Anatomy Lecture 2 Flashcards by Andrew Hay

Give a brief basic description of the primordial gut tube

Develops during the 4th week of human development.

Derived from the endoderm lining the yolk sac

For descriptive purposes it is divided into 3 parts- Foregut, midgut and hindgut

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What are the structures of the foregut?

Primordial pharynx and its derivatives

Lower respiratory system

Oesophagus and stomach

Duodenum (proximal to the opening of bile duct)

Liver, biliary apparatus and pancreas

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What makes up the biliary apparatus?

Hepatic ducts
Gall bladder
Bile duct

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What is the artery supplying the foregut?

Celiac trunk

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What are the 3 constrictions of the oesophagus?

Cervical (pharyngo-oesophageal)
- 15cm from incisor teeth

2. Thoracic (broncho-arotic)
Crossed by arch of aorta
-22.5 cm from IT
Crossed by left main bronchus
-27.5 cm from IT

Diaphragmatic
Where is passes through the oesophageal hiatus
-40 cm from IT

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What are the 4 parts of the stomach and where are they located?

Cardia- next to lower oesophageal sphincter

Fundus - superior part of the stomach

Body - Main middle portion

Pyloric antrum- near pyloric sphincter next

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What is the function of the pyloric sphincter?

Control discharge of stomach contents into the duodenum

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What structures form the “bed” of the stomach inside the abdominal cavity.

Diaphragm
Spleen
Left kidney
Adrenal gland
Splenic artery
Pancreas
Transverse mesocolon
Colon

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Along with the spleen what other structures does the splenic artery supply?

Stomach and Pancreas

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What clinical problems can arise in the stomach?

Congenital pyloric stenosis: Thickening of smooth muscle in the pylorus

Carcinoma of the stomach

Gastric ulcers and Vagotomy

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What structures make up the portal triad?

Hepatic artery
Portal vein
Bile duct

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What structure links the liver and stomach?

The lesser omentum

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What is the function of the biliary ducts?

Bile produced in the liver and is then carried to the gallbladder where it is stored and concentrated.

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How much bile can the gallbladder store?

50ml of bile

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What is the artery supplying the gallbladder and where does it lie?

Cystic artery

Lies in the triangle of calot
Triangle between common hepatic duct, cystic duct and visceral surface of the liver

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What two ducts make up the bile duct?

Cystic duct plus the common hepatic duct

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What two ducts make up the common hepatic duct?

Right and left hepatic duct

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What is the function of the pancreas in terms of a gland?

Accessory digestive gland
(Exocrine-pancreatic juice,
Endocrine- Insulin and glucagon)

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What are the parts of the pancreas?

Head, neck, body and tail

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What plane does the pancreas lie on?

The transpyloric plane (L1/L2)

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What structure is formed behind the neck of the pancreas?

The portal vein

Where does the tail of the pancreas lie and what clinical significance does this have?

The tail of the pancreas lies touching the spleen.

If the spleen is being removed you have to be careful not to cut the tail.

What type of organ is the spleen?

Haemo-lymphoid organ

what region of the abdomen is the spleen found?

Left hypochondrium

What is the most frequently injured abdominal organ?

The spleen

What is spleenomegaly?

Abnormal enlargement of the spleen Anaemia and typhoid can be causes

What vertebral level does the celiac trunk arise from the abdominal aorta and what is its main branches?

T12 Left gastric artery (runs along the lesser curvature of the stomach) Hepatic artery (supply liver and gallbadder) Splenic artery (runs reteroperitoneally along the superior margin of the pancreas)

What are the structures of the midgut?

Small intestine including most of duodenum The cecum, appendix Ascending colon Two thirds transverse colon

How does the duodenum differ from the rest of the small intestine?

Shortest, widest and most fixed part of the small intestine

What structures join the duodenum in its second part?

Bile duct and pancreatic duct

What is a duodenal ulcer?

Inflammatory erosion of the duodenal wall | Mostly the 1st part

How does the structure of the jejunum differ from the structure of the ileum?

The wall of the jejunum is more thick and heavy. It is more vascular and so has a deeper red colour rather than pale pink. Vasa recta are long and arcades are a few large loops Less fat in mesentery

What is the origin of the superior mesenteric artery?

Branch of abdominal aorta at vertebral level L1

What crosses the superior mesenteric artery anteriorly?

Splenic vein and the neck of the pancreas

What are the two main branches of the superior mesenteric artery?

Jejunal and ileal arteries

What are the structures of the hindgut?

- Left one third of the transverse colon - Descending colon - Rectum - Upper part of the anal canal Epithelium of the urinary bladder and most of the urethra also

What is the artery of the hindgut?

Inferior Mesenteric artery

What is the Teniae coli?

Thickening of the longitudinal muscle which forms a line all along the colon

How can the large intestine be distinguished from the small intestine?

Omental appendices- small fatty peritoneal like projections Haustra (small pouches caused by sacculation which give the colon its segmented appearance) Teniae coli

What is the appendix?

The appendix is a blind intestinal diverticulum with masses of lymphatic tissue

The appendix is variable in its position. What is the most common position?

Retrocecal is the most common position

What is Macburney's point?

Site of maximum tenderness in acute appendicitis

What is the origin of the inferior mesenteric artery and what is its branches?

Anterior branch of abdominal aorta at vertebral level L3 Left colic Sigmoid arteries Superior rectal artery

What branch is the superior rectal artery?

The terminal branch of the inferior mesenteric

Where does the recto-sigmoid junction lie?

Anterior to S3 vertebra

What is the autonomic innervation of the abdominal organs?

Parasympathetic - Vagus nerve - Pelvic splanchnic nerves (S2, S3 and S4) Sympathetic (T5-L2 or L3) - Abdominopelvic splanchnic nerves - --Greater T5-T9 - --Lesser T10-T11 - --Least T12 - Prevertebral sympathetic ganglie - Abdominal aortic plexus

Describe the portal vein

It collects poorly oxygenated by nutrient rich blood from the abdominal part of GI tract, including the spleen, pancreas and gall bladder and carries it to the liver It if formed by the union of splenic vein with the superior mesenteric vein It is located behind the neck of the pancreas (L2)

What are the 3 portocaval shunts and their varices during portal obstruction?

Anorectal region (haemorrhoids or piles) Gastro-oesophageal junction (oesophagus varices) Around the umbilicus (caput medusae)

Describe the lymphatic drainage of the GI tract/ abdomen

The thoracic duct receives most of the lymph from the abdominal wall and abdominal organs. Lymphatic vessels run with their corresponding arteries Lymphatic nodes form groups around the major arteries and abdominal aorta

What are the three terminal groups of the lumber lymph nodes?

Pre-aortic (celiac, superior and inferior mesenteric nodes) -Drains organs supplied by the anterior branches of aorta Lateral aortic (Drains organs supplied by lateral aortic branches) Retro-aortic (Drains the posterior abdominal wall)