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Anatomy Year 2 - Robbie > GI class 2 - dry lab > Flashcards

GI class 2 - dry lab Flashcards

1
Q

the peritoneum is a transparent serous membrane that covers body wall and organs

although it is one continous layer, it is often described differently, depending on whether it lines the body wall or covers the organs

what are the 2 subdivisions?

it can also form folds, such as mesenteries and omenta, as well as ligaments, which may be vascular or avascular

A

parietal

visceral

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2
Q

define the term peritoneal cavity?

A

the potential space between the parietal and visceral peritoneum

The peritoneal cavity is a true space between the parietal peritoneum (the peritoneum that surrounds the abdominal wall) and visceral peritoneum (the peritoneum that surrounds the internal organs)

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3
Q

the 2 major divisions of the peritoneal cavity are termed sacs

which are these?

A
  1. greater sac
  2. lesser sac
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4
Q

through which passage do the two sacs communicate?

A

epiploic foramen

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5
Q

where is the epiploic foramen?

A

posterior to the free edge of the lesser omentum

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6
Q

organs can be described depending upon how they are peritonised

organs completley surrounded by visceral peritoneum are _____________

or only covered on their anterior surface and therefore firmly attached to the posterior wall are ____________

A

intraperitoneal

retroperitoneal

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7
Q

what are some retroperitoneal organs?

A

Main ones: ascending colon, descending colon, kidneys, pancreas

S = Suprarenal (adrenal) Glands

A = Aorta/IVC

D = Duodenum (except the proximal 2cm, the duodenal cap)

P = Pancreas (except the tail)

U = Ureters

C = Colon (ascending and descending parts)

K = Kidneys

E = (O)esophagus

R = Rectum

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8
Q

what are some intraperitoneal organs?

A

main ones: stomach, liver, spleen, transverse colon

The intraperitoneal organs are the stomach, spleen, liver, bulb of the duodenum (1st part), jejunum, ileum, transverse colon, and sigmoid colon

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9
Q

what is present in the peritoneal cavity?

A

peritoneal fluid (50ml)

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10
Q

what is extraperitoneal?

A

the term extraperitoneal is used to describe the structures in the abdomino-pelvic cavity which are not covered in peritoneum

retroperitoneal structures may only be partially peritonised

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11
Q

what layer of peritoneum is more sensitive to pressure, pain, heat and cold?

A

parietal peritoneum

has more somatic nerve innervation

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12
Q

A

A

lesser omentum

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13
Q

B

A

greater sac

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14
Q

C

A

epiploic foramen

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15
Q

D

A

lesser sac

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16
Q

E

A

greater omentum

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17
Q

what is the attachment of the greater omentum?

A

greater curvature of the stomach to posterior abdominal wall

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18
Q

what is the attachment of the lesser omentum

A

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

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19
Q

the greater omentum is often referred to by surgeons as the abdominal policemen, explain this

A

the lower margin and the left and right margins are free, and it moves about the abdominal cavity in response to peristaltic movements

in infection, especially appendicitis, inflammatory exudate causes the omentum to adhere to the site of infection, and wrap itself around the infected organ

this localises the infection to a small area of the cavity, protecting against serious diffuse peritonitis

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20
Q

what is peritoneal pain?

A

pain form the partietal peritoneum lining the abdominal wall is innervated by the lower 6 thoracic nerves and L1, thus pain here is somatic and can be precisely localised. it is extremely sensitive to streching, made use of in clinical diagnosis - rebound tenderness

the visceral peritoneum is innervated by autonomic nerves. pain is often referred, and is dull and poorly localised. becuase the GI tract is a midline structure receiving bilateral nerve supply, pain is referred to the midline

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21
Q

what are some wall msucles of the posterior abdominal wall?

A

psoas major

iliacus

quadratus lumborum

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22
Q

what are some organs of the posterior abdominal wall

A

kidneys

ureter

supradrenal gland

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23
Q

what are some main vessels of the posterior abdominal wall?

A

IVC

aorta

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24
Q

what are some main nerves of the posterior abdominal wall?

A

femoral nerve

obturator

(2 main branches of the lumbar plexus)

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25
Q

what are the 3 main openings in the diaphragm and what vertebral levels do they occur at?

A

caval hiatus - T8

oesophageal hiatus - T10

aortic hiatus - T12

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26
Q

what are the 3 main branches of the abdominal aorta which supplies blood to the gut tube within the abdominopelvic cavity?

A

coeliac artery

superior mesenteric artery

inferior mesenteric artery

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27
Q

at what vertebral level does the abdominal aorta divide into 2 common iliac arteries?

A

L4

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28
Q

how is the IVC formed in the abdomen?

A

formed by the union of the right and left common iliac veins

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29
Q

a

A

left gastric artery

30
Q

b

A

splenich artery

31
Q

c

A

proper hepatic artery

32
Q

d

A

superior mesenteric artery

33
Q

e

A

inferior mesenteric artery

34
Q

a

A

hepatic portal vein

35
Q

b

A

splenic vein

36
Q

c

A

superior mesenteric vein

37
Q

d

A

inferior mesenteric vein

38
Q

what 3 main branches supply the gut tube? and what levels do these 3 midline branches occur?

A

coeliac artery - T12

superior mesenteric artery - L1

inferior mesenteric artery - L3

39
Q

what are foregut strucutres?

A

abdominal part of oesophagus

stomach

proximal duodenum

40
Q

what are midgut structures?

A

distal duodenum

jejunum

ileum

caecum

ascending colon]proximal 2/3 of transverse colon

41
Q

what are hindgut strucutres?

A

distal 1/3 pf transverse colon

descending colon

sigmoid colon

rectum

42
Q

artery supply foregut =

artery supply midgut =

artery supplying hindgut =

A

artery supply foregut = coeliac artery

artery supply midgut = superior mesenteric artery

artery supplying hindgut = inferior mesenteric artery

43
Q

name additional foregut and midgut-derived organs which are not part of the gut tube?

A

pancreas

liver

spleen

gallbladder

44
Q

what is the venous drainage of the GI tract?

A
45
Q

blood from the abdominopelvic gastrointestinal tract drains via a portal system to the liver

what is a portal system?

A

any system of blood vessels which has a capillary network at each end

(the system of blood vessels consisting of the hepatic portal vein with its tributaries and branches)

46
Q

the portal vein is formed by the union of which 2 major veins of the abdominal cavity?

A

superior mesenteric vein

splenic vein

47
Q

blood from the gut tube superior to the diaphragm and inferior to the pelvic floor drains via the systemic venous system. this means that an anastomosis is present at these watersheds: porto-systemic (portocaval anastomoses)

list the 4 sites of portocaval anastomosis in the body?

A

in the distal oesophagus

superior part of the rectum

umbilicus

area of the liver

48
Q

what is the clinical significance of these portocaval anastomoses?

A

in liver disease, e.g. hepatic cirrhosis, could cause back pressure leading to bleeding

can go to systemic blood

49
Q

what is the sympathetic nerve supply to the abdominal viscera done by?

A

abdominopelvic splanchnic nerves (greater, lesser and least)

prevertebral sympathetic ganglia

abdominal aorta plexuses

50
Q

what is the parasympathetic nerve supply yo the abdominal viscera done by?

A

anterior and posterior vagal trunks (vagus nerve - 10th cranial nerve)

pelvic splanchnic nerves (S2, S3 and S4)

51
Q

does parasympathetic and sympathetic innervation increase or decrease GI secretion?

A

parasympathetic -

sympathetic -

52
Q

does parasympathetic and sympathetic innervation increase or decrease GI secretion?

A

parasympathetic -

sympathetic -

53
Q

does parasympathetic and sympathetic innervation increase or decrease GI secretion?

A

parasympathetic - increases

sympathetic - decreases

54
Q

does parasympathetic and sympathetic innervation increase or decrease peristalsis or GI motility?

A

parasympathetic - increases

sympathetic - decreases

55
Q

what is the effect of parasympathetic and sympathetic innervation on blood vessels?

A

parasympathetic - little effect

sympathetic - vasoconstriction

56
Q

what is the effect of vagotomy on gastric secretion?

(a surgical operation in which one or more branches of the vagus nerve are cut, typically to reduce the rate of gastric secretion (e.g. in treating peptic ulcers))

A

reduces it

57
Q

what is the functional difference between the greater, lesser and least splanchnic nerves (splanchnic means viscera) and the pelvic splanchnic nerves?

A

greater, lesser and least are sympathetic

pelvic are paradympathetic

58
Q

what is the chief difference in the arrangement of ganglia in the sympathetic and parasympathetic nervous system?

A

sympathetic goes into sympathetic trunk

sympathetic is short pre-ganglionic and long post-ganglionic

parasympathetic is long pre-ganglionic and short post-ganglionic

different outflow regions

59
Q

study the following image

A
60
Q

although not part of the gastrointestinal system, we will consider these additional posterior abdominal wall organs

what am i and where am i found?

A

the kidney

posterior abdominal wall at the level of T12-L3

61
Q

the right kidney lies slightly at a lower level than the left kidney

what is the reason for this?

A

due to the liver on the right side

62
Q

what are the 3 main structure entering or leaving the hilum of the kidney?

A

renal vein

renal artery

pelvis of the ureter

63
Q

what is the top one?

A

renal artery

64
Q

what is the middle one?

A

renal vein

65
Q

what is the bottom one?

A

pelvis of the ureter

66
Q

what is the anterior-to-posterior arrangement of the structures entering and leaving the hilum of the kidney?

A

renal vein - renal artery - ureter

67
Q

how are the kidneys peritonised?

A

retroperitoneal

68
Q

what is the anatomical location of the suprarenl gland, and what type of gland is it?

A

found above the kidneys and are endocrine glands

69
Q

what are ureters?

A

muscular ducts that carry urine from the kidneys to the urinary bladder

70
Q

what is the term used to describe the expanded upper part of the ureter?

A

renal pelvis

71
Q

the ureter is normally ocnstricted at 3 locations during its course from the kidneys to the urinary bladder, what are they?

A
  1. at the junction of the ureters and renal pelvis (pelviiureteric junction)
  2. as the ureters enter the pelvis and crosses over the common iliac artery bifurcation
  3. at the vesicoureteric junction as the ureter obliquely enter the bladder wall

(UVJ is the most distal portion of the ureter, at the point where it connects to the urinary bladder)

From website:

The ureter has a diameter of 3 mm 1 but there are three constrictions, which are the most common sites of renal calculus obstruction:

at the pelviureteric junction (PUJ) of the renal pelvis and the ureter

as the ureter enters the pelvis and crosses over the common iliac artery bifurcation

at the vesicoureteric junction (VUJ) as the ureter obliquely enters the bladder wall

72
Q

are the ureters intraperiotoneal or retroperitoneal?

A

retroperitoneal

Anatomy Year 2 - Robbie (17 decks)

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