, esophagus, stomach, pancreas & spleen.
3 Main branches:
- Common hepatic (liver)
- L. Gastric (stomach)
- Splenic (spleen)
What is the second major branch of the abdominal aorta?
Superior Mesenteric Artery *Around 1 cm inferior of celiac
What does the Sup. Mesenteric artery supply?
- supplies up to proximal 2/3 of transverse colon via:
- ileocolic
- R. colic
- Middle colic
What is the third major branch of the abdominal aorta?
Inferior Mesenteric Artery * about 5 cm superior to aortic bifurcation.
What does the Inf. Mesenteric Artery supply?
- supplies colon from distal 1/3 of transverse colon via:
- L. Colic
- Sigmoid (4)
- Superior rectal
True or false? Anastomoses exist between colic branches for collateral circulation
True!
Which artery helps form vascular arch around the colon?
The marginal artery of Drummond
Describe the Arterial supply of the pancreas….
Gastroduodenal artery gives off Superior pancreaticoduodenal artery.
- SMA gives of Inferior pancraticoduodenal artery.
- SPA & IPA anastomose and supply head of pancreas along with duodenum.
- Splenic Artery supplies rest of pancreas with additional branches.
Renal Artery. Where does it come from and what does it supply?
- its a lateral branch of abdominal aorta (lateral to SMA)
- It supplies both of the kidneys by entering through the hilum of each one.
- Also sends off branches to adrenal glands and ureters.
Besides the renal artery, what else supplies the adrenal branches?
Branches from inferior phrenic artery and aorta
What are the two gonadal arteries?
- Ovarian artery
- Testicular artery
- Both are lateral branches of abdominal aorta (Inf. to renal artery)
What are the two main venous drainage ways of the abdomen?
- Inferior vena cava
- Portal vein
Tell me about the Inferior vena cava….
- largest vein in body
- begins at L5 level
- returns blood from LL, most of the back, abdominal wall & abdominopelivic viscera.
Tell me about the portal vein..
Formed by union of splenic and superior mesenteric Veins (L2)
- venous return from viscera:
- spleen
- pancreas
- Gallbladder
- Abdominal gastrointestinal tract
- Returns NUTRIENT RICH yet poorly oxygenated blood to liver.
- Then Via IVA to RA of heart.
What are the 4 anastomoses of the Portal-Caval anastomoses?
- gastic v. & esophageal V.
- Paraumbilical v. & Epigastric V.
- Superior rectal V. & Middle/Inf. rectal V.
- Colic V. & Retroperitoneal V.
True or false? The Portal venous system has no valves?
True! This means reversal of blood flow is possible.
- portal hypertension restricts blood flow.—> causes naval vein to become engorged —-> may then become dilated & Varicose.
Dilated esophageal veins produce _________.
Esophageal varices
Dilated epigastric veins produce______.
Caput medusae
Dilated Infr. & Mid. rectal veins produce ________.
Hemorrhoids! *These can lead to vascular rupture and severe hemorrhaging.
What is the innervation to the viscera of abdomen?
Autonomic nerve plexuses.
- Sympatheic fibers originate from T5-L2/3
- Parasympathetic fibers origninate from CN X & S2-4
What are the 4 major Autonomic Ganglia & Plexuses?
- Celiac Ganglion (Plexus travels with celiac branches)
- Superior Mesenteric ganglion (plexus travels with SMA branches)
- Aorticorenal ganglion (plexus travels with renal branches)
- Inferior mesenteric ganglion (plexus travels with IMA branches)
Which autonomic ganglia/plexuses receive thoracic splanchnic nerve & CN X branches?
Celiac, Superior mesenteric & Aorticorenal
Which autonomic ganglion/plexuses receive lumbar splanchnic nerve & S2-S4 branches?
Inferior mesenteric ganglion
Briefly describe the Parasympathetics of the abdomen….
- preganglionic nerves from CNX travel on upper arterial branches (Celiac trunk, SMA, renal a., and branches)
- preganglionic nerves from S2-S4 travel on lower arterial branches (IMA and branches)
- Synapses occur within effector organs)
Briefly describe sympathetics of the Abdomen….
- Preganglionic splanchnic nerves synapse in collateral ganglion.
- Postganglionic fibers leave ganglia to reach effector organs.
(Post synaptic fibers travel on all main arterial branches, Celiac trunk, SMA, Renal, IMA and all their branches)