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Anatomy booklet > GI > Flashcards

GI Flashcards

1
Q

What is the upper extent of the abdominal cavity?

A

Anteriorly the under surface of the diaphragm reaches the 5th intercostal space.

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2
Q

Describe the 9 regions of the abdominal wall

A

Right hypochondriac, Epi-gastric, Left hypocondriac
Right lumbar, Umbillical, Left Lumbar
Right iliac, Hypo-gastric, Left illiac

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3
Q

Describe the nerve supply to the skin of the abdominal wall.

A

The dermatomes of the abdominal wall start at thoracic 5 in the upper epigastrium, with thoracic 10 being at the umbilicus and thoracic 12 being just above the hair bearing area in the lower suprapubic area. Each dermatome starts at the back at the level of the named vertebra; the dermatomes run downwards as they pass round the trunk to the front.

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4
Q

How is the rectus sheath formed?

A

In the upper 2/3 of the abdomen the aponeurosis of the external oblique muscle passes in front of rectus abdominis and the aponeurosis of transversus abdominis passes behind. The aponeurosis of internal oblique sends fibres both in front and behind rectus abdominis. In the lower 1/3 of the abdomen all three aponeuroses pass in front of rectus abdominis.

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5
Q

What is the surface marking of the aortic bifurcation?

A

The level of the umbilicus.

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6
Q

In which regions of the abdomen is pain from the three parts of the bowel felt?

A

Foregut; epigastrium
Midgut; umbilical
Hindgut; suprapubic

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7
Q

Describe the anatomy of a ‘six pack’?

A

The rectus abdominis muscle runs vertically from the pubis up to the costal margin. Along its length there are three places where it becomes a tendon. When exercised the muscle hypertrophies (becomes bigger) but the tendinous part stays the same. The result is three bulges (of muscle) between the tendons. This occurs on either side of the midline; six bulges in all.

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8
Q

With the patient in a supine position, where might fluid collect in the abdomen?

A

Posterior to the liver. (remember when we describe positions of structures we use the anatomical position – even if the patient is lying flat (supine)).

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9
Q

What embryological structure forms the ligamentum teres?

A

The umbilical vein, returning blood from the placenta to the liver

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10
Q

Where does the base of the appendix lie (surface marking and internally)?

A

2/3 of the way from the umbilicus to the anterior superior iliac spine, McBurnies point.

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11
Q

Which parts of the bowel have a mesentery?

A

The first 1cm of duodenum, all of the jejunum and ilium, the transverse and sigmoid colon and the appendix.

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12
Q

What structures form the portal triad?

A

Hepatic portal vein, bile duct, hepatic artery

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13
Q

What is the (greater and lesser) omentum?

A

They are sheets of tissue covered on both surfaces with peritoneum and containing fat, blood vessels, lymphatics and nerves. The greater omentum attaches to the greater curve of the stomach and the posterior abdominal wall. The lesser omentum connects to the lesser curve of the stomach and the liver. The lesser omentum also contains the portal triad entering the porta hepatis.

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14
Q

Describe the location of the small bowel in the abdomen.

A

It is positioned centrally and is often separated from the anterior abdominal wall by the greater omentum.

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15
Q

At what vertebral level does the oesophagus pass through the diaphragm?

A

Thoracic 10.

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16
Q

Which structure(s) passes through the diaphragm alongside the oesophagus?

A

The vagal trunks, inferior oesophageal artery and vein.

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17
Q

Draw and name the parts of the stomach.

A

(see diagram)

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18
Q

From where does the stomach receive its nerve supply?

A

Parasympathetic from the vagus nerves, cranial nerve X

Sympathetic from the greater splanchnic nerves, Thoracic nerves T5-T9

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19
Q

What structure attaches the stomach to the liver?

A

Lesser omentum (hepatogastric and hepatoduodenal ligament are partof this)

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20
Q

Which structures lie behind the stomach?

A

The lesser sac, behind the lesser sac is the pancreas and diaphragm.

21
Q

What is a porto-systemic anastomosis?

A

It is a vein which joins to the hepatic portal system (so can carry blood to the liver) to the systemic system. It can take blood from the bowel and bypass the liver to return the blood to the heart.

22
Q

Which vein drains blood from the colon and where does it flow to?

A

Inferior mesenteric vein drains into the splenic vein.

23
Q

Where does lymph from the small bowel drain?

A

Into the cisterna chyli and to the thoracic duct

24
Q

Which foodstuffs are absorbed through the lymphatic system?

A

Lipids

25
Q

What 4 anatomical features ensure the small bowel has a high surface area for absorption of nutrients?

A

Length, mucosal folds (plicae circularis), villi, micro-villi.

26
Q

Where is the junction between the mid gut and the hind gut?

A

2/3 of the way along the transverse colon.

27
Q

How do you distinguish a loop of large intestine from that of small intestine?

A

Large intestine has appendices epiploicae and tenea coli. The small bowel is centrally located and the colon round the sides

28
Q

Which part of the bowel is supplied by sacral nerves 2, 3 and 4?

A

The hind gut.

29
Q

Which artery is the cystic artery a branch of?

A

It is usually the right hepatic artery but it can be the left hepatic or the hepatic artery.

30
Q

Which structures can be found in the porta hepatis?

A

Macroscopically; portal vein, right and left hepatic artery, right and left hepatic duct

Microscopically, lymphatics branches of the vagus and greater splanchnic nerves

31
Q

What structure degenerates to form the ligamentum venosum?

A

The ductus arteriosis; an embryological bypass for the liver which exists before the liver has fully formed.

32
Q

Where is the bare area of the liver?

A

Under the central tendon of the right side of the diaphragm

33
Q

What is the surface marking of the fundus of the gall bladder?

A

The tip of the ninth costal cartilage. Where the midclavicular line crosses the costal margin. The most lateral attachment of the rectus abdominis onto the costal margin. (These are all the same place and just different ways of saying the same thing).

34
Q

Which nerves may relay pain from diseases of the gall bladder and for each nerve where will the patient feel the pain?

A

(answer not provided - my answer)
phrenic - presents as shoulder pain
pain is ‘colicy’ - severe and intense, resolves in 30-90 minutes

35
Q

Can the spleen be palpated during abdominal examination?

A

Normally no, it needs to be considerably enlarged or displaced by a large mass to be palpable.

36
Q

What structures might a tumour of the head of the pancreas involve?

A

The hepatic portal vein, bile duct or pancreatic duct.

37
Q

What structures join to form the common bile duct and what is its course?

A

The common hepatic and cystic duct. The common bile duct runs in the free edge of the lesser omentum and behind the first part of the duodenum, onto the posterior of the pancreas where it enters the pancreas to run alongside the pancreatic duct before opening into the duodenum.

38
Q

Where is the sphincter of Oddi located?

A

On the medial wall of the duodenum between the second and third parts.

39
Q

Which artery lies behind the first part of the duodenum?

A

Gastroduodenal artery

40
Q

What lies between the pancreas and the stomach?

A

The lesser sac

41
Q

How many pancreatic ducts are there? What is the embryological significance?

A

Two; one from the ventral pancreatic bud and one from the dorsal pancreatic bud.

42
Q

What is the function of the Eustachian tube?

A

To equalize the air pressure either side of the tympanic membrane

43
Q

Why is the maxillary sinus more prone to infection?

A

The opening into the nasal cavity is at the top of the sinus so it does not drain easily.

44
Q

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

A

General sensation – Trigeminal nerve, mandibular branch (cranial nerve Vc)

Taste sensation, facial nerve, (cranial nerve VII)

Muscles, hypoglossal nerve, (cranial nerve XII)

45
Q

Where do the ducts for the submandibular salivary glands open into the mouth?

A

Below the tongue

46
Q

Why may disease in the maxillary sinus cause numbness of the cheek?

A

The nerve which gives sensation to the cheek passes in the roof of the maxillary sinus.

47
Q

What are the attachments of the muscles of the tongue?

A

The hyoid bone

48
Q

What structure stops reflux of liquid into the nose during swallowing?

A

The soft palate

Anatomy booklet (6 decks)

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