Anatomy Flashcards
What muscles are responsible for opening and closing of the mouth?
Opening - lateral pytergoid
Closing - temporalis, masseter and medial pterygoid
What nerve controls mastication?
CN V3
Name the bony processes of the TMJ and what bone they belong to
Head of the condylar process - mandible
Articular tubercle - temporal
Mandibular fossa - temporal
Name the three salivary glands in the face and what nerve controls each
Parotid - CN IX
Sublingual - CN VII
Submandibular - CN VII
Describe the nervation for superior and inferior halves of oral cavity
Superior - CN V2
Inferior - CN V3
What gland inserts into the mouth via the floor of the mouth with linguinal caruncle
Submandibular
Name the tonsils that can be seen at the back of the mouth
Palatine
What nerves can be found in the tongue, anterior and posterior regions? What nerve is responsible for taste?
Ant 2/3 - CN V3 and CN VII (taste)
Post 1/3 - CN IX
What papillae have no taste? Name the other papillae found on tongue from most distal to proximal
Filiform - just touch and temp found at tip of tongue Filiform Fungiform Follate (back side of tongue) Vallate (large back of tongue) GO TO MINDMAP !!
What nerve controls muscle found around lips and what is it called?
CN VII
Orbicularis oris
What nerves control motor and sensory response of gag reflex
Motor - CN IX and CN X
Sensory - CN IX
Link to muscle innervation of pharynx and post tongue
What roles do the intrinsic and extrinsic muscles of the tongue have?
Intrinsic - shape of tongue (intrinsic = natural -> nautrally have shape to our tongues)
Extrinsic - poistion of tongue
Name the 4 pairs of intrinsic muscles of tongue. What nerve controls them?
Palatoglossus - CN X
Styloglossus - CN XII
Hyoglossus - CN XII
Genioglossus - CN XII
What are tonsils?
Aggregates of lymphoid tissue
Where can the superior constrictor, middle constrictor and inferior constrictor muscles be found?
Outer circular layer of muscle in pharynx
What nerve innervates the circular and longitudinal muscle in pharynx?
Circular - CN X and CN IX
Longitudinal - CN X
What level does the pharynx become the anatomical upper oesophageal sphincter and then oesophagus?
C6
At what level does the oesophagus, aorta and IVCpass through the diaphragm?
I ate 10 eggs at 12
IVC - T8
Oesophagus - T10
Aorta - T12
What is different about the muscle layers in the stomach?
The stomach has an oblique layer in muscularis externa
Name the layers of the digestive tract wall from most deep to superficial
Mucosa - Epithelium - Lamina Propria - Mucularis mucosae Submucosa Muscularis externa Adventita
MSMS and ELM tree
Differentiate between visceral and somatic pain
Visceral - dull and achy - hard to localise
Somatic - sharp and stabbing - easy to localise
Whats the only part of GI tract that has oblique muscle in muscularsis externa as well as circular and longitudinal?
Stomach - oblique - deepest layer
Thinking of the wee man name the branches of the coeliac trunk
Look at mindmap
- Left gastric artery
- Splhenic artery
- Common hepatic artery
- > gastric duodenal
- > right gastric artery
- > proper hepatic artery- > left hepatic artery
- > right hepatic artery
- > cystic artery
What arteries anastome on lesser and greater curvature of stomach?
What artery supplies the posterior aspect of the stomach?
Lesser - right and left gastric arteries
Greater - right and left gastro-omental arteries
Sphlenic
What level does the coeliac trunk appear?
just after T12 (aortic hiatus)
What artery gives rise to superior panceratic-duodenal?
Gastroduodenal
Name the layers of the abdominal muscles from most superficial to deep
External oblique Internal oblique (rectus abdominis same level in midline) Transversus abdominis
Name the 9 regions of the abdo
Right hypochondrium, epigastric. left hypochondrium
Right lumbar, umbilicus, left lumbar
Right inguinal, pubic, left inguinal
Name the 4 nerves of the abdo. body wall from superior to inferior
Thoraco-abdominal
Subcostal
Iliohypogastric
Iliohypoinginual
The abdominal body wall is innervated with paraysympathetic, somatic motor and sensory nerves. True/False
False - somatic sensory and motor AND SYMPATHETIC nerves
It is known a patient has a problem with their small bowel. Pain is felt in the epigastric region. What part of the small bowel is likely to be affected?
Duodenum as foregut organ
Pain for jejenum and ileum likely to be felt in umbilical area due to being midgut organs
Is the small intestine intra or retroperitoneal?
The first part of duodenum ad is intraperitoneal like the rest of the small bowel.
The descending, horizontal and ascending part of duodenum is retroperitoneal
Difference between intraperitoneal, with a mesentry and retroperitoneal?
Intra - covered in visceral peritoneum - minimal movement against the posterior body wall
Retro - visceral peritoneum on anterior surface only - held in retroperitoneum (think retro = old days = hidden away)
With mesentry - means very mobile - double layer of visceral peritoneum behind the organ allowing it to be suspended from posterior abdo wall
Where do panceratic and bile secretions enter the duodenum
In the descending part of the duodenum via the major duodenal papilla - protusion of the Ampulla of Vater
How can you tell the difference between the ileum and jejenum?
only macroscopically
jejunum has plicae circulares (folds in mucosa) gets more smooth as goes towards and through ileum
Where does jejunum start?
Duodenaljujenumonal flexture/junction
Where does ileum end and caecum start
Ileocaeceal junction
What are Peyer’s Patches and where are they found?
Aggregates of lymphoid tissue - ileum
At what level would you find the 3 big branches of the abdominal aorta?
Coeliac trunk - T12 (same as aortic hiatis)
SMA - L1
IMA - L2
Name the organs found in fore, mid and hind-gut and state the arterial, venous and lymphatic supply to each
Fore - oesophagus, spleen, stomach, liver, gallbladder, 1/2 pancreas to D2 duodenum
Mid - D2 to proximal 2/3 of transverse colon and 1/2 pancreas
Hind - distal 1/3rd of transverse colon to proximal 1/2 of anal canal
Fore - coeliac trunk, splenic vein and coeliac lymph nodes
Mid - SMA, SMV and superior mesenteric lymph nodes
Hind - IMA, IMV and inferior mesenteric lymph nodes
Where would you find the Marginal Artery of Drummond and what is it?
What is its clinical significance?
Anastomoses of IMA and SMA found as a continuous arterial circle along the inner border of the transverse colon
Most common site of ischaemia - splenic flexure region
Name the branches of the SMA and IMA
SMA - superior panceraticodudoenal middle colic right colic ileocolic appendicular arteries to jejunum and ileum
IMA - left colic
sigmoid colic
superior rectal
When liver undergoes damage and portal pressure increases what can appear
Varices - dilation of anatomises sites between systemic and portal system
- Oesophageal (between hepatic portal and azygous)
- Caput medusae (reopen ligamentum teres)
- Rectal varices (between IMV and internal iliac vein)
Describe the blood flow through portal system
IMV - splenic
Splenic and SMV -> hepatic portal vein -> IVC
Name the 4 lymph nodes of the abdo
Coeliac nodes
Superior mesenteric nodes
Inferior mesenteric nodes
Lumbar nodes (kidneys, pelvis, abdo wall and limbs)
Where is fluid likely to gather in a patient in supine postion?
Subphrenic and LOWEST point = hepatorenal pouch (Pouch of Morrison)
Name the 4 lobes of the liver
Right
Left
Caudate
Quadrate
What is the portal triad formed of?
Branches of:
Hepatic portal vein
Proper hepatic artery
Common hepatic duct
How many functioning segments of the liver are there?
8
Describe blood and bile flow through a lobule
Blood flows from portal vein through sinusiods to central vein -> IVC
Bile is produced by hepatocytes and flows towards bile duct via canaliculi -> gallbladder
Flow is in opposite directions
What ribs protect the liver?
7-11 (think of 7/11)
What is Calot’s Triangle used to find?
Cystic artery
Inferior border of liver - to top
Common hepatic duct
Cystic duct
When the neck of the gallbladder narrows what is formed?
Cystic duct
Where is the gallbladder found?
On the posterior surface of the liver
Anteriorly to the duodenum
What is the Ampulla of Vater?
When common bile duct and pancreatic duct join together
Why are haustra formed and where are they found?
Colon
Formed by tonic contraction of teniae coli
What are teniae coli?
3 bands of longitudinal muscle from caceum to SIGMOID COLON
What is the name for the fatty deposits found on the colon?
Omental appendices
How does the caecum open into appendix?
Appendicular orifice
Colon has microvilli and villi. True/False?
False - colon has microvilli only
Small bowel - microvilli and villi
Function of the gallbladder
To store and concentrate bile
Where can pancreatic pain be felt?
Foregut - epigastric
Midgut - umbilical
Retroperitoneal - back pain
What organ can be found anteriorly to the aorta at L2 and anterior to left kidney, pointing towards the spleen?
Pancreas
What two ways does the pancreas get its arterial blood supply?
Tail - Branches off the splenic artery
Head - Inferior and superior pancreatico-dudodenal arteries anastomose
What nerves supply the pancreas?
Symp - abdominopelvic splanchnic
Para - vagus nerve
What is the difference between endocrine and exocrine gland of pancreas?
Endocrine - released into blood - involves Islets of Langerhans - insulin and glucagon
Exocrine - released into bile ducts - digestive juices and enxymes
Describe the pathway of exocrine enzyme production in pancreas?
Produced by acinar cells -> collecting ducts -> pancreatic duct
What is the difference between haemorrhoids and rectal varices?
Rectal varices - related to portal hypertension and dilation of collateral veins
Haemorrhoids - prolapse of rectal venous plexus due to increased general pressure (not blood pressure)
Name the 3 muscles which make up the pelvic floor muscle and what is it’s name?
Levator ani
- Puborectalis
- Pubococcygeal
- Ileococcygeal
What happens to the levator ani muscle on coughing and sneezing
Reflexively contracts further
What nerve supplies the levator ani?
S2, 3 and 4
S2, 3 and 4 keep the 3 Ps off the floor - poo, pee and penis
At what stage does the sigmoid colon become the rectum and the rectum become the anal canal?
Sigmoid colon -> rectum = ant. to S3
Rectum -> anal canal = ant. to coccyx
What is the pectinate line?
An embryological line in anal canal
Above = endoderm = GI tract
Below = ectoderm = skin
Name the artery, vein and lymph for the anal canal
Above pectinate line = rectum and proximal 1/2 of anal canal
A - IMA (via sup rectal artery)
V - IMV (via sup rectal vein - portal system)
L - IM lymph nodes
Below pectinate line = distal 1/2 of anal canal
A - internal iliac artery (via middle and inferior rectal arteries)
V - internal iliac vein (systemic system)
L - superficial inguinal nodes
What two sphincters are present in the anus? What muscle are each made up of?
Internal sphinter = smooth muscle
External sphincter = skeletal muscle
What sphincter in the anus in constantly contracted until distension causes relaxation and defeacation?
Internal is constantly contracted until distension causes relaxation
WITH contraction of external = defecation
Name the areas on either side of the anal canal filled with fat and connective tissue. What do these areas become a risk site for?
Ishioanal fossae
Sites of abscess formation
What level is the bifurcation of the aorta?
L4
What artery does the cystic artery most commonly branch off?
Right hepatic artery
Where is the site of the femoral artery?
Halfway between the ASIS and the pubic symphysis
What ligament is the portal triad found in?
Hepatoduodenal ligament
