Anatomy #6 (Digestive) Flashcards

1
Q

Understanding of Digestive system through time

A

William Bomant - Practiced medicine in northern michagen as the only healthcare persn in the area

He was called to a store where Alex Markete was shot –> there was not enough tissue to covery the hole s Bomant sutured the edges of the hole –> guy lived and the hole healed over
- Hole would be covered when he was not moile but was open when he moved up = could look inside of hole

After surery - St. Marine had a flap develope that was not always closed

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2
Q

What did the hole in Alex markete open into

A

Hole opened into his stomach

When Bomant sutured he wall of his abdomen and teh wall of his stomach he made a window into the womach

Bomant tried to entice St. Markete to be able to look into his stomach

St. Markete would go away on a bender and when he would come back Bomant would look at the hole in hist stomach –> For the first time they were able to see something in the stocmah changes when we eat food

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3
Q

Bomant experimnte on St. Markete Stomach

A

Bomant would tie food on a thread and put it into his stomach and pulled it out –> see what changed

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4
Q

Thoughts before Bomant

A

Before Bomant - peoople thought that there was osmething inherint in food (food would have something that allows it to decompose)

NOW we know that it is the envirnment/things in the body that break down food

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5
Q

Thoughts before Bomant (Experiments)

A

Before = they did expeirments to see how food is degraed by putting food in a jaw with cloth

They saw the decomposition of food is different if in a uncovered or covered jar = see it is not something in the food itself it is envirnmental factor that chnages food

After Bomant = reserach moved foward

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6
Q

St. Martin + Wife

A

St.Martin ended up outliving Bomant

At the time - Bomant’s reearch was very big

After Bomant died - Olso contacted his wife to see if they could expeirment on his body but the wife said no

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7
Q

Ciculation in GI (overall)

A

Blood goes from the Left ventricle –> Aorta –> Thoracis Aorta –> Diaphram –> Absominal Aorta –> (Major vessle that feed sthe gut) –> Blood goes through the gut –> Blood will go through the portal vein –> Liver –> Inferior Vena cava -> Heart
- Gives Oxygen to Digetsive + will pick u nutrients being broken down by GI –> transports it to the liver –> Liver detoxifies and absorbs the nurteinets –> blood goes to the heart
- Digestive has own blood supply + hets oxygen from ciculatory

Image - Focusing on Blue circle

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8
Q

Digestive system (Overall)

A

Consists of the Alemantary Canal + Accesroy organs

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9
Q

Alamantary canal

A

Tubular space that opens up to the outside world at the mouth and the anus
- Has things to provent infection because open to the outside

Tube goes through the whole body (40 Ft long - of surface area)
- Designed so eveyrthing that we eat has the time and the surface area to be broken down to absorb nutrients

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10
Q

Accesory organs in GI

A
  1. Pancreus
  2. Liver
  3. Gallblader
  4. Salivary Gland

ALL support the function of digestive/Alemantray canal
- They put things into the Alamntary Canal

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11
Q

1st part of digestion

A

First part of digestion = Machanical (Chewing/Mastication) + Hydrolisys
- Need to swallow food (Ex. need to be able to have the trahea give way for bolus food)
- Mastication - Chewing allows food to be maulable + increases Surface area (increases in surface area allows cheamals to surround the food better which allows the chemicals to break the food down)
- Hydrolysis - Salivia in mouth (Fluidity + conetnts of saliva = break food down)

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12
Q

Area of storage in Digestive

A

Gallblader – not producing things
- Bile is made in the liver and goes to the gallbladder for storage

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13
Q

Oral cavity

A

Mouth is bound by the hard pallet and Soft pallet
- Soft pallet = Uvula (thing dangling in back of mouth) ; soft pallet important in swallowing as a sentinal
- Mucosa of oral cavity and orropharynxs = non-ciliated + Digetsive is not ciliated
- Roof of mouth = Hard pallet ; Posterior = soft pallet

Inferior = have the tonigue (takes up most of space in mouth) + gutter of the mouth)
- Tongue = voice + chewing + swallowing

Space between the tongue + the cheeck + the teeth = vetsibule - food goes into vestible as chew

laterally = have cheecks

Anterior = have lips

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14
Q

Boundery of the mouth

A

Boundery of the mouth = affects chewing

Chewing - teeth move up and down because the Jaw bone moves + tongue moves the food to keep food positioned in the right place + mouth muscles contract

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15
Q

Muculature of the lateral side of face

A
  1. Temeraris mucsle
  2. Maseter muscle
  3. Buxinator
  4. Obicular Oras - controls lips
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16
Q

Temperalis muscle

A

Goes to the temperal line –> goes to the tendounous formun (tendenos mprtion that goes to the fronal condice of jaw)

When chew + talk = can see the Tmeralis Fire (espcially in bald people)

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17
Q

Maseter mucle

A

Bone + Master = make up the Jaw line that you can see
- People can have stout maseters = creates a good jaw line
- Goes to underside of zygomatic arch

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18
Q

Buxinator

A

Important in the movement of food around mouth + compression of the oral cavity

There is a foam pad on the Buzanator - More pronounced in infants
- Helps babies feed - Babies need suction to build = volume of the oral cavity needs to be low to increase pressure = Buxinator foam pad keeps the mouth cavity small to increase pressure

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19
Q

Flexibility of the mouth

A

Flexibility of the mouth is usually low

Story - Disey Galespy (Jazz person) –> Cheecks were very extended out –> developed circle breathing
- Bretah out of respirtory like normal and take air in and as breath in they can continue to let chect vcavity relax as they bretah in
- He oulwd take air in –> make resiviror of air in mouth –> muscle would relax and push air ut and could miantain note as he also breathed in through nose
- He closed false vocal cords to do this - to make resvior indepent = could play while breathing in

Fill mouth with air and let recoil tendon of ucle of mouth = move air out ; breath in through nose = can play note for a long time

Shows importnace of mouth in breathing

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20
Q

Teeth (Overall)

A

32 Adult teeth (16 per jaw)

3rd molars = can cause an issue –> very far back in jaw

Molar = for grinding (humans don’t use as much = don’t need 3rd molars = can take them out)
Canine = For ripping
Ensziers (at the front) = for ensizing

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21
Q

Wisdom teeth

A

Teeth can come in so the towards the other molars –> causes crwoding in the lower midsizers because the wisdom teth can push in

40% of people habe wisdom teeth extracted by 20-30

Oral surgury for wisdom teeth = more advancd
- Before it was more complicated - many peope got dry sockets + infection + bleeding

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22
Q

Surface of the tongue

A

Surface of the tongue = rough Have different Types of papilae (raised areas of the tongue)
Papillae Function - House nerve endings for taste (sensory organs = taste buds)

Concical Papilae

Filaform papillae at the front
- Supplied sensation by the facial nerve

Have Fungiforum paillar in middle
- Supplied sensation by the facial nerve

Vallet papilarr = in back
- Supplied sensation by the glossophyrngeal

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23
Q

Areas of the tongue

A

Taste different things in different areas of the tongue

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24
Q

Taste + Smell

A

Story - Rini sense of smell has decreased over time = it is harder for him to taste
- Doesn’t taste well - instead he tastes the sensation of flavors (sensation of salty or sweet but not tasting flavor)

Smell is tied to the sense of taste
- Decrease sense of smell = can’t distiguish flavors well
- Taste = Olfactory + Sensory perception

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25
Q

Salivary Glands

A
  1. Parotoid Gland
  2. Submandbular Gland/Duct
  3. Sublingular Gland
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26
Q

Paratoid Gland

A
  1. Parotoid Gland = biggest salivary glands
    • Opens abive ipper second molar
    • When olfactory or eating causes salivation = saliva dumos from the paratoid gand to oral cavity

Clincal - People can get stones in tha Patroid Gland = gland gets blocked (painful)
- Can get the stone removed
- Gland can also get infection
- Dentists = do sweep of the mouth + makes sure nothing is weird in mouth

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27
Q

Submandbular Gland/Duct

A

Under the Ramus of the jaw

Can palpate it

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28
Q

Sublingular Gland

A

On the floor of the mouth under tongue

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29
Q

1st line of digestion

A

Chewing + Saliva

Saliva = has Tyline = starch degrader
- IF take a salitine and just put in mouth it would dissolve ebcause teh Tyline breaks down strach

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30
Q

Salivary Gland (Picture #2)

A

Paratoid duct - across from second molar on outside of vestibule at the top is fenetration that open paratoid duct
- Where the Paratoid duct dumps saliva in

See Fimbriated Fold = Fold under the tongue - sheet of tissue under tongue

Sublingual ducts - ducts were tongue meets the floor of the mouth
- Sublugual glands have a row of fenetrations - opening of ducts for sublinual gland

Submandibular ducts (come out in renulum - Typically closed when saliva is released
- People shoot Saliva out –> point tongue and move frenum to open mandibular and to eject saliva out

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31
Q

Swallowing Steps

A
  1. Buccinator compresses cheecks = oral cavity gets smaller
  2. Tongue + hyoid bone + thyroid cartildge raise and food is pushed backwards from the mouth into the pharynx
    • Larynx goes up
  3. Several muscles act at once to narrowing the opeing between the mouth and the pharync ; soft pallet elvates which closes off the nasopahrync and prevents the backflow of food or liquid into the nasal cavity
    • Mucles contract in a way to close off nasal cavity (don’t want food going to nasal cavity)
    • People can chose = get food in Eustaton tibe = get food in cilitaed mucus in tube
  4. Tonguge and Hyoid bone elvates which causes the epiglotis and the laryngeal inlet to elevate –> food passes over the anterior surface of the epiglotus into the largypharynx
    • Epiglotis flaps back and allows food to go to the esophogus + make sure food is not going to the trachea
  5. Food is propelled int and down the esopgafus by constrictor muscles + gravity helps move food to esophogus
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32
Q

Midsaigital section + chewing

A

Tongue - puts food to back of

See epiglotus

See opening to Eustacian

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33
Q

Talking + Swallow

A

If talk and swallow = messes up system because talking requires different movements

Breathing and swallowing at the same time = body doesn’t know what to do = get fluid in airway
- Fluid into airway = have strong refelx –. cough so you get air out forfully with vasalvels manuver = removing fluid away from airway
- People can inhale food (example - lobster roll competition -> guy chocked –> governer of maschusets did hymlic)

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34
Q

Hylmlic Manuver

A

Hylic is not good fro self selaing things (Ex. penut butter)

If get too much peanut butter in the airway –> try to cough it out = blows open a hole in the peanut butter = hole opens whe breath out and closes when breath in

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35
Q

Rini + Hylmic

A

Rini met Dr. Hymlic (made the Hmlic manuver)

Hymlic = makes thoracic cavity small fast = increases pressure = frce air out
- To do - put hand below Xyphoid processes –> pull up (push up on diaphram to raise diaphram)

36
Q

Swallowing Video

A

Swallow barium under floroscapy
- Often done in kids because they have issues swallowing

See soft pallet goes back + see epiglots flaps down + see muscle makes tongue and hyloid bone go up

37
Q

Lining of Abdomen

A

Entire Abdomen is lined by Mesothelium –> mesothelium makes up the periteneum
- Lining of Abdommenal (peritenieam) = emerges from wall t come foward to cover liver LI + SI

Image -
Red = Parietal peritenium (mesothelium lining cavity) on the wall –> Parietal refelx on self –> becomes mesocolon
- Have double layer of peretinum = two layers of mesothelium invests the organs of the digestive tracts
- Reflection of petrinal covering = mesocolon

38
Q

Organs behind the Peritenium

A

Some organs live behind the Pareital Peritenium

Back of Abdomenal Cavty is covered with peritenium but do have some organs behind the perutnium
- Ex. Kidneys + duadneum of SI + Ascending and Dcesnding Colon are retroperetiual = live behind the peretinium of the posterior wall

39
Q

Peritenual cavity

A

Wall of the Abdomen + Things in space = Peretineal cavity

Lining of cavity = Peritenium

40
Q

What is found in the lining of the abdomen

A

Mesocolon cotains the vessels (arteries + veins + lymphatic vessels)
- Vessels will go out to the suprior mesonteric –> ___ –> Mesenary –> goes to the intestines

41
Q

Layers of the lining of the peretinium

A

parietal peretinmum –> Mesontary (double leaf) –> Visceral pertenium

Visceral = on all of the organs (like piamoter)

Red = Pareital peritnium (lines abdomonal cavity) –> Pareital emerge from back wall and joins and becomes sheet of peritenium that goes out and surroind the SI - NOW becomes visceral peritenium
- Folds that come out from posterior wall to ecomass intestines = mesontary
- Mesonteric flods (mesontary) makes intestines/Gut mobile - insteines need to be able to move for digestion

42
Q

Peritenium cavity

A

Closed to outside world in males (everything in abdomen is covered by oeretinium)

NOT closed to outside world in females - females have space between overay and follopian tube (communication betwen pertenium cavity and outside world)
- Opening can be a plave for ifection to enter periteniual cavity
- Toxic Shock (often caused by tampon) - infection introduced through falopian tube (often diagnosed when too late to treat) and goes to peretibeal cavity = get peritiniutus (infection of peretinial cavity)

43
Q

Is the samll intestine in abdomenal cavity

A

Yes/No - because it is intraperitineal

Connected to the back wall of the mediastinum + covered by peretinium

44
Q

What is adhered to the back wall of the abdonmen

A

Adhered to the back wall of the body = Kidney + Acsending/Descending colon + Aorta + verna cana = ALL retroperitineal

45
Q

Spaces of the Peritenium

A

Way the peritenial refelcts in body = creates the two spaces

  1. Greater sac - Most of the abdomen
  2. Lesser sac - Behind the stomach

Epicale foramane = communication between the lesser sac and greater sac
- Peitnitus = infection in area –> if infection gets to the lower sac = hard to treat because hard to get to the area

Blue = lesser sac ; Red = Greater Sac

46
Q

Pritinitus/Sepsis

A

Infection in peritenial = can get bad fast because it is a warm moist space
- Spreads fast because big space = in contact with many things
- Infection can go to the lesser and greater sacs

Hard to get AB because have sequestered space –> somtimes pump AB to the peritenal cavity
- Might change how patient is positioned on table tp move the medication through peritneal cavity

47
Q

Septic shock

A

If have GI surgery on bowl = need to be very carful to make sure eveyrthing is sutured shut because whenopen bowl you can have fecal material inside = need to make sure it is completlet closed

IF you put it back into he abdomen and there is an opening = you can get peritinutus/Sepsis
- Ruptured bowl can occur from trauma
- Ex - Rini illistrated for court case where women had things leaking

Can happen with Apendex –> Bursts = puts bowl matareila to parietal cavity = get peritinitus

48
Q

Muppet story

A

Jim Hemson (muppet guy) - died of peritnitus (Steptocohcal infection)

49
Q

Omentum

A

Fold of tissue (Visceral pertinueam that becomes free) - looks like apron of thin tissue with fat that covers intestines
- Provides some lubrictaion (because fat filled) = allows movment
- Omentum will migrate to where injury happens = sequesters area = protection

50
Q
A

Shows retroperiteaal things

Asceding colon + Sigmoid colon + Kidney + Diuadneum + Pancreus = retropertineal
- image = cut the mesontary - see peritnum energing from back wall and coming togtehr to surround in the SI (SI removed in image)
- Sheets coming from the back wall = mesontray
- Transverse colon = NOT retroperetenal

Image = can also see ascending + Transverse + Decending colon

51
Q
A

Image = removed retropreitenual organs (exceot kidneys)

Blue = pariteal peritenium on the back wall
- When reove retropertitenal organs = have bare spots

52
Q
A

3 Parts of Small intestine
1. Duadenum
2. Jejunum
3. Ilum

DUadenum = retroperitenial then becomes intraperitaneal
- In the C of the duadenum = have the pancreus

53
Q

Alimetray canal

A
  1. 3 parts of Small intestine

Mouth –> Pharynx –> Asophogus –> Sphinkter –> Stomach –> sfincter –> Duadenus (1st part of the small intestine) –> Jejunum –> Ilium (last third of SI) –> Colon (Large Intestine) –> Secum (Twisting of the Large intestine) –> Aceding colon –> transverse colon –> Decsening colon –> sigmoid colon –> Rectum

Splenic felxture
Heplanic felxture

54
Q

Stomach

A

Location - Beneath Diaphram
- Has Hydrpcholic acid + mechanicall breaks down food

In stomach = have folds (Called Rugi) – Increase the surface area
- Stomach is making hydrochloric acid = breaks down proteins
- Rugi = have secretory cells

See tube coming from Esophous – goes to the esophogeal hiatus (near inferior vena cava)

See cardiac Oraphic (Sphincter) - Prevnets food from refluxing out of the stomach (Weak)
- Found where asophus goess into the stomach

See Pylerus (end of stcomach going to duadenum) + Pyleris Actrium

See Duadenoum of SI

Fundus of stomach = large part

Have greaer curvature = inferior boarder of stomach + less curvature

55
Q

Pylerus

A

Goes to the small Intestine
- Strong sphicter

Closes until the food is ready to go to the Duadenum

Takes Acidic envirnment and selectivle dumps food to the duadneum
- It is very prescise - din’t get acidic material)

56
Q

Papillae

A

Openings for pancretic duct –> put panreotic juice to Duadenum
- Digestive enzymes from pancreus goes to the Small Intestine

57
Q

Cardiac Sphincter strength

A

Cardiac sphicter is not as strong as the pyleric sphicter

Cardiac can be weaker becayse the angle in which Esophgus comes into stomach - weak sphicter is helped by angle (created mechanical closure) bevase when the stoach is distended/full = makes an more accute angle = blocks esophogus
- Want Esopgus blocked because have stomach acid - don’t wnat that acid going into the esophogus

58
Q

Stomach + fighting infections

A

Acidic envirnment = when swallow bacteria and vrisues - acidic envirnment prevents getting infection + virus

59
Q

Blood Supply of stomach

A

Stomach = well profused - have lots of colateral circulation (creates circle)

After the aorta –> blood goes to the celiac trunk (comes off the aorta)
- Gives rise to the splenic artery (Screw shape)
- Gives rise to left gastic aretry –> Anastomoses with another artery (gastroductual artery?) –> feeds lesser cuvature
- Haptic artery = goes to the gallbaldeer + branch anastomoses and goes ot greater curvature of stomach

Celiac trunk = bramches to lefy gastric artery –> goes to the lesser cruvature of the stomach –> Anastomosas

Branches off Duadenum –> goes around the greater curvature of stomach –> Anastomas with Splenic artery
- Splenic artery is screw shape (spleen is well profused)

Cystic artery + Cystic artery proper go to the gall bladder

60
Q

GERD

A

Problem with cardiac sphicter = get acid in the distal esophogus = get heart burn + can erode esophogus (can cause esophogeal cancer)

OR

Can get herna of the fungus of the stomach into the thoracic cavity (pulls through the hiatus)
- Do surgery to correct - Pull the fungus down through the hiatus –> pull fungus on self –> prevewnts the stomach from being pulled through the hiatus –> Suture the hiatus shut to mkae tighter
- Nisen fundification = takes fundus of stomach –> pul to abdomen –> Wrap fundus around the esophogus and suture (makes knot at top of stomach = won’t pull through diaphram)

61
Q

Baeratirc surgery

A

Overall - reduce area of the stomach

Example - put band around the stomach –> inflate the band –> Make stomach smaller + can adjust size

Gastric Bypass –> Pouch off part of Fondus of stomach = make small stomach –> but jejunum up to puch( revert small intestine t stomach) (food gos to puch and puts on way) ; deudunum is left intact and side to end sutured into new routing so panreotic enzymes can get in

Gastric sleeve - Take greater curvatire of stomach and sutire t make stomach smaller = make new stomach and make same route of digestion but change size of stomach

NOTE - need to be carful who is chose for the surgery because perosn could to take in the same caloreis and keep wieght
- Surgery s trying to make person eat less (people eat less but each more often)
- Surgerie s= very succesful (help people with metabolic issues)

62
Q
A

Image = removed stomach + remove periteneum

See Duadenum – small part is intraperitneal

See Celiac track – branches to feed duadenum

See superior medienteric artry and vein –> branch off abdoman aorta
- Feed whole digestive tract

63
Q

Superior medienteric artry and vein

A

Come out behind pancreus in front of deududeum and goes down to the intestines

64
Q

Pancreotic cancer

A

Hard to treat because diagnosis is often late because it is deeply buried (esocially when the tumor does not affect the pancreotic enzyms going to the duadunum)
- Treatment can be effective if they catch it early enough
- Worse if in the tail of pancreus
- If in head of pancreus = can get digetsive issues because blocks off digestive enzymes + put pressure on vessles going to liver so get juandice

65
Q

Wipple procdeur

A

Rerouts the Bowl

Wipple = remove the head of the pancreus –> retract the small intestine to serve as the pancreatic duct –. connect Stomach to Small intestine
- Bypass the duadenum
- Still get enzymes dumped into the small intestine

Video:
Take jeunum after reoving head of pancreus and duadenum –> bring up jejunum and suture jejum to remainder of the pancreus –> open pancrues into dudeum
- Need to connect stomch to jejunum –> jejunum becomes the duct to the pancreus and dumps in and food goes down

66
Q

Wall of the pancreus

A

Thin walled - looked like a vein but it is the tissue of the pancreus

67
Q

Pancerus

A

See pilerus + deudeum + Jejunum

68
Q

Greater omentum

A

Budlging from stomach = Greater omentum –> double sheet of peritenum
- Don’t know exact purpose but think it reduces frication

If have injury = omentum will migrate and sequester area = proetxts body

Image - Top is the liver ; green is the gall bladder ; below gall blader is epiloic foramoan ; center is the less opentum (less sac)

69
Q

Gall Blader + Ducts

A

Gallballder = adhered to the inferior surface of the liver (stores bile –> puts bile into liver)

Common hepatic duct = joins with the systic duct –> when comes together you get the common bild duct

Cystsic duct + common bild duct + pancretoic duct = come togetrh and dump into the duadenum

70
Q

Gall bladder removal

A

When do a gallblader removal you need to be very carful because the bild has infleunce on emulcification of fats = need to be carful how much you eat

71
Q

Liver

A

Right quandrant = fundas of gall bladder (tucked behind overhand)

See left and right lobe
See Infrior vena cava

Anteriorly = quatrate lobe - smaller lobe
Have caudate lobe - smaller lobe

72
Q

Blood supply to liver

A

Blood supply to liver is from hepatic arty - fans to lobes of livrer (gives liver 30% of O2) ; rest of O2 is from portal system where blood is coming from digestive (has nuterints) –> goes o be filtered and absobed in liver + gives rest of O2 to the liver

hapetaic goes up and feed stomach + also fans out to lobes of liver

73
Q

Blood supply to Large Intestine

A

Blood goes to the superior mesonteric vein –> protal –> liver –> Inferior vena cava
- Portal drains blood with nuertinets to the liver

Artery and vein follow the same pattern

74
Q
A

See Small intestine + jejunum + Liver + Duadenum

75
Q

Archades

A

When pull intestine out - disect area of mesontary –> seklotnize vessles - see veins and are=teries that come out (called archades - come out in arches and sent supply to bowl)

76
Q
A

mesonraty have branches coming down and fan out to create arcahdes to feed the colon and Small intestine
- See mesontary –> ___ to Small intestine –> Suprior mesonteric –> portal

77
Q

Anaotomy of Colon

A

Have Secum (pouch)

Have Acending

Have hepatic flexture (by liver)

Have transverse

Have spleic flecture (by spleen)

Haved decsdncing colon

Have signmoid colon

Have rectum

78
Q

Secum

A

Secum = begining of the Acdencing colon

ileum comes in and has iliosecal valve (weak valve ; relies on orehintation)
- As secum beocmes filled withmaterial it creates a more oblique angle and blocks it off so there is no material retrograding into ilium

See apendix

79
Q

Iluium

A

Goes to the Large intestine at teh secume
- Angle is important

If there is nothing insecim then the iliosecal valve is open
- Can dump things to secom when open
If the secum is full = angle closed = can’t get things retrograding

80
Q

Blod suppluy to colon

A

Sueprior mesontraic spreading out through mesontray to feed colon

81
Q

Blood supply to the rectum

A

Entire digestive tract = supplied by sperior mesonteric artery EXCET the last 1/3 of the rectum

Inferior emsonteric = need to cut supirorily –> blood is put in digestive = metabolized or goes to system - effficnet at metabolizing bt supriopr can’t put in rectus = venous drains and arteris is back = bypass prtal = sraught to systemic

Video:
Superior mesntretic feds the gut and goes through liver BUT final 1/3 of rectum is no fed by that oath it is fed by the inferior mesonteric (comes off aorta)
- inferior mesonteric feeds diatls 1/3 of the rectum
- reason you can use depositories (would be drained by liver out but this way it goes to systemic )

82
Q

Hemroids

A

Vericisity of veins in anus/rectal area

Pressure of the veins increase because blockage/restcition further up
- get enlargment of veins vecause blook can flow back up
- Liver is often blocked

83
Q
A

Radiograoh

Shows there is a lot of variation
- Long transverse colon + long apendix + long sigmoid colon

84
Q
A
85
Q
A