GI Class 1 - Wet Lab Flashcards

1
Q

name 1 and 2

A

1 - xiphoid process

2 - right and left costal margins

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2
Q

name 3 and 4

A

3 - 12th rib

4 - iliac crest

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3
Q

name 5 and 6

A

5 - anterior superior iliac spine

6 - pubic tubercle

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4
Q

name 7 and 8

A

7 - pubic crest

8 - pubic symphysis

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5
Q

name 9 and 10

A

9 - body of lumbar vertebrae

10 - sacroiliac joint

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6
Q

name the 4 quadrants of the abdomen

A

1 - right upper

2 - left upper

3 - right lower

4 - left lower

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7
Q

what are the two imaginary lines used to divide the abdomen into 4 quadrants?

name A and B

A

A - transumbilical line

B - medial line (midsagittal)

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8
Q

what are the lines used to divide the abdomen into 9 regions?

name 1, 2 and 3

A

1 - right and left midclavicular lines

2 - trans tubercular line

3 - subcostal/transpyloric line

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9
Q

name the 9 regions of the abdomen

A

right hydrochondriac, epigastric, left hydrochondriac

right lumbar, umbilical, left lumbar

right iliac/inguinal, hypogastric/suprapubic, left iliac/inguinal

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10
Q

what organs or structures may be present in the right hypochondriac region of the abdomen

A

liver

gallbladder

right kidney

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11
Q

what organs or structures may be present in the epigastric region of the abdomen

A

adrenal glands

part of the duodenum

most of the stomach

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12
Q

what organs or structures may be present in the left hypochondriac region of the abdomen

A

left kidney

pancreas

part of the stomach

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13
Q

what organs or structures may be present in the right lumbar region of the abdomen

A

gallbladder

ascending colon

right kidney

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14
Q

what organs or structures may be present in the umbilical region of the abdomen

A

umbilicus

transverse colon

many parts of the small intestine e.g. duodenum, jejunum, illeum

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15
Q

what organs or structures may be present in the left lumbar region of the abdomen

A

descending colon

left kidney

part of the spleen

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16
Q

what organs or structures may be present in the right iliac region of the abdomen

A

caecum

appendix

right iliac fossa

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17
Q

what organs or structures may be present in the hypogastric region of the abdomen

A

bladder

anus

part of the sigmoid oclon

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18
Q

what organs or structures may be present in the left iliac region of the abdomen

A

sigmiod colon

part of the descending colon

left iliac fossa

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19
Q

the antero-lateral abdominal wall is constituted by ______ flat muscles and ____ vertical muscles

A

the antero-lateral abdominal wall is constituted by three flat muscles and two vertical muscles

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20
Q

what is the action of the external oblique?

A

compress and support abdominal viscera

flex and rotate trunk

(functions to pull the chest downwards and compress the abdominal cavity, which increases the intra-abdominal pressure as in a valsalva maneuver. It also performs ipsilateral (same side) side-bending and contralateral (opposite side) rotation)

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21
Q

what is the innervation of the external oblique?

A

thoraco abdominal nerves (anterior rami of T7-11) and subcostal nerve

The external oblique muscle is supplied by ventral branches of the lower six thoracoabdominal nerves and the subcostal nerve on each side

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22
Q

what is the action of the internal oblique?

A

compress and support abdominal viscera

flex and rotate the trunk

(This muscle supports the abdominal wall, assists in forced respiration, aids in raising pressure in the abdominal area, and rotates and turns the trunk with help from other muscles)

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23
Q

what is the innervation of the internal oblique?

A

thoraco-abdominal nerve (anterior rami T7-11), subcostal nerve and the first lubar nerve

(Thoracoabdominal nn. (T7-T11), Subcostal n. (T12), Iliohypogastric n. (L1) and Ilioinguinal n. (L1))

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24
Q

what is the action of the transversus abdominis?

A

compress and supports abdominal viscera

(support for the abdominal wall

role in maintenance of posture

trunk movements: flexion, extension, lateral flexion

raise intra-abdominal pressure e.g. for forced expiration, defaecation, micturition and parturition

via the conjoint tendon, to support the posterior wall of the inguinal canal)

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25
Q

what is the innervation of the transversus abdominis?

A

thoraco-abdominal nerve (anterior rami T7-11), subcostal nerve and the first lubar nerve

(innervated by the anterior primary rami of T7 to T12. The conjoint tendon is supplied by the ilioinguinal nerve (L1))

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26
Q

what is the action of the rectus abdominis?

A

flexes trunk and compresses abdominal viscera

stabilizes and controls tilt of the pelvis

(The action of this muscle pulls the rib cage and the pelvic bone towards the middle of the abdomen, just like the movement when a person performs a sit-up or crunch)

(Flexion of the lumbar spine)

27
Q

what is the innervation of the rectus abdominis?

A

thoraco-abdominal and sub-costal nerves (anterior rami of T7-12 spinal nerves)

(segmentally by thoraco-abdominal nerves (T7 to T11) and subcostal (T12))

28
Q

A

A

transversus abdominis

29
Q

B

A

internal oblique

30
Q

C

A

external oblique

31
Q

D

A

rectus abdominis

32
Q

is the following pictures from above or below the umbilicus?

A

left - below level of umbilicus

right - above level of umbilicus

33
Q

what is the rectus abdominis muscles action on the trunk?

A

flexes trunk and compresses abdominal viscera, stabilizes and controls tilt of the pelvis

34
Q

what is the rectus sheath?

A

contains the rectus abdomins and pyramidalis muscles

The rectus sheath, also called the rectus fascia, is formed by the aponeuroses of the transverse abdominal and the internal and external oblique muscles. It contains the rectus abdominis and pyramidalis muscles

35
Q

what is the rectus sheath made up of?

A

the aponeuroses of the transverse abdominal muscle, external oblique muscle and the intenral oblique muscle

36
Q

what is an aponeurosis?

A

fibrous tissue that takes the place of a tendon in flat muscles having a wide area of attachment

37
Q

how does the rectus sheath differ above and below the umbilicus?

A

above umbilicus: the external oblique runs above the rectus abdominis, transverse abdominis goes behind and the internal oblique splits into 2 and goes above and below

below umbilicus: the rectus sheath only runs on top of the rectus abdominis

arcuate line = a horizontal line that demarcates the lower limit of the posterior layer of the rectus sheath

38
Q

at what vertebral level is the position of the umbilicus on the abdominal wall?

A

L3/4

39
Q

is the umbilicus a good surface landmark?

A

yes

easily visible

20mm off aortic bifurcation

may be used to estimate the position of the aortic bifurcation however, clinicians must be aware that excessive abdominal wall fat may render this landmark inaccurate

40
Q

which thoracic spinal segments innervate the anterior abdominal wall?

A

T7-12

L1

41
Q

what dermatome supplies the level of the umbilicus?

A

T10

42
Q

the inguinal canal is formed during the……

A

relocation of the gonds during fetal development

it is formed from layers of the anterior abdominal wall as these layers push through the wall obliquely, thus forming a canal

43
Q

what is the size and location of the inguinal canal?

A

the canal is approximatley 4cm long and lies parallel to and above the medial half of the inguinal ligament

44
Q

the inguinal ligament is attached to which two bony points of the hip bone?

A

anterior superior iliac crest of the iliac

pubic tubercle of the pubic bone

45
Q

the inguinal canal has what?

A

2 walls

floor

roof

46
Q

what makes up the anterior wall of the inguinal canal?

A

aponeurosis of the external obliques reinforced by the internal oblique muscle laterally

47
Q

what makes up the posterior wall of the inguinal canal?

A

transversalis fascia

(a thin aponeurotic membrane which lies between the inner surface of the transverse abdominal muscle and the parietal peritoneum)

48
Q

what makes up the roof of the inguinal canal?

A

transversalis fascia

internal oblique and transverus abdominis (muscle and apponeurosis)

49
Q

what makes up the florr of the inguinal canal?

A

inguinal ligament

50
Q

what are the 2 openings of the inguinal canal?

A

deep inguinal ring superiorly

superficial inguinal ring inferiorly

51
Q

what is the relationship of the deep inguinal ring to the inferior epigastric vessels?

A

lateral to them

inferior epigastric vessels lie immediately medial to the deep inguinal ring

52
Q

where does the superficial ring lie in relation to the pubic tubercle?

A

just superior (lateral) to it

The superficial (external) ring marks the end of the inguinal canal, and lies just superior to the pubic tubercle

53
Q

what are the superior and inferior epigastric vessels (deep to the rectus abdominis) branches of?

A

superiorly - internal thoracic artery

inferiorly - external iliac artery

54
Q

what are the contents of the male inguinal canal?

A

spermatic cord

ilioinguinal nerve (a branch of the first lumbar nerve (L1))

blood and lymphatic vessles

55
Q

what are the contents of the female inguinal canal?

A

round ligament of the uterus

ilioinguinal nerve (a branch of the first lumbar nerve (L1))

blood and lymphatic vessles

56
Q

name 3 abdominal hernias

A

inguinal hernia

femoral hernias

umbilical hernias

57
Q

what is an inguinal hernia?

A

most common form of hernias

inguinal hernias can be classified as direct or indirect

58
Q

what are indirect inguinal hernias

A

most common

results from congenital weakness in the deep inguinal ring, allowing abdominal contants to enter into the inguinal canal lateral to the inferior epigastric vessles, and even out of the deep inguinal ring

(Indirect inguinal hernias occur when abdominal contents protrude through the deep inguinal ring, lateral to the inferior epigastric vessels; this may be caused by failure of embryonic closure of the processus vaginalis)

59
Q

what are direct inguinal hernias

A

direct hernias account for 1/3 of inguinal hernias

abdominal contents do not pass through the deep inguinal ring, but simply push through weak spot in the muscles making up the posterior wall of the inguinal canal, allowing contents to enter the canal and, again, even pass through the superficial inguinal ring

60
Q

what are femoral hernias?

A

occur below the inguinal ligament, when abdominal contents pass into weak area at the posterior wall of the femoral canal medial to the inferior epigastric vessels

these are more common in females

the risk of strangulation in a femoral hernia is high

61
Q

what are umbilical hernias?

A

occurs when the abdominal contents pass through a weakness at the site of the passage of the umbilical cord through the abdominal wall

in adults umbilical hernias are aquires, rather than congenital

abnormal fibres at the linea alba may also contribute to weakness of the wall

62
Q

what are the layers of the GI tract?

A
  1. mucosa: made of 3 layers
    a) epithelium
    b) lamina propria
    c) muscularis mucosae
  2. submucosa
  3. muscularis externa/propria
  4. serosa (or adventitia)
63
Q

what are the 4 basic mucosal types found in the GI tract and in what locations are they found?

depending on their function

A

protective - oral cavity, pharynx, oesophagus and anal canal

secretory - seen only in the stomach

absorptive - typical of entire small intestine

absorptive/protective - lines the whole of the large intestine

64
Q

describe the featues of each image

A

1 - villi with short glands

2 - stratified squamous epithelium

3 - simple columnar epithelium with tubular glands

4 - closely packed straight glands with goblet cells