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RAD414 pt 2 > GI tract and accessory organs > Flashcards

GI tract and accessory organs Flashcards

1
Q

label the 12 parts of the digestive system

A
  • mouth
  • salivary glands
  • oesophagus
  • stomach
  • liver
  • gallbladder
  • pancreas
  • large/small intesting
  • appendix
  • rectum
  • anus
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2
Q

define body hiatus in terms of GI tract

A

Body habitus refers to the common variations in the shape of the human body, which in turn determines the position of internal viscera.

Body habitus indicates the body wall thickness and the placement of organs

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3
Q

what are the 3 types of body habitus/ physiques of the Gi tract

A
  • hypersthenic
  • sthenic
  • hyposthenia/asthenic
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4
Q

describe a sthenic body habitus

A

average, mesomorphic. It is a moderately heavy build with the organs orientated as such:

heart - moderately transverse
lungs - moderate in length
diaphragm - moderately high
colon - spread evenly with a slight dip in the transverse colon
gallbladder - right upper abdomen

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5
Q

describe a hypersthenic body hiatus

A

Also known as endomorphic. It is a largerbuild with the organs orientated as such:

heart - axis is almost transverse
lungs - short apices lie near the clavicles
diaphragm - high
stomach - high transverse and in the middle
colon - around the periphery of the abdomen
gallbladder - high

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6
Q

describe a hyposthenic/asthenic body hiatus

A

Also known as very slender, ectomorphic. It is a frail build with the organs orientated as such:

heart - nearly vertical and in the midline
lungs - long apices above clavicles
may be broader above base
diaphragm - low
stomach - low near the midline
colon - low folds on itself
gallbladder - relatively lower close to the midline

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7
Q

what are the 3 salivary glands

A
  • parotid salivary gland
  • sublingual salivary gland
  • submandibular salivary gland
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8
Q

what percentage of saliva do the parotid and submandibular gland produce

A

parotid = 25%

sub mandible = 70%

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9
Q

what are the 5 functions of saliva

A
  • lubricates oral mucosa
  • lubricates food during mastication
  • initiates digestion of starches
  • protective pellicle on teeth
  • secrete proteins, enzymes, glycoproteins, antibacterial agents
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10
Q

what enzyme found in saliva breaks down starches

A

amylase

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11
Q

what examination is done to look into salivary glandds

A

sialography

  • injection of small vol of contrast into salivary ducts of single gland then xray projection
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12
Q

the abdominal organs are derived primarily from where

A

endoderm, which forms the primitive gut tube

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13
Q

what 3 sections is the gut tube divided into

A

foregut
midgut
hindgut

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14
Q

what abdominal contents are found in the foregut

A

from abdominal oesophagus to 2nd part of duodenum

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15
Q

what does the midgut consist of

A

from the 2nd part of duodenum up to 2/3 along the transverse colon

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16
Q

what does the hindgut consist of

A

from 2/3 of transverse colon all the way to rectum

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17
Q

what vasculature supplies the foregut, midgut and hindgut

A

foregut = coeliac trunk
midgut = superior mesenteric trunk
hindgut = inferior mesenteric trunk

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18
Q

what are the 3 pre-aortic lymph nodes

A
  • celiac node
  • superior mesenteric node
  • inferior mesenteric node
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19
Q

where is the start and end of the oesophagus (give landmarks)

A
  • starts at inferior border of cricoid cartilage (c6)
  • ends at t10/11 (cardiac orifice of stomach)
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20
Q

describe the structure of the oesophagus going into the abdomen

A

The oesophagus begins in the neck, at the level of C6. Here, it is continuous superiorly with the laryngeal part of the pharynx (the laryngopharynx).

It descends downward into the superior mediastinum of the thorax, positioned between the trachea and the vertebral bodies of T1 to T4. It then enters the abdomen via the oesophageal hiatus (an opening in the right crus of the diaphragm) at T10.

The abdominal portion of the oesophagus is approximately 1.25cm long – it terminates by joining the cardiac orifice of the stomach at level of T11.

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21
Q

at what landmark does the distal end of the oesophagus enter the abdomen thru the abdominal hiatus found in the diaphragm

A

t10

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22
Q

at what landmark does the abdominal oesophagus end as it joins with the cardiac orifice of the stomch

A

t11

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23
Q

what is UES and what is its purpose

A

upper esophageal sphincter

  • high-pressure zone located in between the pharynx and the cervical esophagus.
  • The physiological role of this sphincter is to protect against reflux of food into the airways as well as prevent entry of air into the digestive tract.
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24
Q

what is LES and its purpose

A

The lower esophageal sphincter (LES) is a high-pressure zone located where the esophagus meets the stomach and protects the esophagus from the reflux of gastric contents

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25
Q

what are the 3 layers of the stomach muscle

A
  • longitudinal (outermost)
  • circular
  • oblique (innermost)
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26
Q

rugae is found on the inner wall of the stomach, what is this

A

a series of ridges produced by folding of the wall of an organ.

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27
Q

how many parts of the duodenum are there and what are tehy

A

4
1st (pylorus) (superior)
2nd (descending)
3rd (inferior)
4th (ascending)

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28
Q

what part of the gut comes after the 4th part of the duodenum

A

jejunum (middle part of small gut)

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29
Q

what vascualture supplies the first half and 2nd half of the duodenum

A

up to 2nd part = coeliac trunk
3rd and 4th part = superior mesenteric artery

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30
Q

what pH is the mouth

A

pH 5-7

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31
Q

what pH is the stomach

A

pH 1-3

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32
Q

what pH is the small intestine

A

pH 6-7.5

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33
Q

what pH is the large intestine / colon

A

pH 5-7

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34
Q

what is the transpyloric plane

A

imaginary horizontal plane located halfway between the suprasternal notch of manubrium and upper border of the pubic symphysis

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35
Q

what landmark is the pubic symphysis found

A

L1

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36
Q

is the pancreas found in the fore, mid or hind gut

A

foregut

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37
Q

what is unique about the blood supply to the pancreas despite it being located in the foregut

A
  • has supply from both the coeliac trunk and superior mesenteric trunk
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38
Q

what part of the pancreatic structure is the connection to the coeliac and superior mesenteric supply found

A

at the uncinate process

  • area of the pancreas that bends backwards and beneath the body of the pancreas.
39
Q

describe the 5 structural components of the pancreas

A
  • head
  • neck
  • body
  • tail
  • uncinate process
40
Q

what structure does the head of pancreas sit in

A
  • duodenum
41
Q

what are the 2 main functions of the pan creas

A
  • The exocrine pancreas produces enzymes that help to digest food, particularly protein
  • secrets bicarbonate to neutralise stomach acid
42
Q

what are the 2 ducts found in the pancreas and their roles

A
  1. Main pancreatic duct (of Wirsung)
  • drains most of the pancreas, the uncinate process and caudal aspect of the head
  1. Accessory pancreatic duct (of Santorini)
  • accessory duct typically communicates with the main duct and drains into the duodenum via the minor papilla
43
Q

the common bile duct and main pancreatic duct of wirsung (pancreas) joins at which location/structure

A

hepatopancreatic ampulla

44
Q

the connection of the bile duct and main pancreatic duct drain through which structure

A

draining into the ampulla of Vater through the Sphincter of Oddi. (tiny hole that connects to the duodenum)

45
Q

what is the role of the illeocecal valve

A

separates the luminal environments of the small and large intestines as they have different pH and bacterial content

  • stops reflex from large to small intestine
  • helps regulate small intestinal tract
46
Q

what are the 5 different positions the appendix can be found

A
  • pre-ileal (over illeocecal valvue)
  • post ileal (under illeoceacal valve)
  • retro-cecal (behind caecum)
  • subcaecal (below caecum)
  • pelvis (towards pelvis)
47
Q

what is the most common appendix position

A

retro-cecal

48
Q

note the appendix is INTRAPERITONEAL
(within peritoneal cavity)

A
49
Q

what are the 7 structures of the large intestine (not counting appendix)

A
  • ascending colon
  • right colic flexure
  • transverse colon
  • left colic flexurre
  • descending colon
  • sigmoid
  • rectum
50
Q

what is the taeniae coli found in the large intestine

A

3 smooth longitudinal muscles of the colon

51
Q

what are hastura found in the large intestine

A

sacculations of colon wall between taeniae (bumpy/ lumps of colon wall)

52
Q

what is the omental appendices of the large intestien

A
  • pouches of peritoneum that are filled with fat
  • They’re attached to the external surface of the large intestine, opposite the side that the mesentery arising from the posterior abdominal wall attaches to.
53
Q

what feature of the large intestine allows back and forth movement of the food, enhancing mixing of food with mucus and enzymed

A

haustrations (segmentation of the large intestine)

54
Q

compare what small and large bowel obstruction looks like on scan

A

small = stacks of pennies ( valvulae conniventes)

large = dilated transverse and sigmoid colon

55
Q

what is the major muscle found in the anus

A

levator ani

56
Q

what plexus is found to be innervating the entire gut

A

myenteric plexus

57
Q

what additional plexus is found to be innervating the gut minus the oesophaus

A

submucosal plexus

58
Q

note that we do not need para/sympathetic innervation to control gut motility but it can modify the frequencuy

A
59
Q

which nerve leads to the myenteric and submucosal plexus

A

vagal/vagus nerve

60
Q

how do vagus nerves help the GI tract

A
  • helps control oesophageal propulsion
  • gastric acid secrretion
  • emptying bladder
  • gallbladder contraction
61
Q

how long is the long and small intestine

A

small = 6.5 m
large = 1.8 m

62
Q

what prevents the intestines from tying into knots

A

they are held in place by the peritoneum

63
Q

the abdomen is filled with metres of churning and peristaltic tubes with their own blood vessels, lymphatics and nerves

A
64
Q

what is the peritoneal cavity

A

potential space between the parietal peritoneum and the abdominal wall and visceral peritoneum and the organ it covers

  • space that lies between the parietal peritoneum and the visceral peritoneum
65
Q

what sits within the peritoneal cavity and why

A

peritoneal fluid, lubricates the organs

66
Q

what is parietal innervation

A
  • detects pain/temp/chemical stimulations with pain localised to the precise area affected

(contains same sensory bodies found in skin)

67
Q

what is visceral inneervation

A
  • detects stretch or irritation but can only localise to rough area e.g foregut
68
Q

what 9 Gi structures are retroperitoneal, use mnemonic SAD PUCKER

A
  • suprarenal adrenal gland
  • aorta
  • duodenum
  • pancreas (except tail)
  • ureters
  • colon (ascending and descending)
  • kidneys
  • esophagus
  • rectum
69
Q

what 10 GI structures are intraperitoneal, use mnemonic SALTDSPRSS

A
  • stomach
  • appendix
  • liver
  • transverse colon
  • duodenum (1st part0
  • small intestine (jejunum and ileum)
  • pancreas (only tail)
  • rectum (upper 3rd)
  • spleen
  • sigmoid colon
70
Q

what 5 parts can the peritoneal cavity be split into

A
  • right/ left subphrenic space
  • sub hepatic space
  • right/left infra-mesocolic space
71
Q

be aware that the different spaces within the peritoneal cavity can accumulate fluid collections

A
72
Q

what is the greater omentum

A

a large apron-like fold of visceral peritoneum that hangs down from the stomachs greater curvature

73
Q

what is the lesser ommentum

A

the double layer of peritoneum that extends from the liver to the lesser curvature of the stomach, and to the first part of the duodenum.

74
Q

the venous drainage unlike usual where they follow the arteries, travel through what

A

liver

75
Q

the portal system (GI venous system) is the exception of rule that veins always follow arteries.

in the gut, all venous blood containing the nutrients, drugs etc get processed through the liver first

A
76
Q

what is the portal system

A

carries all venous blood from the abdomen and GI tract to the liver for processing

77
Q

where might metastases from colon cancer be found

A

liver , as all venous blood from GI tract and abdomen goes to the liver first

78
Q

what ligament stops the liver from moving

A

falciform ligament

79
Q

what is the difference between the diaphragmatic and visceral surface of the liver

A

Diaphragmatic surface – the anterosuperior surface of the liver.

It is smooth and convex, fitting snugly beneath the curvature of the diaphragm.

The posterior aspect of the diaphragmatic surface is not covered by visceral peritoneum and is in direct contact with the diaphragm itself (known as the ‘bare area’ of the liver)

Visceral surface – the posteroinferior surface of the liver.

With the exception of the fossa of the gallbladder and porta hepatis, it is covered with peritoneum.
It is moulded by the shape of the surrounding organs, making it irregular and flat.

It lies in contact with the right kidney, right adrenal gland, right colic flexure, transverse colon, first part of the duodenum, gallbladder, oesophagus and the stomach.

80
Q

what percentage of arterial and venous blood reaches the liver and through what vessels

A

hepatic artery = 25% arteriole blood

hepatic portal vein = 75% venous blood

81
Q

where is the arteriole blood reaching the liver from

A

coeliac trunk

82
Q

where is the venous blood reaching the liver from and how does this allow liver to carry out its function

A

supplies the liver with partially deoxygenated blood from abdomen/GI tract, carrying nutrients absorbed from the small intestine.

This is the dominant blood supply to the liver parenchyma and allows the liver to perform its gut-related functions (such as detoxification).

83
Q

understan the gallbladder structure

A
84
Q

what is the main function of the gallbladder

A

concentrate and store bile which is produced by the liver.

85
Q

describe the 3 sections of the gallbladder

A

fundus
body
neck

86
Q

describe the billiary system and how it goes down to the duodenum

A
  • cystic duct branches from gall bladder joins to the common hepatic duct from the liver
  • as the cystic duct and common hepatic duct join, it forms the common bile duct
  • towards the distal end, the pancreatic duct joins to the common bile duct forming the hepatopancreatic ampulla of vater
  • it the enters the duodenum through the sphincter of oddi
87
Q

describe the arterial supply of the gallbladder

A
  • receives blood from the cystic artery (which is a branch of the right hepatic artery coming from the common hepatic artery as part of the coeliac trunk)
88
Q

describe the venous drainage of the gallbladder

A

via the cystic veins, which drain directly into the portal vein. Venous drainage of the fundus and body of the gallbladder flows into the hepatic sinusoids.

89
Q

describe the arterial supply of the pancreas

A

pancreatic branches of the splenic artery.

The head is additionally supplied by the superior and inferior pancreaticoduodenal arteries which are branches of the gastroduodenal (from coeliac trunk) and superior mesenteric arteries, respectively.

90
Q

describe the venous system of pancreas

A

Venous drainage of the head of the pancreas is into the superior mesenteric branches of the hepatic portal vein. The pancreatic veins draining the rest of the pancreas do so via the splenic vein.

91
Q

find image and understand all structures found in abdomen / GI tract

A
92
Q

what is the left and right colic flexure of large intestine also known as

A

right hepatic flexure

left splenic flexure

93
Q
A

RAD414 pt 2 (33 decks)

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