Gastrointestinal Anatomy Outcomes Flashcards

1
Q

Where is the temporomandibular joint?

A

Between the articular surface of the temporal bone and the condylar processes of the mandible.

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2
Q

Describe the muscles of mastication that open the jaw.

A

The lateral pterygoid is the only muscle responsible for opening the jaw.

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3
Q

Describe the muscles of mastication that close the jaw.

A

Temporalis, masseter, and medial pterygoid.

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4
Q

What innervates the muscles of mastication?

A

The mandibular division of the trigeminal nerve - CN V3.

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5
Q

Describe the medial pterygoid.

A

Muscle of mastication. CLOSES jaw. From the angle of the mandible (medial side) to the pterygoid plates of the sphenoid bone.

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6
Q

Describe the lateral pterygoid.

A

Muscle of mastication. OPENS jaw.

From the condyle of the mandible to the pterygoid plates of the sphenoid bone.

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7
Q

Describe the temporalis muscle.

A

Muscle of mastication. CLOSES jaw. From the coronoid process of the mandible to the temporal fossa.

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8
Q

Describe the masseter muscle.

A

Muscle of mastication. CLOSES jaw. From the angle of the mandible to the zygomatic arch.

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9
Q

Major features of the oral cavity?

A
Hard palate superiorly.
Pharynx posteriorly.
Tongue inside.
Mandible and teeth anteriorly.
Muscle of the floor of the mouth, hyoid bone & epiglottis inferiorly.
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10
Q

Describe the anterior anatomy of the tongue.

A

Anterior 2/3rds = horizontal part. In the oral cavity, responsible for taste (CNVII) - foliate, vallate & fungiform papillae. General sensory (CNV3)- filiform papillae: touch, temperature etc.

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11
Q

Describe the posterior anatomy of the tongue

A

Posterior 1/3rd = vertical part. In the oropharynx. Enables taste and general sensation (CNIX)

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12
Q

Which nerve provides innervation to the lingual nerve branch of the anterior 2/3rds of the tongue?

A

Chorda tympani branch of CN VII: connects to the lingual nerve branch of CN V3 providing taste to the anterior 2/3rd of the tongue. Parasympathetic.

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13
Q

which parasympathetic nerve supplies secretomotor innervation to the submandibular salivary gland?

A

CN VII parasympathetic axons.

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14
Q

which parasympathetic nerve supplies secretomotor innervation to the sublingual salivary gland?

A

CN VII.

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15
Q

what provides the superior half of the oral cavity with general sensation?

A

CN V2

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16
Q

What provides the inferior half of the oral cavity with general sensation?

A

CN V3

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17
Q

Describe the components of the gag reflex.

A

protective reflex against foreign body entry into the pharynx/larynx.
Sensory part carried out by CN IX.
Motor part carried out by CN IX and CN X.
Pharynx constricts, attempting to close off entry.

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18
Q

Describe parotid gland.

A

Parotid duct crosses the face & secretes into the mouth by the upper 2nd molar.

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19
Q

Describe submandibular gland.

A

Submandibular duct enters the floor of the mouth & secretes via the lingual caruncle.

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20
Q

Describe the sublingual gland.

A

Lays in floor of mouth secretes via several ducts superiorly.

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21
Q

Extrinsic muscles of the tongue.

A

Change tongue position. 4 pairs: hyoglossus, styloglossus, genioglossus, palatoglossus. All innervated by CN XII, EXCEPT PALATOGLOSSUS.

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22
Q

Intrinsic muscles of the tongue

A

4 pairs. Modify shape of tongue. Innervated by CN XII.

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23
Q

Function of the pharynx.

A

Contracts sequentially - peristaltic.

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24
Q

Describe pharynx structure.

A

External layer of circular constrictor muscles, voluntary & overlap each other. Innervated by CN X.

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25
Q

Describe inner longitudinal muscles of the pharynx.

A

Inner layer - supplied mainly by CN X and IX. Elevate pharynx & larynx.

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26
Q

Function of longitudinal muscles of the pharynx.

A

Contract to shorten pharynx.

Raise the larynx to close over the laryngeal inlet.

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27
Q

Enteric Nervous system

A

Extensive nerve network.
Found only in walls of GI tract.
Independent of other parts of the nervous system - but can be influenced by autonomic motor nerves.

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28
Q

Lower oesophageal sphincter.

A

Physiological rather than anatomical sphincter. Due to contraction of diaphragm, slightly higher intra-abdominal pressure than intragastric & the oblique angle at which the oesophagus enters the cardia of the stomach.

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29
Q

Presence of this reduces effectiveness of lower oesophageal sphincter.

A

Hiatus hernia.

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30
Q

Anatomical location of lower oesophageal sphincter.

A

Immediately superior to gastro-oesophageal junction. Abrupt change in type of mucosa lining the wall - z-line.

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31
Q

areas of the stomach.

A

Cardia, fundus (superior), greater curvature, body, pyloric antrum, lesser curvature. Pyloric sphincter.

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32
Q

Anatomical location of the stomach.

A

Mainly in the left hypochondrium, epigastric & umbilical regions when supine.

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33
Q

Anatomical relations of the stomach.

A

Lesser omentum superiorly.
Greater omentum inferiorly.
Left hemi-diaphragm superiorly.

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34
Q

Composition of the small intestine

A

Duodenum, jejunum, ileum.

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35
Q

Large intestine

A

colon, rectum anal canal, anus

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36
Q

Colon

A

Caecum, appendix, ascending colon, transverse colon, descending colon, sigmoid colon.

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37
Q

foregut organs

A

Oesophagus, stomach, mid-duodenum, liver, gallbladder, spleen, 1/2 of pancreas.

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38
Q

Midgut organs

A

Mid-duodenum to proximal 2/3 of transverse colon, 1/2 of pancreas

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39
Q

Hindgut organs

A

distal 1/3rd of transverse colon to proximal 1/2 anal canal.

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40
Q

nine areas of the abdomen

A
R&L hypochondrium
L&R lumbar
L& R inguinal
Epigastric
Umbilical
Pubic
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41
Q

muscles of the anterolateral abdominal wall

A

Rectus abdominis
External oblique
Internal oblique
Transversus abdominus

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42
Q

Peritoneal Cavity

A

The peritoneal cavity lies between the visceral & parietal layers of the peritoneum.

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43
Q

Peritoneum

A

Peritoneum is a thin, transparent, semi-permeable continuous membrane. Lines walls of the abdominopelvic cavity & organs.

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44
Q

intraperitoneal organs

A

almost completely covered in visceral peritoneum, minimally mobile.

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45
Q

Intraperitoneal organs with a mesentery

A

Covered in visceral peritoneum which wraps behind the organ to form a double layer - mesentery.

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46
Q

Mesentery

A

Suspends an organ from the posterior abdominal wall - very mobile.

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47
Q

retroperitoneal organs

A

only has visceral peritoneum on its anterior surface, located in the retroperitoneum.

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48
Q

omentum

A

double layer of peritoneum that passes from stomach to adjacent organs

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49
Q

peritoneal ligaments

A

double layer of peritoneum connecting organs to one another or the body wall.

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50
Q

greater omentum

A

four layered, hangs like an apron. Attaches greater curvature of stomach to transverse colon.

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51
Q

Lesser omentum

A

Double layered, runs between the lesser curvature of the stomach & duodenum to the liver. Has a free edge.

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52
Q

Greater and lesser sacs.

A

omenta divide peritoneal cavity into a greater and lesser sac.
Lesser sac is much smaller, two sacs communicate through ommental foramen.

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53
Q

Lies at the free edge of the lesser omentum

A

Portal triad.

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54
Q

peritoneum drapes over the superior aspect of pelvic organs to form pouches. how do they differ in males & females?

A

One pouch in the male - RECTOVESICAL POUCH.

Two pouches in the female - VESICO-UTERINE & RECTO-UTERINE POUCH.

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55
Q

Pouch of douglas

A

Recto-uterine pouch

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56
Q

abdominocentesis/paracentesis

A

needle placed lateral to the rectus sheath to drain ascetic fluid from the peritoneal cavity

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57
Q

Inferior epigastric artery

A

ascends in the anterior abdominal wall deep to rectus abdominis,
Arises from the external iliac, medial to the deep inguinal ring.

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58
Q

Biliary tree

A

set of tubes connecting liver to the 2nd part of the duodenum.

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59
Q

Liver

A

Largest organ in the body. Receives nutrients absorbed from GI tract.

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60
Q

Liver surface anatomy

A

mainly located in RUQ, protected by ribs 7-11, location changes in breathing.

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61
Q

anatomical lobes of liver

A

right, left, caudate and quadrate lobes

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62
Q

porta hepatis

A

site of entrance for portal triad structures

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63
Q

Functional lobes of the liver allow for what

A

segmentectomy: branch of hepatic artery, hepatic portal vein, bile drainage (bile duct), venous drainage (to IVC).

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64
Q

how many hepatic veins join together before entering the IVC.

A

Hepatic veins join together as 3 veins before entering the IVC.

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65
Q

Portal triad

A

Hepatic portal vein, hepatic artery proper, the bile duct.

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66
Q

First of three midline branches of the aorta, retroperitoneal, leaves aorta at T12 vertebral level.
Supplies organs of the foregut.

A

Coeliac trunk

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67
Q

trifurcates into 3 branches: splenic artery, left gastric artery & common hepatic artery.

A

Coeliac trunk

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68
Q

Intraperitoneal organ within the left hypochondrium. Protected by ribs 9-11

A

Spleen

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69
Q

Artery with a very tortuous course that runs along the superior border of the pancreas.

A

Splenic artery.

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70
Q

Functions within the haematological system to break down red blood cells to produce bilirubin.

A

Spleen

71
Q

Blood supply to the stomach

A

R&L gastric arteries, run along juncture of lesser curvature & lesser omentum & anastomose together.
R&L gastro-omental arteries, run along the junction of greater curvature & greater omentum & anastomose together.

Minor: posterior gastric arteries & short gastric arteries.

72
Q

Blood supply to the liver

A

R & L hepatic arteries - branches of the hepatic artery proper.
20-25% of blood received by liver.

Majority from the hepatic portal vein.

73
Q

2 clinically important areas of the peritoneal cavity related to the liver.

A

Hepatorenal recess (Morrison’s pouch) and sub-phrenic recess.

74
Q

Where are the hepatorenal and sub-phrenic recesses located?

A

Hepatorenal recess is posterior to the liver, and subphrenic is anterior.
Both lie within the peritoneal cavity.

75
Q

One of the lowest parts of the peritoneal cavity when the patient is supine

A

Hepatorenal recess.

76
Q

Pus from an abscess in the subphrenic recess can drain into where when a patient is bedridden?

A

Hepatorenal recess

77
Q

Hepatic portal vein drains blood from where to the liver, for first pass metabolism?

A

Foregut, midgut & hindgut.

78
Q

Splenic vein & superior mesenteric vein form what?

A

Hepatic portal vein.

79
Q

Drains blood from the hindgut to the splenic vein

A

Inferior mesenteric vein.

80
Q

Drains foregut

A

Splenic vein

81
Q

Drains midgut

A

Superior mesenteric vein

82
Q

Drains hindgut to splenic vein

A

Inferior mesenteric

83
Q

Retroperitoneal, drains cleaned blood from hepatic veins into the right atrium.

A

Inferior vena cava

84
Q

Lies on the posterior aspect of the liver (often firmly attached).

A

Gallbladder

85
Q

Stores & concentrates bile in between meals.

A

Gallbldder

86
Q

Bile flows in and out of the gallbladder via the

A

cystic duct

87
Q

Blood supply to the gallbladder is via the ?

A

cystic artery (usually a branch of the right hepatic artery)

88
Q

Cystic artery is located where

A

cystohepatic triangle of calot

89
Q

Foregut organ - early pain will present in the epigastric region. May also present in the right hypochrondrium with or w/o referral to the right shoulder. Visceral afferents enter the spinal cord between T6-T9.

A

Gallbladder

90
Q

Surgical removal of the gallbladder

A

cholecystectomy

91
Q

Bilirubin is used to form bile where?

A

In the liver

92
Q

Biliary tree

A

transports bile. R & L hepatic ducts unite to form - common hepatic duct.
Common hepatic duct unite with cystic duct to form the common bile duct.

93
Q

Begins at the pyloric sphincter. 4 parts: superior (partly intraperitoneal), descending (retroperitoneal), horizontal (retroperitoneal) and ascending (retroperitoneal).

A

Duodenum

94
Q

Anatomical sphincter controlling the flow of chyme from the stomach to the duodenum. Smooth muscle - autonomic nerves.

A

Pyloric sphincter.

95
Q

Ends at the duodenojejunal flexure. Secretes a number of peptide hormones into the blood - gastrin, CCK.

A

Duodenum

96
Q

Pain from an ulcer of this structure tends to present at the epigastric region.

A

Duodenum

97
Q

Retroperitoneal organ which lie transversely across the posterior abdomen.

A

Pancreas.

98
Q

Has: head (with uncinate process), neck, body, tail.

A

Pancreas

99
Q

The head of this structure is described as being surrounded by the “c-shape” formed by the duodenum.

A

Pancreas

100
Q

Lies posteriorly to the stomach. Retroperitoneal.

A

Pancreas.

101
Q

Secretes pancreatic digestive enzymes into the min pancreatic duct.

A

Exocrine acinar cell.

102
Q

Secretes insulin & glucagon into the bloodstream.

A

Endocrine islets of langerhans.

103
Q

Bile duct travels into a groove on the posterior aspect of the pancreas, joins with the main pancreatic duct to form?

A

Ampulla of Vater.

104
Q

Where does the ampulla of vater drain?

A

Into the 2nd part of the duodenum.

105
Q

smooth muscle sphincters of the biliary system

A

Bile duct sphincter, pancreatic duct sphincter, sphincter of Oddi.

106
Q

Investigation used to study the biliary tree & pancreas. Also able to treat some associated pathologies.

A

ERCP

107
Q

Bile is diverted into the pancreas leading to irritation & inflammation due to what?

A

Blockage of the ampulla by a gallstone causing pancreatitis.

108
Q

Foregut AND midgut organ. Pain can present in epigastric region and/or umbilical region. May radiate to patients back

A

Pancreas

109
Q

Grey turner’s and Cullen’s sign arise due to what

A

Vascular haemorrhage in acute pancreatitis, leading to blood/fluid accumulation in the retroperitonea space.

110
Q

duodenum, jejunum, ileum

A

small intestines

111
Q

foregut organs of the small intestines

A

1st and 2nd parts of the duodenum

112
Q

Midgut organs of the small intestines

A

Jejunum, ileum and duodenum (EXCEPT 1st & 2nd parts)

113
Q

peyer’s patches present where in the small intestine

A

lymphoid tissue present in the ileum

114
Q

Arterial blood supply of jejunum and ileum

A

superior mesenteric artery via jejunal and ileal arteries

115
Q

Venous drainage from jejunum & ileum

A

Jejunal and ileal veins to superior mesenteric vein, to the hepatic portal vein.

116
Q

Leaves aorta at L1, posterior to the neck of the pancreas. Travel inferiorly, anterior to the uncinate process of the pancreas to enter the mesentery proper.

A

superior mesenteric vessels

117
Q

Lymph nodes of foregut organs

A

coeliac

118
Q

Lymph nodes of midgut organs

A

superior mesenteric

119
Q

Lymph nodes of hindgut organs

A

inferior mesenteric

120
Q

Lymph nodes of kidneys, posterior abdominal wall, pelvis & lower limbs.

A

Lumbar

121
Q

Major lymphatic drainage angle

A

thoracic duct at the left venous angle

122
Q

Drains lymph from right (1/4) of the body

A

Right lymphatic duct at the right venous angle.

123
Q

intraperitoneal and secondarily retroperitoneal organ, which has its own mesentery. Inferior to liver and spleen.

A

Colon

124
Q

L & R - lie between the lateral edges of the ascending & descending colon, and the abdominal wall.

A

R& L paracolic gutters.
R- ascending
L- descending

125
Q

the paracolic gutters are part of what

A

the greater sac of the peritoneal cavity.

126
Q

omental appendices, teniae coli, haustra.

A

Colon

127
Q

3 distinct longitudinal bands of thickened smooth muscle, running from the caecum to the distal end of the sigmoid colon & come together at the appendix.

A

Teniae coli

128
Q

small fatty projections of the colon

A

omental appendices

129
Q

formed by tonic contraction of the teniae coli

A

haustra

130
Q

Most common position of the appendix

A

retrocaecal

131
Q

McBurney’s point

A

1/3 of the way between the right ASIS to the umbilicus. Supposedly maximum tenderness in appendicitis

132
Q

Lies in the left iliac fossa. Long mesentery.

A

Sigmoid colon

133
Q

Long mesentery of sigmoid colon increases risk of what

A

sigmoid volvulus - bowel obstruction & infarction

134
Q

midline retroperitoneal structure, lies anterior to the vertebral bodies & to the left of the IVC.

A

Abdominal aorta

135
Q

Lateral branches of abdominal aorta

A

Renal arteries, gonadal arteries, lumbar arteries.

136
Q

abdominal aorta bifurcates into what?

A

The internal and external iliacs

137
Q

Branches of the superior mesenteric artery

A

jejunal and ileal arteries, appendicular, ileocolic, right colic, middle colic, inferior pancreaticoduodenal,

138
Q

vasa rectae and arcades of jejunum

A

long vasa rectae

Larger and fewer arcades

139
Q

vasa rectae and arcades of ileum

A

Short vasa rectae, small and many arcades

140
Q

branches of inferior mesenteric artery

A

left colic, sigmoid arteries, superior rectal artery.

141
Q

arterial anastomoses between branches of SMA and IMA

A

marginal artery of drummond

142
Q

Blood supply to rectum and anal canal

A

superior rectal artery, branch of IMA

143
Q

Epigastric veins drain where?

A

caval system

144
Q

Para-umbilical veins drain to the hepatic portal vein along what

A

the round ligament of the liver.

145
Q

superior part of the distal end of the oesophagus drains to what?

A

Azygous vein

146
Q

inferior part of the distal end of the oesophagus drains to what?

A

Hepatic portal vein

147
Q

rectum and superior anal canal drains to what?

A

inferior mesenteric vein

148
Q

inferior part of the GI tract drains to?

A

Internal iliac veins

149
Q

What senses “fullness of the rectum”?

A

Visceral afferent nerve fibres.

150
Q

What responds to “fullness” of the rectum?

A

Functioning muscle sphincters around the distal end of the GI tract.

151
Q

Lies within the bony pelvis, continuous with the abdominal cavity. Lie between the pelvic inlet & pelvic floor.

A

Pelvic cavity

152
Q

Contains pelvic organs & supporting tissues. Rectum is located within.

A

Pelvic cavity

153
Q

skeletal muscle that forms the pelvic floor

A

levator ani muscle.

154
Q

Sigmoid colon become the rectum here

A

Anterior to S3 at the rectosigmoid junction.

155
Q

Rectum becomes the anal canal here

A

anterior to the tip of the coccyx, just prior to passing through the levator ani muscle

156
Q

Rectum is where?

Anal canal & anus are where?

A

Pelvis.

Perineum

157
Q

Lies immediately superior to the levator ani muscle.

Walls relax to accommodate faecal material

A

Rectal ampulla

158
Q

covers the superior rectum

A

peritoneum

159
Q

in males, lies anterior to inferior rectum

A

Prostate gland

160
Q

in females, lies anterior to inferior/middle rectum.

A

Vagina & cervix

161
Q

Provides continual support for pelvic organs - tonically contracted most of the time.

A

levator ani muscle

162
Q

Muscle must relax to allow defecation and urination

A

levator ani muscle

163
Q

part of the levator ani muscle, particularly important for maintaining faecal continence

A

puborectalis

164
Q

internal anal sphincter muscle?

A

smooth muscle - involuntary. Contraction stimulated by sympathetic nerves.

165
Q

external anal sphincter muscle?

A

skeletal muscle - voluntary. Contraction stimulated by pudendal nerve.

166
Q

Branch of the sacral plexus, supplies the external anal sphincter

A

pudendal nerve

167
Q

marks the junction between the part of the embryo which formed the GI tract & part which formed the skin.

A

Pectinate line

168
Q

lymph drainage of inferior pelvic structure

A

internal iliac nodes

169
Q

lymph drainage of lower limb & more superior pelvic structures.

A

External iliac nodes

170
Q

drains lymph from external and internal iliac nodes.

A

common iliac nodes

171
Q

lymph draining from common iliac nodes drains to where?

A

lumbar nodes.

172
Q

Lie on each side of the anal canal, filled with fat & loose connective tissue. Two fossae which communicate with each other posteriorly.

A

Ischioanal fossae

173
Q

Infection within the ischioanal fossa

A

ischioanal abscess