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Gastrointestinal Block > GI Anatomy > Flashcards

GI Anatomy Flashcards

1
Q

what are the 4 functions of the upper GI tract (mouth to stomach)?

A

mastication
taste
salivation
deglutition

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2
Q

what does the mixing of food with saliva due to mastication enable? (2)

A

taste

digestion

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3
Q

what muscle in the face pushed food towards the occulsive surfaces of the teeth?

A

buccinator

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4
Q

how many teeth are there?

A

32 (separated into 4 quadrants of 8)

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5
Q

what is the temporomandibular joint between?

A

the articulation between the mandibular fossa and the condylar process which joins the temporal bone of the skull and the mandible

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6
Q

the TMP ____ to allow movement and slides towards the ____ ____

A

dislocates

articular tubercle

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7
Q

the articular disc between the mandibular fossa and the condylar process creates to cavities the ____ and ____

A

superior for translation (gliding)

inferior for rotation

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8
Q

the opening of the jaw at the TMJ is controlled by _ muscles of mastication. _ for opening and _ for closing

A

4
1
3

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9
Q

what nerve are the muscles of mastication supplied by?

A

mandibular division of the trigeminal nerve (CN V3)

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10
Q

what muscles are involved in closing the jaw? (3)

A

temporalis
masseter
medial pterygoid

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11
Q

picture the temporalis muscle. what is it attached to?

A

coronoid process

temporal fossa

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12
Q

picture the masseter muscle. what is it attached to?

A

angle of the mandible

zygomatic arch

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13
Q

picture the medial pterygoid. what is it attached to?

A

medial side/deep of angle of the mandible

pterygoid plates of the sphenoid bone

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14
Q

what muscle is involved in opening the jaw?

A

lateral pterygoid

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15
Q

picture the lateral pterygoid. what is it attached to?

A

condylar process of the mandible

pterygoid plates of the sphenoid bone

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16
Q

CN V3 is what division of the vagus nerve?

A

mandibular division

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17
Q

CN V3 has which kinds of nerve fibres? (2)

A

sensory and motor

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18
Q

CN V3 originates from the _____ and travels through the ______ its motor fibres supply _____ and its sensory fibres supply ______

A

pons
foramen ovale
muscles of mastication
lower third of the face

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19
Q

the hard palate is ____ and the soft palate is _____

A

anterior
posterior
(they are also different colours)

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20
Q

what closes off the nasopharynx during swallowing? (2)

A

soft palate

uvula

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21
Q

what nerve supplies general sensation to the superior half of the oral cavity?

A

CN V2

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22
Q

what nerve supplies general sensation to the inferior half of the oral cavity?

A

CN V3

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23
Q

which cranial nerve carries the sensory part of the gag reflex?

A

CN IX

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24
Q

which cranial nerves carry the motor part of the gag reflex?

A

CN IX and CN X

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25
Q

what is the tongue divided into?

A

posterior 1/3rd

anterior 2/3rds

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26
Q

where is the posterior 1/3rd of the tongue situated?

A

oropharynx

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27
Q

where is the anterior 2/3rds of the tongue situated?

A

oral cavity

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28
Q

what nerve supplies taste and general sensation to the posterior 1/3rd of the tongue?

A

CN IX (glossopharyngeal nerve) for taste and general sensation

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29
Q

what nerve supplies taste to the anterior 2/3rd of the tongue?

A

CNVII (facial nerve)

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30
Q

what nerve supplies general sensation to the anterior 2/3rd of the tongue?

A

CNV3 (mandibular division of the trigeminal nerve)

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31
Q

all the papillae of the tongue have taste buds apart from the ______ papillae

A

filiform

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32
Q

name the 4 types of papillae on the tongue

A

foliate
fungiform
filiform
vallate

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33
Q

the extrinsic muscles of the tongue change the _____ of the tongue during mastication, swallowing and speech

A

position

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34
Q

the intrinsic muscles of the tongue change the ____ of the tongue

A

shape

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35
Q

what are the 4 extrinsic muscles of the tongue?

A

palatoglossus
styloglossus
hyoglossus
genioglossus

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36
Q

all of the extrinsic and intrinsic muscles of the tongue are supplied by CN XII (hypoglossal nerve) apart from which muscle?

A

palatoglossus (innervated by CN X)

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37
Q

what is CN V2?

A

the maxillary division of the trigeminal nerve

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38
Q

what kind of kind of fibres make up CN V2?

A

sensory only

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39
Q

CN V2 originates from the ____ and travels through the _________

A

pons

foramen rotundum

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40
Q

what does CN V2 supply sensory innervation to?

A

the mid-face

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41
Q

what is CN IX?

A

glossopharyngeal nerve

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42
Q

what kind of fibres make up the glossopharyngeal nerve? (5)

A 
special sensory
sensory
motor
visceral afferents
parasympathetic fibres
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43
Q

CN IX originates from the ____ and travels through the ________

A

medulla

jugular foramen

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44
Q

CN IX is the sensory supply to the ________?

A

posterior wall of the oropharynx

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45
Q

CN IX is the secretomotor supply to the ______

A

parotid gland

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46
Q

CN IX supplies sensation and taste to the ________

A

posterior 1/3rd of the tongue

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47
Q

what is CNVII?

A

facial nerve

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48
Q

what kind of fibres make up the facial nerve? (4)

A

special sensory
sensory
motor
parasympathetic

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49
Q

CNVII travels from the ________ junction and then through the ____ bone via the internal ______ then the _______ foramen

A

pontomedullary
temporal bone
internal acoustic meatus
stylodmastoid foramen

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50
Q

what does the CNVII supply? (5)

A 
taste to the anterior 2/3rd of the tongue
muscles of facial expression
oribicularis oris
sublingual salivary gland
submandibular salivary gland
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51
Q

the CNVII nerve splits into 2 branches. one branch supplies _______ and the other branch (________) connects with the CN V__ to supply the _____ and _____ salivary glands

A 
muscles of facial expression
chorda tympani
3
sublingual 
submandibular
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52
Q

name the 3 pairs of salivary glands

A

parotid
submandibular
sublingual

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53
Q

what muscles is the pharynx composed of?

A

3 circular constrictor muscles (outer)

3 longitudinal muscles (inner)

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54
Q

the muscles of the pharynx are involuntary/voluntary?

A

voluntary

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55
Q

which cranial nerve are the pharynx muscles innervated by? (bar one which is innervated by CN_)

A

CN X

palatopharyngeus (one of the longitudinal muscles) is innervated by CN IX

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56
Q

what does the action of the 2 muscle layers of the pharynx cause? (2)

A

elevation of the larynx (closing the laryngeal inlet which prevents aspiration during swallowing)
shortening of the pharynx
(during swallowing and speaking)

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57
Q

what is the midline raphe?

A

the “seam” of the pharynx where all the muscles insert

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58
Q

the ________ is the sphincter between the pharynx and the oesophagus at the level of C_

A

cricopharygeus

C6

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59
Q

where does the oesophagus start and end?

A

starts at the inferior edge of the cricopharyngeus and ends when it enters the cardia of the stomach

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60
Q

what is the nervous supply to the oesophagus?

A

oesophageal plexus

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61
Q

where is the lower oesophageal sphincter?

A

between the oesophagus and the stomach

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62
Q

why is the oesophageal sphincter a physiological instead of anatomical sphincter?

A

has the action of a sphincter (produced by diaphragm contraction and a difference in pressure between the stomach and abdomen) but shows no anatomical thickening of smooth muscle

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63
Q

where are the 3 places the oesophagus is constricted?

A

cervical constriction
thoracic constriction
diaphragmatic constriction

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64
Q

the oesophagus enters the stomach at T__

A

T10

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65
Q

what is the Z-line?

A

the change from oesophageal mucosa to gastric mucosa

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66
Q

what does the pyloric sphincter regulate?

A

chyme entering the duodenum

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67
Q

what does the ileocaecal valve regulate?

A

flow from the ileum to the caecum (distention of the ileum opens the sphincter distention of the colon closes the sphincter)

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68
Q

the internal anal sphincter is made of ___ muscle and the external anal sphincter is made of _____ muscle

A

smooth

skeletal

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69
Q

what is the cardia?

A

where the oesophagus connects with the stomach

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70
Q

where can a gastric bubble be seen?

A

the fundus of the stomach

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71
Q

what is the purpose of rugae in the stomach?

A

to enable distension

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72
Q

what is the incisura angularis?

A

the notch/bend in the lesser curvature of the stomach

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73
Q

what is the sphincter of Oddi?

A

the sphincter that controls the flow of digestive juices through the hepatopancreatic ampulla of vater into the duodenum

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74
Q

what are the 3 parts that make up the small intestine?

A

duodenum
jejunum
ileum

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75
Q

what 3 parts make up the large intestine?

A

colon
rectum
anal canal

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76
Q

what 6 parts make up the colon of the large intestine?

A 
caecum
appendix
ascending colon
transverse colon
descending colon
sigmoid colon
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77
Q

what makes up the foregut?

A

the oesophagus to mid-duodenum
liver and gall bladder
spleen
1/2 of pancreas

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78
Q

what makes up the midgut?

A

mid-duodenum to 2/3rd of transverse colon

1/2 of pancreas

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79
Q

what makes up the hindgut?

A

distal 1/3rd of the transverse colon to proximal 1/2 of anal canal

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80
Q

what is the peritoneum?

A

a thin, transparent, semi-permeable, serous membrane that lines the walls of the abdominopelvic cavity and organs

81
Q

the peritoneum is a ______ membrane made up of ______ and the _______ peritoneum

A

continuous
parietal
visceral

82
Q

what is the peritoneal cavity and what does it contain?

A

the space between the visceral and parietal layers of peritoneum. it contains lubricating fluid that reduces the friction of the gut movement

83
Q

what is the peritoneal cavity divided into?

A

the greater sac

the lesser sac (omental bursa)

84
Q

what are the 2 features of intraperitoneal organs?

A

are almost completely covered in visceral peritoneal

minimally mobile

85
Q

what are the 4 features of intraperitoneal organs with a mesentery?

A

covered in visceral peritoneum
visceral peritoneum wraps behind the organ to form a double layer (mesentery)
mesentery attaches the organ to the body wall
very mobile

86
Q

what are the 2 features of retroperitoneal organs?

A

they are situated behind the peritoneum (the retroperitoneum)
only have visceral peritonuem on their anterior surface

87
Q

what are the 9 intraperitoneal organs?

A 
Liver 
Gall bladder
Stomach
Spleen
1st part of the duodenum
Ileum
Jejunum
Transverse colon
Sigmoid colon
88
Q

what are the 7 retroperitoneal organs?

A 
Kidneys
Adrenal glands
Pancreas
Caecum 
Ascending colon
Descending colon
2nd, 3rd and 4th parts of the duodenum
89
Q

what are the 3 peritoneal formations?

A

mesentery
omentum
peritoneal ligaments

90
Q

what is the mesentery?

A

a formation of a double layer of peritoneum that connects an organ to the posterior abdominal wall

91
Q

mesentery have a core of _______ tissue consisting of (x4 things)

A 
connective
blood
lymph vessels and nodes
nerves
fat
92
Q

what is the mesentery proper attached to?

A

the small intestine

93
Q

what are the 2 omentums?

A

greater omentum

lesser omentum

94
Q

where does the greater omentum hang from and what does it connect to?

A

the greater curvature of the stomach and the duodenum and then folds back on itself to attach to the transverse colon

95
Q

what is the lesser omentum connected to?

A

the lesser curvature of the stomach and the duodenum to the liver

96
Q

what is a key feature of the lesser omentum?

A

it has a free edge (which the portal triad is contained within)

97
Q

through what do the greater and lesser sacs communicate?

A

omental foramen (which is located at the free edge of the lesser omentum)

98
Q

what is a peritoneal ligament and what does it do?

A

A peritoneal ligament is a double-layer of peritoneum which connects an organ with another organ or the body wall

99
Q

Hepatogastric ligament attaches the ______ and the _____ to each other

A

liver

stomach

100
Q

what is the hepatoduodenal ligament and what does it contain?

A

it is the thickened free edge of the lesser omentum and contains the portal triad

101
Q

hepatoduodenal ligament attaches the ______ and the _______ to each other

A

liver

duodenum

102
Q

The falciform ligament attaches the _____ to the ____________

A

liver

anterior abdominal wall

103
Q

Gastrosplenic ligament attaches the ______ and the _____ to each other

A

stomach

spleen

104
Q

Splenorenal ligament attaches the ____and the _______ to each other

A

spleen

left kidney

105
Q

what pouches does the inferior part of the peritoneum create in females?

A

vesico-uterine pouch

recto-uterine pouch

106
Q

what pouches does the inferior part of the peritoneum create in males?

A

recto-vesical pouch

107
Q

what kind of nerves supply the visceral peritoneum (and abdominal cavity organs)? (3)

A

visceral afferents
enteric nervous system
autonomic motor nerves

108
Q

what kind of nerves supply the parietal peritoneum (and abdominal wall)? (3)

A

somatic sensory nerves
somatic motor nerves
sympathetic nerve fibres

109
Q

where do the abdominal associated sympathetic nerves leave the spinal cord?

A

T5-L2

110
Q

abdominal associated sympathetic nerves synapse at the sympathetic chain (true/false)

A

false - they do not synapse here

111
Q

what do the abdominal associated sympathetic nerves pass out of the sympathetic chain within?

A

the abdominopelvic splanchnic nerves

112
Q

where do abdominal associated sympathetic nerves synapse?

A

at prevertebral ganglia

113
Q

what are the prevertebral ganglia that abdominal associated sympathetic nerves synapse at? (3)

A

celiac ganglia
superior mesenteric ganglia
inferior mesenteric ganglia

114
Q

what is a periarterial nerve plexus?

A

an autonomic plexus that accompanies an artery surrounding it in a network of autonomic nerve fibres

115
Q

what is different about the sympathetic nerves supplying the adrenal gland compared to the sympathetic nerves supplying the rest of the abdominal organs?

A

they do not synapse at prevertebral ganglia and instead synapse directly onto the cells of the adrenal glands

116
Q

where do the abdominal associated parasympathetic nerves leave the spinal cord?

A

CNX

pelvic splanchnic nerves (S2,3,4)

117
Q

how does the vagus nerve enter the abdominal cavity?

A

on the surface of the oesophagus

118
Q

where does the vagus nerve supply parasympathetic innervation to in the GI tract?

A

up the the border between the midgut and the hindgut

119
Q

where do the pelvic splanchnic nerves supply parasympathetic innervation to in the GI tract?

A

hindgut

120
Q

where is foregut pain referred to?

A

epigastric region

T6-T9 dermatome

121
Q

where is midgut pain referred to?

A

umbilical region

T8-T12 dermatome

122
Q

where is hindgut pain referred to?

A

pubic region

T12-L2

123
Q

why is appendicitis pain felt as dull and aching then sharper?

A

The appendix is a midgut organ so the pain is felt in the umbilical region initially (dull and aching)

As the appendix inflames it starts to touch the body wall causing somatic pain (sharp)

124
Q

what are the thoracoabdominal nerves?

A

intercostal nerves arising from the anterior rami of T7-T11

125
Q

what is the subcostal nerve?

A

T12 anterior ramus

126
Q

what is the iliohypogastric nerve?

A

half of L1 anterior ramus

127
Q

what is the ilioinguinal nerve?

A

the other half of the L1 anterior ramus

128
Q

what nerves supply the abdominal muscles?

A 
(somatic motor, somatic sensory and sympathetic)
thoracoabdominal nerves
subcostal nerve
iliohypogastric nerve
ilioinguinal nerve
129
Q

what abdominal muscles do the thoracoabdominal nerves supply? (4)

A

External oblique
Internal oblique
Transversus abdominis
Rectus abdominus

130
Q

what abdominal muscles does the subcostal nerve supply? (2)

A

External oblique

Transversus abdominis

131
Q

what abdominal muscles does the iliohypogastric nerve supply? (2)

A

Internal oblique

Transversus abdominis

132
Q

what abdominal muscles does the ilioinguinal nerve supply? (2)

A

Internal oblique

Transversus abdominis

133
Q

what quadrant is the liver located in?

A

right upper quadrant

134
Q

what ribs protect the liver?

A

7-11

135
Q

where is the gall bladder in relation to the liver?

A

posterior and inferior

136
Q

the stomach is ____ to the liver

A

posterior

137
Q

what is bilirubin the by-product of?

A

red blood cell breakdown

138
Q

peritonitis can result in a collection of pus in which recesses of the peritoneal cavity? (this can then lead to the formation of an abscess)

A

heptorenal recess (Morrison’s pouch)

sub-phrenic recess

139
Q

how many anatomical lobes does the liver have and what are the called?

A 
4
right lobe
left lobe
caudate lobe
quadrate lobe
140
Q

how many functional segments does the liver have and in what direction are they named?

A

8

named in a clockwise direction from the 1st segment in the middle

141
Q

what does each functional liver segment have? (4 things)

A

hepatic artery branch
hepatic portal vein branch
bile drainage
hepatic vein for venous drainage

142
Q

how many veins come from the liver to enter the IVC?

A

3

143
Q

what is the 1st midline branch from the aorta?

A

coeliac trunk

144
Q

what is the arterial supply to the forgut?

A

coeliac trunk

145
Q

at what vertebrae level does the coeliac artery branch from the aorta?

A

T12

146
Q

what 3 branches does the coeliac trunk trifurcate into?

A

splenic artery
left gastric artery
common hepatic artery

147
Q

why is the splenic artery tortuous?

A

to allow it to stretch when the stomach expands as it runs posterior to the stomach

148
Q

what does the common hepatic artery branch to give?

A

hepatic artery proper
gastroduodenal artery
right gastric artery

149
Q

the right and left gastric arteries ______

A

anastomose

150
Q

which artery supplies the spleen?

A

splenic artery

151
Q

which region of the stomach is the spleen located in?

A

left hypochondrium

152
Q

what is posterior to the spleen?

A

diaphragm

153
Q

what is anterior to the spleen?

A

stomach

154
Q

what is inferior to the spleen?

A

splenic flexure

155
Q

what is medial to the spleen?

A

kidney

156
Q

what ribs protect the spleen?

A

9-11

157
Q

what is the most injured abdominal organ?

A

the spleen

158
Q

where are red blood cells broken down to produce bilirubin?

A

spleen

159
Q

what is the major blood supply to the stomach? (2)

A

gastric arteries

gastro-omental arteries

160
Q

where do the right and left gastric arteries anastamose?

A

the junction between the lesser curvature and the lesser omentum

161
Q

where do the right and left gastric arteries anastamose?

A

the junction between greater curvature and the greater omentum

162
Q

what is the minor blood supply to the stomach? (2)

A

posterior gastric arteries

short gastric arteries

163
Q

what is the arterial supply to the liver?

A

right and left hepatic arteries (which are branches of the hepatic artery proper)

164
Q

what vein drains the foregut to the liver?

A

splenic vein

165
Q

what vein drains the midgut to the liver?

A

superior mesenteric vein

166
Q

what vein drains the hindgut to the splenic vein then the liver?

A

inferior mesenteric vein

167
Q

what is the function of the gallbladder?

A

to store and concentrate bile

168
Q

what are the 4 parts of the gallbladder?

A

fundus
body
neck
cystic duct (spiral valve)

169
Q

what artery supplies the gallbladder with blood?

A

cystic artery

170
Q

the cystic artery is usually a branch of which other artery?

A

the right hepatic artery

171
Q

where is the cystic artery located?

A

the cystohepatic triangle of calot

172
Q

what forms the cystohepatic triangle of calot?

A

the cystic duct and the common hepatic duct

173
Q

what is a cholescystectomy?

A

the surgical removal of the bladder

174
Q

where is gallbladder pain referred to?

A

epigastric region
right hypochondrium
right shoulder

175
Q

what is the biliary tree?

A

a series of ducts that directs the secretions from the liver, gallbladder and pancreas to the duodenum

176
Q

where does the heptopancreatic ampulla of Vater drain into?

A

2nd part of the duodenum

177
Q

where does the heptopancreatic ampulla of Vater enter the 2nd part of the duodenum?

A

the major duodenal papillae

178
Q

what enters the duodenum via the minor papillae?

A

accessory pancreatic duct

179
Q

what are the 4 parts of the pancreas?

A

head (with uncinate process)
neck
body
tail

180
Q

where does the head of the pancreas sit?

A

within the curvature of the duodenum

181
Q

what does the tail of the pancreas touch?

A

the spleen

182
Q

where does duodenal ulcer pain radiate to?

A

the epigastric region

183
Q

where does pancreatic pain radiate to?

A

epigastric region
umbilical region
back

184
Q

branches of which midline branches of the aorta supply the duodenum and pancreas? (2)

A

coeliac trunk

superior mesenteric artery

185
Q

what arteries anastamose to supply the pancreas and duodenum?

A

superior and inferior pancreaticduodenal arteries

186
Q

what do the inferior pancreaticduodenal arteries branch from?

A

the superior mesenteric artery

187
Q

what do the superior pancreaticduodenal arteries branch from?

A

gastroduodenal artery (from the common hepatic artery which branches from the coeliac trunk)

188
Q

where does the jejunum begin?

A

the duodenaljejunal flexure

189
Q

where does the ileum end?

A

ielocaecal junction

190
Q

the jejunum/ileum is darker in colour

A

jejunum

191
Q

which part of the small intestine has a thinner, lighter walls?

A

ileum

192
Q

which part of the small intestine is more vascular?

A

jejunum

193
Q

which part of the small intestine has more mesenteric fat?

A

ileum

194
Q

which part of the small intestine has lymphoid tissue (Peyer’s patches)?

A

ileum

195
Q

which part of the small intestine has more plicae circularis?

A

jejunum

196
Q

what supplies the jejunum and ileum with blood and venous drainage?

A

superior mesenteric artery/vein (via jejunal and ileal arteries/veins)

197
Q

The vessels that supply the jejunum and ileum with blood travel within the ________

A

mesentery

198
Q

where is fat from digestion returned to the bloodstream?

A

thoracic duct (as it is absorbed into the lymphatic system via the lacteals in the small intestine)

Gastrointestinal Block (8 decks)

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