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Anatomy/Physiology Flashcards

1
Q

Muscles of Mastication

A

temporalis, masseter, medial pterygoid, lateral pterygoid

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2
Q

Muscles of mastication are supplied by

A

CN V3 (trigeminal)

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3
Q

Movement of mouth occurs at which joint?

A

TMJ

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4
Q

Lateral pterygoid - originates at ——- and inserts at ——–

A

Lateral pterygoid - originates at condyle of mandible and inserts at pterygoid plates

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5
Q

Temporalis - originates at ———- and inserts at ————-

A

Temporalis - originates at coronoid process of mandible and inserts at temporal fossa

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6
Q

Masseter - originates at ———— and inserts at —————–

A

Masseter - originates at angle of mandible and inserts at zygomatic arch

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7
Q

Medial pterygoid - originates at ——- and inserts at —————

A

Medial pterygoid - originates from angle of mandible and inserts to pterygoid plate

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8
Q

TMJ is made from ——–

A

mandibular fossa on temporal bone, head of condylar process and articular tubercle

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9
Q 
Oral cavity innervation =
Superior ½ supplied by -------
Inferior ½ supplied by ---------
Orbicularis oris supplied by ------
Gag reflex - motor supply --------- sensory supply --------
A

Superior ½ supplied by CN V2
Inferior ½ supplied by CN V3
Orbicularis oris supplied by CN VII
Gag reflex - motor supply CN IX & CN X, sensory supply CN IX

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10
Q

Salivary Glands
Parotid - duct enters at ——- innervated by ——–
Submandibular - duct enters at ——- innervated by ——–
Sublingual - duct enters at ——- innervated by ——–

A

Parotid - upper 2nd molar, CN IX supply
Submandibular - enters floor of mouth and secretes via lingual caruncle, CN VII supply
Sublingual - lays in floor of mouth and secretes via several ducts superiorly, CN VII supply

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11
Q

Tongue innervation =

A

Posterior 1/3rd - CN IX glossopharyngeal

Anterior 2/3rd - CN VII facial (taste), CN V3 trigeminal (general sensory)

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12
Q

Tongue papillae

A

foliate, vallate, fungiform, filiform

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13
Q

Intrinsic tongue muscles =

A

styloglossus, genioglossus, hyoglossus, palatoglossus

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14
Q

Tongue muscles are innervated by

A

CN XII except palatoglossus (innervated by CN X)

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15
Q

The pharynx is made up of the

A

Nasopharynx, Oropharynx and Laryngopharynx

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16
Q

The 2 muscle layers of the pharynx are

A

Constrictor muscles (outer), Longitudinal muscles (inner)

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17
Q

The outer muscle layer of the pharynx functions to

A

constrict sequentially and move food down the oesophagus

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18
Q

The inner muscle layer of the pharynx functions to

A

elevate pharynx, close laryngeal inlet and shorten pharynx to aid swallowing

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19
Q

The pharyngeal muscles are innervated by —–

A

CNX vagus nerve (constrictor + longitudinal layers), CNIX glossopharyngeal (longitudinal layer)

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20
Q

Upper oesophageal sphincter

(cricopharyngeus) is at the level of ——

A

C6 (same level as Thyroid)

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21
Q

Oesophagus sphincters =

A

Anatomical upper oesophageal sphincter and physiological LOS

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22
Q

Oesophagus passes through diaphragm at —
Vena Cava passes through at —
Aorta passes through at —

A 
Oesophagus = T10
IVC = T8
Aorta = T12

***I ate 10 Eggs at 12.
Vena cava has 8 letters = T8. Oesophagus has 10 letters = T10. Aortic hiatus= T12

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23
Q

Layers of the digestive tract wall =

A

Mucosa, submucosa (connective tissue), muscularis externa, adventitia (outer connective tissue)

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24
Q

Muscle in digestive tract wall

A

Circular muscle = part of muscularis externa, lengthens and narrows the lumen
Longitudinal = part of muscularis externa, shortens and widens the digestive tract
Muscularis mucosae = part of the mucosa layer, folds to aid in absorptive and secretory functions.

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25
Q

Muscle type in the oesophagus =

A

Striated skeletal muscles in upper 1/3rd and SM in lower 2/3rds

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26
Q

Peristalsis is controlled by the —- nervous system

A

enteric nervous system via the myenteric plexus in the muscularis mucosae (containing interstitial cells of Cajal - pacemakers connected to SM cells)
AND
extrinsic nervous system via opening of Ca channels to reach AP threshold in cells (can be hormonal/mechanical stimuli)

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27
Q

Peristalsis is triggered by —- potentials

A

slow wave potentials that reach the threshold to trigger an AP and cause a contraction

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28
Q

Peritoneum =

A

continuous membrane lining the abdominal cavity walls and organs

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29
Q

Intraperitoneal organs = ——

e.g. ——–

A

covered in visceral peritoneum, minimal mobility e.g. liver, gallbladder, stomach, spleen, transverse colon, small bowel

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30
Q

Retroperitoneal organs = ——

e.g. ——–

A

only has visceral peritoneum on anterior surface, no mobility e.g. kidneys, pancreas, ascending and descending large bowel

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31
Q

Organs with a mesentery = ——

e.g. ——–

A

visceral peritoneum wraps around organ to form double layer, very mobile e.g. small bowel, transverse and sigmoid colon

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32
Q

Omentum = ———-

Divides the peritoneal cavity into —-

A

Omentum = fold of visceral peritoneum

Divides cavity into greater and lesser sac (communicate via omental foramen)

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33
Q

Pouches in the peritoneal cavity are formed by —–
Males = —– pouch
Females = —– pouch

A

Pouches in the peritoneal cavity are formed by peritoneum draping over superior part of pelvic organs
Males = recto-vesicular pouch (between bladder and rectum)
Females = rectouterine pouch (of Douglas) and vesico-uterine pouch

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34
Q

ACh results in {increased/decreased} peristalsis

NO and VIP result in {increased/decreased} peristalsis

A

ACh results in increased peristalsis

NO and VIP result in decreased peristalsis

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35
Q
  • —— = small bowel mesentery

- —— = large bowel mesentery

A

Mesentery proper = small bowel mesentery

Mesocolon = large bowel mesentery

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36
Q

To get to the abdominal cavity, sympathetic nerves synapse at {pre-vertebral/post-vertebral} ganglia located at exit points of the ———-, then travel with the arteries (—————-)

A

Sympathetic nerves synapse at pre-vertebral ganglia located at exit points of the abdominal aorta; then travel with the arteries (periarterial plexuses)

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37
Q

To get to the abdominal cavity, presynaptic parasympathetic nerves travel on the ————-; then travel via the —————-
Main parasympathetic fibres of abdominal cavity = ——— and ———

A

Presynaptic parasympathetic nerves travel on the oesophagus; then travel via the periarterial plexuses
Main parasympathetic fibres of abdominal cavity = Vagus nerve and Pelvic Splanchnic nerve

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38
Q

Abdominal cavity visceral afferents run alongside {parasympathetic/sympathetic fibres}} back to the spinal cord
Pain from these areas can be perceived in their relevant dermatomes = ——— pain
Liver pain can be referred to ———-
Pancreatic pain can be referred to ———–

A

Abdominal cavity visceral afferents run alongside sympathetic fibres back to the spinal cord
Pain from these areas can be perceived in their relevant dermatomes (referred pain)
Liver pain can be referred to right shoulder
Pancreatic pain can be referred to back

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39
Q

In the abdominal cavity:
Vagus nerve - supplies the ————
Pelvic Splanchnic nerve (S2, 3, 4) - supplies the ————-

A

Vagus nerve - supplies GI tract to distal transverse colon

Pelvic Splanchnic nerve (S2, 3, 4) - supplies colon and anal canal

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40
Q

The abdominal wall consists of the ————

A

skin to parietal peritoneum

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41
Q

Sympathetic nerves get from the CNS to abdominal organs via —————-

A

Sympathetic nerves get from the CNS to abdominal organs via abdominopelvic splanchnic nerves (T5-L2)

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42
Q

Pre-vertebral ganglia are named according to ———-

A

their exit points, the same as the artery names; so coeliac, superior mesenteric, inferior mesenteric ganglia

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43
Q

Parasympathetic has a ——— outflow; sympathetic has a ————- outflow

A

Parasympathetic has a craniosacral outflow; sympathetic has a thoracolumbar outflow

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44
Q

In appendicitis, the initial dull generalised pain is caused by ————— nerves.
Later, the sharp localised pain is caused by —————- nerves.

A

In appendicitis, the initial dull generalised pain is caused by visceral afferent nerves.
Later, the sharp localised pain is caused by somatic sensory nerves of the body wall (the parietal pleura becomes involved as the appendix is more inflamed)

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45
Q

Abdominal wall muscles - superficial&raquo_space; deep =

A

external oblique > internal oblique > transverse abdominis > rectus abdominis

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46
Q

Plane between epigastric and umbilical regions =

Plane between umbilical and pubic regions =

A

Plane between epigastric and umbilical regions = subcostal plane (T10)
Plane between umbilical and pubic regions = transtubecular plane

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47
Q

Spinal region
Foregut =
Midgut =
Hindgut =

A

Spinal region
Foregut = T6-9
Midgut = T8-12
Hindgut = T12-L2

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48
Q

Organs
Foregut =
Midgut =
Hindgut =

A 
Foregut = Oesophagus to D2, Liver, Gallbladder, Spleen, ½ pancreas
Midgut = D2 to proximal  ⅔ transverse colon, ½ pancreas
Hindgut = Distal ⅓ transverse colon, proximal ½ anal canal
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49
Q

Vasculature
Foregut =
Midgut =
Hindgut =

A 
Foregut = Coeliac axis (T12), Splenic vein, Coeliac lymph nodes
Midgut = SMA (L1), Superior mesenteric vein (drains into hepatic portal vein), Superior mesenteric lymph nodes
Hindgut = IMA (L2), Inferior mesenteric vein (drains into splenic vein then hepatic portal vein), Inferior mesenteric lymph nodes
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50
Q

The stomach muscle layers differ from the rest of the GI tract because ———-

A

the stomach has an oblique layer in muscularis externa

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51
Q

Areas of stomach (superior&raquo_space; inferior) =

A

fundus > carida > body > (antrum) > pylorus (pyloric sphincter at end)

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52
Q

The mechanical regions of the stomach are:
1)
2)

A

1) Orad = fundus and proximal body - tonic contraction, no slow wave activity, minimal mixing to allow starch to digest
2) Caudad = distal body and antrum - phasic contraction, slow wave activity present, retropulsion

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53
Q

3 phases of gastric secretion in the stomach =

A

1) Cephalic - before food reaches the stomach, increased HCl secretion
2) Gastric - stomach distension causes increase in HCl secretion via mechanoreceptors
3) Intestinal - after food has left the stomach

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54
Q

3 secretagogues inducing HCl secretion in the stomach =

A

1) ACh - activates parietal cells, inhibits D cells
2) Gastrin - activates parietal cells
3) Histamine - activates parietal cells to secrete HCl

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55
Q

In cephalic phase of gastric secretion in the stomach, vagal stimulation promotes release of ————

A

3 secretogogues (ACh, gastrin, histamine) which increase HCl secretion

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56
Q

Control of hunger occurs in the ——

A

hypothalamus

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57
Q
  • ———— neurons go to the feeding centre in the lateral hypothalamic area and stimulates appetite
  • ————- neurons go to the satiety centre in the ventromedial nuclei and inhibits appetite
A

Orexigenic neurons go to the feeding centre in the lateral hypothalamic area and stimulates appetite
Anorexiogenic neurons go to the satiety centre in the ventromedial nuclei and inhibits appetite

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58
Q

Orexigenic neurons go to the ———- centre in the ————- hypothalamic area and ———- appetite
Anorexiogenic neurons go to the ———- centre in the ventromedial nuclei and ——— appetite

A

Orexigenic neurons go to the feeding centre in the lateral hypothalamic area and stimulates appetite
Anorexiogenic neurons go to the satiety centre in the ventromedial nuclei and inhibits appetite

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59
Q

Secretion of HCl by gastric parietal cells occurs via

A

H/K/ATPase pump (proton pump)

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60
Q

Vomiting centre is in the ——-

A

Medulla

Many different pathways and stimuli e.g. toxin, mechanical, motion etc

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61
Q

Blood supply to the stomach all originates from the ——–

A

coeliac trunk

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62
Q

Right and left gastric arteries run along the ——-curvature of the stomach (anastamose)
Right and left gastro-omental arteries run along the ———- curvature of the stomach (anastamose)

A

Right and left gastric arteries run along the lesser curvature of the stomach (anastamose)
Right and left gastro-omental arteries run along the greater curvature of the stomach (anastamose)

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63
Q
  • ————— arteries run along the lesser curvature of the stomach (anastamose)
  • ————— arteries run along the greater curvature of the stomach (anastamose)
A

Right and left gastric arteries run along the lesser curvature of the stomach (anastamose)
Right and left gastro-omental arteries run along the greater curvature of the stomach (anastamose)

64
Q

Gastrin is released by —– cells in the ———–

Function =

A

Gastrin is released by G cells in the gastric antrum, duodenum.
Function = H+ secretion, decreases stomach contractions, delays gastric emptying to aid digestion

65
Q

CCK is released by —– cells in the ———–

Function =

A

CCK is released by l cells in the duodenum, jejunum

Function = bile secretion, satiety, pancreatic enzymes eg lipase

66
Q

Secretin is released by —– cells in the ———–

Function =

A

Secretin is released by S cells in the duodenum

Function = HCO3- (bicarbonate) secretion

67
Q

Motilin is released by —– cells in the ———–

Function =

A

Motilin is released by M cells in the duodenum, jejunum

Function = Initiates MMC during fasting state

68
Q

GIP is released by —– cells in the ———–

Function =

A

GIP is released by K cells in the duodenum, jejunum

Function = Insulin release from pancreatic B cells

69
Q

GLP-1 is released by —– cells in the ———–

Function =

A

GLP-1 is released by L cells in the bowel

Function = promotes insulin secretion & inhibits glucagon

70
Q

Ghrelin is released by —– cells in the ———–

Function =

A

Ghrelin is released by Gr cells in the gastric antrum, small bowel
Function = Stimulates hunger

71
Q

Somatostatin is released by —– cells in the ———–

Function =

A

Somatostatin is released by D cells in the pyloric gland area
Function = Inhibits HCl secretion

72
Q

Pepsinogen is released by —– cells in the ———–

Function =

A

Pepsinogen is released by Chief cells in the Oxyntic mucosa (gastric mucosa)
Function = Combines with HCl to form pepsin and break down protein

73
Q

Histamine is released by —– cells in the ———–

Function =

A

Histamine is released by Enterochromaffin like cells in the Oxyntic mucosa (gastric mucosa)
Function = Stimulates HCl

74
Q

Gastroferrin is released by —– cells in the ———–

Function =

A

Gastroferrin is released by parietal cells in the Oxyntic mucosa (gastric mucosa)
Function = B12 & Fe2+ absorption

75
Q

Leptin is released by —– cells in the ———–

Function =

A

Leptin is released by adipose cells

Function = inhibits hunger

76
Q

Small bowel sections = ——-&raquo_space; ——–&raquo_space; ——–

A

duodenum > jejunum > ileum

77
Q

Pain from the duodenum is felt in the ——- region

A

epigastric region

78
Q

In the duodenum, ———- gland in the submucosa will release alkaline mucous in order to ————-

A

Brunner’s gland in the submucosa will release alkaline mucous to neutralise the acidic chyme.

79
Q

Pancreatic secretions in the duodenum =

A 
Digestive enzymes (protease, amylase, TAG-lipase) from acinar cells
Alkaline fluid to neutralise acid
80
Q

Biliary secretions in the duodenum =

A

Bile salts break down large lipids for attack by TAG lipases

81
Q

Pancreatic and Biliary secretions are released into the duodenum via ———-

A

the major duodenal papilla

82
Q

The superior part of the duodenum is {intraperitoneal/retroperitoneal} while the rest (descending, horizontal and ascending) is {intraperitoneal/retroperitoneal}
Both the jejunum and ileum are {intraperitoneal/retroperitoneal}

A

The superior part of the duodenum is intraperitoneal while the rest (descending, horizontal and ascending) is retroperitoneal.
Both the jejunum and ileum are intraperitoneal.

83
Q

Jejunum begins at around vertebrae level ——-

A

L2

84
Q

Mucosa in the jejunum is highly folded for absorption - folds are called ————-

A

plicae circularis

85
Q

Pain from midgut organs is usually felt in the ——- region

A

umbilical region

86
Q

What is absorbed in the small bowel?

A 
Lipids (triglycerides, cholesterol, phospholipids)
Na and water
Carbohydrates
Proteins
Calcium (covered in Endocrine)
Iron
Vitamins
87
Q

Ingested lipids are broken down by —————

A

churning, gastric enzymes and duodenal secretions - increasing the surface area to then be broken down by lipases

88
Q

Lipid absorption

A

broken down by lipases in duodenum
» form emulsion droplets with bile salts
» CCK releases TAG lipases from pancreas to hydrolyse TAGs
» small fatty acid chains diffuse across enterocytes into blood
AND
» large fatty acid chains move via transport mechanisms and are resynthesised into triglycerides in enterocytes&raquo_space; incorporated into chylomicrons

89
Q

How are small chain fatty acids AND large chain fatty acids absorbed into blood?

A

> > small fatty acid chains diffuse across enterocytes into blood capillaries
AND
large fatty acid chains move via transport mechanisms into enterocytes, resynthesised into triglycerides and incorporated into CHYLOMICRONS. Released into LYMPH VESSELS by exocytosis

90
Q

TAG

A

triglyceride (glycerol + 3 fatty acids)

91
Q

Water movement out of the GI tract relies on —-

A

the movement of SODIUM (which produces osmotic force)

92
Q

What are the most important sodium transporters?

A

Na/glucose and Na/amino acid transporters (post-prandial, in duodenum/jejunum)

93
Q

The fat soluble vitamins are ——–

They are absorbed via ———

A

A D E K

passively diffuse into the enterocytes, incorporated into micelles/chylomicrons for release into lymphatics

94
Q

The water soluble vitamins are ——-

They are absorbed via ———

A

B C H

transport across membrane with transporter. May involve Sodium transporter.

95
Q

Digestive juices are produced throughout the small intestine by ——-

A

Goblet cells (mucous) and crypts of Lieberkühn (aqueous salts)

96
Q

3 main motility patterns of small intestine

A

1) SEGMENTATION- after meals, alternating contraction and relaxation of circular muscle to churn contents.
2) PERISTALSIS driven by the Migrating Motor Complex (MMC) - between meals. Sweeping contraction that clears debris through small intestine.
3) COLONIC MASS MOVEMENT - contraction that moves faeces into the rectum. Occurs a couple times/day

97
Q

The Common Hepatic artery gives off the ——— to become the —————

A

The Common Hepatic artery gives off the Gas (gastroduodenal artery) to become the Proper Hepatic artery

98
Q

The ———- supplies the foregut organs

A

The coeliac trunk supplies the foregut organs

99
Q

The ——————- is an anastomosis between the IMA and SMA and can help prevent intestinal ischaemia.

A

The Marginal Artery of Drummond is an anastomosis between the IMA and SMA and can help prevent intestinal ischaemia.

100
Q

The Marginal Artery of Drummond

A

an anastomosis between the IMA and SMA and can help prevent intestinal ischaemia.

101
Q

The lumbar nodes drain lymph from the ——–

A

pelvis, kidneys, abdominal wall, limbs

102
Q

Venous drainage of GI tract

A

The inferior mesenteric vein (hind gut) drains blood into the Splenic Vein (foregut), which then drains into the Hepatic portal vein.
The superior mesenteric vein (midgut) drains directly into the Hepatic portal vein.
The hepatic portal vein goes through liver (cleaning blood from absorptive organs) and drains into IVC.

103
Q

Large bowel parts

A

caecum > appendix > ascending colon > hepatic flexure > transverse colon > splenic flexure > descending colon > sigmoid colon > rectum

104
Q

Paracolic Gutters are found ———

A

on the lateral aspects of the ascending and descending colon (towards the abdominal wall and are part of the greater sac)

105
Q

Haustra

A

‘bumps’ in the large bowel formed by tonic contraction of teniae coli

106
Q

Teniae coli

A

3 longitudinal smooth muscle bands running from caecum to sigmoid colon

107
Q

Omental appendices

A

fatty deposits

108
Q

The splenic flexure lies {inferiorly/superiorly} to the hepatic flexure

A

The splenic flexure lies superiorly to the hepatic flexure

109
Q

The walls of the large intestine have ———– but NO ——–

A

The walls of the large intestine have colonic folds, crypts & microvilli but NO villi

110
Q

Ascending and descending colon are {intraperitoneal/retroperitoneal}
Transverse and sigmoid colon are {intraperitoneal/retroperitoneal}

A

Ascending and descending colon are retroperitoneal; transverse and sigmoid colon are intraperitoneal (so very mobile)

111
Q

Colon primary functions

A

1) Net absorption of Na, Cl, H20
2) Absorption of short chain fatty acids (carbs not absorbed by small bowel are fermented by colonic flora into short chain fatty acids)
3) Net secretion of K, HCO3, mucus

112
Q

3 main motility patterns of small intestine

A

1) HAUSTRATION - non-propulsive segmentation, allows for long transit time to absorb fluid & electrolytes
2) PERISTALTIC PROPULSION - mass movement of faeces into rectum, typically after breakfast, triggers defaecation reflex
3) DEFAECATION

113
Q

Roles of colonic flora

A

1) Help with intestinal immunity by competing with pathogens
2) Promote motility
3) Synthesises vitamin K and free fatty acids
4) Helps in drug absorption (e.g. IBD drugs)

114
Q

Water absorption in the colon occurs via ———

A

1) Parallel Na/H & Cl/HCO3 exchange - proximal colon, during inter-digestive period, also allows passive absorption of Cl
2) Epithelial Na channels (ENaC) - distal colon, regulated by aldosterone, also allows passive absorption of Cl

115
Q

The —————- muscle relaxes for defaecation and reflexively contracts during coughing/sneezing

A

Levator ani

116
Q

Pelvic floor muscle

A

Levator ani

117
Q

The sigmoid colon becomes the rectum anterior to vertebrae level ——–
The rectum becomes anal canal anterior to the ——– bone

A

S3

coccyx

118
Q

Rectal varices vs. haemorrhoids

A

Rectal varices - related to portal hypertension, dilation of collateral veins
Haemorrhoids - prolapse of rectal venous plexuses, due to increased pressure

119
Q

Internal vs external anal sphinctor

A 
Internal = smooth muscle (involuntary), superior ⅔ of anal canal, tonic contraction, contracted by sympathetic nerves 
External = skeletal muscle (voluntary), inferior ⅓ of anal canal, voluntary contraction in response to rectal ampulla distension (simultaneous relaxation of internal sphincter), contraction by puodendal nerve
120
Q

Ishioanal fossae

A

On either side of anal canal
Filled with fat & loose connective tissue
Risk site for abscess formation

121
Q

Pectinate Line

A

an embryological line between the endoderm (GI Tract) and ectoderm (skin)

122
Q

Above vs below pectinate line

A

Above = visceral (all hindgut), autonomic nervous system, IMA supply, venous drainage to hepatic portal, inferior mesenteric lymph nodes

Below = parietal, somatic and pudendal nerves, internal iliac artery, venous drainage to systemic veins, superficial inguinal nodes

123
Q

Nerve Supply to Rectum & Anal Canal

A

1) Sympathetic (contraction of internal anal sphincter, inhibits peristalsis) - T12-L2 - travel to inferior mesenteric ganglia, synapse, travel vis periarterial plexuses
2) Parasympathetic (inhibits internal anal sphincter, stimulates peristalsis) - S2,3,4 - pelvic-splanchnic nerves
3) Visceral afferents (sense stretch, ischaemia etc) - S2,3,4 - run with parasympathetics
4) Somatic Motor (contraction of external anal sphincter & puborectalis) - pudendal nerve (S2,3,4) and levator ani nerve (S3,4)

TIP: S2, 3, 4 keeps the 3 Ps off the floor (pee, poo, penis)

124
Q

Pudendal nerve

A

Branch of sacral plexus that supplies the internal and
external anal sphincters
(exits pelvis via greater sciatic foramen and enters perineum via lesser sciatic foramen)

125
Q

Liver functions

A 
Carbohydrate, fat and protein metabolism
Production and secretion of bile
Storage 
Immune protection
Interaction with hormones
Detoxify and metabolise drug
126
Q

4 Main lobes of the liver

A

Right Lobe
Left Lobe
Caudate Lobe
Quadrate Lobe

127
Q

The portal triad

A

Hepatic artery proper
Hepatic bile duct
Portal vein

128
Q

How is blood and lymph circulated through liver lobules?

A

Blood will filter from a branch of the portal triad through the functional unit and be collected in the central vein of the lobule
At the same time, hepatocytes are producing bile that moves in the opposite direction out towards the bile duct in the portal triad. his will eventually flow into the hepatic duct and to the gallbladder.

129
Q

The portal venous system drains blood from ——– through the ———–
The systemic circulation drains blood from ————- into the ————

A

The portal venous system drains blood from the midgut, foregut and hindgut through the liver.
The systemic circulation drains blood from all other organs and tissues into the SVC and IVC

130
Q

Points of anastomosis between the systemic and portal systems.

A

1) Oesophagus (anastomosis between hepatic portal vein and azygous vein)
2) Anal canal (anastomosis between IMA and internal iliac vein)
3) Umbilicus (ligamentum teres is opened and blood flows to the inferior epigastric veins)

131
Q

When the portal venous system resistance increases due to blockage, liver cirrhosis, etc. the blood will travel through ————

A

the path of least resistance. Which is through anastomoses into systemic circulation, leading to dilatation at these points:
Oesophageal varices
Caput medusae
Rectal varices

132
Q

Drug metabolism in liver
Phase 1 =
Phase 2 =

A

Phase 1 = activation - oxidise, hydrolyse, reduce the drug - making drug more polar.
Phase 2 = conjugation - add another functional group to the polarised molecule e.g. methyl, acetate, sulphate etc. - makes drug inactive, less toxic, available to be excreted by liver

133
Q

Cytochrome P450

A

Family of enzymes that are present in hepatocytes and will oxidise drugs

134
Q

The ——— joins with the ———– to form the common bile duct (CBD)

A

The cystic duct joins with the common hepatic duct to form the common bile duct (CBD)

135
Q

Calot’s Triangle

A

Where the cystic artery is located

Borders - liver, common hepatic duct, cystic duct

136
Q

Amphipathic

A

hydrophillic + hydrophobic

137
Q

Bile is composed of ———–

A

water, bile salts, bilirubin, cholesterol; alkaline in nature

138
Q

Liver hepatocytes make primary bile salts by converting ———-&raquo_space; ————

A

cholesterol&raquo_space; cholic acid

139
Q

The intestines then dehydroxylate primary bile salts into ———–

A

deoxycholic acid (secondary bile salts)

140
Q

When chyme enters the duodenum, ——- is secreted by l cells into the blood, triggering ———

A

When chyme enters the duodenum, CCK is secreted by l cells into the blood, triggering gall bladder contraction and relaxation of the sphincter of Oddi (allowing bile to enter D2)

141
Q

Action of bile

A

emulsifies lipids to aid breakdown and absorption

142
Q

Bilirubin Excretion

A

1) old RBCs&raquo_space; haem + globin, by macrophages
2) globin&raquo_space; amino acids, and haem&raquo_space; iron, protoporphyrin
3) protoporphyrin&raquo_space; unconjugated bilirubin (UCB)
4) UCB (not water-soluble) binds to albumin to be transported to the liver
5) hepatocytes in the liver convert UCB&raquo_space; conjugated bilirubin (CB)
6) CB secreted into the bile
7) in intestines, CB&raquo_space; urobilinogen
Some urobilinogen&raquo_space; stercobilin (gives faeces brown colour)
Some urobilinogen&raquo_space; urobilin, in kidneys (gives urine yellow colour)
Some urobilinogen is recycled through the blood into the liver

143
Q

What region of the abdomen is the spleen found in?

A

left hypochondrium

144
Q

Anatomical relations of the spleen

A

Stomach anteriorly
Diaphragm posteriorly
Left Kidney medially
Splenic flexure inferiorly

145
Q

Spleen function

A

Breaks down RBC to produce bilirubin

146
Q

Anatomical relations of the pancreas

A

Duodenum sits in a C shape around pancreas.
Head- anterior to SMA branches (small projection - uncinate process - lying posterior)
Body- over Aorta at vertebrae level L2
Tail - anterior to left kidney, pointing to spleen

147
Q

Arterial supply to pancreas

A

Superior and inferior pancreaticoduodenal artery anastomose and supply the pancreas
Inferior originates from SMA
Superior originates from gastroduodenal artery

148
Q

Pain from pancreas can sometimes be referred to the back because ——–

A

the pancreas is retroperitoneal and interacts with the posterior abdominal wall
AND also due to referred pain and convergence of several sensory afferent nerves at one ganglia.

149
Q

Nerve supply to pancreas
Parasympathetic comes from ————–
Sympathetic comes from ————–

A

Parasympathetic comes from Vagus Nerve

Sympathetic comes from Abdominopelvic splanchnic

150
Q

Pancreas exocrine function

A

involves the production of digestive juices and enzymes by acinar cells, released VIA DUCTS (drain into collecting ducts and eventually the central pancreatic duct)

151
Q

Pancreas endocrine function

A

involves the islet of langerhan release of insulin and glucagon, released INTO BLOOD

152
Q

The ———- duct and ———- duct join together and form a widened duct: Ampulla of Vater

A

The main pancreatic duct and the common bile duct join together and form a widened duct: Ampulla of Vater

153
Q

The digestive enzymes and bile are released into the small intestine through the ———–

A

Main Duodenal papilla.

154
Q

Which muscle of mastication allows opening of the mouth?

A

Lateral pterygoid

155
Q

Blood supply to lesser curvature of stomach =

Blood supply to greater curvature of stomach =

A

lesser curvature = left gastric artery

greater curvature = left and right gastro-omental arteries

156
Q

The peritoneal cavity is lined by mesothelial cells that produce surfactant. True/false?

A

True

GI (9 decks)

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