Anatomy wk 2 Flashcards
1
Q
How long is the oesophagus + where does it begin and end
A
25cm
From pharynx to stomach
2
Q
Name the 3 areas where there are constrictions in the oesophagus
A
Cervical
Thoracic
Diaphragmatic
3
Q
What is the vertebral level of the oesophageal opening in the diaphragm
A
T10
4
Q
Name 4 things that traverse the oesophageal opening in the diaphragm
A
Oesophagus
Vagus nerve
Oesophageal arteries
Lymphatic vessels
5
Q
Blood supply of the abdominal part of the oesophagus
A
Branches of left gastric artery
6
Q
Venous drainage of the abdominal part of the oesophagus
A
Left gastric vein
7
Q
Lymphatic drainage of the abdominal part of the oesophagus
A
Left gastric lymph nodes
8
Q
The lower end of the oesophagus is a site of portosystemic anastamosis, therefore in portal hypertension, what condition can you get at this site
A
Oesophageal varices
9
Q
Major symptom of oesophageal varices
A
Haematamesis
10
Q
How many orifices, curvatures and surfaces does the stomach have
A
2 - cardiac orifice + pyloric orifice
2 - greater + lesser
2 - anterior + posterior
11
Q
What orifice connects the oesophagus and stomach
A
Cardiac
12
Q
What orifice connects the stomach and duodenum
A
Pyloric
13
Q
What is the most superior part of the stomach called
A
Fundus
14
Q
What is the pyloric sphincter
A
Smooth muscle controlling gastric connects entering duodenum
15
Q
Pyloric sphincter is formed from the thickening of which histological layer of the gut tube
A
Circular layer of muscularis externa
16
Q
What are the gastric folds (rug) formed from
A
Folded mucosa and submucosa
17
Q
7 structures forming the stomach bed (below + behind stomach)
A
Left dome of diaphragm Left kidney Spleen Pancreas Left adrenal gland Colon Mesocolon
18
Q
Name the artery coming off the aorta at T12 and the 3 branches it gives not long after branching off the aorta, that goes on to supply the stomach
A
Coeliac trunk
Common hepatic artery
Left gastric artery
Splenic artery
19
Q
Name 4 arterial branches that supply the stomach
A
Right gastric artery
Left gastric artery
Left gastro-omental artery (branch of splenic artery)
Right gastro-omental artery (branch of gastroduodenal artery which is branch of common hepatic a)
20
Q
Venous drainage of the stomach (name the 5 veins and where they drain into each)
A
Right and left gastric veins –> hepatic portal v
Right and left gastro-omental veins –> superior mesenteric v
Short gastric vein –> superior mesenteric v
21
Q
What group of lymph nodes does the stomach drain into
A
Coeliac lymph node
22
Q
Gastric carcinoma usually occurs along which curvature of the stomach
A
Greater
23
Q
What cranial nerve innervates the stomach and controls gastric motility
A
CN X
24
Q
Increased vagal stimulation of the stomach causes what 2 things
A
Relaxes pyloric sphincter to allow more gastric contents into duodenum
Increases gastric secretion (HCl)
25
Where does the small intestine begin and end
Pylorus of stomach to ileocaecal junction
26
Which part of the small intestine receives the opening of the common bile and pancreatic duct + the specific name of the area that the ducts enter and the sphincter controlling this area
2nd part of duodenum
Enters at the major duodenal papilla controlled by the sphincter of oddi
27
Foregut/midgut boundary
Proximal half of duodenum
28
Describe how the duodenum is peritonised (2)
1st part intraperitoneal
2nd - 4th part retroperitoneal
29
Which part of is shortest and widest
Duodenum
30
```
Describe the jejunum in terms of:
Colour
Wall
Vascularity
Vasa recta
Arcades
Fat in mesentery
Circular folds
```
```
Deep red
Thick + heavy
Greater vascularity than ileum
Long vasa recta
Few large loops
Little fat in mesentery compared to ileum
Large, tall and closely packed
```
31
```
Describe the ileum in terms of:
Colour
Wall
Vascularity
Vasa recta
Arterial arcades (loops)
Fat in mesentery
Circular folds
```
Pale pink
Thin + light
Less vascularity than jejunum
Short vasa recta
Many short loops
More fat in mesentery compared to jejunum
Small, short + sparse folds; absent in distal ileum
32
Which organ sits in the curve of the duodenum and capable of compressing the common bile and pancreatic duct if there's a tumour of this organ
Pancreas (specifically the head)
33
3 features that distinguish large intestine from small
Omental appendices (yellow fatty tissue)
Haustra
Teniae coli
34
How is the caecum peritonised
Intraperitoneal
35
How is the ascending colon peritonised
Retroperitoneal
36
How is the descending colon peritonised
Retroperitoneal
37
How is the transverse colon peritonised
Intraperitoneal
38
How is the sigmoid colon peritonised
Intraperitoneal
39
Midgut/hindgut boundary
Hindgut begins distal 1/3rd transverse colon
40
What abdominal region is the caecum and appendix in
Right iliac
41
What 2 structures open into the cavity of the caecum
Appendix
| Ileum
42
Normal position of appendix
Retrocaecal
43
What is the McBurney's point (clinical definition and anatomical definition)
Point of max tenderness in appendicitis
Point of right side of abdomen that's 1/3 of the way from the anterior superior iliac spine to the umbilicus
44
3 parts of the rectum
Superior 1/3
Middle 1/3
Inferior 1/3
45
Arterial supply of superior 1/3 rectum
Arterial supply of middle 1/3 rectum
Arterial supply of inferior 1/3 rectum
Superior rectal artery (branch of IMA)
Middle rectal artery (branch of internal iliac a)
Inferior rectal artery (branch of internal iliac a)
46
What is the superior rectal artery a branch of
IMA
47
What is the middle and inferior rectal artery a branch of
Internal iliac a
48
Venous drainage of the
- superior 1/3 rectum
- middle 1/3 rectum
- inferior 1/3 rectum
Superior rectal vein
Middle rectal vein
Inferior rectal vein
49
How is the rectum peritonised:
Retroperitoneal
50
What 2 other things are involved in faecal continence apart from pelvic floor muscles
External and internal anal sphincter
51
What is the purpose of both somatic and visceral (autonomic) innervation to the anal canal
Somatic motor innervation of the external anal sphincter
Autonomic innervation for the smooth muscle of the anal canal
52
Arterial supply of proximal duodenum (1st and 2nd part)
Coeliac artery/trunk
53
Venous drainage of duodenum
Portal system (--> portal vein --> hepatic veins --> IVC)
54
Lymphatic drainage of duodenum
Coeliac group of lymph nodes
55
Arterial supply of distal duodenum (3rd and 4th part)
Superior mesenteric artery
56
Arterial supply of jejunum and ileum
Superior mesenteric artery
57
Venous drainage of jejunum and ileum
Portal system
58
Lymphatic drainage of jejunum and ileum
Superior mesenteric group lymph nodes
59
Arterial supply of caecum
Superior mesenteric artery
60
Venous drainage of caecum
Portal system
61
Lymphatic drainage of caecum
Superior mesenteric group lymph nodes
62
Arterial supply of ascending colon
Superior mesenteric artery
63
Venous drainage of ascending colon
Portal system
64
Lymphatic drainage of ascending colon
Superior mesenteric group lymph nodes
65
Arterial supply of proximal 2/3 transverse colon
Superior mesenteric artery
66
Venous drainage of proximal 2/3 transverse colon
Portal system
67
Lymphatic drainage of proximal 2/3 transverse colon
Superior mesenteric group lymph nodes
68
Arterial supply of distal 1/3 transverse colon
Inferior mesenteric artery
69
Venous drainage of distal 1/3 transverse colon
Portal system (vein corresponds to artery so in this case inferior mesenteric vein --> portal vein --> hepatic vein --> IVC)
70
Lymphatic drainage of distal 1/3 transverse colon
Inferior mesenteric group lymph nodes
71
Arterial supply of sigmoid colon
Inferior mesenteric a
72
Venous drainage of sigmoid colon
Portal system
73
Lymphatic drainage of sigmoid colon
Inferior mesenteric lymph nodes
74
Lymphatic drainage of majority of rectum
Inferior mesenteric group lymph nodes
75
Lymphatic drainage of lower rectum
Internal iliac lymph nodes
76
Superior rectal vein drains into what system vs middle/inferior rectal veins drain into what system
Superior rectal v --> portal system
Middle/inferior --> systemic venous system (IVC)
77
Nerve supply of the rectum (3 fibre types)
ALL AUTONOMIC:
Sympathetic - lumbar splanchnic nerves, Superior and inferior hypogastric plexuses
Parasympathetic - pelvic splanchnic nerves (S2-S4)
Visceral sensory - follows the parasympathetic supply
78
Nerve supply of the anal canal (2 types)
Autonomic - inferior hypogastric plexus
Somatic motor - inferior rectal nerves
79
What is the falciform ligament
Separates right and left lobe of liver and joins the liver to the anterior abdominal wall
80
What lies within the free border of the falciform ligament
Round ligament of liver
81
What is the round ligament of the liver an embryological remnant of
Left umbilical vein
82
What is an omentum (omenta)
Double fold of peritoneum connecting the stomach with other abdominal organs or the body wall
83
What is a mesentery
Double fold of continuous peritoneum that attaches your intestines (and other abdominal organs) to the posterior abdo wall
84
What is a ligament in terms of abdominal cavity
Double layers of peritoneum which span between organs and organs or body wall
85
How many layers of peritoneum present in greater omentum
4
86
What are the paracolic gutters
Spaces between the surface of the colon and posterolateral abdo wall
87
Clinical significance of paracolic gutters
Passage for infectious fluids that leak in the abdomen
88
List 3 abdominal structures which lie in the free edge of a mesentery
Jejunum
Ileum
Transverse colon
89
What 2 layers of muscle are present in the muscularis externa
Circular and longitudinal
90
Which third of the oesophagus has skeletal muscle and what muscle type are the other two thirds made of
Upper 1/3 skeletal
Other 2/3 are smooth muscle
91
What epithelium lines oesophagus
Stratified squamous
92
What type of muscle is the musclaris mucosae in the mucosal layer
Smooth
93
What are the large folds called present inside the stomach wall
Rugae
94
What 3 cell types are in the gastric pits
Mucus neck
Parietal
Chief
95
What are the large folds called extending into the lumen of the small intestine
Villi
96
What are superimposed on each villi of the small intestine
Microvilli
97
What type of epithelium lines the small intestine
Simple columnar
98
What 2 parts of the GI tract do you find glands in the submucosa as well as the lamina propria
Oesophagus and duodenum
99
What secretory cells are found the small intestine
Goblet - secrete mucous
100
Where do you find Peyer's patches the most
Ileum
101
What is the predominant cell present in the surface epithelium of the colon
Goblet cells
102
What is the epithelium transition from rectum to anal canal
Simple columnar --> stratified squamous in anal canal
103
What is the transpyloric plane
Transverse line halfway between jugular notch and pubic symphysis at L1 level
104
What vertebral level and costal cartilage level is the transpyloric plane
L1
8th costal cartilage
105
List 6 structures present in the transpyloric plane
```
Pylorus of stomach
1st part of duodenum
Hilum of kidneys
Neck of pancreas
8/9th costal cartilage
Gallbladder
```
106
What costal cartilage level is the gallbladder
9th
107
Name 6 imaging procedures used to investigate GI diseases
```
Barium study
Endoscopy
CT
MRI
USS
XR
```
108
What organ is a barium meal used for
What organ is a barium swallow used for
Stomach
Oesophagus
109
Name the 4 types of barium studies
Barium swallow
Barium meal
Barium follow through
Barium enema
110
What organ is a barium follow through used for
SI
111
What organ is a barium enema used for
LI
112
Kidneys vertebral level range
T12 - L3
113
Name 5 accessory organs of the GI tract
Liver
Gallbladder
Kidneys
SpleenPANCREAS
114
How is the spleen peritonised
Intraperitoneal
115
Does the spleen move with respiration + what other abdo organ moves with respiration
Yes
| Liver
116
Name 3 structures present in the hilum of the spleen
Splenic artery
Splenic vein
Lymphatic vessels and nerves
117
The tail of which organ is closely related to the hilum of the spleen
Pancreas
118
4 functions of the spleen
Storage/production of RBCs
Blood filtration
Storage of WBCs
Phagocytosis
119
What type of gland is the pancreas
BOTH exocrine + endocrine
120
What does the exocrine part of the pancreas do + what does the endocrine pancreas do
Secrete digestive enzymes
Secrete hormones
121
4 components of the pancreas
Head
Neck
Body
Tail
122
How is the pancreas peritonised
Retroperitoneal
123
Which vein is posterior to the neck of the pancreas
Portal v
124
What quadrant is the liver in
RUQ
125
How many lobes does the liver have + name them + which is the biggest
Right - biggest
Left
Caudate
Quadrate
126
What ligament connects the liver to the undersurface of the diaphragm
Coronary ligament
127
Which lobe of the liver has the bare area + what is it
Right
| Area not covered by peritoneum, directly contacts diaphragm
128
What is the porta hepatis
Area of the liver where structures enter and leave
129
Name 3 structures in the porta hepatis
Hepatic artery
Portal vein
Bile duct
130
What ligament is wrapped around the 3 structures in the porta hepatis
Hepatoduodenal ligament
131
Extrahepatic biliary apparatus consists of what 5 things
```
L & R hepatic ducts
Common hepatic duct
Gallbladder
Cystic duct
Common bile duct
```
132
Common bile duct is formed by the union of what 2 ducts
Cystic and common hepatic
133
What organ produces bile + what stores bile
Liver
Gallbladder
134
Where does bile enter the gut tube
Major duodenal papilla in the 2nd part of duodenum
135
Bile function
Emulsify fats
136
What do the common bile duct and the main pancreatic duct join to form
Hepatopancreatic duct
137
What is biliary obstruction + potential causes
When passage of bile into duodenum is partially or completely blocked
Gallstones
Cancer of head of pancreas
138
What is calot's triangle
Triangular space formed by cystic duct, common hepatic duct and inferior surface of liver
139
3 histological features of pancreas
Islets of langerhans - clumps of poorly stained cells
Pure serious acini - large strongly stained cells
Small lobules surrounded by connective tissue septa
140
How to differentiate between exocrine and endocrine pancreas on histology
Endocrine pancreas will have small clumps of lightly stained cells (islets of langerhans)
Exocrine pancreas more strongly stained because they secrete enzymes which are protein which is strongly stained
141
2 histological features of liver
Cells arranged in sheets and converging towards the centre (central vein in centre)
At the corners of a lobule, connective tissue encloses the vessels of the portal triad
142
Spleen is covered by what
Dense fibromuscular capsule formed of collagen and elastic fibres
143
What is the parenchyma of the spleen called
Pulp
144
What is the red pulp of the spleen
Made up of sinusoids (large wide capillaries filled with blood) where most blood filtration occurs
145
What is the white pulp of the spleen
Made up of plasma cells and lymphocytes
146
Surface anatomy position of gallbladder
9th costal cartilage
147
Surface anatomy position of the spleen
9th - 11th ribs
148
Which abdominal plane crosses the pancreas + which part of the pancreas does it pass through
Transpyloric
Neck of pancreas
149
What imaging modality can be used to view the arteries coming off the abdominal aorta
Abdominal arteriography
150
What nerve is secretomotor to stomach
Vagus
151
What parts of the GI tract are goblet cells found more in
Distal ileum + LI
152
Does LI have villi
No
153
What vein drains the liver
Hepatic vein
NOT PORTAL - PORTAL V IS ACTUALLY A BLOOD SUPPLY OF LIVER
