APE 11: The GI System and the Abdomen Flashcards
What are the 3 different salivary glands?
Submadibular, parotid and sublingual
Where is the submandibular gland found?
Under the body of the mandible, floor of the mouth
Where is its orifice found?
Under the tongue, in the floor of the mouth
Where is the parotid gland found?
Between the ramus of the mandible and the external ear
Which muscle is anterior to the parotid gland?
The masseter muscle
What is formed at the superior base of the parotid gland?
The external acoustic meatus
How is the parotid gland related to the facial nerve?
The parotid gland is the origin of the extracranial part of the facial nerve
What is the clinical importance of the relationship between the parotid gland and the facial nerve?
During parotid gland surgery- facial nerve innervate muscles of facial expression so it could be damaged
How does the parotid duct run?
It runs anteriorly from the parotid gland to pierce the buccinator muscle
Where does the parotid gland enter the mouth?
Adjacent to the crown of the second upper molar tooth
Where is the sublingual gland found?
Under the tongue
What is the position of the sublingual gland with respect to the submandibular duct?
It is immediately lateral to the submandibular duct
Where are the hard and soft palates found?
Both at the roof of the mouth
Hard= more anterior than the soft
What are the three papillae found on the tongue and which part?
Fungiform and filiform, on the anterior 2/3 of the tongue
Circumvalate, form a V shape posteriorly
What is the purpose of papillae?
They increase the surface area of contact between the surface of the tongue and the contents of the oral cavity
What are the boundaries of the nasopharynx?
Posterior to the posterior apertures of the nasal cavity, above level of soft palate
What are the boundaries of the oropharynx?
Posterior to oral cavity, inferior to the level of the soft palate and superior to the upper margin of the epiglottis
What are the boundaries of the laryngopharynx?
Extends from superior margin of epiglottis to top of oesophagus at C1
What is found distally to the epiglottis?
Larynx
What must you not do in suspected cases of epiglottitis?
Not attempt to examine child’s throat, not place anything in their mouth, not lay them on their back
At which vertebral level does the oesophagus begin?
C6
The fibres of which nerve runs to the right and left of the oesophagus?
Vagus nerve initially runs on the right and left, as it passes through the diaphragm:
Left= anteriorly
Right= posteriorly
What does the oesophagus pass through?
The oesophageal hiatus
What is the vertebral level of the opening of the oesophageal hiatus?
T10
What is the common clinical problem associated with the oesophageal hiatus?
Hiatus hernia and heartburn
Which plexus surrounds the oesophagus?
The oesophageal plexus
What are the two main muscles of mastication?
Temporalis and masseter
Which muscle of mastication is the most powerful?
Masseter
What is the difference between the masseter and temporalis muscles?
Masseter- only elevates the jaw
Temporalis- elevates and retracts the jaw
What is the role of buccinator in chewing?
Holds cheek to the teeth and assists with chewing
What is the importance of buccinator in infants?
Sucking reflex
What is the transpyloric plane?
The horizontal line halfway between suprasternal notch and pubic symphysis
Which vertebral level is the transpyloric plane on?
L1
Which other structures are found on the transpyloric plane?
Pylorus, neck of pancreas, hila of both kidneys
What are the names of the two horizontal planes of the abdomen?
Subcostal and transtubercular
At which vertebral levels are the two horizontal planes found?
Subcostal= L3 Transtubercular= L5
What are the 4 quadrants of the abdomen?
Right Upper, Right Lower, Left Upper and Left Lower
Which organs lie in the Right Upper Quadrant?
Liver, right kidney, colon, pancreas and gall bladder
Which organs lie in the Right Lower Quadrant?
Appendix, colon, small intestine and ureter
Which organs lie in the Left Upper Quadrant?
Stomach, left kidney, spleen, colon and pancreas
Which organs lie in the Left Lower Quadrant?
Colon, small intestine and ureter
What are the 9 regions of the abdomen?
Right and left hypochondrion, epigastric, right and left lumbar, umbilical, right and left iliac and hypogastric
Where is the parietal peritoneum found?
On the internal aspect of the abdominal wall
In cases of peritonitis, which two clinical signs are elicited on palpation?
Abdominal pain/tenderness and distention in abdomen
What is continuous with the parietal peritoneum and what does it cover?
Visceral peritoneum, covers the internal organs
What is the greater omentum?
A sheath that hangs down over the intestines
Why is the greater omentum sometimes referred to as the abdominal policeman?
As it fights ‘intra-abdominal’ infection
What is the peritoneal cavity?
A potential space between the walls of the abdominal cavity and the viscera
Where is the lesser omentum found?
The peritoneal fold between the lesser curvature and the porta hepatis
Where is the opening to the lesser sac found?
Behind the right edge of the lesser omentum
What is the name of the opening of the lesser omentum?
The epiploic foramen (foramen of Winslow)
What are the different features of the stomach?
Fundus, body, pyloric antrum, greater and lesser curvature and rugae
What is continuous with the pylorus?
The duodenum
What is the pyloric sphincter?
The thickening at the junction between the pylorus of the stomach and the duodenum
Which trunk supplies the foregut?
Coeliac trunk
What are the 3 main branches of the coeliac trunk?
Left gastric, splenic and common hepatic
What are the 4 lobes of the liver?
Left, right, quadrate and caudate
Which structures enter the porta hepatis?
Bile duct, hepatic portal vein and hepatic artery
What are the component parts of the gallbladder?
Neck, body and fundus
Where does the peritoneal cavity extend between and what is the name of the cavity?
Between the liver and the diaphragm
Subphrenic space
What is the name of the pouch between the liver and the right kidney?
The hepatorenal pouch
How would you examine a patient with hepatomegaly?
Palpation and percussion
Which two ducts join to form the common bile duct?
The cystic duct and the common hepatic duct
Which organ does the common bile duct first enter?
Pancreas
What is cholecystitis?
Inflammation of gallbladder
What is cholelithiasis?
Formation of gallstones
What can happen if a gallstone blocks the common bile duct?
Bile builds up in the liver causing jaundice (yellowing of liver) which develops due to bilirubin in the blood
Which is a more serious condition that may block the common bile duct?
Pancreatic cancer
What are the ligaments on the spleen on .w.here do they attach?
Spleno-renal/lieno-renal ligament- attachment to the posterior abdominal wall
Gastro-splenic ligament- attachment to the stomach
Where is the notch of the spleen found?
On the antero-inferior border
Where would you begin palpation for an enlarged spleen?
Right lower quadrant
Why may the spleen be the cause of a surgical emergency?
If it doesn’t work properly it may start to remove healthy blood cells
Is the pancreas intra or retro-peritoneal?
Retro-peritoneal
What are the 4 components of the pancreas?
Head, neck, body and tail
Which artery runs along the superior border of the pancreas?
The splenic artery
Which artery is immediately distal to the neck of the pancreas?
Superior mesentric artery
Which structure is C shaped?
The duodenum
What does the duodenum enclose?
The pancreas
What is found on the posterior wall of the the duodenum what does this form a junction between?
Duodenal papilla
Forms a junction between the foregut and midgut
What does the duodenum continue to become?
The jejunum
What are the 2 junctions of the small intestine?
The duodeno-jejunal junction and the iliocaecal junction
What does the jejunum become after the first 3/5 of the small intestine?
Ileum
What is the name of the peritoneum that suspends the small intestine?
The mesentery
Where do the blood vessels passing the mesentery originate from?
The superior mesenteric artery
Which artery supplies the midgut?
The superior mesenteric artery
What is the root of the mesentery?
The attachment of the mesentery to the posterior abdominal wall
Extends from the duodenojejunal flexure to the ileocoecal junction
What are the 4 main parts of the colon?
Ascending, transvere, descending and sigmoid
Which parts of the colon are retroperitoneal and don’t have a mesentery?
The ascending and descending colon
What is the dip in the peritoneum lateral to the ascending and descending colon?
The paracolic gutters
What can happen in the paracolic gutters and what can this lead to?
Fluid may collect in and course through these gutter, potentially spreading infection
Which artery supplies the splenic flexure and beyond, which part of the gut does this supply?
The inferior mesenteric artery, supplies the hindgut
What is the name given to the mesentery of the transverse colon?
Transverse mesocolon
What does the descending colon become?
The sigmoid colon and then finally the rectum
Do the sigmoid colon and rectum have a mesentery?
Sigmoid colon and upper part of the rectum have a mesentery but the lower part lies below the peritoneum
