GI Tract Flashcards
omenta are
double folds passing from the stomach and duodenum to other organs
arterial branches in the GI tract gain access to peritonised organs through
the double folds of peritoneum
the peritoneal cavity contains
only peritoneal fluid
the peritoneal cavity is anatomically divided into
the greater and lesser (omental bursa) sacs
the greater and omental bursa are linked by
the epiploic foramen
upper right quadrant is called
the right hypochondrium
middle upper quadrant is called
epigastrium
upper left quadrant Is called
left hypochondrium
right middle quadrant is called
right lumbar
middle quadrant is called
periumbilical
left middle quadrant is called
left lumbar
lower middle quadrant is called
hypogastrium
lower right quadrant is called
iliac fossa
lower left quadrant is called
iliac fossa
the oesophagus has how many constrictions and what are they called?
cervical (15cm)
thoracic (27cm)
diaphragmatic (40cm)
the stomach consists of anatomically
cardia, fundus, body, pyloric, antrum, greater and lesser curvatures
the portal triad contains
hepatic artery, portal vein, bile duct
gallbladder can store up to
50ml of bile
cystic artery lies in the triangle of
calot
the triangle of calot is
between common hepatic duct, cystic duct and visceral surface of the liver
what is the exocrine function of the pancreas
pancreatic juice
what is the endocrine function of the pancreas
insulin and glucagon
pancreas lies along what plane?
transpyloric L1/L2
the pancreas is retro or peritoneal?
retroperitoneal
the spleen is related to what ribs
9-11
the main trunk to the foregut is
celiac trunk
the origin of the celiac trunk is
T12 aorta
the main branches of the celiac trunk is
the left gastric artery, the hepatic artery and the splenic artery
midgut structures include
small intestine, 2/3rds of the duodenum, cecum, appendix, ascending colon, 2/3rds of transverse colon.
midgut blood supply is from
superior mesenteric artery
origin of the superior mesenteric artery is
aorta L1
the main branches of the superior mesenteric artery is
jejunal and ileal
the hindgut structures include
left 1/3rd of transverse colon, signmoid colon, rectum and upper part of anal canal.
the blood supply for the hindgut is
the inferior mesenteric artery
the large intestine can be identified from its
omental appendices, sacculations and teniae coli
teniae coli is
thick bands of smooth muscle (longitudinal layer)
the most common position for the appendix is
retrocecal
Macburney’s point is
site of maximum tenderness in acute appendicitis
origin of the inferior mesenteric artery is
L3 aorta
the branches for the inferior mesenteric artery is
left colic, sigmoid and superior rectal.
parasympathetic innervation is from
vagus nerve 10 and pelvic splanchnic nerves s2,s3,s4
sympathetic innervation is from
abdominopelvic splanchnic nerves greater T5-T9, lesser T10-11 and least T12
the portal vein is formed by
union of the splenic vein with the superior mesenteric vein
location of the portal vein is from the
pancreas L2
portocaval shunts sites are
anorectal, gastroesophageal and umbilical
majority of the lymph drainage is done by
the thoracic duct.
foregut is drained lymphatically by the nodes
celiac group
mid gut lymph nodes are
superior mesenteric group
hindgut lymph nodes are the
inferior mesenteric group
contents of inguinal canal in men
spermatic cord
contents of inguinal canal in females
round ligament
the inguinal canal in both sexes contains
blood, lymphatics, ilioinguinal nerve
inguinal canal runs parallel and superior to what
inguinal ligament
what are the four distinct layers of the GI canal
mucosa
submucosa
muscularis externa
serosa/adventitia
the musoca of the GI tract can be broken down into
epithelium
lamina propria
muscularis mucosae
epithelium of the mouth, oesophagus, and anal canal are
stratified squamous
epithelium of the stomach, small intestine and the large intestine are
simple columnar
the submucosa is what and contains what
thick irregular connective tissue and contains neurones, blood vessels and lymph
stomach blood is drained by
gastric veins
pancreas’s blood is drained by
the splenic vein
small intestine, caecum, ascending colon and transverse colon blood flow is drained by
superior mesenteric vein
the descending colon, sigmoid colon and rectum are blood are drained by
inferior mesenteric vein
the hepatic portal vein drains
the gastric, splenic, superior and inferior mesenteric veins
the hepatic portal vein is drained by
hepatic vein
the hepatic vein is drained by
inferior vena cava
innervation of the external oblique
thoraco-abdominal nerves; anterior rami of T7-T11 and subcostal nerve
innervation of the internal oblique and transversus abdominas
thoraco-abdominal nerves; anterior rami of T7-T11 subcostal and first lumbar nerve
rectus abdominas innervation
thoraco abdominal and subcostal nerves; anterior rami of T7-T12
action of external oblique
compress and support abdominal viscera; flexion and rotation
action of internal oblique
compress and support abdominal viscera; flexion and rotation
action of transversus abdominis
compresses and supports abdominal viscera
action of rectus abdominas
flexes trunk and compresses abdominal viscera whilst stabilising and controls tilt of pelvis
what is an aponeurosis
white fibrous connective tissue
umbilical position vertebrate
L3/L4
acruate line is
horizontal line that marks lower limit of the posterior layer of the rectus sheath
inguinal ligament is attached to
anterior iliac spine and pubic symphisis
anterior wall of the inguinal canal
external oblique aponeurosis
posterior wall of the inguinal canal
transversalis fascia
floor of the inguinal canal
inguinal ligament
what is the relationship between the deep inguinal ring to the inferior epigastric vessel
lateral
superior epigastric vessel is a branch of the
internal thoracic
inferior epigastric vessel is a branch of
external iliac artery
superior epigastric vessel supplies
upper rectus abdominas
inferior epigastric vessel supplies
lower rectus abdominas
describe how the greater and lesser omentum sacs communicate
the omental foremen
retroperitoneal organs
kidney, ureter, adrenal gland and rectum
intraperitoneal organs
spleen, stomach, liver, small intestine
what layer of the peritoneum is more sensitive to pressure, pain , heat and cold
parietal
psoas major innervation and function
lumbar plexus via anterior branches of nerves L2-L4 aids with flexing thigh and flexes vertebral column laterally for balance when sitting and flexion of trunk
illiacus innervation and function
femoral nerves L2-L4 and flexes thigh and stabilizes joint with psoas major
quadratus lumborum innervation and function
anterior branches of T12 and L1-L4 and it extends and flexes vertebral column
what are the three openings in the diaphragm and their vertebral levels
caval (T8) esophageal (T10) aortic T12
what vertebral level does the abdominal aorta bifurcate
L4
what does the greater, lesser and least splanchnic nerves supply
foregut, midgut and hindgut
order of kidney hilum
vein, artery, ureter
what is the term for the expanded upper part of the ureter
renal pelvis
where are the three constrictions of the ureter
junction of the ureter and renal pelvis
crossing the pelvic brim
piercing the wall of the bladder
what structures are within the hilum of the spleen
splenic artery, splenic vein, and gastrosplenic ligament
round ligament (ligamentum teres) is the remnant of which embryological structure
umbilical vein
what layer fold of peritoneum encases the porta hepatis
lesser omentum
the appendix is
a blind intestinal diverticulum with masses of lymphatic tissue often found in the retrocecal position
the change in rectal epithelium is indicated by the
dentate line
the preaortic lymph nodes are
superior mesentaric, inferior mesentaeric and coeliac
retro aortic lymph nodes drain
posterior abdominal wall
the terminal artery of the IMA is
superior rectal artery
liver surface anatomy, it’s located between what ribs
7-11 ribs
location of the portal vein vertebral level
L2 behind the head of the pancreas
inguinal canal lies in what relation to the inguinal ligament
parallel and superior to the medial half of the inguinal ligament
anterior wall of the inguinal canal is
external oblique aponeurosis
posterior wall of the inguinal canal is
transversalis fascia and inguinal falx
roof of the inguinal canal is the
transversalis fascia and internal oblique and the transversus abdominas muscle
floor of the inguinal canal is the
iliopubic tract, inguinal ligaments and lacunar ligament
retroperitoneal SADPUCKER
suprarenal glands, aorta/IVS, Pancreas, ureter and bladder, colon ascending and descending, kidneys, oesophagus, rectum lower 2/3rds).
parietal peritoneum is innervated by the
the lower 6 thoracic nerves and L1, making it somatic and more sensitive to pain.
supracolic compartment contains
stomach, liver and spleen
infracolic compartment contains
small intestine, ascending, descending colon
oesophagus arterial supply is the
arterial supply from the oesophageal branches of the left gastric artery, a branch of the left gastric artery, celiac trunks and left inferior phrenic artery
gall bladder arterial supply
supplied by the cystic artery a branch of the right hepatic artery.
oesophagus venous drainage
distally left gastric vein to the portal venous system, proximally the oesophageal vein entering the azygos vein
oesophagus lymphatic drainage
left gastric lymph nodes which drain into the celiac lymph nodes
stomach lymphatic drainage
gastric and gastro-omental lymph nodes to the celiac lymph nodes.
duodenum lymphatic drainage
anterior lymphatic vessels that feed into the pancreaticoduodenal lymph nodes and the pyloric lymph node. Posterior lymphatic vessels feed into the superior mesenteric lymph nodes. These then feed into the celiac.
spleen lymphatic drainage
pancreatic splenic lymph nodes
pancreatic lymphatic drainage
pancreatic splenic lymph nodes and pyloric draining into the celiac.
liver lymphatic drainage
hepatic lymph nodes drain into the cisterna chyli. Posterior superficial lymph nodes drain into the phrenic lymph nodes or into the posterior mediastinal lymph nodes
gall bladder lymphatic drainage
hepatic lymph nodes
oesophagus innervation
vagal trunks and the thoracic sympathetic trunks via the greater splanchnic nerves and the periarterial plexus
stomach innervation
parasympathetic from the anterior vagal trunk and posterior vagal trunk. Sympathetic from the T6-T9 via the celiac plexus via the greater splanchnic nerves
duodenum innervation
parasympathetic from the vagus. Sympathetic from the greater and lesser splanchnic nerves via the celiac and super mesenteric peri arterial plexus
pancreas innervation
vagus and the abdominosplanchnic nerves passing through the diaphragm.
liver innervation
hepatic plexus of the celiac plexus from the posterior and anterior vagal trunks and sympathetic fibres.
gall bladder innervation
celiac nerve plexus sympathetic and visceral arrive from here, vagus nerve and the right phrenic nerve
gall bladder surface anatomy
right to the 9th costal cartilage in the midclavicular line.
jejunum and ileum innervation
sympathetic T8-T10 segments via the splanchnic nerves through the celiac and SMA ganglia. Parasympathetically via the posterior vagal trunk.
jejunum and ileum lymphatic drainage
lacteals that feed into the juxta intestinal lymph nodes, mesenteric lymph nodes and the central lymph nodes. These then feed into the superior mesenteric lymph nodes.
rectum arterial blood supply
inferior mesenteric artery branches to the superior rectal artery to supply the proximal part. The right and left middle rectal arteries arise from the inferior vesicle (male) or the uterine (female) arteries, the inferior rectal arteries arise from the internal pudendal arteries.
rectum venous blood supply
venous drainage Is the superior rectal vein into the inferior mesenteric vein which flows into the poral system, and the middle and inferior flow into systemic.
lymphatic drainage of rectum
superior half of the rectum there is the pararectal lymph nodes that flow to the inferior mesenteric lymph nodes. Inferior half of the rectum flow into the sacral lymph nodes into the internal iliac lymph nodes
innervation of rectum and anal canal
sympathetic is from the lumbar via the hypogastric plexus, parasympathetic is via S2-S4 through the pelvic splanchnic nerves and inferior hypogastric plexus.
gender variation in anal canal and rectum in men
in men the rectum lie anteriorly to the fundus of the urinary bladder, terminal parts of the ureter, ductus deferens, seminal glands and prostate.
gender variation in anal canal and rectum in women
In females it is closely associated with the vagina and separated by the fornix and cervix by the recto-uterine pouch.
internal structure of the anal canal
there is the columnar zone following the anorectal junction, the pectinate line then the anal pecten followed by the anocutaneous line followed by peri-anal skin.
arterial supply of the diaphragm superior
superior surface supplied by the pericardiophrenic and the musculophrenic arteries branches of the internal thoracic artery and the superior phrenic artery from the thoracic aorta.
arterial supply of diaphragm inferior
The inferior surface is supplied by inferior phrenic arteries branches of the abdominal arteries.
venous supply of diaphragm superior
superior surface drained by the pericardiophrenic and musculophrenic veins into the internal thoracic vein and on the right the superior phrenic vein which drains into the IVC.
inferior supply of diaphragm venous
inferior phrenic vein drains blood from the inferior surface of the diaphragm.
innervation of the diaphragm
motor supply is from the right and left phrenic arteries arising from the anterior rami of C3-C5, peripherally it may be supplied from the intercoastal and subcostal nerves.
cisterna chyli location
L1-L2
thoracic journey through the abdomen
The thoracic duct then continues through the aortic hiatus into the diaphragm and ultimately ends at the junction of the left subclavian and internal jugular veins
ureter journey through the abdomen
the ureters run anterior to the psoas major and the tips of the transverse processes of the lumbar vertebrae and crosses the external iliac artery just beyond the bifurcation of the common iliac. They then run along the lateral wall of the pelvis to enter the urinary bladder.
diaphragm caval opening
T8
oesophageal opening in diaphragm
T10
aortic hiatus opening in diaphragm
T12