Alimentary System Overview 2 Flashcards

1
Q

What are the 9 regions of the GIT?

A
  • R Hypochondrium
  • Epigastrium
  • L Hypochondrium
  • R Lumbar
  • Periumbilical
  • L Lumbar
  • R Iliac fossa
  • Hypogastrium
  • L Iliac fossa
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2
Q

What ailments can affect the foregut?

A
  • Peptic ulcer
  • Gastric disease
  • Biliary disease
  • Pancreatic disease
  • Hepatic disease
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3
Q

What ailments can affect the midgut?

A
  • Appendicitis
  • Small bowel obstruction
  • Proximal colon cancer
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4
Q

What ailments can affect the hindgut?

A
  • Large bowel obstruction
  • Diverticular disease
  • Carcinoma of the colon
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5
Q

What is the oesophagus?

A

Muscular tube that normally has 3 constrictions

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6
Q

How long is the oesophagus?

A

25cm

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7
Q

What are the constrictions of the oesophagus?

A
  • Cervical
  • Thoracic
  • Diaphragmatic
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8
Q

Where is the cervical constriction of the oesophagus?

A

15cm from the incisor teeth

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9
Q

What is the thoracic constriction of the oesophagus crossed by?

A
  • Arch of the aorta (22.5 cm from incisor teeth)

- Left main bronchus (27.5 cm form incisor teeth)

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10
Q

What is the diaphragmatic constriction of the oesophagus?

A

Where it passes through the oesophageal hiatus of the diaphragm (40cm from the incisor teeth)

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11
Q

Why is awareness of the constrictions of the oesophagus important?

A

For passing instruments through the oesophagus into the stomach

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12
Q

What are the parts of the stomach?

A
  • Cardia
  • Fundus
  • Body
  • Pyloric part
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13
Q

What are the curvatures of the stomach?

A
  • Greater

- Lesser

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14
Q

What is the pyloric sphincter in charge of?

A

Control of discharge of stomach contents into the duodenum

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15
Q

What does the stomach bed consist of?

A
  • Diaphragm
  • Spleen
  • Left kidney
  • Adrenal gland
  • Splenic artery
  • Pancreas
  • Transverse mesocolon
  • Colon
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16
Q

Congenital pyloric stenosis

A

Thickening of smooth muscle in the pylorus

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17
Q

What is the portal triad of the liver?

A
  • Hepatic artery
  • Portal vein
  • Bile duct
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18
Q

What is the surface anatomy of the liver?

A

Lies deep to ribs 7-11 on the right side

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19
Q

Where is the portal triad of the liver found?

A

Lesser omentum

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20
Q

What do the biliary ducts do?

A

Carry bile form the liver to the gallbladder

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21
Q

Where is bile produced?

A

Liver

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22
Q

Where is bile concentrated and stored?

A

Gall bladder

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23
Q

How much bile can the gallbladder store?

A

Up to 50ml

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24
Q

What is the artery of the gallbladder?

A

Cystic artery

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25
Q

Where does the cystic artery lie?

A

Lies in the triangle of calot

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26
Q

What is the triangle of calot?

A

Triangle between common hepatic duct, cystic duct and visceral surface of liver

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27
Q

What is the pancreas?

A

Accessory digestive gland

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28
Q

What does the pancreas produce as an exocrine gland?

A

Pancreatic juice

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29
Q

What does the pancreas produce as an endocrine gland?

A

Insulin and glucagon

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30
Q

Where does the pancreas lie?

A

Lies along the transpyloric plane (L1/L2)

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31
Q

What are the parts of the pancreas?

A
  • Head
  • Neck
  • Body
  • Tail
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32
Q

Where is the portal vein formed?

A

Behind the neck of the pancreas

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33
Q

How does the pancreas lie in relation to the peritoneum?

A

Retroperitoneal

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34
Q

What is the spleen?

A

Mobile haemo-lymphoid organ

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35
Q

Where is the spleen located?

A

Left hypochondrium

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36
Q

How is the spleen covered?

A

Entirely covered by the peritoneum except at the hilum

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37
Q

What is the surface anatomy of the spleen?

A

Ribs 9-11 on the left side

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38
Q

What is the most frequently injured abdominal organ?

A

Spleen

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39
Q

Splenomegaly

A

Abnormal enlargement of spleen

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40
Q

What are some causes of splenomegaly?

A
  • Anaemia

- Typhoid fever

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41
Q

What is the blood supply of the foregut?

A

Celiac trunk

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42
Q

What is the origin of the celiac trunk?

A

Abdominal aorta (T12)

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43
Q

What are the main branches of the celiac trunk?

A
  • Left gastric artery
  • Hepatic artery
  • Splenic artery
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44
Q

What does the left gastric artery run along?

A

The lesser curvature of the stomach

45
Q

What does the hepatic artery supply?

A

Liver and the gallbladder

46
Q

What does the splenic artery run along?

A

Runs retroperitoneally along the superior margin of the pancreas

47
Q

What constitutes midgut structures?

A
  • Small intestine including most of the duodenum
  • Cecum
  • Appendix
  • Ascending colon
  • Right 1/2-2/3rds of the transverse colon
48
Q

What is the duodenum?

A

Shortest, widest and most fixed part of the small intestine

49
Q

What does the 2nd part of the duodenum receive?

A
  • Bile

- Pancreatic duct

50
Q

Duodenal ulcer

A

Inflammatory erosions of the duodenal wall (mostly 1st part)

51
Q

Colour of jejunum

A

Deep red

52
Q

Wall of jejunum

A

Thick and heavy

53
Q

Vascularity of jejunum

A

Grater than ileum

54
Q

Vasa recta of jejunum

A

Long

55
Q

Arcades of jejunum

A

A few large loops

56
Q

Lymphois nodules (peyers patches) of jejunum

A

Few

57
Q

Fat in mesentery of jujunum

A

Less than ileum

58
Q

Colour of ileum

A

Pale pink

59
Q

Wall of ileum

A

Thin and light

60
Q

Vascularity of ileum

A

Less than jejunum

61
Q

Vasa recta of ileum

A

Short

62
Q

Arcades of ileum

A

Many short loops

63
Q

Lymphoid nodules (peyers patches) of ileum

A

Many

64
Q

Fat in mesentery of ileum

A

More than jejunum

65
Q

What is the blood supply of the midgut?

A

Superior mesenteric artery

66
Q

What is the origin of the superior mesenteric artery?

A

Branch of the abdominal aorta at L1

67
Q

What are the main branches of the superior mesenteric artery?

A

Jejunal and ileal arteries

68
Q

What branches other than the main branches of the superior mesenteric artery are there?

A
  • Middle colic
  • Right colic
  • Iliocolic
69
Q

What crosses the superior mesenteric artery anteriorly?

A

Splenic vein and neck of pancreas

70
Q

What constitutes hindgut structures?

A
  • Left 1/3rd of transverse colon
  • Descending colon
  • Sigmoid colon
  • Rectum
  • Upper part of anal canal
71
Q

What is the artery of the hindgut?

A

Inferior mesenteric artery

72
Q

What epithelium is part of the hindgut?

A

Urinary bladder and most of the urethra

73
Q

How can the large intestine be distinguished from the small intestine?

A
  • Omental appendices
  • Haustra or sacculations
  • Teniae coli
74
Q

Omental appendices

A

Small, fatty peritoneal like projections

75
Q

Teniae coli

A

Thickened bands of smooth muscle

76
Q

What is the appendix?

A

Blind intestinal diverticulum with masses of lymphatic tissue

77
Q

What is the position of the appendix?

A

Variable in position but most common is retrocecal

78
Q

Macburneys point

A

Site of maximum tenderness in acute appendicitis

79
Q

What is the origin of the inferior mesenteric artery?

A

Anterior branch of abdominal aorta L3

80
Q

What are the branches of the inferior mesenteric artery?

A
  • Left colic
  • Sigmoid arteries
  • Superior rectal artery
81
Q

What is the terminal branch of the inferior mesenteric artery?

A

Superior rectal artery

82
Q

What is the rectum?

A

Pelvic part of the gut tube

83
Q

Where does the recto-sigmoid junction lie?

A

Anterior to S3 vertebra

84
Q

What is the anal canal made up of?

A

External and internal anal sphincters

85
Q

What structure is palpated only in females during a rectal examination?

A

Cervix

86
Q

What structures are palpated only in males during a rectal examination?

A
  • Prostate

- Seminal gland

87
Q

What structures are palpated in both sexes during a rectal examination?

A
  • Ischial spines and tuberosities
  • Enlarged internal iliac lymph nodes/ swelling in the ischioanal fossa
  • Sacrum
  • Coccyx
  • Collections in rectovesical (male) and rectouterine fossa (female)
88
Q

What parasympathetic innervation of the abdominal organs are there?

A
  • Vagus nerve (10th cranial nerve)

- Pelvic splanchnic nerves (S2,S3,S4)

89
Q

What sympathetic innervation of the abdominal organs are there?

A

-Abdominopelvic splanchnic nerves (greater T5-T9, lesser T10-T11 and least T12)
-Prevertebral sympathetic ganglia
Abdominal aortic plexus

90
Q

What is the venous drainage of the abdominal part of the GIT?

A

Portal vein

91
Q

What does the portal vein do?

A

-Collects poorly oxygenated but nutrient rich blood from the abdominal part of the GIT including the spleen, pancreas and gall bladder and carries it to the liver

92
Q

How is the portal vein formed?

A

By the union of splenic vein with the superior mesenteric vein

93
Q

What is the location of the portal vein?

A

Behind the neck of the pancreas (L2)

94
Q

What are common sites of porto-systemic anastomoses?

A
  • Anorectal junction
  • Gastroesophageal junction
  • Around the umbilicus
95
Q

What are porto-systemic anastomoses at the snorectal junction known as?

A

Haemorrhoids or piles

96
Q

What are porto-systemic anastomoses at the gastroeophageal junction known as?

A

Oesophageal varices

97
Q

What are porto-systemic anastaomoses around the umbilicus known as?

A

Caput medusae

98
Q

What are portocaval shunts?

A

Venous enlargements during portal obstruction

99
Q

What is the lymphatic drainage of the GIT?

A

The thoracic duct receives most of the lymph from the abdominal wall and abdominal organs

100
Q

How do lymphatic vessels run?

A

Run with their corresponding arteries

101
Q

What do lymphatic nodes form?

A

Groups around the major arteries and abdominal aorta

102
Q

What are the 3 terminal groups included in lumbar nodes?

A
  • Pre-aortic
  • Lateral aortic
  • Retro-aortic
103
Q

What nodes are pre-aortic?

A
  • Celiac

- Superior and inferior mesenteric

104
Q

What do pre-aortic nodes do?

A

Drains organs supplied by the anterior branches of aorta

105
Q

What do lateral aortic nodes do?

A

Drains organs supplied by lateral aortic branches

106
Q

What do retro-aortic nodes do?

A

Drains the posterior abdominal wall

107
Q

What group of nodes is associated with foregut structures?

A

Celiac group

108
Q

What group of nodes is associated with midgut structures?

A

Superior mesenteric group

109
Q

What group of nodes is associated with hindgut structures?

A

Inferior mesenteric group