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OB - abdominal anatomy > GI tract > Flashcards

GI tract Flashcards

1
Q

length of oesophagus

A

about 25 cm

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2
Q

muscle of oesophagus

A

upper 1/3 = skeletal

lower 2/3 = smooth

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3
Q

start of oesophagus

A

C6/7 at upper oesophageal sphincter

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4
Q

route of oesophagus

A

posterior to trachea, tracheal bifurcation and left atrium
passes through diaphragm at T10
associated with vagus nerves

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5
Q

stomach start point

A

abdominal oesophagus enters stomach in the cardia region = upper oesophageal sphincter
about T10

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6
Q

parts of stomach

A 
entry with oesophagus = cardia
rounded bit to right = fundus 
main body 
greater curvature around the right and lesser curvature to the left 
pyloric antrum and canal at base
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7
Q

parts of pyloric region

A

antrum, canal sphincter

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8
Q

greater omentum and stomach

A

attaches the stomach to the transverse colon

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9
Q

lesser omentum and stomach

A

attaches the stomach and duodenum to the liver

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10
Q

pyloric stenosis

A

narrowing of pylorus, food can’t enter duodenum

projectile vomiting, found early in children

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11
Q

gastric ulceration

A

loss of protective mucus surrounding stomach tissue
acid breaks down stomach tissue
can be caused by the infection helicobactor pylori

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12
Q

sphincter of duodenum with stomach

A

pyloric sphincter

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13
Q

spinal levels of duodenum,

A

L1-3

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14
Q

position of duodenum with peritonum

A

first part is mobile, attached to the lesser omentum

remainder is retroperitoneal

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15
Q

entry of pancreatic and bile duct into duodenum

A

enter in descending part

flow controlled by sphincter of oddi

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16
Q

anchoring of duodenojejunal junction

A

anchored by suspensory ligament of duodenum to right diaphragmatic crus

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17
Q

parts of the oesophagus

A

cervical (starts at level of cricoid), thoracic (mediastinum), abdominal (after diaphragm)

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18
Q

liver divisons

A

4 anatomical lobes

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19
Q

separation of liver lobes

A 
anterior = R/L lobes separated by the falciform ligament 
posterior = fissure of ligamentum teres/venosum
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20
Q

names of liver lobes

A

right, left, caudate, quadrate

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21
Q

position of liver

A

RUQ

superior = diaphragm, inferior = costal margin

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22
Q

what is the porta hepatis

A

entry/exit point for the hepatic portal vein, bile duct and hepatic artery

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23
Q

blood supply to liver

A

hepatic artery and hepatic portal vein provide blood flow to liver
drain to the hepatic vein into the IVC

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24
Q

bile formation

A

formed in the liver
secreted via bile ductules into right and left hepatic ducts
hepatic ducts join at porta hepatis to form the common hepatic duct

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25
Q

gall bladder function

A

stores and concentrates bile

connected to common hepatic duct by cystic duct, which from the common bile duct

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26
Q

bile drain into duodenum

A

pancreatic duct and common pile duct join the second part of the duodenum at the ampulla of vater

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27
Q

what does the free edge of the lesser omentum contain

A

common bile duct, hepatic artery and hepatic portal vein

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28
Q

pancreas position in peritoneum

A

retroperitoneal

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29
Q

parts of pancreas

A

head, body, tail

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30
Q

pancreas and duodenum

A

pancreatic head within the duodenal curvature, neck behind duodenum, tail in contact with spleen

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31
Q

pancreatic duct

A

combines with common bile duct to enter the duodenum

enters at the major duodenal papilla

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32
Q

small intestine parts

A

duodenum
jejunum = surrounded by mesentery, numerous mucosal folds
ileum = enters into the caecum, suspended by mesentery (narrower than other regions)

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33
Q

anatomical relationship of stomach

A 
anterior = abdominal wall, diaphragm, left lobe of liver 
posterior = separated by sac from pancreas, left kidney and gland, spleen, aorta, transverse colon
superior = diaphragm
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34
Q

sotomach innervation

A

celiac plexus T6-T9 = sympathetic nerves (via greater splanchnic nerve)
vagus is parasympathetic

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35
Q

duodenum innervation

A

supplied with blood vessels
sym = coeliac and superior mesenteric plexus
para = vagus

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36
Q

jejunum and ileum position

A 
jejunum = umbilical 
ileum = hypogastric and pelvis
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37
Q

mesentery and small intestine

A

carries blood vessels, autonomic fibres and lymphatic vessels
starts at duodenal - jejunal junction, attaches most to posterior abdominal wall

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38
Q

jejunum and ileum innervation

A

parasym and sym in the myenteric and submucosal plexus
parasym = vagus
sym = coeliac plexus via sympathetic trunks and greater splanchnic nerves

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39
Q

large intestine parts

A

begins at ileo-caceal junction

caecum, ascending colon, trasnverse colon, descending colon and sigmoid colon

40
Q

large intestine smooth muscle layers

A

inner circular and outer longitudinal layers of smooth muscle

41
Q

distinguishing features of large intestine

A 
taeniae coli (3 flattened, thick, muscular bands that run across the entire wall of the caecum and colon)
haustrae (pouches of mucosa between the taenia coli)
epiploic appendices (fat filled pouches on the outer surface)
42
Q

caecum position

A

right iliac fossa
over ilacus and psoas
projects downwards at the start
peritoenum but no mesentery

43
Q

appendix position

A

variable around caecum

most lie behind

44
Q

appendix structure

A

devoid of taeniae coli, blind ended tube

45
Q

appendicitis

A

usually bacterial infection
pain = visceral peritoneum, back to T10 dermatome
typically pain at mcburneys point (1/3 between ASIS and belly button)

46
Q

mesentery in colon

A

attached to transverse and sigmoid, so both intraperitoneal

47
Q

rectum features

A

begins at S3
retroperitoneal
follows the curve of the sacrum

48
Q

ano-rectal junction

A

where the rectum passes posterior and inferior to pass through the pelvic floor muscles

49
Q

anal sphincters

A 
internal = smooth, autonomic
external = striated, pudendal nerve (sym)
50
Q

large intestine innervation

A 
parasym = mostly vagus, distal = pelvic splanchnic nerves 
sym = T10-L2, lumbar sympathetic chain and the superior hypogastric plexus
51
Q

blood supply to foregut

A

coeliac trunk

52
Q

where does the coeliac trunk come from

A

abdominal aorta, just underneath diaphragm at T12

53
Q

branches of coeliac trunk

A

left gastric, splenic, and common hepatic arteries

54
Q

left gastric supplies

A

oesophagus and anterior/posterior stomach

55
Q

splenic artery supplies

A

across posterior abdominal wall to supply the spleen an pancreas, also produces all gastric arteries for the stomach
also branches into left gastroepiploic artery

56
Q

common hepatic artery divides into

A

right gastric, gastro-duodenal and hepatic

57
Q

right gastric artery supplies

A

anterior/posterior stomach

58
Q

hepatic artery supplies

A

liver

59
Q

gastroduodenal artery supplies

A

duodenum (first part)

60
Q

venous drainage of the foregut

A

follows arteries

drains into hepatic portal or one of the derivatives

61
Q

venous draining of the stomach

A

gastroepiploic and short gastric veins drain into splenic vein or superior mesenteric -> portal vein

62
Q

portal vein produced from

A

superior mesenteric and splenic veins

inferior mesenteric drain into splenic

63
Q

position of portosystemic anastomoses

A 
end of oesophagus 
wall of upper anal canal 
umbilicus
bare area of liver 
retroperitoneal
64
Q

what does obstruction of the portal vein cause s

A

anastomoses vessels widen

get portal hypertension which produce varicose veins on the abdominal wall

65
Q

splenic vein drains

A

spleen
stomach fundus
part of pancreas

66
Q

superior mesenteric vein drains

A

small intestine, caecum, ascending and transverse colon, distal parts of stomach

67
Q

inferior mesenteric artery drains

A

descending colon, rectum and sigmoid

68
Q

liver and gall bladder blood supply

A

coeliac trunk -> common hepatic artery
common hepatic artery divides into the hepatic and then cystic and R/L hepatic arteries
cystic -> gall bladder (usually branch of right hepatic)
R/L hepatic -> liver

69
Q

blood supply to pancreas

A

at the border for foregut/midgut so both coeliac and superior mesenteric
coaelic trunk -> splenic and superior pancreatic/duodenal arteries
superior mesenteric -> inferior pancreatic/duodenal artery

70
Q

superior mesenteric artery originates

A

abdominal aorta about L1

71
Q

branches of superior mesenteric

A

inferior pancreatic duodenal
jejunal branches
ileal branches
ileocolic artery -> appendicular and R/L colic

72
Q

superior mesenteric artery supplies

A

distal duodenum
jejunum and ileum
colon up to 2/3 along transverse - to SPLENIC FLEXURE

73
Q

what are the arterial arcades

A

series of anastomosing arterial arches between the jejunum and ileum
nearest duodenum = primary loops, vasa recta are long
towards ileocolic artery = secondary and tertiary loops

74
Q

inferior mesenteric origniates

A

about L3

75
Q

branches of inferior mesenteric

A

left colic, sigmoid and super rectal branches

76
Q

inferior mesenteric supplies

A

ascending colon, sigmoid colon and superior part of rectum

splenic flexure to rectal-anal junction

77
Q

what are the marginal vessels

A

anastaomosis between superior and inferior mesenteric
also called artery of Drummond
continuous arterial circle along the inner border of the coloin

78
Q

control of gut arterial supply

A

controlled by sympathetic nerves

vasoconstrictor neurons with cell bodies win the paravertebral and pre vertebral ganglia

79
Q

lymphatic drainage of abdomen and pelvis

A

reaches the lumbar and intestinal lymphatic trunks, unite at the cistern chyli forming the thoracic duct

80
Q

GI tract lymph drains into

A

superior and inferior mesenteric lymph nodes

81
Q

retroperitoneum drains into

A

lumbar lymph nodes

82
Q

stomach lymph nodes

A

follow the lesser and greater curvatures

embryo into the gastric, gastroomental and pyloric lymph nodes -> celiac lymph nodes

83
Q

small intestine lymph nodes

A

junta intestinal
intermediate mesenteric
superior mesenteric

84
Q

what vessels to lymph vessels follow

A

arteries

85
Q

large intestine lymph vessels

A

each part has its own nodes
all drain into superior mesenteric
descending and sigmoid colon into inferior mesenteric nodes

86
Q

liver and gall bladder lymph nodes

A

cystic and hepatic nodes

87
Q

sequence of drainage of lymph

A

all lymph drains into the intestinal trunks, then the cisterna chyli and then the thoracic duct

88
Q

sympathetic innervation to gut

A

celiac, superior mesenteric and inferior mesenteric ganglia from T6-L2 spinal nerves

89
Q

celiac ganglion supplies

A 
stomach
blood vessels
liver and bile duct
pancreas
adrenal gland 
small intestine
90
Q

superior mesenteric ganglion supplies

A

small intestine

large intestine

91
Q

inferior mesenteric ganglion supplies

A 
distal large intestine 
kidney
bladde
rectum 
gonads
92
Q

parasympathetic nerve supply

A

vagus to vast majority of organs

S2-S4 supply to hind gut (distal large intestine, rectum, anus)

93
Q

afferent fibres of the gut

A

general visceral afferent fibres

conduct sensory impulses from internal organs to CNS

94
Q

afferent fibres pathway

A

accompany sympathetic efferent
travel from organ to ganglion, along a splanchnic nerve, into the sympathetic trunk and then into a ventral ramus and the mixed spinal nerve
goes into the dorsal root ganglion

95
Q

afferent fibres also found in

A

vagus nerve

OB - abdominal anatomy (4 decks)

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