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1st year Anatomy > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

What is the course of the trigeminal nerve (CNV)

A

Comes off the CNS at the pons

Passes through the foramen ovale of the sphenoid bone

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2
Q

How many divisions of the trigeminal nerve are there?

A

3

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3
Q

What is the course of the facial nerve (CNVII)?

A

Comes off the CNS between the pons and the medulla
Leaves through the internal acoustic meatus of the temporal bone
Emerges externally through the stylomastoid foramen

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4
Q

What are some of the innervations of the facial nerve?

A

Supplies muscles of facial expression
It branches in to the chorda tympani which innervates the anterior 2/3rds of the tongue and is involved in taste and sensation
It supplies the sublingual salivary glands with parasympathetic axons.

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5
Q

What branch of CNV supplies what part of the oral cavity?

A

CNV2 supplies the superior oral cavity

CNV3 supplies the inferior oral cavity

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6
Q

What is the course of CNV2?

maxillary division of the trigeminal nerve

A

Comes off the CNS at the pons

Exits through the foramen rotundum in the sphenoid bone

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7
Q

What is the course of the glossopharyngeal nerve (CNIX) ?

A

It leaves the CNS at the medulla

Exits through the jugular foramen which is between the temporal and occipital bones

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8
Q

What is the course of the hypoglossal nerve (CNXII) ?

A

Connected to the CNS via many rootlets that attach to the medulla oblongata
Leaves through the hypoglossal canal in the occipital bone

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9
Q

What are the 4 pairs of muscles of mastication?

A

Temporalis
Masseter
Medial pterygoid
Lateral pterygoid

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10
Q

Which three cranial nerves supply sensation to the tongue?

A

CNVII (facial nerve)
CNV3 (trigeminal)
CNIX (glossopharyngeal)

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11
Q

What effect do autonomic nerves have on peristalsis?

A

Parasympathetics speed up peristalsis

Sympathetics slow down peristalsis

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12
Q

At what level does the laryngopharynx become the oesophagus?

A

C6

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13
Q

What is the name of the anatomical upper sphincter of the oesophagus?

A

Cricopharyngeus

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14
Q

The lower oesophageal sphincter is physiological not anatomical. What two things produce its physiological effect?

A

Contraction of the diaphragm

Higher intra-abdominal pressure than intra-gastric pressure

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15
Q

What 3 regions does the stomach lie in?

A

Left hypochondrium, epigastric, umbilical

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16
Q

On the lesser curvature side of the stomach, what is the indent called?

A

Incisura Angularis

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17
Q

Talk logically through the nine regions of the abdomen

A

Right hypochondrium, epigastric, left hypochondrium
Right lumbar, umbilical, Left lumbar,
Right inguinal, pubic, left inguinal

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18
Q

What are the two ligaments of the liver?

A

Falciform ligament

Round ligament

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19
Q

Which liver ligament attaches the liver to the body wall?

A

The falciform ligament

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20
Q

What are the three parts of the small intestine?

A

Duodenum, Jejunum, Ileum

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21
Q

What are the parts of the large intestine?

A 
Appendix 
caecum 
Ascending colon 
Hepatic flexure 
Transverse colon 
Splenic flexure 
Descending colon 
Sigmoid colon 
Rectum 
Anal canal 
Anus
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22
Q

Explain the musculature of the anterolateral abdominal wall

A

The rectus abdominus are the ‘ab muscles’ at the front
There are three layers of muscles at the side;
The external oblique
The internal oblique
The transverses abdominus

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23
Q

If blood/pus or faeces enter the peritoneal cavity, what will this cause?

A

Peritonitis

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24
Q

What is mesentery?

A

A double layer of peritoneum that comes together and wraps behind the organ

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25
Q

Name 3 retroperitoneal organs and 3 intraperitoneal organs

A 
RETROPERITONEAL; 
Kidneys 
Adrenal Glands 
Pancreas 
INTRAPERITONEAL; 
Stomach 
Spleen 
Liver
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26
Q

What is omentum?

A

A double layer of peritoneum that passes from the stomach

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27
Q

How many layers does the greater momentum have and what are its attachments?

A

4 Layers
It hangs over many structures
Attached to the greater curvature of the stomach and the transverse colon

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28
Q

How many layers does the lesser momentum have and what are its attachments?

A

2 (double-layered)

Attached to the lesser curvature of the stomach and the liver. It has a right ‘free’ edge.

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29
Q

Peritoneum forms pouches at its inferior aspect. What are these pouches called in males and females?

A

There is 1 pouch in males - called the ‘rectovesical pouch’
There are 2 pouches in females - called the ‘vesicle-uterine pouch’ and ‘recto-uterine pouch (a.k.a pouch of douglas) in females.

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30
Q

What is ascites, what is its most common cause and how is it managed?

A

Ascites is a collection of fluid in the peritoneal cavity
it is most commonly caused by liver disease.
It is managed by paracentesis in which a needle is used to drain the fluid.

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31
Q

What nerves supply the abdominal organs and what nerves supply the abdominal wall?

A 
ORGANS 
Visceral afferents 
ENS 
Parasympathetics and sympathetics 
WALL 
Somatic sensory and motor 
Sympathetics
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32
Q

At what level do sympathetic nerves leave the spinal cord and where do they synapse? what is the exception to this rule?

A

T5 - L2
Synapse at pre vertebral ganglia

*Sympathetics for the adrenal gland leave at T10-L1
Synapse directly onto the cells

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33
Q

What is the outflow of parasympathetic nerves?

A

CRANIAL-SACRAL OUTFLOW;

CNX (vagus)
Pelvic splanchnic nerves (S2,3 &4)

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34
Q

At what levels do visceral afferents from the different areas of the gut enter the spinal cord?

A

FOREGUT - T6 - T9
MIDGUT - T8 -T12
HINDGUT - T10 - L2

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35
Q

What are the common areas that the gut refers pain to?

A

FOREGUT - Epigastric
MIDGUT - Umbilical
HINDGUT - Pubic

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36
Q

Explain how appendicitis presents in terms of pain

A

Initially, the pain from appendicitis can be described as dull, and localised to the umbilical region.
As the condition worsens however the pain become sharp and ‘pin-pointed’ to the right iliac fossa.
The pain can be described as having changed from visceral to somatic.

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37
Q

What causes jaundice and how can it be detected?

A
  • An increase in the blood levels of bilirubin (a normal break-down product of red blood cells)
  • can be detected by;
  • Yellowing of sclera
  • Yellowing of the skin
  • Itchiness of the skin
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38
Q

What is the role of the gall bladder?

A

Storage and concentration of bile

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39
Q

What is the role of bile?

A

It is important for the normal absorption of fats from the small intestine!

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40
Q

State 3 functions of the liver

A

Glycogen storage
Bile secretion
Metabolic functions

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41
Q

Describe the location of the liver and its anatomical relations

A

The liver is mainly located in the RUQ and is protected by ribs 7-11
Its location is affected by breathing
- Inferior to the diaphragm
- Anterior to the gallbladder
- Superior to the hepatic flexure
- Anterior to the kidney, IVC and abdominal aorta
- Anterior to the stomach

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42
Q

What are the 4 anatomical lobes of the liver?

A

Right lobe
Left Lobe
Caudate lobe
Quadrate lobe

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43
Q

What are the ligaments of the liver?

A

The falciform ligament (attaches to the body wall)
The round ligament (embryological remnant of the umbilical vein)
The triangular ligaments
The coronary ligaments

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44
Q

Where is the bare area on the liver?

A

The bare area is the area of the liver where there is no peritoneum as this is the attachment to the diaphragm

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45
Q

What is the porta hepatis?

A

The site of entrance of the portal triad structures

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46
Q

What specific vasculature do each of the 8 functional lobes of the liver all have? List 4

A

Branch of a hepatic artery
Branch of a hepatic portal vein
Bile drainage to the bile duct
Venous drainage to the IVC

47
Q

Which two vessels associated with the liver lack valves?

A

IVC
Hepatic veins
(thus an increase in central venous pressure is directed to the liver)

48
Q

What 3 structures make up the portal triad? And which ligament do these structures run within?

A

Hepatic portal vein
Hepatic artery proper
Bile duct
*Run within the hepatoduodenal ligament

49
Q

The coeliac trunk is one of the first 3 midline branches of the aorta.
At what level does it leave the aorta?

A

T12

50
Q

What 3 branches does the coeliac trunk branch into?

A

Splenic artery
Left gastric artery
Common hepatic artery

51
Q

What does the common hepatic artery branch into?

A

Gastroduodenal

Hepatic artery proper, then Right gastric

52
Q

Describe the location of the spleen and its anatomical relations

A

Left hypochondrium, protected by ribs 9-11
Medial to the left kidney
Posterior to the stomach
Superior to the splenic flexure

53
Q

Describe the anastomoses of the vessels supplying the stomach

A

Right gastric artery anastomoses with the left gastric artery at the junction of the lesser curvature and the lesser omentum
Right gastro-omental artery anastomoses with the left gastro-omental at the greater curvature and the greater omentum

54
Q

What kind of blood supply does the liver have? What are the vessels called?

A

DUAL blood supply

  • Right and left hepatic arteries
  • Hepatic artery proper
  • Hepatic portal vein
55
Q

What structures do liver lobules contain?

A

Central vein

Interlobular portal triad

56
Q

What is the function of the hepatic portal vein?

A

It is formed from the splenic veins and the superior mesenteric vein which drain the foregut and midgut respectively. The vein then transports this blood to the liver.

57
Q

Where does the inferior mesenteric vein drain blood from?

A

It drains blood from the hindgut to the splenic vein, which then becomes the hepatic portal vein, and drains back to the liver

58
Q

Name the two recesses around the liver in the peritoneal cavity within the greater sac

A

Subphrenic recess

Hepatorenal recess

59
Q

What are the lowest parts of the peritoneal cavity when the patient is supine?

A

Hepatorenal recess

Rectovesical/ recto-uterine pouch

60
Q

Describe the location of the gall bladder

A

It lies on the posterior aspect of the liver, anterior to the duodenum

61
Q

Explain the blood supply to the gall bladder

A

The cystic artery (a branch of the right hepatic artery) - it branches within the triangle of clot before entering the gall bladder

62
Q

Explain how gall bladder pain may be felt

A

The gall bladder is a foregut organ and so visceral afferents enter the spinal cord between T6-T9 - early pain is felt in the epigastric region
Pain can later present in the hyperchondrium, with or with out referral to the right shoulder/neck

63
Q

What is the term used to describe surgical removal of the gall bladder

A

Cholecystectomy

64
Q

Describe the relationship of the duodenum with the peritoneum

A

The 1st part is intraperitoneal

2nd, 3rd and 4th parts are retroperitoneal

65
Q

Which two peptide hormones does the duodenum secrete?

A

Gastrin

CCK

66
Q

What does the head of the pancreas have?

A

An uncinate process

67
Q

Which cells make up the exocrine pancreas and are responsible for secreting enzymes?

A

Acinar cells

68
Q

Which cells make up the endocrine pancreas and are responsible for secreting hormones?

A

Islets of Langerhan

69
Q

Explain the nerve supply to the pancreas

A

abdomino pelvic splanchnic nerves - SYMPATHETIC
Vagus nerve - PARASYMPATHETIC
VISCERAL AFFERENTS

70
Q

The bile duct joins with the main pancreatic duct to form what structure?

A

The hepatopancreatic ampulla (of Vater)

71
Q

Where does the hepatopancreatic ampulla drain into?

A

The 2nd part of the duodenum

72
Q

How many sphincters are involved in the drainage of the biliary system and what are they called?

A

3

  • Bile duct sphincter
  • Pancreatic duct sphincter
  • Sphincter of Oddi
73
Q

What two things can obstruct the biliary tree, causing jaundice?

A
  • Gallstones
  • Carcinoma at the head of the pancreas (blocks sphincters)
  • These things cause flow of bile back up to the liver and overspill of bile and bilirubin into the blood.
74
Q

Which two vessels anastomose at the pancreas?

A

Superior pancreaticduodenal artery

Inferior pancreaticduodenal artery

75
Q

Where can pancreatic pain radiate to?

A

The back

76
Q

What two signs can vascular haemorrhage presents with as a consequence of acute pancreatitis?

A

Grey-turner’s sign
(huge deep purple bruises on the flanks)
Cullen’s sign
(deep purple around the umbilicus)

77
Q

What are the main groups of abdominal lymph nodes?

A

Celiac
Superior mesenteric
Inferior mesenteric
Lumbar

78
Q

Where do the left and right venous angles drain into?

A

Left - thoracic duct

Right - right lymphatic duct

79
Q

Where are paracolic gutters found and what can accumulate here?

A

Greater sac in the peritoneal cavity - between the ascending/ descending colon and the abdominal wall
(pus can accumulate here)

80
Q

What are the omental appendices on the colon?

A

Small fatty projections

81
Q

What are teniae coli?

A

The 3 distinct bands of longitudinal muscle on the colon

82
Q

What are haustra?

A

The pouches which give the colon its segmental appearance

83
Q

What are the two orifices on the caecum?

A

The appendiceal orifice (at McBurney’s point)

The ileocaecal orifice

84
Q

At what level do the three branches of the abdominal aorta come off?

A

Celiac trunk - T12
Superior Mesenteric artery - L1
Inferior Mesenteric artery - L3

85
Q

What are the branches of the SMA? (6)

A 
Inferior pancreaticduodenal artery 
Middle colic artery 
Right colic artery 
Ileocolic artery 
Jejunal and Ileal arteries
86
Q

Describe the differences between the jejunal and ileal arteries in terms of vasa rectae and arcades

A 
JEJUNUM 
- Longer vasa rectae 
- Less complex arcades
ILEUM 
- Shorter vasa rectae 
- more complex arcades
87
Q

What are the branches of the IMA? (3)

A

Left colic artery
Sigmoid arteries
Superior rectal artery

88
Q

The Marginal Artery of Drummond involves the anastomosis of which 2 vessels?

A

Superior and Inferior mesenteric arteries

89
Q

There are two venous systems in the body - where do these drain to?

A

Hepatic Portal Venous System - drains to the liver

Systemic Venous System - drains to the IVC

90
Q

What are the three important sites of venous anastomosis between the portal and systemic circulations?

A

Distal end of the oesophagus
Skin around the umbilicus
Rectum/ anal canal

91
Q

How can portal hypertension present clinically?

A

Oesophageal varices
Caput medusa
Rectal varices

92
Q

What muscle makes up the pelvic floor?

A

Levator Ani Muscle

93
Q

At what vertebrae level does the sigmoid colon become the rectum and what is this junction called?

A

S3

Rectosigmoid junction

94
Q

What pouch is formed in males between the bladder and the rectum?

A

Rectovesical pouch

95
Q

what pouch is formed in females between the uterus and the rectum?

A

Rectouterine pouch

96
Q

What 3 smaller muscles make up the levator ani muscle?

A

iliococcygeus
pubococcygeus
Puborectalis

97
Q

What is the nervous supply of the levator ani muscle?

A

A branch of the sacral plexus involving S2, 3 & 4

98
Q

Which smaller muscle within the levator ani muscle has a crucial role in maintaining faecal continence?

A

Puborectalis

99
Q

Which nerve fibres stimulate contraction of the internal anal sphincter and which stimulate contraction of the external anal sphincter?

A

Sympathetics - Internal

Pudendal - external

100
Q

Which kind of muscle is the internal and external anal sphincter made up of? Which is voluntary and which is involuntary?

A

Internal anal sphincter - smooth muscle, involuntary

External anal sphincter - skeletal muscle, voluntary

101
Q

Which area of the spinal cord do sympathetic fibres come from which cause contraction of the internal anal sphincter and cause inhibition of peristalsis?

A

T12 - L2

102
Q 
Which area of the spinal cord do; 
- somatic motor (pudendal) 
- parasympathetic fibres 
- visceral afferents 
come from?
A

S2 - S4

103
Q

Which nerves do parasympathetic fibres run alongside?

A

Pelvic splanchnic nerves

104
Q

Which foramen does the pudendal nerve pass through?

A

Greater sciatic foramen - exits the pelvis

Lesser sciatic foramen - enters the perineum

105
Q

What does the pectinate line mark the junction between?

A

The part of the embryo which formed the GI tract (endoderm) and the part which formed the skin (ectoderm)

106
Q

Is above the pectinate line endoderm or ectoderm derived?

A

Above the line - endoderm

Below the line - ectoderm

107
Q

What is a rectal varice and why does it form?

A

A dilation of collateral veins between the portal and the systemic venous system which forms due to portal hypertension

108
Q

Why do haemorrhoids form?

A

Haemorrhoids form due to raised pressure. E.g coughing and constipation

109
Q

What is the name of the fossae which lie either side of the anal canal?

A

Ischioanal fossae

110
Q

Describe the location of the parotid gland and how its secretions enter the mouth

A

Anterior to the ear, Inferior to the zygomatic arch

- The duct of stensen enters the mouth opposite second maxillary molar teeth

111
Q

Describe the location of the submandibular gland and how its secretions enter the mouth

A

Medial to the body of the mandible on the floor of the mouth
- The duct of wharton enters the mouth under the tongue by lingual frenulum via sublingual caracula

112
Q

Describe the location of the sublingual gland and how its secretions enter the mouth

A

Medial to the submandibular glands

- The duct of rivinus and common bartholin connect with wharton’s at the sublingual caruncular

113
Q

Describe he anatomy of the inguinal canal in terms of the walls and the floor and roof

A

Posterior wall = transversals fascia

Anterior wall = aponeurosis of external oblique, internal oblique

Floor =
Inguinal ligament and the lacunar ligament

Roof =
Transversalis fascia
Internal oblique
Transversus abdominus

114
Q

At what level do the iliohypogastric and the ilioninguinal nerves branch off the intercostal nerves?

A

At the level of L1

1st year Anatomy (7 decks)

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