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Study Notes - Gastroenterology > Anatomy 1 (Lectures 1 and 2) > Flashcards

Anatomy 1 (Lectures 1 and 2) Flashcards

1
Q

Parts of the GI tract (11)

A

Oral cavity
Pharynx
oesophagus
stomach
small intestine
large intestine (including rectum and anal canal)
accessory organs (tongue, salivary glands, pancreas, liver, and gallbladder)

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2
Q

What joint is involved in opening the mouth

A

The temperomandibular joint (TMJ)

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3
Q

3 pairs of jaws “closing” muscles names?

A

Masseter
Temporalis
Medial pterygoid

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4
Q

Where does the masseter stretch?

A

From angle of mandible to zygomatic arch

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5
Q

Where does the temporalis run?

A

From coronoid process of mandible to temporal fossa

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6
Q

Where does the Medial Pterygoid run?

A

From angle of mandible (medial side) to pterygoid plates of sphenoid bone

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7
Q

What is the 1 pair of jaw opening muscle and where does it run

A

lateral pterygoid

Condyle of mandible to pterygoid plates of sphenoid bone

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8
Q

What supplies all the jaw muscles

A

Mandibular division of trigeminal nerve - CN V3

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9
Q

What cranial nerve number is the trigeminal nerve and what division is the mandibular division?

A

CN 5

3rd division

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10
Q 
CN V3 course:
CNS part
Intracranial part
Base of skull foramen part
Extra-cranial part of course
A

Pons
Inferior to the edge of the tentorium cerebelli between the posterior and middle cranial fossa
foramen oval of sphenoid bone
From foramen oval towards structures they supply

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11
Q

What part of the mouth is particularly sensitive to touch

A

the posterior wall of the oropharynx

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12
Q

What is aspiration?

A

Inhalation of liquid or solid matter into the lungs (different from choking)

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13
Q

What are the arches of the soft palate made from?

A

Skeletal muscle covered in mucosa

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14
Q

Surface anatomy of the mouth (8)

A 
Hard palate
Soft palate (made up of arches)
Upper dental arch
Lower dental arch
Palatine tonsils
tongue
uvula
gingivae
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15
Q

What 2 parts can the tongue be divided into and how much of each tongue is classed as what

A

Anterior 2/3rds (horizontal and in oral cavity)

Posterior 1/3rd (vertical and not in oral cavity)

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16
Q

What supplies the:
general sensory parts of the tongue?
Special sensory areas of the tongue
general and sensory supply of posterior 3rd of tongue

A 
CN V3 (3rd division of trigeminal nerve)
CN VII (facial nerve)
CN IX (glossopharyngeal)
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17
Q

What gives general sensation to the gingiva of oral cavity and palate (superior half)

A

CN V2

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18
Q

What gives general sensation to the gingiva of oral cavity and floor of mouth (inferior half)

A

CN V3

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19
Q

What is the gag reflex

A

A protective reflex that prevents foreign bodies from entering the pharynx or larynx

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20
Q

Sensory part of gag reflex

A

CN IX

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21
Q

Motor part of gag reflex

A

CNIX and CNX

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22
Q

What CN’s does spraying a local anaesthetic block the sensory action potentials of

A

CN V2, CN V3, CN VII and CN IX

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23
Q

What does the gag reflex cause that helps close off the entry to the body

A

Constrict the pharynx

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24
Q 
CN V2 course:
CNS part
Intracranial part
Base of skull foramen part
Extra-cranial part of course
A

Pons
Inferior to the edge of the tentorium cerebella between the posterior and middle cranial fossae
Formane rotundum in sphenoid bone
From foramen rotunda towards structures they supply

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25
Q 
CN VII course (special sensory, sensory, motor and parasympathetic):
CNS part
Intracranial part
Base of skull foramen part
Extra-cranial part of course
A

junction between the pons and medulla
Directly into internal acoustic meatus in the posterior cranial fossa
Passes through the temporal bone through the internal acoustic meatus and stylomastoid foramen
most fibres pass through he stylomastoid foramen

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26
Q

What branch of CN VII connects to the lingual nerve branch of CN V3?

A

The chorda tympani

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27
Q

What does the chorda tympani contain?

A

Taste axons for the anterior 2/3rds of the tongue

Parasypathetic axons for salivary glands

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28
Q

where does the chorda tympani branch off of CN VII

A

At the stylomastoid foramen

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29
Q 
CN IX course (special sensory, sensory, motor, visceral afferent and parasympathetic):
CNS part
Intracranial part
Base of skull foramen part
Extra-cranial part of course
A

Medulla
Directly towards jugular foramen in the posterior cranial fossa
Jugular foramen at the junction between the temporal bone and occipital bone
Axons mainly pass to or from the tongue and palate
posterior wall of oropharynx
parasympathetic secretomotor to parotid salivary glands

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30
Q

3 pairs of salivary glands

A

Parotid
Submandibular
Sublingual

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31
Q

4 pairs of extrinsic muscles of the tongue?

A

Palatoglossus
Styloglossus
Hypoglossus
Geniolossus (check powerpoint for positions of these)

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32
Q

What is the function of the extrinsic muscles of the tongue

A

To change the position of the tongue during mastication, swallowing and speech

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33
Q

How many intrinsic muscles does the tongue have and what do these do?

A

4

Modify the shape of the tongue during function

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34
Q

What CN are the muscles of the tongue supplied by

A

CN XII (except palatoglossus)

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35
Q 
CN XII course (motor):
CNS part
Intracranial part
Base of skull foramen part
Extra-cranial part of course
A

Medulla
Passes anteriorly towards hypoglossal canal in the posterior cranial fossa
Hypoglossal cancal (anterior wall of formate magnum)
Descneds in neck lateral to cartoid sheath
At level of hyoid bone it passes anteriorly towards the lateral aspect of the tongue
Supplies most of the muscles of the tongue

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36
Q

What muscles form the external layer of the pharynx

what type of muscles are these

A

Superior, middle and inferior constrictor (circular)
Skeletal (and striated) - we decide we want to swallow but once we have made that decision, we cannot control the muscles

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37
Q

What nerve supplies the pharynx

A

CN X

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38
Q

Look at diagram of the pharynx (posterior and anterior)

A

…

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39
Q

What muscles make up the inner layer of the pharynx

A

Longitudinal muscles

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40
Q

What is the purpose of the longitudinal muscles of the pharynx

A

To elevate the larynx and pharynx (attach to larynx, contract to shorten pharynx, raise the larynx close to the laryngeal inlet)

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41
Q

What are the steps of swallowing a food bolus?

A

Tongue pushes bolus of food towards oropharynx (voluntary)
Soft palate elevated, larynx elevated (involuntary skeletal muscles)
Circular layer of pharyngeal constrictor muscles contracts (involuntary)
Bolus of food enters oesophagus and travels inferiorly by peristalsis (involuntary)

42
Q

What is the inferior pharyngeal constrictor called?

A

Cricopharyngeus (forms the upper oesophageal sphincter)

43
Q

what muscle and what relevant cranial nerve prevents drooling

A

Orbicularis oris

CN VII

44
Q

What type of muscles are the muscles involved in swallowing (orbicularis Doris, tongue muscles, pharyngeal constrictor muscles, longitudinal layer of of pharyngeal muscles)

A

Skeletal muscles

The initiation of swallowing is voluntary

45
Q

On a barium swallow, what would causes a cervical constriction

A

Contraction of the cricopharyngeus

46
Q

At what spinal feel is the cricopharyngeus muscle?

A

C6

47
Q

What type of sphincter is the upper and lower (out of physiological or anatomical)

A 
Upper = anatomical
Lower = physiological (isn't actually anatomically there although a number of factors combine to create a sphincteric effect)
48
Q

Is the oesophagus anterior/ posterior to the heart

A

Posterior

49
Q

On a barium swallow, what causes thoracic constriction(s) of the oesophagus

A

Arch of aorta

Left main bronchus

50
Q

On a barium swallow, what causes the diaphragmatic construction of the oesophagus

A

Result of passing through the diaphragm

Lower oesophageal sphincter

51
Q

What leads to the lower oesophageal sphincter

A

Contraction of diaphragm
intrabdominal pressure slightly higher than intragastric pressure
Oblique angle at which the oesophagus enters the cardia of the stomach

52
Q

What does the oesophageal sphincter help reduce the occurrence of

A

Reflux (presence of a hiatus hernia will reduce effectiveness and can lead to symptoms of reflux)

53
Q

Where does the lower oesophageal sphincter lie

A

Immediately superior to gastro-oesophageal junction (here there will be an abrupt change in type of mucosa lining the wall causing the z-line)

54
Q

What regions of the abdomen does the stomach mainly lie in when the patient is supine

A

Th left hypochondrium, epigastric and umbilical regions

55
Q

Parts of stomach

A 
Cardia
Fundus
Body
Pyloric antrum 
pylorus
56
Q

Name for series of ridges in stomach

A

Rugae

57
Q

What notch marks the dividing line between the body of the stomach and pyloric antrum

A

Incisura angularis

58
Q

Parts of the small intestines?

A

Duodenum (short), jejunum (about 3m), ileum (about 4m)

59
Q

Parts of the large intestine

A

Colon (caecum, appendix, ascending colon, transverse colon, descending colon, sigmoid colon)
Rectum
Anal canal
Anus

60
Q

Name for turn between the transverse and ascending colon?

Turn between transverse and descending colon?

A

Hepatic flexture

Splenic flexture

61
Q

What are the 3 parts the abdominal organs are split into

A

Foregut
Midgut
Hindgut
(based on embryological origins)

62
Q

Organs of the foregut

A 
Oesophagus to mid-duodenum
liver
gallbladder
spleen 
1/2 of pancreas
63
Q

Organs of midgut

A

Mid-duodenum to proximal 2/3rds of transverse colon

1/2 of pancreas

64
Q

Organs of the hindgut

A

distal 1/3rd of the transverse colon to proximal 1/2 of the anal canal

65
Q

What are all the organs in each of the regions of the abdomen (divided best on embryological origin) supply by the same

A

Arterial blood from common artery
Venous drainage from common vein
Lymphatic drainage from shared route
Nerve supply via common route

66
Q

9 regions of the abdomen

A 
Right/ left hypochondrium
Epigastric
Right/ left lumbar (flank)
Umbilical
Right/ let inguinal (iliac fossa)
Pubic  (suprapubic)
67
Q

Where are the lines drawn to divide the abdomen into 9 regions

A

Mid-clavicular
Subcostal
Trans-tubercular

68
Q

4 quadrants of the abdomen

A

UQ
LUQ
RLQ
LLQ

69
Q

Muscles of the abdomen (4)

A 
Rectus Abdominis
External oblique
Internal oblique
transversus abdominis
parietal peritoneum
70
Q

When do the abdominal muscles contract to “guard”

A

to protect the abdominal organs when injury threatens

Peritonitis

71
Q

2 parts of the peritoneum

A

Parietal

Visceral (both parts are continuous with each other)

72
Q

Does peritoneum contain nerves

A

Yes, also secretes a small amount of lubricating fluid

73
Q

In terms of the peritoneum,how are organs classified?

A

Intraperitoneal (almost completely covered in visceral peritoneum, minimally mobile) e.g. liver
Retroperitoneal e.g. pancreas and kidneys (only has visceral peritoneum on its anterior surface - located in the retroperitoneum)
With a messentery (e.g. parts of intestines, covered in visceral peritoneum which wraps itself behind the organ to form a double layer, mesentery suspends the organ fro the posterior abdominal wall = very mobile)

74
Q

What is are the name of 3 condensations of the peritoneum?

A

Greater omentum
Lesser omentum
Messentery
(double layers that attach organs to each other and to the abdominal wall)

75
Q

What do the omenta do?

A

Divide the peritoneal cavity into a greater sac and a much smaller lesser sac

76
Q

How do the 2 peritoneal sacs communicate

A

throughs the omental foramen

77
Q

What lies on the free edge of the lesser omentum

A

The portal triad

78
Q

What pouches (which are part of the greater sac) are formed when the inferior aspect of the peritoneum “drapes over” the superior aspect of the pelvic organs?

A

Rectovesical (in males)

Rectouterine (pouch of douglas) and uterovesical (In females)

79
Q

Ascites

A

Excess fluid within the peritoneal cavity

80
Q

How is ascites fluid drained

A

Through paracentesis/ abdominocentesis

81
Q

During paracentesis, where is the needle placed and why?

A

Lateral to the rectus sheath to avoid the inferior epigastric artery which ascends deep to the rectus abdomens after it iris from the external iliac just medial to the deep inguinal ring)

82
Q

What are the characteristics of visceral pain

A

Hard to localise and dull, achy and nauseating (visceral includes visceral peritoneum)

83
Q

Characteristics of somatic pain

A

Easier to localise and sharp and stabbing

84
Q

What may colicky pain be caused by

A

A GI obstruction as peristalsis comes in waves

85
Q

How do the sympathetic nerves get from the CNS to the abdominal organs

A

Leave the spinal cord between levels T5 and L2 and enter the sympathetic chains (but don’t synapse)
Leave the sympathetic chains within the abdominopelvic splanchnic nerves
Synpase at prevertebral ganglia which are located anterior to the aorta at the exit points of the major branches of the abdominal aorta

86
Q

Where does the postsynaptic sympathetic nerve fibres pass?

What do they form along with other nerve fibres?

A

From the prevertebral ganglia onto the surface of the arterial branches leaving the abdominal aorta
They form periarterial plexuses as they hitch a ride with the arteries and their branches towards (or away from) the smooth muscles and glands of the organs

87
Q

What is the course of the sympathetic nerves that supply the adrenal gland

A

Leave the spinal cord at T10-L1
Enter the abdominopelvic splanchnic nerves (do not synapse at the prevertberal ganglia) and instead are carried with periarterial plexuses to the adrenal gland and synapse directly onto cells

88
Q

What are the 2 ways by which the parasympathetic nerves get from the CNS to the abdominal organs
How much of the digestive tract does each supply?

A

CNX (vagus nerve) - up tot he distal end of the transverse colon
Pelvic Splanchnic nerves (S2,3,4) - smooth muscle/ glands of the descending colon to anal canal

89
Q

How does the vagus nerve provide parasympathetic nerve fibres to the abdominal organs

A

presynaptic parasympathetic nerve fibres enter abdominal cavity on surface of the oesophagus (“vagal trunks”)

travel into the periarterial plexuses around the abdominal aorta

carried to the walls of the organs where they synapse in ganglia

90
Q

Where does pain from the foregut, midgut and handgun tend to be felt

A 
Foregut = epigastric region
Midgut = umbilical region
Hindgut = pubic region
91
Q

How do visceral afferent nerve fibres get from the abdominal organs to the CNS

A

Pain fibres from the bast majority of the abdominal organs run alongside sympathetic fibres back to the spinal cord

92
Q

Where do visceral afferent nerve fibres from the foregut structures enter the spinal cord

A

At approx. T6-T9

93
Q

Where do visceral afferent nerve fibres from the midgut structures enter the spinal cord

A

T8-T12

94
Q

Where do visceral afferent nerve fibres from the hindgut structures enter the spinal cord

A

T10 - L2

95
Q

Where does pain from the organs tend to be perceived

A

In the dermatomes of the levels at which they enter the spinal cord (bit of overlap) - type of referred pain

96
Q

What pain can be felt in the right shoulder

A

Liver/ gallbladder pain

97
Q

What pain can be felt in the centre of the back

A

Stomach pain/ pancreatic pain

98
Q

Where is kidney and ureter pain felt

A

From groin right up back

99
Q

Where is appendicitis pain felt

A

In centre and then travels to right bottom corner as it irritates the peritoneum

100
Q

Where areThe somatic motor, somatic sensory and sympathetic nerve fibres supplying the structures of the abdominal part of the “body wall” are conveyed within?

A 
The thoracoabdominal nerves (7th - 11th intercostal nerves -Travel anteriorly, then leave the intercostal spaces, travel in the plane between the internal oblique and transversus abdominis, as thoracoabdominal nerves)
Subcostal nerve (T12 anterior ramus)
Iliohypogastric nerve (half of L1 anterior rams)
Ilioinguinal nerve (other half of L1 anterior ramus)

Study Notes - Gastroenterology (42 decks)

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