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anatomy > gastroenterology > Flashcards

gastroenterology Flashcards

1
Q

state the four quadrants of the abdomen

A

right upper quadrant
left upper quadrant
right lower quadrant
left lower quadrant

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2
Q

what is the horizontal plane that divides the quadrants

A

transumbilical plane

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3
Q

what is the vertical plane that divides the quadrants

A

median plane

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4
Q

state the 9 regions of the abdomen

A 
right hypochondriac 
epigastric 
left hypochondriac 
right lumbar (lateral)
umbilical 
left lumbar (lateral)
right inguinal (groin)
hypogastric (pubic)
left inguinal (groin)
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5
Q

what are the vertical lines which divide the regions

A

mid clavicular lines

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6
Q

what are the horizontal lines which divide the regions

A

subcostal

transtubercular

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7
Q

what dermatome is the umbilicus in

A

T10

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8
Q

what is the vertebral level of the umbilicus

A

between l3 and l4

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9
Q

state the 4 muscles in the abdomen

A

external obliques
internal obliques
transversus abdominis
rectus abdominus

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10
Q

what direction do the external obliques run

A

inwards and lateral

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11
Q

what direction do the internal obliques run

A

out and lateral

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12
Q

what direction do the transversus abdominis run

A

horizontal

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13
Q

what direction do the rectus abdominis run

A

vertical

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14
Q

the aponeurosis of which three muscles form the rectus sheath

A

external oblique
internal oblique
tranversus abdominis

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15
Q

what two muscles lie within the rectus sheath

A

rectus abdominis

pyramidalis mucles

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16
Q

what is the line where the posterior layer of the rectus sheath ends called

A

curved arcus tendinous

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17
Q

what do the superior arteries arise from

A

distal aspect of internal thoracic arteries

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18
Q

where do the superior veins drain to

A

internal thoracic veins

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19
Q

what do the inferior arteries arise from

A

tributaries from the abdominal aorta

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20
Q

where do the inferior veins drain to

A

external iliac veins

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21
Q

define caput medusa

A

formation of dilated abdominal wall veins which extend from the umbilicus

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22
Q

the inguinal ligament is formed from the aponeurosis of which muscle

A

external oblique

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23
Q

the superficial inguinal ring is a break in the aponeurosis of what muscle layer?

A

external oblique

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24
Q

what are the borders of the inguinal canal

A

anterior wall: medially - aponeurosis of external oblique, laterally - internal oblique muscles
posterior wall: transversalis fascia
roof: transversals fascia, internal oblique, transverse abdominus
floor: inguinal ligament , lacunar ligament

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25
Q

state the layers of the spermatic cord

A

internal spermatic fascia
cremasteric fascia
creamaster muscle
external spermatic fascia

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26
Q

define an indirect hernia

A

results from a congenital weakness in the deep inguinal ring, allowing abdominal contents to enter into the inguinal canal lateral to the inferior epigastric vessels, and even out the deep inguinal ring

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27
Q

define a direct hernia

A

abdominal contents do not pass through the deep inguinal ring, but simply push through a weak spot in the muscles making up the posterior wall of the inguinal canal, allowing contents to enter the canal and, again, even pass through the superficial inguinal ring

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28
Q

define a femoral hernia

A

occur below the inguinal ligament, when abdominal contents pass into the weak area of the posterior wall of the femoral canal medial to the inferior epigastric vessels

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29
Q

define umbilical hernia

A

occur when the abdominal contents pass through a weakness at the site of the passage of the umbilical cord through the abdominal wall.

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30
Q

state the muscles of the posterior abdominal wall

A

iliacus
quadratus lobotum
psoas major
psoas minor

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31
Q

what is the action of the iliacus

A

flex the hip joint

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32
Q

what is the action of the quadratus lobortum

A

lateral flexion of trunk to same side

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33
Q

what is the action of psoas major

A

flex hip joint, pull trunk and pelvis forward, medial rotator of hip

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34
Q

what is the action of psoas minor

A

weak flexor of lumbar spine

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35
Q

what are the three main openings in the diaphragm and what vertebral level do these occur at

A

IVC foramen - T8
esophagus hiatus - T10
abdominal aorta - T12

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36
Q

what is the route of the foregut

A

runs from the mouth to the duodenum (including liver, gall bladder, spleen and pancreas)

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37
Q

what is the route of the midgut

A

runs from the opening of bile duct to duodenum to the proximal 2/3rd of transverse colon

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38
Q

what is the route of the hindgut

A

runs from the distal 1/3rd of transverse colon to anal canal

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39
Q

what artery supply the foregut

A

celiac trunk

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40
Q

what artery supply the midgut

A

SMA

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41
Q

what artery supply the hindgut

A

IMA

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42
Q

at which vertebral level does the Celiac trunk Come off at

A

T12

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43
Q

at which vertebral level does the SMA Come off at

44
Q

at which vertebral level does the IMA Come off at

45
Q

name the three branches of the celiac trunk

A

left gastric artery, common hepatic artery, splenic artery

46
Q

at what vertebral level does the abdominal aorta divide into 2 common iliac arteries

47
Q

what vessels merge to form the IVC

A

common iliac arteries

48
Q

the portal vein is formed by union of which 2 major veins of the abdominal cavity

A

SM vein

IM vein

49
Q

what are the 4 sites of portal-systemic anastomoses

A

anorectal junction
gastroesophageal junction
umbilicus
retroperitoneal

50
Q

state the sympathetic nerve supply to the viscera

A

abdominopelvic splanchnic nerves (greater, lesser and least)
prevertebral sympathetic ganglia
abdominal aortic plexuses

51
Q

state the parasympathetic nerve supply of the viscera

A

anterior and posterior vagal trunks (vagus nerve - 10th cranial nerve)
pelvic splanchnic nerves (S2,S3 and s4)

52
Q

state where the various parts of the gut pain are referred to

A 
foregut = epigastric region 
midgut = umbilical area 
hindgut = suprapubic region
53
Q

where do the kidneys lie

A

on posterior wall at the level of T12-L3 vertebrae

54
Q

identify the 3 main structures at hilum of kidney

A

renal artery
renal vein
uretra

55
Q

where does the head of the pancreas sit

A

duodenal curve

56
Q

what structures compose the small intestine

A

duodenum
jejunum
ileum

57
Q

what is the name given to the peritoneal lining the body wall

58
Q

what is the name given to the peritoneal lining the viscera

59
Q

what layer of the peritoneum is more sensitive to pressure, pain, heat and cold

60
Q

state the retroperitoneal organs

A 
SAD PUCKER 
suprarenal (adrenal) gland 
aorta/ ivc 
duodenum (2nd/3rd part)
pancreas (except tail)
ureters
colon (asc and desc)
kidneys 
oesophagus 
rectum
61
Q

what are the lesser and greater sacs and where do they live

A

lesser sac = part sequestered behind stomach

greater sac = remainder of cavity

62
Q

through which passage do the lesser and greater sac communicate

A

epiploic foramen

63
Q

describe the boundaries of the epiploic foramen

A

free border of the lesser momentum lesser sac/ omental bursa

64
Q

what is the falciform ligament and what structures lie within its free border

A

it is a peritoneal ligament that consists of a double layer of peritoneum that connects an organ with another organ or to the abdominal wall, liver connects to anterior abdominal wall

65
Q

what structure in the free edge of the falciform ligament is a remnant of an embryonic blood vessels

A

round ligament of liver

66
Q

list 3 abdominal viscera which lie in the free edge of a double layer of peritoneum describe as the mesentery

A

sigmoid colon
transverse colon
rectum

67
Q

what is the transpyloric plane

A

horizontal plane located halfway suprarenal notch of the manubrium and upper border of the symphysis of pubis at L1

68
Q

what costal cartilage is the surface marking of the gall bladder

69
Q

what does the large intestine include

A

caecum, appendix, and colon (ascending, transverse, descending, sigmoid)

70
Q

what are the four parts of the stomach

A

fundus
body
pyloric part
duodenum

71
Q

what is the pyloric sphincter

A

band of smooth muscle at the junction between the pylorus of the stomach and the duodenum of small intestine

72
Q

what are the gastric folds/rugae formed from

A

mucosa and submucosa

73
Q

what are the 4 main veins draining the stomach

A
  1. left gastric which drains into the hepatic portal vein
  2. right gastric which drains into the hepatic portal vein
  3. left gastroepiploic which drains first to the splenic vein then to the hepatic portal vein
  4. right gastroepiploic which drains first to the superior mesenteric vein then to the hepatic portal vein
74
Q

what is the name of the small opening in the duodenum where pancreatic and bile fluids enter the gut tube

A

ampulla of vater

75
Q

what is the sphincter that controls the ampulla of water called

A

sphincter of oddi

76
Q

which major blood vessel supplies the jejunum and ileum

A

superior mesenteric artery

77
Q

what 3 features help distinguish the large intestine

A

teniae coli
epiploic appendages
haustra

78
Q

what is mcburneys point

A

the site of max tenderness in appendicitis

79
Q

what is the pectinate line

A

divides upper 2/3rds and lower 1/3rd of anal canal - irregular circle

80
Q

state the 4 distinct functional layers of GI tract

A
  1. mucosa - 3 layers
    - epithelium
    - lamina propria
    - muscular mucosa (interna)
  2. submucosa
  3. muscular externa - 2 layers
    - circular muscle
    - longitudinal muscle
  4. serosa (or adventia)
81
Q

state the 4 basic mucosal types

A

protective
secretory
absorptive
absorptive/ protective

82
Q

what kind of epithelium lines the oesophagus

A

stratifies squamous non-keratinised epithelium

83
Q

what is the epithelial lining of the stomach

A

simple columnar epithelial cells

84
Q

what secretory cells are present in the gastric glands

A

parietal and chief cells

85
Q

what kind of cells are found in the small intestine and what do they secrete

A

crypts, secrete mucus

86
Q

what is the distinguishing factor for duodenum

A

presence of brunners glands

87
Q

what is the function of brunners glands

A

s ecrete alkaline based mucus to protect the duodenal lining from the acid secreted from the stomach

88
Q

what cells are found in the small intestine

A

peyers patches

89
Q

name the four lobes of the liver

A

left lobe
right lobe
caudate lobe
quadrate lobe

90
Q

what is meant by the term ‘bare area’ of the liver

A

large triangular area of the liver which has no peritoneal covering

91
Q

the round ligament of the liver is the remnant of which embryological structure

A

umbilical vein

92
Q

what is portages hepatis

A

deep fissure in the inferior surface of the liver through which all neurovascular structures (except hepatic vein) and hepatic ducts enter or leave liver

93
Q

name structures present in the porta hepatitis

A 
portal vein 
hepatic artery 
hepatic nerve plexus 
hepatic ducts 
lymphatic vessels
94
Q

what structures are in the portal triad

A

hepatic artery
bile duct
portal vein

95
Q

where does the central vein drain to

A

hepatic vein which drains to IVC

96
Q

what does the extrahepatic biliary apparatus consist of

A 
right and left hepatic ducts
common hepatic duct
gallbladder
cystic duct 
bile duct or common bile duct
97
Q

describe calots triangle

A

triangular space formed by cystic duct, common hepatic duct and inferior surface of liver - the triangle contains cystic artery

98
Q

state the 4 parts of the pancreas

A

neck
head
tail
body

99
Q

how is the pancreas peritonised

A 
tail = intraperitoneal 
rest = retroperitoneal
100
Q

name the structures in the hilum of the spleen

A

gastrosplenic ligament
splenic artery
splenic vein

101
Q

what is the function of the spleen

A

storage of RBCs
immune response
haemopoiesis
phagocytosis

102
Q

describe the main histological features of the liver

A

cells are arranged in sheets and converging towards the central vein
at the corner of the lobule connective tissue encloses portal areas which contain blood vessels and ducts (portal tracts or portal triad)

103
Q

describe the main histological features of the pancreas

A

islets of langerhans composed of clumps of small poorly stained cells
pure serous acini composed of large strongly stained cells
small lobules surrounded by connective tissue septa

104
Q

what does white pulp contain

A

lymphoid tissue

105
Q

what does red pulp contain

A

venous sinuses (mainly RBC)

anatomy (12 decks)

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