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Nick's MD1 > GI anatomy > Flashcards

GI anatomy Flashcards

1
Q

Where do the lowermost fibres of internal oblique muscle take origin from?

A

lateral 2/3 of inguinal ligament

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2
Q

Which artery perfuses the pancreas?

A

Splenic artery

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2
Q

At what vertebral levels are preganglionic sympathetic fibres for the hindgut derived from?

A

T12-L2

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3
Q

In which quadrant is the jejunum?

A

LUQ

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4
Q

Which kidney is slightly more superior?

A

Left

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4
Q

Which is brighter on CT: fat or soft tissue?

A

Soft tissue

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4
Q

Which organ is just below the celiac trunk?

A

Pancreas

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5
Q

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

A

Intersection of linea semilunaris with costal margin on right side

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5
Q

What do we call the aponeurotic envelope that contains the rectus abdominus on each side of the midline?

A

Rectus sheath

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5
Q

Where is the deep inguinal ring?

A

Exactly half way between ASIS (ant sup iliac spine) and the pubic tubercle and a fingers breadth above the inguinal ligament

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5
Q

What are the 4 muscles in the paravertebral gutter?

A

Psoas major. Psoas minor. Quadratus lumborum. Iliacus

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5
Q

What contributes to the major duodenal papilla?

A

Bile duct and pancreatic duct

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5
Q

Is the pancreas intraperitoneal or retroperitoneal?

A

Retroperitoneal

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5
Q

Where do the unpaired intraperitoneal structures have venous drainage to?

A

Portal venous system

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5
Q

How is the transpyloric plane identified on surface anatomy?

A

The intersection of the lines semilunaris with costal margin

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5
Q

What does the proper hepatic artery divide into?

A

The right and left hepatic arteries

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6
Q

Where do the lower most fibres of the transverse abdominus originate?

A

Lateral 1/2 of ingiunal ligament

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6
Q

What is the ligamentum teres a remnant of?

A

Umbilical vein

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7
Q

Which aspect of the rectus sheath is present all the way from superior to inferior?

A

Anterior

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7
Q

What defines the limits of the fundus of the stomach?

A

Cardiac notch (incisure) and angular notch

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7
Q

Is the horizontal part of the duodenum intraperitoneal or retroperitoneal?

A

Retroperitoneal

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7
Q

Which part of the duodenum is intraperitoneal?

A

The first inch of the duodenal cap

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8
Q

Is the cecum intra- or retro-peritoneal?

A

Intraperitoneal

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8
Q

What does the aorta bifurcate into?

A

Common iliac arteries

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9
Q

Between which muscles is the neurovascular bundle of the anterior abdominal wall?

A

Between internal oblique and abdominis transversus muscles

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9
Q

How many segmental arteries are there from the renal artery?

A

5

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11
Q

Which muscles arch up and over to insert into the pubic crest via conjoined tendon

A

Inner oblique and transverse abdominus

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11
Q

What is the rectus sheath?

A

An aponeurotic envelope that contains the rectus abdominus on each side of the midline

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11
Q

Which arteries supply the greater curvature of the stomach?

A

Left and right gastro-epiploic arteries

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12
Q

How long are the ureters?

A

20-30cm

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12
Q

Which has more numerous mucosal folds: jejunum or ileum?

A

Jejunum

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13
Q

Where are the 3 tendinous intersections of the rectus abdominis?

A

At level of umbilicus At level of xiphisternum At level half way between these two

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14
Q

What is the esophageal opening part of the stomach called?

A

The cardiac orrifice

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15
Q

If there is an inflamed gall bladder, where will tenderness be noted?

A

Junction of right costal margin with linea semilunaris

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17
Q

Which muscle does the kidney overlie?

A

Quadratus lumborum

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19
Q

What is the inferior epigastric artery a branch of?

A

External iliac artery

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20
Q

What surrounds the head of the pancreas?

A

Duodenum

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21
Q

What does the ‘C’ shape of the duodenum curl around?

A

Head of the pancreas

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22
Q

Where is pain from the hindgut referred to?

A

Suprapubic region

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23
Q

What lies just lateral to the duodenal cap?

A

Right kidney

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23
Q

Which is darker on CT: fat or soft tissue?

A

Fat

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24
Q

Define aponeuroses

A

Layer of flat, broad tendon

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25
Q

What are the 3 free edges of the external oblique?

A

Superior aponeurotic edge (which pec major takes origin from) Free posterior muscular edge Free inferior edge (between ASIS and pubic tubercle)

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25
Q

What do we call the clear lateral border of rectus abdominis?

A

Linea semilunaris

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25
Q

What is the surface landmark for the base of the appendix

A

McBurney’s point

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26
Q

What do the left and right hepatic ducts unite to form?

A

Common hepatic duct

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26
Q

Which hormones does the pancreas release?

A

Glucagon. Insulin. Somatostatin.

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27
Q

Where does the internal oblique muscle take its origin from inferiorly?

A

anterior 2/3 of iliac crest

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27
Q

How long is the esophagus?

A

25cm

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27
Q

What is the anatomical border separating the right and left halves of the liver?

A

Falciform ligament

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28
Q

How can you identify a piece of small intestine is jejunum and not ileum?

A

Thicker wall with more numerous mucosal folds. Less fat is mesentery so it’s easier to see vessels in the mesentery. Mesentery has long vessels (vasa recta) instead of the many arterial arcades seen in the ileum

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29
Q

At what vertebral level is the transpyloric plane?

A

L1

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31
Q

Where is the junction of the midgut and hindgut?

A

2/3 of the way along the transverse colon, towards the splenic flexure

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32
Q

What does the common hepatic artery branch into?

A

Proper hepatic artery and gastroduodenal artery

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34
Q

What does the gastroduodenal artery divide into?

A

Anterior superior pancreaticduodenal artery. Right gastroepiploic artery

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34
Q

What does the portal vein pass behind?

A

First part of the duodenum

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35
Q

Under which ribs does the spleen lie?

A

9, 10 and 11

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36
Q

Where can the cystic artery branch off? Which is more common?

A

Right hepatic artery most commonly, but also can branch from proper hepatic artery

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37
Q

Which passes to the right of the other: hepatic ducts or hepatic artery?

A

Hepatic ducts

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38
Q

What structures does the left gastric artery supply?

A

Abdominal esophagus. Lesser curvature of stomach.

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40
Q

What is the lesser curvature of the stomach attached to? And via what?

A

To liver via lesser omentum

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41
Q

Where is the junction of the foregut and midgut?

A

Major duodenal papilla

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42
Q

What are the 2 components of the dual venous system of the abdomen?

A

Inferior vena cava (caval system) Portal vein (portal venous system)

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42
Q

What vascular structures are behind the pancreas?

A

Splenic artery and vein

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43
Q

Where will irritation of the mid-sigmoid colon to rectum be referred?

A

Peri-anal

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44
Q

Where is the junction between foregut and midgut?

A

The major duodenal papilla

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45
Q

What is a landmark for the dermatome of L1?

A

Groin

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46
Q

What is the first part of the large intestine called?

A

Cecum

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47
Q

What are the 2 surfaces of the liver?

A

Diaphragmatic and visceral surface

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48
Q

Which aspect of the rectus sheath is only present superiorly?

A

Posterior

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49
Q

What is posterior to the head and neck of the pancreas?

A

IVC and aorta

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51
Q

What does the right renal artery pass behind?

A

IVC

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52
Q

What are the 3 layers that surround the testicular neurovascular bundle?

A

Internal spermatic fascia Cremasteric fascia External spermatic fascia

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53
Q

Where does the left renal vein pass with relation to the aorta?

A

Anterior

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53
Q

What attaches the liver to the anterior abdominal wall?

A

Falciform ligament

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54
Q

What is behind the foramen of Winslow?

A

IVC

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55
Q

What is the superior epigastric artery a branch of?

A

internal thoracic aa

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55
Q

What forms the superficial inguinal ring?

A

The triangular opening in external oblique between its attachment between the pubic tubercle and the pubic crest

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57
Q

Which artery supplies the abdominal oesophagus?

A

Left gastric artery

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58
Q

Which muscles do external obliques iie edge to edge with?

A

Pec major and serratus anterior

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58
Q

Where does psoas major lie?

A

In the paravertebral gutter between bodies and transverse processes of lumbar vertebrae

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59
Q

Where is the appendix is 65% of people?

A

Retrocecal

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61
Q

Where does the portal vein empty into?

A

Hepatic sinusoids

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62
Q

In what does the portal triad run?

A

Between two layers of lesser omentum

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63
Q

Where do the paired retroperitoneal structures have venous drainage to?

A

Systemic caval system

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64
Q

What do we call the point of junction from esophagus to stomach?

A

Z line

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65
Q

Where should a vein always pass relative to an artery?

A

Anterior to the artery

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67
Q

What is the orientation of internal oblique muscles?

A

Postero-inferior (back pockets)

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67
Q

What is the linea semilunaris?

A

Clear lateral border of rectus abdominis.

68
Q

Where does external oblique meet with the contralateral external oblique?

A

In a strong vertical line of insertion (linea alba = white line)

70
Q

From which artery does the hepatic artery arise?

A

Celiac trunk

71
Q

At what vertebral levels are preganglionic sympathetic fibres for the foregut derived from?

A

T6-T9

72
Q

How is the superior margin of the liver identified on surface anatomy?

A

Plane between the nipples

73
Q

Where is pain from the midgut referred to?

A

Periumbilical region

73
Q

Where is McBurney’s point?

A

1/3 of the way from the right ASIS to the umbilicus

74
Q

How many free edges does the external oblique have?

A

3

75
Q

In which quadrant is the ileum?

A

RLQ

77
Q

Where is the junction between hindgut and midgut?

A

2/3 the way along the transverse colon, towards the splenic fleexure

79
Q

What do we call the line at the inferior end of the posterior segment of the rectus sheath?

A

Arcuate line

81
Q

Is the jejunum intraperitoneal or retroperitoneal?

A

Intraperitoneal

82
Q

What are the ridges of the stomach called?

A

Rugae

83
Q

Haematemesis due to eroded duodenal ulcer is likely to involve which artery?

A

Gastroduodenal artery

84
Q

While looking at the posterior surface of the liver, what are the 4 lobes starting at 12 o’clock and moving clockwise?

A

Caudate. Right. Quadrate. Left

86
Q

Where does the internal oblique muscle take its origin from posteriorly?

A

Thoracolumbar fascia

88
Q

How many free edges does the internal oblique have?

A

None

89
Q

What is the greater curvature of the stomach attached to? And via what?

A

Spleen via greater omentum

91
Q

Is the duodenal cap intraperitoneal or retroperitoneal?

A

First inch is intraperitoneal. Second inch is retroperitoneal

91
Q

What are the 3 branches off the celiac trunk?

A

Splenic artery. Left gastric artery. Common hepatic artery

92
Q

Through what do the greater and lesser sacs communicate?

A

The epiploic foramen of Winslow

93
Q

At what level does the esophagus pass through the diaphragm?

A

T10

94
Q

At what dermatome level is the umbilicus?

A

T10

96
Q

Where does the minor duodenal papilla enter the duodenum?

A

Just proximal to the major duodenal papilla

97
Q

How long is the small intestine from the point of the D-J flexure?

A

4-6 meters

99
Q

What forms the common bile duct?

A

Common hepatic duct and cystic duct

100
Q

What is the most posterior structure at the renal hilum?

A

Renal pelvis

102
Q

Is the stomach intraperitoneal or retroperitoneal?

A

Intraperitoneal

103
Q

What forms the opening of the common bile duct?

A

Sphincter of Oddi

104
Q

What forms the minor duodenal papilla?

A

Accessory pancreatic duct

104
Q

Where does the tail of the pancreas lead?

A

The hilum of the spleen

105
Q

Where does the foregut begin?

A

Abdominal esophagus

106
Q

Where does rectus abdominis attach inferiorly?

A

To body and crest of pubis

106
Q

How big is the spleen?

A

Clenched fist

107
Q

What forms the common hepatic duct?

A

Left and right hepatic ducts

109
Q

What is the most superior part of the stomach called?

A

The fundus

111
Q

Never put an artery in front of a ______

A

Vein

112
Q

What vertebral levels do the kidneys span?

A

T12 to L3

113
Q

Which muscles from the roof of the inguinal canal?

A

Internal oblique and transversus abdominis

114
Q

Is the ascending colon intraperitoneal or retroperitoneal?

A

Retroperitoneal

115
Q

Which organs does the splenic artery perfuse?

A

Spleen, pancreas and stomach

116
Q

At what level does the inferior mesenteric artery branch off the aorta?

A

L3

117
Q

What is the blind end of the gall bladder called?

A

Fundus

119
Q

What is the most distal part of the stomach?

A

Pyloric sphincter

120
Q

How long is the appendix?

A

7-10 cm

122
Q

In which quadrant is the spleen?

A

LUQ

123
Q

What is a landmark for T10 dermatome?

A

Umbilicus

124
Q

What gives the liver its visceral peritoneum?

A

The lesser omentum

126
Q

At what level does the aorta end?

A

L4

127
Q

What are the 4 parts of the duodenum?

A

Duodenal cap. Descending. Horizontal. Ascending.

128
Q

Is the ilieum intraperitoneal or retroperitoneal?

A

Intraperitoneal

130
Q

What part of the stomach is most likely to show as a gas bubble on X ray?

A

Fundus

131
Q

Never put a ________ in front of a ______

A

An artery in front of a vein

133
Q

Where does blood from the rectum drain to?

A

Caval system or hepatic portal system

134
Q

Which part of the duodenum is retroperitoneal?

A

All but the first inch of the duodenal cap

136
Q

What is the only dead-straight horizontal branch of the lateral aspect of the aorta?

A

Renal artery

137
Q

At what vertebral levels are preganglionic sympathetic fibres for the midgut derived from?

A

T8-T12

138
Q

What organ is just behind the pancreas?

A

Left kidney

139
Q

Is the ascending part of the duodenum intraperitoneal or retroperitoneal?

A

Retroperitoneal

140
Q

Where does the ileum end?

A

At the ileo-cecal junciton

141
Q

What is the free inferior edge of the liver called?

A

Ligamentum teres

142
Q

Which arteries supply the lesser curvature of the stomach?

A

Left and right gastric arteries

143
Q

Which muscle of the anterior abdominal wall underlaps the costal margin?

A

Transverse abdominus

144
Q

What is formed by an opening in the transversalis fascia?

A

Deep inguinal ring or internal inguinal ring

145
Q

Behind which organ does the portal vein form?

A

Neck of the pancreas

146
Q

What are the structures in the renal hilum from anterior to posterior?

A

Renal vein. Renal artery. Renal pelvis

147
Q

At what level does the superior mesenteric artery branch off the aorta?

A

L1

149
Q

Where does the testis exit the inguinal canal during development?

A

Superficial (or external) inguinal ring

151
Q

What does the duodenal cap lie on?

A

Right psoas major

152
Q

In which quadrant is the liver?

A

RUQ

153
Q

What does the sphincter of Oddi envelope?

A

Common bile duct and pancreatic duct

155
Q

What loops over the left renal vein as it passes the aorta?

A

Superior mesenteric artery

157
Q

At what vertebral level does the portal vein form?

A

L2

158
Q

Where is visceral pain from the foregut referred to?

A

Epigastric region

159
Q

Where is visceral pain from the midgut referred to?

A

Peri umbilical region

160
Q

Where is visceral pain from the hindegut referred to?

A

Supra pubic region

161
Q

Where is the junction between foregut and midgut?

A

Major duodenal papilla

162
Q

Where is the junction between midgut and hindgut?

A

2/3 the way along the transverse colon, towards the splenic flexure

164
Q

What are the 3 most common locations of kidney stones?

A

Uretopelvic junction. Crossing of iliac artery. Uretovesicle junction.

165
Q

At what vertebral level does the esophagus begin?

A

C6

166
Q

How long is the duodenum?

A

10cm

167
Q

What passes through the porta hepatis?

A

Portal vein. Proper hepatic artery. Hepatic ducts. Nerves. Lymphatics

168
Q

Which gland sits on the kidney?

A

Adrenal gland

169
Q

In which quadrant is the gall bladder?

A

RUQ

170
Q

At what vertebral level is the celiac trunk?

A

T12

171
Q

What is in front of the foramen of Winslow?

A

Portal triad

172
Q

Is the transverse colon intraperitoneal or retroperitoneal?

A

Intraperitoneal

173
Q

What is the common site of opening of the bile duct and pancreatic duct called?

A

Major duodenal papilla

174
Q

What are the 3 muscular layers of the anterolateral abdominal wall from superficial to deep?

A

External oblique Internal oblique Transversus abdominus

175
Q

What is the z line?

A

Esophogeal-gastic junction

176
Q

In which quadrant is the stomach?

A

LUQ

178
Q

Where is pain from the foregut referred to?

A

Epigastric region

179
Q

What landmark defines the boundary between the body and fundus of the stomach?

A

The cardiac notch or incisure

180
Q

Where linea semilunaris intersects with costal margin on the right side is the surface marking for what?

A

Fundus of gall bladder

181
Q

What overlies the neck of the pancreas?

A

Pylorus

182
Q

What artery supplies the head of the pancreas?

A

Anterior superior pancreaticduodenal artery

183
Q

What is above the foramen of Winslow?

A

Quadrate lobe of liver

184
Q

Where does the iliac crest end?

A

At the ASIS (anterior superior iliac spine)

186
Q

What is the most posterior structure in the porta hepatis?

A

Portal vein

187
Q

Where is the rectus abdominis wider?

A

Superiorly

188
Q

From which artery does the splenic artery arise?

A

Celiac trunk

189
Q

Where does the major duodenal papilla enter the duodenum?

A

Half way down the posteromedial wall of the descending segment of the duodenum

190
Q

At what vertebral levels are preganglionic sympathetic fibres derived from?

A

T6-L2

191
Q

What is the dermatome of the loins?

A

L1

192
Q

In what direction does abdominus transversus run?

A

Horizontal

193
Q

What is the part of the stomach distal to the body?

A

Antrum

194
Q

Which lobes of the liver is the gall bladder between?

A

Quadrate and right.

195
Q

Which lobes of the liver is the IVC between?

A

Caudate and right.

196
Q

Is the sigmoid colon intra- or retro-peritoneal?

A

Intraperitoneal

197
Q

What is the part of the stomach between the pyloric sphincter and the antrum?

A

Pyloric canal

198
Q

What does THE mesentery connect?

A

Posterior abdominal wall to jejunum and ileum

199
Q

What is the largest part of the stomach called?

A

Corpus or body

200
Q

Where do superior and inferior epigastric arteries anastamose with each other?

A

Behind rectus abdominis in posterior rectus sheath

202
Q

Where is visceral pain from the foregut referred to?

A

Epigastric region in the midline

203
Q

Is the horizontal part of the duodenum intraperitoneal or retroperitoneal?

A

Retroperitoneal

204
Q

What forms the inguinal ligament?

A

The free inferior edge of the external oblique extending from the anterior superior iliac spine to the pubic tubercle

205
Q

What is the orientation of external oblique muscles?

A

Antero-inferior (front pockets)

206
Q

What demarcates the lateral edge of the pubic crest?

A

Pubic tubercle

207
Q

What forms the floor of the inguinal canal?

A

Inguinal ligament

208
Q

What is an approximate radiological landmark for the descent of the ureters?

A

Tips of lumbar transverse processes

209
Q

Which artery does the left gastroepiploic artery branch from?

A

Splenic artery

210
Q

What are the 3 parts of the esophagus?

A

Cervical, thoracic, abdominal

211
Q

Is the descending part of the duodenum intraperitoneal or retroperitoneal?

A

Retroperitoneal

212
Q

The rami of which spinal nerves contribute to the lumbar plexus?

A

L1-L4

213
Q

Which artery does the superior rectal artery come from?

A

Inferior mesenteric artery

214
Q

How long does the esophagus extend in the abdomen before it enters the stomach?

A

1.25 cm

215
Q

What sits directly above the fundus of the stomach?

A

Left hemidoaphragm

216
Q

Where do the unpaired retroperitoneal structures have venous drainage to?

A

Portal venous system

217
Q

Which arteries supply derivatives of the fore-, mid- and hind-gut?

A

Celiac trunk, superior mesenteric artery, inferior mesenteric artery

218
Q

What are the 6 layers of the antero-lateral abdominal wall from superficial to deep?

A

1 skin 2 superficial fascia 3 abdominal muscles 4 fascia transversalis 5 extraperitoneal fat 6 parietal peritoneum

219
Q

How long is the large intestine?

A

1.5 meters

220
Q

Is the descending colon intraperitoneal or retroperitoneal?

A

Retroperitoneal

221
Q

To which organs does the greater omentum attach?

A

Greater curvature of the stomach and transverse colon

Nick's MD1 (28 decks)

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