GI Flashcards

(53 cards)

1
Q

which is the lower most costal cartilage which is palpable

A

T10

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2
Q

what level does the transpyloric plane pass through? what is it the half way point between?

A

L1 vertebrae. It is half way between the umbilicus and the sternal notch

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3
Q

name 4 structures lying in the transpyloric plane

A

liver, gall bladder, pylorus and hilum of the spleen.

also the head of the pancrease, and 2nd part of the duodenum

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4
Q

what dermatome is on the umbilicus

A

T10

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5
Q

what is the origin of the external oblique

A

posterior thoracolumbar fascia and lower ribs

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6
Q

how does the external oblique insert?

A

it forms an aponeurosis with the linea albia

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7
Q

what is the origin of the internal oblique

A

posterior lumbar fascia and the iliac crest, to the lateral 2/3rds of the inguinal ligament

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8
Q

what is the surgical importance of the tendinous intersections on the rectus abdominis?

A

they divide the rectus abdominis muscle into portions so that in operations they can section off areas

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9
Q

what are the contents of the rectus sheath

A

rectus abdominis, the inferior and superior epigastric arteries and veins, lymphatics and the terminal branches of the spinal nerves

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10
Q

what structures are supplied by the internal thoracic artery?

A

the anterior thoracic wall, the mammary glands (breasts) and the anterior abdominal wall down to the umbilicus

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11
Q

between which bony points does the inguinal ligament run

A

the anterior superior iliac spine and the pubic tubercle

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12
Q

name 2 common sites for a hernia to occur in the abdomen

A

at the umbilicus and the inguinal canal

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13
Q

the external iliac artery gives off a branch to…..

A

the inferior epigastric

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14
Q

what is the arcuate line

A

the line formed by the inferior aspect of the transversalis fascia

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15
Q

if the patient is lying in supine position where might fluid collect

A

in the peritoneal cavity

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16
Q

what is the ligamentum teres a remnant of

A

the umbilical vein

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17
Q

which structures surround the epiploic foramen

A
anteriorly= the free edge of the lesser omentum
posteriorly= inferior vena cava
inferiorly= duodenum
superiorly= caudate lobe of the liver
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18
Q

what connects teh jejunum to the psoterior abdominal wall?

A

the small bowel mesentry

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19
Q

which parts of the large bowel are intraperitoneal

A

sigmoid colon and transverse colon

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20
Q

what are the borders of the stomach

A

greater curve and lesser curvature

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21
Q

what nerve lies infront of the oesophagus (abdominal) and posteriorly?

A

left vagus is anterior and right vagus is posterior

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22
Q

what structures lie in front of the abdominal oesophagus?

A

left lobe of the liver

23
Q

blood supply of the stomach

A

from the coeliac axis, right and left epiploic arteries, (greater curvature) right and left gastric arteries (lesser curvature) and short gastrics to the fundus

24
Q

which structure passes through the diaphragm alongside the oesophagus

A

left ascending oesophageal artery

25
what is the nerve supply to the stomach?
vagus nerve- parasympathetic, | sympathetic- greater splanchnic from T5-T9
26
which structures lie infront and behind the stomach
``` anteriorly= left lobe of the liver and abdominal wall posteriorly= pancreas, splenic artery and vein, diaphragm ```
27
what structure attaches the stomach to the liver
lesser omentum
28
what is the porto-systemic anastomosis
where the portal system of the liver and the systemic blood systems meet
29
where may merkel's diverticulum be attached?
from the ilium to the umbilicus
30
what structures does the root of the small gut mesentery cross
the aorta, inferior vena cava, right ureter and gonadal artery.
31
how are arterial archades and vasa recta different in the jejenum and ilium
jejenum has long vasa recta and few archades | ilium has short vasa recta and more archades
32
what is the innervation of the small intestine
the vagus nerve to messiners and auerbacks plexus (parasympathetic) and sympathetic innervation from the superior mesenteric plexus
33
what 4 mechanisms ensure high surface area for absorption of nutrients
vili, microvili, plicae and crypts
34
where is McBurney's point?
1/3rds of the way between the anterior superior iliac spine and the umbilicus
35
what are the main differences between the small and large intestine
the large intestine has haustrations (sac like folds), taenia coli and epiploicae appendicies whereas the small intestine does not!
36
what is the significance of the marginal artery of Drummond?
ensures blood supply to both midgut and hindgut is good incase one of the mesenteric arteries occludes
37
where may the tip of the vermiform appendix lie
in the pouch of douglas behind the caecum
38
what is calots triangle, and what are its contents?
a triangle made up of the hepatic ducts, gall bladder and cystic duct and the liver. it contains a lymph node
39
where is the bare area of the liver
top right
40
what is the surface markings of the fundus of the gall bladder
9th costal cartilage midclavicular line on the right
41
what structure degenerates to form the ligamentum venosum
the ductus venosus which is a shunt from the hepatic artery to the inferior vena cava during foetal life
42
what artery lies behind the first part of the duodenum
the gastrointestinal artery- can be eroded by ulcers leading to bleeding
43
what is the embryological significance of the major duodenal papilla?
it is the junction between the foregut and midgut
44
what structures open into the major duodenal papilla
the common bile duct and the major pancreatic duct, it is 5cm distal to the pylorus
45
what is the course of the common bile duct and what does it form from?
It forms from the cystic duct and common hepatic ducts. | It flows posterior to the duodenum, and into the pancrease where it opens into the ampulla of Vater
46
where is the sphincter of Oddi located
between the 2nd and 3rd parts of the duodenum, 5cm distal to the pylorus
47
where does the splenic vein join the superior mesenteric vein?
behind the neck of the pancreas
48
what is the duodenal cap
the first part of the duodenum just dystal to the pylorus
49
how many pancreatic ducts are there
2 ducts- one forms dorsally and the other ventrally. Development of the bud and in rotation they fuse forming the head of the pancrease and unicate process. The superior mesenteric artery is fused between the two.
50
level of transpyloric plane
L1
51
level of subcostal plane
L2
52
level of trantubercular plane
L4
53
where is the spleen found?
behind ribs 9,10,11