GI AND LIVER Flashcards
What is the blood supply for the foregut?
Coeliac trunk
What is the blood supply for the midgut?
Superior mesenteric artery
Blood supply for the hindgut?
Inferior mesenteric artery
Nerve supply of foregut and nerve roots of this?
Greater splanchnic nerve T5-T9
Nerve supply of midgut and nerve roots of this?
Lesser splanchnic nerve T10-T11
Nerve supply of hindgut and nerve roots of this?
Least splanchnic nerve T12
What make up the foregut?
Oesophagus, stomach, duodenum (1st & 2nd), liver, pancreas, biliary apparatus, gall bladder
What makes up the midgut?
Duodenum (3rd & 4th part), jejunum, ileum, caecum, appendix, ascending colon, proximal 2/3rd of transverse colon.
What makes up the hindgut?
Distal 1/3rd of transverse colon, descending colon, sigmoid colon, rectum.
What is the 1st part of the duodenum suspended by?
Greater omentum and hepatoduodenal ligament
Where is the ampulla of vater located and what is it?
2nd part f duodenum, and this is the opening where the pancreatic duct drains into the duodenum along with the common bile duct.
What are the 2 sphincters of the stomach?
From oesophagus to stomach = cardiac sphincter
From stomach to intestines = pyloric sphincter
What are the muscular ridges called in the stomach and what do they do?
Rugae - help digest food (increase surface area)
*What supplies the greater curvature of the stomach?
Right & left gastro-epiploic arteries
*Where do the right and left gastro-epiploic arteries arise from?
Right = arises from common hepatic artery via gastroduodenal artery Left = branch of splanchnic artery
*What supplies the lesser curvature of the stomach?
Right & left gastric arteries
*Where do the right and left gastric arteries arise from?
Right = arises from common hepatic artery Left = direct from coeliac trunk
*What is the blood supply of the fundus of the stomach?
Short gastric arteries - branches of splenic artery
How is the stomach attached to the liver?
Via lesser omentum
What does the lesser omentum carry?
The portal triad
What is the portal triad?
hepatic artery, hepatic portal vein and common bile duct
What is the gastric bed?
Pancreas & splenic artery & part of duodenum
What is the environment of the stomach?
High acidity
How can peptic ulcers form?
By destruction of mucosa due to high acidity of stomach
Where does the coeliac trunk branch?
In front of aorta just below the diaphragm (at aortic hiatus T12)
Where does the foregut receive it’s sympathetic and parasympathetic nerve supply?
Sympathetic - greater splanchnic nerve T5-T9
Parasympathetic - Vagal trunk (Vagus nerve/CN X)
*Gastroduodenal artery is a branch of?
Common hepatic artery
What is the space called behind the stomach?
Lesser sac
What is the epiploic foramen?
It’s a hole behind the portal triad into the lesser sac
What are the bounds of the lesser sac?
Bounded from greater curvature of the stomach by the greater omentum
Bounded from lesser curvature of the stomach and caudate lobe of liver by lesser omentum
RADIOLOGY: What substance is given to a patient before an x-ray is taken of the GI tract and why?
Barium sulfate because it isn’t absorbed by the body but absorbs xrays to show the lining of the stomach and GI tract.
Where is the common site of a peptic ulcer?
Posterior wall of the 1st part of the duodenum
At what vertebral level does the oesophagus pass through the duodenum?
T10
Which structures pass through the diaphragm alongside the oesophagus?
Vagal trunks, inferior oesophageal artery & vein
From where does the stomach receive it’s nerve supply?
Sympathetic - greater splanchnic nerve T5-T9
Parasympathetic - vagus nerves (CN X)
Which structures lie in front of the stomach?
Left lobe of liver, anterior abdominal wall
Which structures lie behind the stomach?
Lesser sac, behind the lesser sac is the pancreas & diaphragm
What is porto-systemic anastomosis?
A vein which joins the hepatic portal system to the systemic system. It can take blood from the bowel and bypass the liver to return the blood to the heart.
What are the functions of the stomach? (9 in total)
- store and mix food
- dissolve and continue digestion
- regulate emptying into the duodenum
- kill microbes
- secrete proteases
- secrete intrinsic factor (that absorbs Vit B12 in the ileum)
- activate proteases
- lubrication
- mucosal protection