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GI system > Anatomy > Flashcards

Anatomy Flashcards

1
Q

What are the components of the GI tract?

A

Oral cavity, pharynx, oesophagus, stomach, small intestine, large intestine, accessory muscles, rectum, anal canal and anus

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2
Q

What joint is used to hinge the jaw to the skull?

A

temperomandibular joint

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3
Q

What muscles are associated with opening or closing of the Jaw?

A

3 pairs of closing muscles - messier, temporals and medial pterygoid
1 pair of opening - lateral pterygoid

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4
Q

which nerves supply opening and closing of the mouth?

A

CN V3

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5
Q

where does the CNV3 nerve enervate?

A

the muscles of mastication (chewing) and sensory areas

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6
Q

How are the teeth in an adult mouth described (location) and what does each number (1 to 8) correspond with?

A

upper right and left lower left and right

1-2 insisors, 3 canine, 4-5 premolars and 6-8 are wisdom teeth

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7
Q

Describe the sensation of the oral cavity

A 
superior half of palate - CNV2 
inferior half (floor of mouth) - CNV3
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8
Q

How is the tongue split up in terms of sensory nerves?

A

anterior two thirds = CN3 and CN7

posterior third = supplied by CN 9

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9
Q

what does CN7 supply?

A

anterior tongue for taste, muscles for facial expression and glands in floor of mouth

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10
Q

What does CN 9 innervate?

A

parotid gland and posterior aspect of tongue

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11
Q

What stimulates the gag reflex?

A

sensory = CN9 and motor is cranial nerve 9 and 10

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12
Q

How does local anaesthetic work on the back of throat?

A

block sensory action potentials = CN 5, 7 and 9

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13
Q

Detail the mechanism of swallowing

A

1) close lips to avoid drool
2) tongue pushes bolus of food towards oropharynx
3) inner layer of longitudinal muscles contracts to raise larynx, shorten pharynx and close of laryngeal inlet to prevent aspiration
4) bolus of food enters oesophagus and travel inferiorly by peristalsis
5) initiation of swallowing is voluntary and all the muscles are supplied by cranial nerves

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14
Q

What do the intrinsic muscles of the tongue do?

A

modify shape of tongue

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15
Q

What nerve innervates tongue? (except palatoglossus)

A

all supplied by CN 12 (hypoglassal)

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16
Q

What does CNV12 innervate?

A

extrinsic and intrinsic muscles of the tongue

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17
Q

What innervates the posterior pharynx?

A

Vagus nerve

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18
Q

What is the function of the longitudinal muscles of the pharynx?

A

elevate pharynx and larynx(close over laryngeal inlet)

contract to shorten pharynx

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19
Q

where does the oesophagus start?

where does it end?

A

inferior edge of cricopharynxgeus (vertebral level C6)

ends - cardia of the stomach

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20
Q

what are the sphincters involved in the oesophagus?

A

anatomical upper and physiological lower(helps reduce reflux, lies immediately superior to gusto-oesophageal junction)

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21
Q

What is the purpose of oesophageal plexus?

A

runs on surface to supply smooth muscle within its walls

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22
Q

What is the peritoneum

A

serous membrane, is in contact with the body wall and the organs

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23
Q

where is the peritoneal cavity located?

A

between the visceral and parietal layers

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24
Q

What are some intraperitoneal organs, retroperitoneal and organs with a mesentery

A

I = liver - covered in visceral peritoneum
R - pancreas and liver - visceral peritoneum on its anterior surface
mesentery - parts of intestines

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25
Q

Why are the intestines very mobile?

A

mesentery (double layer of visceral peritoneum) suspends the organ from the posterior abdominal wall

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26
Q

How do the omen divide in the peritoneal cavity?

A

greater sac and lesser sac - communicate through omental foramen

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27
Q

What pouches are formed in men and women?

A

one pouch in males = rectovesical

2 in females vesicouterine pouch and rectouterine pouch (pouch of Douglas)

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28
Q

What is ascitic fluid? - how is drained?

A

excess fluid within the peritoneal cavity - drained by a procedure called paracentesis

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29
Q

What is the small intestine made up of?

A

duodenum, jejunum and ileum

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30
Q

What is the large intestine made up of?

A

the colon - caecum, appendix, ascending colon, transverse colon, descending colon and sigmoid colon
The rectum
anal canal
anus

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31
Q

What embryological regions are the abdominal organs described to be within?

A

foregut (upper), midgut (leftish) and hindgut (far right going down to anus)

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32
Q

How do sympathetic nerves get from CNS to abdominal organs?

A

leave spinal cord between T5 and L2
enter sympathetic chain but do not synapse
leave as abdominopelvic splanchnic nerves
synapse at prevertebral ganglia
hitch a ride with other nerve fibres going towards smooth muscle and glands of the organs

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33
Q

What about adrenal gland as an exception to the sympathetic nerves?

A

leave spinal cord, enter abdominopelvic splanchnic nerves but do not synapse at prevertebral ganglia they synapse directly onto cells

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34
Q

How do parasympathetic nerves get to the abdominal organs?

A

enter on the surface of the oesophagus, travel into periarterial plexuses, carried to walls of organs where they synapse in ganglia

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35
Q

When are pelvic splanchnic neves used for para innervation?

A

smooth muscle or glands of depending colon to anal canal

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36
Q

How do visceral afferents get to the CNS form organs?

A 
travel up the sympathetic chain
foregut = T6 to T9
midgut = T8 to T12 
hindgut = T10 to L2 
pain form these organs tends to come depend on the location of the dermatome in relation to the entering of the visceral afferent
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37
Q

Where is pain felt in foregut, midgut and hindgut?

A

Epigastric, umbilical and pubic region

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38
Q

What is the alimentary canal?

A

series of hollow organs running form mouth to anus (oral to aboral) that are separated by sphincters

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39
Q

What are the four major functions of the alimentary canal?

A

motility - mechanical activity mostly involving smooth muscle

secretion - into the lumen of digestive tract in response to food, hormones or neural signals:

Digestion - chemical breakdown by enzymatic hydrolysis of complex foods into small absorbable units

absorption - transfer of absorbable products of digestion from digestive tract to the blood or lymph

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40
Q

what is the result of circular muscle contraction, longitudinal and muscularis mucosae contraction:

A

circular - lumen becomes narrower and longer

long - intestine becomes shorter and fatter

musculais - mixing activity

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41
Q

What organs are involved if a patient is jaundiced?

A

Liver, spleen, gallbladder, pancreas and small intestines

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42
Q

What is bilirubin

A

by-product of the breakdown of RBC

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43
Q

What is bilirubin used for?

A

used to form bile, which travels through the biliary tree

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44
Q

Why is the gall bladder important for bile?

A

It plays an important rile in the storage and concentration of bile

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45
Q

Why is bile important?

A

Used for the normal absorption of fats from the small intestine

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46
Q

What does the portal triad consist of?

A

three important tubes - hepatic artery(blood supply), hepatic vein(drainage) and the common bile duct (part of biliary tree)

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47
Q

What is the anatomy of the celiac trunk?
where is it found on a vertebral level?
When does it trifurcate?

A

First of the three midline branches of the abdominal aorta

T12 vertebral level

trifurcates into splenic artery, hepatic artery and left gastric artery

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48
Q

Describe the anatomical path of the splenic artery

where is the spleen found

A

Very tortuous course, intraperitoneal organ within the left hypochondrium

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49
Q

How is the spleen palpated clinically?(diaphragm)

A

Palpation is time with the persons breathing due to being anatomically linked to the diaphragm

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50
Q

Where does the blood supply from the stomach come from?

A

right and left gastric arteries - run along lesser curvature (anastomose together)

Right and left gastro-mental
run along greater curvature (anastomose together)

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51
Q

Where does the blood supply from the liver come from?

A

hepatic artery which branch into right and left hepatic arteries
75% is from portal vein in order to be cleared

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52
Q

What are the four anatomical segments of the liver?

A

Right lobe, left lobe, caudate lobe and quadrate lobe

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53
Q

How is the liver split up in terms of functional segments?

A

8 functional segments each with their own blood supply

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54
Q

Where does the liver drain?

A

via 3 main hepatic veins into the IVC

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55
Q

Why does hepatomegaly occur?

A

rise in central venous pressure is directly transmitted to the liver

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56
Q

In relation to the liver, what are the two man areas of the peritoneal cavity

What happens when patient is lying supine?

A

hepatorenal recess and sub-phrenic recess

when the patient is supine - the hepatorenal recess is one of the lowest parts of the peritoneal cavity

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57
Q

Describe the venous drainage of the liver in terms of the foregut

A

hepatic portal vein - drains blood from foregut, midgut and hindgut to the liver for first pass metabolism

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58
Q

splenic vein venous drainage?

A

drains the blood from the foregut

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59
Q

What does the inferior mesenteric vein do?

A

Drains the blood from the hindgut

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60
Q

inferior vena cava?

A

drains cleaned blood from the hepatic veins into the right atrium

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61
Q

How do you take a lobe of liver out?

A

cut off hepatic vein and remove lobe

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62
Q

What is the function of the gall bladder?

what is the purpose of a cystic duct?

A

To store and concentrate bile in-between meals

contains a cystic duct that bile can blow in and out of

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63
Q

What is the blood supply of the gall bladder?

A

via the cystic artery - branch of the right hepatic artery (75% of people)

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64
Q

Where can pain be present if a patient has gallstones?

A

early pain will be in the epigastric area

can also be present in the hypochondrium

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65
Q

What important structures need to be identified when carrying out a cholecystectomy

A

cystic duct and cystic artery

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66
Q

How is the biliary tree formed? (common hepatic duct then common bile duct)

A

Right and left hepatic ducts unite - common hepatic duct

the common hepatic duct then comes together with cystic duct to form the bile duct (common bile duct)

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67
Q

Where does the biliary tree drain into?

A

2nd part of the duodenum

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68
Q

What is the definition of being jaundiced? - how is it caused?

A

yellowing of sclera - whites of eyes (or skin)

caused by an increase in blood levels of bilirubin

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69
Q

What are the anatomical locations of the bile duct?

A

Descend posteriorly to the first part of the duodenum

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70
Q

How is the ampulla of vater formed?

A

Bile duct joins with main pancreatic duct to form the ampulla of vater

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71
Q

Where does the ampulla of vater drain into?

A

2nd part of duodenum through the major duodenal papilla

72
Q

What is the sphincter involved with the ampulla of vater?

A

Smooth muscle sphincters - bile duct, pancreatic duct and the sphincter of Oddi

73
Q

How can jaundice occur extra hepatically or post hepatically ? - how does this occur?

A

Blockage of biliary tree caused by gallstones, carcinoma at the head of pancreas (compresses duodenum)

Bile can flow back into the liver and overspill into the blood

74
Q

What are the 4 different parts of the pancreas

A

Head (uncinate process), neck, body and tail

75
Q

What surrounds the head of the pancreas?

A

duodenum

76
Q

What are the two functions of pancreas?

A

Exocrine - acinar cell (pancreatic digestive enzymes into main pancreatic duct)

endocrine - islets of langerhans and secrete insulin and glucagon

77
Q

What arteries supply the pancreas?

A

branches from splenic artery

gastroduodenal artery - superior pancreaticoduodenal

Superior mesenteric artery - inferior pancreaticoduodenal

78
Q

If there is a blockage of the ampulla where can the pain be felt?

A

Foregut and midgut organ so pain is felt in epi or umbilical region

but can also radiate to the back

79
Q

How can the small intestine be split up into embryological origins?

A

1st and second part of the duodenum are foregut organs

the rest are midgut

80
Q

What is the anatomy of the small intestine?

A

4 parts - superior, descending, horizontal and ascending

begins at pyloric sphincter

81
Q

How is the small intestine supplied with blood?

A

gastroduodenal artery - superior pancreaticoduodenal

Superior mesenteric artery - inferior pancreaticoduodenal

82
Q

How do you differentiate between the 3 different types of small intestine?

A

found in all 4 quadrants

jejunum begins at duodenaljejunal flexure

ileum ends at ileocaecal junction

83
Q

What are the different types of mucosa int he jejunum and ileum?

A

mucosa of jejunum = plicae circulares - loads of like little folds

distal ileum is much smoother

84
Q

Describe the blood supply and drainage to the ileum and the jejunum

A

arterial blood - superior mesenteric artery (jejunal and ileal arteries)

Venous drainage - jejunal and ileal veins, to superior mesenteric vein and hepatic portal vein

85
Q

Describe the process of fat absorption

A

bile is used to help intestinal cells absorb fats

lacteals( pick up the fats) travel via the lymphatic system to eventually drain into the venous system at the left venous angle

86
Q

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

A

celiac(foregut), superior mesenteric(midgut), inferior mesenteric(hindgut) and lumbar (everything else)

87
Q

Detail the lymph drainage of the human body

A

superficial vessels drain into deep lymph vessels -

drain into thoracic duct or the right lymphatic duct (venous angles)

eventually drain into venous system to be recycled

88
Q

What parts of the colon are mobile?

A

start of the colon(caecum) - intraperitoneal
transverse colon - intraperitoneal
sigmoid colon - intraperitoneal

89
Q

Where are the paracolic gutters found?

A

2 of them - found between lateral edge of ascending and descending wall
part of greater sac of peritoneal cavity

90
Q

What is the risk involved in paracolic gutters?

A

potential sites for pus collection

91
Q

what are haustra?

A

segmented pouches formed by tonic conctractions of teniae coli

92
Q

What are teniae coli?

A

3 distinct longitudinal bands of thickened smooth muscle running from the caecum to the distal end of the sigmoid colon

93
Q

How can faeces been seen on a radiograph

A

Distinct mottled (marked with spots) appearance

94
Q

Where the caecum and apprendix found?

A

both lie in the right ileac fossa - appendix is most often retrocaecal

95
Q

What is the McBurney point?

Why is it important in appendicitis?

A

Appendiceal orifice on posteromedial wall of caecum -

in theory this is the area of maximum tenderness in appendicitis

96
Q

Where is the sigmoid colon found?

A

left iliac fossa

97
Q

What does the sigmoid colon have?

A

long mesentery (sigmoid mesocolon) - gives rise to a considerable degree of movement

98
Q

Why in a clinical scenario is the movement of the sigmoid colon bad?

A

at risk of twisting around itself - sigmoid vovulus (at risk of ischaemia)

99
Q

What are the three midline branches of the aorta?

A

Celiac trunk - foregut
superior mesenteric artery - midgut
inferior mesenteric artery - hidngut

100
Q

What do the lateral branches of the abdominal aorta supply?

A

kidneys/ adrenal glands, gonads and body wall - abdominal aorta eventually bifurcates into common iliacs

101
Q

What organs are in the fore gut?

A

oesophagus to mid duodenum

liver, gall bladder, spleen and half of pancreas

102
Q

What organs are in the midgut?

A

mid-duodenum to 2/3rds of transverse colon

1/2 of pancreas

103
Q

What organs are in the hindgut?

A

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

104
Q

What is an important arterial anastamoses in the GI tract?

A

between branches of SMA and IMA - predominantly one artery called the artery of Drummond

105
Q

What supplies the remainder of the GI tract after the proximal 1/2 of the anal canal?

A

supplied by internal iliac artery

106
Q

What is haematemesis? and how could a peptic ulcer cause this?

A

vomiting up blood

peptic ulcer erodes through mucosa and stomach/duodenum fills with blood

107
Q

How can oesophageal varices cause bleeding?

A

abnormally dilated veins are thing and susceptible to bursting so causing bleeding

108
Q

What is the body’s two main venous systems?

A

hepatic portal vein -drain blood from the GI tract to be cleaned by the liver (absorptive parts)
systemic venous system - takes blood from everywhere else straight into the inferior vena cava

109
Q

What does the inferior vena cava do?

A

drains cleaned blood from the hepatic veins into the right atrium

110
Q

Hepatic vein?

A

Drains blood from foregut, hindgut and mid gut organs to the liver for first pass metabolism

111
Q

Splenic vein?

A

drains blood form foregut structures to hepatic portal vein

112
Q

superior mesenteric vein

A

drains blood from midgut structures to hepatic portal vein

113
Q

inferior mesenteric vein

A

drains blood from hindgut structures to splenic vein

114
Q

Where are the three clinically important sites for venous anastamoses? (blood can flow in either directions due to the presence of small collateral veins (no valves))

A

Distal end of oesophagus (superior goes to azygous vein)
skin around umbilicus (superior goes to portal)
rectum/anal canal (inferior goes to internal ileac vein)

115
Q

What is portal hypertension?

A

raised blood pressure in the portal venous system - blood is diverted through collateral veins into system circulation

116
Q

Where are the three sites of portal hypertension?

A

oesophageal varices, caput medusae (umbilicus) and rectal varices

117
Q

What does the superior mesenteric vein do?

A

Drains blood from the midgut

118
Q

What are some factors that need to be in place for faecal continence

A

Holding area, normal visceral afferent nerve fibres, function muscle spincters, normal cerebral function

119
Q

What is the pelvic floor?

A

Contains an opening to allow ailemntary, ranl and reproductive tractd to pass

120
Q

What is the pelvic floor made up of?

A

levator ani - + roof of perineum

number of small muscles - iliococcygeus
pubococcygeus and puborectalis

all skeletal muscles!

121
Q

Why are the levator ani muscles tonically contracting?

A

To provide support to the abdominal organs and prevent prolapse

122
Q

What are the nerves that supply levator ani

A

nerve to levator ani and pudendal

123
Q

WHen does sigmoid become rectum?

A

anterior to S3 (rectosigmoid junction)

124
Q

When does the rectum become the anal canal?

A

anterior to tip of coccyx

125
Q

WHere is the rectum, anal canal and anus found?

A

rectum - pelvis

anal canal and anus - perineum

126
Q

What is the rectal ampulla?

A

lies just above levator ani muscle

functioning muscle and muscle sphincer ………..

127
Q

What is the rectal ampulla?

A

lies just above levator ani muscle

functioning muscle and muscle sphincer ………..

128
Q

What are some anatomical relationships of the rectum

A

peritoneum coveres superior rectum

rectouterine/ rectovesical pouch lie anterior to the superior rectum

129
Q

Why is a puborectais muscle important?

A

contraction of this muscle decreases anorectal angle, acting like a sphincter

voluntary contraction of this msucle will help to maintian continence

130
Q

S2 S3 S4 keeps the rectum off the floor - which nevre is this?

A

Peudental nerve - anterior rami
supplies external anal sphincter
branches to supply structures of perineum

131
Q

What are teh key differences between internal and external spincters?

A

internal
contracted all the time, relaxes reflexively in response to distension (filling) of the rectal ampulla

External -
voluntary contracted (along with puborectalis msucle) in response to rectal ampulla distention in internal sphincter relaxation
132
Q

Why is the location of the pelvis/perineum important in the nerve supply?

A

Fundamental to deciding what nerve type carries out what function…

133
Q

Detail the nerve supply to the rectum/ anal canal

A

Visceral affents back to S2-S4; run with parasympathetics - sense stretch, ischaemia etc

sympathetic fibres form T12-L2 travel to inferior mesenteric ganglia, synapse, then travel via periarterial plexuses around branches of IMA - contraction of internal anal sphincter and inhibit peristalsis

para sympathetic nerves from S2-S4 via pelvic splanchnic nerves synapse in walls of rectum - inhibit internal anal spnicter and stimulate peristalisis

Somatic motor form pudendal nerve (S2-S4) and nerve to levator ani (S3,S4) - contraction of external anal spincter and puborectalis

134
Q

What can happen during labour that damages pudendal nerve/ sphincter?

A

Branches of the nerve can be stretched
fibres within puborectalis or external anal sphincter could be torn
faecal incontinence could result

135
Q

What is the ischioanal fossa?

What can spread easily?

A

Lie on each side of the anal canal
filled with fat and loose connective tissue
can communicate with eachother - abbcess can spread easily due to only fat and connective tissue being present

136
Q

What is the blood supply to the rectum and anal canal?

A

IMA - hindgut
remainder is internal iliac artery - degree of anastamoses between the vessels

Venous =
Inferior mesenteric vein drains the hindgut organs - above petinate line, portal veous system

internal iliac veins drains below pectinate line to the portal venous system

137
Q

What is the difference between rectal varicies and haemorrhoids

A

rectal varicies = relation to portal hypertension

haemorrhoids - prolapses of rectal venous plexuses (raised pressure)

138
Q

What is a PR exam good for?

A

to assess anal tone

139
Q

What is in the right upper quadrant?

A

Liver, gall bladder & biliary tree
Duodenum (1st, 2nd, 3rd parts), Pancreatic head
Colon (hepatic flexure, AC, TC)
Right kidney/adrenal gland

140
Q

What is in the left upper quadrant?

A 
Spleen
Stomach, Small Bowel
Pancreatic tail
Colon (splenic flexure, DC, TC)
Left kidney/adrenal gland
141
Q

Why are ruage important?

WHat are the curvatures of the stomach? - what is suspended on it?

A

Rugae increase surface area of stomach

Lesser curve forms right border, suspended on lesser omentum

Greater curve forms left border, greater omentum suspended from it

142
Q

What is the blood supply of the stomach like?

A

Arterial supply from branches of the COELIAC AXIS

Venous drainge via tributaries to the SMV and PORTAL VEIN

143
Q

Where does the small bowel start and end?

A

LIGAMENT of TREIZ to ILEOCAECAL VALVE

144
Q

What is the small bowel suspended on?

Detail the differences in mesenteric attachment in jejunum and ileum

A

Suspended on a MESENTERY

The mesentery of jejunum is attached to the left of aorta while the mesentery of ileum is attached to the right
‘arcades’ of vessels run in the mesentery to supply & drain the small bowel

145
Q

What does the terminal ileum do?

A

The terminal ileum conveys liquid waste to the caecum

The terminal ileum also reabsorbs bile salts for recycling by the liver.

146
Q

What is the blood supply like in the spleen?

A

Arterial Supply from SPLENIC ARTERY

Venous drainage via SPLENIC VEIN to PORTAL VEIN

147
Q

What lies in the RIF?

A

Caecum/terminal ileum
Appendix
Right Ureter (ovary/fallopian tube/uterus)
Bladder

148
Q

What does the LIF contain?

A

Sigmoid colon
Left Ureter (ovary/fallopian tube/uterus)
Bladder

149
Q

What does the colon contain?

What does it exhibit?

A

It stores gas and faeces, making it visible on an x-ray

Exhibits HAUSTRA

150
Q

Detail the parts of the colon-

A

From proximal to distal, caecum, ascending colon, hepatic flexure, transverse colon, splenic flexure, descending colon, sigmoid colon and rectum

151
Q

Whtt does the rectum do?

Where does it lie? In relation to males and females

A

The RECTUM stores faeces prior to defaecation via the anal canal

It lies anterior to the SACRUM/COCCYX and posterior to the
VAGINA in females
PROSTATE & SEMINAL vesicles in males

152
Q

What is retroperioneal and intraperitoneal

A

Caecum = INTRAPERITONEAL
Ascending and Descending colon = RETROPERITONEAL
Transverse colon = INTRAPERITONEAL, suspended on a mesentery
Sigmoid colon = INTRAPERITONEAL, suspended on a mesentery
Rectum = upper 2/3 covered by peritoneum, lower 1/3 isn’t

153
Q

What are the different parts of the peritnoeum? (retro, intra - why can intra move about?

A

objects that are only just covered are ‘retroperitoneal’

those that are completely wrapped up are ‘intraperitoneal’

intraperitoneal objects that can move because behind them, the cling film has stuck to itself have a ‘mesentery’

154
Q

What is the blood supply to the colon?

A

SUPERIOR MESENTERIC ARTERY forms MIDDLE COLIC(transverse colon), RIGHT COLIC and ILEOCOLIC ARTERIES

Supply CAECUM, ASCENDING and PROXIMAL TRANSVERSE colon

INFERIOR MESENTERIC ARTERY forms LEFT COLIC, SIGMOID and SUPEIOR RECTAL ARTERIES

Supply DISTAL TRANSVERSE, DECENDING, SIGMOID COLON and UPPER RECTUM

155
Q

What all forms into the portal vein?

A

Superior mesenteric + splenic vein, gastric + part form inferior mesenteric

156
Q

Describe the hepatic blood flow

A

oxygenated blood from hepatic artery and nutrient rich -deoxygenated blood from hepatic portal vein

liver sinusoids

central vein

hapatic vein

inferior vena cava

right atrium of the heart

157
Q

Why is portal hypertension worse in cirrhosis?

A

resistance to outflow but a dramatically increased inflow into the portal circulation

158
Q

What are the causes of portal hypertension?

A

Prehepatic - blockage of protein vein before liver - thrombosis or occlusion secondary to congenital portal venous abnormalities

Intrahepatic - distortion of the liver architecture

Budd chair syndrome and veno-occlusive disease

159
Q

What is herniation

A

Any structure passes through another and ends up in the wrong place

160
Q

What are the 2 things required for hernias to occur?

A 
structural weakness (normal - diaphragmatic, umbilicus) 
(abnormal - congenital (diaphragmatic hernia, surgical scar - incisional hernia)

Increased pressure - chronic cough, pregnant, strenuous activity

161
Q

What does the lineas semilunar separate?

A

Anterior and lateral abdominal wall

162
Q

What does the linea alba meet?

A

anterolateral abdominal wall muscles

163
Q

Why is the inguinal region important anatomically and clinically

A

Passage into and out of abdomen

clinical - Potential for passages to have weakness that can lead to herniation

164
Q

Which way do the external oblique muscles run?

Internal oblique and transverses abdominis muscle

A

(hand in pockets - anteroinferior)

(hands on chest - anterosuperior fibre direction)

Transversus abdominus muscle - horizontal fibres

165
Q

What marks the anterior boundary between the abdomen and the thigh?

A

Inguinal ligament

166
Q

How is the inguinal ligament formed?

A

Inferior thickening of the external oblique

167
Q

What is the 4cm long passageway through the anterior abdominal wall in the inguinal regions?

A

Inguinal canal

168
Q

What surrounds each inguinal canal?

A

Deep ring and a superficial ring

169
Q

What is the gubernaculum?

A

connects inferior pole of gonads to the peritoneum

170
Q

In the dropping of the testis why is the vaginal process important?

A

Protrudes the other layers of the body down with the decent of the gonads

171
Q

What is the hesselbach’s triangle?

What are the structures that form the triangle?

A

site of direct inguinal herniation
inguinal ligament
inferior epigastric artery
Lateral border fo the rectus abdomens

172
Q

Deep inguinal ring

A

Site of indirect inguinal herniation

173
Q

What is the definition of a direct inguinal hernia?

Does it occur medially to the epigastric artery?
What is it parallel to?

A

Directly through abdominal wall
Yes
Spermatic cord

174
Q

What does indirect hernia use for herniation?

What is it lateral to?
What is it within?

A

Inguinal canal

Lateral to inferior epigastric artery
Within spermatic cord or layers of abdominal wall

175
Q

Where does femoral herniation occur?

A

Through the femoral canal which is medial to the vessels (artery and veins)

176
Q

Where is the myopectineal orifice?

A

Whole area of innate weakness at the inguinal ligament

177
Q

On the body - where is the deep inguinal ring and the superficial inguinal ring?

A

deep - superior to the Half way point along the inguinal ligament
Superficial - superior and lateral to the pubic tubercle

GI system (8 decks)

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