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Anatomy Flashcards

1
Q

Large intestine components (proximal to distal)

A

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

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2
Q

Large intestine functions

A 
Defence = Commensal bacteria 
Absorption = H2O and electrolytes
Excretion = Formed stool
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3
Q

Where are the Paracolic Gutters?

A

Between the lateral edge of the ascending and descending colon, and abdominal wall.

Potential for pus/fluid collection

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4
Q

What are haustra and why do they occur?

A

Small “pouches” along the colon

Formed by tonic contraction of the teniae coli

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5
Q

What are teniae coli?

A

Three distinct longitudinal bands of thickened smooth muscle. Run from caecum to distal end of sigmoid colon.

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6
Q

What is the most common position of the appendix?

A

Retrocaecal

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7
Q

Variation in appendix position causes…..?

A

Variation in pain felt with appendicitis

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8
Q

Where is the appendiceal orifice found?

A

Posteromedial wall of caecum (below the ileocaecal orifice)

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9
Q

What is McBurney’s point?

A

Point 1/3rd of the way between the right ASIS and umbilicus. Should correspond to appendiceal orifice. Should be point of maximum tenderness.

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10
Q

Where does the sigmoid colon lie?

A

Left iliac fossa

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11
Q

What do you call the long mesentery specific to the sigmoid colon?

A

Sigmoid Mesocolon

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12
Q

Due to it’s degree of movement, what is a particular risk to the sigmoid colon?

A

Twisting around itself (sigmoid volvulus). Causes obstruction, ishaemia, infarction and rupture

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13
Q

Where does the abdominal aorta sit?

A

Midline, retroperitoneal, anterior to vertebral bodies, left of IVC

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14
Q

Three midline branches of the abdominal aorta

A

Celiac trunk (forgeut)
Superior mesenteric artery (midgut)
Inferior mesenteric artery (hindgut)

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15
Q

Lateral branches of the abdominal aorta supply…?

A

Kidneys/adrenal glands
Gonads
Body wall (posterolateral)

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16
Q

Abdominal aorta bifurcates into…?

A 
Common iliacs
(then to internal and external iliac)
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17
Q

Superior mesenteric branches (Superior to Inferior)

A 
Inferior pancreaticoduodenal
Middle colic
Right colic
Ileocolic 
Jejunal and Ileal
Appendicular
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18
Q

Inferior mesenteric branches (Superior to Inferior)

A

Left colic
Sigmoid colic
Superior rectal

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19
Q

What is the marginal artery of Drummond?

A

An anastomoses between the superior and inferior mesenteric artery branches

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20
Q

Why is the marginal artery of Drummond important?

A

Helps to prevent ischaemia by providing collateral route for blood flow

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21
Q

Describe the blood supply of the rectum and anal canal

A

Inferior mesenteric artery = proximal half of anal canal (to pectinate line)
Internal iliac artery = Rest of anal canal
Anastomoses between

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22
Q

How could peptic ulcers cause haematemesis?

A

Peptic ulcer erodes mucosa of stomach/duodenum, through to blood supply, which then fills stomach/duodenum

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23
Q

What is an oesophageal varice?

A

Abnormal, dilated veins. Thin-walled, so rupture easily, causing bleeding into oesophagus

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24
Q

What could cause haematemesis?

A

Peptic/Duodenal Ulcers

Oesophageal Varices

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25
Venous drainage - Inferior Vena Cava
Drains cleaned blood from hepatic veins into right atrium
26
Venous drainage - Hepatic Portal Vein
Drains from forget, midgut and hindgut to the liver for first pass metabolism
27
Venous drainage - Splenic Vein
Drains from foregut to hepatic portal vein
28
Venous drainage - Superior Mesenteric Vein
Drains from midgut to hepatic portal vein
29
Venous drainage - Inferior Mesenteric Vein
Drains hindgut to splenic vein
30
Where are the three "portal systemic anastomoses"?
Distal end of the oesophagus Skin around the umbilicus Rectum/anal canal
31
Describe veins involved in the oesophageal anastomoses
Inferior part drains to hepatic portal vein | Superior part drains to azygous vein
32
Describe the veins involved in the anastomoses around the umbilicus
Inferior epigastric vein | Usually) closed ligamentum teres (round ligament
33
How could the three anatomical anastomoses become varicosed?
Portal hypertension causes blood to be diverted through the collateral veins back to the systemic venous circulation. Increased blood volume = dilation (varicosed)
34
Muscles of Mastication
Masseter Temporalis Medial Pterygoid Lateral Pterygoid
35
At which joint does jaw opening and closing occur?
Temporomandibular Joints | Synovial joint between mandibular fossa and articular tubercle of temporal bone AND head of condylar process of mandible
36
Four Types of Papillae on the Tongue
With tastebuds = Foliate Vallate Fungiform Without tastebuds = Filiform
37
Components of the Distal GI Tract
Rectum Anal Canal Anus
38
Components Necessary for Faecal Continence
Holding area = rectum Visceral afferent nerve fibres = fullness Functioning muscle sphincters = contract and relax to prevent and allow defecation Normal cerebral function = control time of defecation
39
Factors Affecting Faecal Continence
Neurological pathology Medications Age-related degeneration muscle nerve innervation Consistency of stool
40
Pelvic Cavity
Between pelvic inlet and pelvic floor Contains pelvic organs and supporting tissues Rectum located here
41
Anatomical Locations of Distal GI Tract
``` Rectosigmoid junction = S3 Rectum becomes anal canal = anterior to tip of the coccyx Anus = orifice through which faeces pass Pelvis = rectum Perineum = anal canal, anus ```
42
Rectum
Rectal ampulla = superior to levator ani muscle | Walls relax to accomodate faeces
43
Anatomical Relationships of Rectum
``` Male = Prostate lies anterior Female = Vagina and cervix lie anterior ```
44
Components of Levator Ani
``` Iliococcygeus Pubococcygeus Puborectalis All skeletal muscle Supplied by nerve to levator ani Forms floor of pelvis/roof of peritoneum ```
45
Levator Ani Function
All skeletal muscle Forms floor of pelvis/roof of peritoneum Tonic contraction provides support for pelvis organs Relax to allow defecation and urination
46
Puborectalis
Forms a sling around the rectum Contraction decreases anorectal angle, acting like a sphincter Skeletal muscle Voluntary contraction helps to maintain continence
47
Anal Sphincters
One internal = smooth muscle One external = skeletal muscle Overlap between the two
48
Internal Anal Sphincter
Superior two thirds of anal canal Contraction = Sympathetic Relaxation = Parasympathetic Tonic contraction, reflexive relaxation due to distension of rectal ampulla
49
External Anal Sphincter
Inferior two thirds of anal canal Contraction = pudendal nerve Voluntarily contracted due to rectal ampulla distension and internal anal sphincter relaxation
50
Nerve Supply to Pelvic Structures
Body cavity | Sympathetic, parasympathetic, visceral afferent
51
Nerve Supply to Perineum Structures
Body Wall | Somatic motor and somatic sensory
52
Somatic Motor Supply to Anal Canal
Via pudendal nerve and nerve to levator ani Leave SC from S2-S4 Contraction of external anal sphincter and puborectalis
53
Parasympathetic Supply to Rectum
Via pelvic splanchnic nerves, synapsing in rectum wall Leave SC from S2-S4 Inhibit internal anal sphincter Stimulate peristalsis
54
Visceral Afferent Supply to Rectum
Run with parasympathetics Enter SC by S2-S4 Sense stretch, ischaemia etc.
55
Sympathetic Supply to Rectum
Via inferior mesenteric ganglia, synapsing, then via periarterial plexuses around branches of IMA Leave SC from T12-L2 Contraction of internal anal sphincter Inhibit peristalsis
56
Pudendal Nerve
``` Branch of sacra plexus S2, S3, S4 anterior rami Supplies external anal sphincter Exits pelvis via greater sciatic foramen Enters perineum via lesser sciatic foramen Branches to supply perineum structures ```
57
Pudendal Nerve or Sphincter Damage
Can occur during pregnancy Stretching of nerve fibres or tearing of muscle fibres = Weakened muscle Faecal incontinence
58
Pectinate Line
Marks junction between visceral and parietal parts | Different arterial, venous, lymphatic and nerve supply at either side
59
Superior to Pectinate Line
``` Nerve = autonomic Arterial = inferior mesenteric artery Venous = portal venous system (IMV) Lymphatics = inferior mesenteric nodes (internal iliac nodes) ```
60
Inferior to Pectinate Line
``` Nerve = somatic and pudendal Arterial = internal iliac artery Venous = systemic venous system (internal iliac) Lymphatics = superficial inguinal nodes ```
61
Lymphatics of Pelvis
Tend to lie alongside arteries Internal iliac = drains inferior pelvis structures External iliac = drains lower limb, and more superior pelvic structures Common iliac = drains external and internal iliac Lymph then drains to lumbar nodes, thoracic duct then left sternal angle
62
Haemorrhoids
Prolapses of the rectal venous plexuses Not related to portal hypertension Due to raised pressure e.g. chronic constipation, straining, pregnancy
63
Ischioanal Fossae
Right and left, but communicate posteriorly Form a "U" shape around the anal canal Filled with fat and connective tissue Infection here is called an ischioanal abscess

GI (24 decks)

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