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(SALMA) Anatomy Handbook Questions > Anatomy of the GI tract > Flashcards

Anatomy of the GI tract Flashcards

1
Q

where do the rectus abdominis muscles lie

A

either side of the midline

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2
Q

which direction do ext obliques run

A

downwards and inwards

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3
Q

which direction do int obliques run

A

upwards and inwards

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4
Q

which direction does transverse abdominis run

A

transversely

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5
Q

what forms the sheath for rectus abdominis

A

as ext/int obliques and transverse abs (3 muscle layers) pass forwards the muscles become aponeurotic (these aponeuroses form sheath for rectus abdominis)

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6
Q

where does the aponeurosis of the external oblique attach

A

ASIS laterally
pubic tubercle medially

thesis the inguinal ligament

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7
Q

where does the costal margin run from

A

7th-10th ribs

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8
Q

what are the 3 central abdominal regions from sup to inf

A

epigastric
umbilical
suprapubic/hypogastric

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9
Q

what are the 3 lateral abdominal regions

A

hypochondriac
flank/loin/lumbar
iliac region

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10
Q

what lies on the transpyloric plane of addison

A

gall bladder
pancreas
pylorus
duodeno-jejunal flexure

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11
Q

where does the transpyloric plane run

A

horizontally across epigastrium - releases costal margin @ lateral part of rectus abs (

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12
Q

what is the sub-costal plane

A

lies at lowest points of costal margin (10th)

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13
Q

what is the usual site of the base of the appendix

A

mcburney;s point

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14
Q

where does McBurney’s point lie

A

2/3 of way along a line joining umbilicus to right ASIC

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15
Q

at what vertebra does the umbilicus usually lie

A

l3

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16
Q

what plane marks the bifurcation of abdominal aorta

A

l4 - inter tubercular plane

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17
Q

what is the inter tubercular plane

A

tubercles of iliac crest

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18
Q

where does the greater splanchnic nerve arise from

A

t5-9

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19
Q

what is the innervation of foregut

A

greater splanchnic nerve

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20
Q

where is greater splanchnic nerve pain felt

A

anteriorly in midline - epigastrium

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21
Q

what is the innervation of midgut

A

lesser splanchnic nerve

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22
Q

where does the lesser splanchnic nerve arise from

A

t10-11

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23
Q

what is the innervation of the hindgut

A

least splanchnic nerve

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24
Q

where does the least splanchnic nerve arise from

A

t12

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25
Q

what does the peritoneum covering the inside of the abdominal wall have the same sensory nerve supply as

A

the skin overlying the same area

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26
Q

if c3/4/5 affected (diaphragm) where may pain be felt?

A

shoulder

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27
Q

what is the sensory innervation of the kidney and gonads

A

sympathetic plexus (t10,11,12)

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28
Q

what is the upper extent of the abdominal cavity

A

under surface of diaphragm

reaches 5th intercostal space

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29
Q

what are the dermatomes of the abdomen like

A

correspond to relative vertebra

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30
Q

where is foregut, midgut and hindgut pain felt

A

epigastrium
umbilicus
suprapubis

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31
Q

what kind of epithelium is the abdominal cavity lined by

A

simple squamous

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32
Q

what is ascites

A

accumulation of protein-containing fluid within abdomen

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33
Q

what is the line alba

A

fibrous structure at midline of abdomen - runs from xiphoid process

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34
Q

what is the midline median umbilical ligament a remnant of

A

allantois which helped embryo to exchange gases and handle liquid waste

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35
Q

what is the deep inguinal ring

A

entrance to inguinal canal

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36
Q

what is the falciform ligament

A

separates l and r lobe of liver

attaches liver to anterior body wall

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37
Q

what is the double layer of peritoneum that attaches liver to diaphragmatic undersurface called

A

left triangular ligament

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38
Q

is the left lobe of the liver above or below the costal margin

A

above

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39
Q

where does the lesser momentum run from

A

liver to lesser curvature of stomach

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40
Q

what is the porta hepatis aka

A

hilum of the liver

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41
Q

what runs through the portal hepatis

A

all neuromuscular structures minus hepatic veins (and hepatic ducts also run through)

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42
Q

where does portal vein carry blood from and to

A

from GI tract, gallbladder, pancreas, spleen

to liver

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43
Q

what is the epiploic foramen aka

A

foramen of winslow

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44
Q

where is the epiploic foramen

A

passage of communication btwn g and l sac

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45
Q

what is attached to the deep surface of the greater omentum

A

transverse colon

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46
Q

do fixed organs produce pain on movmeent

A

no, only mobile parts eg ileum or appendix will move with movement of body n breathing

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47
Q

what is a supine position

A

patient laying face upwards

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48
Q

with patient supine, where might fluid collect in the abdomen

A

posterior the liver

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49
Q

which parts of the bowel have a mesentery

A

1st cm of duodenum
all jejunum/ileum
transverse n sigmoid colon
appendix

50
Q

what structures form portal triad

A

hepatic portal vein
bile duct
hepatic artery

51
Q

what can lead to a peptic ulcer

A

stomach = harsh acidic env

may lead to destruction of mucosa

52
Q

what is the origin of the hepatic artery

A

common hepatic artery

53
Q

what does the gasproduodenal artery supply

A

blood directly to the pylorus and proximal duodenum

54
Q

what kind of muscle is the pylori sphincter

A

smooth

55
Q

what are the diff stomach parts

A 
cardia
fundus
body
antrum
pylorus
56
Q

where does blood from the caudate lobe directly drain

A

into the IVC

57
Q

where do veins in the lower third of the oesophagus usually drain into

A 
portal vein
(may also join with veins in the chest that drain into SVC)

in bowel disease, portal, the liver’s portal channels become smaller until insufficient - venous blood will then flow up veins of oesophagus and into SVC: porto-systemic shunt which can lead to oesophageal varicose veins

58
Q

why might some babies in the first 6w projectile vomit and what symptoms do they have

A

over developed pyloric sphincter
stomach cannot empty into duodenum
after feeding, food is forced out the mouth
bc child is not getting nutrition - hungry and eager to feed

59
Q

what is a common site of peptic ulcer

A

post wall of first part of duodenum

60
Q

which structures pass through the diaphragm alongside the oesophagus

A

vagal trunks

inferior oesophageal artery and vein

61
Q

where does the stomach receive its sympathetic and parasympathetic nerve supply

A

sympathetic - greater splanchnic (t5-9)

parasympathetic: vagus

62
Q

what lies in front of the stomach

A

left liver lobe

ant abdominal wall

63
Q

what lies behind stomach

A

lesser sac

behind lesser sac is pancreas/diaphragm

64
Q

what is a porto-systemic anastomosis

A

a vein which joins to the hepatic portal system to systemic system

65
Q

what does the post wall of the duodenum lie in contact with

A

gastroduodenal artery

66
Q

what differentiates duodenum from rest of small intestine

A

duodenum - it is retroperitoneal so fixed and constant

jejunum/ileum - attached to post abdominal wall by mesentery so relatively mobile

67
Q

what are plaice circulares

A

mucosal folds

68
Q

what are some adaptations for maximum absorption for the small intestine

A
  • plicae circulares (mucosal folds)
  • villi on mucosal folds
  • microvilli on each individual epithelial cell
69
Q

where are mucosal folds/plicae circulares most pronounced

A

jejunum

70
Q

what is the ileum marked by

A

Peyer’s patches; large syubmucosal lymph nodules

71
Q

what is mickel’s diverticulum

A

occasionally, ileum bears a blind-eded diverticulum 1m(?) from termination - an embryonic remnant of attachment of midgut loop to yolk sac

72
Q

what are the arterial arcades

A

series of anastomosis arterial arches btwn arterial branches of jejunum and ileum

73
Q

to the right of he sup mesenteric arteries are branches to the colon; name them (3)

A

ileo-colic
right colic
middle colic

74
Q

what is the diff btwn jejunum n ileum in terms of arcades and vasa rectae

A

jejunum: fewer arcades
ileum: more arcades

jejunum: longer vasa rectae
ileum: fewer vasa rectae

75
Q

what does the splenic vein form

A

portal vein

76
Q

where does the large intestine form

A

ileo-caecal valve in right iliac fossa

77
Q

what are the ascending and descending colon usually

A

retroperitoneal

78
Q

where do the transverse and sigmoid colon usually lie

A

within a mesentery

79
Q

what is the name of the 3 bands that the longutudinal muscular layer of stomach forms

A

taenia coli

80
Q

what are appendices epiploica

A

pouches of peritoneum filled w fat

where blood vessels penetrate muscles of bowel wall to supply mucosa n sub mucosa

81
Q

where does appendix arise from

A

base of caecum

82
Q

does the caecum have mesentery

A

no not usually

83
Q

does the inferior mesenteric artery arise from just above or below the bifurcation

A

above

84
Q

what does the superior rectal artery supply

A

rectum and upper anal canal

85
Q

whats the first pass effect

A

all drug dose absorbed from the GI tract is first delivered to the liver by the portal vein

a fraction of the drug can then be metabolized in the liver

overall concentration of the drug is reduced before it even reaches the systemic circulation

86
Q

which vein drains blood from the colon and where does it flow to

A

inferior mesenteric vein drains into the splenic vein

87
Q

where does lymph from small bowel drain

A

into the cisterna chyli (lol wtf, cba to google) and to the thoracic duct

88
Q

which foodstuffs are absorbed through the lymphatic system

A

lipids

89
Q

which part of the bowel is supplied by s2,3,4

A

hindgut

90
Q

where does the liver develop in an embryo

A

ventral mesentery

91
Q

what does the ventral mesentery become in an adult

A

lesser omentum

92
Q

whats the bare area of the liver

A

triangular surface that has no peritoneal covering - direct contact with diaphragm

93
Q

what is the blood supply of liver

A

hepatic portal vein

94
Q

what can gall stones lead to

A

jaundice

95
Q

what does the hepatic artery arise from

A

coeliac trunk

96
Q

what does the cystic duct join with to form the common bile duct

A

common hepatic duct

97
Q

what is immediately behind the epiploic foramen (passage btwn greater and lesser sac)

A

aorta on the left

IVC on the right

98
Q

what is the hepatic flexure

A

sharp bend btwn ascending and transverse colon

99
Q

what is the blood supply to the hepatic flexure

A

superior mesenteric artery

100
Q

what can cause gallstones

A

too much bilirubin
too much cholesterol
not enough bile salts

101
Q

which artery is the cystic artery a branch of

A

usually right hepatic artery

102
Q

which structures can be found in the portal hepatis (2)

A

macroscopically: portal vein, r and l hepatic artery, r and l hepatic duct
microscopically: lymphatic branches of vagus and greater splanchnic nerves

103
Q

what is an embryological bypass for the liver

A

ductus arterioles - forms into ligamentum venosum

104
Q

what is the surface marking of the funds of the gall bladder

A

tip of the 9th costal cartilage

midclavicular line crosses costal margin

105
Q

where do the hepatic veins drain

A

directly into IVC

106
Q

what happen sin spleen

A

old RBC are recycled

platelets and WBC are stored

107
Q

where does the head of the pancreas lie

A

in the curve of the duodenum

108
Q

hwhat are the 4 parts of the pancreas

A 
uncinate process
head
neck
body
tail
109
Q

what are the 4 parts of the duodenum

A

superior
ascending
horzintal
ascending

110
Q

how does the first part of the duodenum appear on endoscopy

A

smooth walled - almost no mucosal folds

111
Q

where does the spleen lie

A

btwn 9th and 11th ribs

  • located in the left hypochondrium and partly in the epigastrium
  • situated between the fundus of the stomach and the diaphragm.
112
Q

what is pancreatitis

A
  • blockage of pancreatic duct
  • high pressure
  • digestive enzymes leak out to the duct and start digesting the pancreas
113
Q

can the spleen be palpated during normal abdominal examination

A

no

114
Q

what structures might a tumour the head of the pancreas involve

A

hepatic portal vein
bile duct
pancreatic duct

115
Q

what structures join to forrm the common bile ducft

A

common hepatic duct

cystic duct

116
Q

what is the path of the common bile duct

A

runs in the free edge of the lesser momentum, behind 1st part of duodenum
- onto post pancreas - enters pancreas to run alongside the pancreatic duct before opening into the duodenum

117
Q

where is the sphincter of Oddi located

A

on medial wall of the duodenum btwn 2nd and 33rd parts

118
Q

which artery lies behind 1st part of duodenum

A

gastroduodenala rtery

119
Q

what lies btwn pancreas and stomach

A

lesser sac

120
Q

how many pancreatic ducts are there and what is the embryological significance

A

2

  • 1 from the ventral pancreatic bud
  • 1 from the dorsal pancratic bud

(SALMA) Anatomy Handbook Questions (6 decks)

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