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year 2 sem 1 > anatomy yr 2 > Flashcards

anatomy yr 2 Flashcards

1
Q

lateral fissure

A

separates the temporal lobe and frontal lobe

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2
Q

central sulcus

A

separates frontal lobe and parietal lobe

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3
Q

whats contained in the frontal lobe

A
  • Prefrontal-area – planning complex movements and thinking
  • Motor cortex – controlling muscles
    o Speech production (Broca’s Motor speech area) – specialised area of motor area
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4
Q

whats contained in the parietal lobe

A
  • Somato-sensory area – receiving sensory information from skin/joints etc
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5
Q

what’s contained in the temporal lobe

A
  • Auditory
  • Language, understanding, intelligence
  • Behaviour, emotions, motivation (small bit is partly in the frontal lobe)
  • wernickes speech area
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6
Q

what are brodmann’s areas

A
  • Brodmann stained areas of the brain and looked at the distribution of neurones across brain tissues
  • Gave each area of tissue a number
  • These numbers predict the functional areas of the brain
  • Practically overlap the functional areas of the brain…
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7
Q

association, commissural and projection fibres

A

Association Fibres (within same hemisphere)

Commissural Fibres (between hemispheres) eg corpus callosum

Projection Fibres (cortex to sub-cortical areas) eg internal capsule

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8
Q

diancephalon

A

Position - deep in middle of brain
- Below the corpus callosum and above the top of the brainstem

  • Subconscious level
  • Sub regions – all contain the name thalamus
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9
Q

areas of the diancephalon

A

o Epithalamus- contains the pineal gland (secretes/generates melatonin)

o Thalamus – one structure with 2 sides (L and R) looks like 2 birds egg
 Sifting and sorting information

o Subthalamus – sits below thalamus, not seen clearly above
 Motor control

o Hypothalamus – master regulator in partner with pituitary gland (intimate physical and vascular relationship)
 Pituitary gland is not seen in dissected brains as its pulled away during dissection

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10
Q

parts of the brainstem

A

midbrain
pons
medulla

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11
Q

what divides the cerebellum medially

A

the vermis

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12
Q

what are the ridges of the cerebellum called

A

folia

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13
Q

what are the 3 white axon tracts linking the cerebellum to the brainstem

A
  • Superior Peduncle (link it to midbrain)
  • Middle Peduncle (link to pons)
  • Inferior Peduncle (link to medulla)
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14
Q

what level does the brain become the spinal cord

A

the foramen magnum roughly

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15
Q

ventral grey horns vs dorsal grey horns

A

Ventral grey horns

  • Motor activities (signal going out)
  • Encased in white matter
  • Don’t reach ventral edge of cord

Dorsal grey horns

  • Sensory activities (signals coming in)
  • Reach right up to the edge (dorsal surface) of cord
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16
Q

falx cerebri

A

fold of dura matter in the midline of skull between hemispheres, sits in great longitudinal fissure

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17
Q

tentorium cerebelli

A

partition between occipital lobes and cerebellum

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18
Q

where do the carotid arteries branch from

A

brachiocephalic trunk

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19
Q

where do the vertebral arteries branch from

A

subclavian artery

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20
Q

what arteries do the internal carotid arteries give rise to

A

middle and anterior cerebral artery

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21
Q

what are the 3 communicating arteries

A

left posterior
right posterior
anterior

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22
Q

what do the vertebral arteries give rise to

A

unite to form the midline basilar artery

this terminates as a pair of post. cerebral arteries

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23
Q

venous drainage

A
  • no valves
  • occurs through gravity
  • drained through dura venous sinuses

since dura is double layered…

  • 2 membranes come apart to form a space which is the sinuses that drain the brain
  • via internal jugular veins
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24
Q

different dura venous sinuses

A

superior sagittal sinus
- runs along falx cerebri

transverse sinuses
- splits at back of the head

sigmoid sinuses
- arise from transverse sinuses and drains to jugular veins

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25
Q

ventricles of the brain

A

lateral ventricles

  • left and right
  • anterior, posterior, inferior horns
  • chambers comes together in midline & intraventricular foramen (FORAMEN OF MUNRO) connects them to 3rd ventricle

3rd ventricle
- connects through CEREBRAL AQUEDUCT to 4th ventricle

4th ventricle
- sits between the pons of the brainstem in front and cerebellum of brainstem behind

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26
Q

what are the specialised cells called within the ventricles

A

ependymal cells

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27
Q

what structure secretes CSF

A

choroid plexus

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28
Q

where and what are the arachnoid granulations

A

in the superior sagittal sinus

- they suck up CSF

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29
Q

what’s the small inferior part of the cerebellum called

A

the flocculondular lobe

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30
Q

what divides the anterior and posterior lobe of the cerebellum

A

primary fissure

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31
Q

what are the 3 main divisions of the cerebellum evolutionary

A

central part – vestibulocerebellum (archicerebellum)
o fastigal nucleus
 2 way connections with vestibular nucleus
 Connected to where one is positioned in space, and movement in space

middle part – spinocerebellum (paleocerebellum)
o interposed nucleus
 spino-cerebellar connections with the spinal cord
 deals with posture and gait

outer part – pontocerebellum (neocerebellum)
o dentate nucleus
 connected with pons and neocortex
 uniquely large in humans
 deals with fine motor control eg hand movements

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32
Q

what are the 3 cellular layers of the cerebellum

A

outer - molecular layer
- stellate cells, basket cells

middle - piriform layer
- purkinje cells

inner - granular layer
- granule cells, golgi cells

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33
Q

what fibres are associated with what layers of the cerebellum (input)

A
  • Granular layer through mossy fibres

- Molecular layer through climbing fibres

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34
Q

spinal cord tracts that send info to the cerebellum

A

a. Posterior spino-cerebellar
b. Cuneocerebellar
c. Anterior spinocerebellar
d. Rostral spinocerebellar

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35
Q

head, neck and brainstem tracts that send info to the cerebellum

A

a. Oliviocerebellar
b. Tectocerebellar
c. Pontocerebellar
d. Reticulocerebellar
e. Trigeminal nerve

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36
Q

where does the cerebellum send info (efferents)

A
  • vestibular nuclei
  • reticular formation
  • red nucleus
  • ventrolateral thalamus
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37
Q

symptoms of ataxic syndrome (cerebellar problem)

A
  • Ataxia of upper and lower limbs
    o Clumsiness of motor movement
  • Truncal ataxia
    o In-coordination of postural sense – unsteadiness and falls
  • Gait ataxia
    o In-coordination of walking
  • Dysarthria – speech coordination
  • Nystagmus – eye incoordination
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38
Q

lenticulo-striate arteries

A

Supply deep brain nuclei ie basal ganglia and thalamic nuclei

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39
Q

lipohyalinosis

A
  • Degeneration process initiated by fibrinoid necrosis

- Segmental arteriole disorganisation

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40
Q

arteriosclerosis

A
  • Concentric hyaline wall thickening of small arteries and arterioles
  • Deeply seated intracerebral haematoma associated with ht
  • Common sites
    o Basal gangla
    o Brain stem
    o Cerebellum
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41
Q

lobar haematoma

A

commonest cause - beta-amyloid immunohistochemistry

- alzheimers disease predisposes

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42
Q

venous infarction

A 
-	Sagittal sinus thrombosis 
o	Oral contraceptives
o	Dehydration
o	Meningitis
-	Cortical vein thrombosis
o	meningitis
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43
Q

what are the 2 divisions of the dorsal column

A

fasciculus gracilis
- lower body/ limbs

fasciculus cuneatous
- upper body/ limbs

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44
Q

what is a key feature of being in the caudal medulla

A

internal arcuate fibres

  • these are dorsal column fibres that are decussating in the medulla
  • pass into a white-matter tract known as the medial lemniscus pathway
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45
Q

what happens to medial lemniscus pathway in the thalamus

A

in diacephalon…

  • 3rd order neurone cell bodies are found in the VPL (ventral posterolateral nucleus of the thalamus)
  • then info proceeds to the primary somatosensory cortex
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46
Q

what part of the internal capsule do the dorsal column/ medial lemniscus axons pass through

A

posterior limb

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47
Q

where do the 1st order neurones synapse onto 2nd order cell bodies in the spinothalamic pathway

A
  • immediately in the spinal cord
  • substantia gelatinosa and
  • nucleus proprius
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48
Q

what is the white matter bridge the spinothalamic fibres use to decussate

A

ventral white commisure

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49
Q

therefore the sensory info in the spinal cord is organised into…

A

o Ipsilateral info about discrimitive touch and proprioception
o Contralateral info about pain, non-discrimitive touch, and temperature

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50
Q

what pathway do spinothalamic fibres pass through in the midbrain

A

spinal lemniscus

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51
Q

how many orders are there in the spinocerebellar pathway

A

2

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52
Q

dorsal spinocerebellar pathway

A
  • enters at dorsal part of spinal cord via dorsal rootlets
  • enter spinal cord at dorsal horn of spinal cord
  • 2nd order neurone in middle region of grey matter of spinal cord (between ventral and dorsal horns)
  • this area known as CLARKES COLUMN
  • 2nd order neurone passes axon into dorsal spinocerebellar tract into the medulla
    through INFERIOR PEDUNCLE
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53
Q

ventral spinocerebellar pathway

A
  • enters through dorsal rootlets
  • synapses immediately with 2nd order neurone in clarke’s column
  • 2nd order neurone decussates in the ventral white commisure
  • entering ventral part of spinocerebellar tract and ascending to the pons
  • crosses back over behind the brainstem at this point into the original side
  • goes through SUPERIOR CEREBELLAR PEDUNCLE
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54
Q

what are the subregions of the trigeminal nerve nucleus

A

 Mesencephalic nucleus
 Chief sensory nucleus
 Nucleus of the spinal tract of the trigeminal

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55
Q

what’s the pathway of the second neurone of the trigeminal nerve

A
  • decussates in brainstem then heads up to the thalamus

- in the internal capsule the 3rd order nucleus is in the VPM NUCLEUS (ventral posteromedial nucleus)

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56
Q

important dermatome levels

A

C3 and C4
o Area around the neck
o Expect the collar of a shirt

C6
o Skin of thumb

C7
o Middle finger

C8
o Skin of little finger

T4
o Nipples in male

T10
o Umbilicus – belly button

L4
o Front of Knee

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57
Q

whats the difference between cranial nerves I & II vs cranial nerves III-XII

A

olFactory and optic nerves (I & II)
o Direct outgrowths of the brains
o Same structure as CNS – same myelin

Other cranial nerves (III – XII)
o Similar to PNS
o When they leave the CNS have a peripheral nerve type structure

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58
Q

what does damage to the oculomotor nerve (III) result in

A

o Result in ipsilateral eye being deviated downward and laterally
o Ptosis
o Fixed dilated pupil
o May be damaged due to raised intracranial pressure with tentorial herniation, or disorders involving the cavernous sinus

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59
Q

what eye muscles does the oculomotor nerve supply

A
  • superior rectus
  • inferior rectus
  • medial rectus
  • inferior oblique
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60
Q

what does the trochlear nerve (IV) supply

A

superior oblique

- if damaged = diplopia (double vision) looking downwards and medially

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61
Q

what does the abducens nerve (VI) supply

A
  • supplies the lateral rectus muscle

- when damaged results in diplopia (double vision) looking laterally

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62
Q

what are the 3 branches of the trigeminal nerve

A

o Ophthalmic
o Maxillary
o Mandibular
 Also contains efferent motor fibres that supply muscles of mascication

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63
Q

what are the 3 sensory nuclei of the trigeminal nerve

A

o Mesencephalic; proprioception form jaw
o Chief sensory nucleus and spinal nucleus; 2nd order neurones from spinothalamic pathway
- These fibres decussate and pass to thalamus

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64
Q

cavernous sinus

A
  • Brings together III, IV, V, VI cranial nerves
  • Dural venous sinus
  • Lies in middle of cranial fossa
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65
Q

cavernous sinus syndrome

A

o Give rise to variable ocular palsies and upper trigeminal sensory loss
o Caused by trauma, neoplasia, thrombosis, inflammatory conditions

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66
Q

facial nerve (VII) afferent/ efferent supply

A
  • muscles of facial expression
  • sensory info from external ear (geniculate nucleus)
  • 2/3rds of tongue
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67
Q

UMN vs LMN lesion effects on facial nerve

A

UMN

  • upper facial muscles relatively well preserved due to bilateral innervation of the facial nucleus
  • lower facial muscles paralysed

LMN
- paralysis of both upper and lower facial muscles

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68
Q

where are cell bodies of lower motor neurones

A

ventral grey horn

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69
Q

where are there enlarged ventral grey horns and why

A
  • cervical enlargement
  • lumbar-sacral enlargement

extra no.s of LMN cell bodies to supply upper and lower limbs

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70
Q

what are the 2 types of motor neurone axons and whats the difference

A

alpha and gamma

gamma
- small group of MN that supply muscle spindle

alpha

  • fastest conduction velocity
  • largest diameter
  • always myelinated
  • don’t want to delay of getting info from CNS to muscles
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71
Q

NMJ

A

one per muscle fibre

  • but indiv. motor neurone can innervate multiple muscle fibre (motor unit)
  • fine control = small motor unit
  • power = big motor unit

almost always cholinergic fibres - Ach

only needs one action potential to activate (not summative)

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72
Q

where is the primary motor cortex

A
  • in the prefrontal gyrus

- has 6 layers of neurones (lamina)

73
Q

what do the corticospinal UMN travel through from the PMC to internal capsule

A

corona radiata (looks like rays of sun)

74
Q

whats are the parts of the internal capsule

A

anterior limb
genu
posterior limb

75
Q

what part of the internal capsule do the corticospinal tracts cross through

A

posterior limb
- beside ascending sensory axons

arranged so head and neck fibres are up towards the genu and lower limb fibres are at the bottom in the RETRO LENTICULAR PART

76
Q

what are the white matter tracts the corticospinal fibres travel down in the midbrain

A

crus cerebri

- /basis pedunculi

77
Q

what are the corticospinal fibres called once they enter the pons

A

transverse pontine fibres which criss-cross side to side

thereby separating up UMN and segregating them into sub-tracts
- called PONTINE SPINAL TRACTS

78
Q

what are the corticospinal tracts called in the medulla

A

the pyramids

  • 75-90% of fibres cross here
  • usually at caudal (lower) end of medulla
79
Q

what different fibres are int he ventral and lateral corticospinal tracts

A

ventral
- those that remain ipsilateral

lateral
- those that decussate

80
Q

rubrospinal tract

A

contralateral

  • from red nucleus in midbrain
  • alternative route for higher centre LMN control
81
Q

vestibulospinal tract

A

ipsilateral

  • from vestibular nuclei in pons and medulla
  • 2 bundles (medial and ventrolateral)
  • receive info from vestibular apparatus in inner ear
  • rapid feedback on pos. and movement of head
82
Q

tectospinal tract

A

contralateral

  • from superior colliculus in midbrain
  • relay centre on visual pathways
83
Q

reticulospinal tract

A

ipsilateral and bilateral

  • from reticular nuclei in brainstem
  • 3 potential tracts (lateral, medial, ventral)
  • volume control on motor activity
  • complex
84
Q

clinical affects of UMN loss

A
  • no profound muscle atrophy
  • spasticity
  • pos. “babinksi” reflex (big toe dorsiflexion)

LMN still intact which is why muscle not paralysed and doesn’t waste away bc LMN still sends signals to muscle

85
Q

clinical affects of LMN loss

A
  • connectivity between NS and muscle lost
  • weak or paralysed
  • profound muscle atrophy
  • tendon reflexes are weak or absent
  • fibrillation potentials (muscles firing random AP)
  • fasciculations (muscle twitching)
86
Q

basal ganglia

A
  • interconnected group of grey matter structures in the brain
  • scattered throughout sub-cortical and brainstem regions
  • check motor activities
87
Q

basal ganglia function

A
  • filters out background activity in motor control
  • so stops unwanted, jerky movements
    1) takes info from cerebrum and checks it
    2) amplifies or pos. reinforces movement
88
Q

input areas of basal ganglia

A
  • caudate nucleus
  • lentiform nucleus (outside of putamen)

known together at the STRIATUM

89
Q

cranial nerve I

A

olfactory nerves

  • picks up smell
  • contributes to sense of taste
90
Q

cranial nerve II

A

optic nerve

  • perception of vision
  • receives impulses from photoreceptors in the eye
  • goes through optic canal into cranial cavity
  • lateral geniculate nucleus
  • optic chiasm is where the 2 optic nerves join
91
Q

cranial nerve III

A

oculomotor nerve

  • somatic and visceral motor axons
  • cavernous sinus
  • superior and inferior branches

supply muscles of the eye…

  • levator palpebrae superioris muscle
  • superior rectus muscle
  • inferior rectus muscle
  • medial rectus muscle
  • inferior oblique muscle

autonomic functions

  • control pupil and lens
  • ciliary muscles alter curvature of lens (vision focus)
92
Q

cranial nerve IV

A

trochlear nerve

  • innervates
  • superior oblique muscle
  • movements of eyeball - abduction, depression, internal rotation
93
Q

cranial nerve V

A

trigeminal nerve

  • senspry innervation to face, facial muscles, sinuses, mucosa
  • muscles of musculation (chewing)

emerges from pons in motor and sensory routes

  • both routes come together at trigeminal ganglion
  • > has an extension of the dura called Meckel’s cave
94
Q

what are the 3 main branches of the CNV

A

opthalmic

maxillary

mandibular

95
Q

cranial nerve VII

A

facial nerve

  • muscles of facial expresion
  • taste sensation
  • autonomic innervation of
  • salivary and lacrimal glands

2 routes

  • motor route (motor neurones)
  • intermediate nerve (sensory and autonomic)

geniculate ganglion

96
Q

cranial nerve VIII

A

vestibulocochlear nerve

  • made up of vestibular(posterior trunk) and cochlear nerve (anterior trunk)
  • purely sensory

vestibular

  • from semicircular canals, utircle and saccule
  • posture and balance

cochlear

  • spirals
  • from hair-like cells in cochlea
  • hearing and isolation of sound
97
Q

cranial nerve IX

A

glossopharyngeal
- sensory, motor, parasympathetic

sensory to…
- oropharynx, middle ear cavity, auditory tube, carotid body and sinus, post 1/3rd of tongue (and taste)

parasymp to…
- carotid gland

motor to
- stylopharyngeus muscle
swallowing and speech

jugular foramen

98
Q

cranial nerve X

A

vagus nerve

  • from medulla oblingata of brainstem to medullary olive
  • jugular foramen

branches

  • meningeal
  • auricular
  • pharyngeal
  • superior laryngeal

recurrent laryngeal nerve

supplies

  • diffuse innervation to thorax and abdomen
  • parasymp. innew
  • autonomic to heart through deep cardiac plexus and superficial cardiac plexus
99
Q

what are the main nerves of the brachial plexus

A
  • musculocutaneous
  • median
  • radial
  • ulnar
100
Q

what are the 3 main nerves of the lumbosacral plexus

A
  • femoral
  • obturator
  • sciatic
101
Q

what cranial nerves have parasympathetic innervation

A

3, 7, 9, 10

oculomotor, facial, glossopharyngeal, vagus

102
Q

what are neurones called when they go in and out the sympathetic chain without synapsing

A

splanchnic nerves

103
Q

how do sympathetic neurones get into the sympathetic chain

A
  • pass into mixed spinal nerve
  • go through white rami communicans (myelinated)
  • synapse with post ganglionic neurone in symp. chain
  • axon travels back through grey rami communicans (non-myelinated)
104
Q

layers of the abdominal wall

A
  • skin
  • subcutaneous layer
  • muscle layer (3 layers)
  • neurovascular plane
  • transversalis fascia
  • extraperitoneal fat
  • parietal peritoneum
105
Q

what are the 3 muscle layers of the abdomen

A
  • external oblique
  • internal oblique
  • transverse abdomins

these 3 layers fuse together into single longitudinal muscles on each side that insert into rectus sheath

106
Q

external oblique

A
  • from lower thoracic cage then pass downwards and medially to the rectus sheath
  • free lower margin known at the inguinal ligament
107
Q

what are the sheet like fibrous tendons in the abdomen called

A

aponeurosis

108
Q

internal oblique

A
  • fibre direction is upward and medially

- from rectus sheath to the thoracolumbar fascia

109
Q

transverse abdominis

A
  • fibres pass transversely
  • insert via the rectus sheath to the thoracolumbar fascia
  • intercostal nerves run in the neurovascular plane of this muscle
110
Q

rectus abdominis

A
  • arise from pubic bone
  • insert into the thoracic cage
  • fibres interrupted by tendinous intersections
111
Q

what is the distribution of abdominal aponeurosis’s above and below the arcuate line

A

below arcuate line

  • aponeurosis (tendons of the abdominal muscles) all pass anteriorly
  • no posterior rectus sheath so no transverse abdominus fibres and the internal oblique fibres all pass anteriorly

above arcuate line

  • posterior rectus present
  • in ternal oblique splits into anterior and posterior layers and passes 50/50 infront an dbehind the radius bdominis
112
Q

what spinal levels supply the neurovascular plane of the abdomin

A

T7-L1

113
Q

`what are the longitudinal arteries of the abdomin

A
  • superior epigastric artery (arising from the internal thoracic artery)
  • inferior epigastric artery (arises from the external iliac artery)
114
Q

functions of the abdominal wall

A
  • moving the trunk
  • protecting major body organs
  • assists bodily functions
  • assists breathing
115
Q

whats the inguinal canal

A
  • found in the medial part of the inguinal region which conveys the spermatic cord(male) and the round ligament of the uterus (females)
116
Q

how does the inguinal canal form

A
  • testis starts its life in abdominal wall
  • it pushes through the abdominal wall creating a well
  • as testis pulled out of the wall so is a part of the peritoneal cavity
  • called PROCESSUS VAGINALIS
  • so now testis is surrounded by a mini peritoneal cavity which is connected to the main peritoneal cavity by the processus
117
Q

whats an indirect inguinal hernia

A

normally processus closes

  • in some cases it persists or recanalizes
  • creates a connection with the peritoneal cavity > sac of an indirect hernia
118
Q

what forms the anterior and posterior walls of the inguinal canal

A

anterior wall

  • formed by aponeurosis of external oblique and partly by internal oblique
  • strong laterally but weak medially where it’s deficient at the superficial inguinal ring

posterior wall

  • weak laterally where it’s deficient at the deep inguinal ring
  • but strong medially where it’s formed by the conjoint tendon
119
Q

inguinal shutter

A

if the internal oblique and transversus abdominus contract the inguinal canal will shut to reduce risk of herniation of abdominal contents along the inguinal canal

120
Q

direct inguinal hernias

A
  • the protrusion of a peritoneal sac through a weakened area of the abdominal wall ( with or without abdominal contents)
121
Q

layers of the GI tract

A

mucosa

  • epithelium
  • lamina propria
  • muscularis mucosae

submucosa
muscularis externa
adventitia/ serosa

122
Q

mucosa

A

epithelium

  • where most variation takes place
  • S.I > vili
  • L.I > stratified squamous
  • glands

lamina propria
- connective tissue and vessels and nerves

muscularis mucosae
- inner circular layer and outer longitudinal layer

123
Q

submucosa

A
  • loose connective tissue
  • contains blood vessels, nerves, lymphatic channels
  • submucousal glands secrete mucous
  • meissner plexus (nerve cells supplying muscularis mucosa and secretatory glands)
124
Q

muscularis externa (propria)

A

smooth muscle

  • inner - circular
  • outer - longitudinal

coordination activity results in peristalsis

innervated parasympathetically mostly but also autonomically

125
Q

adventitia and serosa

A
  • outer layer of connective tissue - adventitia
  • in some areas of GI tract there’s a second layer - serosa
  • blood and lymph vessels
  • serosa (covers inter-peritoneal organs, secretes serous fluid to lubricate)
126
Q

what layer are lymphatics in the GI tract

A

submucosa

127
Q

oesophagus histological features

A

mucosa

  • stratified squamous epithelium
  • proliferated basal layer (thats highly turned over)

submucosa

  • large qualities of elastin fibres for expansion
  • production of a mucus layer

muscularis externa

  • upper 3rd - striated muscle
  • mid - striated and smooth
  • lower - smooth

adventitia
- serosa (simple squamous epithelium) forms outermost layer

128
Q

stomach histology

A

mucosa

  • simple columnar epithelium (really tall, one layer)
  • gastric glands project into lamina propria (spaces between these projections = gastric pits)
  • surface mucousal cells (thick protective later ontop of epithelium to prevent digestion of gastric wall)

lamina propria
- cell rich (fibroblasts, macrophages etc)

muscularis mucosa
- contracts to expel contents of the gastric pits into the lumen of the stomach

submucosa

  • large blood vessels, nerve and lymphatic channels
  • elastin for distention and movement

muscularis externa
- 3 muscular layers (innermost oblique, middle circular, external longitudinal)

adventitia
- visceral peritoneum

129
Q

gastric glands cells

A
  • stem cells in the neck
  • neck mucus cells
  • parietal cells
  • peptic/ chief cells
  • neuroendocrine cells
130
Q

what are the 3 types of projections in the small intestines

A
  • plicae circulares (folds of the mucosa)
  • villi (project out of the plicae circulares)
  • columnar epithelial cells (project out the villi)

all to inc. SA of s. intestine

131
Q

histology of the small intestines (mucosa)

A
  • projections^
  • goblet cells
  • simple columnar epithelium
  • lacteals and capillaries
  • crypts of lieberkuhn
  • > between villi
  • > open into the lumen at the base of the villi
  • > contain stem cells, absorptive cells, etc
  • lymphatic deposits
  • > connected to lacteal networks
  • > monitor intestinal bacteria (prevent overgrowth of pathogens)
132
Q

histology of the small intestines (submucosa, muscularis externa, serosa)

A 
submucosa
- many vessels and lymphoid aggregations
- main blood supply to the mucosa
- Brunner's glands - duodenum
-> produces alkaline secretions to neutralise stomach chyme
Peyer's patches - ileum
-> large congregation of lymphoid tissue
-> monitor intestinal bacteria

muscularis externa

  • 2 layers of smooth muscle
  • peristalsis

serosa
- produces serous fluid to allow intestines to move over each other

133
Q

large intestine histology (mucosa)

A
  • smooth thick mucosa
  • deep crypts
  • no villi

epithelium

  • columnar mucous absorptive cells
  • goblet cells
  • basal cells (turnover quickly - 6days)

lamina propria

  • collagen dense
  • regulates water and electrolyte balance (from absorptive cells into blood circulation)
134
Q

large intestine histology (submucosa, muscularis externa, serosa)

A

submucosa

  • similar to s. intestine
  • large aggregates of lymphoid tissue

muscularis externa

  • inner circular layer of smooth muscle
  • outer longitudinal is condensed into 3 bands (taeniae coli)
  • myenteric plexus between muscle layers

adventitia

  • outer serosal layer - intraperitoneal
  • serosa doesn’t go all the way arounf the tube of the L.I
  • this part of the LI that doesn’t have a serosa layer is where it’s continous with the abdominal wall/ mesentery (only adventitia here)
135
Q

what is peritoneum and what are the types

A

peritoneum is mesothelium tissue, it’s a supportive layer of connective tissue

parietal peritoneum - lines abdominal wall

visceral peritoneum - covers abdominal/ pelvic organs

136
Q

what are the folds of the peritoneum called

A

mesentery

137
Q

intraperitoneal organs

A
  • organs invested in the peritoneum

- 1st part of duodenum, spleen, liver, jejunum, ileum, transverse colon, sigmoid colon, superior rectum

138
Q

retroperitoneal organs

A
  • organs behind peritoneal cavity
  • covered by parietal peritoneum anteriorly
  • end of duodenum, kidneys, ureters, ascending and descending colon
  • viscera not actually in the peritoneum they are pushed in like pushing your finger into a balloon
139
Q

omentum

A
  • another form of peritoneum
  • double layered fold of peritoneum
  • sim. to mesentery

2 parts
- greater and lesser omentum

140
Q

mesentery

A

connects jejunum and ileum to posterior abdominal wall

- allows movement for digestion, breathing etc

141
Q

greater omentum

A
  • 4 layers
  • “policeman of the abdomen”
  • move to areas that are inflamed and wrap around structure to protect from inflammation
  • attached to greater curvature of stomach and first part of duodenum -> transverse colon
  • moves via peristalsis
  • made up of fat, connective tissue, lymphatics
  • also bad bc allows for spread of cancer due to lymphatics in it
142
Q

lesser omentum

A
  • 2 layers

- lesser curvature of stomach and 1st part of duodenum -> inferior surface of liver

143
Q

peritoneal cavity

A

the potential area between the parietal and visceral peritoneum

has a thin layer of peritoneal fluid

  • enables viscera to move against each other during resp and digestion
  • fluid formed form water, electrolytes and other
  • contains leukocytes and antibodies that resist infection
144
Q

what are the 2 sacs in the peritoneum

A

greater sac

  • largest part
  • diaphragm -> pelvic cavity

lesser sac/ omental bursa

  • post. to liver and stomach
  • omental/ epiploic foramen
  • bounded anteriorly by lesser omentum
  • cont. with greater sac via epiploic foramen/ omental foramen
145
Q

epiploic foramen

A
  • communication between greater and lesser sacs

- opening located posteriorly to free edge of the lesser omentum

146
Q

how to locate the epiploic foramen

A
  • locate gall bladder
  • run finger along the gall bladder to find free edge of lesser omentum
  • foramen usually 2 fingers in width
  • behind portal triad
147
Q

what ligament connects the liver to the anterior abdominal wall

A

faliciform ligament

148
Q

what ligament connects the liver to the stomach

A

hepatogastric ligament

  • membranous portion of the lesser omentum
  • continous with lesser omentum
149
Q

what ligament connects the liver to the duodenum

A

hepatoduodenal ligament

  • free edge of lesser omentum
  • contains the portal triad
  • continous with part of lesser omentum
150
Q

what ligaments connect the stomach…

A

gastrophrenic ligament
- connects stomach to inferior surface of diaphragm

gastrosplenic ligament
- connects stomach to spleen

gastrocolic ligament

  • connects stomach to the transverse colon
  • part of the greater omentum
151
Q

peritoneal spaces

A

=potential spaces within the peritoneal cavity

supracolic compartment
- stomach, liver, spleen

infracolic compartment
- s. intestine, asc. and desc. colon, behind greater omentum, r. and l. infracolic spaces

152
Q

paracolic gutters

A
  • depressions between ascending and descending colon and posterolateral abdominal wall
  • passage between supracolic and infracolic compartments
153
Q

why are paracolic gutters clinically important

A
  • allow for communication between supra and infra colic compartments
  • passageway for infections/ cancer to spread
154
Q

hepatorenal recess

A
  • between liver and R. kidney and suprarenal gland
  • also known as morrisons pouch
  • continuous witht he right subphrenic recess anteriorly
155
Q

peritoneal spaces in the pelvic cavity

A

rectouterine pouch

  • pouch of douglas
  • only in females
  • peritoneum fold between the rectum and the uterus

vesico-uterine pouch
- between bladder and uterus

rectovesical pouch

  • between bladder and rectum
  • males only
156
Q

functions of peritoneal spaces

A
  • contains peritoneal fluid to lubricate adjacent peritoneal membrane
  • create more room for viscera
  • reducing congestion of structures
  • sites for catheter insertion
157
Q

subphrenic recess

A
  • subphrenic abscesses may form in here
  • accumulation of pus in L or R subphrenic space

most common in right due to…

  • appendicitis
  • ruptured duodenal ulcer
  • pus from appendix to subphrenic recess via R paracolic gutter
158
Q

what are the oesophageal constrictions

A
  • boundary between pharynx and oesophagus (C6)
  • aorta
  • left main bronchi
  • diaphragm
159
Q

what are the 4 regions of the stomach

A
  • cardia
  • fundus
  • body
  • pyloric part (antrum, canal)
160
Q

curvatures of the stomach

A

lesser curvature
- attached to lesser omentum

gretaer curvature
- attached to greater omentum and gastrosplenic ligament

161
Q

what are the longitudinal folds that allow the stomach to expand called

A

gastric rugae

162
Q

duodenum

A

4 parts

  • superior
  • descending
  • inferior
  • ascending
163
Q

what are the duodenal papilla

A

minor
- for accessory pancreatic duct
major
- for main ducts for pancreas and bile ducts emptying into duodenum for digestion

164
Q

jejenum

A
  • thicker and larger in diameter than ileum
  • longer vasa recta
  • numerous folds of inner lining PLICAE CIRCULARES
165
Q

variation of arterial arcades throughout the intestines

A
  • in proximal s. intestine longer and fewer

- in distal s. intestine numerous and shorter

166
Q

ileum

A
  • mostly in the lower r. quadrant
  • thiner walls and less prominent plicae circulares
  • shorter vasa recta
  • more mesenteric fat
  • contents move faster
167
Q

cecum

A 
- located in the right iliac fossa
(lower right quadrant)
- inferior to ileocecal opening
- continous with ascending colon
- attached to posteromedial wall of cecum
168
Q

appendix

A
  • narrow, hollow, blind ended tube attached to base of cecum
  • aggregation of lymphoid tissue in walls
  • base is continous with end of taeniae coli
  • pos. of rest of appendix if=s highly variable
169
Q

how to locate the appendix

A
  • McBurney’s Point
  • found between umbilicus and anterior-superior iliac spine
  • divide into 3
  • > in middle third and lateral third = base of appendix
170
Q

hows the colon different form the small intestine

A
  • larger in diameter
  • omental appendices (fat tags)
  • taeniae coli
  • sacculation’s (haustra of the colon)
171
Q

ascending colon

A
  • retroperitoneal
  • connects cecum to transverse colon
  • ascends as high as right lobe of the liver before rotating 90 degreed (right colic flexure)
172
Q

transverse colon

A
  • links left and right colic flexures
  • midgut-hingut boundary = 2/3rds of the way along transverse colon
  • suspended in transverse mesocolon
173
Q

descending colon

A
  • retroperitoneal

- connects left colic flexure to sigmoid colon

174
Q

sigmoid colon

A
  • s-shaped
  • suspended by sigmoid mesocolon
  • located in left lower quadrant
  • runs from above pelvic inlet to S3
  • continuous with rectum
175
Q

rectum

A
  • starts at rectosigmoid junction
  • lacks features of typical l. intestine
    retroperitoneal
  • 3 lateral flexures (superior, middle, inferior)
  • ampulla accomodates contents just before they’re expelled
176
Q

what level is the coeliac trunk

A

T12

177
Q

the liver coverings

A
  • intraperitoneal
  • covered by visceral peritoneum
  • except bare area, gallbladder fossa and porta hepatis
178
Q

what are the 4 lobes of the liver

A
  • right
  • left
  • caudate
  • quadrate

year 2 sem 1 (13 decks)

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