Digestive System Flashcards
1
Q
Trace path of food through the mouth to the anus
12
A
Mouth, pharynx, esophagus, stomach, duodenum, jejunum, ileum, acending-transverse-descending colon, rectum
2
Q
Layers of the stomach from outer to inner
A
serosa, muscularis, submucosa, mucosa, lumen
3
Q
What kind of muscle forms the pyloric sphincter?
A
muscularis externa
4
Q
Sympathetic and Parasympathetic control over the digestive system
A
Sympathetic will inhibit digestive function and parasympathetic will stimulate it
5
Q
Main nerves involved in the function of the digestive tract?
A
Sympathetic trunk
vagus nerve
greater splanchnic nerve
lesser splanchnic nerve
6
Q
How do we make sure the air/food enter the correct areas?
2
A
The soft palate protects the nasopharynx
the epiglottis protects the trachea
7
Q
What two types of tissue layers make up the muscularis in the lining of the esophagus?
A
Circular layer and longitudinal layer
8
Q
Gastroesophageal Reflux disease
GERD
A
Lower esophageal sphincter is weak and allows stomachs contents to flow back up to the esophogus
9
Q
Hiatal hernia
A
Stomach bulges up through lower esophageal spinchter past the diaphragm
10
Q
What is the underlyng pathology for gastric ulcers?
A
Breach in the mucosa from acid and pepsin
11
Q
What are haustra?
A
Small pockets caused by sacculation in the colon.
When looking inside they are separated by ridges
12
Q
What are diverticulae?
A
outpouchings from the colon
13
Q
Diverticulitis?
Note the haustra
A
These outpuchings may get inflammed, start bleeding or infected.
Haustra look like the have holes in them
14
Q
Why do we get excited about colorectal polyps?
A
They can become malignant
15
Q
Where would you see most colon cancers?
A
Distal Large bowel because carcinogens spend more time there than proximally
16
Q
Why do we do colostomies or ileostomies?
A
After a tumor or dysfunctional resection These can be permanent or temporary Each will have different discharges Colon to skin Ileum to skin
17
Q
What is ileus?
When is this often seen?
A
Cessation of peristalsis
- Small and large bowels fill with air
- seen following surgery, trauma, or obstruction
18
Q
What is the function of the omentum?
3
A
Fat deposition
Immune contribution
Protect against infection, tumor,
19
Q
What does the omentum connect?
2
A
the stomach to liver for lesser omentum
the greater omentum hangs off greater curvature and connects to the transverse colon
20
Q
What creates the foramen of winslow?
A
the lesser omentum
21
Q
What goes on in the red pulp of the spleen?
3
A
There are reserves of RBCs there
It removes old RBCs
It contains 50% of the body’s monocytes
22
Q
What goes on in the white pulp of the spleen?
3
A
Creates antibodies
Removes WBCs and bacteria coated with antibodies
Its part of the lymph system
23
Q
What happened in the picture taken during surgery on page 18 of GI slides?
3
A
Its a ruptured spleen
The spleen is covered by the ribs but it still can be injured by blunt trauma because its very vascular.
This bleeding can be fatal
24
Q
How are the spleen and liver connected anatomically?
A
The splenic vein flows into the hepatic portal vein
25
What is the orientation of the pancreas in the body?
The head lies on/is connected with the duodenum and the tail lies on/connected with the spleen
26
What are the two main functions of the pancreas?
| 2
Its part of the digestive system: producing pancreatic juice and digestive enzymes
Its part of the endocrine system: creates insulin, glucagon, and somatosatin (GH)
27
What happens with cancer at the head of the pancreas?
| 2
The tumor blocks the bile ducts and the patient turns yellow (jaundice = due to excess bilirubin)
The tumor also blocks pancreatic juices causing severe pain. (could cause ulcers?)
28
What do gall stones cause?
| 3
Obstruction
Subsequent bowel changes
Local inflammation
29
Desrcibe portal hypertension?
Vessels in the liver are blocked due to liver damage so blood cannot flow properly through the liver. As a result high pressure in the portal system develops. This leads to large swollen (dilated) vessels. These vessels can rupture and cause life threatening issues.
30
What are the main causes of portal hypertension?
| 2
```
vessel blockage (portal/heptaic veins)
cirrhosis (alcohol/hep C)
```
31
Where are three places where the portal and systemic venous systems connect?
Esophagus
Umbilicus
rectum
32
What is the function of mesentary?
Layer of tissue that attaches the intestines to the chest wall.
Supplies blood, innervation and lymph to the stomach
33
What structure is the mesentery most associated with?
```
Small intestine
(thin in the jejunum, thick in the ileum)
```
34
Main functions of the esophagus?
| 2
```
Swallowing food (peristalsis)
The upper and lower esophageal sphincters help prevent acid reflux
```
35
Where does the esophagus start?
C6, lower border of the cricoid cartilage
36
Where are the points of constriction in the esophagus?
C6-Junction of the pharynx and esophagus(narrowest part of the esophagus)
Where it delves behind the Aortic arch and main left bronchi (and is pushed slightly to the left)
Where it passes the diaphragm-lower esophageal sphincter
37
What glands are found in the submucosa of the esophagus?
esophageal glands proper-secrete acid mucin for lubrication
38
What does the esophageal cardiac glands produce?
neutral mucus that protects the esophagus from acidic gastric juices
39
Identify the muscle composition of the esophagus?
Mostly smooth muscle
The upper portion contains striated(skeletal muscle) for voluntary swallowing
Longitudinal layers are on the outer portion and circular layers are on the inner portion
40
What do contractions of the two muscular layers of the esophagus do?
Circular muscle contraction-causes an increase in luminal pressure needed for peristalsis
Longitudinal muscle contraction-causes shortening
41
Blood supply to the upper esophagus comes from?
inferior thyroid artery
42
Blood supply to the middle portion of the esophagus comes from?
thoracic aorta
43
Blood supply to the lower portion of the esophagus comes from?
left gastric artery
44
Functions of the stomach?
- Churning action of the stomach along with release of pepsin and other enzymes helps break down food into a consistency that is easier for the intestines to digest
- Can temporarily store food
45
Structure in the stomach you need to know
| 9
```
Greater curvature
lesser curvature
cardia
fundus
body
pyloric antrum
pyloric canal
pyloric sphincter
esophagogastric junction
```
46
Function of rugae?
| 2
Allow for expansion of the stomach. They are folded when its empty and unfolded when its full.
Also increase surface area for absorption of nutrients.
47
What does the left gastric artery supply blood to?
| branch?
lesser curvature
| and to lower esophagus via the esophageal brach of the left gastric
48
What does the splenic artery supply blood to and what are its branches?
short gastric branch to the fundus
| left gastroepiploic to the greater curvature of the stomach
49
branches of the celiac trunk?
left gastric
splenic
common hepatic
50
What does the common hepatic supply blood to and what are its branches?
3
branches:
Gastroduodenal
Right gastric-supplies blood to the lesser curvature of the stomach
Right gastroepiploic- supplies blood to the greater curvature of the stomach
51
What arteries supply the lesser curvature of the stomach?
| 2
```
Right gastric (from the hepatic)
Left gastric
```
52
What arteries supply blood to the greater curvature of the stomach?
Right gastro-epiploic
Left gastro-epiploic
Short gastric arteries
53
Where does all drainage from the stomach go to indirectly or directly?
hepatic portal vein
54
Venous drainage of the fundus is through what veins? And where do they drain into?
short gastric veins to the splenic vein
55
Venous drainage of the greater curvature of the stomach through what veins? And where do these veins drain into?
left gastro-epiploic and right gastro-epiploic to superior mesenteric vein
56
Venous drainage of the lesser curvature of the stomach though what veins?
left gastric vein to the portal vein
| right gastric vein to the portal vein
57
Parasympathetic nerve supply to the stomach?
Preganglionic from the right and left vagus nerves
| Postganglionic are very short and inside the stomach
58
Sympathetic nerve supply to the stomach?
Pregonglionic from the thoracic splanchnic nerves
| Postganglionic arise in the celiac plexus
59
What are the folds in the small intestine called?
plica
| circular folds
60
Function of the duodenum?
Receive chyme from the stomach and digestive secretions from the pancreas to neutralize its acids before they can damage the surfaces of the small intestine
61
Function of the jejunum?
Bulk of chemical digestion and nutrient reabsorption happens here.
62
Function of the ileum?
Mainly to absorb vitamin B12 and bile salts (etc) that weren't absorbed in the jejunum.
63
Compare and contrast the parts of the small intestine
```
Duodenum:
Shortest
Retroperitoneal
Few circular folds (plica)
Small villi
Jejunum:
Second longest
Intraperitoneal
Numerous circular folds (plica)
Villa are abundant and very long
Ileum:
Longest
Intraperitoneal
Fewer circular folds (plica)
Villi are short and stumpy
```
64
Junctions of the small intestine?
Pylorus (pyloric canal and sphincter)- junction between the stomach and duodenum.
Duodenojejunal flexure- is marked by the Ligament of Treitz and the entry of the pancreas into the duodenum.
Jejunum and Ileum- there is a gradual change from one to the other but the jejunum generally has a thinner mesentery than the ileum.
Ileocecal valve- sphincter valve that separates the small intestine from the large.
65
What is the Ligament of Treitz and where is it found?
Suspensory muscle of the duodenum connecting to the diaphragm.
It marks the division of the upper and lower gastrointestinal tracts and is found at the duodenojejunal flexure.
It is used to determine bleeding in the GI tract.
66
Function of the ileocecal valve?
Limit reflux of colonic contents into the ileum
67
What artery supplies most of the blood to the small intestine?
Superior mesenteric
68
Where does the ascending colon begin and end?
Begins at the cecum and ends at the inferior surface of the liver (hepatic flexure or right colic flexure)
69
Where does the traverse colon begin and end?
Begins at the hepatic flexure and ends at the right colic or splenic flexure.
70
What separates the transverse colon from the anterior abdominal wall?
greater omentum
71
Where does the descending colon begin and end?
Splenic(left colic) flexure to the iliac fossa where the sigmoid flexure is at.
72
Where does the sigmoid colon begin and end?
Begins at the sigmoid flexure and ends at the rectum
73
Function of the rectum?
Expandable organ for the temporary storage of feces. The movement of fecal material into the rectum triggers the urge to defecate.
74
What is the teniae coli (longitudinal muscle fibers)?
| 3
Smooth muscle that runs along the outer surface of the colonist deep to the serosa (muscularis externa). They help with peristaltic movements.
75
What makes the haustra?
the teniae coli
76
Function of the haustra?
permit the expansion of and elongation of the colon. (like the bellows that allow an accordion to lengthen)
77
Which artery supplies blood to the right side of the colon?
Superior mesenteric artery
78
Which artery supplies blood to the left side of the colon?
Inferior mesenteric artery
79
What makes of the anterior and lateral boundaries of the abdominal cavity?
4
External and internal obliques
transervsus abdominus
rectus abdominus
80
Structures that compromise the posterior abdominal wall?
| 6
5 lumbar vertebrae
Thoracolumbar fascia
Muscles: Psoas, quadrates lumborum, obliques
Some nerves and vessels
81
Superior boundary of the abdominal cavity
diaphragm
82
Inferior boundary of the abdominal cavity
pelvis
83
The center point of the horizontal and vertical lines that divide the abdomen in four quadrants is?
umbilicus
84
Right upper quadrant contains?
| 5
```
Liver
Right kidney
gall bladder
colon
pancreas
```
85
Right lower quadrant contains?
| 5
```
Appendix
Colon
Small intestine
Ureter
Major veins and arteries to the right leg
```
86
Lower Left quadrant contains?
| 4
Colon
Small intestine
Ureter
Major veins and arteries of the left leg
87
Upper left quadrant contains?
| 5
```
Stomach
left kidney
spleen
colon
pancreas
```
88
What are the divisions centrally for the abdomen?
Epigastric (ends at the diaphragm)
Periumbilical (Ends right inside the walls of the pelvis)
Suprapubic or hypogastric (ends on the floor of the pelvis)
89
Organs and structures in the retroperitoneum?
| 11
```
Parts of the duodenum
Parts of the pancreas
kidneys
adrenals
ureters
bladder
aorta
inferior vena cava
thoracic duct
colon
rectum
```
90
Organs and structures in the peritoneal cavity?
| 3
Stomach
liver
Intestines
91
What is the peritoneum?
Serous membrane that forms the lining of the abdominal cavity
92
Where is the lesser omentum located?
Comes off the lesser curvature of the stomach and proximal duodenum and connects to the liver
93
Where is the greater omentum located?
| 4 things it interacts with
it comes off the greater curvature of the stomach passing in front of the small intestines and reflects on itself to ascend to the transverse colon to get to the posterior abdominal wall
94
Where is the foramen of Winslow (epiploic foramen) and what is the significance of the area?
It comes off the lesser omentum and the inferior vena cava, hepatic vein, run through it. If you press your finger in their it stops bleeding from the major vessels
95
Describe the location of the spleen
In the left upper quadrant of the abdomen beneath the diaphragm and next to the stomach.
It is protected by the 9th, 10th and 11th ribs.
96
What structures are part of the hilum of the spleen?
Point of attachment/insertion for the:
gastrosplenic ligament
splenic artery
splenic vein
97
Where is the pancreas located in regards to the spleen?
The tail of the pancreas is near the hilum of the splenic hilum
98
Structures to know of the pancreas
| 7
```
head
neck
body
tail
pancreatic duct
bile duct
ampulla of vater
```
99
What forms the ampulla of vader?
Union of the pancreatic duct and the common bile duct
100
What is the direction of flow of bile from the liver?
| 6 ducts
```
right and left hepatic ducts
to
the common hepatic duct
then
cystic duct comes from gall bladder to join hepatic duct
and both join to flow
to
the common bile duct
the common bile duct flows into the pancreas and joins the pancreatic duct at the ampulla vater
```
101
Where is the visceral surface of the liver located?
inferior surface that faces the other abdominal organs. The gall bladder and porta hepatic are located on this surface.
102
Why is the right kidney lower?
Because of the position of the liver
103
Describe the flow of hepatic circulation
Splenic, superior mesenteric and inferior mesenteric all feed into the hepatic portal vein where blood is filtered in the liver and flows out through the hepatic veins and into the inferior vena cava
104
What is the function of the gall bladder?
It stores bile that is not being used for digestion
105
Where is bile produced?
In the liver
106
Function of bile?
Digestion and absorption of fats and fat soluble vitamins in the small intestine (B12).
107
Parts of the gall bladder you should know?
| 3
fundus, body, neck
108
What structures are adjacent to the gall bladder?
| 4
cystic duct
right and left hepatic ducts
bile duct
109
Where do the pancreatic and bile duct enter the duodenum?
ampulla of vater
110
How does the esophageal vein get blood to the liver?
esophageal vein
to left gastric vein
hepatic portal vein
111
What is the function of the paraumbilical vein?
established an anastomosis between the veins of the anterior abdominal wall and hepatic portal, hypogastric and iliac veins
112
Rectal vein flows into where?
hepatic portal system
113
What are varies?
Abnormal, enlarged, bulging veins due to increases in pressure and dilation of the vein
114
What makes up the parietal peritoneum?
mesenteries and omentum
115
How does the body protect the spleen and liver?
Covered by ribs, spine, and back muscles and abdominal muscles in the front
116
What is caput medusa?
Appearance of distended and engorged paraumbilical veins.
117
What happens when a gastric ulcer occurs?
Acid breaks through the mucosa to the muscularis
118
Where are common areas for hernia?
| 4
surgical incsions
inguinal hernias
umbilicus
diaphragmatic hernias
119
What layer in digestive tissue is where the action happens/vasculature/nutrient absorption etc.
submucosa
