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X. MRCS: Anatomy > Abdomen: Oesophagus & Stomach > Flashcards

Abdomen: Oesophagus & Stomach Flashcards

1
Q

Layers of the Oesophageal wall

A

Mucosa
Submucosa
Muscle Layer
Adventitia

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2
Q

Mucosa of oesophagus

A

non-keratinised stratified squamous epithelium

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3
Q

Muscle layer of oesophageal wall

A

Superior third: voluntary striated
Middle third: voluntary striated & smooth
Inferior third: smooth muscle

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4
Q

Adventitia of oesophagus

A

Outer layer of connective tissue

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5
Q

Oesophageal sphincters

A

Upper Oesophageal sphincter

Lower oesophageal sphincter

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6
Q

Upper Oesophageal sphincter

A

Cricopharyngeus muscle

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7
Q

Lower Oesophageal sphincter

A

Located at gastro-oesophageal junction
Left of T11 vertebra
Functions due to 4 factors:
1. Acute angle of entry to stomach
2. Intra-abdominal section compressed by pressure
3. Mucosal folds at GOJ
4. Right crus of diaphragm has “pinch-cock” effect

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8
Q

Anatomical relations to oesophagus, cervical/thoracic: anterior

A

Trachea
Left recurrent laryngeal nerve
Pericardium

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9
Q

Anatomical relations to oesophagus, cervical and thoracic: posterior

A

Thoracic vertebral
Thoracic duct
Azygous vein
Descending aorta

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10
Q

Anatomical relations to oesophagus, cervical and thoracic: right

A

Pleura

Terminal part of azygous vein

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11
Q

Anatomical relations to oesophagus, cervical and thoracic: left

A

Subclavian artery
Aortic arch
Thoracic duct (upper part)
Pleura

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12
Q

Anatomical relations to oesophagus, abdominal: anterior

A

Left vagus nerve

Posterior surface of heart

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13
Q

Anatomical relations to oesophagus, abdominal: posterior

A

Right vagus nerve

Let crus of diaphragm

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14
Q

Oesophagus entry to the abdomen

A

Oesophageal Hiatus
T10
Oesophagus, oesophageal branches of left gastric, anterior and posterior vagal trunks

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15
Q

Blood supply to oesophagus

A

Thoracic: inferior thyroid artery, thoracic aorta
Abdominal: Left gastric artery (coeliac axis), left inferior phrenic artery

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16
Q

Venous drainage of the oesophagus

A 
Thoracic: azygous vein, inferior thyroid vein
Abdominal:
Portal circulation: Left gastric vein
Systemic circulation: azygous vein
(Site of porto-systemic anastomosis)
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17
Q

Lymphatic drainage of oesophagus

A

Superior third: deep cervical lymph nodes
Middle third: superior & posterior mediastinal nodes
Lower third: left gastric & coeliac nodes

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18
Q

Divisions of the Stomach

A

Cardia
Fundus
Body
Pylorus

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19
Q

Cardia

A

Surrounds the superior opening of the stomach at T11 level

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20
Q

Fundus

A

Rounded dome, often gas filled part.

21
Q

Body

A

Large central portion inferior to fungus

22
Q

Pylorus

A

Connects stomach to duodenum.

Can be divided into pyloric antrum, pyloric canal, pyloric sphincter

23
Q

Transpyloric plane

A

At the level of pyloric sphincter.
L1
Halfway between suprasternal notch and pubis symphysis
Structures:
2nd part of duodenum, neck of pancreas, fundus of gallbladder, SMA, portal vein, left colic flexure, spleen

24
Q

Greater curvature

A

Long convex, lateral border of stomach.

25
Q

Lesser curvature

A

Shorter, concave medial surface of stomach.

Gives rise to hepatogastric ligament

26
Q

Greater omentum

A

Hangs down from greater curvature of stomach. Folds back upon itself where it attaches to transverse colon

27
Q

Lesser Omentum

A

Continuous with peritoneal layers of stomach and duodenum. Smaller peritoneal fold arises at lesser curvature and attaches stomach and duodenum to liver

28
Q

Greater Sac

A

Divided into supra colic and infra colic compartments.

29
Q

Greater Sac

A

Divided into supra colic and infra colic compartments.

30
Q

Lesser Sac

A

Posterior to the stomach

Connected to greater momentum by epiploic foramen (of Winslow)

31
Q

Epiploic foramen (of Winslow)

A

Posterior to the free edge of lesser momentum (hepatoduodenal ligament)

32
Q

Structures inside of hepatoduodenal ligament

A

Hepatic artery proper
Portal vein
Common bile duct

33
Q

Blood supply to the stomach

A

Right gastric (branch of common hepatic, arising from coeliac trunk)
Left gastric (coeliac trunk)
Right gastro-omental (terminal branch of gastroduodenal artery, arising from common hepatic)
Left gastro-omental (branch of splenic, arising from coeliac)
Short gastric arteries ((branch of splenic, arising from coeliac)

34
Q

Venous drainage of the stomach

A

Left gastric vein (portal vein)
Right gastric vein (portal vein)
Right gastro-omental vein (superior mesenteric vein)
Left gastro-omental vein (splenic vein, SMV)
Short gastric veins (splenic vein, SMV

35
Q

Innervation of the stomach

A

Parasympathetic: anterior and posterior vagal trunks
Sympathetic: T6-T9 spinal cord to coeliac plexus via greater splanchnic nerve

36
Q

Lymphatic drainage of stomach

A

Gastric and gastro-omental lymph nodes

37
Q

Layers of the Gastric Wall

A

Mucosa
Submucosa
Muscular Layer
Adventitia

38
Q

Mucosa layer of stomach

A

3 layers:
Epithelial layer: absorbs/secretes mucus and enzymes
Lamina propria: blood/lymph/MALT
Muscularis mucosae

39
Q

Mucosa layer of stomach

A

3 layers:
Epithelial layer: absorbs/secretes mucus and enzymes
Lamina propria: blood/lymph/MALT
Muscular mucosa

40
Q

Types of stomach epithelial cells

A

Foveolar cells: secrete mucus
Parietal cells: secrete hydrochloric acid
Chief cell: secrete pepsinogen
G-cells: secrete gastrin
Enterochromaffin Cells: produce histamine
D cells: produce somatostatin

41
Q

Acid stimulating hormones/molecules

A

Gastrin
Acetylcholine
Histamine

42
Q

Gastrin, source and function

A

Peptide hormone
Released by G-cells in the mucosa
Act directly on parietal cells to stimulate acid secretion
Also act of Enterochromaffin cells to produce histamine

43
Q

Acetylcholine function in the stomach

A

Released by parasympathetic neurones
Stimulates muscarinic receptors on parietal and Enterochromaffin cells
Stimulating acid secretion

44
Q

Histamine, function and source

A

Produced by endochromaffin and mast cells
Acts on the H2 receptor on the parietal cells
Simulates acid secretion
Also released by gastrin and Acetylcholine

45
Q

Acid reducing hormones/molecules

A

Somatostatin

Prostaglandin

46
Q

Somatostatin, functions in the stomach

A 
Released by D cells in stomach
Overall reduced acid production
Inhibits Gastrin release from G cells
Inhibits HCL release from parietal
Inhibits histamine release from Enterochromaffin Cells
47
Q

Prostaglandin function on the stomach

A

Binds to prostaglandin receptor on parietal cell. Reducing acid secretion
Binds to foveolar (mucus) cells increasing mucus production

48
Q

Parietal cell function

A

H+/K+-ATPase pump (proton) directly pumps H+ into lumen (exchanged for K+)
K+ excreted with Cl-

X. MRCS: Anatomy (18 decks)

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