Human Anatomy and Physiology Quiz

1003 Final Review Topics

• Pancreas
• Urinary System
• Spleen
• Adrenal Glands
• Abdominal Cavity and Wall
• Lymphatic System
• Portal System (veins)

Sagittal Image Directions

• The sagittal plane is a vertical plane that divides the body into left and right sections.
• Images taken in this plane can show structures in the body from the front to the back.

Common Bile Duct (CBD) Location

• The CBD travels from the union of the common hepatic duct and cystic duct to the duodenum near the head of the pancreas.
• It runs along the posterolateral aspect of the pancreatic head.
• It enters the duodenum at the ampulla of Vater, passing through the sphincter of Oddi.
• The main pancreatic duct joins the CBD at the duodenum.

Portal System

• A unique venous system that drains blood from the spleen, stomach, pancreas, and intestines.
• Supplies the liver with nutrient-rich blood.
• Consists of the splenic vein, inferior mesenteric vein, superior mesenteric vein, and main portal vein.
• System routes blood from the digestive system to the liver for processing.

Pancreas Location and Landmarks

• Posterior to the perivertebral connective tissue.
• Adjacent to the IVC and aorta.
• Positioned behind the left and right kidneys.
• Subjacent to the diaphragm.

Lesser Sac

• A potential space for fluid collections.
• Formed from greater omentum and lesser omentum.
• Location between the pancreas and stomach (perihepatic and subphrenic spaces are common locations)

Pancreatic Ducts

• Primary duct, extending the entire length of the gland, enters the duodenum medial side.
• Secondary duct: measures less than 2mm; drains the upper anterior head.

Pancreas Congenital Anomalies

• Pancreas Divisum: Failure of the dorsal and ventral pancreatic ducts to fuse.
• Annular pancreas: A ring of pancreatic tissue encircles the duodenum.

Pancreas Physiology

• Exocrine function: Produced by acinar cells; produces enzymes in pancreatic juices (2 L/day).
  • Sodium bicarbonate: Neutralizes stomach acid.
  • Amylase: Digests carbohydrates.
  • Lipase: Digests fats.
  • Trypsin: Digests proteins.
• Endocrine function: Produced in the islets of Langerhans.
  • Beta cells: Convert glucose to glycogen (lowers serum glucose) with insulin.
  • Alpha cells: Convert glycogen to glucose (raises serum glucose) with glucagon.
  • Delta cells: Inhibit alpha and beta cells.

Pancreas Sonography

• The uncinate process is a posteromedial extension of the pancreas head.
• It lies anterior to the inferior vena cava (IVC) and posterior to the superior mesenteric vein (SMV)

Portal Vein

• Runs posterior to body and tail of the pancreas.
• The splenic vein and superior mesenteric vein form the portal confluence (posterior to the neck of the pancreas)
• IVC located posterior to the pancreas head.
• SMA marks the pancreas body. In the pancreas head, GDA and CBD may be found.

Short Sections of Pancreas

• Sagittal scanning plane across the pancreas head.
• Sagittal scanning plane across the pancreas body.
• Sagittal scanning plane displays the pancreas neck and uncinate process.

Urinary System Components

• Kidneys: Main organs that filter blood and produce urine.
• Ureters: Transport urine from the kidneys to the bladder.
• Urinary Bladder: Stores urine until expulsion from the body.
• Urethra: Tube that extends from the bladder to an external opening. Males have an additional function related to reproductive processes.
  • Lab values to assess renal function:
    • Blood Urea Nitrogen (BUN)
    • Creatinine (Cr)

Kidney Protective Layers

• Renal Capsule: Innermost connective tissue layer.
• Adipose Layer: Perirenal fat surrounding the kidney.
• Gerota's Capsule: Outermost protective fibrous sheath.

Kidney Regions

• Renal Sinus: Collecting system for urine.
• Renal Cortex: Part of the functional kidney; contains tubules and capillaries.
• Renal Medulla: The inner section of the kidney, containing collecting ducts.

Kidney Hilum

• The medial aspect of the kidney. Blood vessels, nerves, lymphatic vessels, and the ureter enter or exit.

Left Renal Vein

• Longer than the right renal vein.
• Runs between the aorta and SMA.
• Accepts left gonadal and suprarenal veins.

Renal Variants: Column of Bertin, Dromedary hump, Junctional parenchymal defect, Fetal lobulation

• Variations in kidney structure; mostly congenital.
• Column of Bertin: Indentation in the kidney medulla, resembling a mass.
• Dromedary Hump: Bulge on the kidney's lateral border, often on the left.
• Junctional Parenchymal Defect: Triangular area in the upper pole of the kidney.
• Fetal Lobulation: Indentation/lines on the surface of the kidney.

Ureter

• Thin muscular tube (25-30 cm long, 4-7 mm in diameter).
• Originates at the ureteropelvic junction (renal pelvis, proximal ureter)
• Courses through retroperitoneum to the ureterovesical junction where it passes obliquely through the bladder wall to prevent urine reflux.

Bladder and Urethra

• Bladder: Large muscular bag; shape changes based on urine volume.
• Apex: Anterior extension, attached to the umbilical ligament.
• Base (Trigone): Inferior part with ureter openings and inferior urethral opening; crucial for preventing urine reflux.
• Urethra: Canal that drains urine; longer in males.

Spleen

• Largest lymphatic organ.
• Located between the 8th and 11th ribs (left upper quadrant)
• Inferior to the left hemidiaphragm.
• Posterior to the stomach.
• Normal measurements range between 7 and 13cm in length.

Accessory Spleen

• Congenital anomaly; Small, round, same echogenicity as the spleen.
• Usually near splenic hilum or adjacent to pancreas tail

Splenic Microanatomy

• White pulp (T cells, B cells, macrophages): Lymphoid tissue that plays a role in fighting infections.
• Red pulp (RBCs): Filtering out (removing) and recycling old RBCs.
• Consists of cords and venous sinuses: allowing blood (RBCs) to flow through freely

Adrenal Gland - Hormones

• Adrenal Cortex: Produces steroid hormones.
  • Zona Glomerulosa: Mineralocorticoids (e.g., aldosterone), regulates electrolyte balance (especially sodium and potassium concentration) & BP.
  • Zona Fasciculata: Glucocorticoids (e.g., cortisol), stress response.
  • Zona Reticularis: Gonadocorticoids, regulates sex hormones (androgens and estrogens).
• Adrenal Medulla: Produces catecholamine hormones (epinephrine & norepinephrine, vital for the fight-or-flight response.

GI Tract

• Digestive Tract: Parts above the diaphragm.
• Gastrointestinal Tract: Parts below the diaphragm.
  • Mouth, esophagus, stomach, small intestine, large intestine, liver, pancreas, salivary glands.
• Parts of the GI Tract (alimentary canal): Stomach, small intestine, and large intestine.
• Important digestive organs (liver, pancreas): Assist with digestion.

5 Layers of the Gut

• Mucosa contacts lumen; contains epithelial folds.
• Muscularis Mucosa (hypoechoic): Thin muscle layer.
• Submucosa (echogenic): Contains loose connective tissue fibers.
• Muscularis Propria: Outer muscle layer (contains circular and longitudinal fibers).
• Serosa: Thin outer layer (connective tissue).

Gastroesophageal Junction

• Important anatomical region between the esophagus and stomach.
• Gastroesophageal junction: Region between the esophagus and stomach. Crucial for preventing reflux.

Appendix

• Rudimentary extension from the large intestine (cecum).
• Varia in size and position; typically 9cm.
• Crucial for preventing inflammation which may lead to appendicitis.
• Appendix lies under abdominal wall; at McBurney's point.

Meckel's Diverticulum

• A congenital outpouching of the small intestine; Often located near the ileocecal valve (within 2 feet).

GI Tract Organ Blood Supply

• Stomach: Supplied by the Right and Left Gastric arteries, gastroepiploic artery, and vasa brevia.
• Small Intestines: Supplied by Superior Mesenteric artery (SMA).
• Large Intestines: Supplied by Superior Mesenteric Artery (SMA), Inferior Mesenteric Artery (IMA), and Colic Arteries.
• Venous: Parallels arteries and drains into the portal venous system.

Abdominal Cavity Compartments

• Intraperitoneal: Organs suspended in the peritoneal cavity (e.g., stomach, liver, intestines).
• Retroperitoneal: Organs behind the peritoneum (e.g., kidneys, pancreas).
• Subperitoneal: Organs lying below the peritoneum (e.g, some parts of bladder, and some parts of reproductive organs).

Abdominal Wall Muscles and Aponeurosis

• The abdominal wall is composed of multiple layers of muscles and aponeuroses.
• Important external and internal layers surround the intraperitoneal cavity.

Crura of the Diaphragm

• Right and left fibromuscular bundles that attach the diaphragm to the lumbar vertebrae.

Lymph Nodes

• Major clusters: Para-aortic, groin areas, cervical regions, peri-portal, and axillary.
• Normal Sonographic Appearance: Hypoechoic cortex, hyperechoic fatty hilum, oval (or wider than taller).