Anatomy - Oesophagus , Stomach & Small Intestines Flashcards
How long is the abdominal oesophagus?
1-2 cm
At what structure does the oesophagus enter the stomach?
Cardiac Orifice - T11
Where does the Cervical Part of the oesophagus extend from?
From the Pharyngo-oesophageal junction to the substernal notch.
Where does the Thoracic part of the oesophagus extend from?
From the Suprasternal notch to the diaphragmatic hiatus
Where does the Abdominal part of the oesophagus extend from?
From the diaphragmatic hiatus to cardiac orifice of the stomach
What are the names of the two oesophageal sphincters?
Upper oesophageal sphincter - Cricopharyngeous muscle
Lower oesophageal spincter
What is Zenker’s Diverticulum and what is its relation to the oesophagus?
This is an oesophageal diverticulum (aka pharyngeal pouch ) above the esophageal sphincter at Killian dehiscence , the region between the cricopharyngeus and the lower inferior constrictor muscles ( weakened area) . During swallowing it may trap food causing regurgitation, dysphagia, and halitosis
In what regions of the abdominal wall does the stomach lie?
Epigastric region, Left Hypochondric region and Umbilical region
What is the name of the opening in which the stomach communicates with the duodenum of the small intestines?
Pyloric Orifice - L1
True or False? The Angular notch is found in the Greater curvature while the Cardiac notch is found in the Lesser curvature?
FALSE!! The Angular notch is found in the Lesser curvature while the Cardiac Notch is found in the Greater curvature.
” less angle “
“the cardiac heart is great “
Where is the gastro-oesophageal junction located?
2.5 cm to the left of the midline at the level of T10/T11 vertebrae behind the seventh left costal cartilag
How long is the stomach away from the incisor teeth ?
40 cm -
Leduinqui says 44
In what area of the diaphragm is the fundus of the stomach in communication with?
Left dome of the diaphragm
Where does the Pyloric canal lie?
On the head and neck of the pancreas
Fill in the blanks. The pyloric sphincter position is indicated on the anterior surface by the ________.
Prepyloric vein (of Mayo).
What is the blood supply of the stomach?
Branches from the coeliac trunk
What is the name of the notch found on the Greater curvature of the Stomach?
Sulcus Intermedius
What are the branches of the Coeliac Trunk?
Left Gastric Artery
Splenic Atery
Common Hepatic Artery
What is the Most common site for Peptic ulcers?
On the lesser curvature on the stomach or the Duodenum.
What is the most common site for Gastric ulcers to develop on ?
They develop on the Lesser Curvature at the Angular Notch
What section of the Stomach contains parietal cells and what substances do they produce?
Fondus and the body of the stomach .They produce H+ ions and Cl- ions ( for Hcl ) and Intrinsic factor.
In what section of the stomach are G- cells located and what substances do they produce?
They are in the Pyloric Antrum and they produce Gastrin
Which other specific type cells are also found in the Pyloric Antrum and what substances do they produce?
D- Cells - They produce a hormone called Somatostatin
What are the boundaries for the epiploic foramen ( Foramen of Winslow / Aditus) ?
Upper boundary - Caudate process of liver
Lower boundary- First part of duodenum
Posterior boundary - Inferior Vena Cava
Anterior boundary - Right free margin of the lesser omentum.
What is the blood supply of the duodenum?
Superior Mesenteric Artery
What is the venous drainage for the duodenum?
Superior Mesenteric Vein
What is the innervation of the small intestines?
Superior Mesenteric Plexus
True or False? The first part of the duodenum is Retroperoteneal while the second and third parts are Intraperetoneal.
FALSE!! First part is Intraperetoneal
Where is the major duodenal papilla located?
In the Second part of the duodenum
What structures drain through the major duodenal papilla?
Common Bile Duct
and Major pancreatic duct
(Hepatopancreatic Ampulla of Vater)
Where does the duodenum extend from?
From the Pylorus to the Duodenojejunal flexure ( DJ flexure)
How long is the duodenum?
10 inches long ( 25 cm)
How long is the first part (superior) of the duodenum?
5 cm ( 2 inches)
How long is the descending ( second) part of the duodenum?
7.5cm ( 3 inches)
How long is the Horizontal ( third ) part of the duodenum ?
10 cm ( 4 inches)
How long is the Ascending (fourth) part of the duodenum?
2.5 cm ( 1 inch)
How far is the major duodenal papilla located from the pylorus?
8-10 cm
What structure drain through the minor duodenal papilla?
Minor/ Accessory pancreatic duct.
How far is the Minor duodenal papilla away from the major duodenal papilla?
2 cm
What are the names of the circular folds found in the duodenum?
Plicae circulares ( valves of Kerckring)
Valvulae conniventes
Where is the duodenojejunal junction located?
2.5 cm to the right of the median plane and a little below the transpyloric plane
Where is the duodenum located?
In the abdominal cavity above the umbilicus opposite to L1, L2 and L3 vertebrate.
Where does the upper & lower half of the second part of the duodenum develop from?
Upper half - Foregut
Lower half- Midgut
What is the name of the semilunar fold of mucous membrane found above the major duodenal papilla?
Arch of plica semilunaris (Monks hood)
What type of muscle fibres are found in the Ligament of Treitz?
Upper part- Striated muscle fibres
Middle part- Elastic fibres
Lower part- Non-striated fibres
What is the function of the Ligament of Treitz?
It suspends the duodenojejunal flexure from the right crus of the diaphragm .
Which duodenal recess is the largest recess but is rarely present?
Retroduodenal recess
What is the blood supply of the duodenum?
-Superior pacreaticoduodenal artery ( branch of gastroduodenal artery)
- Inferior pancreaticoduodenal artery ( branch of superior mesenteric artery )
- Supreadudodenal artery of Wilkie ( branch of gasproduodenal artery)
- Retroduodenal branches of gasproduodenal artery .
Where are duodenal ulcers mostly found?
In the first part of the duodenum
Which part of the duodenum is most protected from injury?
Second part of duodenum
True or False? Peyer’s patches( aggregated lymphoid follicles) are found only in the jejunum.
FALSE!! They are found in the ILEUM/
What is the total surface area of mucosa of the small intestines?
About 200m2
What is the length of the small intestines?
18 ft
What structures are found at the base of the villi in the Jejunum and Ileum?
Intestinal Glands ( Crypts of Lieberkuhn)- they secrete digestive enzymes and mucous
What is the submucosa of the jejunum and ileum made of and what is its innervation
It is made of loose areolar tissue &
Meissner’s plexus
What structure is found between the two muscle layers ( outer longitudinal and inner circular ) of the jejunum and ileum?
Auerbach’s plexus
What is the name of the sphincter that surrounds the major duodenal papilla?
Sphincter of Odi
What is the name of the procedure that is used to mobilise the duodenum?
Kocher procedure
What is the name of the structure that should an incision should be placed when trying to dissect the peritoneum near duodenum?
White line of Toldts
From what structure is the ligament of Trietz a remnant of ?
Dorsal Mesentery
What type of Diverticulum is a Meckel’s diverticulum?
True Diverticulum
What type of Diverticulum is Zenker’s diverticulum?
True diverticulum
What type of epithelium lines Serosa?
Simple squamous epithelium
Where is the Jejunum and Ileum found?
They lie in the free margin of the mesentery
What type of diverticulum is Meckel’s diverticulum ?
True diverticulum
What is Meckel’s diverticulum a remnant of?
The vitelline duct
What is Meckel’s diverticulum ?
It is an out pouching of the lower part of the small intestines. It is commonly remembered by the rule of 2: found in 2% of the population, usually occurs within 2 feet of the ileocecal valve( from caecum) , 2 inches in length, containing two types of ectopic tissue (gastric and pancreatic), and with 2% of those affected becoming symptomatic, usually before 2 years of age.
What is the blood supply of the Jejunum and Ileum?
Jejunal and ileal branches arise from the left side of the superior mesenteric artery and enter the mes- entery by passing between the two layers of the root.
Fill in the blanks. “The jejunal branches join each other in a series of anastomosing loops to form _____.
Arterial arcades
How are the arcades differentiated in the ileum and jejunum ?
Arcades in Jejunum - longer and narrow windows
Arcades in Ileum - shorter (3-5) and wider windows
What is the lamp drainage for the Jejunum and Ileum?
Jejunal and ileal lymph drains to superior mesenteric nodes via mural and intermediate nodes in the mesentery.
What is the sympathetic and parasympathetic nerve supply to the Jejunum and Ileum?
Sympathetic- The lateral horn cells of spinal segments T9 and 10.
The lesser ommentum derives from what structure?
Ventral Mesagustrum
What is the name of the connection between the coeliac artery snd the superior mesenteric artery ?
Arc of Buhler
At what level is the Superior Mesenteric artery located?
At the lower border or L1 of the transpyloric plane approximately 1 cm below the celiac trunk
What are the branches of the Superior Mesenteric Artery ?
Inferior Pancreaticoduodenal artery
Jejunal arteries
Ileal arteries
Ileocolic artery
Right Colic artery
Middle Colic artery
Where is the Ileocecal junction located?
Transtubercular plane (L5) at the right mid-clavicular line
What ligaments are apart of the Lesser momentum ?
Hepato- duodenal ligament
Hepato- gastric ligament
What type of diverticulum is Zenker’s diverticulum?
False diverticulum
What type of muscle is presented in the upper third of the oesophagus?
Striated muscle
What type of muscle is presented in the middle third or the oesophagus ?
Mixed- Striated & smooth muscle
What type of muscle is presented in the Lower third of the oesophagus ?
Smooth muscle
What is the first brach of the abdominal aorta ?
Inferior Phrenic artery
What is known as the organ of Zuckerkandl?
A paraganglia
What is a paraganglia?
These are functional neural crest cells at the origin of the inferior mesenteric artery in a foetus and these usually regress at birth but may persist and a phaeochromocytoma can develop here.
True or False? The pineal gland is apart of epithalamus.
TRUE!!
What are the superior relations of the Pineal gland?
- The splenium of corpus callosum(CC) superior
*Great vein of Galen
Which nucleus of the hypothalamus at H will be also involved with the pineal gland in modulating sleep/wake patterns?
Suprachiasmatic nucleus
