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Gastrointestinal Anatomy and Histology > GI A + H > Flashcards

GI A + H Flashcards

1
Q

the transpyloric plane exists at what vertebral level

A

L1

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2
Q

the subcostal plane exists at what vertebral level

A

L3

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3
Q

the transtubercular plane exists at what vertebral level

A

L5

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4
Q

the interspinous plane exists at what vertebral level

A

S2

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5
Q

neurovascular bundles in the abdominal wall run between which muscular layers

A

transversus abdominis

internal oblique

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6
Q

name the superficial lymph nodes that drain the abdomen and thorax as well as the landmark that delineates to which nodes lymph will drain

A

the transumbilical plane is the demarcating feature
above the transumbilical plane: axillary and parasternal lymph nodes
below the transumbilical plane: superficial inguinal lymph nodes

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7
Q

identify the deep lymph nodes that drain the abdomen

A

external iliac nodes
common iliac nodes
lumbar (caval or aortic nodes)

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8
Q

identify the venous drainage of the abdomen

A

thoracoepigastric vein
peri-umbilical vein
superficial epigastric vein

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9
Q

what forms the median umbilical fold?

A

Median umbilical ligament

remnant of urachus

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10
Q

what forms the medial umbilical fold?

A

medial umbilical ligament

remnant of obliterated umbilical arteries

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11
Q

what forms the lateral umbilical folds?

A

inferior epigastric arteries and veins

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12
Q

the supravesicular fossa is defined by what abdominal features

A

median umbilical fold and

medial umbilical fold

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13
Q

the medial inguinal fossa is defined by what abdominal features

A

medial umbilical fold and

lateral umbilical fold

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14
Q

the lateral umbilical fossa is defined by what abdominal features

A

lateral umbilical fold and

lateral body wall

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15
Q

the deep inguinal ring lies in what fascial layer?

A

transversalis fascia

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16
Q

what makes up the posterior wall of the inguinal canal (lateral 1/3 to medial 1/3/superficial ring)

A

transversalis fascia
transversalis fascia
conjoint tendon plus reflected inguinal ligament

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17
Q

what makes up the anterior wall of the inguinal canal (lateral 1/3 to medial 1/3)

A 
internal oblique + lateral crus of external oblique
external oblique aponeurosis (lateral crus and intercrural fibers)
external oblique (intercrural fibers) with the aponeurosis continuing as external spermatic fascia
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18
Q

what makes up the roof of the inguinal canal (lateral 1/3 to medial 1/3)

A

transversalis fascia
muscluo-aponeurotic arches (Internal Oblique and T.A.)
medial crus of external oblique

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19
Q

what makes up the floor of the inguinal canal (lateral 1/3 to medial 1/3)

A

iliopubic tract
inguinal ligament
lacunar ligament

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20
Q

parietal peritoneum is sensitive to what stimuli?

A

pressure, pain, temperature

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21
Q

visceral peritoneum is sensitive to what stimuli?

A

stretch and chemical irritation

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22
Q

what is the anterior boundary of the epiploic foramen?

A

hepatoduodenal ligament and portal triad

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23
Q

what is the posterior boundary of the epiploic foramen?

A

inferior vena cava

right crus of diaphragm

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24
Q

what is the superior boundary of the epiploic foramen?

A

caudate lobe of liver

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25
Q

what is the inferior boundary of the epiploic foramen?

A

1st part of the duodenum

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26
Q

list the different ligaments that comprise the greater omentum

A

gastrophrenic ligament
gastrosplenic ligament
gastrocolic ligament

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27
Q

list the different ligaments that comprise the lesser omentum

A 
gastrohepatic ligament
hepatoduodenal ligament (contains portal triad)
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28
Q

what structures are anterior to the lesser sac

A

lesser omentum
stomach
gastrocolic ligament

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29
Q

what structures are posterior to the lesser sac

A

pancreas
left suprarenal gland
left kidney

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30
Q

what structures are superior to the lesser sac

A

liver

diaphragm

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31
Q

what structures are inferior to the lesser sac

A

transverse mesocolon

1st part of duodenum

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32
Q

what structures are to the left of the lesser sac

A

hilum of spleen

gastrosplenic ligament

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33
Q

what structures are to the right of the lesser sac

A

epiploic foramen opens into greater sac

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34
Q

list the structures contained within the supracolic compartment

A

stomach
liver
spleen

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35
Q

list the structures contained within the infracolic compartment

A

small intestine
ascending colon
descending colon

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36
Q

what allows communication between the infracolic and supracolic compartments

A

paracolic gutters

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37
Q

the tail of the pancreas is at what vertebral level?

A

L1

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38
Q

the head of the pancreas is located at what vertebral level?

A

L2

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39
Q

what lies anterior to pancreas

A

lesser sac

stomach

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40
Q

what lies posterior to pancreas

A 
aorta
IVC
splenic vein
bile duct
right crus of diaphragm
left kidney and vessels
left suprarenal gland
SMV
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41
Q

what lies to the right of the pancreas

A

2nd part of duodenum

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42
Q

what lies to the left of the pancreas

A

spleen

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43
Q

what lies inferior to the pancreas

A

3rd part of duodenum

44
Q

In the portal - caval anastomoses, describe the esophageal vein anastomosis

A

portal - esophageal v. from left gastric vein

caval - esophageal v. from azygos vein

45
Q

in the portal - caval anastomoses, describe the umbilical anastomosis

A

portal - para-umbilical vein

caval - inferior epigastric vein

46
Q

in the portal - caval anastomoses, describe the rectal anastomosis

A

portal - superior rectal

caval - inferior rectal and middle rectal

47
Q

in the portal - caval anastomoses, describe the visceral anastomosis

A

portal - inferior and superior mesenteric veins

caval - posterior abdominal wall veins and diaphragm veins

48
Q

what is renal vein entrapment syndrome?

A

AKA nutcracker syndrome

downward traction of SMA can compress left renal vein (can also compress 3rd part of duodenum)

49
Q

list the components of the foregut

A 
esophagus
stomach
duodenum (first and second parts)
liver
pancreas
biliary aparatus
gallbladder
50
Q

list the components of the midgut

A 
duodenum (second, third and fourth parts)
jejunum
ileum
cecum
appendix
ascending colon
transverse colon (proximal 2/3)
51
Q

list the components of the hindgut

A 
transverse colon (distal 1/3)
descending colon
sigmoid colon
rectum
anal canal (above pectinate line)
52
Q

what is the origin of the parasympathetic innervation of the hindgut

A

pelvic splanchnic nerves

53
Q

describe the sympathetic innervation of the foregut

A

preganglionics: thoracic splanchnic nerves (T5-9; greater splanchnic nerve)
postganglionic cell bodies: celiac ganglion

54
Q

describe the sympathetic innervation of the midgut

A

preganglionics: lesser and least splanchnic nerves

postganglionic cell bodies: superior mesenteric ganglion

55
Q

describe the sympathetic innervation of the hindgut

A

preganglionics: lumbar splanchnic nerves (L1-L2)

postgnaglionic cell bodies: inferior mesenteric ganglion

56
Q

what sort of vascular changes and GI motility changes are elicited by sympathetic activity

A

vasoconstriction, inhibition of peristalsis

57
Q

pelvic splanchnic nerves are derived from anterior rami of spinal nerves from what levels?

A

S2-S4

58
Q

describe the two principal components of the enteric nervous system of the GI tract

A

myenteric plexus - motility

submucosal plexus - secretion, absorption

59
Q

describe the various components of the parasympathetic division of the ANS in the GI tract

A

anterior/posterior vagal trunks
pelvic splanchnic nerves
autonomic plexuses with periarterial plexuses
enteric nervous system

60
Q

list the things that touch the stomach anteriorly

A

anterior abdominal wall
diaphragm
left lobe of the liver

61
Q

list the things that touch the stomach posteriorly

A 
diaphragm
spleen
left suprarenal
left upper kidney
pancreas
transverse colon
transverse mesocolon
omental bursa
62
Q

list the features of the first part of the duodenum

A

hepatoduodenal ligament

63
Q

list the features of the second part of the duodenum

A

retroperitoneal

bile duct and pancreatic ducts enter at duodenal papilla

64
Q

list the features of the third part of the duodenum

A

retroperitoneal
superior mesenteric artery and vein + root of mesentery cross anteriorly
head of pancreas is superior

65
Q

list the features of the fourth part of the duodenum

A

becomes intraperitoneal
posterior: left margin of aorta and psoas major muscle
suspensory ligament of duodenum

66
Q

is the jejunum intraperitoneal or retroperitoneal

A

intra

67
Q

is the ileum intraperitoneal or retroperitoneal

A

intra

68
Q

is the duodenum intraperitoneal or retroperitoneal

A

1 -
2- retro
3 - retro
4 - intra

69
Q

where is the jejunum located in the 4 quadrant system

A

left upper quadrant

70
Q

where is the ileum located in the 4 quadrant system

A

right lower quadrant

71
Q

3 bands of longitudinal muscle on the large intestine are called what

A

tenia coli

72
Q

the product of tenia coli are

A

haustra/sacculations

73
Q

what structures lie anterior to the spleen

A

stomach

tail of pancreas

74
Q

what structures lie posterior to the spleen

A

diaphragm

75
Q

what structures lie inferior to the spleen

A

left colic flexure

76
Q

what structures lie medial to the left spleen

A

left kidney

77
Q

list the lobes of the liver

A

left
right
caudate
quadrate

78
Q

where does the gallbladder contact the anterior abdominal wall

A

9th costal cartilage

79
Q

in general the organization of the digestive tube can be organized into 4 layers. what are those 4 layers

A

mucosa
submucosa
muscularis externa
serosa/adventitia

80
Q

what are the subcomponents of the mucosa, generally speaking

A

epithelium
lamina propria
muscularis mucosae

81
Q

what are the subcomponents of the muscularis externa in general when referring to the digestive tract

A

inner circular layer

outer longitudinal layer

82
Q

what layer of the digestive tract supplies the mucosa with nerve vascular and lymphatic supply

A

submucosa

83
Q

the nerves and vasculature supplying the muscularis externa lie in what layer

A

between the inner circular and outer longitudinal layers

84
Q

visceral afferent cell bodies are present in what layer of the GI tract

A

muscularis externa (plexus of auerbach/myenteric plexus)

85
Q

sympathetic efferent fiber cell bodies are present in what layer of the GI tract

A

submucosa (meissner’s plexus/submucosal plexus)

86
Q

presynaptic parasympathetic fibers run in what layer of the GI tract

A 
muscularis externa
myenteric plexus (auerbach's plexus)
87
Q

the epithelium of the esophagus is best described as what

A

non-keratinized stratified squamous epithelium

88
Q

describe the muscularis mucosae of the esophagus

A

not present mostly

becomes present near the stomach

89
Q

what sort of glands are present in the esophagus

A

mucosa –> cardiac esophageal glands in the lamina propria

submucosa –> tubuloacinar glands (esophageal glands proper)

90
Q

describe the epithelium of the stomach

A

simple columnar without goblet cells

91
Q

GERD can lead to what sort of esophageal abnormality?

A

Barrett Esophagus

92
Q

rugae are most present where

A

greater curvature

pylorus

93
Q

describe the muscularis mucosae of the stomach

A

in the esophagus its almost nonexistent but in the stomach there is an inner circular layer and outer longitudinal layer

94
Q

describe the layering of the muscularis externa in the stomach

A

inner oblique
middle circular –> forms the pyloric sphincter
outers longitudinal
the aurbach plexus runs in between these two layers

95
Q

where do we find the most G cells

A

pylorus

96
Q

where do we find the deepest gastric pits

A

pylorus

97
Q

where do we find the most parietal and chief cells

A

pylorus

98
Q

what secretes pepsin

A

chief cell

99
Q

what secretes HCl

A

parietal cell

100
Q

where in the gland are parietal cells located

A

upper segment of gastric gland and near the neck

101
Q

where in the gland do we find chief cells

A

predominate in lower 1/3 of the gland

102
Q

where do we find the most peyer’s patches

A

ileum

103
Q

where do we find brunner’s glands?

A

only in duodenum

104
Q

M cells are generally found where?

A

overlying the lymphoid tissue of the gut (GALT)

105
Q

what is the function of the paneth cells?

A

bottom of the crypts, they have prominent eiosinophilic apical granules. defensive function

106
Q

how can you tell the difference between the enteroendocrine cells and paneth cells

A

granules subnucularly in the enteroendocrine cells

107
Q

what do enteroendocrine cells do

A 
secrete local enzymes
CCK
Gastrin
Secretin
each one only secretes one enzyme though

Gastrointestinal Anatomy and Histology (1 decks)

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