Gastrointestinal - Anatomy Flashcards
What are the surface markings of the abdomen from top left?
- Right hypochondrium
- Epigastric
- Left hypochondrium
- Right flank/lumbar
- Umbilical
- Left flank/lumbar
- Right iliac/groin
- Pubic/hypogastric
- Left iliac/groin
What are the retroperitoneal organs?
Suprarenal (adrenal) glands Aorta/IVC Duodenum (2+3 segments) Pancreas (except tail) Ureters Colon (ascending and descending) Kidney (o)Esophagus Rectum
What does retroperitoneal mean?
Organs which only have peritoneum on their anterior surface.
What are primary retroperitoneal organs, and which organs are they?
- Organs which developed AND remained outside of parietal peritoneum.
- KER: Kidney, (o)esophagus, rectum
What are secondary retroperitoneal organs, and which organs are they?
- Organs which were intraperitoneal but became retroperitoneal during embryological development.
- Colon
What is the GI tract?
A hollow muscular tube from mouth to anus, which contains accessory organs.
List the course of the GI tract.
Mouth Oral cavity Pharynx Oesophagus Stomach Intestines Rectum Anus
List the accessory organs of the GI tract
- Salivary glands
- Liver
- Pancreas
- Gallbladder
What are the 4 basic layers of the entire GI tract?
Mucosa
Submucosa
Muscularis externa
Serosa/Adventitia
What is the transpyloric plane of Addison?
Level at L1.
Location of gallbladder, pancreas and pylorus of stomach.
What is McBurney’s point?
2/3 of the way between the line that joins umbilicus and right anterior superior iliac spine.
Shows base of appendix.
What are the layers of the abdominal wall?
- Skin
- Fascia
- Muscle
- Parietal peritoneum
What is the fascia of the abdominal wall above and below the umbilicus?
- Above: single layer.
- Below:
fatty layer - Camper’s
membranous layer: Scarpa’s
What are the 2 groups of muscle in the abdominal wall and how many of each?
- Flat: 3
- Vertical: 2
List the vertical and flat muscles of the abdominal wall.
Flat: external oblique, internal oblique, transversus abdominis.
Vertical: rectus abdominis, pyrimidalis.
What is the origin, attachment and innervation of the external oblique?
- Origin: Ribs 5-12
- Insertion: pubic tubercle and iliac crest
- Innervation: T7-T12
What is the origin, attachment and innervation of the internal oblique?
- Origin: Inguinal ligament and iliac crest
- Insertion: Ribs 10 - 12
- Innervation: T6-T12
What is the origin, attachment and innervation of the transversus abdominis?
- Origin: Inguinal ligament, iliac crest, costal cartilages 7-12
- Insertion: Xiphois process, pubic crest.
- Innervation: T6-T12
What is the origin, attachment and innervation of the rectus abdominis?
- Origin: Pubic crest
- Insertion: Xiphoid process, costal cartilages 5-7
- Innervation: T7-T11
What is an aponeurosis?
Where muscles meet/attach.
What is the linea alba?
An aponeurosis in the midline of all the flat muscles.
How is the inguinal ligament formed?
By the free border of the external oblique aponeurosis.
What is the rectus sheath?
Aponeurosis of the 3 flat muscles which encloses the vertical muscles.
What are the layers of the rectus sheath from top to bottom?
- External oblique
- Internal oblique
- Transversus abdominis
- Transversalis fascia
- Parietal peritoneum
- ** Rectus abdominis lies in middle of this.
What is the peritoneum?
2 continuous layers, parietal and visceral, made of simple squamous epithelium.
What does the parietal peritoneum line?
The abdominal wall
What does the visceral peritoneum line?
Invaginates to line the viscera of the abdomen - i.e. the gut and other organs
What is the potential space between the parietal and visceral peritoneum called?
Peritoneal cavity
What is mesentery?
A double layer of visceral peritoneum usually connecting interperitoneal organs to the posterior abdominal wall.
What is the greater omentum?
4 layers of peritoneum, descending from the greater curvature of the stomach, looping back up to attach to the anterior surface of the transverse colon.
What is the lesser sac formed by?
The lesser and greater omentum and surrounding organs
Where is the lesser sac located?
Roughly behind the stomach
How are the greater and lesser sac connected?
By an opening in the lesser sac called the epiploic foramen
What is the pouch created by the peritoneum in the male pelvis called and where is it located?
Rectovesical pouch, between the bladder and rectum.
What is the pouch created by the peritoneum in the female pelvis called and where is it located?
Rectouternine pouch (Pouch of Douglas). Between the rectum and posterior uterine wall
What are the 4 parts of the stomach from oesophagus to duodenum?
Cardia, fundus, body, pylorus
What are the 2 sphincters of the stomach and where are they located?
- Inferior oesophageal: Where oesophagus and stomach meet.
- Pyloric: Between pylorus and duodenum
What supplies blood to the lesser curvature of the stomach?
Right and left gastric arteries
What supplies blood to the greater curvature of the stomach?
Right and left gastro-omental arteries
What are the veins of the stomach and where do they run?
Right and left gastric veins, right and left gastro-omental veins. Run parallel to arteries.
Where do the right and left gastric arteries drain?
Hepatic portal vein
Where do the right and left gastro-omental arteries drain?
Superior mesenteric vein
What are the 4 parts of the jejunum from stomach to jejunum?
Superior, descending, inferior, ascending
What is the duodenum supplied blood by?
- Gastroduodenal artery
- Inferior pancreaticoduodenal artery
Which part of the small intestine is in contact with the mesentery and what does this do?
Jejunum and ileum. Anchors them to the posterior abdominal wall.
What are the differences between jejunum and ileum?
Jejunum:
- Less complex arterial arcades.
- Longer vasa recta.
- More inner foldings (plicae circulares)
- No fat in mesentery
What are the jejunum and ileum supplied blood by?
- Superior mesenteric artery which branches into arcades (loops), which then become vasa recta (long, straight arteries.)
Where is venous drainage of the jejunum and ileum?
- Superior mesenteric vein.
What are the 5 parts of the large intestines?
- Caecum
- Appendix
- Colon
- Rectum
- Anus
What are the 4 parts of the colon?
- Ascending
- Transverse
- Descending
- Sigmoid
What is the structure and function of the caecum?
Blind ended tube. Was used for cellulose digestion in ancestors, but now is just a reservoir for chyme from ileum.
What is the structure and function of the veriform appendix?
Blind ended tube. Contains large amount of lymphoid tissue, but it has no vital function.
In which region are the ceacum and appendix found?
- Right iliac.
Where does the caecum begin?
Ileo-caecal valve
Where does the top of the appendix lie within the abdomen?
It’s position is highly variable.
What is the blood supply to the caecum?
ileocolic artery (superior mesenteric)
What is the venous drainage of the caecum?
ileocolic vein (superior mesenteric)
What is the blood supply to the appendix?
Appendicular artery (superior mesenteric)
What is the venous drainage of the appendix?
Appendicular vein (superior mesenteric)
Where does the colon run?
From the caecum to anal canal.
What is the function of the colon?
Receives digested food from the small intestines, absorbs water and ions to form faeces.
Is the ascending colon retroperitoneal or intraperitoneal and within a mesentery?
Retroperitoneal
What is the name if the 90 degree turn of the ascending colon and where does this occur?
- Right colic (hepatic) flexure.
- Occurs at right lobe of liver.
Where does the transverse colon run?
From the right colic (hepatic) flexure to the spleen.
What is the name if the 90 degree turn of the transverse colon and where does this occur?
- Left colic (splenic) flexure.
- Occurs at spleen.
What is the name of the ligament attaching the transverse colon to the diaphragm?
Phrenicocolic ligament
Is the transverse colon retroperitoneal or intraperitoneal and within a mesentery?
Intraperitoneal and within a mesentery
Is the descending colon retroperitoneal or intraperitoneal and within a mesentery?
Retroperitoneal
Is the sigmoid colon retroperitoneal or intraperitoneal and within a mesentery?
Intraperitoneal and within a mesentery
What are omentum appendices?
Small pouches of fat-filled peritoneum
How many layers of muscle run longitudinally along the colon and what are they called?
- 3
- Teniae coli
What is the name of the bulges created by the contraction of the teniae coli, causing the inner layer to bulge out?
- Haustra
What happens to the teniae coli at the rectum?
It broadens to form a continuous layer.
What supplies the ascending colon with blood? Where do the vessels originate?
Ileocolic and right colic arteries from superior mesenteric artery
What supplies the transverse colon with blood? Where do the vessels originate?
Right colic artery from superior mesenteric artery.
Middle colic artery from superior mesenteric artery.
= first 2/3
Left colic artery from inferior mesenteric artery.
= distal 1/3
What supplies the descending colon with blood? Where do the vessels originate?
Left colic artery from inferior mesenteric artery.
What supplies the sigmoid colon with blood? Where do the vessels originate?
Sigmoid arteries, branches of the inferior mesenteric artery.
What is the venous drainage for the colon?
Same as supplying arteries, but the veins.
Where does the foregut start and end?
Mouth to descending duodenum (2nd part.)
Where does the midgut start and end?
Inferior duodenum (3rd part) to 2/3 along transverse colon.
Where does the hindgut start and end?
Distal 1/3 of colon to anal canal.
What is the foregut innervated by?
Greater splanchnic nerve (T5-T9.)
What is the midgut innervated by?
Lesser splanchnic nerve (T10-T11.)
What is the hindgut innervated by?
Leasr splanchnic nerve (T12.)