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► Med - Anatomy & Physiology > Digestion 2 > Flashcards

Digestion 2 Flashcards

1
Q

Which bone is a long bone and has a tuberosity and a malleolus?

A

Tibia

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2
Q

Which bone is a flat bone and provides an attachment for abdominal wall muscles and forms part of the acetabulum?

A

Ilium

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3
Q

Which bone has a proximal head, forms a tuberosity at the insertion of the biceps tendon and has sulci for several tendons on its distal dorsal aspect?

A

The radius

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4
Q

What are the three pairs of jaw closing muscles and what are their attachments?

A
  1. Masseter - angle of mandible to zygomatic arch
  2. Temporalis - coronoid process of the mandible to temporal fossa
  3. Medial pteerygoid - angle of mandible (medial side) to pterygoid plates of sphenoid bone.
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5
Q

What is the pair of jaw opening muscles?

A

Lateral pterygoid - condyle of mandible to pterygoid plates of the sphenoid bone

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6
Q

What nerve are the masseter, temporalis, medial pterygoid and lateral pterygoid all supplied by?

A

Mandibular division of the trigeminal nerve (V3)

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7
Q

Where does trigeminal nerve V3 exit/enter the CNS

A

At the pons

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8
Q

What hole in the base of the skull does trigeminal nerve V3 go through?

A

Foramen ovale

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9
Q

What is the name of the droopy bit of soft pallate that hangs down?

A

Uvula of soft pallate

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10
Q

In the posterior third of the tongue what nerve supplies all general and taste sensation?

A

CN IX - glossopharyngeal

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11
Q

In the anterior 2/3rd of the tongue what is the general sensation and the taste sensation supplied by?

A

General - CN V3

Taste - CN VII (facial)

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12
Q

What nerve supplies the superior half of the tongues general sensation?

A

CN V2

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13
Q

What nerve supplies the inferior half of the tongue general sensation?

A

CN V3

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14
Q

The sensory part of the gag reflex is carried by what nerve?

A

CN IX

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15
Q

The motor part of the gag reflex is carried by what nerve?

A

CN IX and CN X

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16
Q

When about to use an endoscope what nerves will be blocked by spraying a local anaesthetic?

A

CN V2, CN V3, CN VII and CN IX

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17
Q

Where does CN V2 enter/exit the CNS?

A

at the pons

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18
Q

Where does CN V2 leave the base of the skull?

A

Foramen rotundum

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19
Q

Where does the facial nerve (CN VII) enter/exit the CNS?

A

Junction of pons and medulla

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20
Q

Where does the facial nerve (CN VII) exit/enter the base of the skull?

A

Exits the internal acoustic meatus (IAM) and enters the stylomastoid foramen (SMF)

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21
Q

What is the chorda tympani?

A

A branch of CN VII (facial nerve) that gives special sensory ‘taste’ to the anterior 2/3rd of the tongue

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22
Q

Which cranial nerve gives parasympathetic secretomotor to the submandibular and sublingual salivary glands?

A

The facial nerve (CN VII)

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23
Q

Where does the glossopharyngeal nerve (CN IX) enter/exit the CNS?

A

At the medulla

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24
Q

Which hole in the base of the skull does CN IX (glossopharyngeal nerve) enter/exit?

A

The jugular foramen

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25
Q

Which cranial nerve gives parasympathetic secretomotor to the parotid salivary glands?

A

Glossopharyngeal (CN IX)

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26
Q

What are the three pairs of salivary glands?

A

Parotid, submandibular and sublingual

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27
Q

What are the four pairs of extrinsic skeletal muscles of the tongue (originate external to the tongue and insert into it) and what do they do?

A
  1. Palatoglossus
  2. Styloglossus
  3. Hypoglossus
  4. Genioglossus
    Suspend the tongue in the oral cavity, move the tongue around
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28
Q

Where are the 4 intrinsic skeletal muscles of the tongue (originate and insert within the tongue) and what do they do?

A

Located mainly dorsally and posteriorly

Modify the shape of the tongue during function

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29
Q

What nerve are all the tongue muscles suppled by except the palatoglossus?

A

The CN XII - hypoglossal

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30
Q

Where does the CN XII (hypoglossal) nerve enter/exit the CNS?

A

At the medulla

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31
Q

Where does the hypoglossal (CN XII) enter/exit the cranial cavity?

A

At the hypoglossal canal

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32
Q

At what vertebral level is the upper oesophageal sphincter located at?

A

C6

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33
Q

What are the 3 outer circular layers of pharyngeal constrictor muscles (supplied by CN X)?

A

Superior pharyngeal constrictor
Middle pharyngeal constrictor
Inferior pharyngeal constrictor

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34
Q

What muscle and what nerve take part in the closing of the lips?

A

Orbicularis oris and CN VII (facial)

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35
Q

What nerves supply the innter longitudinal layer of pharyngeal muscles?

A

CN IX & X

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36
Q

What is another term for the upper oesophageal sphincter?

A

Cricopharyngeus muscle

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37
Q

What do the para and sympathetic nerves do in relation to the speed of peristalsis?

A

Parasympathetic speeds up

Sympathetic slows down

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38
Q

What is the angle in the stomach called between the body and the pyloric antrum?

A

Incisura angularis

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39
Q

What five structures are in the foregut?

A
  1. oesophagus to mid-deuodenum
  2. Liver
  3. Gall bladder
  4. Spleen
  5. half of the pancreas
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40
Q

What two structures are in the midgut?

A
  1. Mid-duodenum to proximal 2/3rd of transverse colon

2. Half of pancreas

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41
Q

What structure is present in the hindgut?

A

Distal 1/3rd of the transverse colon to proximal half of the anal canal

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42
Q

What can cause severe and painful inflammation of the peritoneum (peritonitis)?

A

Blood, pus or faeces

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43
Q

Is the liver intraperitoneal or retroperitoneal?

A

Intraperitoneal

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44
Q

Name two organs that are retroperiteal?

A

Pancreas and kidneys

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45
Q

How many pouches does the peritoneum form in a male and female?

A

Male - one (rectovesical - behind bladder)

Female - two (uterovesical - in front of uterus) (rectouterine/pouch of douglas - behind uterus

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46
Q

During paracentesis (draining of ascitic fluid) where must the needle be placed?

A

Lateral to the rectus sheath (this avoids the inferior epigastric artery)

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47
Q

How do sympathetic nerve fibres get from the CNS to the abdominal organs?

A

Leave the spinal cord between levels T5 and L2
Enter the sympathetic chains (bilaterally) but do not synapse
Leave the sympathetic chains within the abdominopelvic splanchnic nerves
Synapse at prevertebral ganglia which are located anterior to the aorta at the exit points of the major branches of the abdominal aorta

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48
Q

In relation to how sympathetic nerve fibres get from the CNS to the abdominal organs: Post-synaptic sympathetic nerve fibres pass from what to what?

A

Postsynaptic sympathetic nerve fibres pass from the prevertebral ganglia (celiac, superior mesenteric etc) onto the surface of the arterial branches leaving the abdominal aorta

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49
Q

At what level of the spine to sympathetic nerve fibres for the adrenal gland leave the spinal cord?

A

T10-L1

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50
Q

What nerves supply smooth muscle/glands of teh descending colon to the anal canal?

(Presynaptic parasympathetic nerve fibres)

A

Pelvic Splanchnic Nerves (S2, 3, 4)

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51
Q

What region of the abdomen does foregut pain tend to be felt?

A

Epigastric region

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52
Q

What region of the abdomen does midgut pain tend to be felt?

A

Umbilical region

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53
Q

What region of the abdomen does hindgut pain tend to be felt?

A

Pubic region

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54
Q

Pain fibres from the foregut structures enter the spinal cord at what level?

A

T6 - T9

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55
Q

Pain fibres from the midgut structures enter the spinal cord at which level?

A

T8-T12

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56
Q

Pain fibres from hindgut structures enter the spinal cord at which level?

A

T10-T12

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57
Q

7th-11th intercostal nerves travel anteriorly, then leave the intercostal spaces and travel in the plane between which two muscles?

A

Internal oblique and transversus abdominis (as thoracoabdominal nerves)

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58
Q

What does the subcostal nerve come from?

A

T12 anterior ramus

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59
Q

What does the iliohypogastric nerve come from?

A

Half of L1 anterior ramus

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60
Q

What does the ilioinguinal nerve come from?>

A

Other half of L1 anterior ramus

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61
Q

What type of organ is the appendix?

A

Midgut organ

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62
Q

What is jaundice caused by?

A

An increase in the blood levels of bilirubin

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63
Q

Bilirubin is the normal bi-product of what?

A

The breakdown of red blood cells in the spleen

64
Q

What role does the gall bladder play in relation to bilirubin?

A

Stores and concentrates bile

65
Q

What three tubes does the portal triad consist of?

A

Hepatic artery, hepatic portal vein and common bile duct

66
Q

What is the first of the three midline branches of the abdominal aorta?

A

The celiac trunk

67
Q

Is the abdominal aorta/celiac trunk retroperitoneal or intraperitoneal?

A

Retroperitoneal

68
Q

At what spinal level does the celiac trunk arise?

A

T12

69
Q

What three branches does the celiac trunk trifurcate into?

A

The splenic artery, hepatic artery and left gastric artery

70
Q

What ribs protect the spleen?

A

9-11

71
Q

The blood supply to the stomach comes mainly from which 4 arteries?

A
  1. Right and left gastric arteries - run along the lesser curvature and anastomose together
  2. Right and left gastro-omental arteries - run along the greater curvature and anastomose together
72
Q

Where does the liver get its blood supply from?

A
  1. the hepatic artery which branches into right and left hepatic arteries
  2. the hepatic portal vein
73
Q

What substance does the liver convert?

A

Bilirubin to bile

74
Q

What ribs protect the liver?

A

7 - 11

75
Q

What are the 4 anatomical segments of the liver?

A
  1. Right lobe
  2. Left lobe
  3. Caudate lobe (behind liver)
  4. Quadrate lobe
76
Q

How is hepatomegaly caused?

A

The IVC and hepatic veins lack valves so a rise in central venous pressure is directly transmitted to the liver

77
Q

What does each liver interlobular portal triad contain?

A
  1. Branch of hepatic portal vein
  2. Branch of hepatic artery
  3. Biliary duct (bile formed in hepatocytes drains here)
78
Q

What are the names of the two recesses related to the liver?

A 
Hepatorenal recess (Morison's pouch)
Subphrenic recess
79
Q

What does the hepatic portal vein do?

A

Drains blood from the foregut, midgut and hindgut to the liver for first pass metabolism

80
Q

What does the splenic vein do?

A

Drains the blood from the foregut to the hepatic portal vein

81
Q

What does the inferior mesenteric vein do?

A

Drains the blood from the hindgut to the splenic vein

82
Q

What does the superior mesenteric vein do?

A

Drains the blood from the midgut to the hepatic portal vein

83
Q

Name the three ligaments that attach the liver?

A
  1. Coronary ligaments (attachment to the diaphragm)
  2. Falciform ligament (attachment to the anterior abdominal wall)
  3. Ligamentum teres/round ligament (remnant of the embryological umbilical vein)
84
Q

What does the neck of the gall bladder narrow to become?

A

Cystic duct (potential site for gallstone impaction)

85
Q

What artery supplies the gallbladder?

A

The cystic artery (branch of right hepatic artery in 75% of people)

86
Q

Is the gallbladder foregut, midgut or hindgut?

A

Foregut

87
Q

At what level of the spinal cord to gallbladder visceral afferents enter?

A

between T6 and T9

88
Q

What is cholecystectomy?

A

Removal of the gallbladder

89
Q

What do the right and left hepatic ducts drain into?

A

The common hepatic duct

90
Q

What does the common hepatic duct unite with to form the bile duct (common bile duct)?

A

Cystic duct

91
Q

What part of the duodenum does the bile duct drain into?

A

2nd part

92
Q

What forms the ampulla of Vater?

A

The bile duct and main pancreatic duct

93
Q

What forms the sphincter of Oddi?

A

The major duodenal papilla

94
Q

Name two things that can obstruct the biliary tree?

A
  1. Gallstones

2. Carcinoma at head of pancreas

95
Q

What type of jaundice is caused by extra hepatic obstructions?

A

Post-hepatic jaundice

96
Q

What are the five parts of the pancreas?

A
  1. Head
  2. Uncinate process
  3. Neck
  4. Body
  5. Tail
97
Q

What does a pancreatic acinar cell do? (exocrine)

A

Secretes digestive enzymes into the main pancreatic duct

98
Q

What do the pancreatic cells - Islets of Langerhans - do? (endocrine)

A

Release insulin and glucagon into the bloodstream

99
Q

What gives the pancreas its main blood supply?

A

Branches from the splenic artery (pancreatic branches)

100
Q

What branches from the gastroduodenal artery that supplies the pancreas?

A

Superior pancreaticoduodenal artery

101
Q

What branches from the superior mesenteric artery to supply the pancreas?

A

The inferior pancreaticoduodenal

102
Q

What innervation causes the smooth muscle to contract at the pyloric sphincter?

A

Sympathetic

103
Q

What innervation causes relaxation of the smooth muscle at the pyloric sphincter?

A

Parasympathetic nerve (vagus)

104
Q

Name two peptide hormones that the duodenum secretes into the blood?

A
  1. Gastrin

2. CCK

105
Q

What are the folds called in the mucosa of the jejunum?

A

Plicae circularis

106
Q

What branches of the superior mesenteric artery supply the jejunum and ileum?

A

The jejunal and ileal arteries

107
Q

What helps the absorption of fat from the GI tract lumen into the intestinal cells?

A

Bile

108
Q

What are specialised lymphatic vessels of the small intestine called?

A

Lacteals

109
Q

Where do lacteals eventually drain to?

A

The left venous angle

110
Q

What makes up the right venous angle?

A

Angle between the right subclavian and right internal jugular veins

111
Q

What makes up the left venous angle?

A

Angle between the left subclavian and left internal jugular veins

112
Q

Where do the two paracolic gutters exist?

A

Between the lateral edge of the ascending and descending colon and the abdominal wall

113
Q

What are the teniae coli?

A

Three distinct longitudinal bands of thickened smooth muscle running from caecum to the distal end of the sigmoid colon

114
Q

What are haustra formed by?

A

Tonic contractions of the teniae coli

115
Q

What two holes occur in the caecum?

A
  1. The ileocaecal orifice and valve

2. The appendiceal orifice on posteromedial wall of caecum

116
Q

Where is McBurneys point?

A

A third the way from the right ASIS to the umbilicus.

117
Q

What is it called when the sigmoid colon twists around itself?

A

Sigmoid volvulus

118
Q

What does the right common iliac artery bifurcate into?

A

Right internal iliac artery and right external iliac artery

119
Q

What does the inferior mesenteric artery branch into?

A

Left colic artery
Sigmoid colic artery
Superior rectal artery

120
Q

What 6 arteries come from the superior mesenteric arteries?

A
  1. Inferior pancreaticoduodenal artery
  2. Middle colic artery
  3. Right colic artery
  4. Ileocolic artery
  5. Appendicular artery
  6. Jejunal and ileal arteries
121
Q

What artery forms anastomoses with the branches of the SMA and IMA?

A

The marginal artery of Drummond

122
Q

What two arteries does the internal iliac artery split into?

A

The middle and inferior rectal arteries

123
Q

Which arteries supply the greater curvature of the stomach?

A

The right and left gastro-omental arteries

124
Q

There are 3 clinically important sites of venous anastomosis between the systemic and the portal venous systems “portal systemic anastomoses”. At these sites, the presence of small collateral veins means blood can flow both ways, either into the systemic or portal venous system (there are no valves in these veins). Normally there is very little blood flow within these collateral veins. Name the 3 anastomoses.

A
  1. Distal end of the oesophagus
  2. Skin around umbilicus
  3. Rectum/anal canal
125
Q

Describe the distal end of the oesophagus anastomosis

A

The most distal part drains into the hepatic portal vein

The most superior part drains into the azygous vein

126
Q

Describe the skin around the umbilicus anastomosis?

A

Normally the ligamentum teres remains closed throughout adult life and blood flows from the skin around the umbilicus via the inferior epigastric veins to the IVC.

127
Q

Decribe the rectum/anal canal anastomosis

A

The rectum adn superior anal canal drains to the inferior mesenteric vein
The most distal part of the GI tract drains to the internal iliac vein

128
Q

What vein does the superior rectal vein drain into?

A

The IMV

129
Q

What vein does the middle rectal vein and inferior rectal vein drain into?

A

Internal iliac vein

130
Q

During portal hypertension what can happen to the ligamentum teres?

A

It can re-open and blood flows through the collateral veins

131
Q

Give two clinical features of portal hypertension

A
  1. Caput medusae - dilated collateral veins and dilated epigastric veins
  2. Oesophageal varices - dilated submucosal collateral veins
    (also rectal varices)
132
Q

What is the pelvic floor muscle?

A

The levator ani

133
Q

Where is the rectum?

Where is the anal canal and anus?

A

Pelvis

Perineum

134
Q

Where does the rectal ampulla lie?

A

Immediately superior to the levator ani muscle

135
Q

What two anatomical structures are anterior to the rectum in a male?

A

The bladder and prostate gland

136
Q

What type of muscle is the levator ani?

A

A skeletal muscle

137
Q

What nerve supplies the levator ani muscle?

A

Nerve to the levator ani - a branch of the sacral plexus

138
Q

What part of the levator ani muscle is particularly important for maintaining faecal continence?

A

The puborectalis muscle

139
Q

What does contraction of the puborectalis muscle do?

A

Decreases the anorectal angle, acting in effect like a sphincter

140
Q

What type of muscle is the puborectalis muscle?

A

Skeletal muscle

141
Q

What type of muscle is the external anal sphincter?

A

Skeletal

142
Q

What type of muscle is the internal anal sphincter?

A

Smooth muscle

143
Q

What is contraction of the internal anal sphincter stimulated by?

A

Sympathetic nerves (i.e. sphincter closed)

144
Q

What inhibits contraction of the internal anal sphincter?

A

Parasympathetic nerves

145
Q

What nerve stimulates contraction of the external anal sphincter?

A

Pudendal nerve

146
Q

Parasympathetic nerve fibres travel from S2, S3 and S4 via the pelvic splanchnic nerves, then synapse at ganglia within the walls of the rectum. What do the nerves do?

A

Inhibit the internal anal sphincter (open it)

Stimulate peristalsis

147
Q

Visceral afferent nerve fibres from the rectum run alongside parasympathetic nerve fibres and enter the spinal cord at levels S2, S3 and S4. What do they do?

A

They sense ischaemia, strech etc (as other visceral afferents do); they will sense fullness of the rectal ampulla

148
Q

Somatic motor nerve fibres in the pudendal nerve (S2, S3, & S4) and the nerve to levator ani (S3, S4). What do they do?

A

Stimulate the external anal sphincter and puborectalis to contract

149
Q

Sympathetic nerve fibres travel from T12-L2, synpase at the inferior mesenteric ganglia and then reach the rectum via periarterial plexuses around the branches of the IMA. What do they do?

A

Stimulate contraction of the internal anal sphincter (close it)
Inhibit perstalsis

150
Q

The axons make up the sacral plexus?

A

The S2, S3 and S4 anterior rami

151
Q

What does prolapse of the venous plexus result in?

A

Haemorrhoids

152
Q

Rectal varices form in relation to what?

A

Portal hypertension

153
Q

Where do the ischioanal fossae lie?

A

On each side of the anal canal

154
Q

What are ischioanal foaase filled with?

A

Fat and loose connective tissue

155
Q

What is an infection within the ischioanal fossa called?

A

An ischioanal abscess

156
Q

From superior to inferior - which arteries arise from the anterolateral aspect of the abdominal aorta (pairs)?

A

Adrenal, renal, gonadal

► Med - Anatomy & Physiology (130 decks)

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