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Anatomy > GI > Flashcards

GI Flashcards

1
Q

Describe the anatomy of the TMJ

A

Articulation between condyle of the mandible and the mandibular fossa of the temporal bone
Articular disc allows a small degree “subblux” for greater movement
Superior cavity for translation
Inferior cavity for rotation

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2
Q

List the muscles of mastication

A

Temporalis
Masster
Medial pterygoid
Lateral pterygoid

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3
Q

Which of the 4 muscles of mastication is for opening

A

Lateral pterygoid

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4
Q

Which nerve innervates the muscles of mastication

A

Mandibular division of the trigeminal nerve

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5
Q

Where does the temporalis muscle span

A

Coronoid process of mandible to temporal fossa

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6
Q

Where does the masseter muscle span

A

Angle of mandible to zygomatic arch

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7
Q

Where does the medial pterygoid span

A

Angle of mandible to pterygoid plate of sphenoid bone

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8
Q

Where does the lateral pterygoid span

A

Condyle of mandible to pterygoid plate of sphenoid bone

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9
Q

What is the sensory innervation of the oral cavity

A

Superior half CNV2

Inferior half CNV3

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10
Q

What is the sensory aspect of the gag reflex

A

CN IX

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11
Q

What is the motor aspect of the gag reflex

A

CN IX & CN X

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12
Q

Describe the course of the salivary ducts

A

Parotid: crosses face and secretes into mouth by upper 2nd molar

Submandibular: enters floor of mouth and secretes via lingual caruncle

Sublingual: lays in floor of mouth secretes via several ducts superiorly

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13
Q

What nerve innervated the sublingual salivary gland

A

CN VII

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14
Q

What nerve innervated the sub mandibular salivary gland

A

CN VII

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15
Q

What nerve innervates the paratoid salivary gland

A

CN IX

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16
Q

List the extrinsic muscles of the tongue

A

Genioglossus
Hypoiglossus
Styloglossus
Paloatoglossus

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17
Q

What is the innervation of the genioglossus

A

CN XII

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18
Q

What is the innervation of the hypoiglossus

A

CN XII

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19
Q

What is the innervation of the styloglossus

A

CN XII

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20
Q

What is the innervation of the palatoglossus

A

CN X

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21
Q

What is the funciton of the extrinsic muscles of the tongue

A

To change the position of the tongue during: mastication, swallowing and speech

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22
Q

What is the funciton of the intrinsic muscles of the tongue

A

Modify the shape of the tongue during its functions

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23
Q

What is the innervation of the circular muscle of the pharynx

A

CN X

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24
Q

Explain the musculature of the pharynx

A

3 circular skeletal constrictor muscles that insert to the midline raphe
External layer overlap each other and contract sequentially

3 longitudinal skeletal muscles form the inner layer
Attach to larynx and contract to shorten the pharynx

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25
Q

What is the innervation of the longitudinal muscle of the pharynx

A

CN IX & CN X

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26
Q

Explain the process of swallowing

A

The lips are closed to prevent drooling (orbicularis oris, CN VII)

The tongue pushes the bolus posteriorly (CN XII)

Sequential contraction of the circualr muscles of the pharynx (CN X) pushes the bolus to the oesophagus

The inner longitudinal layers contract (CN IX, CN X) to raise the larynx to close off the laryngeal inlet

The food reaches the oesophagus

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27
Q

Describe the route of the oesophagus

A

Starts from the cricopharyngeus muscle at the level of C6
Posterior to trachea and anterior to the vertebral bodies at rib 1
In chest posterior to heart (contact with left atrium)
In abdomen through diaphragm at T10 where it connects to the stomach immediately at the cardia

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28
Q

State the major features of the oesophagus

A

Anatomical upper sphincter (criocopharyngeus)
Physiological lower oesophageal sphincter
Oesophageal plexus runs on the surface to supply the smooth muscle

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29
Q

State the major observation of the oesophagus on Ba swallow

A 
Cervical constriction
- Cricopharyngeus muscle
Thoracic constriction (s)
- Arch of the aorta
- Left main bronchus
Diaphragmatic constriction
- Result of passing through hiatus of the diaphragm (T10)
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30
Q

What is the Z-line

A

The differentiation between the stomach endothelium and that of the oesophagus

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31
Q

State the areas of the stomach

A

Cardia, immediately after the oesophageal entrance
Fundus, superior part of the stomach
Body, major section
Pyloric antrum, final section just proximal to pyloric sphincter

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32
Q

Where in the abdomen does the stomach lie

A

Left hypochondrium, epigastric and umbilical region

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33
Q

What is posterior to the stomach

A

Spleen, left kidney, splenic artery, pancreas

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34
Q

What is lateral to the stomch

A

Left side: body wall

Right side: liver, gallbladder

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35
Q

What are the areas of the mouth (dentistry)

A

Upper and lower left and right dental arches

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36
Q

How are teeth numbered

A

1 to 8 from medial to lateral

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37
Q

What numbers are the incisors

A

1 & 2

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38
Q

What numbers are the canines

A

3

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39
Q

What numbers are the premolars

A

4 & 5

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40
Q

What numbers are the molars

A

6 to 8

8 is the wisdom tooth

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41
Q

What are the components of the foregut

A

Oesophagus to mid duodenum
Liver + gall bladder
Spleen
1/2 of the pancreas

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42
Q

What are the components of the mid gut

A

Mid duodenum to proximal 2/3 of the transverse colon

1/2 of the pancreas

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43
Q

What are the components of the hindgut

A

Distal 1/3 of the transverse colon to the proximal 1/2 of the anal canal

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44
Q

What are the order of the large intestine segments

A

Caecum (appendix), ascending colon (hepatic flexure), transverse colon (splenic flexure), descending colon and sigmoid colon

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45
Q

What is an intraperitoneal organ

A

Almost completely covered in visceral peritoneum and has minimal mobility

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46
Q

What are organs with a messentary

A

A double folding of the peritoneum internationally to allow mobility

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47
Q

Is the liver intraperitoneal or retroperitoneal

A

Intraperitoneal

48
Q

Is the stomach intraperitoneal or retroperitoneal

A

Intraperitoneal

49
Q

Is the spleen intraperitoneal or retroperitoneal

A

Intraperitoneal

50
Q

Is the kidney intraperitoneal or retroperitoneal

A

Retroperitoneal

51
Q

Is the pancreas intraperitoneal or retroperitoneal

A

Retroperitoneal

52
Q

Which parts of the colon are retroperitoneal

A

Ascending and descending

53
Q

What is the name of the messentery to the appendix

A

Mesoappendix

54
Q

Where is the sympathetic supply to the abdomen from

A

T5 to L2

Abdominopelvic splanchnic nerves

55
Q

Where do sympathetic nerves synapse to the abdominal organs

A

At prevertebral ganglia which are located anterior to the aorta, exit at the same points as the vessels from the aorta

56
Q

Explain the afferent nerves in the abdomen

A

They join together form the periatrial plexuses in which they hitch a ride with the arteries

57
Q

sympathetics to the adrenal glands

A

Sympathetic fibres from T10-L1 enter the abdominopelvic splanchnic nerves
Do not synapse with the prevertebral ganglia
Carried from pariatrial plexus from the prevertebral ganglion to the adrenal gland

58
Q

Explain the parasympathics to the abdomen

A

The vagus nerve enters on the oesophagus surface to enter the periaterial plexus
Carried from here to the organ walls where they synapse

The pelvic splanchnic nerves (S2-4) supply the smooth muscle and glands of the descending colon to anal canal

59
Q

Where is foregut pain refered to

A

Epigastric region

entering at T6-T9

60
Q

Where is the midgut pain refered to

A

Umbilical region

entering at T8-T12

61
Q

Where is the hindgut pain refered to

A

Pubic region

entering at T12-L2

62
Q

Describe the somatic nerves to the abdominal wall

A 
The thoracoabdominal nerves 
- 7 to 11 intercostal nerves
Subcostal nerve 
- T12 anterior rami
Lilohypogastric
- Half of L1 anterior ramus
Llionguinal nerve
- Other half of L1 anterior ramus
63
Q

What is the surface anatomy of the liver

A

Located mostly in the Right Upper quadrant

64
Q 
What are the anatomical relationships of the liver
Diaphragm
Gallbladder
Hepatic flexure of colon
Right kidney
IVC
Abdominal aorta
Stomach
A

Inferior is the right hemi diaphragm
Posterior and inferior is the gallbladder
Inferior is the hepatic flexure of colon
Posterior is the right kidney, IVC and abdominal aorta
Posterior at the mid/left side is the stomach

65
Q

How are the liver segments numbers

A

Numbered from the lingula and numbered clockwise untill VIII

66
Q

What is the content of the portal triad

A

Portal vein
Hepatic artery
Bile duct

67
Q

What are the branches of the coeliac trunk

From left to right

A 
Common hepatic artery
- Hepatic artery proper
- Gastrodudenal artery
-- supraduodenal artery
Left gastric artery
Splenic artery
68
Q

What artery supply the lesser curvature of the stomach

A

The left gastric artery

69
Q

What artery runs posterior to the stomach

A

Splenic artery

70
Q

What is the position of the spleen

A 
Anterior of the diaphragm
Posterior of the stomach
Superior to the splenic flexure
Lateral of the left kidney
Deep to ribs 9-11
71
Q

What is the blood supply to the spleen

A

Splenic artery from the coeliac trunk

72
Q

Where does the coeliac trunk come from the aorta

A

T12

73
Q

What is the major blood supply to the stomach

A

Right (from hepatic artery proper) and left gastric arteries along the lesser curvature
Right and left gastro-omental arteries along the greater curvature

Posterior gastric arteries from the splenic is the minor supply

74
Q

What is the blood supply to the liver

A

Right and left hepatic arteries steming from the hepatic artery proper

Most blood from the hepatic portal vein

75
Q

Where is the hepatorenal recess

A

Between the liver and right kidney

76
Q

Where is the sub-phrenic recess

A

Between the liver and the diaphragm

77
Q

Which vessels form the hepatic portal vein

A

Splenic vein (foregut)
- Inferior mesenteric vein (hindgut)
Superior mesenteric vein (midgut)
IVC, retroperiotoneal and drains cleaned blood to the hepatic vein

78
Q

Define the triangle of callot

A

Formed between cystic duct, hepatic duct and cystic artery

79
Q

How does bile leave the gall bladder

A

Through the cystic duct

80
Q

Explain the biliary tree

A

Right and left hepatic duct joining to the common hepatic duct
Cystic duct from the gall bladder
Cystic and common hepatic joining to form the bile duct
Bile duct drains to the 1st part of duodenum through ampulla of vater and sphincter of oddi

81
Q

What is the position of the pancreas

A

Retroperitoneal

Lies transversely across the posterior abdomen

82
Q

What are the parts of the pancreas

A

Head (with uncinate process)
Neeck
Body
Tail

83
Q

What are minor duodenal sphincters

A

These are entrances of the accessory pancreatic ducts

84
Q

What is the blood supply to the duodenum

A

Gastroduodenal artery to superior pancreaticoduoduodenal artery to inferior pancreaticoduodenal artery

85
Q

Does the jejunum of ileum have a thicker wall

A

Jejunum is thicker

86
Q

Describe the circular folds of the jejunum

A

Large, tall and closely packed folds

87
Q

Describe the circular folds of the ileum

A

Low and sparse folds

88
Q

Blood supply to jejunum?

A

Jejunal arteries from the superior mesenteric artery

89
Q

Blood supply to ileum

A

Ileal arteires from the superior mesenteric artery

90
Q

What level does the superior mesenteric artery leave the abdominal aorta

A

L1

91
Q

What is the blood drainage from the jejunum

A

The jejunal vein

92
Q

What is the blood drainage from the ilium

A

The ileal veins

93
Q

Are the vasa recta shorter in the jejunal or ileal arteires

A

The ileal arteries

They also have more arcades

94
Q

What is the lymph drainage of the abdomen

A 
Named for the major vessels they site on
Coeliac
Superior mesenteric
Inferior mesenteric
Lumbar (on posterior abdo wall)
95
Q

What are the spaces to the side of the colon

A 
Paracolic gutters (left and right)
These are part of the greater sac
96
Q

What is McBurney’s point

A

1/3 way between ASIS to umbilicus

Max tenderness in appendicitis

97
Q

What is the level of the inferior mesenteric artery

A

T3

98
Q

List the branches of the superior mesenteric artery from right to left

A 
Jejunal and ileal arteires
Appendicular
Ileocolic branches
Right colic artery
Middle colic artery
Inferior pancreaticoduodenal artery
99
Q

List the branches of the inferior mesenteric artery from right to left

A

Left colic artery
Sigmoid arteries
Superior rectal artery

100
Q

What is the anatomosis of the colic arteries

A

Marginal arteires of drummond

101
Q

What is the blood supply to the rectum

A

Superior rectal artery (from IMA)

Middle and inferior rectal arteries from the internal iliac artery

102
Q

Whats the veins of the abdomen

A

IVC
Hepatic portal
Splenic along with splenic artery
Superior and inferior mesenteric veins

103
Q

Where are the anastamosis of the portal-systemic vein systems

A

Distal end of oesophagus
Skin around umbilicus
Rectum/anal canals

Where portal hypertension shows

104
Q

Whats the venous drainahe of the rectum and anal canal

A

Superior rectal vein to the inferior mesenteric vein

Middle and inferior rectal veins to the internal iliac vein

105
Q

What is the muscle of the pelvic floor

A

Levator ani

106
Q

What is the lowest point of the standing patient in a male

A

Rectovesical pouch

107
Q

What is the lowest point of the standing patient in a female

A 
Rectouterine pouch (of Douglas)
Vesicouterine
108
Q

What is the major part of the levator ani muscle

A

Puborectalis

- Band from pubic bone wrapping around the anal canal

109
Q

What are the anal sphincters

A

Internal smooth muscle

External skeletal muscle

110
Q

What is the nervous innervation of the external anal sphincter

A

Pudendal nerve (S2-S4)

111
Q

What is the sympathetic innervation of the rectum and anal canal

A

T12 to L2

112
Q

Parasymapthetic innervation of the rectum is from where

A

S2 to S4

113
Q

What is the somatic motor supply to the levator ani

A

Nerve to levator ani (S3, S4)

114
Q

Define the pectinate line

A

The line between the somatic and autonomic innervations

115
Q

Important note on blood supply to rectum memory

A

Hindgut section by superior rectal artery (from IMA)

Body wall from the middle and inferior rectal artery (internal illeac artery)

116
Q

What is the organisaton of drainage of the rectum

A

The middle and inferior rectal vein for a venous plexus in the rectal wall

Anatomy (6 decks)

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