Question | Answer |
At what vertebral level does the esophagus pierce the diaphragm to enter the abdomen? | T9/10. |
What happens to the vagal trunks associated with the esophagus in the thorax? | The left and right vagi become anterior/posterior respectively and pass through the diaphragm to supply parasympathetic innervation to the prevertebral plexuses of the abdomen. |
Is there an anatomical sphincter at the gastroesophageal junction? | No. |
What keeps gastric reflux from normally occurring at the gastroesophageal junction? | It is a physiological sphincter, the negative pressure of the thorax keeps the esophagus pressed closed. |
List organs that have an anatomical relationship with a specific aspect of the stomach | Anterior/superior: anterior abdominal wall, left costal margin, diaphragm; Left: spleen; Right: quadrate and left lobes of the liver; Posterior: diaphragm, left suprarenal gland, upper pole of left kidney, pancreas and left colic flexure. |
What divides the right and left lobes of the liver anatomically when viewed from its anterior
aspect? | The falciform ligament. |
What does the anatomical arrangement between the visceral peritoneum of the liver and the
diaphragm form by its reflection. | It creates the bare area of the liver, left triangular ligament and right coronary ligaments. |
What does the bare area of the liver come into contact with? Be specific. | The bare underside of the diaphragm. |
Why is the bare area of the liver important? | Liver abcesses can pass “silently” up through the diaphragm giving little notice before perforating through into the pleural cavity. |
What is the function of the gallbladder? | To store and concentrate bile secreted by the liver. |
Why does the gallbladder have a serosa and an adventitia? | That portion of the gallbladder exposed to the abdominal cavity is covered with peritoneum, that portion attached to the underside of the liver has no peritoneum = adventitia. |
List the 3 parts of the small intestinal, in order, from proximal to distal. | Duodenum, jejunum, ileum. |
Which of these 3 regions is predominantly retroperitoneal? | The duodenum. |
Which of these 3 regions are mesenterized? | Jejunum and ileum. |
In which direction does the root of the mesentery cross the posterior abdominal wall? | From upper left to lower right. |
How can you differentiate the ileum from the jejunum? | The fat within the mesentery does not encroach upon the wall of the jejunum leaving “mesenteric windows” (except in obese individuals); in the ileum the fat comes right up to the ileal wall obliterating these windows. |
What is a taeniae coli? | One of 3 longitudinal bands of smooth muscle. |
What is the function of these 3 taeniae? | They “shorten” the tube, gathering it up and creating pocket-like compartments called haustra. |
What is the function of a haustral compartment? | They slow down the movement of feces through the large intestine allowing water resorption to occur. |
Where do the taenia coalesce into a complete outer layer of longitudinal smooth muscle? | On the surface of the rectum as well as over the surface of the appendix. |
Identify the abdominal organs considered to be retroperitoneal. | Descending aorta, duodenum, pancreas, inferior vena cava, suprarenal glands, kidneys, ureters, ascending and descending colon. |
List the 4 parts of the duodenum. | 1st (superior); 2nd (descending); 3rd (horizontal); and 4th (ascending). |
Which portion contains the duodenal papilla? | The 2nd (descending). |
What empties into the duodenal lumen at this papilla? | Bile and pancreatic enzymes. |
What organ is found nestled within the C-shape concavity of the duodenum? | The head of the pancreas. |
What two important anatomical structures lie posterior to the 1st part of the duodenum? | Biliary duct (common bile duct) and main pancreatic duct. |
Which anatomical structures pass anterior to the 3rd part of the duodenum? | The supermester mesenertic vein and artery. |
Cite the anatomical relationship each of the duodenum to the pancreas: | head of pancreas nestled in C-shaped concavity |
Cite the anatomical relationship each of hepatic portal vein to the pancreas: | formed behind the neck |
Cite the anatomical relationship each of superior mesenteric a and v to the pancreas: | pass anterior to the uncinate process |
Cite the anatomical relationship each of splenic a to the pancreas: | often lies embedded along the superior border of the pancreas |
Cite the anatomical relationship each of spleen to the pancreas: | the tail of the pancreas lies in the hilus of the spleen. |
List the 3 main arterial trunks off the aorta that are responsible for supplying the G.I.T. | Celiac trunk; superior mesenteric and inferior mesenteric aa. |
Which general region of the gut does each of these 3 main arteries of the aorta supply? | Celiac trunk: foregut; superior mesenteric a.: midgut; and inferior mesenteric a.: Hindgut. |
What specific portions of the tubular G.I.T. are contained within each of these regions? | Foregut: lower esophagus to mid duodenum; midgut: mid duodenum to mid transverse colon; hindgut: mid transverse colon to rectum. |
Know the anatomical extent of each of viscera supplied by each of these 3 aa. | Celiac trunk: lower esophagus to mid duodenum; superior mesenteric a.: mid duodenum to mid transverse colon; inferior mesenteric a.: mid transverse colon to rectum. |
Where does the formation of the hepatic portal vein occur? | Posterior to the head/neck of the pancreas. |
What is the function of the hepatic portal system? | To ensure that ingested materials from the G.I.T. are screened by the liver prior to release into the systemic circulation. |
What is the importance of the portocaval anastomoses? | They are indicative of a blockage of either of the two circulatory systems (hepatic portal and systemic) concerned. |
Name the location of at least 3 of the more clinically relevant ones. | Esophagus: esophageal varices, anal canal: hemorrhoids, and umbilicus: caput medusa |