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JazGI > Anatomy and Imaging > Flashcards

Anatomy and Imaging Flashcards

1
Q

Skeletal muscle in the GI tract is found in the (4)

A

mouth
pharynx
upper oeso
external anal sphincter

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2
Q

4 activities of the GI tract =

A

motility (mainly SM)
secretion
digestion
absorption

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3
Q

contains epithelial, exocrine and endocrine gland cells
lamina propria
muscularis mucosae

A

GI mucosa

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4
Q

4 layers of GI tract wall =

A

mucosa > submucosa > musularis externa > serosa

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5
Q

Regulates the SA and shape of mucosa layer in gut

A

muscularis mucosae

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6
Q

Lamina propria of gut wall contains:

A

capillaries
enteric NS
immune cells

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7
Q

made up of connective tissue, blood and lymph vessels, glands and nerve network

A

submucosa

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8
Q

regulates the absorptive and secretive functions of the submucosa

A

Meissner’s/submucosal plexus

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9
Q

___ muscle then _____ plexus (regulates mechanical activity of the gut) then ____ muscle
In typical gut wall muscularis externa

A

circular
Myenteric/Auerbach’s
longitudinal

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10
Q

Connective tissue layer of gut wall that secretes sticky fluid so gut slides over itself

A

serosa

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11
Q

Contraction of gut circular muscle causes ___

A

tube to narrow and lengthen

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12
Q

Contraction of gut longitudinal muscle causes ____

A

tube to shorten and fatten

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13
Q

3 bands of muscularis externa longitudinal muscle in colon

A

teniae coli

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14
Q

Slow wave electrical activity in the enteric NS is driven by ____

A

ICC pacemakers

Interstitial cells of Cajal

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15
Q

ICCs lie in :

A

between muscle layers of muscularis externa
in submucosa
few in SM cells

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16
Q

___ allow depolarisation and contraction in the gut to occur as a functional syncytium

A

gap junctions => single unit SM

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17
Q

Upstroke of slow wave electrical activity in the gut is caused by ___

A

voltage activated Ca2+ channels = Ca2+ influx

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18
Q

Downstroke of slow wave electrical activity in the gut is caused by ____

A

voltage and Ca2+ activated K+ channels = K+ efflux

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19
Q

ICC are regulated by ,+_

A

enteric+autonomic nerves

hormones

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20
Q

The force of gut contraction is directly proportional to the ___ from ICC

A

number of APs produced

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21
Q

Determines the max. frequency, direction and velocity of gut contractions

A

Slow wave electrical activity - driven by ICCs

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22
Q

BER (basic electrical rhythm) is determined by:

A

slow wave electrical activity

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23
Q

BER in duodenum is greater/less than in ileum = food moves in ___ direction

A

greater

aboral

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24
Q

BER in proximal colon is greater/less than in the sigmoid colon = food moves in ___ direction

A

less

oral

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25
Q

neuronal, hormonal and mechanical stimuli increase the chance of slow waves getting to threshold by ____

A

increasing basal depolarisation by opening Ca2+ L channels

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26
Q

Plexus in gut that modulates epithelia and blood vessels=

A

Meissner’s/submucosal

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27
Q

Plexus in gut that regulates motility and sphincters =

A

Myenteric/Auerbach’s

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28
Q

Key transmitters in enteric NS =

A

ACh, substance P, NO + VIP - regulate peristalsis

5-HT

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29
Q

sensory neurones in the gut are __,_+___ receptors

A

thermo, chemo and mechano

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30
Q

Most abundant type of neuron in enteric NS

co-ordinate reflexes and motor programs

A

interneurones

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31
Q

motor neurones in the enteric NS supply the (4)

A

SM, secretory epithelium, endocrine glands + blood vessels

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32
Q

Vagus nerve supplies ___(4) in the gut with parasympathetics

A 
oesophagus
stomach
small intestine
ascending colon
(synapses with ENS)
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33
Q

Supplies the descending and sigmoid colon with parasympathetics

A

pelvic nerves

S2-4 (synapses with ENS)

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34
Q

Excitatory effects of parasympathetics on GI tract (3)

A

Increase gastric, pancreatic and small int secretions
increase blood flow to gut
increase SM contraction

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35
Q

Inhibitory effects of parasympathetics on GI tract

A

relax some sphincters and the stomach

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36
Q

Pre/postganglionic autonomic fibres synapse with ENS

answer for para and symp

A 
para = pre
symp = post (synapses first in superior cervical and prevertebral - celiac aand sup inf mesenteric - ganglia)
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37
Q

excitatory effects of sympathetics on GI tract

A

increase sphincter tone

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38
Q

inhibitory effects of sympathetics on GI tract

A

decrease motility, secretions and blood flow

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39
Q

Example of a local reflex in the GI tract

A

peristalsis

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40
Q

In local and short reflexes in the GI tract the sensory, inter and effector neurones are found in the

A

myenteric plexus in the muscularis externa

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41
Q

Example of a short reflex in the GI tract

A

intestino-intestinal inhibitory reflex

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42
Q

What happens in the intestino-intestinal inhibitory reflex?

A

local distension > (sensory neurone) > sympathetic pre-ganglion > (interneurone) > (effector neurone) > decreased muscle activity in adjacent areas

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43
Q

Example of a long reflex in the GI tract

A

gastroileal

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44
Q

What happens in the gastro-ileal reflex?

A

increased gastric activity > increased propulsion in terminal ileum

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45
Q

…> sensory neurone (outwith muscularis externa) > dorsal motor nucleus (of vagus in medulla oblongata) > interneurone > effector neurone > …
occurs in which reflex?

A

Long reflex in GI tract eg. gastroileal

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46
Q

__+___ causes muscle layers in the gut to contract in peristalsis

A

ACh and substance P

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47
Q

__+___ cause muscle layers in the gut to relax in peristalsis

A

NO and VIP

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48
Q

In the gut segment in front of food in peristalsis

longitudinal SM ___ and circular SM ___

A

In front =
longitudinal contracts
circular relaxes

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49
Q

In the gut segment behind food in peristalsis

longitudinal SM ___ and circular SM ___

A

Behind =
longitudinal relaxes
circular contracts

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50
Q 
Rhythmic circular contraction in the small intestine =
function =
occur in \_\_ state
A

segmentation
mixes food
fed state

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51
Q

rhythmic circular contraction in large intestine that mixes food =

A

haustration

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52
Q

powerful contraction that moves faeces into the rectum and occurs a couple x per day

A

colonic mass movement

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53
Q

causes a powerful contraction to move food from the stomach to the terminal ileum

A

MMC - migrating motor complex

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54
Q

tonic contractions occur in organs with ___ function
eg. ___+___ = __ pressure
and in sphincters = ___ pressure

A 
storage = gallbladder and stomach = low P
sphincters = high P
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55
Q

Two skeletal sphincters in GI tract

A

UOS and external anal

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56
Q

Pressure upstream/downstream of a sphincter ___ it

A 
up = opens
down = shuts
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57
Q

UOS relaxes in ___

closes in ___

A 
open = swallowing
closes = inspiration
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58
Q

LOS relaxes in ___

closes in ___

A

open in food>stomach

closes to prevent reflux

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59
Q

Pyloric sphincter regulates ___ and prevents ___

A

gastric emptying

prevents duodenal reflux

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60
Q

Muscle(s) that opens the mouth

A

lateral pterygoid

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61
Q

muscle(s) that close the mouth

A

medial pterygoid, masseter and temporalis

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62
Q

deglutition =

A

swallowing

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63
Q

1st/Voluntary/___ phase of deglutition:
___ receptors are stimulated when bolus reaches oropharynx
> afferents via ____ > __+___ > efferents ___ >

A 
oral
mechanoreceptors
CN IX and X
pons and medulla
CN 7, 9, 10, 11
skeletal muscles of pharynx and larynx
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64
Q

2nd/pharyngeal phase of deglutition:
soft palate ___ and post. pharynx wall ___ to separate naso and oropharynx
ventilation is ___
___ muscles close the glottis and raise the ___
Sup. and middle pharyngeal ____
bolus moves ___ enters ___

A 
soft palate rises
post. pharynx wall constricts
vent = inhibited 
laryngeal muscles raise larynx
pharyngeal constrictors constrict
epiglottis -> oesopahgus
ventilation resumes
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65
Q

3rd/Oesophageal phase of deglutition lasts -

A

4-10 seconds

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66
Q

3rd/Oeso phase of deglutition:

___+___ > CNX -> ____ + ____

A

pons and medulla

close UOS and cause primary peristaltic wave

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67
Q

If bolus is lodged in oesophagus ____ receptors cause ___ and increased ___

A

local pressure receptors =

2ndry more powerful peristaltic wave and increased saliva production

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68
Q

Parotid gland lies:

A

anterior to ear and below zygomatic arch

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69
Q

The parotid duct/ _____ enters the mouth opposite the ____

A

duct of Stensen

2nd maxillary molar teeth

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70
Q

Parotid gland makes up ___% of salivary production

A

25%

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71
Q

Parotid gland is innervated by ___

A

CN IX and sympathetic plexus

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72
Q

___ cells in the Parotid gland secrete and ___ solution

A

serous cells =

watery α-amylase rich

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73
Q

Submandibular salivary glands lie ___

A

medial to body of the mandible

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74
Q

the submandibular salivary duct/____ enters mouth via the ___ at ____

A

duct of Wharten

via sublingual caruncula at the lingual frenulum (under tongue)

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75
Q

Submandibular glands make up __% of saliva secretion

A

70%

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76
Q

Submandibular glands have ___ cells

There secretion is more/less viscous than parotids

A

mucous and serous cells

more

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77
Q

Submandibular salivary glands are innervated by :

A

CN 7 and sympathetic plexus

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78
Q

Sublingual salivary glands lie ___

A

medial to submandibular glands

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79
Q

Sublingual salivary duct/___ -> ___ duct and connects with duct of Wharten at the ___

A

ductus of Rivinus
common Bartholin
sublingual caruncula

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80
Q

Sublingual glands make up __% of saliva secretions

A

5%

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81
Q

Sublingual glands have ___ cells = a ___ solution

A

mucous

mucus rich solution

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82
Q

Sublingual glands are innervated by ___

A

CN 7

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83
Q

Salivary glands are complex endo/exocrine glands.
Have an external ___
fibrous ___ between lobes and lobules
lobules are composed of ___

A

EXOcrine
external CAPSULE
fibrous SEPTA
lobules composed of SALIVONS

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84
Q

3 main parts of a salivon =

A

secretory acinus
intercalated duct
striated duct

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85
Q

Basic structure of secretory acinus in salivon

A

pyramiddal acinar cells around a central lumen

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86
Q

Serous acinar cells in salivons secrete ___ from ___ secretory granules

A

watery α-amylase rich secretion

small dense

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87
Q

Mucous acinar cells in salivons secrete ___ from ___ granules

A

mucus

large, pale

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88
Q

Serous and mucous acinar cells in salivons are surrounded by ___ which ___

A

myoepithelial cells

squeeze saliva into ducts

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89
Q

_____ at terminal end of secretory acinus in salivons secrete lysozymes

A

Serous demilunes

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90
Q

Intercalated ducts in salivons are made of ___ epithelium

A

cuboidal

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91
Q

Striated ducts in salivons are ___ epithelium with lots of ___ for active transport to modify saliva
combine to form __ and then ___

A

columnar epithelium with lots of mitochondria

interlobular > excretory ducts

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92
Q

attachments of the masseter muscle

closes mouth

A

angle of mandible

zygomatic arch

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93
Q

attachments of the temporalis muscle

closes mouth

A

coronoid process of mandible

temporal fossa

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94
Q

attachments of the medial pterygoid

closes mouth

A

medial side angle of mandible

pterygoid plates of the sphenoid

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95
Q

attachments of the lateral pterygoid

opens mouth

A

condyle of mandible

pterygoid plates of the sphenoid

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96
Q

the muscles that open and close the mouth are supplied by ____ nerve

A

mandibular CNV division

CNV3

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97
Q

course of CNV3

attaches to pons -> inferior edge of ____ between post.+middle ____ > ____ in sphenoid bone > structures

A

pons >
tentorium cerebelli ; cranial fossa >
foramen ovale

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98
Q

provides sensation to anterior 2/3 of tongue

special and general

A 
general = CNV3
special = CNVII
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99
Q

provides sensation to posterior 1/3 of tongue

special and general

A

general and special = CNIX

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100
Q

Provides sensation to the superior 1/2 of oral cavity

gingivae and palate

A

general = CNV2

Vert2go - vertigo=high part

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101
Q

Provides sensation to the inferior 1/2 of oral cavity

gingivae and floor

A

general = CNV3

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102
Q

sensory nerves of gag reflex =

respond to ___

A

CNIX

touch to posterior wall of oral cavity

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103
Q

motor nerves of gag reflex =

cause ___

A

CNIX and X

pharynx to constrict

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104
Q

in endoscopy local anaesthetic spray blocks nerves:

A

CN V2, V3, VII, IX

5, 7, 9

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105
Q

Course of CNV2:

__ > inf. edge of ____ between post. and middle ____> ____ in sphenoid > structures

A

pons
tentorium cerebelli ; cranial fossa
foramen rotundum

106
Q

CN__ is the only nerve to attach directly to the pons

A

CNV

107
Q

Course of CNVII/7:
junction between__+__>____ in posterior ___> in temporal bone ____ to _____ (most fibres) OR ___ (over tympanic membrane > + lingual branch > tongue and submandibular gland)

A

pons + medulla
internal acoustic meatus ; cranial fossa
internal acoustic meatus to stylomastoid foramen
OR chorda tympani

108
Q

CN VII joins with ____ branch of CN_ to supply __ to the anterior tongue and parasympathetics(____) to ___ salivary glands

A

lingual branch of V3 ; taste

secretomotor to submandibular

109
Q

CNVII has __,__,__+__ nerve fibres

A

parasympathetic
special sensory
sensory
motor

110
Q

The CNVII fibres that pass out of the stylomastoid foramen supply the____

A

muscles of facial expression

111
Q

Course of CN IX/9:
___ > __ in posterior ___ between ___+___bone> posterior ___, palate, posterior ___ wall and parasympathetics to the ___

A

medulla>
jugular foramen ; posterior cranial fossa ; temporal and occipital bone>
post. tongue, post. oropharynx wall , parasymp to parotids

112
Q

CN IX has ____(5) fibres

A 
special sensory
sensory
motor
visceral afferent
parasympathetic
113
Q

4 extrinsic muscles of the tongue =

A

palatoglossus
styloglossus
hyoglossus
genioglossus

114
Q

palatoglossus attaches to ___ and the tongue

A

palatine bone

115
Q

styloglossus attaches to ___ and the tongue

A

styloid process of temporal bone

116
Q

hyoglossus attaches to ___ and the tongue

A

hyoid bone

117
Q

genioglossus attaches to ___ and the tongue

A

genial tube on the mandible

118
Q

There are ___ intrinsic muscles of the tongue

A

4 intrinsic muscles of the tongue

119
Q

All tongue muscles (except _____) are supplied by CN___

A

CN XII - hypoglossal nerve

except palatoglossus = CNX

120
Q

palatoglossus is supplied by CN ___

A

CNX - vagus

121
Q

The course fo CNXII (12):
___ > ____ in posterior ___ >____ at anterior wall of ___ in ___ bone > descends lateral to ____ > level of __ bone and supplies ___

A

medulla >
hypoglossal canal in posterior cranial fossa
hypoglossal canal at ant. wall of foramen magnum in occipital bone
lateral to carotid sheath
hyoid bone
tongue

122
Q

External layer of the pharynx = ___muscles
superior, medial and inferior layers ___
involuntary/voluntary muscles

A

constrictor/circular
overlap
voluntary

123
Q

External circular muscles of pharynx are innervated by ___

muscles insert onto midline ___

A

CN X

midline raphe

124
Q

The UOS / _____ muscle is at __ level and marks the boundary between + and __+__

A

cricopharyngeus muscle
C6
pharynx>oeso
larynx>trachea

125
Q

The internal muscles of the pharynx (4) are ___ innervated by ___/___
Function =+

A 
longitudinal muscles
CNX - 3 muscles
CNIX - sylopharyngeus
contract to shorten - elevates pharynx
close over laryngeal inlet - elevates larynx
126
Q

the oesophageal plexus has __+___ fibres that supply the ___ NS and alters the rate of ___

A

para(CNX) and symp
enteric NS
para increases + symp decreases = peristalsis

127
Q

Oesophageal plexus stops at ___

A

cardia of the stomach

128
Q

All of the muscles involved in the initial stage of swallowing (until the oeso) are ___ and supplied by __

A

skeletal

cranial nerves

129
Q

Normal anatomical indents in oesophagus shown in barium swallow =

A

cervical - C6 cricopharyngeus
2x thoracic - aortic arch and L bronchus
diaphragmatic - diaphragm and LOS

130
Q

LOS is a ____ sphincter and lies superior to ___

which is an abrupt mucosal change = ____

A

physiological sphincter
GOJ
Z-line

131
Q

Indent in lesser curvature in stomach =

A

incisura angularis

132
Q

Longest > shortest part of small intestine

A

ileum (4m)
jejunum (3m)
duodenum (short)

133
Q

Foregut organs =

A

oeso-> mid duodenum + liver, gallbladder, spleen and 1/2 pancreas

134
Q

Midgut organs =

A

mid duodenum to 2/3rds of transverse colon

1/2 pancreas

135
Q

Hindgut organs =

A

distal 1/3 of transverse colon -> prox. 1/2 anal canal

136
Q

4 lines that split the 9 regions of the gut =

A

mid clavicular x2
trans-tubercular
subcostal

137
Q

Thin, transparent, semi-permeable, serous membrane =

A

peritoneum

138
Q

Liver is a ___peritoneal organ = __ movement

A

intraperitoneal

little movement

139
Q

double layers of mesentery =

A

condensations

140
Q

lesser omentum is from __ to ___

A

liver to stomach

141
Q

greater omentum has __ layers of mesentery and hangs from ___

A

4

stomach

142
Q

free edge of lesser omentum contains the ___

A

portal triad

143
Q

greater and lesser omentum communicate via the ____

A

omentum foramen

144
Q

Pericentesis for ascites:

needle is inserted___ to avoid ___

A

lateral to rectus sheath

avoids inferior epigastric artery behind the rectus abdominus

145
Q

inferior epigastric artery branches off the ___, __ to deep inguinal ring

A

external iliacs

medial to deep inguinal ring

146
Q

Visceral peritoneum and the abdo organs are innervated by

A

enteric NS and autonomic NS

147
Q

Parietal peritoneum and body wall are innervateed by

A

somatic sensory and motor

sympathetic NS

148
Q

Sympathetic nerves to abdomen leave via ___ > enter symp chain > ______ nerves > synapse at prevertebral ganglia ____) > postsynaptic nerves > ___ plexus where combine with para and visceral afferents ->

A 
T5-L2
abdomino-pelvic splanchnic nerves
anterior to aorta - celiac, aortico-renal and sup+inf mesenteric ganglia
periarterial plexus
SM and glands of organs
149
Q

Adrenal glands are supplied by sympathetic nerves from __ which become ____ nerves -> periarterial plexus > synapse directly onto adrenals

A

T10-L2

abdomino-pelvic splanchnic nerves

150
Q

Parasympathetic supply to gut organs up until distal end of transverse colon =

A

CNX

151
Q

Parasympathetic supply to descending colon> anal canal =

A

pelvic splanchnic nerves (S2,3 and 4)

152
Q

Pain in foregut is felt in ___ region

A

epigastric

153
Q

Pain in midgut is felt in ___ region

A

umbilical

154
Q

Pain in hindgut is felt in ___ region

A

pubic

155
Q

Visceral afferents from foregut enter spinal cord at ____

A

T6-9

156
Q

Visceral afferents from midgut enter spinal cord at ____

A

T8-12

157
Q

Visceral afferents from hindgut enter spinal cord at ____

A

T10-L2

158
Q

the 7th-11th intercostal nerves extend to become the ___ nerves and travel between ____+___
supply __

A

thoracoabdominal nerves
internal oblique and transversus abdominis
body wall

159
Q

T12 anterior rami becomes ___ to supply

A

subcostal nerve

body wall

160
Q

iliohypogastric nerve comes from __

A

half of L1 anterior ramus

161
Q

ilioinguinal nerve comes from ___

A

half of L1 anterior ramus

162
Q

Body wall nerves = (4)

A

thoracoabdominals
subcostal
iliohypogastric
ilioinguinal

163
Q

Pancreatic pain is felt __ +___

A

epigastric

upper back

164
Q

liver and gallbladder pain are felt

A

RUQ
back RUQ
right shoulder

165
Q

Icterus =

caused by

A

jaundice

increased bilirubin in the blood

166
Q

Portal triad =

A

hepatic artery
HPV
common bile duct
(+ nerves and lymphatics)

167
Q

3 midline anterior branches of abdominal aorta

superior -> inferior

A

celiac
superior mesenteric
inferior mesenteric

168
Q

Celiac trunk arises at __ level

A

T12

169
Q

Celiac trunk trifurcates into

A

hepatic artery
splenic artery
L gastric artery

170
Q

Runs a tortuous course over the top of the pancreas

A

splenic artery

171
Q

Spleen is __peritoneal

protected by ribs ___

A

intraperitoneal

ribs 9-11

172
Q

Hepatic artery branches into __+___+_ ->

A

R and L hepatic
R gastric (anastamoses with L gastric)
gastroduodenal ->superior pancreatico-duodenal + R-gastric omental

173
Q

Branch of splenic artery that supplies greater curvature of the stomach
anastamoses w. ___

A

L gastro-omental artery

anastamoses with R. gastric-omental from hepatic artery

174
Q

Ribs ___ protect the liver

A

Ribs 7-11

175
Q

4 anatomical segments of liver =

_ functional segments

A

right, left, caudate (superior), quadrate (next to gallbladder)
8

176
Q

Posterior recesses of peritoneal cavity

both lie within the ___ omentum

A

hepatorenal (Morrison’s)
subphrenic
greater omentum

177
Q

Ligaments of the liver

A 
coronary ligaments (attach to diaphragm)
falciform ligament ( splits L+R lobe and attach to ant. abdo. wall)
ligamentum teres/round ligament (to umbilicus)
178
Q

The ___ artery supplies the gallbladder
In 75% of people branches off of ___
In 25% of people branches off of __

A

cystic
R hepatic 75%
L hepatic/hepatic/celiac 25%

179
Q

Biliary tree =

descends posterior to ___

A

R+L hepatic > common hepatic
+ cystic duct > CBD
first part of duodenum and pancreas

180
Q

CBD joins pancreatic duct at ___ which leads to ___ and drains into the ___

A

the ampulla of Vater
major duodenal papilla
2nd part of duodenum

181
Q

Post-hepatic causes of jaundice are due to ___

eg.s =

A

bile backflow into liver and blood

gallstones, pancreatic cancer, cholangitis, pancreatitis

182
Q

Pre-hepatic causes of jaundice are due to ___

eg.s =

A

increased haemolysis of RBCs

malaria, sickle cell, AI

183
Q

Hepatic causes of jaundice cause an increase in ____ bilirubin
eg.s =

A

unconjugated+/conjugated

cirrhosis, hepatitis, drugs, liver ca, AI, Gilbert’s

184
Q

5 parts of pancreas =

A 
uncinate process
head
neck
body
tail
185
Q

Pancreas is at level of ___

A

L1-2

186
Q

Nerve supply for pancreas
para=
symp=
+___

A

para = vagus
symp = abdomino-pelvic splanchnic nerves
visceral afferents

187
Q

blood supply to pancreas

A

pancreatic arteries off of splenic artery (mainly)
superior pancreaticoduodenal off of gastroduodenal
inferior pancreaticoduodenal off of superior mesenteric

188
Q

What parts of duodenum are foregut?

A

1st and 2nd

189
Q

1st/___ part of duodenum/____
__ in length
Is ___peritoneal

A

superior
duodenal cap
2cm
intraperitoneal

190
Q

Which parts of duodenum are intra and retroperitoneal

A 
1st = intraperitoneal
2,3,4th = retroperitoneal
191
Q

Duodenum:
2nd part=
3rd part=
4th part=

A

2=descending
3=horizontal
4=ascending

192
Q

Blood supply to duodenum =

A

superior and inferior pancreaticoduodenal arteries

193
Q

Beginning of the jejunum

is ___ degrees

A

duodenaljejunal flexure

90 degrees

194
Q

jejunum is ___peritoneal
the mucosa is ___ folded
folds =

A

intraperitoneal
highly
plicae circularis

195
Q

blood supply and drainage to jejunum

A

superior mesenteric > jejunal arteries (long loops)

jejunal veins>sup mes

196
Q

Ileum is ___peritoneal
Has __ folds+ muscle than jejunum
Absorbs ___+__

A

intraperitoneal
less
bile and B12

197
Q

Blood supply and drainage to ileum

A

sup mes > ileal arteries - short loops

ileal vein > sup mes

198
Q

Fat absorbed in gut enters blood via the ____

A

left venous angle

199
Q 
Lymph nodes that drain:
foregut:
midgut:
hindgut
kidneys, post abdo. wall, pelvis, lower limbs
A

foregut=celiac nodes
midgut=superior mesenteric nodes
hindgut = inferior mesenteric nodes
kidneys etc. = lumbar nodes

200
Q

Parts of colon that are 2ndry retroperitoneal

A

ascending and decending = less mobile

201
Q

Parts of colon that are intraperitoneal and so are mobile

A

caecum
transverse (very mobile)
sigmoid

202
Q

lateral edge of asc + desc colon and abdominal wall=__

is part of the ___

A

paracolic gutters

greater sac of the peritoneal cavity

203
Q

teniae coli are present on the colon until the ___

A

sigmorectal junction

204
Q

64% of the time the appendix lies ___

A

retrocaecal

205
Q

Appendix lies at ___ point, max area of pain in appendicits, which =

A

McBurney’s

1/3 of the way between ASIS and umbilicus

206
Q

Most likely part of colon to form a volvulus

A

sigmoid

207
Q

Abdominal aorta lies to the L/R of the IVC

lateral branches and final bifurcation sup to inf =

A 
L
renal
gonadal
body wall (posterolateral)
common iliac
208
Q

internal iliac artery supplies the ___

A

pelvic organs

209
Q

external iliac becomes the femoral artery after ___

A

after going behind the inguinal ligament

210
Q

Branches off of the superior mesenteric artery superior to inferior

A

inferior pancreaticoduodenal
middle colic (transverse)
right colic (ascending)
ileocolic -> appendicular, jejunal and ileal

211
Q

middle colic branch of sup mes artery supplies

A

transverse colon

212
Q

right colic branch off of sup mes artery supplies

A

ascending colon

213
Q

inferior mesenteric artery branches superior to inferior

A

left colic - descending
sigmoid colic
superior rectal (supplies until pectinate line)

214
Q

The distal anal canal starts at the ___ and is supplied from the ___ artery

A

pectinate line

internal iliac -> middle and inferior rectal arteries (slightly anastamose with sup. rectal artery

215
Q

anastamosis of the SMA and IMA is predominantly by 1 artery called

A

marginal artery of Drummond

216
Q

Superior part of oeso usually drains to ___ and distal end drains to ____
Is an anastamosis between systemic and portal systems

A 
sup = azygous
inf = HPV
217
Q

rectum becomes anal canal just before passing through ___ + anterior to ___

A

levator ani

tip of coccyx

218
Q

anal canal and anus lie in pelvic cavity/perineum

A

perineum

219
Q

at __ level sigmoid becomes rectum

A

S3

220
Q

rectal ampulla lies superior to ___

A

levator ani

221
Q

pelvic diaphragm =

A

levator ani and fascial covering

222
Q

3 main levator ani muscles =

A

iliococcygeus
pubococcygeus
puborectalis
all = skeletal and voluntary

223
Q

levator ani muscle that slings around rectum and contracts to lower anorectal angle
important in continence

A

puborectalis

224
Q

Nerves to levator ani =

cause its and internal anal sphincter contraction

A

nerve to levator ani mostly - S3+4

pudendal - S2, 3 and 4

225
Q

internal anal sphincter site =

contraction is inhibited by ___ when the ampulla is distended

A

superior 2/3rds of anal canal

parasympathetics

226
Q

external anal sphincter site =
is continuous superiorly with ___
contraction is stimulated by ___ nerve

A

inferior 2/3rds of anal canal
puborectalis muscle
pudendal nerve

227
Q

Sympathetic nerves that cause internal anal sphincter to contract and inhibits peristalsis

A

T12-L2

228
Q

Visceral afferents go to ___ with ___

sense - stretch and ischaemia of rectum and anal canal

A

S2-4

parasympathetics

229
Q

paraympathetic supply to rectum and anal sphincter is from ___
relaxes internal anal sphincter

A

S2-4

230
Q

Pudendal nerve comes from a branch of the ____

exits pelvis at ___ and enters via ___ to supply perineum

A

sacral plexus
greater sciatic foramen
lesser sciatic foramen

231
Q

Embryologically pectinate marks line between __derm and ___ derm derived parts

A

endoderm and ectoderm

232
Q

nerve, lymphatics, vein and artery for above pectinate line

A

autonomic NS
IMA
sup. rectal vein >IMV->HPV
internal iliac nodes > inf mes nodes

233
Q

nerve, lymphatics, vein and artery for below pectinate line

A

somatic and pudendal nerves
internal iliac artery
middle and inf rectal vein >int iliac vein -> systemic veins
superficial inguinal nodes

234
Q

epithelium above and below pectinate line =

A 
above = columnar
below = non keratinised stratified squamous
235
Q

inferior pelvic structures drain to ____ nodes

A

internal iliac nodes

236
Q

superior pelvic structures and lower limb drain to ___ nodes

A

external iliac nodes

237
Q

internal and external iliac nodes drain to ___ nodes to ___ nodes

A

common iliac nodes

lumbar nodes

238
Q

Haemorrhoids are caused by ___

defintion =

A

raised P

prolapses of rectal venous plexuses

239
Q

Red horseshoe around anus =

A

ischioanal abcess

240
Q

ischioanal fossae contains

R and L communicate ____

A

fat and loose connective tissue

posteriorly

241
Q

US is good for imaging ___ organs and free ___

A

solid eg. biliary tree and urinary tract

fluid

242
Q

MRI is good for imaging ___ and has no ___

A

soft tissues

no radiation

243
Q

Parts of pancreas and duodenum that lie in RUQ

A

1,2,3rd parts of duodenum

head of pancreas

244
Q

Duodenal jejunum junction is also called ___

A

ligament of Treitz

245
Q

scintigraphy =

A

production of imaging using radioactive compounds to = 2D image

246
Q

cytochemisty =

A

identifying biochemistry of cell

eg. Perl’s stain for Fe, for enzymes, for leukaemia

247
Q

cytogenetic analysis =

A

study of chromosomes and their abnormalities

248
Q

immunophenotyping =

A

investigate the pattern of antigen expression on/in cells through a panel of antibodies
can produce a protein expression profile unique to different cell types eg. T cells

249
Q

First line imaging for biliary colic/cholycystitis=

and further clarification=

A

US

MRCP/ERCP

250
Q

Pancreatitis firstline imaging =

imaging to show complications after 1wk =

A

US

CT/others

251
Q

Firstline imaging for perforation =

__ shows source and complications

A

Erect CXR - subphrenic gas

CT

252
Q

1st line imaging for appendicitis

A

US

253
Q

Imaging for diverticulitis to see inflammatory change and associted complications =

A

CT

254
Q

Imaging for distended abdomen (suspected that it’s due to bowel gas)

A

AXR (shows if obstruction/ileus)

CT

255
Q

Imaging for distended abdomen (suspect fluid)

A

US

256
Q

1st line investigation for haematemesis/lower GI bleed

complements it =

A

endoscopy

Radiology - CT with IV contrst +/ angiography

257
Q

1st line investigation for dysphagia =

___ gives you functional and anatomical/pathological info

A

endoscopy

barium/contrast studies

258
Q

Change in bowel habit examination/imaging =

A

PR
CT colonography if want R colon information
if IBD considered = endoscopy

259
Q

typical appearance of liver met.s on US =

A

target

260
Q

1st line investigation for jaundice=
biliary cause =>
liver lesions =>
nodular and course contours of liver=>

A

US ->
M/ERCP
CT (cancer)
US guided biopsy (cirrhosis)

JazGI (26 decks)

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