Anatomy

Question 1

name each component of the alimentary canal and what it does…

Answer 1

mouth & oropharynx: processes food
oesophagus: propels food into stomach
stomach: stores & churns
small intestine: digestion & absorption
large intestine: absorbs water and stores faeces
rectum & anus: expulsion

Question 2

what are accessory structures of the alimentary canal

Answer 2

salivary glands, pancreas, liver & gall bladder

Question 3

what are the 4 functions of the alimentary canal?

Answer 3

motility: muscle contraction
secretion: hormones, NTS
digestion: chemical breakdown
absorption: transfer of digestive products to blood or lymph

Question 4

what are the pacemaker cells of the GI tract called?

Answer 4

interstitial cells of Cajal (ICCs)

Question 5

True/False…

ICC activity is in slow waves?

Answer 5

True

Question 6

slow waves are…

Answer 6

the BER and vary in frequency

Question 7

what is the force of contractions of the intestine muscle dependent upon?

Answer 7

the no of APs discharged

Question 8

what are organs innervated with?

Answer 8

visceral afferents & autonomic and enteric nerves

Question 9

what is the body wall innervated with?

Answer 9

somatic sensory, motor nerves, and ANS

Question 10

parasympathetic nerves of the GI tract can be..

Answer 10

excitatory: inc secretions, blood flow, contraction
inhibitory: relaxation of some sphincters and stomach

Question 11

how do parasympathetic nerves reach organs?

Answer 11

enter abdominal cavity on surface of oesophagus > reach periarterial plexuses around abdominal aorta and travel to organs

Question 12

where does parasympathetic innervation reach in the GI tract?

Answer 12

up to transverse colon

Question 13

sympathetic nerves can be…

Answer 13

excitatory: inc sphincter tone
inhibitory: dec motility, blood flow and secretions

Question 14

how do sympathetic nerves reach organs?

Answer 14

leave spinal cord at T5 & L2 and enter sympathetic chain > exit via splanchnic nerve and synapse at anterior of aorta where major branches of abdominal aorta branch out> reach organs

Question 15

where do visceral afferents for foregut travel back to?

Answer 15

T6-T9

Question 16

where do visceral afferents for midgut travel back to?

Answer 16

T8-T12

Question 17

where do visceral afferents for hindgut travel back to?

Answer 17

T10-L2

Question 18

what do visceral afferents run along side with?

Answer 18

sympathetic nerves

Question 19

what is the enteric nervous system?

Answer 19

mesh like system of neurones that governs GI tract

Question 20

describe the 5 types of motility patterns in GI tract?

Answer 20

peristalsis: waves of relaxation & contraction
segmentation: contraction of circular muscle
colonic mass movement: sweeping contraction that pushes faeces to rectum
migrating motor complex: sweeping contraction from stomach to terminal ileum
tonic contractions: low & high pressure contractions

Question 21

True/False…

low pressure contractions occur in sphincters

Answer 21

False..
low pressure occur in organs with storage function
high pressure occur in sphincters

Question 22

how man sphincters are there in GI tract

Answer 22

6

Question 23

what are sphincters?

Answer 23

acts as 1 way valves encircled by SM which contract and relax according to stimuli

Question 24

what are the 3 closure muscles of the mouth

Answer 24

masseter, temporalis, medial pterygoid

Question 25

what is the 1 open muscle of the mouth

Answer 25

lateral pterygoid

Question 26

what are the names of the 3 salivary glands...

Answer 26

parotid, submandibular, sublingual

Question 27

what 2 cranial nerves are responsible for the gag reflex

Answer 27

CN IX, CN X

Question 28

what cranial nerve supplies tongue muscles

Answer 28

CN XII

Question 29

what cranial nerve supplies pharyngeal muscles

Answer 29

innervated by CN X

Question 30

what is the part of the body with an anatomical and physiological sphincter?

Answer 30

oesophagus

Question 31

where does the oesophageal plexus terminate?

Answer 31

cardia of stomach

Question 32

what is the physiological sphincter...

Answer 32

lower oesophageal sphincter and due to the oesophagus's oblique entrance to cardia it creates sphincter effect

Question 33

why is lower oesophageal sphincter important?

Answer 33

prevents reflux

Question 34

what organs belong to foregut, midgut, hindgut?

Answer 34

Foregut : oesophagus, mid duodenum, liver, gall bladder, spleen, ½ pancreas Midgut: mid duodenum to 2/3of transverse colon, ½ of pancreas Hindgut: distal 1/3 of transverse colon, ½ of anal canal

Question 35

what are the layers of the abdominal wall?

Answer 35

rectus abdominus external & internal oblique transverse abdominus parietal peritoneum

Question 36

what are the 2 layers of the peritoneum and its function

Answer 36

parietal peritoneum: body wall visceral peritoneum (organs) - secretes lubricant and has nerve supply

Question 37

what does retroperitoneal mean?

Answer 37

the visceral peritoneum is on anterior surface of organs

Question 38

what does in a mesentery mean?

Answer 38

visceral peritoneum covers organs entirely suspending them from posterior and anterior walls of abdomen

Question 39

what can peritoneum form?

Answer 39

pouches 1-males 2-females

Question 40

what is peritonitis?

Answer 40

inflammation of peritoneum

Question 41

what does the omentum do?

Answer 41

divides peritoneal cavity into greater and lesser sacs

Question 42

is bile alkaline or acidic?

Answer 42

alkaline

Question 43

what does bilirubin do?

Answer 43

provides bile with colour

Question 44

purpose of cholangiocytes?

Answer 44

modify 1y bile

Question 45

what cells produce bile and where does it go?

Answer 45

hepatocytes- flows via canaliculi into bile duct

Question 46

where does bilirubin originate

Answer 46

produced in break down of red blood cells which occurs in spleen

Question 47

why is bile important?

Answer 47

for digestion and absorption of fats

Question 48

what is the anatomical location of the spleen and what does it do?

Answer 48

left hypochondriac | breaks down red blood cells

Question 49

what is the blood supply of the spleen

Answer 49

cephalic trunk (1st of 3 branches of abdominal aorta)

Question 50

what does the cephalic trunk trifurcate into?

Answer 50

splenic, hepatic, left gastric arteries

Question 51

describe the location and and action of liver...

Answer 51

right upper quadrant | converts bilirubin to bile and synthesises cholesterol

Question 52

what are the segments of the liver?

Answer 52

right lobe left lobe caudate lobe quadrate lobe

Question 53

what is an anatomical pathology of the liver?

Answer 53

contains hepatorenal and subphrenic recess which can become inflamed and infected

Question 54

what is the blood supply to the liver?

Answer 54

portal triad (hepatic artery, hepatic portal vein and common bile duct)

Question 55

what is the hepatic portal vein sub-comprised of?

Answer 55

splenic vein: drains blood from foregut to HPV inferior mesenteric vein: drains blood from hindgut to splenic vein superior mesenteric vein: drains blood from midgut to HPV

Question 56

where does the hepatic portal vein drain into?

Answer 56

Inferior vena cava where cleaned blood is returned to RA of heart

Question 57

location and function of gallbladder...

Answer 57

posterior to liver but anterior to duodenum- foregut | stores and concentrates bile

Question 58

segmentation of gall bladder

Answer 58

body and neck (neck narrows to form cystic duct)

Question 59

what is most common pathology of gallbladder

Answer 59

gallstones causing cholecystitis

Question 60

where does pain usually refer to?

Answer 60

pain often radiates to right shoulder

Question 61

what is the blood supply to the gallbladder?

Answer 61

cystic artery (branch of right hepatic artery)

Question 62

what is the bile duct made up of?

Answer 62

right & left hepatic ducts (common hepatic duct) & cystic duct

Question 63

where does bile duct usually join onto?

Answer 63

main pancreatic duct which drain into duodenum

Question 64

location and function of pancreas...

Answer 64

stomach lies anteriorly and duodenum surrounds head | - produces digestive enzymes, insulin and glucagon

Question 65

segments of pancreas?

Answer 65

head, neck, body, tail

Question 66

what is the blood supply of the pancreas?

Answer 66

splenic artery, gastroduodenal artery and superior mesenteric artery

Question 67

what are the 3 components of the small intestine?

Answer 67

duodenum, jejunum, ileum

Question 68

location and function of SI?

Answer 68

close to pancreas, starts at pyloric sphincter | - secretes peptide hormones

Question 69

True/False... | duodenum is highly folded

Answer 69

False... | jejunum and ileum are

Question 70

blood supply of SI?

Answer 70

superior mesenteric artery, jejunal and ileal arteries | superior mesenteric, jejunal, ileal veins

Question 71

where does GI tract lymph eventually drain into?

Answer 71

thoracic duct or right lymphatic duct and returns to venous system at venous angle

Question 72

which lymphatic drainage vessel drain into right venous angle?

Answer 72

right lymphatic duct

Question 73

what are the 4 lymph node groups of the GI tract?

Answer 73

celiac superior mesenteric inferior mesenteric lumbar

Question 74

why do hernias typically occur?

Answer 74

structural weakness and inc pressure

Question 75

where does gut typically push through in inguinal herniation?

Answer 75

Hasselbach's triangle

Question 76

True/False... | a DIRECT inguinal hernia will use pathway already created by body to gain inguinal access ie. testes pathway

Answer 76

False... that is INDIRECT inguinal pathway DIRECT inguinal pathway pushes directly through to access inguinal canal

Question 77

how to identify a direct inguinal hernia?

Answer 77

hernia lies parallel to spermatic cord | passes medial to inferior epigastric vessels

Question 78

how to identify an indirect hernia?

Answer 78

hernia lies within spermatic cord | passes laterally to inferior epigastric vessels to enter inguinal ring

Question 79

what are the 2 inguinal ligament attachments?

Answer 79

``` Lateral= asis Medial= Pubic Tuberal ```

Question 80

how to clinically differentiate between direct and indirect inguinal hernias?

Answer 80

note 2 inguinal ligament attachements- deep inguinal ring is halfway between these. if protrusion there then = direct hernia

Question 81

other than Hasselbach's triangle, what is a common area of weakness for abdominal hernias?

Answer 81

Myopectineal Orifice

Question 82

describe the 3 abdominal muscle appearances...

Answer 82

external oblique: hands in pockets fibres internal oblique: hand on chest fibres transversus abdominus: horizontal fibres

Question 83

what does the inguinal canal contain for women and men?

Answer 83

spermatic cord, round ligament of uterus, blood & lymph vessels, iliolinguinal nerve