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ESA 3 > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

What is the tonicity of saliva?

A

Hypotonic

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2
Q

What is the pH of saliva?

A

Usually alkaline, due to potassium and bicarbonate, can be from slightly acidic to pH 8

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3
Q

Contents of saliva (6)

A 
Mucins
Amylase
Lingual lipase
IgA
Lysozyme
Lactoferrin
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4
Q

Purpose of mucins?

A

lubrication

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5
Q

Function of saliva? (7)

A 
Lubrication for speech
Transmits infections
Digestion
Solvent for taste molecues
Lubrication of food
Dental hygiene
Lysozyme to kill pathogens
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6
Q

What is Xerostomia?

A

Dry mouth, sign of dehydration

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7
Q

Location of salivary glands? (3)

A

Sublingual
Submandibular
Parotid

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8
Q

Location of entry of salivary ducts? (3)

A

Sublingual - lateral
Submandidular - medial
Parotid - opposite crown of 2nd upper molar tooth

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9
Q

Neural control of salivary glands (5)

A

Autonomic
Parasympathetic
Sympathetic causes slight increase in production but mostly vasconstriction
Sublingual and Submandibular - chorda tympani (CN VII)
Parotid - Glossopharyngeal (CN IX)

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10
Q

What effect would antimuscarinic drugs have?

A

Cause xerostomia

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11
Q

Stages of swallowing (3)

A

Oral preparatory phase
Pharyngeal phase
Oesophageal stage

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12
Q

Describe the oral preparatory phase? (3)

A

Voluntary (CN V3)
Pushes bolus to pharynx
Once bolus touches pharyngeal wall, pharyngeal phase starts

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13
Q

Describe the pharyngeal phase? (5)

A

Involuntary
Soft palate seals off nasopharynx (CN V3)
Larynx elevates closing epiglottis (Suprahyoid muscles)
Vocal cords adduct (CN X)
Opening of upper oesophageal sphincter

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14
Q

Describe the oesophageal phase? (3)

A

Involuntary
Closure of UOS
peristaltic wave caries bolus downwards

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15
Q

Main nerves involved in swallowing? (40

A

CN V3 (soft palate)
CN IX
CN X
CN XII (intrinsic muscles of the tongue)

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16
Q

How can babies eat and swallow at the same time?

A

Their epiglottis projects into the nasopharynx and their necks are shorter, meaning the epiglottis is always protecting the laryngeal inlet and the aspiration of fluid, but they can’t talk until epiglottis moves out of the way

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17
Q

Neural control of swallow and gag reflex? (5)

A 
Mechanoreceptors at the back of the throat
CN IX
medulla
CN X
Pharyngeal constrictors
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18
Q

Which parts of the control of the head and neck are close in the brain?

A

Control of face and swallowing close so can both be affected

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19
Q

Describe the anatomical position of the oesophagus? (2)

A

Posterior to trachea

Right of aorta

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20
Q

Where does the narrowing of the oesophagus occur? (4)

A

UOS
Where aorta crosses oesophagus
where left main bronchus crosses the oesophagus
oesophageal hiatus where it passes through diaphragm

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21
Q

Prevention of gastro-oesophageal reflux (5)

A

LOS formed of smooth muscle
Diaphragm which causes narrowing of oesophagus
Intra-abdominal oesophagus compresses when intra-abdominal pressure rises
Mucosal rosette at cardia prevents backflow
actue angle of entry of oesophagus

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22
Q

What muscular changes occur as you move distally in the oesophagus?

A

Goes from skeletal to smooth, in the middle there is a mix

23
Q

What is a hernia?

A

A protrusion of the abdominal contents beyond the normal confines of the abdominal walls

24
Q

What are the parts of the hernia (3)

A

The sac
The contents of the sac
The covering of the sac

25
What is the sac made of?
peritoneum
26
What is the contents of the sac?
contents that would usually be confined to the abdominal cavity i.e. loops of bowel, omentum etc.
27
What are the coverings if the sac?
``` layers if the abdominal wall Transversus abdominis Internal oblique External oblique Transversalis fascia ```
28
Where do weaknesses of the abdominal wall occur? (4)
Inguinal canal Femoral canal Umbilicus Sites of previous incisions
29
What is the inguinal canal? (3)
Oblique passage through the lower part of the abdominal wall In males abdomen to testis In females round ligament from uterus to labia majora
30
What is the processus vaginalis?
A pouch of peritoneum that accompanies the testis on their descent and normally eventually disintegrates If this doesn't disintegrate this leaves a communication between the peritoneal cavity and the scrotum
31
What structures form the floor of the inguinal canal? (2)
Inguinal ligament laterally | Lacunar ligament medially
32
What structures form the roof of the inguinal canal? (2)
Internal oblique | Transverse abdominus
33
What structures form the posterior wall of the inguinal canal? (3)
Transversalis fascia Deep ring laterally Conjoint tendon medially
34
What is the conjoint ligament?
common ligament of the internal oblique and the transverse abdominis that attaches to the crest of the pubis, reinforces an otherwise weak area of the posterior wall
35
What structures form the anterior wall of the inguinal canal? (2)
The aponeurosis of the external oblique | Superficial ring medially
36
Clinical features of the inguinal hernia (4)
Most common abdominal hernia Indirect is the most common of the 2 Most common in men (7:1) Mainly right sided
37
Types of inguinal hernia? (2)
Direct | Indirect
38
Features of a indirect inguinal hernia (3)
Enters deep ring, travels through inguinal canal, exits via superficial ring Depending on where processus vaginalis was obliterated can potentially descend into testis Location: Lateral to inferior epigastric vessels
39
Features of direct inguinal hernia (2)
Bulges through Hesselbach's triangle straight through superficial ring Location: Medial to inferior epigastric vessels
40
Hesselbachs triangle (2)
``` Area of relative weakness in abdominal wall Borders: Medial - rectus abdominis Superior - inferior epigastric vessels Inferior - lacunar ligament ```
41
What are the consequences of herniation of the small bowel?
Bowel obstruction
42
Features of a femoral hernia (3)
Occur through femoral ring, medial to femoral vein Mostly in females due to width of hips Can easily become incarcerated and not reducible Exit via saphenous opening
43
Hernia strangulation (3)
Compromised blood supply Necrosis Sepsis
44
Borders of the femoral ring (4)
Posterior - inguinal ligament Anterior - Pectineus Lateral - Femoral vein Medial - Lacunar ligament
45
Types of umbilical hernia (3)
Congenital Acquired infantile Acquired adult
46
Types of congenital hernia (2)
Omphalocele | Gastrochisis
47
What is an Omphalocele?
From week 6 to 8 of the embryological development of the GIT the primary intestinal loop herniates into through the umbilicus into the umbilical cord, rotating 90 degrees counterclockwise around the SMA. If there is improper retraction of the intestinal loop in the 11th week, it remains outside of the abdominal cavity, but is covered in peritoneum. Associated with neural tube defects and cardiac malformations
48
What is Gastroschisis?
Failure of the closure of the abdominal wall during folding if the embryo can leave a hole, usually to the right of the belly button, through which abdominal contents can herniate. It is not covered in peritoneum and can be irritated by the amniotic fluid causing inflammation.
49
Meckel's diverticulum
Failure of the disintegration of the vitelline duct
50
Describe an acquired infantile umbilical hernia
Contents of the abdominal cavity herniates through weakness in scar of umbilicus, resolves itself after a few years
51
Describe an acquired adult umbilical hernia
occurs in the linea alba region of the umbilicus, affects women more than men
52
Describe and epigastric hernia
Occurs through linea alba between xiphoid process and umbilicus Starts with a small hernia of extra-peritoneal fat Chronic straining forces more fat out which can eventually pull peritoneum through
53
Symptoms of a hernia
Pain Vomiting Sepsis
54
What is meant by the term incarcerated?
A hernia that has become stuck and is irreducible

ESA 3 (5 decks)

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