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Anatomy Flashcards

1
Q

What makes up the small intestine?

A
  1. Duodenum 2. Jejunum 3. ileum
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2
Q

What makes up the large intestine?

A
  1. Caecum
  2. ascending colon
  3. transverse colon
  4. descending colon
  5. sigmoid colon
  6. rectum
  7. anal canal
  8. appendix
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3
Q

What is the longitudinal layer which is concentrated into three bands in the large intestine called?

A

Taeniae coli

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4
Q

What is the difference between the mucosa of the large and small intestines?

A
  1. Large intestine contain no villi but do have microvilli and crypts
  2. Tighter tight junctions in the large intestine- prevents back diffusion of ions into the lumen
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5
Q

What does the parasympathetic branches of the vagus innervate in the large intestine?

A

Caecum, ascending and tranverse colon

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6
Q

What does the parasympathetic branches of the pelvic from the sacral spinal cord innervate in the large intestine?

A

Descending and sigmoid, rectum and anal canal

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7
Q

What supplies the sympathetic fibres to the large intestine?

A

superior mesenteric plexus
inferior mesenteric plexus
superior hypogastric plexus

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8
Q

What supplies the sympathetic fibres to the anal canal and rectum?

A

inferior hypogastric plexus

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9
Q

What is the difference between the external and internal sphincters’ structures?

A

Internal sphincter- circular

External sphincter- striated

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10
Q

What are the accessory structures?

A

i. Salivary glands
ii Pancreas
iii. Liver and gall bladder

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11
Q

What are the layers of the tract wall from deep to superficial?

A

Mucosa
Submucosa
Muscularis externa
Serosa

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12
Q

What makes up the mucosa layer?

A

Mucous membrane
Lamina propria
Muscularis mucosae

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13
Q

What makes up the submucosa layer?

A

Connective tissue
larger blood and lymph vessels glands
submucous plexus

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14
Q

What makes up the muscularis externa?

A

Circular muscle layer
Myenteric plexus
Longitudinal muscle layer

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15
Q

What makes up the serosa?

A

Connective tissue

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16
Q

What three pairs of muscles are involved in closing of the jaw?

A
  1. Tempeoralis
  2. Masseter
  3. Medial pterygoid
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17
Q

Which pair of muscles are involved in the opening of the jaw?

A

Lateral Pterygoid.

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18
Q

Where does the jaw open?

A

TMJ (temperomandibular joint)

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19
Q

Which nerve supplies these muscles related to the Jaw?

A

CN V3- mandibular division of the trigeminal

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20
Q

Describe the course of the CN V3

A
  1. Starts in the pons goes through the formaen ovale then to muscles of mastication and sensory area
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21
Q

What are the bottom layer of the teeth referred to as?

A

Mandibular teeth

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22
Q

What are the top layer of teeth referred to as?

A

Maxillary teeth

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23
Q

Which arteries and supply the maxillary teeth?

A

Superior alveolar arteries/vein

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24
Q

Which arteries and veins supply the mandibular teeth?

A

inferior alveolar arteries/vein

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25
Q

Where do the lymph vessels of the teeth and gingivae mainly drain to?

A

Submandibular lymph node

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26
Q

what nerves supply the mandibular teeth?

A

inferior alveolar nerve ( CN V3)

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27
Q

What nerves supply the maxillary nerves?

A

superior alveolar nerve (CN V2)

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28
Q

What are the main sections of the tongue?

A
  1. apex (tip)
  2. Anterior part (body)
  3. Posterior part (root)
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29
Q

What are the two surfaces of the tongue?

A
  1. Dorsum of the tongue ( superior)

2. Inferior surface of the tongue ( underside0

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30
Q

What are the gingivae?

A

gums

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31
Q

What separates the posterior and anterior part of the tongue on the dorsum surface?

A

terminal sulcus and foramen cecum

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32
Q

where are the lingiual papillae found?

A

Anterior part of the tongue

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33
Q

Name the different types of lingual papillae.

From anterior to posterior

A
  1. Fungiform
  2. filiform
  3. vallate
  4. Foliate
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34
Q

What divides the anterior of the tongue into left and right?

A

midline groove

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35
Q

What are the groups of lymphoid nodules called on the tongue?

A

Lingual tonsil

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36
Q

Where is the lingual tonsil found?

A

Mucosa of the posterior part of the tongue.

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37
Q

What connects the inferior surface of the tongue to the floor of the mouth?

A

Frenulum of the tongue

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38
Q

What are the three pairs of salivary glands?

A
  1. Parotid
  2. sublingual
  3. submandibular
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39
Q

What does the superior half of the oral cavity consist of in regards to sensation areas?

A

Gingiva of oral cavity and palate

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40
Q

What does the inferior half of the oral cavity consist of in regards to sensation areas?

A

gingiva of oral cavity and floor of mouth

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41
Q

Where does the anterior part of the tongue lie in the mouth?

A

oral cavity proper

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42
Q

Where does the posterior part of the tongue lie in the mouth?

A

oropharynx

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43
Q

Which nerve overall supplies the superior half of the oral cavity?

A

CN V2

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44
Q

Which nerve overall supplies the inferior half of the oral cavity?

A

CN V3

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45
Q

What is the name of the CN V2?

A

Maxillary division of the trigeminal nerve

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46
Q

What is the name of the CN V1?

A

Opthalmic division of the trigeminal nerve

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47
Q

How many divisions of the trigemnial nerve are there?

A

3

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48
Q

What is the course of the CNV2 sensory fibres?

A

Starts at pons

through Foramen rotundum

to Sensory area (midface)

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49
Q

What type of reflex is the gag reflex?

A

Protective reflex

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50
Q

Which nerves carry the sensory part of the gag reflex?

A

CN IX

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51
Q

Which nerves carry the motor part of the gag reflex?

A

CN IX and CN X

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52
Q

What occurs during the gag reflex?

A

Causes constriction of the pharynx

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53
Q

What is the general function of the extrinsic muscles of the tongue?

A

alter the position of the tongue

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54
Q

What is the general function of the intrinsic muscles of the tongue?

A

alter shape of the tongue

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55
Q

Name all the extrinsic muscles.

A
  1. Genioglossus
  2. Hyoglossus
  3. styloglossus
  4. palatoglossus
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56
Q

Name all the intrinsic muscles

A
  1. Superior longitudinal- make tongue short and thick
  2. Inferior longitudinal- make tongue short and thick
  3. transverse- make tongue long and narrow
  4. vertical- make tongue long and narrow
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57
Q

Which nerves are responsible for the motor innervation of the muscles of the tongue?

A

All muscles CN XII- hypoglossal nerve

except for

Palatoglossus- palatine muscle which is supplied by pharyneal plexus

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58
Q

Which nerves supply the mucosa of the anterior two thirds of the tongue for sensation?

A

General- Lingual nerve (branch of CN V3)

special - Chorda tympani ( branch of CN VII)

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59
Q

WHich nerves supply the mucosa of the anterior 1/3rd of the tongue for sensation?

A

General and special - Glossopharyngeal nerve ( CN IX)

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60
Q

What is the general course of CN VII?

A
  1. starts at Pontomedullary junction
  2. Travels through temporal via internal acoustic meatus then stylomastoid foramen
  3. supplies: Taste for anterior 2/3 of tongue
    muscles of facial expression
    glands in floor of mouth
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61
Q

What is the general course of CN IX?

A

Starts in medulla

through jugular foramen

Supplies:

Posterior wall of oropharynx (sensory)

Parotid gland (secretomotor)

Posterior 1/3rt of tongue (sensation and taste)

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62
Q

Where do the arteries of the tongue derive from?

A

lingual artery

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63
Q

Where does the lingual artery derive from?

A

External carotid artery

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64
Q

Which artery supplies the root of the tongue?

A

dorsal lingual arteries

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65
Q

Which artery supplies the body of the tongue?

A

deep lingual veins

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66
Q

What separates both the intrinsic and extrinsic muscles in each half of the tongue?

A

lingual septum

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67
Q

Which veins supply the tongue?

A

dorsal and deep lingual veins- accompany their artery siblings

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68
Q

discuss how the both lingual veins drain?

A

form a lingual vein which then drains into Internal jugular vein or drain directly into the IJV

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69
Q

Discuss the lymphatic drainage of the tongue.

A
  1. Lymph from root of tongue drain bilaterally into superior deep cervical lymph nodes
  2. Lymph from the medial part of the body drain bilaterally to inferior deep cervical lymph nodes
  3. lymph from the right and left lateral parts of body drain to submandibular lymph nodes on the ipsilateral side
  4. Apex and frenulum drain to submental lymph nodes - medial poriton drains bilaterally
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70
Q

Where do all lymph from the tongue ultimately end up?

A

deep cervical nodes

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71
Q

where are the parotid glands located?

A

lateral and posterior to the rami of the mandible and masseter muscles

WIthin unyielding fibrous sheaths

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72
Q

Where are the submandibular glands found?

A

along the body of the mandible

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73
Q

Where are the sublingual glands found?

A

in the floor of the mouth between the mandible and the genioglossus muscle

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74
Q

What is the motor course of CN XII?

A

From medulla

through the hypoglossal canal

to extrinsic and intrinsic muscle of the tongue (except for the palatoglossus)

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75
Q

where does the pharynx start and end?

A

extends from the cranial base to the inferior border of the cricoid cartilage anteriorly and the inferior border of the C6 vertebra posteriorly

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76
Q

What are the three parts of the pharynx?

A
  1. Nasopharynx
  2. oropharynx
  3. laryngopharynx
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77
Q

What is the pharyngeal tonsil commonly referred to as when it is enlarged?

A

Adenoid

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78
Q

Discuss the muscular layer of the pharynx

A
  1. Entirely voluntary

external layer- circular muscle (constrictors)

internal layer - longitudinal

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79
Q

What are the three pharyngeal constrictors found in the external layer of the pharyngeal muscles

A
  1. Superior
  2. middle
  3. inferior
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80
Q

What are the muscles of the longitudinal layer?

A
  1. Palatopharyngeus
  2. stylopharyngeus
  3. salpingopharyngeus
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81
Q

Where do all the circular muscles insert on to?

A

midline raphe

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82
Q

What is the main action of the external layer of the pharynx muscles?

A

constrict walls of pharynx during swallowing

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83
Q

What is the main action of the internal layer of the pharynx muscles?

A

elevate pharynx and larynx ( shortens and widens them) during swallowing and speaking

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84
Q

Which nerves innervate the external layer of the pharynx?

A

Pharyngeal branch of the Vagus ( CN X) and pharyngeal plexus

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85
Q

Which nerves innervate the internal layer of the pharynx?

A

Palatopharyngeus and salpingopharyngeus- CN X

Stylopharyngeus- CN IX

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86
Q

What do the overlapping of the pharyngeal constrictor muscles allow for?

A

leaves four gaps for structures to enter or leave the pharynx

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87
Q

Which vessels supply the pharynx muscles?

A

tonsillar branch and external palatine vein

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88
Q

What is the destination of the tonsillar branch?

A

palatine tonsils

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89
Q

Where does the tonsillar branch derive from?

A

facial artery

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90
Q

Where does the oesophagus begin?

A

In the neck - inferior continuation of laryngopharynx at the pharyngo oesophageal junction

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91
Q

Discuss the muscular layer of the oesophagus.

A

first 1/3- striated (voluntary)

mid 1/3- mixture of smooth and striated

bottom 1/3 - smooth (involuntary)

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92
Q

What is the first part of the oesophagus called?

A

cervical oesophagus

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93
Q

What veterbral level does the oesophagus start at?

A

C6

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94
Q

What is the upper oesophageal sphincter called?

A

cricopharyngeal

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95
Q

Where is the pharyngo-oesophageal junction in relation to the cricopharyngeal muscle?

A

It begins at the inferior edge of the muscle

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96
Q

Where does the oesophagus end?

A

cardia of the stomach

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97
Q

What are the three interior sections of the oesophagus called?

A

cervical

thoracic

abdominal

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98
Q

When does the cervical oesophaggus become the thoracic oesophagus?

A

when the oesophagus enters the superior mediastinum via the superior thoracic aperature

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99
Q

Which arteries/veins supply the cervical oesophagus?

A

branches of the inferior thyroid arteries/ veins

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100
Q

Where do lymphatic vessels of the cervical oesophagus drain into?

A

paratracheal lymph nodes and inferior deep cervical lymph nodes

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101
Q

Describe the nerve supply to the oesophagus

A

oesophageal plexus run on surface to supply smooth muscle within its walls- contains parasympathetic nerve fibres ( vagal trunks) and sympathetic nerve fibres

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102
Q

What three constrictions occur in the oesophagus?

A
  1. cervical constrictions
  2. thoracic constriction
  3. diaphragmatic constriction
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103
Q

what causes cervical constriction? (U.O.S)

A

cricopharyngeus muscle contraction

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104
Q

what causes thoracic constriction?

A

compressions of aortic arch

and left main bronchus

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105
Q

what causes diaphragmatic contractions?

A

Lower osesophageal sphincter

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106
Q

what vertebral level is the oesophageal hiatus?

A

T 10

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107
Q

what vertebral and costal cartilage level is the cardial orifice of the stomach?

A

7th left costal cartilage and T 11 vertebra

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108
Q

what joins the oesophagus to the margins of the oesophagus hiatus in the diaphragm?

A

phrenico-oesophageal ligament

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109
Q

when does the thoracic oesophagus become the abdominal oesophagus?

A

oesophageal hiatus

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110
Q

what is the posterior surface of the abdominal part of the oesophagus covered by?

A

peritoneum of the omental bursa

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111
Q

what separates the left border of the oesophagus to the fundus of the stomach?

A

cardinal notch

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112
Q

what vertebral level is the gastro-oesophageal junction?

A

left of T 11

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113
Q

where is the L.O.S in relation to the gastro-oesophageal junction?

A

sphincter is immediately superior to the junction

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114
Q

What is the Z line?

A

jagged line where mucosa drastically changes from oesophageal mucosa to gastric mucosa

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115
Q

what are the main arteries which supply the abdominal oesophagus?

A

left gastric and inferior phrenic arteries

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116
Q

what are the main veins which supply the oesophagus?

A

left gastric vein- portal system

oesophagus vein to azygos vein- systemic venous system

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117
Q

what are the four main parts of the stomach from superior to inferior?

A
  1. fundus
  2. cardia
  3. body
  4. pyloric part
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118
Q

what are the main parts of the pyloric part of the stomach starting from the body to the duodenum?

A
  1. pyloric antrum
  2. pyloric canal
  3. pylorus ( pyloric sphincter)- contains the pylroric orifice
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119
Q

what is the pylorus made out of?

A

circular layer of smooth muscle

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120
Q

when in the supine, what region is the stomach mainly found in?

A

left hypochondrium,epigastric and umbilical regions

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121
Q

what is the shorter concave right border of the stomach called?

A

lesser curvature

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122
Q

what is the most ifnerior part of the lesser curvature called?

A

incisura angularis ( angular incisure)

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123
Q

what is the name given to the longitudinal ridges which form when the gastric mucosa is contracted?

A

gastric rugae ( folds)

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124
Q

what is stomach mainly covered by except where the blood vessels run along its curvatures?

A

visceral peritoneum

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125
Q

what is the longer convex left border of the stomach called?

A

greater curvature

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126
Q

what is the name given to the visceral peritoneum layers which cover the greater curvature?

A

greater omentum

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127
Q

what is the name given to the visceral peritoneum layers which cover the lesser curvature?

A

lesser omentum

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128
Q

what is anterior to the stomach?

A

diaphragm
left lobe of liver

anterior abdominal wall

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129
Q

where is the transverse colon in relation to the stomach?

A

it is inferiorly lateral to the stomach

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130
Q

What is the bed of the stomach?

A

area on which the stomach rests in the supine position- caused by the organs which the stomach lies upon

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131
Q

what makes up the bed of the stomach?

A
  1. posterior wall of the omental bursa

Organs therefore are;

left dome of diaphragm

spleen

left kidney

suprarenal gland

splenic artery

pancreas

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132
Q

what are the main arteries which supply the stomach?

A

left and right gastric arteries

left and right gastro-omental arteries

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133
Q

what doe the gastric arteries supply in the stomach?

A

lesser curvature

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134
Q

what do the gastro-omental arteries supply?

A

greater curvature

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135
Q

what branch is the right gastric artery from?

A

hepatic

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136
Q

what branch is the left gastric artery from?

A

celiac trunk ( directly)

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137
Q

what branch is the left gastro-omental from?

A

splenic artery in hilum of spleen

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138
Q

what branch is the right gastro-omental from?

A

gastroduodenal which is apart of hepatic

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139
Q

the gastric lymphatic vessels drain into which main lymph nodes?

A
  1. lymph from superior two thirds of stomach drain to gastric lymph nodes
  2. lymph from right 2/3 of inferior third of stomach drain to pyloric lymph node
  3. lymph from 1/3 of greater curvature drain to prancreatic duodenal lymph
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140
Q

which nerve give the parasympathetic nerve supply of the stomach?

A

left vagus nerve to the anterior vagal trunk

right vagus nerve to posterior vagal trunk

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141
Q

where does the sympathetic nerve supply for stomach originate from?

A

T6 to T9 segments of the spinal cord- passes to celiac plexus through the greater splanchnic nerve

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142
Q

name the abdominal organs

A
  1. liver
  2. stomach
  3. distal part of oesophagus
  4. gallbladder
  5. pancreas
  6. both intestines
  7. rectum
  8. anus
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143
Q

Describe the foregut.

A

Oesophagus to mid - duodenum

WHi , gallbladder, spleen and 1/2 of pancreas

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144
Q

Describe the midgut.

A

Mid-duodenum to proximal 2/3rd of transverse colon

1/2 of pancreas

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145
Q

Describe the hindgut.

A

distal 1/3rd of the transverse colon to proximal colon

1/2 of anal canal

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146
Q

Name the 9 regions of the abdominal cavity

A
  1. Right hypochondrium
  2. Epigastric
  3. Left hypochondrium
  4. Right Lumbar
  5. Umbilical
  6. Left Lumbar
  7. RIght Lingual
  8. Pubic
  9. Left Lingual
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147
Q

Name the four quadrants of the abdominal cavity.

A
  1. Right/left upper quadrants

2. Right/left lower quadrants

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148
Q

What plane divides the right quadrants from the left quadrants?

A

Median planes

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149
Q

What plane divides the upper from the lower quadrants

A

trans-umbilical planes

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150
Q

What planes are responsible for dividing the 9 regions?

A

Midclavicular ( vertical)

Subcostal ( superior horizontal)

Transtubercular Plane ( inferior horizontal)

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151
Q

What are the main organs found in the RUQ?

A
  1. Liver (right lobe)
  2. Gallbladder
  3. head of pancreas
  4. stomach’s pylorus

Duodenum

  1. right kidney
  2. right suprarenal gland
  3. superior ascending colon
  4. right part of transverse colon
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152
Q

What are the main organs found in the LUQ?

A
  1. Liver (left lobe)
  2. spleen
  3. stomach
  4. jejunum and proximal ileum
  5. Left Kidney
  6. Left suprarenal gland
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153
Q

What are the main organs found in the RLQ?

A
  1. cecum
  2. appendix
  3. distal ileum
  4. ascending colon
  5. Right ovary/right spermatic cord ( abdominal part for cord)
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154
Q

What are the main organs found in the LLQ?

A
  1. sigmoid colon
  2. descending colon
  3. Left ovary
  4. left ovary/right spermatic cord ( abdominal part for cord)
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155
Q

What are the abdominal vsicera?

A

Internal organs covered in peritoneum found in the abdominal cavity

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156
Q

What is the periotneum?

A

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

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157
Q

what are the two layers of the peritoneum called?

A

Visceral and parietal - note that they are continuous with each other

158
Q

Which layer of the peritoneum is in contact with the body wall?

A

parietal

159
Q

Which layer of the peritoneum is in contact with the organs?

A

visceral

160
Q

What is the gap between the layers of the peritoneum?

A

peritoneal cavity

161
Q

What type of cells do both layers contain?

A

mesothelium cells

162
Q

what is the difference in regards to sensation between the two layers of peritoneum

A
  1. Visceral- insensitive to heat,touch,cold and laceration

Pain is poorly localised

  1. Parietal - sensitive to heat,touch,cold and lacerations

Pain is well localised

163
Q

What is secreted inside the peritoneal cavity?

ii what is the purpose of this?

A

peritoneal fluid

ii. To allow organs to slide past each other without friction

164
Q

What is the difference between the peritoneal cavity in men and women?

A

men- fully closed

women- communication pathway to exterior of the body though uterine tubes, uterine cavity and vagina

165
Q

What are three types of relationships the viscera has with the periotoneum?

A
  1. intraperitoneal- almost completely covered in visceral peritoneum- minimally mobile
  2. retroperitoneal- only has visceral peritoneum on its anterior surface
  3. organs with a mesentery- visceral peritoneum wraps around viscera to form a double layer - very mobile
166
Q

What is the mesentery?

A

double layer of peritoneum wrapped around organs

It provides a means for neurovascular communications between the organ and body wall

Connects an intraperitoneal organ to the body wall- usually the posterior body wall

167
Q

What type of organ is the liver?

A

Intraperitoneal

168
Q

What type of organs are the kidneys and pancreas?

A

Retroperitoneal

169
Q

Which organs have a mesentery?

A

small intestine

transverse and sigmoid mesocolon

Mesoesophagus

mesoappendix

170
Q

What is an omentum?

A

double layered extensions or fold of the peritoneum that passes from the stomach and proximal part of duodenum to adjacent organs in the abdominal cavity

171
Q

What are the differences between the greater and lesser omentums

A
  1. Greater omentum is bigger

2. Greater omentum is four layered lesser is double layered

172
Q

What are bare areas?

A

non peritoneal areas of organs to allow for entrance and exit of neurovasculature

173
Q

what do the omenta do?

A

divide the peritoneal cavity into greater/lesser sac

174
Q

What is the lesser sac also called?

A

omenta bursa

175
Q

What does the transverse mesocolon divide the abdominal cavity into?

A

Supracolic compartment- stomach,liver and spleen

Infracolic compartment-small Intestine, ascending and descending colon

176
Q

How do the supracolic and infracolic compartments communicate?

A

paracolic gutters

177
Q

How does the omenta bura communicate with the greater sac?

A

via omental foramen

178
Q

What lies in the free edge of the lesser omentum?

A

the portal triad

179
Q

What is the name given to excess fluid which can collect in the peritoneal cavity as a result of pathology?

A

ascitic fluid- patient has ascites

180
Q

Where does the inferior epigastric artery ascend ?

A

anterior abdominal wall

181
Q

Where does the inferior epigastric artery arise from?

A

external iliac artery

182
Q

Where do the sympathetic fibres arise from in the spinal cord which innervate the abdominal organs?

A

Between T5-L2

183
Q

Discuss the course of the sympathetic fibres which innervate the abdominal organs.

A
  1. leave spinal cord
  2. enter sympathetic chain bilaterally but do not synapse
  3. Leave chain within the abdominopelvic splanchnic nerves
  4. Synapse at the prevertebral ganglia which are located anterior to the aorta at the exit points of the major branches of the abdominal aorta
  5. postsynaptic sympathetic fibres pass from the prevertebral ganglia via the peri-arterial plexus which the fibres then go on the surface of the arteries and their branches towards the abdominal viscera ( organ’s smooth muscle and glands to be exact)
184
Q

Where do the sympathetic fibres which innervate the adrenal gland originate from on the spinal cord?

A

T10-L1

185
Q

Discuss the course of the sympathetic nerves which innervate the adrenal gland

A
  1. originate from T10-L1
  2. Enter the abdominopelvic splanchnic nerves
  3. Do not synapse at prevertebral ganglia
  4. Carried with periarterial plexuses to the adrenal gland
  5. synapse directly onto cells
186
Q

Pelvic splanchnic nerves are what kind of nerves?

A

presynaptic parasympathetic nerve fibres

187
Q

Vagus nerve supplies which abdominal organs?

A

oesophagus to distal end of the transverse colon

188
Q

where do the presynaptic parasympathetic nerve enter the abdominal cavity?

A

surface of the oesophagus

189
Q

Pelvic splanchnic nerves originate where on the spinal cord?

A

S2,3,4

190
Q

The pelvic splanchnic nerves supply which abdominal organs?

A

descending colon to anal canal

191
Q

Pain fibres from the majority of the abdominal organs run alongside sympathetic fibres back to the spinal cord true or false?

A

true

192
Q

visceral afferent fibres of the foregut enter the vertebra at what levels?

A

T6-T9

193
Q

Visceral afferent fibres of the midgut enter the vertebra at what level?

A

T8-T12

194
Q

Visceral afferent of the hindgut enter the vertebra what levels?

A

T10-L2

195
Q

Where is visceral pain usually felt?

A

in the dermatomes of the levels of which they enter the spinal cord

196
Q

what does the iliohypogastric nerve supply?

A

some body wall areas of the ileum and the hypochondrium

197
Q

what does the ilioinguinal nerve supply?

A

some ileal and inguinal body wall

198
Q

what are thoracoabdominal nerves?

A

somatic motor, somatic sensory and sympathetic nerve fibres that supply the abdominal body wall.

199
Q

What does the portal triad consist of ?

A
  1. hepatic artery
  2. Hepatic portal vein
  3. common bile duct
200
Q

Where is the portal triad found?

A

Free edge of the lesser omentum

201
Q

What type of organ is the spleen?

A

intraperitoneal organ

202
Q

name the midline branches does the abdominal aorta.

A
  1. Celiac trunk
  2. inferior mesenteric
  3. superior mesenteric
203
Q

what level of the vertebrae does the celiac trunk form?

A

T12

204
Q

What are the three branches of the celiac trunk

A
  1. splenic
  2. Hepatic
  3. Left gastric
205
Q

Name the branches of the hepatic artery.

A

Proper hepatic cystic
Right gastric
Gastroduodenal : (right gastroepiploic superior pancreaticoduodenal supraduodenal)

206
Q

What is the only part of the spleen that is not covered in peritoneum?

A

splenic hilum

207
Q

What region is the spleen found in?

A

left hypochondrium

208
Q

What are the three borders of the spleen?

A
  1. Anterior extremity (colic area)
  2. Inferior border (renal area)
  3. superior border ( Gastric area)
209
Q

Discuss the organs anatomically related to the spleen

A

Anteriorly is the stomach

Posteriorly is the diaphragm

Inferiorly is the splenic flexure

Medially is the left kidney

210
Q

Which ribs protect the spleen?

ii what are the potential risks?

A

9-11

ii could puncture spleen

211
Q

spleen is a vital organ true or false?

A

false

212
Q

what is the neurovasculature of the spleen

A

artery/vein- splenic artery/vein

lymph fluid drains into pancreaticosplenic lymph nodes

nerves- derive from celiac plexus

213
Q

Which blood vessels supply the liver?

A

Right and left hepatic arteries which are branches of the common hepatic artery

and the hepatic portal vein

214
Q

Which region is the liver found?

A

right upper quadrant

mainly right hypochondrium and upper epigastrium

215
Q

What are the surfaces of the liver called?

A
  1. diaphragmatic

2. visceral

216
Q

what parts of the liver are not covered in visceral peritoneum?

A

diaphragmatic surface- bare area of liver

visceral surface- fossa for the gallbladder and porta hepatis

217
Q

What is the porta hepatis?

A

Transverse fissures where the vessels ( hepatic artery, portal vein and lymphatics), hepatic nerve plexus and ducts enter and leave the liver

Also links the right and left sagittal fissures

218
Q

Discuss the position of the liver to other organs.

A

superior, anterior and posterior is the stomach

inferior and posterior is the gallbladder

219
Q

Which ribs protect the liver?

A

7-11

220
Q

How many anatomical segments are there in the liver?

A

2 anatomical lobes ( right and left)- left much smaller)

2 Accessory lobes ( quadrate and caudal)- quadrate is inferior

Can only see anatomical lobes on anterior surface.

Therefore 4 in total

221
Q

How many functional segments are there in the liver?

ii why are they classed as functional?

A

8

ii Have there own blood supply

222
Q

How many functional lobes are found in the right liver? Not right anatomical lobe

A

4- ( V,VI,VII,VIII)

223
Q

How many functional lobes are found in the left liver?

A

3- (II,III,IV)

224
Q

How many functional lobes found in the caudate lobe?

A

1-(I)

225
Q

IVC and hepatic veins have valves true or false?

A

false

226
Q

What happens if central venous pressure rises?

ii what does this cause?

A
  1. IVC and hepatic vein transmit blood to liver

ii causes hepatomegaly

227
Q

Discuss the anatomy of the liver lobule.

A

Central vein in the middle

interlobular portal triad at each corner (6)

228
Q

What carries blood from the hepatic portal vein to the central vein in the lobule?

A

sinusoid

229
Q

what carries bile from hepatocytes to the biliary ducts in the lobule?

A

bile canaliculi

230
Q

what are the three main hepatic veins?

A

right,left and intermediate

231
Q

What are the two recesses relates to the liver?

A

Hepatorenal recess (morison’s pouch)

Sub-phrenic recess

232
Q

Where are these recesses found?

A

the greater sac

Hepatorenal - between the right kidney and liver

Sub-phrenic- liver and the diaphragm

233
Q

When supine, which recess is considered one of the lowest parts of the peritoneal cavity?

A

Hepatorenal

234
Q

The IVC is what type of structure?

A

Retroperitoneal

235
Q

Where does the hepatic portal vein drain to and from?

A

From foregut, midgut and hindgut to the liver

236
Q

Where does the splenic vein drain to and from ?

A

from foregut to the portal vein

237
Q

Where does the superior mesenteric vein drain to and from?

A

from midgut to the portal vein

238
Q

Where does the inferior mesenteric vein drain to and from?

A

from hindgut to the splenic vein

239
Q

Where does the IVC drain to and from?

A

from hepatic vein to right atrium

240
Q

Which ligaments attach the liver to the diaphragm?

A

coronary ligaments

241
Q

Which ligaments attach the liver to the anterior abdominal wall?

A

falciform ligament

242
Q

What is the ligamentum teres a remnant of ?

A

embryological umbilical vein

243
Q

Where do the nerve fibres which innervate the liver come from?

A

hepatic plexus - consists of sympathetic fibres from the celiac plexus and parasympathetic fibres from the anterior and posterior vagal trunks

244
Q

What are the parts of the gall bladder?

A
  1. Fundus- wide blunt end
  2. body
  3. neck
245
Q

what connects the gallbladders neck to the common hepatic duct?

A

cystic duct

246
Q

How does the gallbladder bind to the liver?

A

via fibrous capsule of the liver

247
Q

What artery/veins supply/drain the gallbladder?

A

cystsic artery/vein

248
Q

in 75% of people what is the cystic artery a branch of?

A

right hepatic artery

249
Q

Where do visceral afferents enter the vertebra which supply the gallbladder?

A

T6 and T9

250
Q

Where do the parasympathetic and sympathetic fibres which supply the gallbladder and cystic duct come from?

A

para- vagal trunk

sympathetic- celiac trunk

251
Q

What is the splenic pulp?

A

substance of the spleen

252
Q

Where does the bile duct descend to?

A

descends posteriorly to the first part of duodenum

253
Q

What does the bile duct join and then form?

A

Joins with the main pancreatic duct to form the ampulla of vater

254
Q

Where does the ampulla of vater drain into and through what?

A

Drains into second part of the duodenum

via the major duodenal papilla- papilla means nipple lol

255
Q

Name the smooth muscle sphincters involved in pancreatic and bile duct secretion

A
  1. Bile duct sphincter
  2. pancreatic duct sphincter
  3. hepatopancreatic sphincter ( Sphincter of oddi)
256
Q

What are the main role of the these smooth muscle sphincters?

A

prevent reflux of duodenal contents and digestive secretions

257
Q

What is the difference between the bile duct sphincter in comparison to the other two sphincters?

A

It has an active role in the control of bile secretion (digestive secretion)

258
Q

Where is the sphincter of oddi found?

A

In the ampulla of vater

259
Q

what type of organ is the pancreas?

A

elongated accessory digestive gland

retroperitoneal

260
Q

What are the four parts of the pancreas?

A
  1. head - c shaped due to being surrounded by duodenum
  2. neck- anterior surface is adjacent to the pylorus of the stomach
  3. body- lies to the left of the superior mesenteric vessels. Lies over the aorta and L2 vertebra
  4. tail- lies anterior to the left kidney . It is relatively mobile
261
Q

Describe the anatomical relationships of the pancreas.

A

posterior to the stomach

anterior to the right and left kidney

anterior to the right and left Adrenal gland

anterior to the IVC

anterior to the abdominal aorta

anterior to the superior mesenteric vessels

inferoanterior to the splenic vessels

Duodenum on the right ( head of pancreas)

262
Q

What level of the vertebra is the majority of the pancreas found at?

A

L1-L2 (transpyloric plane)

263
Q

WHat is the ucinate process?

A

projection from the inferior part of the pancreatic head

264
Q

Where do the sympathetic and parasympathetic fibres which innervate the pancreas come from?

A

sympathetic- abdominopelvic splanchnic nerves

parasympathetic- vagus nerves

Both pass through the diaphragm and reach the pancreas by passing along the arteries from the celiac plexus and superior mesenteric plexus

265
Q

What are the main arterial blood supply for the pancreas?

A
  1. pancreatic branches (that come from the splenic artery)
  2. superior pancreaticoduodenal (comes from the gastroduodenal)
  3. inferior pancreaticoduodenal (comes from the SMA)

2 and 3 form anteriorly and posteriorly placed arcades which supply the head of the pancreas

266
Q

What are the main veins which take part in the venous drainage of the pancreas?

A
  1. Pancreatic veins - drain into splenic vein

2. tributaries of the splenic and superior mesenteric parts of the hepatic portal vein

267
Q

State the four parts of the duodenum and what type of structures they are

A
  1. Superior- intraperitoneal
  2. Descending- retro
  3. Horizontal- retro
  4. Ascending- retro
268
Q

where is the duodenal cap found?

A

superior part of the duodenum

269
Q

What vertebra levels are the four parts of the duodenum found at?

A

superior- L1 vertebra

descending- L1-L3 vertebra

horizontal- L3

ascending- Begins at L3 and rises to superior border of L2

270
Q

What are the main arteries/veins which supply the duodenum?

A
  1. Superior pancreaticoduodenal artery/vein- branch of Gastroduodenal artery
  2. Inferior pancreaticoduodenal artery/vein- branch of superior mesenteric artery
271
Q

What marks the beginning and end of the duodenum?

A

Begins at pyloric sphincter

ends at duodenaljejunal flexure

272
Q

Which nerves supply the duodenum?

A

Sympathetic- greater and lesser abdominopelvic splanchnic nerves

parasympathetic- vagal nerves

273
Q

Which muscle supports the duodenaljejunal flexure?

A

suspensory muscle of the duodenum (ligament of treitz)

274
Q

Where does the jejunum begin and ileum end?

A

begins at duodenaljejunal flexure

ends at ileocecal junction

No clear demarcation between jejunum and ileum only that mucosa is different

275
Q

State the differences between the ileum and jejunum.

A
  1. Mucosa of distal ileum are much smoother
  2. mucosa of jejunum is highly folded.
  3. colour of jejunum is overall more deeper red
  4. Wall of jejunum is thicker and heavy
  5. vascularity is greater in the jejunum
  6. few large loops in jejunal arteries vs many short loops in ileal arteries
276
Q

What are the folds in the mucosa of the jejunum called?

A

plicae circularis

277
Q

what is the purpose of the mesentery?

A
  1. Connects ileum and jejunum to posterior abdominal wall.

2. between the two layers nerves, veins and arteries which supply the two parts of the small intestine are found.

278
Q

What is it called when arteries unite to form loops and arches?

A

arterial arcade

279
Q

Which arteries/veins supply the jejunum and ileum?

A

jejunal and ileal arteries which are branches of the SMA

SMV drains both jejunum and ileum via the jejunal and ileal branches

Also drain to hepatic portal vein

280
Q

What are the three lymph nodes which lacteal lymph passes through sequentially in the mesentery?

A
  1. juxta-intestinal
  2. mesenteric
  3. superior central
281
Q

Where do these mesenteric lymph nodes eventually drain into?

A

the venous system at the left venous angle

282
Q

Compare the vasa recta between ileum and jejunum.

A

vasa recta are much longer in the jejunal arteries

283
Q

lymph tends to lie where?

A

alongside arteries

284
Q

what are the 4 main groups of lymph nodes draining the abdominal organs?

A
  1. celiac (foregut)
  2. superior mesenteric (midgut)
  3. inferior mesenteric (hindgut)
  4. lumbar (kidney, posterior abdo wall, pelvis and lower limbs)
285
Q

superficial lymph vessels drain into what?

A

deep lymph vessels

286
Q

What are the two ducts which lymph ultimately drain into?

ii. What are the two angles in which lymph fluid is recycled into the venous system?

A
  1. Right lymphatic duct (1/4 of body)Thoracic duct (3/4 of body)
  2. Right venous angle- RLD

Left venous angle- TD

287
Q

What are the macroscopic differences between the small and large intestine?

A
  1. Large intestine contain omental appendices
  2. Large intestine contain Taeniae coli
  3. Large intestine contain haustra
  4. Large intestine has a much greater calibre ( internal diameter)
288
Q

What is an omental appendices?

A

small, fatty Omentum-like projection

289
Q

What type of organ is the cecum?

A

intraperitoneal

290
Q

what type of organ is the appendix?

A

Retroperitoneal

291
Q

Where is the appendix and caecum found?

A

right iliac fossa

292
Q

Where does the appendix join to the caecum?

A

appendicieal orifice- on the posteromedial wall of the caecum

293
Q

What is the usual position of the appendix to the caecum?

A

retrocaecal

294
Q

Where is McBurney’s point?

A

It is 1/3 of the way between the right ASIS to umbilicus

on the anterior abdominal wall side

ASIS- anterior superior iliac spine

295
Q

What is McBurney’s point?

A

Corresponds to the where the base of the appendix is usually found?

296
Q

What usually binds the caecum to the lateral abdominal wall?

A

Caecal folds of the peritoneum

297
Q

What is the relation of the ileocaecal orifice ( and valve) is to the appendiceal orifice?

A

The ileocaecal orifice is superior

298
Q

Which arteries supply the caecum?

A

ileocolic artery- terminal branch of SMA

299
Q

Which arteries supply the appendix?

A

appendicular artery- branch of the ileocolic artery

300
Q

Which veins drain both the appendix and caecum?

A

Ilecolic vein

301
Q

Where do the nerves which innervate the caecum and appendix derive from?

A

the superior mesenteric plexus

302
Q

What type of structure is the ascending colon?

A

retorperitoneal

303
Q

what are the spaces that are part of the greater sac of the peritoneal cavity and sit between the lateral edge of the ascending/ descending colon and the abdominal wall?

A

paracolic gutters

304
Q

What may form in the paracolic gutters?

A

pus

305
Q

What are the 3 bands of taenia coli?

A
  1. mesocolic tenia
  2. omental tenia
  3. Free tenia
306
Q

Where does the ascending colon rise to?

A

from the caecum to the right lobe of the liver.

307
Q

What is the point called where the ascending colon turns to the left leading into the transverse colon?

A

Right colic flexure ( hepatic flexure)

308
Q

What type of structure is the transverse colon?

A

intraperitoneal

309
Q

the transverse colon has a mesentery true of false?

A

true

310
Q

What is the usual vertebral level of the transverse colon?

A

L3

311
Q

What is the point called where the transverse colon turns inferiorly leading into the descending colon?

A

Left colic flexure ( splenic flexure)

312
Q

what is the transverse mesocolon joined to?

A

posterior wall of the omental bursa

313
Q

What are the two flexures inferior to?

ii what is the difference between the flexures apart from the fact they are in different areas?

A

right colic flexure is inferior to the liver

Left colic flexure is inferior to the spleen

ii Left colic flexure is slightly more superior, acute and less mobile

314
Q

What type of structure is the descending colon?

A

Retroperitoneal

315
Q

Where is the point where the descending colon leads into the sigmoid colon?

A

left iliac fossa

316
Q

What is volvulus of the colon?

A

twisting of the colon

317
Q

What type of structure is the sigmoid colon?

A

intraperitoneal

318
Q

What is the the name of the sigmoid’s mesenetery?

A

sigmoid mesocolon

319
Q

Why does the sigmoid mesocolon length matter?

A

As it is long, it gives the sigmoid colon a lot of mobility

This is increases risk of sigmoid volvulus especially in the middle

320
Q

State the arteries and veins which supply the different sections of the colon

A
  1. ascending- ileocolic and right colic arteries/veins
  2. transverse- - middle colic artery/vein
  3. descending- left colic and sigmoid artery/vein
  4. sigmoid- sigmoid artery/vein
321
Q

What are the 4 main arteries that come off the SMA?

A
  1. inferior pancreaticoduodenal artery
  2. middle colic artery
  3. right colic artery
  4. ileocolic artery
322
Q

what arteries come off the ileocolic artery?

A

appendicular artery, jejunal arteries, ileal arteries

323
Q

what are the 3 main arteries that come off the IMA?

A

left colic artery, sigmoidcolic artery, superior rectal artery

324
Q

What is the main arterial anastomoses between the branches of the SMA and IMA?

A

Marginal artery of drummond

325
Q

What are the name of alternative routes for blood to travel?

A

collateral vessels

326
Q

What does the hindgut extend to?

A

Proximal half of the anal canal

327
Q

What separates the proximal part (2/3) and distal part (1/3) of the anal canal?

A

pectinate line

328
Q

which artery supplies the remains part of the large intestine? ( after the pectinate line).

A

Internal iliac artery

329
Q

What are the two main branches of the internal iliac artery which supplies the distal part of the anal canal and the rectum?

A

middle rectal artery

inferior rectal artery

330
Q

what are the three important parts of the portal-systemic anastomses?

A
  1. distal end of the oesophagus
  2. Skin around umbilicus
  3. rectum/anal canal
331
Q

where does the abdominopelvic cavity extend from?

A

extends superiorly into the thoracic cage and inferiorly into the pelvis.

332
Q

What is the pelvic cavity found?

A
  1. It is continuous with the abdomino cavity at the pelvic inlet
  2. continues to the pelvic floor
333
Q

What is the pelvic cavity surrounded by?

A

The pelvic girdle ( boney pelvis)

334
Q

What is the pelvic girdle and what does it consist of?

A

Basin-shaped ring of bones that connects the vertebral column to the two femurs

  1. In mature people it consists of 3 bones

Right and left hip bones

Sacrum

335
Q

What bones make up the hip bones?

A

From superior to inferior

  1. ilium
  2. ischium
  3. pubis
336
Q

What is the pelvis subdivided into?

A

Greater and lesser pelvis

337
Q

What is the greater pelvis surrounded by?

A

Superior pelvic girdle ( iliac alae posterolaterally and the antero-superiro aspect of the S1 vertebra posteriorly)

338
Q

What is the lesser pelvis surrounded by?

A

inferior pelvic girdle ( pelvic surfaces of the hip bones, sacrum and coccyx)

339
Q

What is the greater pelvis occupied by?

A

abdominal viscera

340
Q

What is the lesser pelvis occupied by?

A

True pelvic cavity and perineum

341
Q

What separates the pelvic cavity and perineum?

A

musculofascial pelvic diaphragm

342
Q

what separates the greater and lesser pelvis?

A

the pelvic inlet ( Pelvic brim is the border of this)

343
Q

What joins the right and left hip bone anteriorly and posteriorly?

A

Anteriorly- pubic symphysis

Posteriorly- join with the sacrum at the sacro-iliac joints

344
Q

What is the pelvic brim formed by?

A
  1. Promonotry and ala of the sacrum
  2. Right and left linea terminalis - form a continuous oblique ridge which consists of :
    i Arcuate line

ii. pecten pubis and pubic crest

345
Q

What signifies the end of the lesser pelvis?

A

Pelvic outlet

346
Q

What are the borders of the pelvic outlet?

A
  1. Pubic arch anteriorly
  2. ischial tuberosities laterally
  3. Inferior margin of the sacrotuberous ligament posterolaterally
  4. tip of the coccyx posteriorly
347
Q

What is the pubic arch formed by?

A

right and left ischiopubic rami- compound structure consisting of the following two structures:

from the pubis bone , the inferior pubic ramus
from the ischium bone, the inferior ramus

They meet at the pubic symphysis

348
Q

What determines the width of the subpubic angle?

A

Distance between the right and left ischial tuberosities

349
Q

What does the ilium consist of ?

A
  1. ala ( wing) of the ilium ( superior to the body at a lateral view). Look like the body of an old fan
  2. body - Looks like a handle to an old fan

Parts of the ala
1. iliac crest- curve of the ala. Follows to the ASIS and PSIS

  1. Iliac fossa- anteromedial part of the ala just superior to the body at a lateral view
350
Q

What does the ischium consist of ?

A
  1. Body
  2. Ramus

ischial tuberosity-Large postero-inferior protuberance of the ischium

Ischial spine- small posteromedial projection near the junction of the ramus and body

351
Q

What does the pubis consist of?

A
  1. superior ramus

2. inferior ramus

352
Q

What is the perineum?

A

area of the surface of the trunk between the thighs and buttocks extending from the coccyx to the pubic symphysis. It is inferior to the pelvic diaphragm

353
Q

What is the perineum split into?

A

Urogenital and anal triangles

354
Q

What organs are found in the perineum?

A

anal canal , anus and external genitalia ( scrotum for male and vulva for female)

355
Q

What organs are found in the pelvic cavity?

A
  1. Terminal parts of the ureters
  2. urinary bladder
  3. rectum
  4. pelvic genital organs
  5. blood vessels, lymphatic vessels and nerves
356
Q

What makes up the walls and floor of the pelvic cavity?

A

antero-lateral walls- bodies and rami of the pubic bones and the pubic symphysis

Lateral pelvic walls- right and left hip bones - both include an obturator foramen

Posterior wall ( posterolateral wall and roof)- bony wall, roof in the midline ( formed by sacrum and coccyx) and musculoligamentous posterolateral walls.

pelvic floor- pelvic diaphragm

357
Q

What makes up the pelvic diaphragm

A

Levator ani (main muscles involved) - forms the sheet

coccygeus muscles

Fascial coverings

358
Q

When does the sigmoid become the rectum?

ii What level of the vertebra is this?

A

Rectosigmoid junction

ii S3

359
Q

Due to the curvature of the sacrum and the coccyx what are the main flexures in the rectum and anal canal?

A

sacral flexure of the rectum

anorectal flexure of the anal canal

360
Q

What are the lateral flexures of the rectum which can be seen anteriorly?

A
  1. superior ( left side)
  2. inferior ( left side)
  3. intermediate ( right side)
361
Q

When does the rectum become the anal canal?

A

anorectal junction- Just on the anterior inferior tip of the coccyx - before the anorectal flexure of the canal

I.e just before passing through the levator ani muscle

362
Q

What is the dilated terminal part of the rectum called?

A

the ampulla of the rectum

363
Q

What are the two different pouches formed between men and women based on the peritoneum of the rectum reflecting on different organ?

A
  1. Recto-uterine pouch ( pouch of douglas)- male

2. rectovesical pouch- female

364
Q

Which arteries/vein supply the rectum?

A

proximal part - superior rectal artery/vein

distal part ( middle and inferior)- middle rectal artery/vein

365
Q

What are the anatomical relationships to the rectum?

A
  1. peritoneum covers superior rectum
  2. recto-uterine/vesicle pouch lies anterior to the superior rectum
  3. in Males prostate gland lies anterior to the inferior rectum
  4. in females vagina and cervix lie anterior to inferior/middle rectum
366
Q

What muscles make up the levator ani?

A
  1. iliococcygeus
  2. pubococcygeus
  3. Puborectalis
367
Q

What nerves innervate the levator ani?

A

“nerve to levator ani”- branch of the sacral plexus which is the pudendal nerve ( S2,3 and 4 ) only S3 and S4 supply levator ani

368
Q

what shape is the puborectalis?

A

U Shaped

369
Q

What type of muscle is the levator ani?

A

skeletal

370
Q

What is the part of the levator ani muscle that is particularly important for maintaining faecal continence?

A

puborectalis muscle

371
Q

what surrounds the anal canal?

A

internal and external anal sphincters

372
Q

States the difference between internal and external sphincter?

A
  1. Internal is smooth muscle ( involuntary) external is skeletal ( voluntary)
  2. Internal surrounds superior two thirds of anal canal. external surrounds inferior 2/3s of anal canal
  3. contraction inhibited by parasympathetic fibres in internal sphincter ( extrinsically by pelvic splanchnic nerve, intrinsically ENS). N/A for external
  4. contraction stimulated by sympathetic fibres in internal. Pudendal nerve stimulates external
373
Q

The superior part of the external anal sphincter is continuous with what muscle?

A

the puborectalis muscle of the levator ani muscle

374
Q

sympathetic nerve supply of the rectum and anal canal comes from what vertebra levels?

A

T12- L2

375
Q

What is the course of the sympathetic nerve supply of the rectum and anal canal?

A
  1. Travel from vertebrae to inferior mesenteric ganglia and synapse
  2. Travel the periarterial plexuses of the IMA
376
Q

From what vertebra level do pudendal (somatic motor) and nerve to levator ani come from ?

ii what do they innervate?

A

S2-4 anterior rami

ii. pudendal muscle- causes contraction of the external anal sphincter

puborectalis contraction

377
Q

What vertebral level do visceral afferents of the rectum and anal canal go back to?

A

S2-4

378
Q

What vertebral level do parasympathetic fibres synapse in the walls of the rectum?

ii. What nerve do they follow

A

S2-4

Pelvic splanchnic nerve

379
Q

What foramen does the pudendal nerve exits the pelvis via?

A

Greater sciatic foramen

380
Q

What foramen does the pudendal nerve enter the perineum by?

A

Lesser sciatic foramen

381
Q

What is the superior half of the anal canal mucous membrane characterised by?

II. what do they contain?

A

anal columns

ii. terminal branches of the superior rectal artery/vein

382
Q

What is at the superior and inferior ends of the anal columns?

A

Superior- anorectal canal

inferior end are joined by anal valves.

383
Q

What does the inferior edges of anal valves form?

A

pectinate line (dentate line)

384
Q

Discuss the neurovasculature differences between anal canal above and below the pectinate line.

A
  1. Nerve supply

Above: autonomic ( visceral motor) and sensory innervation
Below: Somatic motor and sensory innervation

  1. Arterial supply

Above: IMA

Below: Internal Iliac

  1. venous drainage

Above: to portal

Below : internal iliac

  1. Lymph

Above: Internal iliac nodes

Below: Superficial inguinal nodes

385
Q

What are the 4 main groups of lymph nodes in the pelvis and what do they drain?

A
  1. Internal iliac - drains inferior pelvic structures
  2. External iliac- drains lower limb and more superior pelvic structures
  3. Common iliac - drains lymph from external and internal iliac nodes
  4. Lumbar nodes- drains lymph from common iliac
386
Q

Where are the ischioanal fossae found?

A

Each side of the anal canal ( right and left)

387
Q

What are ischioanal fossae filled with?

A

Fat and loose connective tissue

388
Q

Most superficial structure on the parotid gland?

A

facial nerve

389
Q

what is the space of disse?

A

Location in the liver between a hepatocyte and a sinusoid. It contains the blood plasma. Microvilli of hepatocytes extend into this space, allowing proteins and other plasma components from the sinusoids to be absorbed by the hepatocytes

390
Q

what artery supplies the omentum?

A

gastroepiploic

My GI (8 decks)

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