Anatomy Flashcards
What are the names of the 3 pairs of jaw closing muscles?
- masseter
- temporalis
- medial pterygoid
Name of the muscle responsible for opening the jaw?
- lateral pterygoid
- (horizontal muscle)
opening the mouth is supplied by what nerve?
- trigeminal nerve
- CN V3
What are the names of the 3 major salivary glands?
- parotid
- submandibular
- sublingual
the CN V2 is a _______ nerve?
- sensory
- trigeminal
The purpose of the gag reflex
- protective reflex
- constrict the pharynx
Sensory part of the posterior oral cavity is supplied by what nerve?
- CN IX
The motor part of the gag reflex is supplied by what nerve?
- CN IX and CN X
The posterior part of the tongue can also be called the____
- anterior wall of the oral pharynx
What are the functions able to be preformed by CN VII
- Special sensory
- sensory
- motor
- parasympathetic
Where does CN VII originate in the skull?
- pontomedullary junction
Which cranial nerve supplies the sublingual salivary gland?
- CN VII
What gland does CN IX supply?
- parotid gland
What nerve supplies the tongue muscles, except palatoglossus?
- CN XII
Name of the muscle responsible for changing the shape of the tongue?
- skeletal intrinsic muscle
- lies dorsally
Name of the oesophageal sphincter muscle and where is it located?
- cricopharyngeus
- Located at C6
The oesophagus is a continuation of the _____
- laryngoparynx
The oesophagus is a muscular tube
True/false
- TRUE
- if nothing if going down it, it will be closed, walls collapse in on itself
To speed up the movement of the oesophagus what system is involved?
sympathetic or parasympathetic?
- parasympathetic
- remember parasympathetic is rest and digest, digestion is promoted
The oesophagus is ____ to the trachea?
- anterior or posterior?
- posterior
Oesophagus goes through the diaphragm at what level?
- T 10
- oesophagus (10 letters)
Inferior vena cava passes diaphragm at what level?
- T8
- Vena cava (8 letters)
What is the line called between the oesophagus and the stomach?
- Z line
- or gastro-oesophagel junction
- complete change in mucosa lining
What are the 3 parts of the Small intestine?
- duodenum
- jejnum
- ileum
What is the large intestine made up of?
- colon
- rectum
- anal canal
- anus
What are the 3 areas of the abdominal organs?
- forgut
- midgut
- hindgut
What makes up the foregut?
- oesophagus to mid-duodenum
- liver gallbladder spleen and 1/2 of pancreas
What makes up the midgut?
- mid-duodenum, to proximal 2/3rd of transverse colon
- 1/2 of the pancreas
What is the peritoneum?
- thin, transparent, semi-permeable serous membrane
- secretes parietal
- parietal peritoneum
- visceral peritoneum
What does intraperitoneal mean?
- fully wrapped in peritoneum
What does with a mesentery mean?
- double layer of peritoneum
What does rectoperitoneal mean?
- covered anterior
How are the intestines mobile?
- due to the mesentery (double layer of peritoneum )
What Is the Greater omentum?
- 4 layer fold
- there are blood vessels, nerves, lymphatics
Wha is the lesser omentum?
- smaller than the greater omentum
- is its behind the stomach
What are the two peritoneum pouches in a female?
- recto-uterine pouch
- vesico-uterine pouch
What is ascitic fluid and how do you treat?
- excess fluid within the peritoneal cavity as a result of pathology
- paracentesis
Irritated diaphragm where might the pain be referred?
- the shoulders
- phrenic nerve supplies both areas
Where can sympathetic nerves leave the central nervous system?
- T5 and L2
- except for the adrenal gland
What is different for the adrenal glands?
- the sympathetic nerves synapse at the adrenal gland itself
- leave the central nervous system at T10-L1
What does the vagal nerve supply in the parasympathetic pathway? what then takes over?
- from the brain to the distal end of the transverse colon
- the pelvic splanchnic nerve takes control past the colon
Pain in the epigastric region, what organs may be effected?
- the foregut
Pain in the umbilical region, what organs may be effected?
- midgut
Pain in the pubic region, what organs may be effected?
- hindgut
Foregut organs pain will enter the spinal cord at what region?
- T6-T9
Midgut organs pain will enter the spinal cord at what region?
- T8-T12
Hindgut organs pain will enter the spinal cord at what region?
- T10-L2
What is bilirubin?
- normal by-product of the breakdown of red blood cells
Where does the breakdown of red blood cells occur?
- spleen
What is bilirubin used for?
- formation of bile
- in the liver
What is the gallbladders role in terms of bile?
- storage and concentration of bile
What does the pancreas do?
- excretes digestive enzymes into the 2nd part of the duodenum
- necessary for the digestion of food
Where is the portal triad found?
- free edge of the lesser omentum
What is the portal triad composed of?
- hepatic artery
- hepatic portal vein
- common bile duct
What is the name of the first of the three midline branches of the abdominal aorta?
- celiac trunk
What is the role of the celiac trunk?
- supplies organs of the foregut
What are the 3 trifurcates of the celiac trunk?
- splenic artery
- hepatic artery
- left gastric artery
What is the function of the spleen?
- within the haematological system
- breaks down red blood cells to produce bilirubin
What ribs protect the spleen?
- ribs 9-11
What side of the stomach does the right and left gastric arteries run?
- along the lesser curvature of the stomach
What side of the stomach does the right and left gastro-omental arteries run?
- along the greater curvature of the stomach
What occurs in the liver?
- conversion of bilirubin to bile
What ribs protect the liver?
- 7-11
What are the names of the 2 clinically important peritoneal cavities?
- Hepatorenal recess (Morison’s pouch) –> 1 of the lowest
- sub-phrenic recess
What is the name of the neck of the gallbladder where bile flows out of?
- cystic duct
If there is inflammation in the gallbladder, where might pain be felt?
- visceral afferents
- early - epigastric region
- hypochondrium
- may have pain referral to the right shoulder
What is the clinical appearance of jaundice and why?
- yellowing of the sclera/skin
- caused by increase in the blood levels of bilirubin
- may be due to an obstruction of the biliary tree
What does the central vein in the liver drain?
- collects cleaned blood and drains into the hepatic veins
The right and left hepatic ducts unite to form what?
- common hepatic duct
Common hepatic duct unites with the cystic duct to form what?
- common bile duct
The bile duct drains into what part of the duodenum?
- 2nd part of the duodenum
The bile duct unites with what before draining into the duodenum?
- main pancreatic duct
- forms the ampulla of Vater
Bile drains from what into the duodenum from the ampulla of Vater?
- major duodenal papilla
What sphincter is responsible for bile drainage into the duodenum?
- sphincter of Oddi
What are the consequences of an obstructed biliary tree?
- back flow of bile into the liver
- overspill into the blood
- jaundice
What are the regions of the pancreas?
- head (‘c-shaped duodenum’)
- neck
- body
- tail
The pancreas is a _______ organ?
- rectroperitoneal
What is the sympathetic and parasympathetic nerves of the pancreas?
- s - abdominoplevic splanchnic nerve
- p- vagus nerve
Where might pancreatic pain be felt?
- epigastric / umbilical
- may radiate to the back
What are the 4 parts of the duodenum?
- superior
- descending
- horizontal
- ascending
What does the duodenum secrete?
- peptide hormones
- gastrin , CCK
Where does the ileum end?
- ileocaecal junction
How does the mucosa differ between the ileum and the jejunum?
- jejunum (more folds)
- ileum much smoother
- jejunum more fat and thicker walled
How are fats within chylomicrons absorbed?
- absorbed from the intestinal cells into specialised lymphatic vessels
- travel via lymphatic system and drain at left venous angle
What are the 4 lymphatics of the abdomen?
- celiac
- superior mesenteric
- inferior mesenteric
- lumbar
How many paracolic gutters are there? and what is their clinical importance?
- there are 2 paracolic gutters
- they are important as they can collect pus during infection
What is teniae coli?
- 3 distinct longitudinal bands of thickened smooth muscle
what lies more superiorly? the splenic flexure or hepatic flexure?
- the splenic flexure lies more superiorly
What is sigmoid volvulus and what can it lead to?
- twitting of the sigmoid colon
- can result in bowel obstruction and infarction
- the sigmoid colon is highly mobile
What are the 3 midline branches of the abdominal aorta?
- celiac trunk
- superior mesenteric artery
- inferior mesenteric artery
what is formed when the abdominal aorta bifrucates?
- forms common iliacs
What arterial anastomoses can help protect against intestinal ischaemia?
- marginal artery of Drummond
After the distal midpoint of anal canal, what is the arterial blood supply provided by?
- internal iliac artery
Define haematemesis
- vomiting blood
What may be the clinical appearance of portal hypertension?
- oesophageal varices
- caput medusae (dilated epigastric veins)
- rectal varices
What is faecal continence?
- the control of the excretion of faeces
What is faecal continence composed of?
- holding area
- visceral afferent nerves
- muscle sphincters
- cerebral function
What may affect faecal continence?
- neurological pathology
- medications
- age related degeneration
- consistency of stool
What is the name given to the pelvic floor muscle?
- Levator Ani
At what spinal level does the sigmoid colon become the rectum?
- S3
The rectal ampulla lies _____ to the levator and muscle?
- superiorly
What type of muscle is the levator ani?
- skeletal
What muscle is part of the levator and that works to decrease the anorectal angle>
- puborectalis
What are the names of the anal sphincters?
- internal anal sphincter
- external anal sphincter
Explain the internal anal sphincter?
- smooth muscle
- superior two thirds of anal canal
- contraction stimulated by sympathetic nerves
Explain the external anal sphincter?
- skeletal muscle
- inferior two thirds
- contraction stimulated by the pudendal nerve
What levels does the sympathetic nerves come out in rectum/anal canal?
- T12-L2
What levels does the parasympathetic nerves come out in the rectum/anal canal
- s2-s4
What may occur during labour?
- fibres within the puborectalis or external anal sphincter may be torn
- pudenal nerve may be stretched
What does the pectinate line mark?
- the junction between the endoderm and the ectoderm
What nerve supply is above the pectinate line?
- autonomic
What nerve supply is below the pectinate line?
- somatic
- pudendal
Where does the internal iliac drain?
- inferior pelvic structures
Where does the external iliac drain?
- lower limbs and superior pelvic structures
Where does the common iliac drain?
- drains lymph from the external and internal iliac nodes
What is venous drainage above the pectinate line?
- inferior mesenteric vein
What is venous drainage below the pectinate line?
- the internal iliac vein
What is an ischioanal abscess?
- infection within the ischioanal fossa
Define herniation
- any structure passing through another
- but ending up in the wrong place
What 2 factors are required for a hernia to be formed?
- structural weakness
- increased pressure
What is structural weakness that may cause a hernia?
- diaphragm
- umbilicus
- inguinal canal
- femoral canal
- surgical scars
What increased pressures may cause a hernia?
- chronic cough
- pregnancy
- staining during bowel movements
Where anatomically is the inguinal region?
- hip crease
What is the linea alba?
- mid line of the body
What is the linea semilunaris?
- separates the anterior and lateral abdomen.
What is the order of the muscles from the external to the deep abdominal muscles?
- external oblique muscle
- internal oblique muscle
- transversus abdominis muscle
What is the lnguinal ligament?
- boundary between the abdomen and the thigh
- inferior thickening of the external oblique muscle
What lies above and below the inguinal ligament?
- above = inguinal canal
- below = sublingual space
What is the entrance and exit of the inguinal canal?
- entrance = deep inguinal ring
- exit = superficial inguinal ring
What does the inguinal canal contain?
- spermatic cord
- round ligament of uterus
- blood and lymph vessels
ilioinguinal nerve
Where is the Hesselbach’s triangle locates?
- posterior surface of anterior lateral abdominal wall
What are the 3 sides of in inguinal triangle?
- inguinal ligament
- lateral border of rectus abdominis
- inferior epigastric artery
Explain a direct inguinal hernia
- directly through the abdominal wall - weakness in the floor of inguinal canal
- lies parallel to the spermatic cord
Explain an indirect inguinal hernia?
- uses inguinal canal and deep inguinal ring
- within the spermatic cord
What is the name given to the anatomical weakness in which hernias may be found?
- myopectineal orficie
Types of hernias?
- epigastric
- umbilical
- inguinal
- femoral
- lumbar
- spigelian
What are the 3 classifications of a hernia?
- reducible
- incarcerated / irreducible
- strangulated
Define a reducible hernia?
- hernia can be easily pushed back into the abdomen
Define a incarcerated or irreducible hernia?
- when a hernia cannot be manipulated back to the abdomen
Define a strangulated hernia?
- vascular supply to the contents contained within the hernia is compromised, resulting in ischaemic and gangrenous tissue
Explain an epigastric hernia?
- fascial defect in the linea alba between the xiphoid process and the umbilicus
What is a sphincter?
- muscle completely encricles the lumen of the tract
What is ERCP used for?
- to investigate the pancreas and biliary tree
- bile stones can be removed
- endoscope place in oral cavity, and dye injected into major duodenal papilla
Explain the journey of absorpbed fats in the small intestine
- bile helps absorb
- absorbed into intestinal cells then into specailised lympathic vessels - lacteals
- carried in lymphatic circulation
- drain into left venous angle
What are lacteals?
- specailsed lympathic vessels which fat drain into
What is portal systemic anastomoses and where is it seen?
- anastomoses between portal and systemic venous systems
- oesophagus
- umbilicus
- rectum/anal canal
What drains the superior aspect of the anal canal and inferior?
- superior –> inferior mesenteric vein
- inferior –> internal ileac vein
Where is caput medusae seen?
- epigastric region
- dilation of collateral veins
What are haemorrhoids?
- prolapse of rectal venous plexus
- due to raised pressure, e.g. constipation, straining or pregnancy
