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anatomy: gastrointestinal Flashcards

1
Q

what are the abdominal wall ligaments called?

A

aponeuroses

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2
Q

what are the vertical muscles on either side of the abdominal midline?

A

rectus abdominis

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3
Q

what are the rectus abdominis muscles attached to?

A

sternum and costal margin superiorly and pubis inferiorly

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4
Q

what direction do the external obliques run in?

A

down and in

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5
Q

what direction do the internal obliques run in?

A

up and in

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6
Q

what are the 3 muscles lateral to the rectus sheath?

A

external obliques, internal obliques, transversus abdominis

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7
Q

what does the inguinal ligament attach to?

A

anterior superior iliac spine (laterally) and pubic tubercle (medially)

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8
Q

what lies just above the inguinal ligament?

A

inguinal canal

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9
Q

what marks the base of the appendix?

A

McBurney’s point

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10
Q

function of the aperneroses?

A

to hold the abdominal viscera within the abdominal cavity and aid breathing

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11
Q

The foregut is supplied by which nerve?

A

The greater splanchnic nerve

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12
Q

The splanchnic nerve arises from where?

A

T5 - T9

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13
Q

Where is the t5 to t9 dermatome level?

A

Epigastrium

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14
Q

What nerve supplies the midgut?

A

Lesser splanchnic nerve

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15
Q

Origins of lesser splanchnic nerve?

A

T10-T11

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16
Q

T10-T11 dermatome?

A

Periumbilical area

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17
Q

Which nerve supplies the hind gut?

A

Least splanchnic nerve

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18
Q

T12 dermatome?

A

Suprapubic area

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19
Q

Kidney pain is felt where?

A

Radiating from the loin to the groin or in the gonodal area

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20
Q

What blood vessels can be found on the rectus abdominis muscle?

A

Superior and inferior epigastric arteries

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21
Q

Which nerves run through the rectus sheath?

A

Intercostal nerves

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22
Q

What is deep to the rectus abdominis muscle? (4 things)

A

Posterior rictus sheath, extra-peritoneal fat, peritoneum, abdominal cavity

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23
Q

History for appendicitis?

A

Vague (dull) central abdominal pain which after a few hours moves to the right iliac fosser and changes character (sharp pain over appendix)

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24
Q

Shingles virus?

A

Herpes Zoster virus

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25
Q

Shingles virus can lie dormant where?

A

Sensory dorsal root ganglia

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26
Q

Peritoneum is lined by which kind of epithelium?

A

Simple squamous

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27
Q

Other name for peritoneum?

A

Serosa

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28
Q

The parietal peritoneum covers what?

A

The inside of the abdominal wall

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29
Q

The visceral peritoneum covers what?

A

Bowl and mesentery

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30
Q

Why are the viscera able to slide freely?

A

The peritoneal cells trap a layer of mucous between their microvilli

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31
Q

What is it called when the peritoneal cavity becomes filled with fluid?

A

ascites

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32
Q

What is the structure extending from the dome of the bladder to the umbilicus?

A

Urachus

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33
Q

What is the function of the urachus

A

Embryological remnant that allowed urine to flow out of the umbilicus

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34
Q

Which vein runs through the falciform ligament?

A

Umbilical vein

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35
Q

What organ is to the left of the falciform ligament?

A

Left lobe of the liver

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36
Q

What attaches the liver to the under-surface of the diaphragm?

A

Left triangular ligament

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37
Q

The entire left lobe of the liver is above what point?

A

Costal margin

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38
Q

What organ lies deep to the left lobe of the liver?

A

The stomach

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39
Q

What is to the right of the falciform ligament?

A

Right lobe of the liver

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40
Q

What’s on the inferior surface of the right lobe of the liver?

A

Gall badder

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41
Q

Above the anterior wall of the stomach there is a thin sheet of fatty tissue, what is this?

A

Lesser omentum

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42
Q

Where is the portal triad found?

A

In the epiploic foramen which is behind the lesser omentum

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43
Q

What other sac is behind the stomach?

A

The lesser sac

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44
Q

The greater omentum is attached to what?

A

Greater curvature of stomach, posterior abdominal wall, transverse colon

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45
Q

Where is there no posterior rectus sheath?

A

Lower 1/3 of the abdomen

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46
Q

In the upper 2/3 of the abdomen, what is the anterior rectus sheath made of?

A

The external obliques and half of the internal obliques

47
Q

In the upper 2/3 of the abdomen, what is the posterior rectus sheath made of?

A

Half of the internal obliques and all of the transversus abdominis

48
Q

Where does the oesophagus pass through the diaphragm ?

A

Oesophageal hiatus

49
Q

Where is the duodenum and what is it attached to?

A

Attached to the pylorus and the jejenum in the retro-peritoneum

50
Q

When does the duodenum become the jejenum?

A

When it develops a mesentery

51
Q

What is the name of the region of abdomen below the greater omentum?

A

Infra-coelic region of the abdomen

52
Q

What is the point where the duodenum joins the jejenum

A

duodeno-jejenal fletcher

53
Q

What valve attaches the ilium to the caecum?

A

The ilio-caecal valve

54
Q

What is the right bend in the colon?

A

Hepatic fletcher

55
Q

What is the left bend in the colon?

A

The splenic fletcher

56
Q

Which parts of the colon have a mesentery (are mobile)?

A

Transverse and sigmoid colon

57
Q

What is the main blood supply to the small bowel?

A

Superior mesenteric artery

58
Q

What is the last bit of the small bowel?

A

Terminal ileum

59
Q

Why does the ilium need less blood flow?

A

Because it doesn’t need to absorb as much nutrients

60
Q

What are the loops of blood vessels in the mesentery called?

A

Arcades

61
Q

What branches come of the arcades?

A

Vasa recta

62
Q

The ilia coelic artery comes off which vessel?

A

The right superior mesenteric artery

63
Q

What vessels supply the ascending colon?

A

Iliocolic and right colic arteries (from the superior mesenteric artery)

64
Q

Branches of the ilio-coelic artery?

A

Colic, anterior cecal, posterior cecal (all supply ascending colon)

65
Q

What supplies the transverse colon and what are their origins?

A

Right, middle and left colic arteries (R and M from superior mesenteric artery, L from inferior mesenteric artery)

66
Q

What supplies the descending colon?

A

Left colic artery

67
Q

What supplies the sigmoid colon?

A

Sigmoid arteries (from inferior mesenteric artery)

68
Q

What is derived from the mid-gut?

A

Ascending colon and proximal 2/3 of the transverse colon

69
Q

What is derived from the hind-gut?

A

Distal 1/3 of the transverse colon, descending colon and sigmoid colon

70
Q

What innervates the midgut derived structures?

A

Superior mesenteric plexus

71
Q

What innervates hindgut derived structures?

A

Sympathetic- lumbar splanchnic nerves

Parasympathetic- pelvic splanchnic nerves

72
Q

What drains the lymph from the ascending and transverse colon?

A

Superior mesenteric nodes

73
Q

What drains the lymph from the descending and sigmoid colon?

A

Inferior mesentenic nodes

74
Q

What are the folds in the jejenum mucosa called?

A

plicae circularis

75
Q

What are the 4 factors that increase the surface area of the small intestine?

A

Length, plicae circularis, villi and microvilli

76
Q

Where does the inferior mesenteric artery bifurcate?

A

L4 /L5

77
Q

Which nerves supply the gall bladder?

A

Vagus and sympathetic nerves

78
Q

What does the hepatic artery do?

A

Bring oxygenated blood to the liver

79
Q

What supplies the hepatic artery?

A

Coeliac axis

80
Q

Where is bile excreted into?

A

The common bile duct → bowel

81
Q

What structures make up the portal triad?

A

Hepatic artery, portal vein and bile duct

82
Q

What does the hepatic portal vein supply?

A

the lower 3rd of the oesophagus, whole bowel down to the end of the rectum. Blood is then brought up to the liver so it can be processed

83
Q

Fat is absorbed through the lymphatic into what?

A

Cysterna chyli

84
Q

Where does absorbed fat enter the circulation?

A

At the confluence of the left subclavian and left internal jugular veins

85
Q

Which structures join to form the common bile duct?

A

Cystic duct and hepatic duct

86
Q

Which duct has a “y-shape”

A

Bile duct

87
Q

Which artery passes behind the bile duct?

A

Cystic artery

88
Q

What is the name of the hole on the right side going into the lesser sac?

A

Epiploic foramina

89
Q

What do the hepatic veins drain into?

A

The inferior vena cava

90
Q

What are the 3 main ligaments of the liver?

A

Falciform, left triangular and right triangular ligaments

91
Q

What is morison’s pouch?

A

Space between the visceral surface of the liver and the right kidney

92
Q

Where is the subphrenic space?

A

Between the diaphragm and the anterior and superior aspects of the liver

93
Q

Where is the subhepatic space?

A

Between the inferior surface of the liver and the transverse colon

94
Q

What are the 3 hepatic recesses?

A

Morison’s pouch, subphrenic space, subhepatic space

95
Q

What is the fibrous layer that covers the liver?

A

Glisson’s capsule

96
Q

What divides the liver into right and left lobes?

A

Falciform ligament

97
Q

What is the bare area of the liver?

A

An area on the right lobe not covered by peritoneum

98
Q

Where is the caudate lobe of the liver?

A

Upper aspect of the visceral surface between the inferior vena cona and the fossa produced by the ligamentum venous

99
Q

Where is the quadrate lobe of the liver?

A

Lower aspect of the visceral surface between the gallbladder and fossa produced by the ligamentum terese

100
Q

What separates the caudate and quadrate lobes?

A

Porta hepatic (a transverse fissure)

101
Q

What does the hepatic plexus consist of?

A

Coeliac plexus (sympathetic) and vagus (parasympatheric) nerve fibres

102
Q

Gisson’s capsule is innovated by what?

A

Lower intercostal nerves

103
Q

What 2 ligaments are attached to the bare area of the liver?

A

Anterior and posterior coronary ligaments

104
Q

Where do the pancreatic and bile ducts enter the duodenum?

A

Duodenal papilla

105
Q

What is the name of the muscular value surrounding the exit of the bile and pancreatic ducts into the duodenum?

A

Sphincter of Oddi

106
Q

What is the name of the point where the bile duct and pancreatic ducts join and empty into the small intestine?

A

Ampulla of Vater

107
Q

Which duct lies next to the bile duct?

A

The pancreatic duct

108
Q

What makes up the Porta Hepatis?

A

Hepatic artery proper, portal vein, hepatic bile duct, vagus nerve branches, sympathetic and lymphatics (NOT HEPATIC VEIN)

109
Q

What supplies arterial blood to the jejenum?

A

Superior mesenteric artery

110
Q

Where does the common bile duct drain into?

A

Duodenum

111
Q

Which duct deposits bile directly in the gull bladder for storage?

A

Cystic duct (comes of common bile duct)

112
Q

What are gallstones made from?

A

Cholesterol, bile salts and bilirubin

113
Q

What is cholecystisis?

A

When gallstones obstruct the cystic duct and become infected

114
Q

What innervates the gallbladder?

A

Greater splanchnic nerve

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