4 - ANATOMY OF THE ABDOMEN (BRS) 2025

What structures pass through the aortic hiatus of the diaphragm

-Aorta

-Thoracic duct

-Azygos vein

-Greater splanchnic nerve

What structures pass through the esophageal hiatus of the diaphragm

-Esophagus

-Anterior and posterion trunks of the vagus nerve

What structures pass through the vena caval hiatus of the diaphragm

-Inferior Vena Cava

-Right phrenic nerve

The vena caval hiatus lies in the central tendon of the diaphragm at what vertebral level?

T8

The esophageal hiatis lies in the muscular part (right crus) of the diaphragm at which vertebral level?

T10

The aortic hiatus lies between the two crura of the diaphragm at which vertebral level?

T12

Which part of the pancreas is closely associated with the bile duct?

Head of the pancreas

The deep inguinal ring lies in which layer of the anterior abdominal wall?

Transversalis fascia

The deep inguinal ring lies lateral to what vessels?

Inferior epigastric vessels

The superficial inguinal ring is located in the aponeurosis of what muscle of the anterior abdominal wall?

External oblique muscle

The aponeurosis of what muscle forms the inguinal ligament and the anterior wall of the inguinal canal?

External oblique muscle

Which portion of the gallbladder is in contact with the transverse colon?

Fundus of the gallbladder

The fundus of the gallbladder is in contact posteriorly with which portion of the large intestine?

Transverse colon

Which portion of the gallbladder is in contact with the duodenum?

Body of the gallbladder

The body of the gallbladder is in contact posteriorly with what structure?

Duodenum

The retroperitoneal organs can be remembered by the mnemonic SAD PUCKER

S - Suprarenal (Adrenal) Glands

A - Aorta + Inferior Vena Cava

D - Duodenum (2nd and 3rd segments)

P - Pancreas

U - Ureters

C - Colon (Ascending + Descending)

K - Kidneys

E - Esophagus

R- Rectum

What is the only organ that directly receives preganglionic sympathetic fibers?

Adrenal (Suprarenal) gland

Which layer of the adrenal gland secretes norepinephrine?

Adrenal medulla

This condition is caused by absence of enteric ganglia in the lower part of the colon leading to dilatation of colon proximal to the inactive segment?

Hirschsprung disease (Aganglionic megacolon)

The left umbilical vein becomes the __________ of the liver after birth

Round ligament

The ___________ does not leave a fibrous remnant because it degenerates during early embryonic period

Right umbilical vein

The right and left hepatic veins drain into the ___________

Inferior Vena Cava

The right gastroepiploic vein drains into the ___________

Superior mesenteric vein

The left gastroepiploic vein drains into the _________

Splenic vein

This is the longest part of the duodenum

Transverse (Third) Part

The transverse part of the duodenum cross 3 structures (from right to left)

-IVC

-Aorta

-Vertebral column

The __________ cross the transverse part of the duodenum anteriorly

Superior mesenteric vessels

What is the afferent limb of the cremasteric reflex?

Femoral branch of genitofemoral nerve

What is the efferent limb of the cremasteric reflex?

Genital branch of genitogemoral nerve

Parasympathetic nerves to the ascending and transverse colons are supplied by __________ nerve

Vagus nerve

Parasympathetic nerves to the descending and sigmoid colons are supplied by __________ nerve

Pelvic splanchnic nerve from sacral spinal nerves (S2-S4)

What condition causes diversion of blood from the portal to the caval system?

Portal hypertension

The adrenal (suprarenal) gland is supplied by the superior, middle and inferior suprarenal arteries. From what respective arteries do these arteries arise?

-Superior Suprarenal Artery from Inferior Phrenic Artery

-Middle Suprarenal artery from Abdominal Aorta

-Inferior Suprarenal Artery from Renal Artery

The left gastroepiploic artery runs through what ligament?

Lienogastric/Gastrosplenic ligament

The splenic artery is found within what ligament?

Lienorenal ligament

The right and left gastric arteries are located within what structure?

Lesser omentum

The diaphragm is supplied by which nerves?

Phrenic nerves

Sensation from the central part of the diaphragm is perceived through what nerves?

Phrenic nerves

The peripheral part of the diaphragm receives sensory fibers from what nerves?

Lower intercostal nerves

What nerve supplies sensory fibers to the peritoneum inferior to the diaphragm?

Subcostal nerve

What are the three branches of the splenic artery?

Pa - Dorsal Pancreatic Artery

Gas - Short Gastric Arteries

Gas - Left Gastroepiploic (Gastro-omental) Arteries

What is located at the junction of the lateral one-third of the line between the umbilicus and the anterior superior iliac spine (ASIS)

McBurney Point

What nerve is located near the McBurney point and is located between the internal oblique and transverse abdominal muscles

Iliohypogastric nerve

Jejunum/Ileum: Which contains more mesenteric arterial arcades?

Ileum

Jejunum/Ileum: Which has longer vasa recta?

Jejunum

Jejunum/Ileum: Which portion has tall and closely packed plicae circulares (circular folds)?

Jejunum

Jejunum/Ileum: More digestion and absorption of nutrients occur in this portion.

Jejunum

Jejunum/Ileum: Which has more fat?

Ileum

The right colic vein empties into what vein?

Superior mesenteric vein

The superior mesenteric vein joins what vein to form the portal vein?

Splenic vein

The splenic vein is joined by what vein to form the portal vein?

Superior mesenteric vein

The portal vein is formed by joining of what two veins?

-Splenic vein

-Superior mesenteric vein

What artery supplying the pancreas arises from the splenic artery and runs retroperitoneally along the superior border of the pancreas?

Dorsal pancreatic artery

Which part of the pancreas has a portion located intraperitoneally?

Tail of the pancreas

The proper hepatic artery runs within the free margin of which structure?

Lesser omentum

What artery runs within the transverse mesocolon?

Middle colic artery

What artery runs within the sigmoid mesocolon?

Sigmoid arteries

This anterior abdominal wall fold contains the remnant of umbilical artery

Medial umbilical fold

This anterior abdominal wall fold contains the remnant of the urachus

Median umbilical fold

This anterior abdominal wall fold contains the inferior epigastric vessels

Lateral umbilical fold

The medial umbilical fold contains the remnant of ____________

Umbilical artery

The median umbilical fold contains the remnant of __________

Urachus

The lateral umbilical fold contains the _____________

Inferior epigastric vessels

What structure contains the fibrous remnant of the ductus venosus?

Ligamentum venosum

The ligamentum venosum contains the fibrous remnant of what embryologic structure?

Ductus venosus

The fibrous remnant of the left umbilical vein is contained within what ligament?

Ligamentum teres hepatic

The ligamentum teres hepatic contains the fibrous remnant of which embryologic structure?

Left umbilical vein

3 veins that drain directly into the portal vein

-Splenic vein

-Superior mesenteric vein

-Left gastric (or coronary) vein

3 Tributaries of splenic vein

Pa - Pancreatic veins

Gas - Short gastric veins

Gas - Left gastroepiploic veins

3 Tributaries of the Superior Mesenteric Vein

-Middle colic vein

-Inferior pancreaticoduodenal vein

-Ileocolic vein

3 Tributaries of the Inferior Mesenteric Vein

Superior rectal vein

Sigmoid vein

Left colic vein

The lower abdominal wall, buttocks, penis, scrotum, labia majora and distal parts of vagina and anal canal drain directly into what group of lymph nodes?

Superficial inguinal lymph nodes

The testis, upper parts of vagina and anal canal drain directly into what group of lymph nodes?

Deep Inguinal Lymph Nodes

The caudate lobe drains bile into which hepatic ducts?

Right and left hepatic ducts

The liver receives blood from which 2 blood vessels?

Hepatic arteryPortal vein

The liver drains its venous blood into which blood vessel?

Hepatic vein

This structure is responsible for storing and concentrating bile?

Gallbladder

What 2 ducts combine to form the common bile duct

-Common hepatic duct

-Cystic duct

The sigmoid colon receives blood from what artery?

Inferior mesenteric artery

The sigmoid colon receives parasympathetic preganglionic fibers from what nerve?

Pelvic splanchnic nerve

The appendicular artery is a direct branch of __________ artery

Ileocolic artery

What arteries supply branches to the stomach?

-Splenic artery

-Gastroduodenal artery

-Left gastroepiploic artery

-Proper hepatic artery

What nerve carries pain fibers from the upper GI tract

Greater splanchnic nerve

Peristence of the middle portion of what fetal structure is responsible for the formation of congenital hydrocele

Processus vaginalis

Persistence of the entire processus vaginalis may lead to what condition?

Congenital indirect inguinal hernia

This fetal structure is a fetal ligament that is responsible for holding the bottom of the testis to the developing scrotum

Gubernaculum testis

This condition is characterized by the failure of the testis to descend from the abdomen to the scrotum

Cryptorchidism

Hematocele is the effusion of blood into the cavity of what structure?

Tunica vaginalis

3 structures contained in porta hepatis

-Hepatic ducts

-Hepatic arteries

-Branches of portal vein

Esophageal and gastric varices occur with dilatation of the portal-caval anastomosis between what two blood vessels?

Esophageal veinsGastric veins

Caput medusae occur with dilatation of the portal-caval anastomosis between what two blood vessels?

Paraumbilical vesselsEpigastric veins

Dilated retroperitoneal veins occur with dilatation of the portal-caval anastomosis between what two blood vessels?

-Inferior mesenteric vein tributaries

-Retroperitoneal veins

Rectal varices (hemorrhoids) occur with dilatation of the portal-caval anastomosis between what blood vessels?

Superior rectal veins

Middle and inferior rectal veins

What are the 7 rule of 2's of Meckel Diverticulum?

-Located 2 feet proximal to ileocecal junction on antimesenteric side

-Approximately 2 inches long

-Occurs in approximately 2% of population

-2 types of ectopic tissues (gastric and pancreatic)

-Presents in first 2 decades

-Most often in first 2 years

-2 times more likely in boys than girls

Which part of the pancreas is located behind the superior mesenteric vessels?

Uncinate Process

The uncinate process of the pancreas is located behind what blood vessels?

Superior Mesenteric Vessels

The superior pancreaticoduodenal artery runs between the duodenum and which part of the pancreas?

Head of the pancreas

What blood vessel is located between the duodenum and the head of the pancreas?

Superior pancreaticoduodenal artery

The portal vein runs behind which part of the pancreas?

Neck of the pancreas

Which blood vessel runs behind the neck of the pancreas?

Portal vein