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3-Organs in the Abdomen


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What forms the visceral peritoneum of the gut wall?
Name the layers of the GI tract?
mucosa, submucosa, smooth muscle, serosa
Name the foregut derivatives.
esophagus, stomach, liver, GB, pancreas, biliary ducts, 1st half of duodenum
Name the midgut derivatives.
2nd half of duodenum, jejunum, ileum, cecum, appendix, ascending colon, proximal 2/3 of transverse colon
Name the hindgut derivatives.
distal 1/3 of transverse colon, descending, colon, sigmoid colon, rectum and upper 2/3 of anal canal
Describe the innervation of the upper 1/3 of esophagus.
PNS from the nerve of arch IV-cranial nerve X the vagus
What type of muscle is the upper 1/3 of esophagus? What is it derived from?
branchial arches
Describe the innervation of the lower 1/3 of esophagus.
SNS from thoracic splanchnic nerves
What type of muscle is the lower 1/3 of esphagus? What is it derived from?
splanchnic mesoderm
What vertebral levels does the esophagus correspond to?
Which sphincter is located at the gastroesophageal junction?
Which thoracic arterial branches supply the esophagus?
inferior thyroid and aorta
To what veins does the esophagus drain?
inferior thyroid, azygos, hemiazygos & accessory
What abdominal arterial branch supplies the esophagus?
left gastric artery and inferior phrenic
What is the condition when the gastroesophageal junction protrudes through the esophageal hiatus? What can alleviate the pain?
hiatal hernia
sitting up from a supine position
With portal vein hypertension, blood leading to the portal vein can be shunted to what vein (w/ respect to esophagus)?
left gastric vein
What is the condition of abnormal contractions at the lower esophagus (abscense of peristalsis)? Which part of the esophagus may atrophy?
upper esophagus
What do parietal cells secrete?
HCl and intrinsic factor
What do chief cells secrete?
In what part of the stomach are the parietal and chief cells?
What part of the stomach are the hormone-secreting cells located?
Where is the primary location of the gastrin's G-cells?
Which sphincter of the stomach (cardiac/pyloric) is a true sphincter?
Does the greater omentum attach to the lesser or greater curvature?
What is the greater omentum between?
greater curvature and transverse colon (gastrocolic ligament)
What is the lesser omentum between?
lesser curvature and hilar area of liver
What are the two ligaments that make up the lesser omentum?
Describe the pattern of the rugae in the fundus and body. Is this the same as in the pyloric?
criss-cross pattern in fundus and body
linear in pyloric antrum
Which branch of the aorta supplies the foregut? What are its branches?
left gastric, common hepatic, splenic
What does the left gastric artery supply?
fundus, lesser curvature
What does the common hepatic artery supply? (with regards to the stomach) What are the branches that provide this blood supply?
pylorus & distal greater curvature and body
gastroduodenal artery and right gastoomental artery
What does the splenic artery supply w/ regards to the stomach? (which branches provide this blood supply?
short gastric A-fundus, proximal greater curvature
left gastroomental A-proximal greater curvature & body
What veins does the blood from the stomach drain?
splenic & SMV, some directly to portal vein
What is the sympathetic innervation of the stomach? What does it regulate?
thoracic splanchnic N to and through the celiac plexus
regulates gastric vasculature tone and response to pain
What is the PNS of the stomach?
gastric branches derived from continuations of the vagal trunks
Where is the left vagal trunk found? Right? What causes this?
due to rotation of stomach
Why is 'trunk' nomeclature of the vagus nerve used below the esophageal level?
b/c there is mixing of R&L vagal N, can't tell separation
What is located anteriorly to the stomach?
left hemidiaphragm
What is located posteriorly to the stomach-'bed of stomach'?
spleen, gastrosplenic ligament, splenorenal ligament, pancreas, L kidney & suprarenal gland, transverse mesocolon & transverse colon
Where are ulcers more common?
Describe a Bilroth-I surgical procedure?
removal of antrum and a vagotomy to reduce acid secretion
remaining proximal stomach is reattached to duodenum
Describe a Bilroth-II surgical procedure?
remain proximal stomach is reattached to jejunum and proximal duodenal segment is closed and left as a blind pouch
What side effects can antrectomy & vagotomy lead too?
rapid emptying of stomach
In the stomach, where is carcinoma most frequent?
Describe how a metastices can travel?
pyloric region
pyloric nodes to celiac nodes to main intestinal tunks and thoracic duct
Displacement of the gastric bubble toward the right side of the abdominal cavity could indicate what?
enlargement of spleen
Describe the location of referred pain of the stomach? About what dermatomes?
to epigastric region & back
T7&8 dermatomes
What is the largest lymphoid tissue mass in the body?
What type of cells are present in the spleen?
lymphocytes, macrophages, fibroblasts
What does the spleen arise from?
mesenchymal cells, not endoderm
What is the name of enlargemnt of the spleen?
What is the location of the spleen? (Quadrant and region and ribs)
ULQ, L hypochondriac region
internal to left ribs 9-11
Which side of the spleen (medial/lateral) contains the hilum or pedicles)?
What organ is within the layers of the splenorenal ligament?
tail of pancreas
Describe the vasculature of the spleen.
splenic artery from celiac trunk
splenic vein drains into portal v
Describe the innervation of the spleen.
splenic nerve plexus from celiac plexus (esp greater thoracic splanchnics), L celiac ganglion & R vagus trunk
Is the plexus innervating the spleen primarily parasympathetic or sympathetic?
What is the pedicle of the spleen medially related to?
tail of pancreas
What is the spleen lateroposterior to?
greater curvature of stomach
What is the spleen anterolateral to?
L kidney
Is the spleen superior or inferior to the L colic flexure?
What is the L costodiaphragmatic recess between?
spleen and lower ribs
Describe the pathway of dye if it is injected through a catheter into the celiac trunk.
celiac trunk -> splenic artery -> spleen -> splenic vein -> portal vein
Where is a needle biopsy of the spleen done?
rib 10 passing through costodiaphragmatic recess
Describe referred pain of the spleen.
rather localized to LUQ

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