Abdomen 3 Flashcards
1
Q
What is the oesophagus?
A
Muscular tube that extends from the pharynx to the stomach
2
Q
What are the 3 constrictions of the oesophagus?
A
Cervical
Thoracic
Diaphragmatic
3
Q
What is the vertebral level of the oesophageal hiatus in the diaphragm?
A
T10
4
Q
What is A?
A
Trachea
5
Q
What is B?
A
Oesophagus
6
Q
What is C?
A
Thoracic duct
7
Q
What is D?
A
Left subclavien vein
8
Q
What is E?
A
Aortic arch
9
Q
What is F?
A
Left bronchi
10
Q
What is G?
A
Thoracic aorta
11
Q
What is H?
A
Pericardium (cut edge)
12
Q
What is I?
A
Oesophageal hiatus
13
Q
What is J?
A
Left crus of diaphragm
14
Q
What is K?
A
Aortic hiatus
15
Q
What is L?
A
Chyle cistern
16
Q
What is M?
A
Inferior vena cava
17
Q
What is N?
A
Right crus of diaphragm
18
Q
What is O?
A
Thoracic duct
19
Q
What is P?
A
Oesophagus
20
Q
What is Q?
A
Right bronchi
21
Q
What is R?
A
Tracheobronchial lymph nodes
22
Q
List the structures that traverse the oesophageal opening?
A
Oesophagus
Left inferior phrenic artery
Left gastric artery
Lymphatics
23
Q
What is the blood supply of the abdominal part of the oesophagus?
A
Branches of left gastric artery
24
Q
What is the venous drainage of the abdominal part of the oesophagus?
A
Left gastric vein
25
What is the lymphatic drainage of the abdominal oesophagus?
Left gastric lymph nodes then to celiac lymph nodes
26
What is the relationship between the oesophagus and portal hypertension?
Lower end of oesophagus is important site for portosystemic anastomoses
In portal hypertension, anastomoses opens and forms venous dilations called oesophageal varices
Their rupature causes severe haematemesis
27
What is the stomach?
Muscular bag
28
What are the 2 orifices of the stomach?
Cardial orifice
Pyloric orifice
29
What are the 2 curvatures of the stomach?
Greater curvature
Lesser curvature
30
What are the 2 surfaces of the stomach?
Anterior
Posterior
31
What is A?
Duodenum
32
What is B?
Pyloric canal
33
What is C?
Fundus of stomach
34
What is D?
Body
35
What is the pyloric sphincter?
Band of smooth muscle between the pyloris and duodenum
36
What is the function of the pyloric sphincter?
Controls flow of partically digested food between stomach and duodenum
Stops acid entering duodenum
37
The pyloric sphincter is formed from the thickening of which layer of the gut tube?
Circular layer of smooth muscle (muscularis externa)
38
Where does the lesser omentum extend from?
Lesser curvature of the stomach to the liver
39
Where does the greater omentum extend from?
Greater curvature of stomach to transverse colon
40
What is A?
Pyloric sphincter
41
What is B?
Gastric canal
42
43
What is C?
Cardiac orifice
44
What is D?
Gastric folds (rugae)
45
What is E?
Pyloric antrum
46
What is F?
Pyloric canal
47
What are gastric folds/rugae formed from?
Gastric mucosa
48
In which portions of the stomac are gastric folds most apparent?
Pyloric region
Greater curvature
49
Which sphincter controls the discharge of food from the stomach to the duodenum?
Pyloric sphincter
50
What is the collective name of the structures that the stomach lies on?
Stomach bed
51
What structures from the stomach bed?
Left dome of diaphragm
Transverse mesocolon
Spleen
Left kidney
Left suprarenal gland
Colon
Pancreas
Splenic artery
52
What is A?
Right gastric artery
53
What is B?
Left gastric artery
54
What is C?
Splenic artery
55
What is D?
Left gastro-omental artery
56
What is E?
Right gastric-omental artery
57
What is the venous drainage of the stomach via?
Portal system
58
What is A?
Portal vein
59
What is B?
Left gastric vein
60
What is C?
Superior mesenteric vein
61
What is D?
Inferior mesenteric vein
62
What is E?
Splenic vein
63
What is F?
Right gastric artery
64
Where do the primary lymph nodes of the stomach eventually drain to?
Celiac lymph nodes
65
What is A?
Celiac lymph nodes
66
What is B?
Superior and inferior pyloric lymph nodes
67
What is C?
Pancreaticoduodenal lymph nodes
68
What is D?
Gastric-omental lymph nodes
69
What is E?
Splenic lymph nodes
70
What is F?
Pancreaticosplenic lymph nodes
71
What is G?
Gastric lymph nodes
72
What effect does the vagus nerve have on the pylorus?
Opens the pyloric sphincter
73
What effect does the vagus nerve have on gastric secretion?
Increases
74
What nerve is key in controlling gastric motility?
Vagus nerve
75
Where does the small intestine extend from?
Pylorus of the stomach to the ileocecal junction
76
What are the 3 parts of the small intestine?
Duodenum
Jejenum
Ileum
77
Which part of the small intestine recieves the opening of the bile and pancreatic duct?
Descending (2nd part) of duodenum
78
Where is the foregut/midgut boundary in the small intestine?
Between descending and inferior duodenum
79
How is the duodenum peritonised?
Bulb is intraperitoneal, rest is retroperitoneal
80
How is the jejenum peritonised?
Intraperitoneal
81
How is the ileum peritonised?
Intraperitonised
82
Which part of the small intestine is the shortest, widest and most fixed?
Duodenum
83
How does the colour differ between the jejenum and ileum?
Jejenum - deeper red
Ileum - paler pink
84
How does the wall differ between the jejenum and ileum?
Jejenum - thick and heavy
Ileum - thin and light
85
How does the vascularitiy differ between the jejenum and ileum?
Jejenum - greater
Ileum - less
86
How does the vaso recta differ between the jejenum and ileum?
Jejenum - long
Ileum - short
87
How does the arcades differ between the jejenum and ileum?
Jejenum - few large loops
Ileum - many short loops
88
How does the fat in mesentery differ between the jejenum and ileum?
Jejenum - less
Ileum - more
89
How does the circular folds differ between the jejenum and ileum?
Jejenum - large, tall and closely packed
Ileum - low and sparse, absent in distal part
90
What is A?
Ileum
91
What is B?
Duodenum
92
What is C?
Jejenum
93
Explain how the morphology of the small intestine changes between the jejenum and ileum?
There is no step transition, but the morphology gradually alters with either end looking quite different
94
Which of A and B is jejenum and which is ileum?
A is ileum
B is jejenum
95
What are arterial arcades?
Arterial loops or arches
96
Do arcades in jejenum or ileum have many loops?
Ileum
97
Which part of the autonomic nervous system stimulates reduction in the secretions and motility of the intestine and also acts as a vasoconstrictor?
Sympathetic
98
What features distinguish the large intestine from the small intestine?
Teniae coli
Haustra
Omental appendices
Caliber (internal diameter much larger)
99
What are teniae coli?
3 seperate longitudinal ribbons of smooth muscle on the outside of the colon
100
What are haustra?
Small pouches caused by sacculation
101
What are omental appendices?
Small pouches of the peritoneum filled with fat
102
103
How is the caecum peritonised?
Intraperitoneal
104
How is the ascending colon peritonised?
Retroperitoneal
105
How is the transverse colon peritonised?
Intraperitoneal
106
How is the descending colon peritonised?
Retroperitoneal
107
How is the sigmoid peritonised?
Intraperitoneal
108
What is A?
Caecum
109
What is B?
Ascending colon
110
What is C?
Transverse colon
111
What is D?
Descending colon
112
What is E?
Sigmoid colon
113
What does the superior mesenteric artery branch into to supply the colon?
Ileocolic artery
Right colic artery
Middle colic artery
Marginal artery (connects superior to inferior mesenteric artery)
114
What artery connects the superior to the inferior mesenteric artery?
Marginal artery
115
What does the inferior mesenteric archery branch into to supply the colon?
Left colic artery
Sigmoid arteries
116
In which abdominal region is the caecum and appendix located?
Right iliac region
117
What is A?
Frenulum of ileocecal valve
118
What is B?
Orifice of appendix
119
What is C?
Terminal ileum
120
What is D?
Ileocaecal valve
121
What is E?
Ileocaecal orifice
122
What is F?
Haustrum of ascending colon
123
Which 2 structures open into the cavity of caecum?
Appendix and ileum
124
What is strange about the anatomical location of the appendix?
Base of appendix is consistently located, but the tail has anatomical variation
125
What is McBurnery's point and why is it useful clinically?
Point of most pain in acute appendicitis
126
Where does the rectum pierce the pelvic floor?
Ano-rectal junction where it becomes the anal canal
127
What is the arterial supply, venous drainage, and peritonisation of the superior 1/3 of the rectum?
Artery - superior rectal artery
Vein - superior rectal vein
Peritonisation - front and sides
128
What is the arterial supply, venous drainage, and peritonisation of the middle 1/3 of rectum?
Artery - right and left middle rectal arteries
Vein - right and left middle rectal veins
Peritonisation - front
129
What is the arterial supply, venous drainage, and peritonisation of the inferior 1/3 of rectum?
Artery - right and left middle rectal arteries
Vein - right and left middle rectal veins
Peritonisation - none
130
What is A?
Superior rectal artery
131
What is B?
Middle rectal artery
132
What is C?
Inferior rectum artery
133
What is the role of the pelvic floor in maintaining continence?
Automatically gently contracted to prevent leakage
134
What structures, other than the pelvic floor, are involved in faecal continence?
Internal anal sphincter
External anal sphincter
135
What is the significance of understanding the differences between visceral and somatic innveration of the anal canal?
Above pectinate line is autonomic, below is somatic
136
What lymphatics drain above the pectinate line of the rectum?
Internal iliac lymph nodes
137
What lymphatics drain below the pectinate line of the rectum?
Superficial inguinal lymph nodes
138
What is A?
Internal anal sphincter
139
What is B?
External anal sphincter
140
What are the main peritoneal folds?
Greater omentum
Lesser omentum
Mesentery
141
The hepatoduodenal and hepatogastric ligaments are parts of what omentum?
Lesser
142
What is the falciform ligament?
Attaches liver to anterior abdomen wall
and seperates left and right lobes of the liver
143
What lies within the free border of the falciform ligament?
Ligamentum teres in free border
144
What embryological structure is the ligamentum teres a remnant of?
Left umbilical vein
145
How many layers of peritoneum are present in the greater omentum?
4
Is it a souble sheet of peritoneum folded in on itself
146
What is the greater omentum often called?
Abdominal policeman
147
What functions of the greater omentum cause it to be known as the abdominal policeman?
Role in fighting intra-abdominal infections
148
What are paracolic gutters?
Spaces between colon and abdominal wall
149
Where are paracolic gutters found in relation to the colon?
Lateral
150
What is the clinical significance of knowing about paracolic gutters?
Determine flow of ascitic fluid
151
List 3 abdominal viscera which lie in the free edge of a double layer of peritoneum described as a mesentery?
Transverse colon
Sigmoid colon
Appendix
152
What muscle types forms the muscularis externa of the oesophagus?
Upper 1/3 is skeletal muscle
Lower 2/3 is smooth muscle
153
154
What kind of epithelium is in the oesophagus?
Stratified squamous
155
What type of muscle makes up the muscularis mucosae of the oesophagus?
Smooth muscle
156
What are the large folds present in the wall of the stomach?
Rugae
157
What secretory cells are present in gastric pits?
Gastric cells (also known as G cells)
158
What structure is this?
Oesophagus
159
What structure is this?
Stomach
160
What are the large folds that can be seen extending into the lumen of the small intestine called?
Villi
161
What structure is this?
Small intestine
162
What are the numerous finger like processes cut in different planes on villi of the small intestine?
Microvilli
163
What is the epithelium of the small intestine?
Simple columnar
164
What type of muscle is the muscularis mucosae of the small intestine?
Smooth
165
Where along the gut tube do glands extend down beyond the muscularis mucosae into the submucosa (they do not normally do this)?
Brunner's cells (found only in duodenum)
166
What are the white bits that appear to be empty spaces in the small intestine histology?
Contents of secretory cells
They are goblet cells
167
What do goblet cells secrete?
Mucus
168
What types of cells are present in the surface epithelium of the small intestine?
Enterocytes (absorptive cells) with scattered goblet cells
169
What are Payer's patches and where are they found?
Small masses of lymphatic tissue found in the ileum
170
What is the predominant cell present in the epithelium of the colon?
Enterocytes
171
What structure is this?
Colon
172
What structure is this?
Recto-anal junction
173
What indicates the change from the rectum to anal canal in this image?
Stratified squamous changing to simple columnar
174
What is the transpyloric plane?
Imaginary horizontal plane
175
How would you locate the transpyloric plane on a patient?
Halfway between jugular notch and upper border of symphysis pubis
Or 9th costal cartilage
176
List the structures present in the transpyloric plane?
Pylorus of stomach
Hila of kidneys
Beginning of duodenum
Neck of pancreas
Superior mesenteric artery from aorta
177
What is the vertebral level of the transpyloric plane?
L1
178
What is the vertebral level of the highest point of the iliac crest?
L4
179
What organ is being examined in 1, 2 and 3?
1 - stomach
2 - small intestine
3 - colon
180
What is 1, 2, 3 and 4?
1 - Liver
2 - right kidney
3 - jejenum
4 - transverse colon
181
What is 1, 2, 3 and 4?
1 - spleen
2 - liver
3 - stomach
4 - aorta
