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GI Flashcards

1
Q

Describe the path through the GI tract

A 
Oesophagus
Stomach
Duodenum
Jejunum
Ileum
Cecum
Asc. colon
Transverse colon
Desc. colon
Sigmoid colon
Rectum
1/3 of anal canal
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2
Q

Where is the intertubercular plane?

A

Where the abdominal aorta bifurcates (L4)

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3
Q

Where is the subcostal plane?

A

Beneath the most inferior rib

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4
Q

Where is the transpyloric plane?

A

Halfway between jugular notch and superior pubic symphysis.

Tip of 9th costal cartilage

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5
Q

What lies on the transpyloric plane? (7)

A 
Gallbladder
Pylorus of stomach
D1 of duodenum
Duodeno-jejunal flexure
Hepatic flexure of colon
Splenic flexure of colon
Neck of pancreas
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6
Q

Where is McBurney’s point?

A

On the right side of abdomen!

2/3rds along a line joining umbilicus and right ASIS

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7
Q

Why is McBurney’s point important?

A

Appendix lies here

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8
Q

Where is the intercristal plane?

A

Lies along highest point of the pelvis

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9
Q

What’s the lateral superior region of the abdomen called?

A

R + L hypochondrium

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10
Q

What’s the lateral-medial region of the abdomen called?

A

R + L flank

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11
Q

What’s the lateral inferior region of the abdomen called?

A

R + L iliac fossa

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12
Q

What’s the medial superior region of the abdomen called?

A

Epigastrium

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13
Q

What’s the middle region of the abdomen called?

A

Umbilicus

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14
Q

What’s the medial inferior region of the abdomen called?

A

Hypogastrium/ Suprapubic

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15
Q

What regions follow the flank posteriorly?

A

Lion and lumbar region

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16
Q

List the muscles of the abdomen working your way IN.

A 
Serratus anterior
External oblique (and its aponeurosis)
Internal oblique
Transverse oblique
Rectus abdominis
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17
Q

What is the linea alba?

A

Fibrous structure running down midline of the abdomen (from xiphoid process to the pubic symphysis)

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18
Q

What doesn’t cross the midline of the abdomen?

A

Muscle fibres

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19
Q

What structures make up the foregut? (8)

A

Oesophagus, stomach, D1 and D2 of duodenum, liver, gallbladder, pancreas and spleen

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20
Q

Blood supply of the foregut?

A

Coeliac trunk

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21
Q

Sympathetic innervation of the foregut?

A

Greater splanchnic nerve (T5-9)

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22
Q

Parasympathetic innervation of foregut?

A

Vagus

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23
Q

Pain in foregut is referred to?

A

Epigastrium

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24
Q

What structures lie in the midgut?

A

D3 and D4 of the duodenum, jejunum, ileum, cecum, appendix, ascending colon, 2/3 along transverse colon

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25
Q

Blood supply of midgut?

A

Superior mesenteric artery

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26
Q

Sympathetic innervation of midgut?

A

Lesser splanchnic nerve (T10-11)

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27
Q

Pain in midgut is referred to?

A

Umbilicus

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28
Q

What structures lie in the hindgut?

A

Last 1/3 of transverse colon, descending colon, sigmoid colon, rectum, upper 1/3 anal canal

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29
Q

Blood supply of the hindgut?

A

Inferior mesenteric artery

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30
Q

Innervation of the hindgut?

A

Least splanchnic nerve (T12)

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31
Q

The rectus abdominis is surrounded by what structure?

A

Rectus sheath

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32
Q

Relationship between rectus abdominis and aponeurosis of transverse oblique

A

Aponeurosis of TO passes BEHIND the rectus abdominis

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33
Q

Relationship between rectus abdominis and internal oblique

A

One part of IO passes OVER and the other part BEHIND the rectus abdominis muscle

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34
Q

Relationship between rectus abdominis and aponeurosis of external oblique

A

Aponeurosis of EO passes OVER the rectus abdominis

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35
Q

What are the 3 ligaments of the liver?

A

Coronary ligament
Falciform ligament
Round ligament (ligamentum teres)

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36
Q

What does the coronary ligament do?

A

Attaches the liver to the inferior surface of the diaphragm

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37
Q

What does the falciform ligament do? (2)

A

Attaches liver to the anterior abdominal wall

Separates liver into R + L lobes

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38
Q

Where does the stomach lie in relation to the liver?

A

Stomach lies deep to the left lobe of the liver

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39
Q

Where does the stomach lie in relation to the liver?

A

Stomach lies deep to the left lobe of the liver

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40
Q

Where does the gallbladder lie in relation to the liver?

A

Gallbladder sits on inferior surface of the right lobe of the liver

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41
Q

What is the lesser omentum?

A

Thin fatty sheet of tissue containing blood vessels and nerves

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42
Q

How is the lesser omentum attached?

A

Attaches the lesser curvature of stomach to the liver superiorly.
Contains the portal triad entering the porta hepatis

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43
Q

What is the free edge of the lesser omentum called?

A

Epiploic foramen (foramen of Winslow)

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44
Q

What is the porta hepatis and why is it important?

A

Deep fissure on inferior surface of liver.

Contains portal triad.

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45
Q

What is the portal triad? (from posterior to anterior –> VAD)

A

Portal vein
Hepatic artery
Bile duct

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46
Q

What is the greater omentum?

A

Double layer of peritoneum that sits over the small intestines and encloses the transverse colon

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47
Q

How is the greater omentum attached?

A

Attached to the greater curvature of the stomach, descends and then doubles back to attach onto the posterior abdominal wall

48
Q

What is the lesser sac?

A

Peritoneal space behind the stomach

49
Q

What forms the lesser sac?

A

Lesser omentum.

Epiploic foramen forms its entrance

50
Q

What 3 arteries branch off the celiac trunk?

A

Common hepatic artery
Splenic artery
Left gastric artery

51
Q

What branches off the common hepatic artery?

A

Right gastric artery
Proper hepatic artery
Gastroduodenal artery

52
Q

Which artery gives the right gastroepiploic artery?

A

Gastroduodenal artery

53
Q

Which artery gives the left gastroepiploic artery?

A

Splenic artery

54
Q

Branches of the left gastric artery?

A

Oesophageal arteries

Short gastric arteries

55
Q

Where does the gastroduodenal artery lie?

A

Behind D1 of duodenum

56
Q

Blood supply to the small bowel?

A

Branches coming off the left side of SMA

57
Q

Branches of the SMA?

A 
Middle colic (transverse colon)
Right colic (asc. colon)
Ileocolic (distal ileum, cecum, appendix)
58
Q

Branches of the IMA?

A

Left colic (desc. colon)
Sigmoid artery
Superior rectal artery

59
Q

Is the duodenum retroperitoneal or extraperitoneal?

A

Retroperitoneal

60
Q

What’s imporant about D2 of the duodenum?

A

Where common bile/pancreatic duct enter

61
Q

What’s important about D3 of duodenum?

A

SMA and SMV run over it

62
Q

Where does the ileum join the cecum?

A

At ileocecal valve

63
Q

What are the two mobile parts of the colon?

A

Transverse colon
Sigmoid colon
(Both have a mesentery.)

64
Q

What are the two immobile parts of the colon?

A

Ascending colon
Descending colon
(Both are retroperitoneal.)

65
Q

How can you distinguish large bowel from small bowel? (3)

A

Appendicies epiploicaes
Haustral folds
Teniae coli

66
Q

What gives the small bowel its large SA? (4)

A

Large length
Plicae circulares
Villi
Microvilli

67
Q

How does the blood supply of the jejunum and ileum differ?

A

Jejunum:

  • Long vasa recta
  • Long arcades

Ileum:

  • Short vasa recta
  • Multiple short arcades on top of each other
68
Q

How can you differentiate jejunum from ileum? (4)

A

Jejunum:

  • Red
  • Many plicae circulares
  • Less fat
  • Lymph aggregates (Peyer’s patches) less common

Terminal ileum:

  • Pink
  • Fewer plicae circulares
  • More fat
  • Lymph aggregates (Peyer’s patches) common
69
Q

What is the upper extent of the abdominal cavity?

A

5th intercostal cartilage (diaphragm)

70
Q

What’s the lower extent of the abdominal cavity?

A

Pubic symphysis

71
Q

What embryological structure forms the ligamentum teres/ round ligament?

A

Umbilical vein (from placenta back to liver)

72
Q

What structures lie behind the lesser sac?

A

Pancreas

Diaphragm

73
Q

Where does lymph from the small bowel drain?

A

Into the cisterna chyli and up thoracic duct

74
Q

What foodstuffs are absorbed through the lymphatic system?

75
Q

Cystic artery is a branch of which artery?

A

Right hepatic artery (more commonly)

76
Q

What separates the R +L lobes of the liver posteriorly?

A

Ligamentum venosum

77
Q

What structure degenerates to form the ligamentum venosum?

A

Ductus venosum

on posterior side, caudate side

78
Q

What are the four lobes on the inferior surface of the liver?

A 
Right lobe (caudate lobe and quadrate lobe)
Left lobe
79
Q

What structures enclose the caudate lobe? (3)

A

IVC
Groove for the ligamentum venosum
Porta hepatis

80
Q

What structures enclose the quadrate lobe? (3)

A

Gallbladder
Porta hepatis
Groove for ligamentum teres

81
Q

Where is the bare area of the liver?

A

Under the central tendon of the right side of the diaphragm

82
Q

Surface marking of the fundus of the gallbladder?

A

Tip of 9th costal cartilage

83
Q

Where do the hepatic veins drain?

A

Directly into the IVC

84
Q

Name the regions of the pancreas (5)

A

Head (head and uncinate process)
Neck
Body
Tail

85
Q

What regions lie in close proximity to the head of the pancreas? (4)

A 
Hepatic portal vein
Bile duct
Pancreatic duct
SMA
SMV
86
Q

Name the regions of the stomach (5)

A 
Cardia
Fundus
Body
Antrum
Pylorus
87
Q

The inner membrane of the stomach is folded into…

88
Q

What structures form the common bile duct?

A

R + L hepatic ducts

Cystic duct

89
Q

What is the sphincter of Oddi?

A

Muscular valve that keeps food from entering the ducts

90
Q

Where is the sphincter of Oddi located?

A

On medial wall of duodenum, between D2 and D3

91
Q

What structures enter the liver?

A

Portal vein

Hepatic artery

92
Q

What structures leave the liver?

A

Hepatic ducts

Hepatic veins

93
Q

What is the ampulla of Vater?

A

Opening of the bile/pancreatic ducts into duodenum

94
Q

What is the nerve supply to the anterior 2/3 of the tongue?

A

Taste: Facial CN VII
General: Trigeminal CN Vc
Motor: Hypoglossal CN XII

95
Q

What is the nerve supply to the posterior 1/3 of the tongue?

A

Taste: glossopharyngeal CN IX
General: glossopharyngeal CN IX
Motor: hypoglossal CN XII

96
Q

What innervates the salivary glands?

A

Facial nerve [CN VII]: submandibular and sublingual

Glossopharyngeal nerve [CN IX]: parotid gland

97
Q

What encloses the hard palate?

A

Maxilla

Palatine bone

98
Q

What forms the soft palate? (5)

A 
Tensor palatine
Levator palatine
Musculus uvuli
Palataglossus
Palatopharyngeus
99
Q

What are the attachments of the muscles of the tongue?

A

Hyoid bone

100
Q

Function of the Eustachian tube?

A

To equalize air pressure on either side of tympanic membrane

101
Q

What 3 bones form the nasal septum?

A

Perpendicular plate of the ethmoid bone
Vomer
Septal cartilage

102
Q

Name the four sinuses in the skull

A

Temporal sinus
Ethmoid sinus
Sphenoid sinus
Maxillary sinus

103
Q

Why is the maxillary sinus more prone to infection?

A

Opening into nasal cavity is from the top, so doesn’t drain easily

104
Q

What drains into the middle meatus?

A

Frontal sinus
Ethmoid sinus
Maxillary sinus

105
Q

What drains into the inferior meatus?

A

Nasolacrimal duct

106
Q

What drains into the superior meatus?

A

Sphenoid sinus

107
Q

Where do the tonsils lie?

A

Gap between palatoglossus and palatopharyngeus muscle

108
Q

Below what line do all the aponeuroses of the abdominal wall muscles travel anteriorly to the rectus abdominis?

A 
Arcuate line
(This happens in lower 1/3 of abdomen.)
109
Q

What is the parasympathetic nerve supply of the hindgut?

A

Sacral 2, 3, 4

110
Q

Medial border of Calot’s triangle?

A

Common hepatic artery

111
Q

Inferior border of Calot’s triangle?

A

Cystic duct

112
Q

Superior border of Calot’s triangle?

A

Inferior border of the liver

113
Q

What’s structures lie in Calot’s triangle?

A

R hepatic artery
Cystic artery
Lymph node of Lund
Lymphatics

114
Q

Why is Calot’s triangle important?

A

Important in laparoscopic cholecystectomy (removal of gallbladder)

115
Q

What structure lies behind the head of the pancreas?

116
Q

A duodenal ulcer can cause bleeding from which vessel?

A

Gastroduodenal artery

Anatomy (13 decks)

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