Abdomen Week 2 (A) Flashcards

1
Q

Abdominal viscera:

  • Constitute majority of _______ system
A

alimentary

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2
Q

Abdominal viscera:

  • Include: (9)
A
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3
Q

How long is the oesophagus? (2)

A
  • ≈ 25 cm long muscular tube between pharynx & stomach
  • Average diameter of 2 cm
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4
Q

What are the muscles of the oesophagus? (2)

A
  • internal circular
  • external longitudinal
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5
Q
  • External layer of superior 1⁄3 is voluntary ____ _____, inferior 1⁄3 is smooth muscle, & middle 1⁄3 is _______
A

striated muscle
transitional

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6
Q

Oesophagus

  • Origin:
A

pharyngoesophageal junction = lower border of cricoid cartilage (C6)

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7
Q

What is the course of the oesophagus? (3)

A
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8
Q

Where does the oesophagus terminate?

A
  • Terminates by entering stomach at cardiac orifice left of midline at level of 7th left costal cartilage & T11
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9
Q

What are the oesophageal constrictions? (3)

A
  1. Cervical constriction
  2. Thoracic (broncho-aortic) constriction
  3. Diaphragmatic constriction
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10
Q
  1. Cervical constriction:
A

pharyngoesophageal junction caused by cricopharyngeus muscle (wraps around beginning of oesophagus on either side of cricoid cartilage) = upper oesophageal sphincter.

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11
Q
  1. Thoracic (broncho-aortic) constriction:
A
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12
Q
  1. Diaphragmatic constriction:
A
  • oesophageal hiatus of diaphragm. (at level oesophagus enters diaphragm)
  • passes through the oesophageal hiatus of the diaphragm, approx. 40cm from the incisor teeth
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13
Q

What is the main function of the Phrenicoesophageal ligament?

A

Connects oesophagus to diaphragm.

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14
Q

Phrenicoesophageal ligament: (3)

A
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15
Q

What is the length of the abdominal oesophagus? (2)

A
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16
Q

What is the abdominal oesophagus? (3)

A
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17
Q

Abdominal oesophagus:

  • Right border continuous =
A

Lesser curvature of stomach

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18
Q

Abdominal oesophagus:

Left border =

A

Cardiac notch

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19
Q

Abdominal oesophagus:

Anterior surface =

A

peritoneum of greater sac

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20
Q

Abdominal oesophagus:

Posterior surface =

A

peritoneum of omental bursa

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21
Q

What is the oesophagogastric junction? (3)

A
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22
Q

Oesophagogastric junction

How is reflux prevented? (2)

A
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23
Q

What is the arterial supply of the oesophagus? (3)

  • Cervical
  • Thoracic
  • Abdominal
A
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24
Q

What is the oesophagus venous drainage? (3)

  • Cervical
  • Thoracic
  • Abdominal
A
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25
Q

Venous drainage

  • Submucosal veins —>
A
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26
Q

What is the lymphatic drainage of the oesophagus? (3)

  • Cervical
  • Thoracic
  • Abdominal
A
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27
Q

What is the innervation of the oesophagus?

Upper:

A
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28
Q

What is the innervation of the oesophagus?

Lower:

Encircled by -
Formed by -

A
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29
Q

What is the stomach? (2)

A
  • Expanded part of GIT between oesophagus & small intestine
  • Mechanical & chemical processing of food
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30
Q
  • Enzymatic digestion:
A

food (bolus) —> chime  to duodenum

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31
Q

Stomach shape:

A
  • Commonly J-shaped
  • Shape and position varies according to body types, position of diaphragm, contents (can expand), position of the person etc.
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32
Q

What is the oesophagus? (3)

A
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33
Q

Parts of the oesophagus: (3)

A
  1. Cervical part
  2. Thoracic part
  3. Abdominal part
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34
Q
  1. Cervical part: (3)

Oesophagus:

A
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35
Q
  1. Thoracic part: (3)

Oesophagus:

A
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36
Q
  1. Thoracic part: (3)
A
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37
Q
  1. Abdominal part: (3)

Oesophagus:

A
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38
Q

Sites of constriction of the oesophagus: (3)

A
  1. Cervical constriction (upper oesophageal sphincter)
  2. Thoracic (bronchoaortic) constriction
  3. Diaphragmatic constriction
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39
Q
  1. Cervical constriction (upper oesophageal sphincter) = (3)
A
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40
Q
  1. Thoracic (bronchoaortic) constriction = (2)
A
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41
Q
  1. Diaphragmatic constriction = (2)
A
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42
Q

NB: Awareness of these constrictions is important when
* Passing _______ through the oesophagus into the stomach and
* Viewing _______ of patients who are experiencing difficulty swallowing

A

instruments
radiographs

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43
Q

Course of the oesophagus: (6)

A
  1. Median at its commencement opposite C6
  2. Deviates slightly to left until C7
  3. Returns to median plane at T5
  4. Inclines to left & forward at T7
  5. Enters abdomen & sharply deviates to left at T10
  6. Joins stomach at T1
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44
Q

Neurovasculature and lymphatics:

Cervical

Arterial supply:
Lymphatics:
Innervation:

A
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45
Q

Neurovasculature and lymphatics:

Thoracic

Arterial supply:
Lymphatics:
Innervation:

A
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46
Q

Neurovasculature and lymphatics:

Abdominal

Arterial supply:
Lymphatics:
Innervation:

A
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47
Q

What are the 4 parts of the stomach?

A
48
Q

Pyloric region of the stomach - funnel shaped region: (4)

A
49
Q

Pyloric region of the stomach - funnel shaped region: (4)

A
50
Q

What are the curvatures of the stomach? (2)

A
51
Q

Stomach - interior

  • Gastric mucosa is smooth ____-______ (pink in the pyloric part)
A

reddish-brown

52
Q

Stomach - interior

  • Mucous layer protects stomach from ____ _____.
A

Gastric acid

53
Q

Stomach - interior

  • Contracted mucosa form longitudinal _____ folds or ____
A

gastric
rugae

54
Q

What is the stomach covered by?

A
  • Covered by peritoneum, except small area posterior to cardiac orifice
55
Q
  • The two layers of lesser omentum envelope stomach and leave greater curvature as ____ ______
A

greater omentum

56
Q

Stomach relation anteriorly:

A

diaphragm, left lobe of liver, anterior abdominal wall

57
Q

Stomach relation posteriorly:

A

omental bursa and pancreas

58
Q

What is the stomach bed?

A
59
Q

How is the transverse colon related to the stomach?

A
59
Q

How is the transverse colon related to the stomach?

A
60
Q

How is the stomach supplied arterially? (2)

A
61
Q

How is the stomach supplied arterially? (2)

A
62
Q

Stomach

A
63
Q

Stomach venous drainage:

  • Gastric v’s —>
  • Short gastric & left gastro-omental v’s. —>
  • Right gastro-omental v. —>
  • Prepyloric v. —>
A
64
Q

Lymphatic drainage
of the stomach:

Anterior & posterior surfaces —>

Gastric lymph vessels —>
Gastro-omental nodes —->

A
65
Q

Stomach - Lymphatic drainage

Superior 2/3:
- Gastric vessels –>
- Fundus and Superior part —>

A
66
Q

Stomach - Lymphatic drainage

Superior 2/3:
- Gastric vessels –>
- Fundus and Superior part —>

A
67
Q

Stomach - Lymphatic drainage

Inferior 1/3:
- Right 2/3 –>
- Left 1/3 –>

A
67
Q

Stomach - Lymphatic drainage

Inferior 1/3:
- Right 2/3 –>
- Left 1/3 –>

A
68
Q

Stomach - innervation
- Anterior vagal trunk: (5)

A
  • Mainly from left vagus nerve (CNX)
  • Single branch on anterior surface
  • Hepatic & duodenal branches
  • Lesser curvature of stomach
  • Anterior gastric branches
69
Q

Stomach - innervation
- Posterior vagal trunk: (6)

A
  • Larger & mainly from right vagus nerve
  • Posterior surface of oesophagus
  • Gives of celiac branch, to celiac plexus
  • Branches to anterior & posterior surfaces
  • Lesser curvature of stomach
  • Posterior gastric branches
70
Q

Stomach - innervation
- Posterior vagal trunk: (6)

A
  • Larger & mainly from right vagus nerve
  • Posterior surface of oesophagus
  • Gives of celiac branch, to celiac plexus
  • Branches to anterior & posterior surfaces
  • Lesser curvature of stomach
  • Posterior gastric branches
71
Q

Stomach innervation:

  • Sympathetic supply from T6 – T9 passes to celiac plexus via greater ______ _____
  • Distributed along ____ & gastro-omental artery
A

splanchnic nerve
gastric

72
Q

What is a hiatus hernia?

A

Protrusion of stomach into mediastinum via oesophageal hiatus.

  • Herniation of part of the stomach through the oesophageal hiatus of the
    diaphragm
73
Q

Factor that contribute to hiatus hernias: (3)

A
  • Common as age
  • Diaphragm and other muscles weaken
  • Oesophageal hiatus widens
74
Q

Hiatus hernias

May cause ___ and ___ and predispose to reflux of gastric contents

A

pain and discomfort

75
Q

Sliding hernias -

A
76
Q

Sliding hernias -

A
77
Q

Rolling hernias -

A
78
Q

What is the stomach?

A
  • Most dilated part of the GIT between the oesophagus and small intestine
79
Q

Location of the stomach: (3)

A

o Epigastric,umbilical and left hypochondriac regions
o Dependent on contents and surrounding viscera
o Can distend down to hypogastric region

80
Q

What is the shape of the stomach? (4)

A

o J-shaped
o Modified by changes in content and surrounding viscera o In obese-high and transverse
o In asthenic-long and narrow

81
Q

What is the capacity of the stomach? (5)

A

o Varies with age
o 30ml at birth
o 1Latpuberty
o 1.5L in adults
o Twice normal capacity in full distension

82
Q

Parts of the stomach:
1. Cardia:

A

o Surrounds the cardial orifice (superior inlet of stomach)

83
Q

Parts of the stomach:
1. Cardia:

o In supine position ,the orifice lies: (3)

A
84
Q

Parts of the stomach:
2. Fundus: (3)

A
85
Q

Parts of the stomach:
2. Fundus:

o In supine position, the fundus lies: (2)

A
  • Posterior to the left 6th rib
  • In the plane of the midclavicular line
86
Q

Parts of the stomach:
2. Fundus:

o In supine position, the fundus lies: (2)

A
  • Posterior to the left 6th rib
  • In the plane of the midclavicular line
87
Q

Parts of the stomach:
3. Body:

A

Largest part

88
Q

Parts of the stomach:
3. Body:

A

Largest part

89
Q

What is the pyloric?

A

Funnel shaped outflow region

90
Q

Pyloricantrum:

A

wider part leading to pyloric canal

91
Q

Pyloric canal:

A

narrower part

92
Q

Pylorus:

A

distal sphincter region of the pyloric part

93
Q

Pylorus:

A

distal sphincter region of the pyloric part

94
Q

In supine position,the pyloric part lies: (2)

A

§ In the transpyloric plane
§ About 1.25cm from the midline

95
Q

What is the Transpyloric plane? (2)

A
96
Q

What is the lesser curvature? (2)

A
97
Q

What is the greater curvature?

A

o Forms the longer convex border of the stomach (4-5 times longer)

98
Q

What is the course of the greater curvature? (3)

A
99
Q

What is the course of the greater curvature? (3)

A
100
Q

o Covered by peritoneum and gives attachment to _______ ligament and greater omentum

A

gastrosplenic

101
Q

What lines the interior of the stomach? (3)

A
102
Q

What lines the interior of the stomach? (3)

A
103
Q

Anterior relations of the stomach: (4)

A
104
Q

Posterior relations of the stomach: (6)

A
105
Q

Arterial supply to stomach:

A
106
Q
  • Right and left gastric anastomose along ______ curvature
  • Right and left gastro-omental anastomose along ______ curvature
A

lesser

greater

107
Q

Venous drainage of the stomach:

A
108
Q

Lymphatic drainage of stomach

  • Superior 2/3: (2)
A

o Along right and left gastric vessels
o To gastric nodes to aortic nodes

109
Q

Lymphatic drainage of stomach

  • Right 2/3 of inferior 1/3: (2)
A

o Along gastro omenta lvessels
o To pyloric (subpyloric) nodes

110
Q

Lymphatic drainage of stomach

  • Left 1/3 of greater curvature: (2)
A

o Along short gastric and splenic vessels
o To suprapancreaticoduodenal nodes —–> to aortic nodes

111
Q

Innervation of the stomach:

Parasympathetic:

A
112
Q

Innervation of the stomach:

  • Sympathetic:
A
112
Q

Innervation of the stomach:

  • Sympathetic:
A
113
Q

What is the function of the small intestines?

A
  • Primary absorption site