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GI Block Module > GI Anatomy > Flashcards

GI Anatomy Flashcards

1
Q

What is the GI tract made up of?

A 
Oral cavity
Pharynx (oropharynx and laryngopharynx) 
Oesophagus 
Stomach 
Small Intestine 
Large intestine 
Rectum 
Anal canal
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2
Q

Name the functions of the GI tract (6 functions)

A

1 - break down food into soft mass in oral cavity via action of teeth and saliva
2 - bypass the airway to move food
3 - convey food to the stomach
4 - mechanical and chemical digestion of food, absorption of nutrients
5 - absorption of water making the faeces more firm
6 - excretion/maintenance of continence

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3
Q

What is the oral fissure?

A

Mouth (lips)

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4
Q

What is the oral vestibule?

A

Space between the teeth and gums internally and the cheeks and lips externally

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5
Q

Where does the parotid duct open?

A

Opposite the upper 2nd molar

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6
Q

What is the oral cavity proper?

A

Alveolar arches, teeth, gingiva, submandibular and sublingual ducts

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7
Q

What makes up the roof and floor of the oral cavity proper?

A

Floor: geniohyoid muscle and mylohyoid muscle + tongue
Roof: hard and soft palate

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8
Q

What is the muscle of the cheek called?

A

Buccinator

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9
Q

Which bones make up the floor, roof and lateral walls of the oral cavity?

A

Roof - hard palate –> maxilla and palatine
Floor - no bones
Lateral walls - alveolar processes of the maxilla and mandible

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10
Q

What part of the mouth is the hard palate vs soft palate?

A

Hard palate is anterior 2/3, non-mobile

Soft palate is posterior 1/3

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11
Q

What makes up the hard palate?

A

Palatine processes of the maxilla
Horizontal processes of the palatine
Sphenoid
** Posterior nasal spine **

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12
Q

Where are the palatine rugae found?

A

Hard palate for holding food in place

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13
Q

Which muscles make up the soft palate?

A 
Tensor palati 
Levator palati
Palatoglossus
Palatopharyngeus 
Musculus uvulae
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14
Q

What epithelium makes up the oral surface of the hard palate?

A

Stratified squamous keratinizing epithelium

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15
Q

What are other features of the soft palate?

A

Palatine aponeurosis

Uvula

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16
Q

What is the function of the palatine aponeurosis?

A

Muscles of soft palate attach to this

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17
Q

What is the name of the opening that connects the oral cavity and oropharynx? Which arches are involved in keeping this open?

A

Oropharyngeal isthmus

Palatoglossal arches

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18
Q

Where is the palatine tonsils positioned?

A

Between the palatoglossal and palatopharyngeal arches

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19
Q

What parts is the tongue divived into?

A

Oral part - anterior 2/3rds, papillae with taste buds

Pharyngeal part - posterior 1/3, lymphatic follicles forming lingual tonsils which forms the wall of the oropharynx

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20
Q

What is the terminal sulcus?

A

V-shaped groove separating the oral and pharyngeal part of the tongue

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21
Q

What is the line called running down the middle of the tongue?

A

Septum

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22
Q

What bones does the tongue attach to?

A

Hyoid and mandible

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23
Q

Name the different parts of the tongue.

A

Lip, dorsum (oral and pharyngeal parts), margins, inferior surface, root, frenulum

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24
Q

Name the different types of lingual papillae.

A

Fungiform papillae - mushroom shaped
Foliate papillae - leaf like
Filiform papillae - filament like, no taste buds
Vallate papillae - posterior near terminal sulcus, rimmed depression surrounding them

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25
Q

Name the intrinsic muscles of the tongue.

A

Superior longitudinal
Vertical
Transverse
Inferior longitudinal

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26
Q

Name the extrinsic muscles of the tongue.

A

Styloglossus
Palatoglossus
Hyoglossus
Genioglossus

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27
Q

What is the function of the intrinsic muscles of the tongue?

A

Alter the shape of the tongue

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28
Q

What is the function of the extrinsic muscles of the tongue?

A

Move the tongue and alter the shape of it

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29
Q

What is the function of saliva?

A

Cleaning
Lubrication
pH
Salivary amylase for starches

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30
Q

Which is the largest salivary gland?

A

Parotid

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31
Q

Where is the parotid gland located?

A

Beside the ear, ensheathed in a fibrous capsule, external to masseter.

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32
Q

Where does the parotid duct open?

A

Penetrates the buccinator opposite the 2nd upper molar in the oral vestibule

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33
Q

Where is the submandibular gland located?

A

Below the mandible in a fibrous capsule

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34
Q

Which gland consists of a deep and superficial part?

A

Submandibular gland

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35
Q

Where does the submandibular duct open into?

A

Into the oral cavity proper on sublingual papilla (caruncle) at the side of the frenulum

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36
Q

Where does the sublingual duct open into?

A

Into the oral cavity proper on the sublingual fold (ridge)

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37
Q

Which parts of the pharynx is involved in the passageway of food?

A

Oropharynx

Laryngopharynx

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38
Q

Describe the walls of the pharynx

A

Mucous membrane
Fibrous Layer - thickened above to form the pharyngobasilar fascia. Fills the interval between the superior constrictor muscle and base of skull.
Muscle layer - inner levators, outer constrictors
Fascial Layer - buccopharyngeal fascia

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39
Q

Name the two muscle groups of the pharynx.

A

Inner levators

Outer constrictors

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40
Q

Which muscles make up the levators?

A

Salpingopharyngeus
Palatopharyngeus
Stylopharyngeus

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41
Q

Describe the origin and insertion of each of the levators.

A

Salpingopharyngeus - cartilage near auditory tube to walls of pharynx
Palatopharyngeus - posterior border of hard palate to sides of pharynx and thyroid cartilage
Stylopharyngeus - styloid process of hyoid bone to thyroid cartilage and side of pharynx

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42
Q

What is the function of the levators?

A

Elevate the pharynx and larynx during swallowing.

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43
Q

Name the constrictor muscles.

A

Superior, middle and inferior constrictors

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44
Q

Where do all the constrictor muscles insert into?

A

Pharyngeal raphe

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45
Q

Describe the locations of the constrictor muscles.

A

Superior - side of the mouth, mandible, tongue. Below the pharyngobasilar fasica.
Middle - hyoid bone, stylohyoid ligament
Inferior - thyroid and cricoid cartilage

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46
Q

What are the lateral wall features of the oropharynx?

A

Palatopharyngeal arch
Palatoglossal arch
Palatine tonsil

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47
Q

How does the oropharynx connect with the oral cavity?

A

Via the oropharyngeal isthmus

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48
Q

How does the oropharynx connect with the nasopharynx?

A

Via the pharyngeal isthmus

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49
Q

What is the piriform fossa and where is it found?

A

The piriform fossa is found in the laryngopharynx. it is a cavity lateral to the laryngeal inlet

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50
Q

What is the arrangement of muscles in the pharynx?

A 
Inner longitudinal (levators) 
Outer circular (constrictors)
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51
Q

What is the arrangement of muscles in the oesophagus?

A

Inner circular

Outer longitudinal

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52
Q

How long is the oesophagus?

A

25-30cm

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53
Q

Name the layers of the oesophagus.

A

Mucosa
Submucosa
Muscle
Adventitia/serosa

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54
Q

Describe how the different thirds of the oesophagus differ in muscle type.

A

Upper 1/3 = skeletal
Middle 1-3 = skeletal and smooth
Lower 1/3 = smooth

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55
Q

Describe the upper oesophageal sphincter.

A

Thickening of inner circular muscle in wall of oesophagus.

Supported by cricopharyngeus muscle of inferior constrictor

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56
Q

Describe the lower oesophageal sphincter.

A

Thickening of inner circular muscle in wall of oesophagus. Supported by muscle fibres of stomach and diaphragm

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57
Q

Which state are the oesophageal sphincters usually in?

A

Contracted state

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58
Q

What is the function of each oesophageal sphincter in the contracted state?

A

Upper esophageal sphincter prevents air from entering the oesophagus from the laryngopharynx.
LES prevents food and gastric secretions from entering the stomach.

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59
Q

What is the function of each oesophageal sphincter in the relaxed state?

A

UES - allows food to enter the oesophagus from the larynx.

LES - allows food to enter the stomach from the oesophagus.

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60
Q

What is another name for the upper esophageal sphincter?

A

Cricopharyngeus sphincter

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61
Q

Name the places where constrictions occur in the oesophagus.

A

Cricopharyngeus sphincter (15cm)
Aortic arch (22cm)
Left main bronchus (27cm)
Diaphragm (38cm)

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62
Q

Describe stage one of swallowing.

A 
· End of mastication 
	· Food on the dorsum of the tongue 
	· Tongue rises to press against hard palate (elevation) 
	· Voluntary 
Forces food mass into the oropharynx
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63
Q

Describe stage two of swallowing.

A

· Elevation and tensing of soft palate and elevation of larynx to prevent food entering the respiratory airways
· Levator and constrictor muscles contract (shortening, peristalsis)
· Food enters the laryngopharynx
· UES relaxes: food enters oesophagus
· UES contracts after food mass has entered the oesophagus
Involuntary and rapid

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64
Q

Describe stage three of swallowing.

A

· Peristalsis in oesophagus to carry food mass
· LES relaxes and food enters stomach
· LES contracts after food mass has entered stomach
Involuntary

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65
Q

Name the bones making up the floor, roof and lateral walls of the oral cavity.

A

Floor - no bones
Roof - maxilla and palatine (hard palate)
Lateral walls - alveolar processes of maxilla and mandible

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66
Q

What is the name of the muscular fold on each side that marks the posterior limit of the oral cavity?

A

Palatoglossal folds/arches

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67
Q

What is the function of this muscular fold?

A

Closes the oral cavity from the oropharynx during deglutition (swallowing)

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68
Q

Name the part of the pharynx that lies posterior to the oral cavity.

A

Oropharynx

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69
Q

What function does saliva have in the mouth?

A

Lubrication
pH
Cleaning
Salivary amylase for starches

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70
Q

Which is the largest of the salivary glands?

A

Parotid gland

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71
Q

What major structures does the parotid gland lie close to?

A

Facial nerve

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72
Q

Where does the parotid gland open into the oral cavity?

A

Opposite the second upper molar

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73
Q

Why does severe pain occur in patients with infected parotid glands?

A

Thick connective tissue capsule that carries sensory nerve fibres.

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74
Q

Why is pain often worse during chewing or sucking a lemon?

A

This activates the production of saliva, which cannot exit the blocked salivary duct. Increased salivary secretion.

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75
Q

Why does the parotid gland disease often cause pain in the auricle, external acoustic meatus, temporal region and temporomandibular joint?

A

Affected innervation from the Auriculotemporal nerve causes this pain.
Referred pain

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76
Q

Describe the position of the tongue in the oral cavity.

A

Floor of the oral cavity

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77
Q

Is the oral part of the tongue freely movable?

A

Yes - movable to help with speech and mastication

Pharyngeal part of tongue is anchored to the hyoid bone

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78
Q

What is the frenulum of the tongue?

A

Fold of mucus membrane located under the central portion of the tongue. Mucosal fold at the inferior aspect of the tongue.

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79
Q

What are the names of the blood vessels that lie close to the thin, transparent mucous membrane on the inferior surface of the tongue and are situated on either side of the lingual frenulum?

A

Deep lingual veins

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80
Q

What is the sulcus terminalis of the tongue? Where is it?

A

V-shaped groove which separates the tongue into the anterior 2/3 and posterior 1/3. Line between the oral and pharyngeal parts of tongue.

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81
Q

What important structure lies just in front of the sulcus terminalis? What is their function?

A

Circumvallate papillae - taste

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82
Q

What is meant by intrinsic and extrinsic muscles of the tongue?

A

Intrinsic muscles - run from side to side of the tongue
Extrinsic muscles are attached to bone. Originate from outside the tongue (from bones - hyoid, styloid, mandible and palate)

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83
Q

How are intrinsic muscles of the tongue arranged?

A 
Superior longitudinal 
Transverse
Vertical 
inferior longitudinal 
Important for changing the shape of the tongue for speech and handling food
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84
Q

List the important extrinsic muscles of the tongue.

A

Palatoglossus
Styloglossus
Hyoglossus
Genioglossus

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85
Q

Which of the extrinsic muscles of the tongue draws the tongue forwards, backwards, upwards and downwards?

A

Forwards - genioglossus
Backwards - hyoglossus, styloglossus
Upwards - styloglossus, palatoglossus
Downwards - genioglossus. hyoglossus

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86
Q

Which two cavities does the palate separate?

A

Nasal cavity and oral cavity

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87
Q

What is the name given to the anterior two-thirds of the palate and posterior third of the palate?

A

Hard palate

Soft palate

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88
Q

Is there any difference in the appearance of the two palates in radiograms?

A

Soft palate consists of soft tissues - appear gray/black on x-ray
Hard palate consists of bone - appears white on x-ray
Difference in opacity

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89
Q

What is the median projection from the posterior margin of the palate called?

A

Uvula

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90
Q

List the muscles of the soft palate.

A 
Tensor palati 
Levator palati 
Palatopharyngeus
Palatoglossus
Muscularis uvulae (uvula)
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91
Q

How is it possible to close off the oropharynx from the oral cavity and from the nasopharynx?

A

Soft palate elevates and tenses to close off the oral cavity from the nasopharynx
Oropharyngeal isthmus controls
Palatoglossal folds and soft palate = ANSWER

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92
Q

During which stage of swallowing does the soft palate elevate and tense?

A

Stage 2 - pharyngeal phase

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93
Q

What separates the posterior wall of the pharynx from the vertebral column?

A

Loose fascia which permits movement

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94
Q

Where does the submandibular duct open into the oral cavity?

A

Near the sublingual papillae/caruncles on floor of mouth, underneath the tongue

95
Q

During which stage of swallowing is the larynx and pharynx raised?

A

Stage 2

96
Q

Is the hyoid bone raised during swallowing?

A

Yes
Hyoid bone needs to be moved to allow the UES to open. Contraction of the mylohyoid bone allows movement of the hyoid bone.

97
Q

To which skeletal structure is the muscle in the upper part of the oesophagus attached?

A

Cricopharyngeal muscle attached to cricoid cartilage

98
Q

What structures cause three impressions in the wall of the thoracic part of the oesophagus?

A

Aortic arch
Left main bronchus
Diaphragm

99
Q

Name the part of the stomach that the oesophagus is continuous with.

A

Cardia

100
Q

What forms the roof, anterolateral wall , posterior wall and floor of the abdominopelvic cavity?

A

• ROOF - formed by the diaphragm
• ANTEROLATERAL WALLS - formed by the AL abdominal muscles, hip bone, pelvic muscles and ligaments
• POSTERIOR WALL - muscles of the posterior abdominal wall, sacrum, coccyx, lumbar vertebrae, pelvic muscles
• FLOOR - muscles of the pelvic and urogenital diaphragm
Most of the space in the abdominal cavity is taken up by abdominal organs and pelvic organs

101
Q

What are the walls of the abdominopelvic cavity lined by?

A

Parietal peritoneum

102
Q

What are abdominal organs covered by?

A

Visceral peritoneum

103
Q

Describe the peritoneal cavity.

A

Space between the parietal and visceral peritoneum.

104
Q

What is the function of the peritoneal cavity?

A

• Contains a thin film of serous fluid - secreted by both peritoneums
Reduces friction and allows for freely movable viscera to slide freely past one another

105
Q

Define mesentery.

A

Mesentery: a 2 layered fold of peritoneum that attaches part of the GI tract to the posterior abdominal wall

106
Q

Define omentum.

A

Omentum: 2 layered fold of peritoneum that attaches the stomach to another organ

107
Q

Define peritoneal ligament.

A

Peritoneal Ligament: 2 layered fold of peritoneum that attaches an organ to the abdominopelvic wall or to another organ

108
Q

Define peritoneal fold.

A

Peritoneal Fold: a reflection formed by peritoneum that covers blood vessels and ducts

109
Q

Describe the divisions of the peritoneal cavity.

A

Greater Peritoneal Sac (general peritoneal cavity)

Lesser Peritoneal Sac - lies behind the stomach and lesser omentum

110
Q

What is another name for the lesser peritoneal sac?

A

Omental bursa

111
Q

How does the greater peritoneal cavity communicate with the lesser peritoneal cavity?

A

Via an opening called the epiploic foramen

112
Q

What forms the subdivision of the greater peritoneal sac?

A

Greater omentum
Transverse colon
Transverse mesocolon

113
Q

What are the subdivisions of the greater peritoneal cavity?

A

Supracolic Compartment - upper/anterior part

Infracolic Compartment - lower/posterior part

114
Q

What is the supracolic compartment further divided into?

A

Divided by the liver into the left and right suphrenic spaces (inferior to the diaphragm) and the left/right subhepatic spaces

115
Q

What is the infracolic compartment divided into?

A

Subdivided by the mesentery of the SI into the left/right infracolic spaces

116
Q

Which spaces are important in an intrahepatic infection?

A

Infracolic spaces - abscesses can form here

117
Q

What does the anterior wall of the lesser peritoneal sac contribute to?

A

Posterior wall = lines posterior surface of the stomach, contributes to the greater and lesser omentum

118
Q

What does the posterior wall of the lesser peritoneal sac contribute to?

A

Greater omentum. Lines some of the posterior abdominal organs and diaphragm.

119
Q

What level does the oesophagus pass through the diaphragm?

A

Level T10 and joins the stomach at the gastroesophageal junction

120
Q

What forms the gastroesophageal sphincter?

A

Inner circular layer of the distal oesophagus and the inner oblique muscular layer of the stomach

121
Q

Which two processes in the stomach breakdown the food?

A

Mechanical and chemical digestion

122
Q

Name the three parts of the stomach.

A

Fundus, body, pyloric part

123
Q

What is the pyloric part split into?

A

Pyloric antrum - wider, proximal part which is continuous with the body of the stomach
Pyloric canal - narrower, distal part, pyloric sphincter in wall

124
Q

Name the openings of the stomach.

A

Cardiac opening

Pyloric opening

125
Q

Name the curvatures of the stomach.

A

Greater curvature

Lesser curvature

126
Q

Name the surfaces of the stomach.

A

Anterior and posterior surface

127
Q

Describe the features of the lesser curvature.

A

Angular notch - distinction between pyloric and body part of stomach
Lesser omentum attaches to lesser curvature and upper surface of the proximal duodenum

128
Q

What does the lesser omentum attach to?

A

Attaches to stomach and proximal upper part of duodenum. Connects these to the liver.

129
Q

What are the features of the greater omentum?

A

Attaches to the greater curvature, then goes in front of the transverse colon and attaches to the posterior abdominal wall

130
Q

Name the layers of the wall of the stomach.

A

Mucosa - folded into rugae with core of submucosa
Submucosa
Muscle - inner oblique, middle circular, outer longitudinal
Serosa - peritoneum covering except in some parts near the cardiac opening

131
Q

What is the function of the SI?

A

Chemical digestion and absorption of low molecular weight compounds.

132
Q

Define the length/boundaries of the small intestine.

A

From the pylorus to the ileocecal junction (continuous with caecum)

133
Q

Which parts of the small intestine are mobile?

A

All parts except the duodenum

134
Q

What is the mesentery of the small intestine?

A

Jejunum and ileum are suspended from this mesentery from the posterior abdominal wall

135
Q

Describe the characteristics of the duodenum.

A

Shortest, widest and most fixed part of the small intestine.
Except for the first 2.5cm, it is stuck to the posterior abdominal wall.
25cm long from the pylorus to duodenojejunal junction.
C-shaped curve around the pancreas and projects upwards toward the vertebral column.

136
Q

Name the 4 parts of the duodenum.

A

1st part is the superior
2nd part is the descending
3rd part is the horizontal
4th part is the ascending

137
Q

Describe the characteristics of the jejunum and ileum.

A

Longest and most mobile part of the SI.
6-7m long
Decreases in diameter as it passes from the proximal jejunum to distal ileum. (2.5cm to 2cm)
Extends from the duodenojejunal junction to the ileocecal junction
Attached to posterior abdominal wall by mesentery of SI

138
Q

Describe the layers in the small intestine.

A

Mucosa - circular folds called plicae circularis - villi and microvili. Found throughout the SI, except the first part of the duodenum.
Submucosa
Muscle - inner circular, outer longitudinal
Serosa

139
Q

Describe how the SA of the SI is increased.

A

Villi and microvilli

Plicae circularis

140
Q

What is the function of microvilli and intestinal glands?

A

Microvilli = enzymes which function in final stages of digestion
Intestinal glands secrete mucus and enzymes

141
Q

Name the external features of the LI.

A

3 thickened bands of longitudinal muscle in its wall = teniae coli
Sacculations of wall between the taeniae coli = haustra
Small pouches of peritoneum filled with fat = omental appendices

142
Q

State the diameters involved in the 3,6,9 rule.

A

SI = 3cm
Large intestine = 6cm
Cecum = 9cm

143
Q

Name the layers in the wall of the LI.

A

Mucosa
Submucosa
Muscle
Serosa

144
Q

State where the mucosal folds are found in the LI.

A

Around the ileocecal opening - ileocecal valve
Between adjacent haustra
Transverse folds in the rectum = support the weight of the faeces and prevent overdistension of the rectal ampulla

145
Q

State the functions of the LI.

A

· Reabsorption of water and electrolytes from faecal material
· Digestion of dietary fibres e.g. cellulose by resident bacteria - by-products of fermentation from bacteria may help to control blood glucose
Secretion of mucus by intestinal glands - facilitates transport of faeces and minimizes damage to mucosal surface of LI as faeces become firmer due to absorption of water

146
Q

Describe the caecum.

A

· Blind pouch that connects with the terminal ileum in its upper part and with the appendix in its lower part
· Lies in the right iliac fossa on the iliopsoas muscle
Longitudinal muscle coat in its wall forms 3 distinct bands, the taeniae coli

147
Q

Does the appendix have taeniae coli?

A

No - it is a continuous layer of longitudinal muscle

148
Q

Name the different parts of the colon.

A

Ascending, transverse, descending, sigmoid

149
Q

Which parts of the colon are fixed?

A

Ascending and descending

150
Q

Describe the rectum.

A

· Continuous with the sigmoid colon and begins in front of the S3 vertebra
· Follows the curvature of the sacrum and coccyx - sagittal plane
· In a coronal plane it is S-shaped having 3 lateral flexures (R, L, R) - at the levels of the flexures are the foldings of the mucosa that project into its cavity, the transverse rectal folds
· Passes through the pelvic diaphragm (formed mainly by the R and L levator ani M) and bends sharply backwards to become the anal canal
Its cavity is expanded towards the lower portion just above the pelvic diaphragm to form the rectal ampulla, which temporarily stores faeces

151
Q

Describe the anal canal.

A

· Passes downwards and backwards from the lower end of the rectum to the anus
· The junction of the rectum and anal canal is at the level of the pelvic floor where puborectalis M (a part of levator ani M) of each side forms a sling around this part of the GI tract and pulls it forwards
Is closed except during the passage of faeces or flatus, its lateral walls being kept apposed to one another by the levator ani Ms and the anal sphincters

152
Q

What are the characteristics of the internal anal sphincter?

A

Thickening of circular fibres of smooth muscle of anal canal
Sympathetic innervaiton
Upper 2/3rds of anal canal

153
Q

Describe the characteristics of the external anal sphincter.

A

Striated muscle
Pudendal nerve (branch of inferior rectal nerve)
Surrounds the whole length of the anal canal, 3 parts

154
Q

State the features of the upper part of the mucosa of the anal canal.

A

Mucus membrane is in folds = anal columns, which each has a small artery and vein (terminal branches of superior rectal vessels)

155
Q

State the features of the lower part of the mucosa of the anal canal.

A

No anal columns
Mucosa of lowermost part of anal canal is very sensitive
Part above the pectinate line is relatively insensitive

156
Q

How do the supracolic and infracolic compartments of the greater peritoneal cavity communicate with each other?

A

Connected by the paracolic gutters

157
Q

What is the name of the muscular fold on each side that marks the posterior limit of the oral cavity?

A

Palatoglossal fold

158
Q

What parts of the pharynx are common to both the air and food pathways?

A

Oropharynx and laryngopharynx

159
Q

What separates the posterior wall of the pharynx from the vertebral column?

A

Retropharyngeal space

160
Q

What is the purpose of the retropharyngeal space?

A

Allows sliding of the pharynx during deglutition

161
Q

What is the purpose of the arrangement of the constrictor muscles?

A

Reinforcement of the muscle wall

162
Q

What are the functions of the constrictor muscles of the pharynx?

A

Propel bolus/food distally

163
Q

In what sequence do the constrictor muscles contract?

A

Proximally to distally (superior to inferior)

164
Q

Is the contraction of the constrictor muscles voluntary or involuntary?

A

Involuntary

165
Q

What initiates the contraction of the constrictor muscles?

A

Presence of bolus

166
Q

During which stage of swallowing are the pharynx and larynx raised?

A

2nd stage - pharyngeal stage

167
Q

Is the hyoid bone raised in the second stage of swallowing?

A

Yes

168
Q

What is the narrowest part of the oesophagus? What is responsible for this narrowing? What is its purpose?

A

Upper sphincter
Circular muscle
To prevent air entry

169
Q

Is the muscle in the wall of the oesophagus striated or smooth for the upper third, middle third and lower third?

A

Upper third - skeletal
Middle third - mixed
Lower third - smooth

170
Q

To which skeletal structure is the muscle in the upper part of the esophagus attached?

A

Cricoid

171
Q

In the passage of bolus of food down the esophagus, there may be a momentary slowing at the level of the clavicles. Explain

A

Transition of muscle type

172
Q

What is the fibrocartilaginous tubular structure that lies anterior to the esophagus in the neck and superior mediastinum?

A

Trachea

173
Q

Name the structures causing 3 impressions of the oesophagus.

A 
Cricoid cartilage (C5/C6) 
Aortic arch (T4/T5) 
Esophageal Hiatus (T10/T11)
174
Q

When will a pharyngeal diverticulum/pouch occur in the pharyngeal wall?

A

When there is muscular weakness

175
Q

Which part of the stomach is stomach is continuous with the oesophagus?

A

Cardia

176
Q

What are possible areas of weakness in the pharyngeal wall?

A

Between the constrictors.

177
Q

What is responsible for the symptoms of dysphagia, a sensation of food sticking in throat and regurgitation?

A

Diverticulum

178
Q

Why is it more likely for a bulge in the oesophagus to be observed in the patient on the left side rather than the right?

A

Oesophagus is more on the left side at the root of the neck

The average left muscle layer is thinner than the right muscle layer.

179
Q

Explain why pulmonary aspiration is a common complication of surgical treatment for excision of pouches.

A

Proximity of the diverticular pouch to the laryngeal inlet - pulmonary aspiration may occur if px inhale saliva/objects during surgery. This occurs because patients do not have sufficient laryngeal protective reflexes due to anaesthesia.

180
Q

Name the lobes of the liver.

A

Left and right lobes

Caudate and Quadrate Lobes

181
Q

How many segments of the liver are there?

A

8 segments of the liver

Each has their own blood supply and function independently

182
Q

Name the recesses of the liver and their locations.

A

Subphrenic: below the diaphragm
Hepatorectal: above the kidney
Subhepatic: immediately below the liver

183
Q

Falciform ligament

A

Attaches liver to the anterior abdominal wall - ends in the ligamentum teres

184
Q

What is the ligamentum teres?

A

Remnant of obliterated umbilical vein

185
Q

Coronary ligament

A

Horizontal reflection of peritoneum from the diaphragm

186
Q

Ligamentum venosum

A

Remnant of the ductus venosus (was a diversion away from the liver during foetal development, it closes after birth)

187
Q

Bare area

A

Diaphragmatic surface of the liver without peritoneum

188
Q

Porta hepatis

A

Deep fissure on the inferior surface which all neurovascular structures and ducts enter or leave the liver.

189
Q

What contains the portal triad?

A

Porta Hepatis

190
Q

What makes up the portal triad?

A 
Bile duct (right)
Portal vein (posterior) 
Hepatic artery (left)
191
Q

How many parts does the pancreas have?

A

4 parts - head, neck, body and tail

192
Q

Which parts of the pancreas are retroperitoneal?

A

All parts except for the tail

193
Q

Main pancreatic duct - what does it unite with and where does it open?

A

Unites with the bile duct and opens via the major duodenal papilla (containing the sphincter of Oddi)

194
Q

What does the accessory pancreatic duct do?

A

Communicates with the main pancreatic duct and opens via the minor duodenal papilla.

195
Q

Name the parts of the gall bladder.

A

Fundus, body and neck.

196
Q

What forms the common bile duct?

A

Cystic duct unites with the common hepatic duct to form the common bile duct.

197
Q

What is the function of the spleen?

A

Site for blood cell formation, proliferation and breakdown.

Acts as a blood reservoir, stores platelets

198
Q

What protects the spleen?

A

Inferior ribs - not usually palpable

199
Q

Name the abdominal aorta branches from superior to inferior.

A 
Celiac trunk (T12) 
Superior mesenteric artery (L1) 
Renal arteries (L1/L2) 
Gonadal arteries (L2) 
Inferior mesenteric artery (L3) 
Aortic bifurcation (L4)
200
Q

What does the coeliac trunk supply?

A

T12 - supplies the foregut

201
Q

What does the superior mesenteric artery supply?

A

L1 - supplies the midgut

202
Q

What does the inferior mesenteric artery supply?

A

L3 - supplies the hindgut

203
Q

What are the 3 main branches of the coeliac trunk (T12)?

A

Left gastric artery
Splenic artery
Common hepatic artery

204
Q

What does the left gastric artery supply?

A

Supplies the lesser curvature of the stomach

205
Q

What are the vessels providing inflow into the liver?

A

Hepatic artery and portal vein

206
Q

What are the vessels providing outflow from the liver?

A

Hepatic vein

207
Q

Name the function of the hepatic portal vein.

A

Transports venous blood full of nutrients from the abdominal viscera to the liver.

208
Q

What vessels form the hepatic portal vein.

A

Superior mesenteric and splenic vein

209
Q

What terminates the splenic vein?

A

Inferior mesenteric vein

210
Q

What vessel supplies the greater curvature of the stomach?

A

Left gastro-omental artery

211
Q

What supplies the fundus of the stomach?

A

Short gastric artery

212
Q

What are the branches of the splenic artery?

A

Left gastro-omental artery
Splenic branches
Short gastric artery

213
Q

What are the branches of the common hepatic artery?

A

Hepatic artery proper
Right gastric artery
Gastroduodenal artery

214
Q

What does the hepatic artery proper split into?

A 
Right and left hepatic arteries (liver)
Cystic artery (gallbladder)
215
Q

What does the gastroduodenal artery give rise to?

A

Right gastro-omental artery

216
Q

What is the GI tract made up of?

A 
Oral cavity
Pharynx (oropharynx and laryngopharynx) 
Oesophagus 
Stomach 
Small Intestine 
Large intestine 
Rectum 
Anal canal
217
Q

What does the right gastric artery supply?

A

The right side of the lesser curvature of the stomach

218
Q

Name the branches of the SMA (L1) and what they supply.

A

Jejunal arteries - supply the jejunum
Ileal arteries - supply the ileum
Ileocolic arteries - supply the ileum, cecum and appendix
Right colic artery - supplies the ascending colon
Middle colic artery - proximal 2/3 of the transverse colon

219
Q

What is the vasa recta and how do you distinguish between the two types?

A

From the jejunal/ileal vessels into the SI
Jejunal vasa recta = huge big spaces
Ileal vasa recta = smaller spaces

220
Q

Name the branches off the IMA L3.

A

Left colic artery - distal 1/3 of the transverse colon, descending colon
Sigmoid arteries - supply the sigmoid colon
Superior rectal arteries - supply the rectume

221
Q

What is the marginal artery?

A

Anastomotic vessel

Shares blood between all the arteries

222
Q

What does the right gastroepiploic artery supply?

A

Greater omentum

223
Q

What does the left gastroepiploic supply?

A

Greater curvature

224
Q

What does the portal vein carry?

A

Venous nutrient rich blood from the abdominal viscera to the liver

225
Q

What makes up the hepatic portal vein?

A

SMV and splenic vein

226
Q

What does the IMV terminate in?

A

Splenic vein

227
Q

Name portocaval anastomoses.

A

Oesophageal varices
Ano-rectal
Caput Medusae

228
Q

Name the lymphatic arrangement of the abdomen.

A

Epiploic nodes - paracolic nodes - intermediate nodes - preaortic nodes

229
Q

Name the splanchnic nerves. Which innervation are they part of?

A

Greater splanchnic: T5 to T9
Lesser splanchnic: T10 to T11
Least splanchnic: T12
Sympathetic innervation

230
Q

Which nerves are involved in the parasympathetic innervation?

A 
Vagus nerve (foregut and midgut) 
Pelvic splanchnic nerve (hindgut)
231
Q

What is the name of the process attached to the pancreas?

A

Uncinate process

232
Q

Where does the uncinate process drain?

A

Minor duodenal papilla

233
Q

What drains at the major duodenal papilla?

A

Bile duct joined with main pancreatic duct

234
Q

What is found at the major duodenal papilla for regulation?

A

Hepatopancreatic ampulla (ampulla of Vater)

GI Block Module (8 decks)

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