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Basics Flashcards

1
Q

What spinal levels does the oesophagus stretch across?

A

C6 (cricoid cartilage) to T11

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2
Q

What is the term given to how food is transported through the GI tract?

A

Peristalsis

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3
Q

Define peristalsis

A

Rhythmic contractions of the muscles which propagate food through the GI tract

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4
Q

What forms the upper oesophageal sphincter?

A

Cricopharyngeus

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5
Q

Where is the lower oesophageal sphincter found?

A

Gastro-oesophageal junction (left of T11 vertebra)

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6
Q

What causes the 4 constrictions in the oesophageal lumen?

A

Arch of aorta
Bronchus (left main stem)
Cricoid cartilage
Diaphragmatic hiatus

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7
Q

What letter shape is the stomach?

A

J-shaped

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8
Q

What are the 4 anatomical divisions of the stomach?

A

Cardia (T11 level)
Fundus
Body
Pylorus (L1 = pyloric sphincter)

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9
Q

What is the pyloric sphincter made of?

A

Smooth muscle

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10
Q

Where is the greater omentum found?

A

Hangs down from the greater curvature of the stomach and folds back up on itself where it attaches to the transverse colon. Can adhere to inflamed areas.

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11
Q

Where is the lesser omentum found?

A

Continuous with peritoneal layers of the stomach and duodenum. Arises at the lesser curvature and ascends to attach to the liver.

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12
Q

Where does the arterial supply of the stomach come from?

A

Coeliac trunk:

Lesser curvature -
Right gastric (branch of common hepatic artery arising from coeliac trunk)
Left gastric (arises directly from coeliac trunk

Greater curvature -
Right gastro-omental (terminal branch of gastroduodenal artery, arises from common hepatic artery)
Left gastro-omental (branch of splenic artery, arising from coeliac trunk)

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13
Q

Venous drainage of the stomach?

A

Right and left gastric veins drain into the hepatic portal vein.
Short gastrin vein, left and right gastro-omental veins drain into the superior mesenteric vein

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14
Q

Parasympathetic supply of stomach?

A

Anterior and posterior vagal trunks from the vagus nerve

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15
Q

Sympathetic nerve supply of the stomach?

A

T6-T9 spinal cord segments
Passes to coeliac plexus via greater splanchnic nerve
Carries some pain transmitting fibres

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16
Q

What nodes do gastric lymphatic vessels drain into?

A

Gastric and omental lymph nodes found at the curvatures

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17
Q

What marks the final part of the small intestine?

A

Ileocaecal junction (meets large intestine at ileocaecal valve)

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18
Q

3 anatomical parts of the small intestine?

A

Duodenum
Jejunum
Ileum

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19
Q

How many parts is the duodenum divided up into?

A

4

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20
Q

Where is the liver connected to the small intestine?

A

Hepatoduodenal ligament in the first section of the duodenum

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21
Q

What internally marks the descending (second part) of the duodenum?

A

The major duodenal papilla = opening at which bile and pancreatic secretions enter from the ampulla of Vater (hepatopancreatic ampulla)

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22
Q

What does the inferior part of the duodenum (third part) pass over?

A

Inferior vena cava and aorta

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23
Q

Where does the duodenum join the jejunum?

A

Duodenojejunal flexture

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24
Q

What muscle is located at the duodenojejunal junction?

A

Suspensory muscle of the duodenum

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25
Q

Way to remember the order of the parts of the small intestine?

A

DJ Ileum

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26
Q

What is a difference between the duodenum and the jejunum+ileum?

A

Jejunum and ileum are intraperitoneal

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27
Q

How are the jejunum and ileum attached to the posterior abdominal wall?

A

By mesentery

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28
Q

Where does the ileum end?

A

Ileocaecal junction

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29
Q

What is found at the ileocaecal junction?

A

Ileocecal valve

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30
Q

Arterial supply of the duodenum?

A

Proximal to the major duodenal papilla –> gastroduodenal artery (branch of common hepatic artery from the coeliac trunk)

Distal to the major duodenal papilla –> inferior pancreaticduodenal artery (branch of superior mesenteric artery)

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31
Q

Lymphatic drainage of the duodenum?

A

Pancreatoduodenal and superior mesenteric nodes

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32
Q

Arterial supply of jejunum and ileum?

A

Superior mesenteric artery

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33
Q

Venous drainage of the jejunum and ileum?

A

Superior mesenteric nodes

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34
Q

What is the cecum?

A

Most proximal part of the large intestine located between the ileum and the ascending colon

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35
Q

Arterial supply to the cecum?

A

Ileocolic artery - branch of superior mesenteric artery

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36
Q

Venus drainage of cecum?

A

Ileocolic vein - emptying into the superior mesenteric vein

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37
Q

Lymphatic drainage of the cecum?

A

Ileocolic lymph nodes

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38
Q

What is the appendix

A

Narrow blind-ended tube that is attached to the posteromedial end of the cecum

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39
Q

Vascular supply to the appendix?

A

Superior mesenteric vessels

40
Q

Sympathetic afferent fibres of the appendix originate…?

A

T10 of the spinal cord - thus visceral pain is felt centrally within the abdomen in early appendicitis

41
Q

Lymphatic drainage of the appendix?

A

Ileocolic lymph nodes

42
Q

How many parts can the colon be divided into and what are they?

A

4:
Ascending
Transverse
Descending
Sigmoid

43
Q

Average length of the colon?

A

150cm

44
Q

Where does the transverse colon extend to and from?

A

From right colic flexure to the spleen

45
Q

The transverse colon is intraperitoneal. What is it enclosed by?

A

Transverse mesocolon

46
Q

What ligament attaches the colon to the diaphragm?

A

Phrenicocolic ligament

47
Q

What spinal levels does the sigmoid colon extend over?

A

Left iliac fossa to S3

48
Q

What attaches the sigmoid colon to the posterior pelvic wall?

A

Mesentery = sigmoid mesocolon

49
Q

What are the small pouches of peritoneum, filled with fat, that are attached to the surface of the colon?

A

Omental appendices

50
Q

What are the 3 trips of muscles running longitudinally along the surface of the colon called?

A

Teniae coli

51
Q

What makes up the teniae coli?

A

Mesocolic, free and omental coli

52
Q

What are the sacculations produced by teniae coli contractions called?

A

Hausta

53
Q

Midgut structures?

A

Distal half of the duodenum, jejunum, ileum, cecum, ascending colon and proximal 2/3 of transverse colon.

54
Q

Hindgut structures?

A

Distal 1/3 of transverse colon, descending colon and sigmoid colon, proximal 3rd of the rectum

55
Q

Foregut structures?

A

Distal end of oesophagus, stomach, proximal part of duodenum, pancreas, liver gallbladder.

56
Q

What is the arterial supply of mid-gut derived structures?

A

Superior mesenteric artery

57
Q

What is the arterial supply of hind-gut derived structures?

A

Inferior mesenteric artery

58
Q

What is the arterial supply of the foregut?

A

Celiac artery

59
Q

Innervation of foregut?

A

Vagus nerve

60
Q

Innervation of midgut?

A

Vagus nerve, and lesser splanchnic nerve

61
Q

Innervation of hindgut

A

Inferior mesenteric plexus
(L1-L2 = sympathetic lumbar splanchnic nerves)
(S2-S4 = parasympathetic innervation)

62
Q

Arterial supply of ascending colon?

A

Ileocolic and right colic arteries from the superior mesenteric artery

63
Q

Transverse colon arterial supply?

A

Right colic artery from SMA
Middle colic artery from SMA
Left colic artery from LMA

64
Q

Descending colon arterial supply?

A

Left colic artery from inferior mesenteric artery

65
Q

Sigmoid colon arterial supply?

A

Sigmoid arteries = branches of IMA

66
Q

Why is the Marginal Artery of Drummond important?

A

Provides collateral supply to the colon

67
Q

Venous drainage of the ascending colon?

A

Ileocolic and right colic veins –> SMV

68
Q

Venous drainage of the transverse colon?

A

Middle colic vein –> SMV

69
Q

Venous drainage of the descending colon?

A

Left colic vein –> IMV

70
Q

Venous drainage of sigmoid colon?

A

Sigmoid veins –> IMV

71
Q

Where do the superior mesenteric veins and inferior mesenteric veins empty into?

A

Hepatic portal vein

72
Q

Where does the rectum terminate into?

A

Anal canal

73
Q

What spinal level does the rectum begin?

A

S3

74
Q

What is the anorectal flexture?

A

Anteroposterior curve (with convexity anteriorly) of the rectum formed by the tone of the puborectalis muscle

75
Q

What is the sacral flexture?

A

Anteroposterior curve (with concavity anteriorly) following the curve of the sacrum and coccyx

76
Q

What is the final section of the rectum called?

A

Ampulla

77
Q

What part of the rectum is covered anteriorly and laterally by peritoneum?

A

Superior 3rd of rectum

78
Q

What part of the rectum is only covered anteriorly by peritoneal?

A

Middle 3rd of rectum

79
Q

Arterial supply to the rectum?

A

Superior rectal artery –> IMA
Middle rectal artery –> internal iliac artery
Inferior rectal artery –> internal pudendal artery

80
Q

Venous drainage of the rectum?

A

Superior, middle and inferior rectal veins

Superior rectal vein –> portal venous system
Middle and inferior rectal veins –> systemic venous system

81
Q

Sympathetic nerve supply of the rectum?

A

Lumbar splanchnic nerves
Superior and inferior hypogastric plexuses

82
Q

Parasympathetic nerve supply of the rectum?

A

S2-S4 via the pelvic splanchnic nerves and inferior hypogastric plexuses

83
Q

Lymphatic drainage of rectum?

A

Pararectal lymph nodes –> inferior mesenteric nodes
Lymph from lower aspect of rectum drains directly into internal iliac lymph nodes

84
Q

What makes up the internal anal spinchter?

A

Thickening of involuntary circular smooth muscle surrounding the supper 2/3 of the anal canal

85
Q

What makes up the external anal spinchter?

A

Voluntary muscle that surrounds the lower 2/3 of the anal canal. Blends superiorly with the puborectalis muscle of the pelvic floor.

86
Q

What makes up the anorectal ring?

A

Anal canal, internal anal sphincter, external anal sphincter, puborectalis muscle

87
Q

What is the pectinate line?

A

Where the internal and external anal sphincters form an irregular circle

88
Q

Above the pectinate line in the anus - embryonic orgination?

A

Hindgut

89
Q

Below the pectinate line in the anus - embryonic orgination?

A

Ectoderm of the proctodeum

90
Q

Arterial supply superior to pectinate line?

A

Superior rectal artery (branch of IMA)
Anastomosing branches from middle rectal artery

91
Q

Arterial supply posterior to pectinate line?

A

Inferior rectal artery (branch of internal pudendal artery)
Anastomosing branches from the middle rectal artery

92
Q

Venous drainage from above the pectinate line?

A

Superior rectal vein (empties into IMA –> portal venous system)

93
Q

Venous drainage from below the pectinate line?

A

Inferior rectal vein (empties into internal pudendal vein –> systemic venous system)

94
Q

Innervation above the pectinate line?

A

Visceral innervation via the inferior hypogastric plexus.
Sensitive to stretch.

95
Q

Innervation below the pectinate line?

A

Somatic innervation via the inferior rectal nerves (branches of pudendal nerves)
Sensitive to pain, temperature, touch and pressure

96
Q

Lymphatic drainage above the pectinate line?

A

Internal iliac lymph nodes

97
Q

Lymphatic drainage below the pectinate line?

A

Superficial inguinal lymph nodes

GI (7 decks)

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