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Soft Tissue Anatomy of the Abdomen-WVSOM Class of 2012

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Question
Answer
what is the potential space between visceral and parietal peritoneum?   peritoneal cavity  
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what fluid can exist in the peritoneal cavity?   ascites  
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cavity that would exist if all viscera were removed from the abdomen?   abdominal space  
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what fascia comprise the abdominal space?   transversalis and inferior phrenic  
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an organ entirely or almost entirely surrounded by peritoneum and is suspended by mesentery?   peritoneal or intraperitoneal organ  
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organs in this category have no free mesentery and have little mobility; only partially covered by peritoneum?   retroperitoneal organ  
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double layer of peritoneum that connects viscus to body wall?   mesentery  
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double layer of peritoneum that links viscus to body wall or to another organ?   peritoneal ligament  
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cutaneous layers of abdomen are innervated by what nerves?   lateral and anterior cutaneous nerves  
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where to lateral and cutaneous nerves of the abdomen originate?   thoracic region  
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first lumbar contribution of lateral and anterior cutaneous nerves happens where? which nerves are involved?   inguinal canal; iliohypogastric and ilioinguinal nerves  
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what veins exist in fascia near the inguinal canaL?   thoraco-epigastric veins  
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when the IVC is compromised, what venous system can provide collateral circulation?   thoraco-epigastric veins  
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thoraco-epigastric veins communicate with the portal systen where?   umbilicus  
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in cases of portal blockage, thoraco-epigastric veins can become dilated; what is this termed?   caput medusa  
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camper's fascia is consistend with what other fascia?   superficial fascia of thorax and thigh  
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scarpa's fascia blends with what superiorly and inferiorly?   superiorly: aponeurosis of external abdominal oblique; inferiorly: fascia lata 3cm distal to inguinal ligament  
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between what layers will urine be found in cases of urethral rupture?   scarpa's fascia and abdominal wall  
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where does external abdominal oblique arise from superiorly and inferiorly?   superiorly: from costal cartilage of lower 8 ribs; inferiorly: lateral margin of thoraco-lumbar fascia  
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what two places will the external abdominal oblique attach to?   linea alba and inguinal ligament  
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inguinal ligament is portion of external abdominal oblique that is found between what two bony landmarks?   ASIS and pubis  
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what is the sharp, medial margin of femoral ring, medial to lymphatics of thigh?   lacunar ligament  
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medial end of inguinal ligament attaches where?   superior pubic ramus  
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fibers of the lacunar ligament continue along pubic ramus and are called what?   pectineal ligament  
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spermatic cord exits from abdominal wall where?   medial end of inguinal ligament  
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what is the gap in the aponeurosis of the external oblique near the medial end of the inguinal ligament? what nerve emerges from here?   superficial inguinal ring; ilioinginal nerve  
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superficial inguinal ring is bounded superiorly by what? inferiorly by what?   medial crus; lateral crus  
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what passes between the medial and lateral crura, reinforcing the superolateral portion of superficial ring?   intercrural fibers  
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what two things are attached to the posterior body wall at the end of the 2nd month of development?   testis and mesonephros  
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what is the condensation of mesenchyme that extends from caudal pole of testis to inguinal region?   gubernaculum testis  
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testes will descend along what structure?   gubernaculum  
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the peritoneum evaginates into abdominal wall along course of gubernaculum into scrotal swellings forming what?   processes vaginalis  
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in females, descent of ovary into labium does not occur. what happens to gubernaculum?   it becomes the ligamentum teres uteri  
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what forms the inferior portion of the inguinal canal?   inguinal ligament  
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what layer splits to form the cremaster muscle and cremasteric fascia of spermatic cord?   internal abdominal oblique  
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conjoint tendon is formed from what two aponeuroses?   internal abdominal oblique and transversus abdominis  
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what forms the posterior wall of the inguinal canal?   inguinal falx (conjoint tendon)  
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where does the inguinal falx attach?   between pubic crest and pectineal line  
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inguinal falx reinforces what? how?   superficial inguinal ring from behind  
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deep inguinal ring is reinforced by what?   external abdominal oblique  
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contraction of what two muscles will reduce potential for hernia by compressing spermatic cord against inguinal ligament?   internal abdominal oblique and transversus abdominis  
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what artery reaches deep surface of rectus abdominis at the arcuate line?   inferior epigastric artery  
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what forms the inguinal triangle?   lateral border:inferior epigastric a.; inferior border: inguinal ligament; medial border: rectus abdominis muscle  
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what passes across the inguinal triangle? where does it attach?   conjoint tendon; attaches to pubic crest and pectin pubis  
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define direct inguinal hernia? indirect?   direct is when gut is pushed directly through the superficial ring; indirect is when it goes through entire inguinal canal  
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cremaster and fascia are derived from what abdominal layer?   internal abdominal oblique  
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internal spermatic fascia corresponds to what abdominal layer?   transversalis fascia  
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what artery and vein pass in the spermatic cord?   testicular  
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what structure serves as a countercurrent heat exchange mechanism to lower blood temperature to testes?   pampiniform plexus  
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what nerve is located at the deep inguinal ring?   genitofemoral nerve  
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what nerve passes through inguinal canal, supplying scrotal sckin through anterior scrotal nerves?   genital branch of genitofemoral nerve  
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femoral branch of genitofemoral nerve exits pelvis along with what artery? what does it supply?   external iliac artery; skin on medial thigh  
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what nerve passes through the superficial inguinal ring and supplies skin of anterior superior scrotum through anterior scrotal nerves?   iliolinguinal nerve  
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in testicular cancer, metastasis is to which nodes first?   para-aortic lymph nodes  
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tunica vaginalis has what two layers?   parietal and visceral layers  
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what is the duct system of the testis?   epididymis  
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what is the visceral layer that covers the connective tissue capsule of the testis?   tunica albuginea  
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3 parts of epididymis?   head, body, and tail  
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tail of epididymis becomes what structure?   ductus deferens  
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laterally, epididymis is separated from the testis by what?   sinus epididymis  
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the round ligament of the uterus connects with what structure internally?   ovarian ligament  
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what does the genital branch of the genitofemoral nerve supply in females?   labia majora  
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what are the origins of the internal abdominal oblique?   posterior layer of thoracolumbar fascia, iliac crest, and lateral 2/3 of inguinal ligament  
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cranial fibers of internal abdominal obliques insert where? caudal?   costal margin and linea alba; linea alba and pecten pubis  
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transversus abdominis originates where?   costal margin, thoracolumbar fascia, iliac crest, and lateral 2/3 of inguinal ligament  
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direction of cranial fibers of transversus abdominis? caudal fibers?   transverse to abdomen; parallel to internal abdominal oblique  
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insertion of superior and inferior fibers of transversus abdominis?   superior: linea alba; inferior: linea alba, forms conjoint tendon, inserts on pecten pubis  
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origin of rectus abdominis muscle?   pubic symphysis and crest  
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insertion of rectus abdominis muscle?   costal cartilage of 5-7 ribs and xyphoid process  
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what biomechanics can be seen in the abdominal muscles when twisting?   right external abdominal oblique with left internal abdominal oblique will twist to the left  
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what arteries are on the deep surface of inferior and superior rectus abdominis muscles? what do these form from that is superior?   inferior and superior epigastric arteries; internal thoracic arteries  
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arcuate line also known as what?   linea semicircularis  
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round ligament of liver is remnant of what structure?   umbilical vein  
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falciform ligament is remnant of what structure?   ventral mesentery  
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falciform ligament and round ligament of the liver run from where to where?   liver to umbilicus  
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a patent round ligament of the liver can be used for what?   injection site  
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median umbilical fold is formed from what structure? where is it found?   urachus; between umbilicus and bladder  
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medial umbilical fold is formed from what structure? where is it found?   umbilical arteries; between umbilicus and common iliac arteries  
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lateral umbilical fold is formed from what structure?   inferior epigastric vessels passing from external iliac vessels to rectus abdominis muscle  
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urachus once formed connection between what two structures?   bladder and allantois  
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what is the most anterior structure of the peritoneal cavity?   greater omentum  
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what 4 organs are in the epigastric region?   liver, gallbladder, stomach, transverse colon  
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hypochondriac regions are lateral to what region?   epigastric region  
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liver margins ventrally?   6th costal cartilage on left to 10th rib on right  
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how can liver hemorrhage be controlled?   pinching hepatoduodenal ligament of lesser omentum  
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left lobe of liver contacts cardiac stomach where?   left midclavicular line  
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what two structures meet up superiorly to liver?   falciform and coronary ligaments  
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what forms the bare area of the liver?   right portion of coronary ligament meets up with right triangular ligament; large separation leaves superior surface without peritoneum  
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what is the lesser omentum?   mesenteric connection between liver and stomach  
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what lies in the lesser omentum?   common hepatic duct, hepatic artery proper, and portal vein  
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what are the 3 borders of the quadrate lobe of liver?   gallbladder, round ligament, and lesser omentum  
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hepatoduodenal ligament is what exactly? what is within it?   lesser omentum presents a free margin on the right; common bile duct, hepatic artery proper, and portal vein  
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opening deep to the hepatoduodenal ligament is what? what does this opening lead to? where exactly does this lie?   omental foramen; omental bursa (lesser sac); space between stomach and pancreas  
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in hollow viscera, what does fundus refer to?   portion furthest from entrance of the organ  
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hepatogastric ligament runs between what structures?   lesser curvature of the stomach and the liver  
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greater omentum is made up of how many layers of peritoneum?   4  
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very short portion between stomach and colon is what? this is actually just part of what?   gastrocolic ligament; greater omentum  
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posterior gastric ulcer will cause stomach contents to enter what structure? eventually it will irritate where? referred pain to where?   lesser sac; underside of diphragm; left shoulder pain  
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left colic flexure is what relation to spleen?   inferior  
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gastrosplenic ligament lies between where and where?   greater curvature of stomach and lower pole of spleen  
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what vessels travel within the gastrosplenic ligament?   short gastric arteries  
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second part of duodenum's relationship to the transverse colon?   transverse colon is anterior to second part of duodenum  
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foregut develops into what structures?   esophagus, trachea, lung buds, stomach, and duodenum (up to the bile duct)  
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proximal duodenum gives rise to what structures embryonically?   liver, biliary system, and pancreas  
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how do the left and right vagal trunks become anterior and posterior vagal trunks in adult?   rotation so that left stomach becomes anterior, right stomach becomes posterior  
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pancreas originally developed as what?   dorsal and ventral pancreatic bud  
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longitudinal columns of muscle on external surface of colon?   tenia coli  
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sacculations of the colon are:   haustra  
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small pouches of fat-filled peritoneum hanging from surface of colon?   omental appendges  
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tenia coli meet up where?   vermiform appendix  
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appendix sits in what recess?   retrocecal recess  
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appendix is suspended by what?   mesoappendix (mesentery of ileum)  
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ascending colon is fixed to the posterior wall, making it what?   retroperitoneal  
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transverse colon is what kind of peritoneal organ?   intraperitoneal  
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what connects the colon to the diaphragm? where is this at ?   phrenicocolic ligament; inferior to spleen at left colic flexure  
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descending colon is what kind of peritoneal organ?   retroperitoneal  
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transverse colon mobile or not?   mobile  
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portion of small intestine that connects to cecum? what is name of juncture?   ileum; ileocecal junction  
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ileum vs. jejunum? which has long vasa recta?   jejunum  
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point where mesentery meets posterior wall?   root of mesentery  
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what is the course of the third part of the duodenum?   crosses midline inferior to superior mesenteric artery in root of mesentery, can be palpated through peritoneum  
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as duodenum emerges from retroperitoneal location, it becomes what? what is this called?   jejunum; duodeno-jejunal flexure  
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what is the structure that suspends the duodeno-jejunal junction?   suspensory ligament of the duodenum  
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majority of adult gut tube derived from what? what organs are included?   midgut; most of duodenum, small intestine, appendix, cecum, colon up to 2/3 of transverse portion  
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what happens to small intestine during development?   it is herniated out through umbilicus, then retracted and rotated 270 degrees around the superior mesenteric artery  
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what happens to the ascending colon during development?   falls back on posterior wall, loses free mesentery and becomes retroperitoneal  
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what forms the boundary of the greater and lesser sacs?   attachment of transverse mesocolon to posterior wall  
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what suspends the sigmoid colon?   sigmoid mesocolon  
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where does sigmoid colon become rectum?   at the pelvic inlet  
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what organs arise from the hindgut?   1/3 of transverse colon, sigmoid colon, rectum, and superior portion of anal canal  
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what is the inferior portion of anal canal formed from?   ectoderm  
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what innervates inferior portion of anal canal?   internal pudendal nerve  
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where is the pyloric sphincter palpated?   6-7 cm superior to umbilicus  
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where is sphincter of oddi palpated?   5-6 cm superior and right of umbilicus  
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where is duodeno-jejunal juncture palpated?   5-6 cm superior and to left of umbilicus  
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where is ileocecal valve palpated?   2-3 cm inferior to mcburney's point  
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where is mcburney's point?   1-2 inches superomedially to ASIS  
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relationship of common bile duct, hepatic artery proper, and portal vein?   duct is to right of artery; duct and artery are anterior to vein  
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cystic artery usually arises from what vessel?   right hepatic artery  
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celiac trunk conveys what nerves to the organs it supplies with blood? what nerves travel along with these?   postganglionic sympathetic fibers from greater splanchnic nerves; preganglionic parasympathetic fibers to the stomach  
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what nerves are found on either side of the celiac trunk? what is this all called?   celiac ganglia; celiac plexus  
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what nerve trunk meets up with the celiac plexus and is distributed with it? where is thie located?   posterior vagal trunk; gastro-esophageal junction  
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what trunk does not enter the celiac plexus but instead runs to the liver and stomach? where does it travel?   anterior vagal trunk; travels along lesser curvature of stomach  
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esophageal branches originate from what vessel? where?   left gastric artery; near gastro-esophageal junction  
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what vessel drains the lesser curvature of the stomach and the inferior portion of esophagus?   left gastric (coronary)vein  
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esophageal branches of left gastric veins connect to what other esophageal branches? why are these important?   azygous-hemiazygous system; when portal vein is blocked, these are used as a shunt and can become enlarged and burst  
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anterior and posterior superior pancreatico-duodenal artery anastomose with arteries from what?   superior mesenteric artery  
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in general, what does the superior mesenteric artery supply?   intestine from duodenum to left colic flexure  
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superior mesenteric ganglia make up what?   superior mesenteric plexus  
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how do nerves run to the superior mesenteric ganglia?   receive preganglionic fibers from the lesser splanchnic nerves and distribute postganglionic fibers along superior mesenteric artery and inferiorly along aorta  
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in addition to receiving preganglionic lesser splanchnic nerves, the superior mesenteric plexus also receives fibers from where?   lumbar splanchnic nerves  
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first branch of the superior mesenteric artery is usually what?   inferior pancratico-duodenal artery  
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describe artery flow to jejunum and ileum?   jejunal arteries->arcades->vasa recta  
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what arteries from the superior mesenteric artery supply the proximal colon?   ileocolic and right colic arteries  
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what are the 4 branches of the ileocolic artery?   anterior and posterior cecal branches, appendicular, and ileal branches (direct to ileum, no arcades)  
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through what structure does the middle colic artery travel?   transverse mesocolon  
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inferior mesenteric artery supplies what structures in general? what is the embryological portion this refers to?   left colic flexure to rectum; hind gut  
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left colic artery supplies what structure?   descending colon  
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the marginal artery is most likely to be compromised at what portions?   left colic flexure and cecum  
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the further distally on the small intestine, what two things occur?   number of arcades increase, vasa recta are shorter  
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superior mesenteric vein drains what structures?   distal duodenum, jejunum, ileum, ascending colon, transverse colon  
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inferior mesenteric vein drains what structures?   descending and sigmoid colons and superior rectum  
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inferior mesenteric vein empties into either of which two veins?   superior mesenteric or splenic veins  
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portal vein is formed at what point?   splenic and superior mesenteric veins join together  
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portal vein branches into right and left portal veins at what point?   porta hepatis  
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the liver drains through what veins? these enter what vessel? where?   right and left hepatic veins; IVC; as it passes through the thoracic diaphragm  
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what are the 4 places that portal and systemic venous systems communicate?   gastric and esophageal veins; umbilical and epigastric veins; superior rectal and middle rectal veins; between veins draining a viscus lying against a body wall and the veins of the body wall  
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