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Gastrointestinal system > GI anatomy and hernias > Flashcards

GI anatomy and hernias Flashcards

1
Q

What are the muscle layers of the abdominal wall from out to in?

A

external oblique
Internal oblique
transversus abdominis
then rectus abdominalis

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2
Q

What is the linea alba?

A

aponeurosis running down the middle of the rectus abdominis

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3
Q

What are the regions of the abdomen called?

A
  • Right and left hypochondrium (upper lateral)
  • epigastric (upper middle)
  • Right/ left flank AKA lumbar (mid lateral)
  • umbellical region (mid mid)
  • R and L groin/ illiac (lower lateral)
  • Pubic/ hypogastric region (lower mid)
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4
Q

List intra pertioneal structures:

A
  • liver
  • stomach
  • gall bladder
  • small bowel
  • spleen
  • uterus and uterine tubes
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5
Q

What connects intrapertioneal structres to the abdominal wall and carries their blood/ nervous supply?

A

Mesenteries

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6
Q

List retroperioneal structures

A
  • vena cava
  • abdominal aeorta
  • kidneys
  • pancreas
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7
Q

What is the greater omentum?

A

A double fold of peritoneum that attaches to the greater curve of the stomach and the transversing colon, and forms a blanket over the small bowl.

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8
Q

What is the role of the greater omentum?

A
  • protection of small bowel

- can migrate to close infection so stop it spreading

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9
Q

What are the names of the gutters created either side of the colon by peritoneal reflections?

A

Paracolonic gutters

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10
Q

What is the name of the two pouches formed in females between anus and uterus and bladder and uterus

A
  • anus- uterus is douglas pouch (recto-uterine pouch)

- uterus- bladder is vesicouterine pouch

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11
Q

What is the name of the pouch of peritoneum in men between anus and bladder

A

rectovesicle pouch

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12
Q

What is the entrance to the lesser sac called?

A

foramen of windslow/ epigloic foramen

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13
Q

Describe the location of the lesser sac:

A
  • posterior to stomach, anterior to pancreas
  • above traversing colon
  • in between spleen and liver
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14
Q

Describe the blood supply to the fore, mid and hind gut

A
  • forgut supplied by branches of the celiac trunk which comes off the abdominal aeorta
  • mid gut supplied by the superior mesenteric
  • hindgut supplied by the inferior mesenteric
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15
Q

What is a hernia?

A

a protrusion of part of the abdominal contents beyond the normal confines of the abdominal wall

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16
Q

What are the three parts of a hernia?

A

The sac, the coverings of the sac and the contents of the sac

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17
Q

What is sac and contents of the sac for abdonimal hernias?

A

sac is usually peritoneum and contents is usually bowel, omentum or fat

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18
Q

What are the three branches of the celiac trunk?

A

The Left gastric
The common hepatic
the splenic artery

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19
Q

What does the left gastric artery do

A

supplies the lesser curve of the stomach

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20
Q

What does the splenic artery do? (4)

A
  • Supplies spleen
  • Supplies pancreas on its way through
  • supplies superior stomach with short gastric arteries
  • Supplies part of greater curve of stomach via left gastro- epiploic artery
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21
Q

Describe the branching of the common hepatic artery? (3 inermediate, 6 final branches)

A
  • Becomes proper hepatic, right gastric and gastro- duodenual
  • Proper hepatic becomes R and L hepatic, R hepatic branches off to gall bladder
  • Gastroduodenal branches off to give superior pancreoduodenal (to panceas and duodenum) and right gastroepiploic artery
22
Q

What artery can be perforated in posterior upper dueodenal ulceration?

A

gastroduodenal artery

23
Q

What are the 4 common abdominal hernia locations?

A
  • inguinal canal
  • femoral canal
  • umbilicus
  • previous incisions
24
Q

What is the inguinal canal (brief definition)

A

The oblique passage through the lower part of the abdominal wall.

25
Q

What makes up the boarders of the inguinal canal?

A

Floor- Inguinal ligament (and lacunar ligament for part)
Anterior- aponeurosis of external oblique and internal oblique
Roof- transversalis fascia, internal oblique and transversalis abdominus
Posterior wall- internal oblique and transversus abdominus + transversalis fascia

26
Q

What runs through the inguinal canal?

A

The spermatic cord- enters in deep inquinal ring, exits at superficial inguinal ring

27
Q

What is a processus vaginalis?

A

Part of the peritoneum which is pinched off by the descending testicle. it should regress to form a small bit of tissue called the obliterated processus vaginalis.

28
Q

What is the difference between a direct and indirect hernia?

A

Indirect goes through deep inguinal ring. Direct bulge through hesselbachs triange (area of weakness in inguinal canal posterior wall).
Direct hernias will therefor be medial to the inferior epigastric vessels.

29
Q

What makes up hesselbaches triangle?

A

medially- rectus abdominus
laterally- inferior epigastric artery and vein
posteriorly- inguinal ligament

30
Q

What anatomical variation means indirect inguinal hernias can go all the way down into scrotum?

A

persisting processus vaginalis

31
Q

Are indirect or direct inguinal hernias more common and on which side are indirect hernias more common?

A
  • indirect more common
  • more common on right
  • more common in males
32
Q

Are femoral hernias more common in M or F? Why?

A

females because they have wider pelvis’ so wider femoral canals so bits can more easily get down there

33
Q

Whats the difference between a incarcerated and a strangulated femoral hernia?

A 
incarcerated= stuck so cant be pushed back in 
strangulated= blood supply cut, usually as a result of incareceration
34
Q

What are congenital umbelical hernias called?

A

omphalocele

35
Q

What are the symptoms of a hernia?

A 
pain 
nausia 
vomiting 
possible sepsis 
visual clue
36
Q

What commonly herniates first in epigastric hernias?

A

usually fat poking through tunica alba, may progress into peritoneum and bowel coming through too

37
Q

What are the parts of the stomach from top to bottom?

A

cardia at entrance
fundus at top
body in middle
pyloris at bottom

38
Q

What are the muscle layers of the stomach from inside out?

A

oblique muscle layer
circular muscle layer
longditional muscle layer

39
Q

State the layers of the bowel from inside out

A
  • mucosa (epethilium, lamina propria (CT+ GALT), muscularis mucosae)
  • Submucosae (dense CT + meissners plexus)
  • inner circular and outer longditional muscle layers + myenteric/ auerbachs plexus
  • peritoneum
40
Q

Describe the epethilia types of the GI tract

A
  • stratified squamous in oesphagus and distal anus

- columnar in between

41
Q

Where is the arcurate line and what is its significance?

A

in middle between pubis and belly button
This marks where there is only aponeurosis over the top of the rectus abdonimus, not below. This means hernias are more likely below here.

42
Q

What are the gastrosplenic and gastrocolic ligaments?

A

double folds of peritoneum connecting stomach to spleen and transvering colon

43
Q

What are the differences between the jejneum and illeum

A

Illeum has more payers patches and is distal

Jejneum is wider, absorbs more, secretes more and has greater blood supply

44
Q

What are the 3 branches of the celiac trunk?

A
  • Left gastric (supplies upper/ lesser curve of stomach)
  • Splenic artery (travels posterior to the stomach, gives off branches along its course + left gastro splenic artery which supplies the lesser curve and short gastric arteries to supply the fundus
  • Common hepatic artery
45
Q

Describe the branches of the common hepatic artery

A

It bifurcates into the proper hepatic which gives off right gastric (supplies some of lesser curve of stomach) and bifucates to become L and R hepatic, the R hepatic also gives branch to gall bladder.
The other part of the bifucation is to the gastroduodenal artery which travels behind the duodenum, and splits into the superior pancreatoduodenual artery and the right gastroepiloic artery (also supplies greater curve of stomach)

46
Q

At what level do the celiac trunk, superior mesenteric and inferior mesenteric arteries branch off the abdominal aeorta?

A

Celiac trunk- T12
SMA- L1
IMA- L3

47
Q

At what levels do the oesophagus, aeorta and IVC penetrate the diaphragm?

A

Oesophagus- T10
Aeortic hiatus- T12
Inferior Vena Cava- T8
count the number of letter in each word

48
Q

What branches does the superior mesenteric artery produce?

A

Jejneal and illeal branches to the small intestine
Middle colic
right colic
ileocolic
these 3 join up along the ascending and transverse colon to from the marginal branch

49
Q

What branches does the inferior mesenteric artery produce?

A 
left colic (contributes to the marginal artery)
sigmoid arteries (multiple)
superior rectal artery
50
Q

What nerve roots make the greater, lesser and least splanchnic nerves?

A 
greater= T5-9
lesser= T9 and 10
least= T11 and 12

Gastrointestinal system (9 decks)

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