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GI > Anatomy > Flashcards

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
Q

Venous drainage - Inferior Vena Cava

A

Drains cleaned blood from hepatic veins into right atrium

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26
Q

Venous drainage - Hepatic Portal Vein

A

Drains from forget, midgut and hindgut to the liver for first pass metabolism

27
Q

Venous drainage - Splenic Vein

A

Drains from foregut to hepatic portal vein

28
Q

Venous drainage - Superior Mesenteric Vein

A

Drains from midgut to hepatic portal vein

29
Q

Venous drainage - Inferior Mesenteric Vein

A

Drains hindgut to splenic vein

30
Q

Where are the three “portal systemic anastomoses”?

A

Distal end of the oesophagus
Skin around the umbilicus
Rectum/anal canal

31
Q

Describe veins involved in the oesophageal anastomoses

A

Inferior part drains to hepatic portal vein

Superior part drains to azygous vein

32
Q

Describe the veins involved in the anastomoses around the umbilicus

A

Inferior epigastric vein

Usually) closed ligamentum teres (round ligament

33
Q

How could the three anatomical anastomoses become varicosed?

A

Portal hypertension causes blood to be diverted through the collateral veins back to the systemic venous circulation. Increased blood volume = dilation (varicosed)

34
Q

Muscles of Mastication

A

Masseter
Temporalis
Medial Pterygoid
Lateral Pterygoid

35
Q

At which joint does jaw opening and closing occur?

A

Temporomandibular Joints

Synovial joint between mandibular fossa and articular tubercle of temporal bone AND head of condylar process of mandible

36
Q

Four Types of Papillae on the Tongue

A

With tastebuds =
Foliate
Vallate
Fungiform

Without tastebuds =
Filiform

37
Q

Components of the Distal GI Tract

A

Rectum
Anal Canal
Anus

38
Q

Components Necessary for Faecal Continence

A

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
Q

Factors Affecting Faecal Continence

A

Neurological pathology
Medications
Age-related degeneration muscle nerve innervation
Consistency of stool

40
Q

Pelvic Cavity

A

Between pelvic inlet and pelvic floor
Contains pelvic organs and supporting tissues
Rectum located here

41
Q

Anatomical Locations of Distal GI Tract

A 
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
Q

Rectum

A

Rectal ampulla = superior to levator ani muscle

Walls relax to accomodate faeces

43
Q

Anatomical Relationships of Rectum

A 
Male = Prostate lies anterior 
Female = Vagina and cervix lie anterior
44
Q

Components of Levator Ani

A 
Iliococcygeus
Pubococcygeus
Puborectalis 
All skeletal muscle
Supplied by nerve to levator ani
Forms floor of pelvis/roof of peritoneum
45
Q

Levator Ani Function

A

All skeletal muscle
Forms floor of pelvis/roof of peritoneum
Tonic contraction provides support for pelvis organs
Relax to allow defecation and urination

46
Q

Puborectalis

A

Forms a sling around the rectum
Contraction decreases anorectal angle, acting like a sphincter
Skeletal muscle
Voluntary contraction helps to maintain continence

47
Q

Anal Sphincters

A

One internal = smooth muscle
One external = skeletal muscle
Overlap between the two

48
Q

Internal Anal Sphincter

A

Superior two thirds of anal canal
Contraction = Sympathetic
Relaxation = Parasympathetic
Tonic contraction, reflexive relaxation due to distension of rectal ampulla

49
Q

External Anal Sphincter

A

Inferior two thirds of anal canal
Contraction = pudendal nerve
Voluntarily contracted due to rectal ampulla distension and internal anal sphincter relaxation

50
Q

Nerve Supply to Pelvic Structures

A

Body cavity

Sympathetic, parasympathetic, visceral afferent

51
Q

Nerve Supply to Perineum Structures

A

Body Wall

Somatic motor and somatic sensory

52
Q

Somatic Motor Supply to Anal Canal

A

Via pudendal nerve and nerve to levator ani
Leave SC from S2-S4
Contraction of external anal sphincter and puborectalis

53
Q

Parasympathetic Supply to Rectum

A

Via pelvic splanchnic nerves, synapsing in rectum wall
Leave SC from S2-S4
Inhibit internal anal sphincter
Stimulate peristalsis

54
Q

Visceral Afferent Supply to Rectum

A

Run with parasympathetics
Enter SC by S2-S4
Sense stretch, ischaemia etc.

55
Q

Sympathetic Supply to Rectum

A

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
Q

Pudendal Nerve

A 
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
Q

Pudendal Nerve or Sphincter Damage

A

Can occur during pregnancy
Stretching of nerve fibres or tearing of muscle fibres
= Weakened muscle
Faecal incontinence

58
Q

Pectinate Line

A

Marks junction between visceral and parietal parts

Different arterial, venous, lymphatic and nerve supply at either side

59
Q

Superior to Pectinate Line

A 
Nerve = autonomic
Arterial = inferior mesenteric artery
Venous = portal venous system (IMV)
Lymphatics = inferior mesenteric nodes (internal iliac nodes)
60
Q

Inferior to Pectinate Line

A 
Nerve = somatic and pudendal
Arterial = internal iliac artery
Venous = systemic venous system (internal iliac)
Lymphatics = superficial inguinal nodes
61
Q

Lymphatics of Pelvis

A

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
Q

Haemorrhoids

A

Prolapses of the rectal venous plexuses
Not related to portal hypertension
Due to raised pressure e.g. chronic constipation, straining, pregnancy

63
Q

Ischioanal Fossae

A

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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