abdominal viscera

Created by jgambre1 

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3 unpaired abdominal aorta arteries

celiac trunk, superior mesenteric, inferior mesenterec

celiac trunk

supplies foregut

superior mesenteric

supplies midgut

inferior mesenterec

supplies hindgut

foregut stuff

lower esophagus; stomach; upper duodenum; pancreas; liver; gallbladder

midgut stuff

lower duodenum; Ileum; Jejunum; Cecum and appendix; Ascending Colon; Prox 2/3 transverse colon

Hindgut stuff

Distal 1/3 transverse colon; descending colon; sigmoid colon; Rectum; upper part of anal canal

gut rotation

between week5-6 and 10-11 gut gets adult configuration w/ midgut rotation totalling 270 degrees counterclockwise

esophagus

25cm muscular tube going through diaphragm at t10 and terminating at cardiac orifice at T11

Esophageal Hiatus

within right crus of diaphragm

GERD

gastroesophageal reflux disorder: incompetent esophageal valve allows acid to rise into esophagus causing lining to change or get eroded

Esophageal Varices

esophageal veins dilation from hypertension. now they're prone to hemorage and can cause death in persons with portal hypertension

Achalasia

25-60y/o. Men=women. Loss of myenteric neurons (auerbach's plexus) in lower esophagus. Lower esophageal sphincter (LES) paralyzed in constricted state and esophagus is dilated

Pyloric sphincter

sphincter muscle at the end of the stomach

transverse colon level

L3

Ampulla of Vater

marks junction between foregut and midgut derived structures

obstructive jaundice due to pancreatic carcinoma

results from retention of bile that stain tissues like sclera (whites) of eyes. Cancer of head of pancreas compresses bile duct or hepatopancreatic ampulla (of vater)

obstructive Jaundice due to pancreatic carcinoma symptoms

severe back pain, large gallstone can cause obstructive jaundice and so one must consider this as possibility of differential

spleen

immune organ (not from foregut) Vascular (filters blood).

Spleen location

left side within greater sac against ribs 9-11.

trauma to spleen

when trauma happens to ribs 9-11 can cause severe internal bleeding

Liver

largest and most vascular organ in abdominal cavity

2 surfaces of liver

diaphragmatic and visceral

bare area of liver

in contact with diaphragm. site where original relationship w/ septum transversum is retained. liver suspended from diaphragm by coronary ligament

Falciform lig.

ligament going vertically up and down on th eanterior side of the liver

ligamentum teres

obliterated left umbilical vein

Liver Lobes

Left, caudate, Right, Quadrate

Gallstones

female 2x liklier. severe epigastric or right upper quadrant pain. can be referred to R shoulder (irritation of diaphragm). Large ones cause obstructive jaundice

Cholelithiasis stats

cholesteral gallstones. 20%men over 75, 35%women over 75 AND women in reproductive years 3x liklier than men

Cholelithiasis

brown pigment gallstones associated w/ bacterial cholangitis due to increased concentration fo unconjugated bilirubin in bile

Blood supply to foregut

celiac trunk

foregut innervation

sympathetic innervation from T6-9 with pain afferents running with them. Other afferents run with parasympathetics (vagus)

superior mesenteric vein and artery vs uncinate process of pancreas

head of pancreas right next to superior mesenteric vein, then more left is the artery

small intestine

7m long starting w/ duodenum. jejunum is upper 2/5 of remainder, located in L upper quadrant. Ileum is lower 3/5 in R lower quadrant

Blood supply of Jejunum

less prominent arterial arcades and long vasa recta are feature of jejunum

Ileum blood supply

ileum has more arterial arcades and shorter vasa recta compared to jejunum

Large Intestine (Colon)

1.5m long

Large Intestine parts (7)

Cecum; Ascending Colon; Transverse Colon; Descending Colon; Sigmoid Colon; Rectum; Anal Canal

Midgut innervation

symp innervation from spinal segments t8-t12, pain running with them. other afferents run w/ parasympathetics (vagus)

midgut to hindgut transition line

line on the left transverse colon between center of body and decending colon

SMA and IMA anastomoses

at left colic flexure

SMA and IMA anastomoses clinical

left colic flexure vulnerable to ischemia. atherosclerosis could occlude openings of either one. marginal artery allows blood distribution of these arteries when one or the other is occluded

Hirschprung's Disease

"Congenital aganglionic megacolon" Failure of neural crest cels to migrate into distal colon (males 4:1) and 1:5000 births

portal vein

formed when splenic and superior mesenteric vein join post. to neck of pancreas at level of L2. Gets blood from GI tract and spleen. Blood from kidneys do not drain into portal vein

Portal-Caval Anastomoses

portal venous drainage w/ somatic venous drainage 4 sites: 1)esophageal veins 2)paraumbilical veins 3) veins of anal canals 4) retroperitoneal veins

alcohol abuse and cirrhosis on anastomoses

affects esophageal veins and paraumbilical veins

recto-anal watershed

lymphatics follow arteries. upper portion of rectum drains along route of inferior mesenterec a. middle and lower portions drain back toward internal iliac arteries. below pectinate line, drainage is to superficial inguinal nodes

hindgut innervation

symp from t12-L2, pain runs with these. Other afferents run w/ parasympathetics (pelvic splanchnics)

gut innervation

fore/midgut get parasympathetic from vagus through left 1/3 transverse colon. symp supply to fore/midgut from thoracic splanchnics

hindgut innervation

parasympathetics from pelvic splanchnics and symps via lumbar splanchnics

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