Anatomy and Embryology Flashcards
1
Q
What are ligaments ?
A
Connective tissue that spans between organs or from organs to the body wall.
2
Q
What are Omenta ?
A
Double folds of peritoneum coming from the stomach to other organs or the body wall.
3
Q
What is the name of the foramen that links the greater and lesser sacs ?
A
Epiploic foramen
4
Q
Name the 4 layers of the GI wall
A
- Mucosa
- Submucosa
- Musculares externa
- Serosa/Adventitia
5
Q
What is the difference between Serosa and Adventitia ?
A
Serosa is only found within the peritoneum where as Adventitia is found outside the peritoneal cavity.
6
Q
Where does lymph drain from the peritoneal organs ?
A
The Coeliac, Superior Mesenteric and Inferior Mesenteric lymph nodes.
7
Q
Define Malrotation
A
Rotation of the intestine does not occur in the correct direction
8
Q
What is the main symptoms of Malrotation ?
A
- Vomiting of bile
- Baby pulls legs towards chest
- Failure to thrive
9
Q
What might Malrotation lead to ?
A
Volvulus
10
Q
Define Omphalocele
A
Herniation of intestines outside the body, the intestine are covered in the amnion
11
Q
Define Gastroschisis
A
Herniation of the intestines outside the body, the intestines aren’t covered in a sac
12
Q
What is the job of the Vitelline duct in an embryo?
A
It act as a connection between the embryonic yolk sac and the primitive midgut.
13
Q
What is Meckel’s diverticulum ?
A
A remnant of the Vitelline duct as seen as an out pouching from the small intestine
14
Q
What is the urogenital sinus ?
A
It is the ventral part of the cloaca, formed after the cloaca separates from the anal canal during the fourth to seventh weeks of development.
15
Q
What is the urogenital septum ?
A
Separates the anal canal and urogenital sinus
16
Q
What is PTX2 gene responsible for ?
A
Left sidedness and the abnormal expression of this gene leads to dextrocardia
17
Q
What is Gastrulation ?
A
The development of the Bilaminar disk from the Trilaminar disk.
18
Q
Where is SHH found and what does it do ?
A
Found in the endoderm and induces the HOX gene in the mesoderm to organise the gut.
19
Q
Which organ is mesodermal in origin ?
A
Spleen
20
Q
What is the name of the bud that forms the lungs ?
A
Laryngotracheal bud
21
Q
What septum separates the oesophagus and trachea ?
A
Tracheo-oesophageal septum
22
Q
What is annular pancreas ?
A
When the ventral and dorsal buds don’t join together to form one pancreas. This may cause duodenal stenosis.
23
Q
What are the 3 parts of the oesophagus known as ?
A
Cervical, thoracic and diaphragmatic
24
Q
What two ligaments make up the less omentum ?
A
Hepatogastric and Hepatoduodenal ligaments
25
What ligaments make up the greater omentum ?
Gastrocolic, Gastrophrenic and Gastrosplenic
26
Which ribs does the liver lie deep to on the right hand side ?
Ribs 7-11
27
Which ribs does the spleen lie deep to on the left hand side ?
Ribs 9-11
28
Which rib does the gallbladder lie deep to on the right hand side ?
Rib 9
29
What are the borders of the Triangle of Calot ?
The common hepatic duct, the cystic duct and the inferior border of the liver.
30
Which artery is found in the Triangle of Calot ?
The cystic artery
31
Which plane does the pancreas lie in ?
Transplyloric plane
32
Is the pancreas intraperitoneal or retroperitoneal ?
Retroperitoneal
33
Which vein forms behind the neck of the pancreas ?
The portal vein
34
What level does the coeliac trunk branch from the aorta ?
T12
35
What level does the SMA branch from the aorta ?
L1
36
What level does the IMA branch from the aorta ?
L3
37
What are the 3 branches of the Coeliac trunk ?
Left gastric, hepatic and splenic arteries
38
```
Jejunum vs Ileum
What colour are they ?
What are there walls like ?
What is the vascularity like ?
Vasa recta ?
Arcades ?
Lymphoid nodules ?
Fat in mesentery ?
```
```
Deep red Pale pink
Thick and heavy Light and thin
Highly vascularised Less vascularisation
Long Short
Few Many
None Many
Low levels High levels
```
39
Which 3 features separate the small intestine from the large intestine ?
Omental appendices
Haustra
Taenia Coli
40
What is the most common position of the appendix ?
Retrocecal
41
What is MacBurney's point ?
Site of maximum tenderness in acute appendicitis
42
Which vertebral level is the retro-sigmoid junction found at ?
S2
43
What will you feel in a male and female during a rectal examination ?
Male - Prostate gland (Round lump with sulcus)
| Female - Cervix or vaginal tampon
44
What is the parasympathetic innervation to the abdomen ?
Vagus nerve and S2,3, and 4
45
What is the sympathetic innervation to the abdomen ?
Abdominopelvic splanchnic nerves (Greater T5-9, Lesser T10-11, and Least (T12).
Abdominal aortic plexus
Prevertebral sympathetic ganglion
46
Which two veins joins to form the portal vein ?
The splenic and superior mesenteric veins.
47
What forms if there is obstruction in the portosystemic anastomoses ?
Varices
48
Where can varies be found ? (3)
1) Umbilicus (Caput medusae)
2) Anorectal junction (Haemorrhoids)
3) Gastro-oesophagus junction (Oesophageal varies)
49
Where does lymph from the abdomen drain ?
Thoracic duct
50
What do pre-aortic nodes drain ?
Organs supplied by anterior branches of the aorta
51
What do lateral aortic nodes drain ?
Organs supplied by lateral branches of the aorta
52
What do retro-aortic nodes drain ?
The posterior abdominal wall
53
Why does referred pain occur ?
Somatic and visceral nerves travel through the same pathway (nerve root) into the spinal cord and up to the brain. The CNS sometimes confuses these signals and cannot differentiate between them. This is the reason pain is sometimes referred away from the region of damage.
54
What are the names of the 4 lobes of the liver ?
Left, right, caudate and quadrate
55
What carries the livers nerve supply ?
The hepatic plexus found along the porta
56
Which three structures enter and leave the liver via the portal hepatis ?
The hepatic arteries, hepatic portal vein and hepatic ducts.
57
What happens as the connective tissue surrounding the liver goes into it ?
It branches into septa and divides the liver into lobules
58
What are hepatic cords made up of ?
Hepatocytes
59
What is the name of the pathway in which bile flows through the liver ?
Bile canaliculi
60
What is the name of the pathway in which blood flows through the liver ?
Hepatic sinusoids
61
What 4 main functions do hepatocytes have ?
- Detoxification
- Nutrient conversion
- Vitamin/glycogen storage
- Bile synthesis
62
What are the 6 components of bile ?
1) Bile acids
2) Cholesterol
3) Bile pigments
4) Toxic metals
5) Bicarbonate
6) Lecithin
63
How are bile pigments produced ?
The breakdown of haemoglobin from old/damaged RBC's. Bilirubin is extracted and secreted into bile.
64
What makes poo brown ?
Bile pigments are broken down by bacterial enzymes and released into faeces making it brown.
65
What makes urine yellow ?
Bilirubin is reabsorbed by enterohepatic circulation then excreted by the kidneys causing urine to be yellow.
66
How are bile acids made ?
They are made from cholesterol in the liver
67
What are the 3 layers of the gallbladder ?
1) Mucosa
2) Muscularis externa
3) Serosa
68
How does the gallbladder concentrate bile ?
By absorbing the sodium and water then follows
69
What is the duodenum involved with ? (3)
- Neutralisation
- Iron absorption
- Digestion
70
What absorption is the ileum involved with ? (4)
- Sodium reabsorption
- Water reabsorption
- Vitamin B12 absorption
- Bile salt reabsorption
71
What is the main function of the cells that make up the villus ?
Absorption
72
What is the main function of the cells that make up the crypts ?
Secretion
73
What do crypts secrete and what follows ?
Cl- and water follows
74
What is the function of water in the lumen of the small intestine ? (4)
- Promotes mixing
- Aids absorption
- Dilutes and washes away harmful substances
- Maintains liquid state
75
What gene is faulty in CF and what does this mean ?
CFTR and it stops Cl- being down into the lumen and so no water follows. This means lack of absorption and mixing.
76
What is the main process occurring in the small intestine when food isn't being processed ?
Peristalsis
77
What is the main process occurring in the small intestine when food is being processed ?
Segmentation
78
What complex occurs during peristalsis in the stomach/small intestine ?
The migrating motility complex
79
What stops the MMC ?
Food entering the stomach
80
How often does the MMC go through the GI tract ?
One beings as another ends
81
What is the function of the MMC ?
To move food into the large intestine and prevent bacterial colonisation of the small intestine
82
Which hormone initiates the MMC ?
Motilin
83
How does parasympathetic innervation get to the gut ?
Vagus nerve
84
How does sympathetic innervation get to the gut ?
Runs with the arteries from the prevertbral ganglion e.g. coeliac, SMA, IMA
85
Describe the muscularis externa of the rectum
Very thick
86
Is the muscular of the rectum thicker or thinner than the anal canal ?
Thinner, the anal canal muscle is very thick due to the internal anal sphincter.
87
What does the colon do with sodium ?
It actively transports it out of the lumen into the blood and water follows.
88
What occurs in the colon due to long transit time ?
Bacterial colonisation
89
What do the bacterial of the large intestine do ?
They ferment undigested carbohydrates into SCFA's
90
What else do the bacteria of the large intestine produce as well as SCFA's ?
Vitamin K
| CH4 (methane), H2, CO2, N2
91
What occurs following a meal in the large intestine ?
A mass movement contraction
92
What reflex occurs when the rectal wall is distended ?
The defecation reflex
93
Define constipation
The retention of faecal material for long time periods
94
What are the symptoms of constipation
- Abdominal distension
- Abdominal pain/cramps
- Headaches
- N/V
- Loss of appetite
95
Define diarrhoea
The increased frequency of faces that are too liquid.
96
What are the 4 main causes of diarrhoea ?
- Bacteria
- Viruses
- Food
- Toxins
97
Which bacteria are a common cause of diarrhoea ?
Enterotoxigenic bacteria e.g. E. coli, Vibrio Cholerae
98
How do enterotoxigenic bacteria cause diarrhoea ?
The produce enterotoxins which cause Cl- to move into the lumen of the GI tract and so water follows. They increase intracellular 2nd messengers cAMP, cGMP and calcium.
99
Define anaerobic
Living without the presence of oxygen
100
Define aerobic
Living only in the presence of oxygen
101
What does it mean by facultative anaerobes and obligate anaerobes ?
Facultative anaerobes - Can live in the presence of oxygen and without it
Obligate anaerobes - Can only live in the absence of oxygen
102
What is meant by OTC ?
Operational taxonomic unit
103
What does it mean by a high OTC ?
High diversity
104
What 3 factors affect the types/numbers of bacteria growing along the GI tract ?
- Oxygen
- pH
- Transit time
105
What do GI bacteria do ?
- Improve immune response
- Provide competition to harmful bacteria
- Defend against pathogens
- Modify host secretions
106
Where is the energy from junk food absorbed ?
In the stomach and small intestine
107
Where is the energy from good food absorbed ?
Large intestine
108
What 3 affects does fibre in the diet have ?
- Easy of passage
- Reduces transit time
- Faecal bulks
109
What does fibre contain ?
Vitamins
Anti-oxidants
Phytochemicals
110
What are the 3 main fatty acids called ?
Propionate
Butyrate
Acetate
111
What is butyrate important for ?
Cell growth and regeneration
112
What is propionate important for ?
Satiety and gluconeogenesis
113
What is acetate important for ?
Lipogenesis
114
Why does the distal colon tend to have more pathogens ?
Higher pH
115
Where is the colon does more protein metabolism take place ?
The distal colon
116
Define autoimmune disease
Disease that occurs when the immune system can no longer distinguish between harmful bacteria and commensal bacteria
117
The bacterium F. prausnitzii is lower in numbers in CD or UC ?
CD
118
The bacteria enterbacteriae is in high or low numbers in CD ?
High
119
In UC what type of bacteria are in low numbers ?
Firmicutes
120
What two things reduce bacterial diversity ?
- Antibioitcs
| - Inflammation
121
What 3 things can be done to increase bacterial diversity ?
- Give pre-probiotics
- Reduce antibiotics
- Boost fibre in diet
122
What is the FODMAP diet ?
Designed to reduce bacterial fermentation and identifies key foods to exclude permanently and reintroduces others.
123
Define probiotics
Probiotics are the live organisms
124
Define prebiotics
Prebiotics is the substrate that is utilised by the host organisms.
125
Where are prebiotics found ?
Found naturally in some plants, but is added to cereals, breads and some drinks.
126
Name 3 prebiotics
FOS
GOS
Insulin
127
What affects do prebiotics have ? (4)
Help to lower blood sugars
Reduce amount of food taken in
Reduce inflammation
Increase calcium absorption
128
Why is polymycin B a good antibiotic ?
Its bacteriocidal and bacteriostatic
129
How are resistant genes shared within a bacterial population ? (3)
Conjugation
Transformation
Transduction
130
What is the main treatment for resistant C . difficile infections ?
FMT - Faecal microbial transplants
131
How is FMT delivered into the body ?
Via colonscopy, an enema or capsule
