Communication between the supracolic and infra colic compartments?
parabolic gutters, grooves between the lateral aspect of the ascending and descending colon and the posteriorlateral abdominal wall.
Greater Omentum components?
- gastrophrenic ligament
- gastrocolic ligament
Infection of the peritoneum
Function of the greater momentum?
- Prevents the visceral peritoneum from adhering to the parietal peritoneum.
- Walls off and prevents spread of infection
Hepatic portal vein is made from?
superior mesenteric vein and the spenic vein
Level of esophageal hiatus and stomach
T10, T11 Z-line
The esophagus goes from voluntary muscle to involuntary
Blood supply to distal esophagus?
Left gastric and left inferior phrenic
Esophogeal portal anastomosis?
portal vein to left gastric vein to esophogeal to azogus
Esophogus lymph drainage and innervation?
- Left gastric lymph nodes to celiac
- vagal truing and sympathetics from the greater splancnic
Four parts of the stomach?
Stomach venous drainage?
- right and left gastric into the splenic vein
- left gastro-omental int ot splenic
- right gastro-omental into the SMV
Stomach lymph drainage is eventually to the celiac nodes
- Para, anterior and posterion vagal trunks
- Sym, T6-T9 via the celiac plexus from the greater splanchnic nerve
Origin of right gastric artery?
The stomach is interperitoneal
Four parts of the duodenum?
- Superior, L1
- Descending, L2-L3
- Inferior, L3 posterior to the SMA
- Ascending, L3-L2, attached to the ligament of Treitz
Where is the junction of foregut and midgut?
Duodenal blood supply?
- Proximal part, gastroduodenal and superior pancreaticoduodenal artery
- Distal part, SMA through the inferior pancreaticduodenal artery
Anastomosis batween colic artery and SMA?
- para, vages
- sym, celiac and superior mesentaric plexi
Lymph drainage of the jejunum and ileum?
Into the lacteals of the villi to the superior mesenteric node
Spinal innervation of the mid gut?
- para from the posterior vagal trunk
- not sensitive to pain but is to stretch and ischemia
Stomach, esophogus, pancrease, duodenum, liver, bile ducts
Degree of gut rotation?
Four Physical features of the large intestine?
- Teniae coli, three thick bands of smooth muscle
- Haustra, Pouches between Teniae, Teniae or shorter then large intestine
- Omental Appenadices
- Caliber, thicker
Cecum blood supply?
- iliiocecal artery of the SMA
- Iliocecal lymph drains to superior mesinteric nodes
Large intersine innervation?
- Para from vegus nerve
- Appendix is T10
Blood Supply to ascending colon?
Iliocolic and right colic artery from SMA
Arterial supply of transverse colon
middle colic artery from SMA
Blood supply and innervation of descending colon?
- IMA and lumbar sympathetic trunk
- Para via the inferior hyporgastric to the pelvic splanchnic
stomach through the esophageal hiatus
Gastric vs peptic ulcers?
- Gastric are open lesions of the mucosa of the stomach
- Peptic are lesions of the mucosa of the pyloric call or the duodenum
Bacteria that infects most stomach ulcers?
Procedure for chronic gastric ulcers
vagotomy, removal of vegus nerve since it causes parietal secretions
Posterior gastric ulcer
can erode through the pancreas inferring pain to the back and could damage the spleenic artery and cause massive hemorrhage
Chronic inflammation of the colon?