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Regional Anatomy 1 > Foregut (stomach and duodenum) > Flashcards

Foregut (stomach and duodenum) Flashcards

1
Q

what is contained in the foregut

A

distal oesophagus
stomach
liver
spleen
proximal duodenum
part of pancreas

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2
Q

what is the arterial blood supply of the foregut

A

blood from branches of coeliac axis (aorta T12)

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3
Q

where is the coeliac axis found on the aorta

A

anterior branch of abdominal aorta at vertebral level T12

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4
Q

blood from the foregut drains where

A

hepatic portal vein

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5
Q

lymph from the foregut drains where

A

local nodes and then into pre-aortic nodes at T12 (coeliac nodes)

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6
Q

where does the digestive system start

A

in oral cavity

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7
Q

the stomach is ____peritoneal

A

intra

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8
Q

what are the attachments of the greater and lesser omentum to the stomach

A

lesser omentum - on lesser curvature
greater omentum - on greater curvature

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9
Q

what lies posterior to the stomach

A

lesser sac

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10
Q

what allows communicaiton between the greater and lesser sacs

A

epiploic foramen

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11
Q

why do the muscle layers of the stomach lie in different orientations

A

to allow stomach to contract and churn food with digestive fluids inside

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12
Q

what is the external surface of the stomach

A

serosa - gives it a smooth shiny external appearance

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13
Q

describe the layers of the stomach wall from outer to inner

A

serosa
muscularis externa
submucosa
mucosa

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14
Q

what are the 3 layers of the muscularis externa

A

outer longitudinal
middle circular
inner oblique

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15
Q

the mucosa of the stomach has folds called

A

rugae

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16
Q

what is the function of rugae

A

allows expansion of stomach as it fills with food

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17
Q

what is the name of the sphincter between the stomach and the duodenum

A

pyloric sphincter

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18
Q

what do you call the part of the stomach that rises above the entrance to the oesophagus

A

fundus

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19
Q

what part of the stomach fills the left dome of the diaphragm

A

fundus

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20
Q

what controls outflow of stomach contents to the first part of the duodenum

A

pyloric sphincter

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21
Q

what forms the main part of the stomach and forms the greater and lesser curvatures

A

body

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22
Q

what are the 2 notches of the stomach

A

cardiac notch
angular notch

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23
Q

where does the fundus lie under the diaphragm

A

as high as 5th - 6th ribs on left side

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24
Q

where does the pyloric valve meet the duodenum

A

transpyloric plane - vertebral level L1 (rib 8)

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25
Q

what level is the transpyloric plane

A

L1 (rib 8)

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26
Q

in what regions does the stomach lie

A

occupies part of the left hypochondrium and epigastric regions

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27
Q

what 3 organs are posterior to the stomach

A

pancreas and spleen
top pole of left kidney

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28
Q

the coeliac axis (trunk) forms how many branches

A

3

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29
Q

what are the 3 branches of the coeliac trunk

A

left gastric artery
splenic artery
common hepatic artery

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30
Q

what is the smallest branch of the coeliac trunk

A

left gastric

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31
Q

the left gastric artery passes towards…

A

the lesser curvature of the stomach

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32
Q

what is the largest branch of the coeliac trunk

A

splenic artery

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33
Q

the splenic artery passes …

A

along the superior surface of the pancreas

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34
Q

the common hepatic artery passes…

A

towards the liver

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35
Q

from where does the right gastric artery originate

A

branch of common hepatic artery

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36
Q

what arteries supply the wall of greater curvature of the stomach and greater omentum

A

anastomosis of right and left gastro-epiploic (gastro-omental) arteries

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37
Q

describe the blood supply of the lesser curvature

A

left gastric (from coeliac trunk) and right gastric (from common hepatic) anastomose on lesser curvature and supply wall

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38
Q

what else does the left gastric artery supply

A

abdominal (distal) part of oesophagus

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39
Q

what is the blood supply of the fundus

A

short gastric arteries that branch from the splenic artery

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40
Q

the left gastro-epiploic artery is a branch from

A

splenic artery

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41
Q

the right gastro-epiploic artery is a branch from

A

gastroduodenal artery

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42
Q

the gastroduodenal artery that gives rise to right gastro-epiploic is a branch from

A

hepatic artery

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43
Q

blood from the stomach drains where

A

hepatic portal system

44
Q

describe the venous drainage of the lesser curvature

A

left and right gastric veins drain directly into the hepatic portal vein

45
Q

the left gastro-epiploic vein drains what where

A

greater curvature
into splenic vein

46
Q

the short gastric veins drain what where

A

fundus
into splenic vein

47
Q

the right gastro-epiploic vein drains what where

A

greater curvature
into superior mesenteric vein

48
Q

how does the blood from the stomach eventually end up in the portal system

A

splenic and superior mesenteric veins unite to form hepatic portal vein

49
Q

where does lymph from the stomach drain

A

into small groups of nodes related to stomach and then to pre-aortic coeliac nodes at T12 level (root of coeliac axis)

50
Q

what is the area called around entrance of oesophagus

A

cardiac ring

51
Q

lymph from the coeliac nodes drains where

A

to cisterna chyli then to thoracic duct

52
Q

sympathetic innervation of the stomach is from where

A

greater splanchnic nerves from sympathetic chain in thorax - passes to celiac plexus then to plexuses on gastric and gastroomental arteries

53
Q

parasympathetic innervation of the stomach is from where

A

parasympathetic fibres form a plexus over surface of oesophagus and form anterior and posterior vagal trunks that pass through diaphragm with oesophagus

54
Q

what contributes fibres to the coeliac plexus

A

posterior vagal trunk and greater splanchnic nerves

55
Q

the duodenum is _ shaped and _ cm long

A

C shaped
25cm

56
Q

the duodenum surrounds the head of what organ

A

pancreas

57
Q

how many named parts are there of the duodenum

A

4

58
Q

the duodenum is ____peritoneal

A

partially retroperitoneal

59
Q

what are the 4 parts of the duodenum

A

1st - duodenal cap
2nd - descending
3rd - transverse
4th - ascending

60
Q

the duodenal cap is suspended by what

A

on a dorsal mesentery

61
Q

what parts of the duodenum are retroperitoneal

A

2nd 3rd 4th

62
Q

what part of the duodenum has the entrance of the bile and pancreatic ducts

A

2nd part (descending)

63
Q

which part of the duodenum is crossed by the superior mesenteric vessels

A

3rd - transverse

64
Q

what is the course of the 4th part of the duodenum

A

ascends to the root of the mesentery to join the jejenum

65
Q

what is the name of the folds on the inner surface of the duodenum

A

plicae circulares

66
Q

describe the wall of the duodenum

A

smooth outer wall and folded inner surface

67
Q

describe the mucous membrane of the duodenum

A

thick
inner surface forms many folds - plicae circulares

68
Q

the 2nd part of the duodenum communicates with the bile and pancreatic ducts via the

A

the bile and main pancreatic ducts unite to form the hepatopancreatic ampulla (of Vater) and enter the posteromedial wall of the descending duodenum at an eminence called the major duodenal papilla

69
Q

what is the hepatopancreatic ampulla

A

union of common bile duct and main pancreatic duct

70
Q

the hepatopancreatic ampulla opens into the duodenum where

A

beneath a small mound on inner surface called the major duodenal papilla

71
Q

how is the flow of pancreatic and bile fluids into the duodenum controlled

A

hepatopancreatic spinchter (sphincter of Oddi) at the hepatopancreatic ampulla

72
Q

bile is made in the ___ and passes into the ____ ___

A

liver
biliary tree

73
Q

the sphincter of Oddi at the end of the biliary tree is normally closed so the bile backs up the biliary tree and into the gall bladder via the _____ ____

A

cystic duct

74
Q

bile is stored where

A

in the gall bladder

75
Q

how does bile enter the duodenum

A

sphincter of Oddi opens and biliary tree contracts to expel bile into duodenum

76
Q

the sphincters are made of

A

smooth muscle

77
Q

where does the duodenum lie

A

between vertebral levels L1-L3 in umbilical region

78
Q

the duodenum begins where

A

just above transpyloric plane

79
Q

the duodenum ends where

A

below transpyloric plane approx. 2-3cm to left of midline

80
Q

where is the duodenal-jejunal junction

A

3cm left of midline

81
Q

what are the relations of the 1st part of the duodenum

A

liver
gall bladder
bile duct
portal vein
IVC

82
Q

what is the course of the 2nd part of the duodenum

A

descends towards the right kidney and wraps around the head of pancreas

83
Q

what are the relations of the 2nd part of the duodenum

A

transverse colon
right kidney
ureter
pancreas

84
Q

what are the relations of the 3rd part of the duodenum

A

superior mesenteric vessels
jejenum
right ureter
right psoas
IVC
aorta
pancreas

85
Q

the 3rd part of the duodenum lies ____ to the superior mesenteric vessels

A

inferior

86
Q

what are the relations of the 4th part of the duodenum

A

root of mesentery
jejenum
aorta
left psoas

87
Q

the 4th part of the duodenum passes ____ to the left psoas and aorta

A

anterior

88
Q

the 4th part of the duodenum joins the jejenum at the

A

root of the mesentery

89
Q

the duodenum receives blood from

A

coeliac axis and superior mesenteric vessels

90
Q

the proximal part of the duodenum is supplied by the

A

celiac axis –> common hepatic artery –> gastroduodenal artery –> superior pancreaticoduodenal artery

91
Q

the superior pancreaticoduodenal artery comes from

A

gastro-duodenal artery from hepatic artery from coeliac axis

92
Q

the distal part of the duodenum is supplied by the

A

inferior pancreaticoduodenal artery

93
Q

the inferior pancreaticoduodenal artery comes from

A

superior mesenteric artery

94
Q

the duodenum is said to lie at junction of what

A

foregut and midgut

95
Q

the venous drainage of the superior part of the duodenum drains

A

into the hepatic portal system

96
Q

the venous drainage of the inferior part of duodenum drains

A

into hepatic portal system via superior mesenteric vein

97
Q

the sympathetic supply of the duodenum is from

A

greater and lesser splanchnic nerves via celiac and superior mesenteric plexuses

98
Q

the parasympathetic supply of the duodenum is from

A

vagus nerves

99
Q

pain from duodenum is referred where

A

epigastric region

100
Q

what nerve plexuses supply the duodenum

A

coeliac and superior mesenteric plexuses

101
Q

lymph from the duodenum drains where

A

local nodes then to pre-aortic nodes at both the coeliac axis and superior mesenteric artery

102
Q

why does the duodenum have dual lymph drainage

A

it as dual arterial supply and as a general rule lymph drainage follows arterial supply

103
Q

lymph from the proximal parts of the duodenum follow

A

pancreaticoduodenal, gastroduodenal and pyloric nodes to pre-aortic coeliac axis at T12

104
Q

lymph from the distal parts follow

A

pancreaticoduodenal nodes to pre-aortic superior mesenteric nodes at L1

105
Q

level of pre-aortic superior mesenteric nodes

A

L1

Regional Anatomy 1 (30 decks)

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