Gastrointestinal Flashcards
1
Q
What is the anterior boundary of the mouth?
A
Opening of lips
2
Q
What is the roof of the mouth formed by?
A
Hard and soft palate
3
Q
What is the floor of the mouth formed by?
A
Soft tissues
4
Q
What is the upper jawbone?
A
Maxilla
5
Q
What is the lower jawbone?
A
Mandible
6
Q
What is the oral vestibule?
A
Space between gum and lips
7
Q
How many teeth does an adult have?
A
32
8
Q
How many teeth does a child have?
A
20
9
Q
List the types of teeth (4)
A
- Incisors
- Canine
- Premolar
- Molar
10
Q
Label teeth diagram
A
See notes
11
Q
How many incisors are there?
A
8
12
Q
How many canines are there?
A
4
13
Q
How many premolars are there?
A
8
14
Q
How many molars are there?
A
8
15
Q
What bones form the hard palate?
A
- Paltal process of maxilla
- Horizontal processes of palatine
16
Q
What 5 muscles form the soft palate?
A
- Uvular
- Tensor veli palati
- Levator veli palati
- Palatooglosseus
- Palatopharyngeus
17
Q
What hangs in the midline of the soft palate?
A
Uvula
18
Q
What is the purpose of the uvula?
A
Stops food and liquid entering nasal cavities
19
Q
Label soft palate muscles
A
See notes
20
Q
What is the blood supply to the palate branched from?
A
Maxillary artery
21
Q
What is the sensory innervation of the palate from?
A
Maxillary division of trigeminal nerve (CNV2)
22
Q
What is the motor innervation of the palate from and what is the exception to this?
A
Pharyngeal plexus (except tensor veli palatine muscle)
23
Q
Where does the tensor veli palatine muscle receive innervation from?
A
CNV3 - mandibular division of trigeminal nerve
24
Q
How many arches of the mouth are there and how are they formed?
A
2 - formed by muscles running between soft palate and pharynx and tongue
25
What forms the anterior arch of the mouth?
Palatoglossus muscle
26
What forms the posterior arch of the mouth?
Palatopharyngeous muscle
27
Label the arches of the mouth
See notes
28
What lymphoid tissue lies between the arches?
Palatine tonsils
29
What is swallowing also known as?
Deglution
30
What two things does swallowing do?
- Elevate and block nasal cavity
| - Creates vaccum in oral cavity, keeps food out of respiratory tract
31
What is the motor supply to the tongue?
Hypoglossal nerve (CNXII)
32
What is the sensory supply to the tongue?
- Mandibular division of trigeminal nerve (CNV3)
| - Glossopharyngeal nerve (CNIX)
33
What is the special sensory supply to the tongue?
- Facial nerve (CNVII)
| - Glossopharyngeal nerve (CNIX)
34
What type of epithelium lines the pharynx?
Stratified squamous
35
Where is the eustachian tube (connecting to opening of auditory canal)?
Nasopharynx
36
What tonsil is in the roof of the nasopharynx?
Pharyngeal tonsil (adenoid)
37
What tonsil lies at the back of the nasopharynx?
Palatine tonsil
38
What is inferior to the laryngopharynx?
Oesophagus
39
Label suprahyoid muscles
See notes
40
Label infrahyoid muscles
See notes
41
What actions do the suprahyoid muscles carry out?
Elevate the pharynx and hyid bone
42
List the suprahyoid muscles
- Mylohyoid
- Stylohyoid
- Geniohyoid
- Digastrics
43
What do the mylohyoid muscles look like?
More posterior and very wide
44
What do the stylohyoid muscles look like?
Very thin
45
What is the position of the stylohyoid muscles?
Styloid process to hyoid bone
| Superior to posterior digastric belly
46
What is the position of the geniohyoid muscle?
Close to neck midline
| Deep to mylohyoid
47
What are the digastric muscles?
2 muscular bellies connected by tendon under stylohyoid
48
What innervates the pharynx?
Pharyngeal plexus
49
What is the action of the infrahyoid muscles?
Depress larynx and hyoid bone
50
List the infrahyoid muscles
- Sternohyoid
- Sternothyroid
- Thyohyoid
- Omohyoid
51
What is the position of the sternohyoid muscle?
- More superficial
| - Sternoclavicular joint ---> hyoid bone
52
What is the position of the thyrohyoid muscle?
- Continuation of sternothyroid
| - Thyroid cartilage to hyoid bone
53
What is the position of the sternothyroid muscle?
- Wide and deep
| - Manibrium to thyroid cartilage
54
What is the omohyoid muscle?
2 muscular bellies connected by tendon
55
What is the position of the omohyoid muscle?
Scapula to hyoid bone
56
List the 3 salivary glands
- Parotid
- Submandibular
- Sublingual
57
What is the position of the parotid gland?
In front and behind ear
58
Where is the opening of the parotid duct?
Inner cheek surface, opposite 2nd maxillary molor
59
What innervates the parotid gland?
Optic ganglion from glossopharyngeal nerve (CNIX)
60
What is the position of the submandibular gland?
Either side of jaw below mandible
61
What is the opening of the submandibular duct?
Sublingual papilla below tongue frenulum (underside)
62
What innervates the submandibular gland?
Submandibular ganglion from facial nerve (CNXII)
63
What is the position of the sublingual gland?
Floor of oral cavity below tongue
64
What is the opening of the sublingual duct?
Floor of mouth
65
What innervates the sublingual gland?
Submandibular ganglion from facial nerve (CNXII)
66
Where does the oesophagus begin?
C6 - level of cricoid cartilage
67
What is the length of the oesophagus?
25cm
68
What does the oesophagus connect between?
Pharynx and stomach
69
What is the outer layer of the oesophagus muscular wall made up of?
Outer - longitudinal fibres
| Inner - circular fibres
70
What layer is absent in the oesophagus?
Serosaul layer
71
What is the mucosa in the oesophagus?
A double layer of smooth muscle in lower part of oesophagus
72
What is anterior to the oesophagus?
Prevertebral fascia
73
What is posterior to the oesophagus?
Trachea in neck
74
What does the oesophagus pass through?
Posterior mediastinum
75
Where does the oesophagus enter the abdomen?
Right crus of diaphargm
76
At what level does the oesophagus enter the abdomen?
T10
77
List the 4 major constrictions of the oesophagus
1) Pharyngealoesophagal junction
2) Aortic arch
3) Right main bronchus
4) Diaphragmatic Constriction
78
What is the pharyngealoesophagal junction?
Oesophagus junction with pharynx at the beginning, constriction due to cricoid cartilage
79
Where is the diaphargmatic constriction?
Right crus of diaphragm
80
What is the blood supply of the oesophagus?
- Upper 1/3: Inferior thyroid artery
- Middle 1/3: thoracic aorta
- Lower 1/3: Left gastric artery
81
Where does the lymph of the oesophagus drain to?
Posterior mediastinal nodes and left gastric nodes
82
Label the oesophagus constrictions
See notes
83
What are the oesophagus constrictions relevant to?
Endoscopy
84
How many inches from incisor teeth is the pharyngealoesophagal junction?
6
85
How many inches from incisor teeth is the aortic arch constriction?
9
86
How many inches from incisor teeth is the left main bronchus constriction?
11
87
How many inches from incisor teeth is the diaphragmatic constriction?
15
88
What are the 3 main regions of the digestive system?
- Foregut
- Midgut
- Hindgut
89
What is the foregut to midgut boundary?
Major duodenal papillae (tube from pancreas to duodenum)
90
What is the midgut to hindgut boundary?
2/3 along transverse colon
91
List the structures of the foregut (7)
- Liver
- Pancreas
- Spleen
- Gall bladder
- Stomach
- Proximal duodenum
- Oesophagus
92
List the structures of the midgut (7)
- Distal duodenum
- Jejunum
- Ilium
- Appendix
- Ascending colon
- Cecum
- Proximal transverse colon
93
List the structures of the hindgut (5)
- Distal transverse colon
- Descending colon
- Sigmoid colon
- Rectum
- Anal canal
94
What is the blood supply of the foregut?
Coeliac trunk
95
What is the blood supply of the midgut?
Superior mesenteric artery
96
What is the blood supply of the hindgut?
Inferior mesenteric artery
97
What is the lymphatic drainage of the foregut?
Coeliac lymph nodes
98
What is the lymphatic drainage of the midgut?
Superior mesenteric lymph nodes
99
What is the lymphatic drainage of the hindgut?
Inferior mesenteric lymph nodes
100
What sympathetic nerve innervates the foregut?
Coeliac ganglion
101
What sympathetic nerve innervates the hindgut?
Inferior mesenteric ganglion
102
What sympathetic nerve innervates the hindgut?
Superior mesenteric ganglion
103
What parasympathetic nerve innervates the foregut and midgut?
Vagus nerve
104
What parasympathetic nerve innervates the hindgut?
Pelvic splanchnic nerves (S2-S4)
105
What type of epithelium lines the peritoneum?
Simple squamous (mesothelium)
106
What is the peritonium?
Serous membrane lining abdominal cavity
107
What are the two layers of the peritoneum and what are they in contact with?
```
Parietal = in contact with abdominal wall
Visceral = in contact with abdominal organs
```
108
What lies between the 2 layers of peritoneum?
Peritoneal cavity
109
What is inside the peritoneal cavity?
Fluid, no organs
110
What is mesenetry?
Double fold of visceral peritoneum attaching organs (e.g intestines) to posterior wall of abdomen where blood vessels and lymphatics run through to supply them
111
Define intrapertoneal
Organs completely inside abdominal cavity covered in visceral peritoneum anteriorly and posteriorly
112
Define retroperitoneal
Organs only covered in peritoneum on anterior surface - lie between parietal peritoneum and abdominal wall
113
Do intraperitoneal organs all have a mesentery?
No some do not
114
List the intraperitoneal organs (11)
- Stomach
- 1st cm duodenal cap
- Jejunum
- Ilium
- Cecum
- Appendix
- Spleen
- Gall bladder
- Transverse colon
- Sigmoid colon
- Liver
115
List the retroperitoneal organs (SAD PUCKER)
- Suprarenal glands
- Aorta (+IVC)
- Duodenum (except 1st 2cm cap)
- Pancreas (not tail)
- Ureter
- Colon (ascending and descending)
- Kidneys
- (o)Esophagus
- Rectum
116
What does the greater mesentery connect?
Jejunum to posterior abdominal wall
117
How many layers is the greater omentum?
4
118
What does the greater omentum connect?
Stomach and transverse colon
119
Give the two purposes of the greater omentum
- Fat storage
| - Prevents infection spread
120
How many layers is the lesser omentum?
2
121
What does the lesser omentum connect?
Stomach and liver
122
What are the quadrants of the abdomen?
- Left upper quadrant
- Right upper quadrant
- Right lower quadrant
- Left lower quadrant
123
What lies in the left upper quadrant of the abdomen? (5)
- Left kidney
- Stomach
- Spleen
- Transverse and descending colon
- Pancreas body
124
What lies in the right upper quadrant of the abdomen? (5)
- Liver
- Right kidney
- Gall bladder
- Duodenum
- Pancreas head
125
What lies in the right lower quadrant of the abdomen? (4)
- Appendix
- Cecum
- Ureter
- Ascending colon
126
What lies in the left lower quadrant of the abdomen? (3)
- Descending and sigmoid colon
- Small intestine
- Ureter
127
What is the superior border of the abdominal cavity?
Thoracic outlet
128
What is the superior border of the abdomen?
Diaphragm
129
What level is the subcostal line at?
L2
130
What regions of the abdomen is the subcostal line between?
Epigrastric and umblical
| Hypochondrium and flank
131
What regions of the abdomen is the midclavicular line between?
Middle and flank/groin/hypochondrium
132
What regions of the abdomen is the intertubercular line between?
Umbilical and suprapublic
| Flank and groin
133
What level is the intertubercular line at?
L5
134
Label the regions of the abdomen
See notes
135
What quadrants of the abdomen is the median saggital line between?
Right quadrants and left quadrants
136
What quadrants of the abdomen is the transumbical plane between?
Upper quadrants and lower quadrants
137
What type of epithelium lines the stomach?
Columnar epithelium
138
Label a stomach
See notes
139
What is the pylorus?
Opening of stomach into duodenum
140
What does the greater curvuture of the stomach attach to?
Greater ommentum
141
What does the lesser curvature of the stomach attach to?
Lesser ommentum
142
What is anterior to the stomach? (4)
- Greater ommentum
- Abdominal wall
- Gallbladder
- Left liver lobe
143
What is posterior to the stomach? (5)
- Lesser sac
- Left kidney
- Left adrenal gland
- Splenic artery
- Common bile duct
144
What is superior to the stomach? (2)
- Oesophagus
| - Diaphragm
145
What does the enteric/intristic nervous system of the stomach control?
Contraction and secretion
146
What is the extrinsic parasympathetic system supply of the stomach via?
Anterior and posterior vagal trunks
147
What is the extrinsic sympathetic system supply of the stomach via?
Sympathetic trunk via coelic plexus
148
Label blood supply stomach diagram
See notes
149
Label omentum diagram
See notes
150
What is the lesser sac?
Subsection of peritoneal cavity
151
What is the lesser sac posterior to?
Lesser omentum and stomach
152
What is the lesser sac anterior to?
Retroperitoneal organs of posterior abdominal wall
153
What is the connection between the lesser sac and greater sac known as?
Omental foramen
154
List the sections of the small intestine in order (5)
- Duodenum
- Illeum
- Jejunum
- Illeum
- Cecum
155
How many parts does the duodenum have?
4
156
What is the shape of the duodenum and where does it wrap around?
C shaped around head of pancreas
157
Where does the 1st part of the duodenum lie?
1/2 way between jugular notch and upper border pubic symphisis
158
In what plane does the 1st part of the duodenum lie?
Transpyloric plane (L1)
159
What is the upper border of the duodenum attached to?
Lesser ommentum
160
What type of epithelium lines the small intestine?
Simple columnar with villi
161
What are the circular folds found in the duodenum?
Pilcae circulates
162
How are the jejunum and ilium attached to the abdominal wall?
Great mesentery
163
Identify vasa recta and arcades
See notes
164
Label small intestine
See notes
165
Label diagram of paracolic gutters
See notes
166
What can the duodenum be divided by?
Embryological origins: upper and lower
167
In what categories do the jejunum and illium differ? (8)
- Folds
- Colour
- Mucosal wall
- Lymphoid tissue
- Arcades
- Vasa recta
- Fat in mesentry
- Quadrant
168
In what ways are the jejunum and illium the same? (2)
- Both intraperitoneal
| - Both have a great mesentry
169
What are the folds of the jejunum like compared to the ilium? (2)
- Thicker (2-3mm)
| - More and deeper
170
What are the folds of the illium like compared to the jejunum? (2)
- Thinner (1-2cm)
| - Less, more shallow
171
What is the colour of the jejunum?
Red
172
What is the colour of the ilium?
Pink
173
What is the mucosal wall of the jejunum like in comparison to the ilium?
Thick
174
What is the lymphoid tissue of the jejunum like in comparison to the ilium?
Less prominent
175
Describe the vascularity of the jejunum in comparison to the ilium? (3)
- Less arcades
- Longer vasa recta
- More vascularised
176
Describe the fat in the mesentry of the jejunum in comparison to the ilium
Less fat
177
What quadrant is the jejunum normally found in?
Upper left
178
What quadrant is the ilium normally found in?
Lower right
179
Where is B12 absorbed in the GI tract?
Terminal ilium
180
What is needed for B12 to be absorbed in the terminal ilium?
Stomach intrinsic factor
181
Where is the large intestine found?
Periphery of abdominal cavity
182
What sphincer muscle valve is found between the small intestine and large intestine?
Iliocecal sphincter
183
What is the iliocecal sphincer?
A sphincer muscle valve between the small intestine and large intestine preventing reflux from the caecum to the ilium
184
How many paracolic gutters are there?
4
185
What is a paracolic gutter?
A space between the colon and the abdominal wall
186
List the paracolic gutters
- Right paracolic
- Left paracolic
- Supracolic
- Infracolic
187
Where is the right paracolic gutter found?
Right of ascending colon
188
Where is the left paracolic gutter found?
Left of descending colon
189
Where is the supracolic gutter found?
Above transverse colon
190
Where is the infracolic gutter found?
Between descending and ascending colon
191
Label paracolic gutters
See notes
192
Label large intestine
See notes
193
List the sphincters of the GI tract (7)
- Upper oesophageal sphincter
- Lower oesophageal/cardiac sphincter
- Pyloric sphincter
- Sphincter of Oddi
- Ileocecal Sphincter
- Internal Sphincter
- External Sphincter
194
Label the sphincters
See notes
195
Where is the upper oesophageal sphincter found?
Between oesophagus and pharynx
196
Where is the lower oesophageal/cardiac sphincter found?
Between low-end of oesophagus and stomach
197
Where is the pyloric sphincter found?
Between the stomach/duodenum
198
What does the sphincter of Oddi surround?
Major duodenal papilla
199
What is the major duodenal papilla?
Common bile duct and pancreatic duct drains into this via hepatopancreatic duct/ampulla
200
Where does the major duodenal papilla drain?
2nd part of duodenum
201
What is the internal anal sphincter?
An involuntary sphincter found in the rectum
202
What is the external anal sphincter?
A voluntary sphincter found in the anal opening
203
What are the distinct features of the large intestine wall?
- Haustra
| - Teniae Coli
204
What are haustra?
Folds of mucosa within the colon formed by circumsectional contraction
205
What are teniae coli?
Three separate longitudinal ribbons of smooth muscle on the outside of the colon
206
Where are teniae coli found?
- Ascending colon
- Descending colon
- Transverse colon
- Sigmoid colon
207
What artery supples the appendix? (2)
- Appendicular branch of ileocolic artery
| - From superior mesenteric plexus
208
Why does the appendix not have tenae coli?
They converge here to form the caecum
