Anatomy overview of Alimentary system 2 Flashcards
Name the 9 areas of the abdomen
Right and left hypochondrium
Left and right iliac fossa
Left and right lumbar
epigastrium, periumbilical and hypogastrium
List some of the clinical diagnoses if there is pain in the foregut
Peptic ulcer/gastric disease
biliary/pancreatic disease
Hepatic disease
List some of the clinical diagnoses if there is pain in the midgut
Appendicitis
Small bowel obstruction
Proximal colon cancer
List some of the clinical diagnoses if there is pain in the hindgut
Large bowel obstruction
colon carcinoma
Diverticular disease
Is pain from the visceral or parietal peritoneum able to be referred elsewhere?
Visceral
Briefly describe the oesophagus
25cm long muscular tube with 3 constrictions
Why are the oesophageal constrictions important? (especially to surgeons)
When passing instruments from oesophagus to stomach
Name the 3 oesophageal constrictions
cervical, thoracic and diaphragmatic
Name the 4 parts of the stomach
Cardia, fundus, body and pyloric part
What is the fundus usually filled with?
Gas
What is the pyloric part of he stomach?
The opening from the stomach to the duodenum
What are the 2 curvatures of the stomach?
Greater and lesser
What does the pyloric sphincter control?
Discharge from the stomach to the duodenum of the stomach contents
List a few structures the stomach bed is anterior to
Pancreas, left kidney, spleen, diaphragm, transverse mesocolon and colon
What are the folds inside the stomach called?
Gastric rugae
How do you tell the cardiac end and pyloric end apart in the stomach?
The pyloric end has a sphincter (thick muscular)
What is congenital pyloric stenosis?
Thickening of the pylorus smooth muscle
What is the falciform ligament a remnant of?
Ventral mesogastrium
What does the falciform ligament do?
Attach the liver to the ventral wall
What is the round ligament of the liver a remnant of?
Left umbilical vein
What does the round ligament of the liver do?
split the left lobe of the liver into 2
What does the plane separating the liver into left and right lobe pass through?
IVC (which does NOT pass through the liver - makes a groove only)
What are the 3 parts of the portal traid?
hepatic artery, hepatic portal vein and bile duct
Where is the caudate lobe found?
Postero-superior surface on right lobe of liver
What ribs does the liver lie deep to?
7-11 on the right
What do biliary ducts do?
Carry bile made in the liver to the gallbladder
What 2 things does the gallbladder do bile?
store and concentrate it
What volume of bile can the gallbladder store?
50ml
What does the cystic artery lie in? what is this?
triangle of calot
cystic duct, common hepatic duct, visceral surface of the liver
What is biliary colic?
Pain due to gallstone obstructing bile duct
What are the 4 F’s of biliary colic?
fatty, fertile, female, forty
What is the pancreas responsible for in relation to the digestive system? What are the “2 types” of the pancreas?
Accessory digestive gland
Exocrine and endocrine
Explain what the exocrine and endocrine pancreas does
Exocrine secretes pancreatic juice
Endocrine secretes glucagon and insulin
Where is the pancreas found?
Retroperitoneal Posterior abdominal wall Transpyloric plane (L1/2)
What are the 4 parts of the pancreas?
Head, neck, body, tail
What vein is found behind the neck of the pancreas?
Portal vein
What is the spleen and where is found?
Mobile haemolymphoid organ
left hypochondrium
What part of the spleen IS NOT covered in peritoneum?
hilum
What ribs is the spleen related to?
9-11
What is spenomegaly and give a few examples of what can cause it
Enlargement of the spleen
anaemia, typhoid fever etc
What are the 3 arteries off the celiac trunk?
Splenic hepatic artery
Left gastric artery
What is the origin of the celiac trunk?
T12
What does the 2nd part of the duodenum receive?
Bile and pancreatic duct
What part of the duodenum is most likely to get ulcers?
1st part
Briefly describe the duodenum in comparison to the rest of the small intestine
shortest, widest and most fixed part of the small intestine
Briefly describe the jejunum in comparison to the ileum
Darker red, thicker with more vasculation and few large loops. Also less fatty.
What is the origin of the superior mesenteric artery?
L1
What is the origin of the inferior mesenteric artery?
L3
What is the terminal branch of the inferior mesenteric artery?
Superior rectal artery
Name 3 ways in which the large intestine is different to the small intestine
Omental fatty appendices
Sacculation
Teniae coli (3) - thickened smooth muscle
What is the appendix?
Blind intestinal diverticulum with masses of lymphatic tissue
What is the position of the appendix?
Retrocecal
What is the macburneys point and where is it?
Site of maximum tenderness in acute appendicitis
Between anterior superior iliac spine and umbilicus
Where is the rectosigmoid junction?
Anterior to S3 vertebrate
Are there internal, external or both sphincters in the rectum?
both
Where is a common site for cancer in the anal canal?
columns of morgagni
List some things you can feel in a rectal examination
prostate and seminal glands
cervix
Sacrum
Iliac lymph nodes
Is the innervation of the gut somatic or autonomic?
Autonomic
What parasympathetic nerves innervate the gut?
Vagus and pelvic splanchnic
What sympathetic nerves innervate the gut?
Abdominopelvic nerves (greater, lesser and least) Prevertabral sympathetic ganglia and abdominal aortic plexus
What does the portal vein carry?
poorly oxygenated blood from abdominal GI tract to the liver (including spleen, pancreas and gallbladder)
What is the portal vein made by?
Junction of splenic and superior mesenteric vein
What are portocaval shunts?
Venous enlargements during portal obstruction
Name the 3 sites of port-systemic anastamoses
Anorectal, gastroesophageal junction and around umbilicus
How do port-systemic anastamoses present at the 3 sites
haemorrhoids/piles, esophageal varices and caput medusae
What duct does the abdomen drain into?
Thoracic duct
What do the lymphatic vessels run alongside?
Corresponding arteries
Where do the lymphatic nodules form groups?
around major arteries and abdominal aorta
What are the 3 groups of lumbar nodes?
Preaortic, lateral aortic and retroaortic
What are the 3 subgroups of the preaortic lumbar nodes?
celiac, superior and inferior mesenteric
What is the link between the 3 lumbar nodes and the organs they drain
Drain the organs supplied by the corresponding aortic branch location
What can spread via the lymphatics?
Cancer
