Anatomy Exam 3: Abdomen

4 quadrants

4 quadrants

right upper, right lower, left upper, left lower

(if you don’t know these by now what have you been doing??)

RUQ structures

Liver, gallbladder, stomach pylorus, duodenum, head of pancreas, right adrenal gland, hepatic flexure

portions of: jejunum, R. kidney, ascending colon, transverse colon

LUQ structures

L lobe of liver, spleen, stomach, body & tail of pancreas, L adrenal gland, splenic flexure

portions of: L kidney, transerve colon, small intestine (jejunum), descending colon

RLQ structures

cecum, appendix, R ureter, urinary bladder, lower portion R kidney

Portions of: jejunum, ileum, ascending colon

Reproductive: R ovary, R fallopian tube, Uterus (if enlarged), R spermatic cord

LLQ structures

sigmoid colon, lower L kidney, L ureter, urinary bladder (if distended)

portions of: jejunum, ileum, descending colon

Reproductive: L ovary, L fallopian tube, Uterus, L spermatic cord

9 regions

R/L hypochondriac, R/L lumbar, R/L iliac, epigastric, umbilical, hypogastric

R Hypochondriac structures

gallbladder, R lobe of liver, hepatic flexure, adrenal gland

portions of: duodenum, ascending colon, R kidney, jejunum

Epigastric structures

stomach, transverse colon, pancreas

Portions of: duodenum, jejunum, liver, adrenal gland

L hypochondriac structures

spleen, pancreas tail, splenic flexure, adrenal gland, upper L kidney

portions of: transverse colon, descending colon

R lumbar structures

lower half of R kidney

portions of: ascending colon, jejunum, ileum

Umbilical structures

jejunum, ileum, portion of transverse

L lumbar structures

lower half of L kidney

Portions of: descending colon, jejunum, ileum

R iliac structures

cecum, appendix, R ureter, distal end of ileum, R spermatic cord, R ovary

Hypogastric (pubic)

ileum, bladder, ureters, urethra, uterus & fallopian tubes, postate & seminal vesicles

L iliac structures

sigmoid colon, L ureter, L spermatic cord, L ovary

Bones

Anterior: ribs. 6-10, diploid, pelvic girdle

Posterior: ribs 10-12, spine T10-L5, sacrum and pelvic girdle

ASIS

anterior superior iliac spine (along the iliac crest)

What is the deepest abdominal muscle?

Transversus abdominus m.

Layers of the Abdomen (superficial to deep)

Skin, Subcutaneous tissue, Camper fascia, Scarpa Fascia, External oblique m., intera oblique m., rectus abdominis m., transversus abdominus m., transversalis fascia, extraperitoneal fat, parietal peritoneum

Anterior Abdominal Wall (superficial to deep) muscles only

external oblique, *internal oblique, *rectus abdominis, transverses abdominis

*internal oblique and rectus abdominis on same level

linea alba

medial to rectus abdominis

(central line down abdomen)

Rectus sheath is formed by

aponeurosis

Structures within rectus sheath

rectus abdominis m.

Inguinal Ring

transmits the spermatic cord

-L1 spinal nerve mediates reflex

Most common hernia?

inguinal: within Hesselbach’s triangle

vena caval foramen

T8; goes through diaphragm

Esophageal Hiatus

T10; goes through diaphragm; vagus nerve innervates

Aortic Hiatus

T12 (between two crura)

-aorta, thoracic duct, azygous vein

external iliac artery heads toward the

lower extremities

internal iliac artery heads towards the

bladder

Mesentery

double layer of visceral peritoneum; attached to organs to hold them in place (posteriorly)

contains arterial blood supply: aorta, superior/inferior mesenteric arteries

Lesser omentum

attached to lesser curvature of stomach and liver

-extension of peritoneum: stomach, duodenum, liver

Greater omentum

hangs from the greater curvature of stomach, drapes in front of intestines

-descends distally: stomach, duodenum, transverse colon

Intraperitoneal Organs

SALTD: Stomach, appendix, liver, transverse colon, duodenum

SPRCSS: small intestine (j&i), pancreas (tail), rectum (top 1/3), cecum, sigmoid colon, spleen

UFO: uterus, fallopian tubes, ovaries

Retroperitoneal Organs

SADPUCKER: suprarenal glands (adrenal), aorta & IVC, duodenum, pancreas (head & tail, ureters & urinary bladder, colon (ascending/descending), kidneys, esophagus, rectum

What is the superior boundary of the abdominal cavity?

diaphragm

lower esophageal sphincter (LES)

prevents acid reflux

stomach features

sphincters: LES, pyloric

curvatures: greater, lesser

regions of the stomach

cardia, fundus, body, pylorus

layers of the stomach (deep to superficial)

mucosa, submucosa, muscalaris externa, serosa

2nd phase of digestion

parietal cells: produce intrinsic factor (b12 absorption), secretes hydrochloric acid

chief cells: secrete pepsinogen

G cells: secrete gastrin

arterial supply to stomach

L/R gastric arteries

bloody supply leaving stomach

L/R gastric veins → hepatic portal vein → liver

order of small intestine

duodenum (c-shaped), jejunum, ileum

small intestine mesentery

Ligament of Treitz → ileocecal junction

duct attachment order

pancreatic + common bile → hepatopancreatic -enter→ descending duodenum (D2)

jejunum

mostly LUQ, contains plicae circulares, slow passage of food and afford an increased surface for absorption

ileum

mostly RLQ, connects to cecum, contains Peyer’s patches

Large intestine (colon)

absorbs fluids and salts, Teniae coli (3 bands) - long slow muscle, absent in appendix and rectum, Haustra: between teniae

Large intestine parts

CARTLDSRAA

cecum, ascending colon, right colic flexure, transverse colon, left colic flexure, descending colon, sigmoid colon, rectum, anal canal, anus

Which part of the colon is the longest?

Transverse

Which part of the colon is the narrowest

descending

GI tract

sigmoid colon, rectum, anal canal, anus

What shared task do the sigmoid colon and rectum have?

store fecal material

Dentate lines

differentiates between anus and rectum

Rectum is supported by

levator ani muscles: iliococcygeus, pubococcygeus, puborectalis

Anococcygeal ligament

external sphincter

voluntary control

PNS innervations

Cranial: Vagus Nerve - innervates upper esophagus to transverse colon

Sacral: Pelvic Nerves - innervates from descending colon to internal anal sphincter

spleen location

proceed by left ribs 9-11

(ruptured 911)

pancreas

connects w/ common bile ducts, head embraced by duodenum

Endocrine: insulin, glucagon via islets of Langerhans

Exocrine: digestive enzymes from acinar cells

Sphincter of Oddi (hepatopancreatic sphincter)

prevents contents from entering duodenum

Liver

largest visceral organ and largest gland

Falciform ligament- dives left and right lobes

lobes of the liver

right (largest), quadrate, caudate, left

Liver lobule

Portal triad: portal venule (goes to intestines), portal arteriole, bile duct

Hepatic veins drain into the

inferior vena cava

Gallbladder

storage and concentration of bile

-fundus, body, neck

-inferior to liver

When does the gallbladder empty?

when food digestion occurs in upper GI

especially when fatty foods enter duodenum