Human Anatomy Chapter on Liver and Vascular System
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Questions and Answers

Which of the following structures is NOT involved in the formation of the hepatic portal vein?

  • Superior mesenteric vein
  • Splenic vein
  • Left renal vein (correct)
  • Inferior mesenteric vein
  • Which of the following organs is considered intraperitoneal, but DOES NOT attach to the abdominal wall via a mesentery?

  • Liver (correct)
  • Stomach
  • Jejunum
  • Appendix
  • Which part of the duodenum is NOT retroperitoneal?

  • Fourth part
  • Second part
  • First part (correct)
  • Third part
  • Which of the following statements about the liver's blood supply is FALSE?

    <p>The hepatic vein carries blood from the liver to the superior vena cava. (D)</p> Signup and view all the answers

    What is the function of the Falciform ligament?

    <p>Connects the liver to the anterior abdominal wall (D)</p> Signup and view all the answers

    Which of the following organs is NOT considered a part of the retroperitoneal organs mnemonic "SAD PUCKER"?

    <p>Spleen (B)</p> Signup and view all the answers

    Which of these does NOT contribute to the inferior vena cava?

    <p>Hepatic veins (A)</p> Signup and view all the answers

    Which of the following is a function of the liver NOT related to its role in metabolism?

    <p>Production of hormones (A)</p> Signup and view all the answers

    Which of these statements about the liver's surgical segments is FALSE?

    <p>The liver's anatomical lobes correspond to the surgical segments. (D)</p> Signup and view all the answers

    The bare area of the liver is devoid of what?

    <p>Visceral peritoneum (B)</p> Signup and view all the answers

    Which of the following statements accurately describes the location of the cell bodies of the presynaptic neurons involved in the parasympathetic innervation of the hindgut?

    <p>Within the sacral spinal cord (S2-S4) (C)</p> Signup and view all the answers

    What is the primary pathway for the distribution of postganglionic fibers from the lumbar splanchnic nerves to their target organs?

    <p>Via periarterial plexuses following branches of the abdominal aorta (A)</p> Signup and view all the answers

    Which of the following cranial nerves does NOT contribute to the parasympathetic innervation of the head?

    <p>CN XI (Accessory) (D)</p> Signup and view all the answers

    Which of the following structures is NOT a target of the parasympathetic innervation via pelvic splanchnic nerves?

    <p>Stomach (A)</p> Signup and view all the answers

    The sympathetic innervation of the kidneys is primarily derived from which of the following?

    <p>T12 (A)</p> Signup and view all the answers

    Where do the presynaptic fibers of the pelvic splanchnic nerves primarily synapse?

    <p>Within ganglia located near or within the wall of target organs (intrinsic/enteric ganglia) (B)</p> Signup and view all the answers

    Which of the following structures does NOT receive parasympathetic innervation from the vagus nerve?

    <p>Descending colon (C)</p> Signup and view all the answers

    Which of the following statements regarding the location of parasympathetic postsynaptic cell bodies is TRUE?

    <p>They are always located near or within the wall of the target organ (A)</p> Signup and view all the answers

    Which of the following structures is primarily responsible for carrying preganglionic fibers of the vagus nerve that contribute to the parasympathetic innervation of the foregut and midgut?

    <p>Anterior and posterior vagal trunks (A)</p> Signup and view all the answers

    Which of the following correctly describes the relationship between the sympathetic and parasympathetic innervation of the digestive tract?

    <p>The sympathetic system inhibits digestion, while the parasympathetic system stimulates digestion (B)</p> Signup and view all the answers

    Which of the following structures is NOT directly involved in the absorption of water and electrolytes in the large intestine?

    <p>Renal pelvis (C)</p> Signup and view all the answers

    Which specific structure is responsible for the pouch-like appearance of the large intestine due to its contraction?

    <p>Haustra (A)</p> Signup and view all the answers

    What structure is the point of union between the pancreatic duct and the common bile duct?

    <p>Hepatopancreatic ampulla (D)</p> Signup and view all the answers

    Which of the following is NOT a characteristic feature of the ileum compared to the jejunum?

    <p>Longer vasa recta (A)</p> Signup and view all the answers

    Which of these structures forms a fan-shaped fold of peritoneum attaching the jejunum and ileum to the posterior abdominal wall?

    <p>Mesentery proper (C)</p> Signup and view all the answers

    Identify the branch of the celiac trunk that supplies the stomach and the spleen.

    <p>Splenic Artery (D)</p> Signup and view all the answers

    Which artery, arising from the abdominal aorta at L1, is responsible for supplying the midgut?

    <p>Superior Mesenteric Artery (D)</p> Signup and view all the answers

    Which of the following structures is NOT considered part of the foregut?

    <p>Appendix (B)</p> Signup and view all the answers

    Which autonomic nervous system division primarily inhibits peristalsis and constricts blood vessels to the GI tract?

    <p>Sympathetic (B)</p> Signup and view all the answers

    What is the primary function of the kidneys?

    <p>Filter blood and create urine (B)</p> Signup and view all the answers

    Which of the following layers surrounding the kidneys is directly responsible for enclosing the kidneys, suprarenal glands, and perinephric fat?

    <p>Renal fascia (A)</p> Signup and view all the answers

    Which of the following represents the correct sequence of structures involved in urine flow from the renal papilla to the ureter?

    <p>Minor calyx → Major calyx → Renal pelvis → Ureter (C)</p> Signup and view all the answers

    What is the name of the structure that provides an anastomotic connection between the superior and inferior mesenteric arteries?

    <p>Marginal artery of Drummond (D)</p> Signup and view all the answers

    Which of the following is a characteristic feature of the autonomic nervous system?

    <p>It is composed of pre- and postsynaptic neurons (C)</p> Signup and view all the answers

    Identify the type of splanchnic nerves that carry presynaptic sympathetic fibers to the abdominal and pelvic viscera.

    <p>Abdominopelvic splanchnics (A)</p> Signup and view all the answers

    Which of these is NOT a major autonomic plexus located in the abdomen and pelvis?

    <p>Cardiac plexus (D)</p> Signup and view all the answers

    Which of the following organs is NOT located in the Right Upper Quadrant?

    <p>Spleen (A)</p> Signup and view all the answers

    What is the function of the mesentery?

    <p>All of the above. (D)</p> Signup and view all the answers

    Which of the following is a peritoneal ligament?

    <p>Falciform Ligament (A)</p> Signup and view all the answers

    The peritoneal cavity is a potential space between which two structures?

    <p>The parietal peritoneum and the visceral peritoneum. (A)</p> Signup and view all the answers

    The abdominopelvic cavity is formed by the combination of which two cavities?

    <p>Abdominal and pelvic cavities. (C)</p> Signup and view all the answers

    Which of the following organs is NOT part of the digestive tract?

    <p>Spleen (B)</p> Signup and view all the answers

    Which of the following is a characteristic of the peritoneal cavity in females?

    <p>It has an opening that allows the passage of oocytes from the ovaries to the fallopian tube. (D)</p> Signup and view all the answers

    Which of the following is NOT a region of the abdomen?

    <p>Supraclavicular (B)</p> Signup and view all the answers

    Which of the following structures represents the presynaptic neuron involved in the sympathetic innervation of the foregut?

    <p>Greater splanchnic nerve (C)</p> Signup and view all the answers

    Where do the presynaptic sympathetic fibers that innervate the abdominal viscera synapse?

    <p>Prevertebral ganglia (D)</p> Signup and view all the answers

    A patient presents with a disorder affecting the superior mesenteric ganglion. Which of the following structures is most likely to be affected?

    <p>Midgut structures (A)</p> Signup and view all the answers

    Which of the following nerve groups contribute to the formation of the renal plexus?

    <p>Aorticorenal ganglion (B), Greater splanchnic nerve (C)</p> Signup and view all the answers

    Which of the following describes the path of postganglionic sympathetic fibers to the abdominal viscera?

    <p>Along branches of the abdominal aorta, forming periarterial plexuses (A)</p> Signup and view all the answers

    What is the role of the least splanchnic nerve in the sympathetic innervation of the abdominopelvic viscera?

    <p>Its role is not clearly defined in the content provided (A)</p> Signup and view all the answers

    The lateral horn of the spinal cord (T1-L2) contains which type of neurons in the context of the sympathetic nervous system?

    <p>Presynaptic sympathetic neurons (C)</p> Signup and view all the answers

    What is the primary role of the abdominopelvic splanchnic nerves in the sympathetic nervous system?

    <p>Carrying presynaptic sympathetic fibers to the prevertebral ganglia (B)</p> Signup and view all the answers

    Which of the following is NOT a part of the Portal Triad?

    <p>Splenic artery (C)</p> Signup and view all the answers

    What structure is responsible for preventing reflux of duodenal contents into the stomach?

    <p>Pyloric sphincter (B)</p> Signup and view all the answers

    In a patient presenting with Caput Medusae, which of the following is the most likely underlying cause?

    <p>Obstruction of the hepatic portal vein. (C)</p> Signup and view all the answers

    Which of these is NOT a part of the stomach?

    <p>Duodenum (C)</p> Signup and view all the answers

    Which of the following correctly describes the location of the major duodenal papilla?

    <p>Descending portion of the duodenum, adjacent to the head of the pancreas. (D)</p> Signup and view all the answers

    Which peritoneal fold connects the liver to the stomach and the superior portion of the duodenum?

    <p>Lesser omentum (B)</p> Signup and view all the answers

    Which of the following accurately describes the relationship between the jejunum and the ileum?

    <p>The jejunum is shorter than the ileum and located inferior to the ileum. (C)</p> Signup and view all the answers

    Which of the following statements about the greater omentum is true?

    <p>It is a double-layered peritoneal fold that connects the stomach to the transverse colon and functions as a protective barrier. (C)</p> Signup and view all the answers

    Which of these is the largest part of the stomach?

    <p>Body (D)</p> Signup and view all the answers

    Flashcards

    Abdominal Cavity

    The space bounded by the abdominal walls, diaphragm, and pelvis, containing digestive organs, spleen, kidneys, and ureters.

    Quadrants of the Abdomen

    The abdominal area divided into four sections: Right Upper, Left Upper, Right Lower, and Left Lower quadrants.

    Right Upper Quadrant

    Contains the liver, gallbladder, pylorus, duodenum, hepatic flexure of colon, and head of pancreas.

    Left Lower Quadrant

    Contains the descending colon, sigmoid colon, and left ovary.

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    Peritoneum

    A membrane lining the abdominal cavity and covering the abdominal organs, consisting of parietal and visceral layers.

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    Visceral Peritoneum

    The layer of the peritoneum that envelops the organs.

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    Mesentery

    A double layer of peritoneum that attaches organs to the posterior abdominal wall, providing pathways for vessels and nerves.

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    Peritoneal Cavity

    The potential space between the parietal and visceral peritoneum, containing a small amount of fluid; closed in males, open in females.

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    Retroperitoneal

    Organs that are partially outside the peritoneal cavity, covered by parietal peritoneum.

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    Intraperitoneal

    Organs completely encased in visceral peritoneum and connected to the abdominal wall by mesentery.

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    Mnemonic for Retroperitoneal organs

    'SAD PUCKER' aids in remembering retroperitoneal organs.

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    Functions of the liver

    The liver detoxifies, stores glycogen, produces hormones, synthesizes proteins, and produces bile.

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    Hepatic portal vein

    Carries 75%-80% of blood to the liver, formed from superior mesenteric and splenic veins.

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    Bare area of the liver

    Part of the liver in direct contact with the diaphragm, not covered by visceral peritoneum.

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    Liver ligaments

    Include anterior & posterior coronary, triangular, falciform, and round ligaments that connect the liver to other structures.

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    Portal venous system

    Transports blood from GI viscera to the liver for filtration via the hepatic portal vein.

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    Caval venous system

    Drains blood from posterior abdominal structures to the right atrium, bypassing the liver.

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    Divisions of the liver

    Anatomically divided into four lobes: right, left, quadrate, and caudate.

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    Presynaptic neuron

    Neurons located in the CNS that send signals to autonomic ganglia.

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    Postsynaptic neuron

    Neurons located in autonomic ganglia that receive signals from presynaptic neurons.

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    Sympathetic ganglia

    Clusters of nerve cell bodies in the sympathetic nervous system.

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    Prevertebral ganglia

    Ganglia located in plexuses around major aortic branches.

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    Celiac ganglion

    A major prevertebral ganglion that innervates the foregut.

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    Abdominopelvic splanchnic nerves

    Nerves that carry presynaptic sympathetic fibers to prevertebral ganglia.

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    Thoracic splanchnic nerves

    Nerves originating from T5-T11 that carry signals to abdominal ganglia.

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    Renal plexus

    Network of nerves surrounding renal arteries, innervated by splanchnic nerves.

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    T12 Sympathetic Origin

    Sympathetic fibers originate at T12, synapsing in aorticorenal ganglia to contribute to the renal plexus.

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    Lumbar Splanchnic Nerves

    Nerves from L1-L2/L3 that synapse in the inferior mesenteric ganglion, supplying hindgut structures.

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    Parasympathetic Division

    Part of the autonomic nervous system that originates from brainstem cranial nuclei and sacral spinal cord (S2-S4).

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    Cranial Outflow

    Parasympathetic innervation to the head, thorax, and abdominal viscera via cranial nerves.

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    Sacral Outflow

    Supplies distal GI tract and pelvic viscera via pelvic splanchnic nerves.

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    Parasympathetic Ganglia in Head

    Ciliary, pterygopalatine, submandibular, and otic are critical parasympathetic ganglia in the head.

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    Vagus Nerve Function

    Carries parasympathetic fibers for innervation of the foregut and midgut from esophagus to left colic flexure.

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    Pelvic Splanchnic Nerves

    Parasympathetic nerves that innervate the distal GI tract and pelvic viscera from S2-S4.

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    Intrinsic/Enteric Ganglia

    Ganglia located near or within the walls of target organs where presynaptic fibers synapse with postsynaptic cells.

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    Aorticorenal Ganglia Synapse

    Location where sympathetic fibers synapse before reaching renal plexus.

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    Portal-Caval Anatomoses

    Connections between hepatic portal and caval veins providing alternative blood flow.

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    Caput Medusae

    Varicose veins around the umbilicus due to portal hypertension.

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    Common Bile Duct

    Duct formed by the cystic and hepatic ducts, transporting bile to the duodenum.

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    Portal Triad

    Contains the hepatic portal vein, hepatic artery, and common bile duct.

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    Stomach Functions

    Stores food and prepares it for digestion through mechanical and chemical processes.

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    Rugae

    Folds in the stomach lining that expand when the stomach is distended.

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    Greater Omentum

    A double-layered sheet of peritoneum hanging from the greater curvature of the stomach.

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    Small Intestine

    Main site for nutrient absorption, consisting of the duodenum, jejunum, and ileum.

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    Duodenum

    First and shortest portion of the small intestine, where major digestion occurs.

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    Jejunum vs. Ileum

    Jejunum absorbs nutrients mainly in the upper abdomen; ileum absorbs in the lower abdomen.

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    Ileum

    The final part of the small intestine, connects to the cecum.

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    Plicae circulares

    Folds of the intestinal lining that increase surface area for absorption.

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    Pancreas

    An accessory digestive gland that produces enzymes and hormones.

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    Haustra

    Pouch-like features in the large intestine caused by muscle contractions.

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    Teniae coli

    Three longitudinal muscle bands found in the large intestine.

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    Kidneys

    Organs that filter blood, removing waste and excess substances.

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    Renal capsule

    Protective layer surrounding each kidney.

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    Foregut

    Part of the gut tube including esophagus, stomach, and upper duodenum.

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    Superior Mesenteric Artery

    Supplies blood to the midgut, including the jejunum and ileum.

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    Parasympathetic nervous system

    Part of the autonomic system that promotes digestion and peristalsis.

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    Splanchnic nerves

    Nerves carrying autonomic signals to/from the abdominal organs.

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    Marginal artery

    An anastomotic connection between superior and inferior mesenteric arteries.

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    Study Notes

    Abdominal Cavity Organs

    • The abdominal cavity is bordered by abdominal walls, diaphragm, and pelvis.
    • It forms the major portion of the abdominopelvic cavity, which is continuous with pelvic cavities.
    • It contains most digestive organs, spleen, kidneys, and ureters.

    Digestive Tract

    • The viscera of the abdomen make up most of the digestive tract.
    • The digestive tract components are listed in the figure.

    Abdominal Quadrants

    • The abdomen is often divided descriptively into four quadrants by imaginary vertical and horizontal lines that cross at the umbilicus.
    • Each quadrant contains specific organs. Right upper quadrant (RUQ) contains liver, gall bladder, pylorus, duodenum, hepatic flexure of colon, and head of pancreas. Left upper quadrant (LUQ) contains spleen, splenic flexure of colon, stomach, body & tail of pancreas. Right lower quadrant (RLQ) contains terminal ileum, cecum, appendix, ascending colon, and right ovary. Left lower quadrant (LLQ) contains descending colon, sigmoid colon, and left ovary.

    Abdominal Regions

    • The abdomen can be subdivided into nine regions for more precise localization of organs. These regions are epigastric, right hypochondriac, left hypochondriac, umbilical, right lumbar, left lumbar, hypogastric/suprapubic, right iliac/inguinal, and left iliac/inguinal.

    Peritoneum

    • The peritoneum consists of parietal peritoneum (lining the abdominopelvic cavity) and visceral peritoneum (investing the viscera).
    • The peritoneal cavity is the potential space between parietal and visceral peritoneum, containing a small amount of peritoneal fluid (~50mL).
    • The space is closed in males and females with an opening for oocytes to travel from ovaries to fallopian tubes.

    Peritoneum: Mesentery & Ligaments

    • Mesentery is a double layer of peritoneum that encloses an organ and connects it to the posterior abdominal wall, providing pathways for nerves, vessels, and lymphatics.
    • Peritoneal ligaments are another double layer of peritoneum that connect one organ to another or to the abdominal wall.

    Intraperitoneal vs. Retroperitoneal Organs

    • Retroperitoneal organs are partly external to the peritoneal cavity and posterior to the peritoneum. They are connected to the abdominal wall. Examples are kidneys.
    • Intraperitoneal organs are completely within the peritoneal sac and are almost entirely invested by visceral peritoneum. Examples of these are stomach and liver.

    Intraperitoneal Organs

    • This list gives examples of intraperitoneal organs: Liver, Tail of Pancreas, Spleen, Stomach, Portion of Duodenum(1st part), Jejunum & Ileum, Cecum, Appendix, Sigmoid Colon, and Upper 1/3 of Rectum.

    Retroperitoneal Organs

    • This list provides examples of retroperitoneal organs: Suprarenal glands, Aorta/IVC, Parts of Duodenum(2nd, 3rd, 4th part), Pancreas (except tail), Ureters, Colon (Ascending and Descending only), Kidneys, Esophagus, and Rectum. Use "SAD PUCKER" as a memory aid.

    Liver

    • The liver has four anatomical lobes: Right, Left, Quadrate, and Caudate.
    • The liver is divided into 8 surgically resectable hepatic segments, each supplied by tertiary branches of the portal triad (portal vein, hepatic artery, and bile duct).
    • Liver functions: Detoxification, glycogen storage, hormone production, plasma protein synthesis, and bile production.
    • The liver can be divided into 4 anatomical lobes, right, left, quadrate, and caudate.
    • The bare area portion of the liver sits directly against the diaphragm and is not covered by peritoneum.
    • Ligaments associated with the liver include the falciform ligament, coronary ligaments, right and left triangular ligaments, and the round ligament. The round ligament is a fibrous remnant of the umbilical vein.

    Liver: Blood Supply

    • Hepatic portal vein brings 75-80% of blood to liver containing nutrients absorbed by Gl tract, formed by superior mesenteric vein & splenic vein, and terminates by dividing into right & left branches.
    • It carries absorbed nutrients or other substances

    Portal Venous System

    • The portal venous system carries blood from GI visceral structures to the liver. The hepatic portal vein is formed by superior mesenteric vein & splenic vein. It typically sends blood to the liver for filtration.

    Caval Venous System

    • The caval venous system drains blood from structures of posterior abdominal wall, kidneys, suprarenal glands, gonads, pelvic region, and lower limbs.
    • This blood bypasses the liver en route to the right atrium of the heart.
    • The inferior vena cava is formed by union of left & right common iliac veins.

    Portal-Caval Anastomoses

    • Anastomoses between caval and portal veins enable collateral circulation in cases of liver or portal vein obstruction.
    • Different anastomotic connections (points where veins meet or communicate) may or may not form as a result of obstruction.

    Stomach

    • The stomach stores and chemically and mechanically breaks down food.
    • Four parts of the stomach are cardia (first part), fundus (dome-shaped superior portion), body (largest/middle section), and pylorus (terminal end).
    • Ligaments connected to the stomach are greater omentum (double-layered peritoneal sheet), gastrosplenic ligament (connects stomach to spleen), gastrophrenic ligament (connects stomach to diaphragm), gastrocolic ligament (apron-like part of greater omentum, connects stomach to transverse colon), hepatogastric ligament, and hepatoduodenal ligament.

    Small Intestine

    • The small intestine is the primary site of nutrient absorption and consists of duodenum, jejunum and ileum.
    • Duodenum is C-shaped and short (about 1 foot).
    • Jejunum is ~8 feet
    • Ileum is ~12 feet
    • Small intestine is divided into 3 parts: Duodenum (first/shortest part), Jejunum, and Ileum.

    Small Intestine: Mesentery

    • The small intestine's mesentery is a fan-shaped peritoneum fold that attaches the jejunum and ileum to the posterior abdominal wall—carrying blood vessels, lymphatics, and nerves.

    Pancreas

    • The pancreas is an accessory digestive gland located behind the stomach between the duodenum and spleen.
    • It produces pancreatic juice (exocrine secretion) that enters the duodenum & endocrine secretions (glucagon & insulin)
    • The pancreas is divided into Head, Neck, Body, and Tail.

    Large Intestine

    • The large intestine absorbs water and electrolytes, produces and absorbs vitamins, and propels feces toward the rectum for elimination. It consists of Cecum, Ascending colon, Transverse colon, Descending colon, Sigmoid colon, & Rectum.

    Kidneys

    • Kidneys remove excess water, salts, and wastes from the blood and return nutrients and chemicals to the blood. They lie retroperitoneally on the posterior abdominal wall.
    • They are positioned on either side of the vertebral column at the level of T12-L3.
    • The left kidney is slightly more superior than the right kidney.
    • The different capsules surrounding the kidneys include fibrous capsule, perinephric fat, renal fascia, and paranephric fat.

    Blood Supply (of Foregut, Midgut, and Hindgut)

    • The foregut is supplied by Celiac Trunk.
    • The midgut is supplied by Superior Mesenteric artery.
    • The hindgut is supplied by Inferior Mesenteric artery.

    Celiac Trunk

    • The Celiac Trunk arises from the abdominal aorta at T12 level. The Celiac Trunk branches into Left Gastric artery, Splenic artery, and Common Hepatic artery.

    Superior Mesenteric Artery (SMA)

    • Arises from abdominal aorta at L1 level and runs between the layers of the mesentery. Its branches include ileocolic, right colic, middle colic, and intestinal arteries.

    Inferior Mesenteric Artery (IMA)

    • Arises from the abdominal aorta at L3 level. This artery provides a supply of blood for descending colon, sigmoid colon, and the superior rectum.

    Innervation (of Abdominal Organs)

    • Sympathetic innervation is involved in inhibiting peristalsis, constricting blood vessels to GI, and contracting internal anal sphincters.
    • Parasympathetic innervation is involved in promoting peristalsis, secretion of digestive juices, and relaxing internal anal sphincters.

    Splanchnic Nerves: Sympathetic and Parasympathetic

    • These nerves carry both visceral efferent & visceral afferent fibers to/from organs in the abdominopelvic cavities.
    • Sympathetic pathways run through cardiopulmonary, abdominopelvic, greater, lesser, least, lumbar and sacral splanchnic nerves.
    • Parasympathetic pathways run through pelvic nerves as presynaptic parasympathetic pathways.

    Autonomic Plexuses

    • Include abdominal aortic plexus (celiac, superior, inferior mesenteric & renal).
    • Superior and Inferior hypogastric plexuses carry autonomic innervation.

    Ganglia

    • Prevertebral/preaortic/collateral ganglia include celiac, aorticorenal, superior, and inferior mesenteric ganglia.

    Parasympathetic Nervous System

    • The parasympathetic system involves presynaptic neurons in cranial nerve nuclei (III, VII, IX, X) & sacral region (S2-S4) and postsynaptic neurons near or within target organs.

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