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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
Lesser curvature
Shorter, concave medial surface of stomach. | Gives rise to hepatogastric ligament
26
Greater omentum
Hangs down from greater curvature of stomach. Folds back upon itself where it attaches to transverse colon
27
Lesser Omentum
Continuous with peritoneal layers of stomach and duodenum. Smaller peritoneal fold arises at lesser curvature and attaches stomach and duodenum to liver
28
Greater Sac
Divided into supra colic and infra colic compartments.
29
Greater Sac
Divided into supra colic and infra colic compartments.
30
Lesser Sac
Posterior to the stomach | Connected to greater momentum by epiploic foramen (of Winslow)
31
Epiploic foramen (of Winslow)
Posterior to the free edge of lesser momentum (hepatoduodenal ligament)
32
Structures inside of hepatoduodenal ligament
Hepatic artery proper Portal vein Common bile duct
33
Blood supply to the stomach
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
Venous drainage of the stomach
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
Innervation of the stomach
Parasympathetic: anterior and posterior vagal trunks Sympathetic: T6-T9 spinal cord to coeliac plexus via greater splanchnic nerve
36
Lymphatic drainage of stomach
Gastric and gastro-omental lymph nodes
37
Layers of the Gastric Wall
Mucosa Submucosa Muscular Layer Adventitia
38
Mucosa layer of stomach
3 layers: Epithelial layer: absorbs/secretes mucus and enzymes Lamina propria: blood/lymph/MALT Muscularis mucosae
39
Mucosa layer of stomach
3 layers: Epithelial layer: absorbs/secretes mucus and enzymes Lamina propria: blood/lymph/MALT Muscular mucosa
40
Types of stomach epithelial cells
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
Acid stimulating hormones/molecules
Gastrin Acetylcholine Histamine
42
Gastrin, source and function
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
Acetylcholine function in the stomach
Released by parasympathetic neurones Stimulates muscarinic receptors on parietal and Enterochromaffin cells Stimulating acid secretion
44
Histamine, function and source
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
Acid reducing hormones/molecules
Somatostatin | Prostaglandin
46
Somatostatin, functions in the stomach
``` 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
Prostaglandin function on the stomach
Binds to prostaglandin receptor on parietal cell. Reducing acid secretion Binds to foveolar (mucus) cells increasing mucus production
48
Parietal cell function
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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