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Medical Studies 2B > 5.1 Digestive System Components > Flashcards

5.1 Digestive System Components Flashcards

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USMLE® Step 1 flashcards
1
Q

Describe the superor/inferior boundaries of the anterolateral abdominal wall

A

Superior: xiphoid process + costal margins

Inferior: Iliac crest, down to ASIS, down to pubic symphysis

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2
Q

What’s the surface anatomical landmark used to palpate the fundus of the gallbladder?

A

Tip of the 9th costal cartilage, right side.

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3
Q

Describe the four lines that pass through the abdomen to form the 3x3 grid of sections

A
  • Iliac crests (horiz)
  • Subcostal border (horiz)
  • Midclavicular lines (vert_
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4
Q

Recall the 9 regions of the anterolateral abdominal wall

A

Top: R/L hypochondriac + epigastric

Middle: R/L Lumbar + Umbilical

Lower: R/L Inguinal + Hypogastric

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5
Q

The transpyloric line is the midpoint between the…

A

Jugular foramen and superior border of pubic symphysis

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6
Q

What GI structures does the transpyloric plane transect?

A
  • Pylorus of stomach
  • Fundus of gallbladder
  • Neck of pancreas
  • Renal hila
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7
Q

What characterises digestive accessory structures? Give 4 examples

A
  • These are structures that aid in digestion, but are not part of the digestive tract itself.
  • Examples include salivary glands, the gall bladder, the pancreas, and the liver
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8
Q

Why are accessory digestive organs important?

A
  • Digestive efficiency (absorbable components)
  • Storage of nutrients (e.g. liver)
  • Homeostasis regulation (pancreas, bile composition)
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9
Q

Liver surface landmarks/quadrant

A
  • Start at right costal margin, push upwards
  • RUQ
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10
Q

Stomach surface landmarks/quadrant

A
  • Start at left costal margin, extends centrally
  • LUQ
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11
Q

Peritoneal position of liver

A

Intraperitoneal

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12
Q

Peritoneal position of gallbladder

A

Intraperitoneal

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13
Q

Peritoneal position of stomach

A

Intraperitoneal

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14
Q

Peritoneal position of the parts of the duodenum

A

First part is intra. Remaining three are retro.

(Starts in, then leaves the system)

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15
Q

Peritoneal position of ileum and jejunum

A

Entirely intraperitoneal

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16
Q

Peritoneal position of all parts of the colon

A
  • Only the transverse is intraperitoneal
  • The remaining (asc, desc, sigmoid, rectum) are retroperitoneal; after all, don’t want shit in the peritoneum
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17
Q

Peritoneal position of pancreas

A
  • Tail is intra
  • Rest is retro

(Tried to escape the system, but got it’s tail caught in the door)

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18
Q

Peritoneal position of spleen

A
  • Intra (w/ the tail of the pancreas; makes sense)
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19
Q

Peritoneal position of kidneys/adrenals

A

Retroperitoneal

20
Q

The peritoneum is a serous cavity. The tissue that lines serous cavities is called…

A

Mesothelium

21
Q

Parietal vs visceral peritoneum

A

Parietal: adheres to abdominal wall
Visceral: adheres to organs

22
Q

What is the mesothelial structure between the parietal and visceral peritoneum? What travels in it?

A
  • Mesentery
  • Double membrane; vessels, arteries, nerves, and lymphatics run through the middle
23
Q

Too much peritoneal fluid is known as…

A

Ascites

24
Q

What are the two sacs of the peritoneal cavity? Where are they? What separates them?

A
  • Lesser sac (area deep to stomach)
  • Greater sac (everything except area deep to stomach)
  • Separated by epicloic window
25
Q

What is the greater omentum comprised of? Where does it attach?

A
  • Comprised of peritoneum; drapes down like apron
  • Attaches to transverse colon and to stomach
26
Q

What is the lesser omentum? Where does it run from? What are its two parts, and why is this important?

A
  • Runs from duodenum/lesser curve of stomach to liver
  • Parts are hepatogastric and hepatoduodenal
  • Hepatoduodenal houses portal triad (hepatic portal vein, hepatic artery, bile duct)
27
Q

What are the names of the vessels that run on the lesser and greater curvature of the stomach? How to remember this?

A
  • Lesser: gastric arteries and veins (lesser = shorter name)
  • Greater: gastro-omental arteries and veins (greater = longer name)
28
Q

Organs are retroperitoneal if…

A

They only have peritoneum on their anterior side (if within the balloon, this is intra)

29
Q

What is the level of the coeliac artery? What are the three branches?

A
  • T12/L1
  • Coeliacs are hippies; they hate SLS = Spleen (splenic artery), Liver (hepatic artery) and Stomach (left gastric artery)
30
Q

Where does the left gastro-omental artery arise from?

A

End of splenic artery, near the tail of the pancreas (does a U turn)

31
Q

Describe the branches of the common hepatic artery

A
  • Gastroduodenal (r. gastro-omental, sup. pancreaticoduodenal)
  • Hepatic proper (L/R hepatic, cystic)
  • r. Gastric
32
Q

Level of sup. mesenteric artery? What other arteries are at this level?

A
  • L1 (very close to coeliac)
  • Renal arteries also at this level
33
Q

Describe the branches of the superior mesenteric artery

A
  • Inf. pancreaticoduodenal
  • Mesenteric branches to ileum and jejunum
  • Ileococlic to coecum
  • Right/middle colic to ascending and 2/3 of transverse colon
34
Q

Level/branches of inf. mesenteric artery

A
  • Level: L3
  • Left colic to 1/3 transverse and descending colon
  • Sigmoid branch to sigmoid colon
  • Superior rectal artery to rectum (until pectinate line)
35
Q

What are the two tributaries of the portal vein?

A
  • Splenic vein
  • Sup. mesenteric vein
36
Q

Which veins can act as backups in the case of portal hTn? How does this explain caput medusae?

A
  1. Paraumbuillical (medusae)
  2. Colic
  3. Oesophageal
37
Q

Describe the relationship between the three arms of the autonomic nervous system…

A
  • 3 parts are para, sympa, and enteric
  • Enteric is modulated by para and sympa
38
Q

Describe the three groups of nerves that extrinsically innervate the gut

A
  • Parasympathetic (vagus)
  • Sympathetic (prevertebral ganglia)
  • Sensory (dorsal root ganglia, sensory portion of vagus)
39
Q

Where do the post-ganglionic sympathetic fibres that innervate the GI tract arise from? Name these regions

A
  • Arise from prevertebral ganglia
  • Sup. mesenteric, inf. mesenteric, coeliac, aorticorenal ganglia
40
Q

Which arm of the autonomic nervous system can be found in splanchnic nerves (pre or post ganglionic)? What are the names of the four splanchnic nerves?

A

(Preganglionic sympathetic nerves)
- Greater splanchnic
- Lesser splanchnic
- Least splanchnic
- Lumbar splanchnic nerves

41
Q

Ganglion vs plexus

A

Ganglion: group of neuronal cell bodies outside CNS

Plexus: cell bodies + surrounding nerve fibres

42
Q

What are the two kinds of sympathetic neurons that act on the GI tract? What are their effects?

A
  • Vasomotor (vasoconstriction)
  • Visceromotor (reduced secretion, absorption, and motility {sphincters closed})

B-SAM, like beta SAM for MI meds

43
Q

How does the sympathetic nervous system affect parasympathetic innervation of the GI tract?

A

Can directly inhibit Ach release from parasympathetic neurons.

44
Q

Describe afferent innervation of the GI tract

A
  • Vagal innervation carried to the NTS
  • Spinal afferents carry information via the DRG into the CNS (these are the only afferent supply to the lower GIT)
45
Q

What are the effects of vagal efferents on the GI tract?

A
  • Relaxation in the anal direction
  • Contraction in the oral direction
46
Q

Effect of sympa/parasympa on hepatic glucose control

A

Sympa: inc. gluconeogenesis, dec. glycogenesis

Parasympa: dec. gluconeogenesis, inc. glycogenesis

Medical Studies 2B (57 decks)

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