Anatomy of Upper GI System Flashcards
List the components of the GI tract?
Head:
Oral cavity
Pharynx
Neck:
Pharynx
Chest:
Oesophagus
Abdomen: Oesophagus Stomach Small intestine e Large intestine Accessory organs
Pelvis:
Rectum
Anal canal
Perineum
Anus
Where does movement of the jaw occur at?
The TMJ - temperomandibular joint
What are the muscles of mastication supplied by?
The mandibular division of the trigeminal nerve - CN V3
How many muscles of mastication are there?
4 in total
3 - close
1 - open
What are the 3 muscles that close the jaw called?
Temporalis
Masseter
Medial Pterygoid
Describe the temporalis muscle?
Attaches at the coronoid process of the mandible to the temporal fossa
Describe the masseter muscle?
It attaches to the angle of the mandible to the zygomatic arch
Describe the medial pterygoid
it attaches to the angle of the mandible (medial side) to the pterygoid plates of the sphenoid bone
What muscle opens the jaw?
The lateral pterygoid
Describe the lateral pterygoid?
IT attaches to the condyle of the mandible to the pterygoid plates of the sphenoid bone
What fibres does the mandible division of the trigemianal nerve contain?
Sensory and motor
Which is the only CN to attach to the pons?
CN 3 - trigeminal nerve
Describe the surface anatomy of the oral cavity?
Tongue Hard palate Soft palate - arches of the soft palate Palatine tonsil - back of mouth Uvula Upper and lower dental arch Gingiva - gums
What is aspiration?
The inhalation of liquid or solid matter into the lungs
Describe the posterior part of the tongue?
Posterior = 1/3rd
In the oropharynx
Taste and general sensation - CNIX
Describe the anterior part of the tongue?
Anterior = 2/3rd
In the oral cavity
Taste = CN VII
General sensory = CNV3
Describe the papillae at the front of the tongue?
Filiform papillae - touch temperature etc
Describe the papillae in the middle of the tongue?
Fungiform papillae - ALL with taste buds
Describe the papillae in the back of the tongue?
Foliate papillae and vallate papillae
Describe the innveration in the facial nerve? (CHECK)
Special sensory, sensory, motor and parasympathetic
What CN is the facial nerve?
CN VII
Where does the mandibular division of the trigeminal nerve come out of the base of the skull?
The sphenoid bone
The foramen ovale
Where does the facial nerve comes out of the base of the skull?
The internal acoustic meatus
Stylomastoid foramen
Describe what CNVII supplies?
The muscle of facial expression - after exiting at the internal acoustic meatus and the stylomastoid foramen
Describe the branch, chords tympani, of the CN VII?
It connects with the lingual nerve branch of CNV3 and supplies taste to the anterior tongue and also parasympathetics
Describe what CNVII supplies after joining with the CNV3?
Supplies the sublingual salivary gland
The parasymapethic axons of CNVII suppling the submandibular salivary gland
Describe the oral sensation of the superior half of the oral cavity?
General sensation felt via CN V2
What is the posterior wall of the oropharynx sensitive to and what half is it in?
In the superior half
Very sensitive to touch
Describe the oral sensation of the inferior half of the oral cavity?
General sensation via the CN V3
What is the gag reflex?
A proactive reflect that prevent foreign bodies from entering the pharynx or larynx
What is the sensory part of the gag reflex carried by?
Carried by nerve fibres within CN IX
What is the motor part of the gag reflex carried by?
Nerve fibres within CN IX and CV X
What happens in the gag relic in terms on constriction?
The patient tries to close off the pharynx and constricts it
What can you do prior to an endoscope to block the sensory action potentials in CNV2, V3 CNVII and CN IX?
Spray a loca anaesthetic on the area
What is the CN V2 known as?
The maxillary division of the trigeminal nerve.
What is the CN V3 known as?
The mandible division of the trigeminal nerve
Where does the CNV2 exit the base of the skull?
The sphenoid bone
The foramen rotundum
What fibres does the glossopharyngeal nerve carry CNIX?
Special sensory, sensory, motor, visceral afferent and parasympathetic
Where does the CNIX connect to the CNS?
The medualla
Where does the CNIX exit the base of the skull?
Junction between the temporal bone and occipital bone - jugular foramen
What does the glossopharyngeal nerve supply? (CHECK)
Axons mainly pass to or from the tongue and palate
Posterior wall of the oropharynx
Parasympathetic secreomotor to the parotid salivary glands.
Describe where you would find the parotid gland - surface anatomy?
Parotid duct crosses face secretes into mouth by upper 2nd molar.
(anterior to ear at TMJ)
Describe where you would find the submandibular gland - surface anatomy?
Submandibular duct enters floor of the mouth and secretes via lingual caruncle
Describe where you would find the sublingual gland - surface anatomy?
Lays in the floor of the moth and secretes via several ducts superiorly. (under the tongue)
What are the 3 salivary glands?
Parotid
Submandibular
Sublingual
What can clogging/blockage cause in salivary ducts?
Swelling due to back up of secretions
What nerves supply each of the salivary ducts?
Parotid - CN IX
Submandibular - CN VII
Sublingual - CNVII
Describe how the tongue is positioned in the oral cavity?
It is suspended in the oral cavity by 4 pairs of skeletal muscles
What do the extrinsic muscles of the tongue do?
Function to change to position of the tongue during mastication swallowing and speech.
What do the intrinsic muscles of the tongue do?
Modifiy the SHAPE of the tongue during function
What invevates all the tongue muscles bar one?
CN XII - hypoglossal nerve
Except palatoglossus
What are the extrinsic muuscles of the tongue?
End in glossus
Extrinsic muscles originate from elsewhere in the body and attach to the tongue.
Palatoglossus
Styloglossus
Genioglossus
Hyoglossus
Where are the intrisinc muscles of the tongue?
They are located mainly dorsally/posteriorly.
What fibres does the hypoglossal nerve contain? CN XII
MOTOR ONLY
Where does the CNXII exit the base of the skull?
Occipital bone - hypoglossal canal (anterior wall of foramen magnum)
What does the hypoglossal nerve mostly supply?
The muscles of the tongue
What is the of the external layer pharynx innervated by?
CN X
at what level is the UOS?
C6
What is the of the internal layer pharynx innervated by?
Mainly by CN X and CN IX
Describe the type of muscles of the pharynx external and internal?
External - circular
Internal - longitudinal
What do the longitudinal muscles of the pharynx do?
longitudinal muscles of the pharynx (CN IX & X) elevate the larynx towards the epiglottis during swallowing reducing the size of the laryngeal inlet
Describe the stages of swallowing?
Tongue pushes bolus of food towards oropharynx
Soft palate elevated, larynx elevated
Circular layer of pharyngeal constrictor muscles contracts
Bolus of food enters oesophagus and travels inferiorly by peristalsis
What cranial nerve helps to prevent drooling?
CN VII
What cranial nerve pushes the bolus of food towards the oropharynx?
CN XII
What cranial nerve contracts the pharyngeal constrictor muscles to push the bolus down the to the oesophagus?
CN X
What cranial nerve contracts the longitudinal layers of the pharyngeal muscles, preventing aspiration by closing laryngeal inlet?
CN IX, CN X
What do parasympathetics and sympathetics do to peristalsis?
Para - speeds up
Sympathetic - slow down peristalsis
At what level does the oesophagus start?
C6
What is the oesophageal plexus?
It runs of the surface to supply the smooth muscle on the walls
contains parasympathetic fibres (vagal trunk) and sympathetics - influence ENS and peristalsis
Where does the oesophagus begin, what muscle?
The inferior edge of the cricopharyngeus muscles
What factors produce the sphincter effect?
Contraction of diaphragm
Intrabdominal pressure slightly higher than intragastric pressure
Oblique angle at which oesophagus enters the cardia of the stomach
What does the LOS help reduce?
Reflux
What is the Z-line
The abrupt change in type of mucosa lining in the wall between the LOS and stomach..
Name the parts of the stomach?
Cardia
Fundus
Body
Pyloric antrum
Lesser curvature
Greater curvature
Incisura angularis - is a small anatomical notch on the stomach located on the lesser curvature of the stomach near the pyloric end.