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Kofi: Pure Clinical Sem 3 > GI: Anatomy > Flashcards

GI: Anatomy Flashcards

1
Q

What are the layers of the abdominal wall?

A
  • Skin
  • Fascia/Fat (superficial and deep)
  • 3X anterolateral muscles
  • Peritoneum
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2
Q

Which muscle is enveloped by the aponeurosis of the lateral muscles?

A

Rectus abdominus

Forms the rectus sheath

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3
Q

What are the 3 anterolateral muscles?

A
  • External oblique
  • Internal oblique, transverse abdominis, Rectus abdominis)
  • Transversalis fascia
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4
Q

What is the arcuate line?

A
  • Lower limit of the posterior layer of rectus sheath
  • Point at which inferior epigastric vessels pierce rectus abdominus
  • Roughly half way between umbilicus and pubic crest
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5
Q

What is mesentery?

A

Double fold of peritoneum that attaches the viscera to the posterior abdominal wall

Contains blood vessels, lymph vessels, nerves and fat

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6
Q

What are the organs that are connected by mesentery?

A
  • Jejenum
  • Ileum
  • Appendix
  • Transverse Colon
  • Sigmoid Colon
  • Rectum
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7
Q

What is the peritoneal ligament?

A
  • Gastrocolic ligament (Stomach to transverse colon)
  • Gastrosplenic ligament (Stomach to spleen)
  • Falciform ligament (liver ot anterior abdominal wall)
  • Triangular ligaments (liver to diaphragm)
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8
Q

What are the omenta?

A
  • Double folds of peritoneum
  • Greater omentum hangs off the greater curve of the stomach and folds back up and attaches to the anterior surface of the transverse colon
  • Lesser omentum connects lesser curve of the stomach to the liver
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9
Q

What is the blood supply to the GI tract?

A

Arterial is from branches of the aorta

  • Coeliac trunk
  • Superior mesenteric artery
  • Inferior mesenteric

Venous drainage goes to the liver via the Hepatic Portal Vein
-Portal system

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10
Q

What is the composition of saliva?

A
  • Mostly water (Hypotonic)
  • Rich in potassium and bicarbonate
  • Mucins to help with lubrication
  • Enzymes: Amylase, Lingual lipase
  • Diversity of immune proteins
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11
Q

What are functions of saliva?

A
  • Creation of bolus
  • Initaite process of digestion
  • Oral hygiene
  • Transmitting disease
  • Protection of mouth
  • Speech
  • Solvent for taste
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12
Q

What are the 3 pairs of salivary glands?

A
  • Parotid gland
  • Sub lingual gland
  • Sub mandibular gland
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13
Q

Outline the anatomical relationships of the oesophagus

A
  • Originates in the neck at 6th cervical vertebrae
  • Sits posteriorly the larynx and trachea
  • Closely related to the aorta (right hand side)
  • Pierces the diaphragm at T10 (oesophageal hiatus)
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14
Q

What are the nervous supply for the submandibular and sublingual?

A

-Parasympathetic from the facial nerve

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15
Q

What is the nervous supply for the parotid gland?

A
  • Parasympathetic fibres from the glossopharyngeal fibres

- Increases production of saliva

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16
Q

What are the narrowings found in the oesophagus?

A
  • Tightest narrowing is the junction between the pharynx and oesophagus
  • Second narrowing is when the arch of aorta crosses the oesophagus
  • Third narrowing is when the left main bronchus crosses the oesophagus
  • Final narrowing is when oesophagus passes through diaphragm (T10)
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17
Q

Describe the protective mechanisms of the nasal cavity and the larynx during swallowing.

A
  • The nasal cavity is protected by elevation of the soft palate
  • The respiratory tract is protected by elevation of the larynx (which closes epiglottis) and adduction of the vocal cords.
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18
Q

What are the contents of the external muscle layers?

A
  • Inner circular muscle

- Outer longitudinal muscle

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19
Q

What are the ligament of the liver and their attachments?

A

Falciform ligament
-Attaches the anterior surface of the liver to the anterior abdominal wall. Free edge contains the ligamentum teres

Coronary ligament
-Attaches the superior surface of the liver to the diaphragm

Right and Left Triangular ligament
-Attaches the superior surface of the liver to the diaphragm

Inferior vena cava – Secures to the posterior surface of the liver through hepatic veins and fibrous tissue

Lesser omentum

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20
Q

What are the parts of the lesser omentum?

A

Hepatic duodenal ligament which extends form the duodenum to the liver

Hepatogastric ligament which extends from the stomach to the liver

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21
Q

What are the macroscopic features of the liver?

A

4 lobes

  • Divided into right and left lobes by the falciform ligament
  • Caudate lobe on the upper aspect of the visceral surface. Lies between inferior vena cava and a fossa produced by the Ligamentum Venosum
  • Quadrate lobe located on the lower aspect of the visceral surface. Lies between gallbladder and a fossa produced by the Ligamentum Teres
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22
Q

What are the main branches of the coeliac trunk and their path?

A
  • Left gastric which travels along the lesser curve of the stomach where it anastomose with the right gastric artery
  • Splenic artery which travels towards the spleen running posteriorly to the stomach and along the superior margin of the pancreas. Terminates to supply the spleen
  • Common hepatic arteries which travels past the superior aspect of the duodenum
23
Q

What are the branches of the splenic artery and area of supply ?

A
  • Pancreatic branches which supply the body and tails of the pancreas
  • Left gastroepiploic which supplies the greater curvature of the stomach
  • Short gastric which supplies the fundus of the stomach
24
Q

What are the branches of the common hepatic artery and path?

A
  • Proper hepatic artery ascends through lesser omentum

- Gastroduodenal artery descends posterior o the superior portion of the duodenum

25
Q

What are the branches of the gastroduodenal artery and area of supply?

A
  • Right gastroepiploic which supplies the greater curvature and greater omentum
  • Superior pancreatoduodenal artery which supplies the head of the pancreas
26
Q

What are the branches of the proper hepatic artery and their area of supply?

A
  • Right gastric to supply the pylorus and lesser curvature of the stomach
  • Right and left hepatic artery which divide inferior to porta hepatis to supply the respective lobes of the liver
  • Cystic which is a branch of the right hepatic which supplies the gallbladder
27
Q

What are the regions of the peritoneal cavity?

A
  • Greater sac (larger portion)

- Lesser sac

28
Q

What are the areas of the greater peritoneal sac separated by?

A

Transverse colon

  • Supracolic
  • Infracolic
29
Q

How are the colics connected by?

A

Paracolic gutters

30
Q

Where does the lesser peritoneal sac lie?

A
  • Lies posterior to the stomach
  • Known as omental bursa
  • Allows stomach to move freely against the structures inferior and posterior to it
31
Q

What connect the greater and lesser sac?

A

-Epiploic foramen which lies posterior to the ligamentum teres

32
Q

Where does the rectovesical pouch lie?

A

Double folding of peritoneum between the rectum and the bladder. The peritoneal cavity is completely closed in males.

33
Q

Where does the pouch of Douglas lie?

A

Rectouterine Pouch

Double folded extension of the peritoneum between the rectum and the posterior wall of the uterus.

34
Q

Where does the vesicouterine pouch lie?

A

The vesicouterine pouch is a double fold of peritoneum between the anterior surface of the uterus and the bladder.

35
Q

What are the primarily retroperitoneal organs?

A
  • Oesophagus
  • Rectum
  • Kidneys
36
Q

What are the secondarily retroperitoneal organs?

A
  • Ascending colon

- Descending colon

37
Q

Describe the surface anatomy of foregut organs on the abdominal wall.

A

Stomach - Epigastrium
Duodenum - Epigastrium
Liver – Lies in the dome of the right diaphragm. Right hypochondrium and epigastric region
Pancreas – Lies in C shape of duodenum. Behind the stomach. Tail in left Hypochodnrium
Spleen – Lies near 10th rib and posterior

38
Q

Describe the surface anatomy of the midgut organs on the abdominal wall.

A

Jejunum - Left lumbar and umbilical regions of abdomen
Ileum – terminate in right inguinal region and mainly lower portion of abdomen
Caecum – Appendix arise here. Right inguinal region
Ascending Colon – Arise from right inguinal region to right lumber region

39
Q

Describe the surface anatomy of the hindgut organs on the abdominal wall.

A

Transverse colon – Arise from the ascending colon and travels transversely across abdomen
Descending colon – Left lumber region to Left inguinal
Sigmoid colon – Arises from left inguinal
Rectum

40
Q

What is formed by the aponeuroses of all the flat muscle in the midline?

A

Linea alba

41
Q

Which muscle is located in the middle of the abdominal wall?

A
  • Rectus abdominus
  • Split into 2 by the linea alba
  • Lateral border is the linea semilunares
  • Tendinous intersections form the six pack
42
Q

What forms the anterior wall of the rectus sheath?

A

-Aponeuroses of the external oblique and half of the internal oblique

43
Q

What forms the posterior wall of the rectus sheath?

A

-Aponeuroses of half the internal oblique and transverse abdoniums

At Arcuate line the apoenurses all become anterior

44
Q

What is the path of the superior mesenteric artery?

A
  • Arises at L1 anteriorly to the abdominal aorta
  • Descends down the posterior aspect of the abdomen.
  • Supplies the midgut
45
Q

What are the anatomical relations with the superior mesenteric artery?

A

Anterior to the SMA

  • Pyloric part of the stomach Splenic vein
  • Neck of the pancreas

Posterior to the SMA

  • Left renal vein
  • Uncinate process of the pancreas – hooks around the back of the SMA
  • Inferior part of the duodenum
46
Q

What are the major branches of SMA?

A

Inferior Pancreaticoduodenal – Inferior region of the dad of the pancreas, uncinate process, duodenum

Right colic – Supplies the ascending colon

Illeocolic artery – Ascending colon, Appendix, Caecum, Ileum

Middle colic artery – Supplies the transverse colon

Jejununal arteries – Supplies the jejunum. Smaller number of arterial arcades but longer vasa recta than illegal arteries

Ileal arteries – Supplies the ileum

47
Q

What is unique about the superior mesenteric artery blood supply?

A

Formation of arcade to supply the parts of the GUT

48
Q

What is the path of the inferior mesenteric artery?

A

Arise at L3 near the inferior border of the duodenum
Depends anteriorly then moves to the left side and it is a retroperitoneal
Supplies the hindgut

49
Q

What are the major branches of the inferior mesenteric artery?

A

Left colic artery

  • Ascending branch which supplies the distal 1/3 of the transverse colon, and the upper aspect of the descending colon.
  • Descending branch – moves inferiorly to supply the lower part of the descending colon. It anastamoses with the superior sigmoid artery.

Sigmoid arteries - supply descending colon and the sigmoid colon

Superior Rectal artery - supplies the rectum

50
Q

What is the marginal artery?

A

Continuous arterial circle along the inner border of the colon. Straight vessels arise form the artery to supply the colon.

51
Q

What makes up the marginal artery?

A
  • Illeocolic, right colic and middle colic of superior mesenteric artery.
  • Left colic and sigmoid branches of the inferior mesenteric artery
52
Q

What is the arc of riolan?

A

Anastomosis between the middle colic branch of superior mesenteric artery and left colic branch of inferior mesenteric artery.

53
Q

Which artery can a horseshoe kidney hook onto?

A

Inferior mesenteric artery

54
Q

What is the venous drainage of the gut?

A

Hepatic portal vein

Kofi: Pure Clinical Sem 3 (44 decks)

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