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Anatomy Flashcards

1
Q

what is the outer connective tissue called in the digestive tract wall?

A

serosa

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2
Q

what is the circular muscle layer called?

A

muscularis externa

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3
Q

what else is in the muscularis externa apart from muscle?

A

myentetric plexus (neurone network)

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4
Q

what is found in the submucosa?

A

connective tissue, larger blood and lympth vessels, glands and submucous plexus (neurone network)

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5
Q

what is found in the mucosa?

A

mucous membrane, lamina propria (capillaries, enteric neurons, gut-associated lympthoid tissue), muscularis mucosae

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6
Q

What are the functions of the upper GI tract?

A
  • mastication (chewing)
  • taste
  • deglutition (swallowing)
  • salivation
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7
Q

how many teeth do adults have?

A

32

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8
Q

which joint articulates between the temporal bone and mandible?

A

temporomandibular joint

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9
Q

what are the muscles of mastication supplied by?

A

mandibular division of trigeminal nerve - CN V3

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10
Q

what does the temporalis m. do?

A

coronoid process of mandible to temporal fossa

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11
Q

what does masseter m. do?

A

angle of mandible to zygomatic arch

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12
Q

how many muscles control mastication?

A

4

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13
Q

how many muscles responsible for jaw opening/closing?

A

3 closing and 1 opening

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14
Q

What is the course of the mandibular division of trigeminal nerve (CNV3)?

A

Comes from pons, through foramen ovale to muscles of mastication and sensory area

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15
Q

what does the lateral pterygoid do?

A

pulls condyle of mandible to pterygoid plates of sphenoid bone

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16
Q

what does medial pterygoid do?

A

pulls angle of mandible to pterygoid plates of phenoid bone

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17
Q

what re the two cavities in the temporomandibular joint divided by?

A

articular disc

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18
Q

what is the superior cavity in temporomandibular joint for?

A

translocation

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19
Q

what is the inferior cavity in temporomandibular joint for?

A

rotation

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20
Q

what is aspiration?

A

inhalation of liquid or solid matter into lungs

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21
Q

what nerve is the posterior 1/3rd of the tongue supplied by?

A

CNIX -

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22
Q

what nerve is the 2/3rd of the tongue supplied by?

A

CNV3 (mandibular division of trigeminal nerve ) and CNVII (facial nerve)

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23
Q

what is the course of the facial nerve?

A
  1. from pontomedullary junction
  2. travel through temporal bone via internal acoustic meatus then stylomastoid foramen
  3. to supply taste ant. 2/3rd tongue, muscles of facial expression and glands in floor of mouth.
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24
Q

what does the chorda tympani nerve supply?

A

taste to anterior 2/3rd of tongue and parasympathetics to glands

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25
Q

what is the lingual nerve a branch of?

A

CN V3

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26
Q

what nerve supplies the gingiva or oral cavity and palate?

A

CN V2

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27
Q

What is the purpose of the gag reflex?

A

protects foreign bodies from entering the pharynx or larynx

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28
Q

what nerve carries the sensory part of the gag reflex?

A

CN IX

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29
Q

what nerves carry the motor part of the gag reflex?

A

CN IX and CN X

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30
Q

what will spraying a local anaesthetic do?

A

block sensory action potentials in CN V2, CN V3, CN VII and CN IX

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31
Q

what is the course of the CN V2?

A

from pons, through foramen rotundum to sensory area

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32
Q

what is the course of CN IX?

A

from medulla, through jugular foramen to posterior wall of oropharynx, parotid gland and post 1/3rd tongue.

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33
Q

where does parotid gland secrete saliva?

A

by upper 2nd molar tooth

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34
Q

what does the submandibular gland do?

A

enters floor of mouth and secretes via lingual caruncle

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35
Q

what does the sublingual gland do?

A

lays in floor of mouth secretes via several ducts superiorly

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36
Q

what can duct clogging/blockage cause?

A

swelling, due to back up of secretions

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37
Q

what do extrinsic muscles of the tongue do?

A

function to change the position of the tongue during mastication, swallowing and speech

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38
Q

what do intrinsic muscles of the tongue do?

A

modify the shape of the tongue during function

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39
Q

what are all tongue muscles innervated by? what is the exception?

A

CNXII except palatoglossus

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40
Q

what are the 4 skeletal muscles of the tongue?

A

palatoglossus
styloglossus
genioglossus
hyoglossus

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41
Q

what is the course of the CN XII?

A

from medulla, through hypoglossal canal to extrinsic and intrinsic muscle of tongue.

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42
Q

what is the name for CN XII?

A

hypoglossal nerve

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43
Q

what is the pharynx innervated by?

A

CN X (vagus)

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44
Q

what is the muscle of the pharynx called?

A

stylopharyngeus

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45
Q

what nerves is the pharynx supplied by?

A

CN X and CN IX

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46
Q

what is the pharynx made of?

A

3x longitudinal muscle

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47
Q

where does the osophagus start?

A

begins at inferior edge of cricopharyngeus muscle (vertebral level C6)

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48
Q

What does parasympathetic stimulation do to peristalsis?

A

speeds it up

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49
Q

What does sympathetic stimulation do to peristalsis?

A

slows it down

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50
Q

what factors produce the lower oesophageal sphincter?

A
  • contraction of diaghram
  • intrabdominal pressure slightly higher than intragastric pressure
  • oblique angle at which oesophagus anters the cardia of stomach
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51
Q

what does the lower oesophageal sphincter do?

A

helps reduce occurrence of reflux

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52
Q

what might a hiatus hernia do to the lower oesophageal sphincter do?

A

reduce effectiveness and lead to symptoms of reflux

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53
Q

what are the four different parts of the colon?

A

ascending, transverse, descending and sigmoid

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54
Q

what organs are in the foregut?

A
  • oesophagus to mid-duodenum
  • liver and gall bladder
  • spleen
  • 1/2 of pancreas
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55
Q

what organs are in the midgut?

A
  • mid duodenum to proximal 2/3rds of transverse colon

- 1/2 pancreas

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56
Q

what organs are in the hindgut?

A

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

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57
Q

what are the nine regions of the abdomen (from top right to bottom left)?

A
  • right hypochondrium
  • epigastric
  • left hypochondrium
  • right lumbar
  • umbilical
  • left lumbar
  • right linguinal
  • pubic
  • left linguinal
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58
Q

which organs contract to ‘guard’ abdominal organs from injury?

A
  • rectus abdominis
  • external oblique
  • internal oblique
  • transversus abdominis
  • parietal peritoneum
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59
Q

apart from injury what other medical condition does guarding also occur in?

A

peritonitis

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60
Q

what is the peritoneum?

A

a thin, transparent, semi-permeable, serous membrane which lines the walls of the abdominopelvic cavity and organs

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61
Q

which layer of the peritoneum lines the body wall?

A

parietal

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62
Q

which layer of the peritoneum lines the organs?

A

visceral

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63
Q

what is the peritoneal cavity?

A

cavity between the visceral and parietal layer

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64
Q

what is peritonitis?

A

when blood, pus or feaces in the peritoneal cavity cause severe and painful inflammation of the peritoneum

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65
Q

what are intraperitoneal organs?

A

organs completely covered by visceral peritoneum, minimally mobile.

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66
Q

what are organs with a mesentery (intraperitoneal)?

A

organs covered in visceral peritoneum but the visceral peritoneum wraps behind the organ to form a double layer (mesentery), the mesentery suspends the organ from the posterior abdominal wall - very mobile

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67
Q

what are retroperitoneal organs?

A

only has visceral peritoneum on its anterior surface, located in the retroperitoneum

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68
Q

which organs are classified as intraperitoneal organs?

A 
liver + gall bladder
stomach
spleen
parts of small intestine 
transverse colon
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69
Q

which organs are classified as retroperitoneal organs?

A 
kidneys
adrenal gland 
pancreas 
ascending colon
descending colon
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70
Q

what are condensations of the peritoneum?

A

double layers that attach organs to each other or to the abdominal wall

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71
Q

what are the different types of peritoneal formations?

A

mesentery, omentum and peritoneal ligaments

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72
Q

what do mesentery formations usually do?

A

connect organ to posterior body wall

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73
Q

what are omentum (greater and lesser) formations?

A

double layer of peritoneum that passes from stomach to adjacent organs (‘ cover of the abdominal organs’)

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74
Q

what do peritoneal ligaments do?

A

double layer of peritoneum connect organs to one another or body wall

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75
Q

what are mesentery formations?

A

have a core of connective tissue with blood and lymph vessels, nerve, lymph nodes and fat

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76
Q

what is the greater omentum?

A

four layered, hangs like apron, attaches the greater curvature of stomach to transverse colon

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77
Q

what is the lesser omentum?

A

double layered, runs between lesser curvature of stomach and duodenum to liver, has a free edge

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78
Q

what does the omenta divide the peritoneal cavity into?

A

a greater sac and a lesser sac

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79
Q

how do the two sacs in peritoneum communicate?

A

through the omental foramen (foramen of winslow)

80
Q

where does the portal triad lie?

A

in the free edge of the lesser omentum

81
Q

what are the two pouches in the pelvic area of the female called?

A
  • vesico-uterine pouch

- recto-uterine pouch (pouch of douglas)

82
Q

what is the pouch in the pelvic area o the male called?

A

recto-uterine pouch (pouch of douglas)

83
Q

what are ascites?

A

collection of fluid in the peritoneal cavity

84
Q

what are ascites most commonly caused by?

A

cirrhosis and portal hypertension

85
Q

how can ascitic fluid be drained?

A

by a procedure called paracentesis

86
Q

what is the character of visceral pain?

A

dull, achy and nauseating

87
Q

what is the character of somatic pain?

A

sharp and stabbing

88
Q

how do sympathetic nerve fibres get from the CNS to the abdominal organs?

A

leave spinal cord between levels T5 and L2, enter the sympathetic chains but do not synapse, leave the sympathetic chains within abdominopelvic splanchnic nerves, synapse at prevertebral ganglia which are located anterior to the aorta at the exit points of the major branches of the abdominal aorta, postsynaptic sympathetic nerve fibres pass from the prevertbral ganglia onto the surface of the arterial branches leaving the abdominal aorta, they take part in periarterial plexuses with other nerve fibres, as they hitch a ride with the arteries and their branches towards the smooth muscle and glands of organs.

89
Q

at which point do sympathetic nerve fibres for the adrenal gland leave the spinal cord?

A

T10-L1

90
Q

If the problem is in the foregut where does the pain tend to be felt?

A

epigastric region

91
Q

If the problem is in the midgut where does the pain tend to be felt?

A

umbilical region

92
Q

If the problem is in the hindgut where does the pain tend to be felt?

A

pubic region

93
Q

which part of the spinal cord do foregut structure nerves enter at?

A

approx T6-T9

94
Q

which part of the spinal cord do midgut structure nerves enter at?

A

approx T8-T12

95
Q

which part of the spinal cord do hindgut structure nerves enter at?

A

approx T12-L2

96
Q

what is jaundice?

A

yellowing of the sclera and skin caused by an increase in the blood levels of bilirubin

97
Q

what is bilirubin?

A

normal by-product of the break down of red blood cells mainly occurring in the spleen

98
Q

what is bilirubin used to form?

A

bile

99
Q

why is bile important?

A

for normal absorption of fats from the small intestine

100
Q

what does the gallbladder do?

A

stores and concentrates bile

101
Q

what is the largest organ in the body?

A

liver

102
Q

what is the function of the liver?

A

glycogen storage
bile secretions
other metabolic functions

103
Q

what is the surface anatomy of the liver?

A

located mainly in RUQ, protected by ribs 7-11, location changes in breathing

104
Q

what are the four anatomical lobes of the liver called?

A

caudate lobe
right lobe
quadrate lobe
left lobe

105
Q

how many functional lobes does the liver have?

A

eight

106
Q

what does each segment of the liver have?

A
  • branch of hepatic artery
  • branch of hepatic portal vein
  • bile drainage (to bile duct)
  • venous drainage (to IVC)
107
Q

what does the portal triad consist of?

A

hepatic portal vein
hepatic artery proper
bile duct

108
Q

what does the portal triad run within?

A

hepatoduodenal ligament

109
Q

what is the first of three midline branches of the aorta called?

A

coeliac trunk

110
Q

what vertebral level does the coeliac trunk leave the aorta?

A

T12

111
Q

what does the coeliac trunk supply?

A

organs of the foregut

112
Q

what does the coeliac trunk trifurcate into?

A

splenic artery
left gastric artery
common hepatic artery

113
Q

which ribs is the spleen protected by?

A

9-11

114
Q

what does the spleen do?

A

breaks down red blood cells to produce bilirubin

115
Q

what are the major blood supplies to the stomach called?

A

right and left gastric arteries and right and left gastro-omental arteries

116
Q

where does the blood supply to the liver come from?

A

right and left hepatic arteries and hepatic portal vein

117
Q

what are the right and left hepatic arteries branches of?

A

hepatic artery proper

118
Q

how much of the blood supply to the liver is from the hepatic arteries?

A

20-25%

119
Q

what are the two clinically important areas of the peritoneal cavity related to the liver?

A
  • hepatorenal recess (morrisons pouch)

- sub-phrenic recess

120
Q

what does the hepatic portal vein (HPV) do?

A

drains blood from foregut, midgut and hindgut to the liver for first pass metabolism (cleaning)

121
Q

what is the hepatic portal vein formed by?

A 
splenic vein (drains foregut) 
superior mesenteric vein (midgut)
122
Q

what does the inferior mesenteric vein do?

A

drains the blood from the hindgut to the splenic vein

123
Q

what does the inferior vena cava do?

A

drains the cleaned blood from the hepatic veins into the right atrium

124
Q

what does bile flow out/in the gallbladder via?

A

cystic duct

125
Q

what is the blood supply to the gallbladder?

A

cystic artery

126
Q

what is the cystic artery a branch of in most people?

A

right hepatic artery

127
Q

where is the cystic artery located?

A

cystohepatic triangle (of calot)

128
Q

what is gallbladder pain a result of?

A

inflammation of the gallbladder or cystic duct following irritation from or impaction of a gallstone

129
Q

what is the name for the surgical removal of the gallbladder?

A

cholecystectomy

130
Q

where will gallbladder pain present?

A

early pain in the epigastric region, can also present in the hypochondrium with or without pain referral to the right shoulder - a result of anterior diaghragmatic irritation

131
Q

what does the central vein do?

A

collects cleaned blood and drains into the hepatic veins

132
Q

what is the biliary tree made up of?

A

a number of ‘ducts’ which transport bile

133
Q

what do the right and left hepatic ducts unite to form?

A

common hepatic duct

134
Q

what does the common hepatic unite with?

A

cystic duct to form bile duct

135
Q

what does the bile duct drain into?

A

2nd part of duodenum, along with main pancreatic duct

136
Q

what are the four parts of the duodenum called?

A
  1. superior - duodenal cap (relatively mobile)
  2. descending
  3. horizontal
  4. ascending
137
Q

where does the duodenum begin?

A

pyloric sphincter

138
Q

where does the duodenum end?

A

duodenojejunal flexure

139
Q

what does the duodenum secrete?

A

a number of peptide hormones into blood e.g. gastrin and CCK

140
Q

where can pain from duodenal ulcer be felt?

A

epigastric region

141
Q

what is the pancreas described as having?

A

head
neck
body
tail

142
Q

what lies posteriorly to the pancreas?

A 
right kidney and adrenal gland 
IVC
bile duct 
abdominal aorta 
superior mesenteric vesels 
left kidney and adrenal gland 
part of the portal venous system
143
Q

what lies anteriorly to the pancreas?

A

stomach

144
Q

what surrounds the head of the pancreas?

A

duodenum

145
Q

what lies superoposteriorly to the pancreas?

A

splenic vessels

146
Q

what are the functions of the pancreas?

A

exocrine: acinar cells - pancreatic digestive enzymes into main pancreatic duct
endocrine: islets of langerhans - insulin and glucagon into bloodstream

147
Q

what does the bile duct form when it joins the main pancreatic duct?

A

ampulla of vater/ hepatopancreatic ampulla

148
Q

what are anatomical sphincters?

A

discrete areas where muscle completely encircles the lumen of the tract

149
Q

what sphincters are located in the biliary tract?

A

bile duct sphincter
pancreatic duct sphincter
sphincter of oddi

150
Q

what is endoscopic retrograde cholangiopncreatography (ERCP)?

A

investigation used to study the biliary tree and pancreas and treat some pathology associated with it

151
Q

what is involved in an ERCP?

A
  • endoscope inserted through oral cavity, oesophagus, stomach and into duodenum
  • cannula placed into major duodenal papilla and radio-opaque dye injected back into biliary tree
  • radiographic images taken of dye-filled biliary tree
152
Q

what could cause an obstruction of the biliary tree?

A

gallstones

carcinoma at head of pancreas

153
Q

what is inflammation of the pancreas called?

A

pancreatitis

154
Q

what is a potential cause of pancreatitis?

A

blockage of ampulla by a gallstone - bile is then diverted into pancreas leading to irritation and inflammation

155
Q

where would pain from the pancreas be present?

A

epigastric and/or umbilical region and can also radiate to back

156
Q

what can happen in advanced cases of pancreatitis?

A

vascular haemorrhage leading to blood/fluid accumulation in the retroperitoneal space

157
Q

where does the jejunum begin?

A

at duodenaljejunal flexure

158
Q

where does the ileum end?

A

ileocaecal junction

159
Q

what are the differences between the jejunum and ileum?

A

colour - jejunum is deep red, ileum is lighter pink

wall - jejunum is thicker and heavy, ileum is thinner and lighter

vascularity - jejunum is more vascular, ileum is less vascular

mesenteric fat - jejunum has less

circular folds - jejunum has large, tall and closely packed fold, ileum has low and sparse folds

lymphoid tissue - present in ileum

160
Q

where does arterial blood come from to the jejunum and ileum?

A

from superior mesenteric artery via jejunal and ileal arteries

161
Q

what is the venous drainage of the jejunum and ileum?

A

from jejunal and ileul veins to superior mesenteric vein to hepatic portal vein

162
Q

what do vessels travel within?

A

the mesentery

163
Q

where are proteins and carbohydrates absorbed?

A

from the small intestine into the portal venous system to be taken to liver

164
Q

at what vertebral level do the superior mesenteric vessels leave the aorta?

A

L1

165
Q

how is fat absorbed?

A

bile helps absorb fat from GI tract into intestinal cells, they are then absorbed into specialised lymphatic vessels of the small intestine called lacteals, they travel via the lymphatic system to eventually drain into the venous system at the left venous angle

166
Q

what are the main groups of lymph nodes draining abdominal organs?

A
  • celiac
  • superior mesenteric
  • inferior mesenteric
  • lumbar
167
Q

what do superficial lymph vessels drain into?

A

deep lymph vessels

168
Q

what will lymphs either drain into?

A

thoracic duct
or
right lymphatic duct

169
Q

where are the venous angles?

A
  • junction between subclavian and internal jugular veins
  • left venous angle - thoracic duct drainage
  • right venous angle - right lymphatic duct drainage
170
Q

what are the functions of the large intestine?

A

defence
absorption - H2O and electrolytes
excretion

171
Q

Where are the paracolic gutters located?

A

between lateral edge of ascending and descending colon, and abdominal wall

172
Q

what are the three distinguishing features of the colon?

A

omental appendices
teniae coli
haustra

173
Q

what are teniae coli?

A

3 distinct longitudinal bands of thickened smooth muscle, running from caecum to distal end of sigmoid colon, come together at the appendix

174
Q

what are omental appendices?

A

small, fatty projections

175
Q

where do the caecum and appendix lie?

A

right illiac fossa

176
Q

where does the sigmoid colon lie?

A

left illiac fossa

177
Q

what does the sigmoid mesocolon give?

A

a degree of movement to the sigmoid colon

178
Q

what is the negative side of a sigmoid mesocolon?

A

risk of twisting around itself - sigmoid volvulus - results in bowel obstruction

179
Q

what are the three midline branches of the abdominal aorta?

A

celiac trunk
superior mesenteric artery
inferior mesenteric artery

180
Q

what do the lateral branches of the abdominal aorta supply?

A 
kidneys/adrenal gland
gonads (testes/ovaries)
body wall (posterolateral)
181
Q

what do the abdominal aorta bifurcate into and where?

A

common iliacs at L4. further bifurcate to internal and extrernal iliacs

182
Q

what could the arterial anastomoses between the SMA and the IMA help prevent and how?

A

intestinal ischaemia by providing an alternative route by which blood can travel

183
Q

what vessel supplies blood to the rectum and anal canal?

A

superior rectal artery (branch of IMA)

184
Q

what is the remainder (not rectum and anal canal) supplied by?

A

internal iliac artery

185
Q

what are the two main venous systems in the body?

A

hepatic portal venous system and systemic venous system

186
Q

what does the hepatic portal venous system do?

A

drains venous blood from absorptive parts of the GI tract and associated organs to the liver for ‘ cleaning’

187
Q

what does the systemic venous system do?

A

drains venous blood from all other organs and tissues into the superior or inferior vena cava

188
Q

what does the inferior vena cava do?

A

drains cleaned blood from the hepatic veins into the right atrium

189
Q

what does the hepatic portal vein do?

A

drains blood from foregut, midgut and hindgut structures to the liver for first pass metabolism

190
Q

what does the splenic vein do?

A

drains blood from foregut structures to hepatic portal vein

191
Q

what does the superior mesenteric vein do?

A

drains blood from midgut structures to hepatic portal vein

192
Q

what does the inferior mesenteric vein do?

A

drains blood from hindgut structures to splenic vein

193
Q

what are the 3 clinically important sites of venous anastomosis between systemic and portal venous systems?

A

distal end of oesophagus
skin around umbilicus
rectum/anal canal

194
Q

what does blood do in the portal-systemic anastamosis?

A

can go either into systemic or portal venous system, normally there is very little blood flow within these collateral veins

195
Q

what does portal hypertension lead to?

A

reversal of blood flow, larger volume of bloof to the anastomatic (collateral) areas causes them to be varicosed

196
Q

what an cause portal hypertension?

A

liver pathology and tumour compressing HPV

GI (10 decks)

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