Foregut and Liver Flashcards

1
Q

Describe foregut

A

Anterior part of alimentary canal
Oral cavity to 1/2 duodenum

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2
Q

Describe foregut blood supply

A

Related to celiac trunk = first unpaired branch abdominal aorta

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3
Q

Describe content of foregut generally

A

Esophagus, stomach, duodenum prox 1/2, liver, gallbladder, biliary system, pancreas, spleen

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4
Q

Is esophagus only in thoracic region

A

No
Thoracic, abdominal and cervical

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5
Q

Where is transition from foregut to midgut

A

Halfway through duodenum

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6
Q

Describe esophagus

A

Muscular tube
25cm long
Connects laryngopharynx to stomach (cricoid cartilage to diaphragm)

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7
Q

Name the 3 portions of esophagus

A

Cervical
Thoracic
Abdominal

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8
Q

Describe cervical eso

A

From inf order cricoid cartilage (c6) to jugular notch

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9
Q

Describe thoracic eso

A

From jugular notch to diaphragm
Descends anterior to thoracic vertebrae
Passes anteriorly to thoracic aorta in posterior mediastinum
Passes through diaphragm = esophageal aperture, t10

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10
Q

Describe abdominal eso

A

From diaphragm to cardia portion of stomach
Shortest part eso

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11
Q

Describe passages of structures through diaphragm

A

Ivc = pass through central tendon = t8
Esophageal hiatus = t10
Abdominal aorta = t12

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12
Q

Describe how esophagus enters abd cavity

A

Through esophageal aperture of thoracic diaphragm
Leads to cardia portion of stomach

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13
Q

What does eso enter with (into abd cavity)

A

2 vagal trunks = anterior (left vagus), and posterior (right vagus)
Rotation due to embryology

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14
Q

What is lower esophageal sphincter

A

Muscle organization
Eso contracts, so do not vomit in mouth

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15
Q

Describe external sphincter - les

A

Right crus of diaphragm
Loops around eso and forms a sling =
When inspire, constricts eso, forms an anatomical sphincter = prevent reflux

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16
Q

Describe internal sphincter - les

A

Bundle of muscle at low end of eso, where it meets stomach
Circular fibers

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17
Q

What is stomach

A

J shaped
Dilated portion gi tract
Between abd eso and duodenum

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18
Q

Describe location of stomach

A

Intraperitoneal

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19
Q

Describe anatomy of stomach

A

Divided into 4 regions = cardia, fundus, body, pyloric part

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20
Q

Describe cardia - stomach

A

Surrounds opening of eso into stomach

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21
Q

Describe fundus of stomach

A

Superior dilation on left, above cardia

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22
Q

Describe body of stomach

A

Large expansion below fundus
Large curvature

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23
Q

Describe pyloric part of stomach

A

Outflow portion of stomach, leads to 1st portion of duodenum, composed of pyloric canal and pyloric sphincter
Constricted part
Pyloric sphincter = very strong circular fibers, gate (since stomach v active = needs to be closed at end)

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24
Q

Name the features of the stomach

A

Greater curvature and lesser curvature

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25
Q

Describe greater curvature of stomach

A

Point of attachment of gastrosplenic ligament and greater omentum (floats down on top of organs )

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26
Q

Describe lesser curvature of stomach

A

Point of attachment for lesser omentum - covers liver, stomach, duo kinda

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27
Q

Describe hepatoduodenal ligament

A

Thicker portion from liver to duodenum
For structures to porta hepatis (contains important structures like biliary tree)

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28
Q

Describe hepatogastric ligament

A

Thinner portion from liver to lesser curvature stomach

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29
Q

What is the stomach

A

Distension organ, can contain up to 3 litres
Has rugae, Intra

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30
Q

Describe rugae

A

Longitudinal folds, allowing fastening
- mucosa, for expansion - stretching and increase surface area contact

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31
Q

Describe stomach - Intra

A

Peritoneum on stomach of anterior and posterior stomach
Unite to form greater omentum hanging from greater curvature

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32
Q

What makes up lesser omentum

A

Hepatoduodenal ligament
Hepatogastric ligament

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33
Q

Describe arterial supply stomach

A

From celiac trunk

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34
Q

Describe arteries found near lesser curvature of stomach

A

Left gastric artery = from celiac trunk
Right gastric artery = from hepatic proper artery
ANASTOMOSE with each other

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35
Q

Describe arteries found near greater curvature of stomach

A

Right gastro omental = from gastroduodenal artery
Left gastro omental = from splenic artery
ANASTOMose with each other

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36
Q

Describe arteries found near fundus of stomach

A

Short gastric arteries for fundus

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37
Q

Describe venous drainage stomach

A

Same system as arterial
Drains into portal venous system - gi blood to liver first = filters

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38
Q

Describe innervation stomach

A

Visceral innervation from Celiac nerves plexus
Sympathetic: vasoconstriction & inhibition of peristalsis
Parasympathetic: stimulate gastric secretion & peristalsis

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39
Q

What is small intestine

A

Longest part gi tract
6-7m long
Divided into duodenum (fore to midgut), jejunum and ileum

40
Q

Describe function of si

A

Primary site digestion and absorption
Extends from pyloric orifice to ileocecal fold

41
Q

Describe duodenum

A

C shaped tube
20-25cm long

42
Q

Describe location of si

A

Around head of pancreas
Retroperitoneal= except 1st portion

43
Q

Describe anatomy of si duo - Gen

A

4 parts of duo = 2 in foregut, 2 in midgut
D1,D2,D,3,D4

44
Q

Describe D1 duo

A

Superior part
Is connected with hepatoduodenal ligament = part of lesser omentum
INTRA

45
Q

Describe D2 duo

A

Descending part
Site of junction of foregut and midgut
Retro
Contains 2 papillae

46
Q

Describe D3 duo

A

Inferior part
Superior mesenteric vessels pass over it

47
Q

Describe D4 duo

A

Ascending part
Ends in duodenal jejunal flexure

48
Q

What is minor duodenal papilla for

A

Entrance of accessory pancreatic duct

49
Q

What is major duodenal papilla for

A

Entrance of bile and pancreatic ducts (hepatopancreatic duct)

50
Q

Describe arterial supply of first 2 parts duo

A

Branches from gastroduodenal artery= superior pancreaticoduodenal artery = anterior and posterior

51
Q

Describe arterial supply of last 2 parts duo

A

Branches from superior mesenteric artery = inferior pancreaticoduodenal = anterior and posterior

52
Q

Describe venous drainage duo

A

Same as arterial
Drains into portal system

53
Q

Describe innervation duo

A

Visceral innervation from Celiac nerves plexus
Sympathetic: vasoconstriction & inhibition of peristalsis
Parasympathetic: stimulate gastric secretion & peristalsis

54
Q

What is function of pancreas

A

Lobulated gland
Vital organ
Exocrine = digestive enzymes
Endocrine = hormones, like insulin and glucagon

55
Q

What is location of pancreas

A

Posterior to stomach
From duo to spleen on left
Retroperitoneal = head, neck, and body, EXCEPT TAIL

56
Q

Describe anatomy of pancreas - parts

A

Head, uncinate process, neck, body and tail

57
Q

Describe head of pancreas

A

Lies within c shaped duo

58
Q

Describe uncinate process of pancreas

A

Projection of head
Posterior to superior mesenteric vessels

59
Q

Describe neck of pancreas

A

Anterior and superior to superior mesenteric vessels

60
Q

Describe body of pancreas

A

Elongated part from neck to tail

61
Q

Describe tail of pancreas

A

Into splenorenal ligament
Intra = needs to be mobile

62
Q

Describe duct system pancreas

A

Exocrine
Consists of main pancreatic duct - wirsung
And accessory duct = santorini

63
Q

Describe main pancreatic duct

A

Traverse its length
Join common bile duct at hepatopancreatic ampulla (bulge, biliary tree and main due to major pap)
Drain into duodenum at major duodenal papilla

64
Q

Describe accessory duct of pancreas

A

Drain through minor duodenal papilla
Connected to main pancreatic duct too

65
Q

Describe arterial supply of pancreas

A

Divided into 2 sections
Several regions with many alternate paths

66
Q

What supplies uncinate process, head and neck of pancreas

A

From gastroduodenal = ant and post superior pancreaticoduodenal arteries (celiac trunk)
From superior mesentery = ant and post inferior pancreaticoduodenal arteries

67
Q

Describe what supplies neck, body and tail of pancreas

A

Pancreatic branches from splenic a

68
Q

Describe function of liver

A

1500grams
2nd largest organ of whole body
Filtrates nutrients and detoxifies substances from GI
Produces bile and stores vitamins and minerals

69
Q

Describe location of liver

A

Intraperitoneal
Suspended under diaphragm
Surrounds ivc (also drains into it)

70
Q

Describe impressions of liver

A

From surrounding organs
Renal - right kidney
Gastric - stomach on left lobe
Colic - hepatic flexure of colon on right
(Esophageal, gastric, renal, colic)

71
Q

Describe visceral surface and diaphragmatic surface of liver

A

Diaphragmatic surface = superior moulded to diaphragm
Visceral surface = inferior moulded to abdominal viscera

72
Q

Describe suspensory system liver

A

Liver covered by peritoneum
Intra
Needs to suspended - heavy organ

73
Q

What is bare area

A

No peritoneum covering = direct contact with diaphragm here- creates vacuum, helps suspend and stick liver to diaphragm

74
Q

Describe suspension of liver = superiorly

A

Peritoneum reflects into coronary ligaments = ant coronary and post coronary
Join to form triangular ligaments - where they meet on each side = right triangular and left triangular

75
Q

Describe suspension of liver = anteriorly

A

Attached to abd wall = falciform ligament, extends into ligament teres (end, hangs down)

76
Q

Describe suspension of liver = posteriorly

A

Lesser omentum (heaptoduodenal ligament) - encloses portal triad

77
Q

Describe anatomy of liver

A

Divided into 4 lobes = right, left, caudate, quadrate
Caudate and quadrate from right lobe

78
Q

Describe right and left lobes of liver

A

Divided by left Sagittarius fissure = featuring ligamentum teres anteriorly and ligamentum venosum posteriorly
Right = larger

79
Q

Describe quadrate lobe of liver

A

Anterior on visceral surface
Between ligamentum teres and fossa of gallbladder
Separated from caudate by hilum

80
Q

Describe caudate lobe liver

A

Posterior on visceral surface
Between ligamentum venosum and ivc

81
Q

Describe location of porta hepatis

A

Visceral surface between caudate and quadrate

82
Q

Describe content of porta hepatis

A

Right - left hepatic ducts (biliary system)
Hepatic arteries (blood supply)
Portal vein (venous drainage)

83
Q

What is porta hepatis contained in

A

Hepatoduodenal ligament = part of lesser omentum

84
Q

What is portal triad

A

Bile duct, portal vein, hepatic proper artery

85
Q

Describe arterial supply liver

A

Celiac trunk gives =
Left gastric a
Splenic a
Common hepatic a —> proper hepatic a —> right and left hepatic a

86
Q

Describe venous drainage liver

A

Hepatic veins draining into ivc

87
Q

What is extrahepatic biliary system

A

Duct system for bile secreted by liver
Connects with gallbladder and empties into 2nd portion duo

88
Q

Describe whole of extrahepatic biliary system

A

Right and left hepatic duct, combines into 1 common hepatic duct (in hepatoduodenal ligament)
Joins cystic duct (from gallbladder) = forms bile duct
Empties with main pancreatic duct through major duodenal papilla

89
Q

Describe gallbladder

A

Pear shaped sac lying on visceral surface between quadrate and right lobes

90
Q

Describe gall bladder function

A

Store bile from liver and concentrate it to release it through extrahepatic biliary duct system

91
Q

Describe gallbladder anatomy

A

Neck = continuity with cystic duct, constricted
Body = enlargement projected over first part duo
Fundus = protruded from inferior border liver

92
Q

Describe blood supply to gallbladder

A

Cystic a from right hepatic a

93
Q

What is spleen

A

Lymphoid gland that filters blood
Part of vascular system

94
Q

Describe location spleen

A

Left hypochondriac recon - behind stomach
Inferior to left dome of diaphragm
Posterior to stomach
Anterior to ribs 9-10-11

95
Q

Describe anatomy spleen

A

Notched on ant border
Helium on medial surface (entry of vessels)
Visceral impression = renal, gastric, colic

96
Q

Is spleen Intra or retro

A

Intra
Connected to greater curvature stomach by gastrosplenic ligament
Connected to left kidney by splenorenal ligament (contains splenic vessels)

97
Q

Describe arterial supply spleen

A

Splenic artery from celiac trunk