GI Tract: Mouth, Esophagus, Stomach, Duodenum Flashcards
What is the position of the cardia?
The fundus?
Pylorus?
Cardia - Th11
Fundus - beneath left dome of diaphragm
Pylorus - 2 cm from midline @ L1
What is the important anatomical cross-section which passes through the stomach?
Where is it in relation to the sternum and pelvis?
Bonus: what important structures does it pass through?
Transpyloric Plane
- halfway between the jugular notch and pubic symphysis
Passes through:
- pylorus
- L1
- gallbladder fundus
- pancreas (body)
- sup. mesenteric A/V (origin/termination)
- colic flexures
- L renal hilum
- transverse mesocolon root
- duodenojejunal flexure
- superior horizontal duodenum
- cisterna chyli
*
What are the 3 muscle layers of the stomach?
One of them is not in the whole stomach… which and where is it?
Outer Longitudinal
Middle Circular
Inner Oblique - only from cardia to angular notch
What are the longitudinal ridges of the gastric mucosa called?
2 names
What do they form which directs food towards the pyloric part of the stomach?
**Gastric Rugae **or Folds
- form the Gastric Canals or Magan Strasse during swallowing
What are the 3 clinically important parts of the stomach according to its contact with other organs?
- Facies Libera - a “free” anterior portion not covered by ribs or liver
- Facies Diaphragmatica - AKA Traube’s Space, covered by the left ribs and sitting under the left diaphragmatic dome
- Facies Hepatica - mostly cardia/fundus covered by left lobe of liver, a bit of superior body/pylorus too
What are the divisions of the celiac trunk?
And the name for all three together?
Haller’s Tripod
(L to R)
- Common Hepatic Artery
- Splenic Artery
- Left Gastric Artery
What are the branches of the splenic artery?
Short Gastric Arteries
Left Gastro-omental Artery
Posterior Gastric Artery
Pancreatic Arteries
What are the branches of the common hepatic artery?
List them in order from its origin.
- Gastroduodenal Artery
- Proper Hepatic (continuation after gastroduod.)
- Right Gastric Artery (may be before gastroduod.)
What are the branches of the gastroduodenal artery?
Right Gastro-omental
Superior Pancreaticoduodenal
What vein drains the superior portion of the lesser curvature of the stomach?
Two names.
Where does it drain to?
**Coronary Vein **or Left Gastric Vein
- drains to Portal Vein
What are the important lymph nodes of the stomach?
- Paracardial (angle of His)
- Inferior (greater curvature under pylorus)
- Superior (lesser curvature)
- Subpyloric (just under pyloric sphincter)
just remember… PISS
Describe the peritoneal relations of the duodenum’s different parts.
- Superior Horizontal - intraperitoneal (AKA duod. bulb)
- Descending - retroperitoneal
- Inferior Horizontal - retroperitoneal
- Ascending - retroperitoneal
- Duodenojejunal Flexure - intraperitoneal again
Describe the 3 main peritoneal folds/recesses relevant to the duodenum.
What is their clinical significance?
- Superior Duodenal Fold/Recess - from duodenojejunal flexure leftward
- Inferior Duodenal Fold/Recess - from inferior end of ascending part leftward
- Paraduodenal Fold/Recess - (Landzert’s Fossa) - sometimes between DJ flexure and left kidney, containing left colic a. + inf. mesenteric v.
- clinically… sites of Treitz Hernias
What are the entrances for digestive juices into the duodenum?
Which ducts empty into them?
-
Major Duodenal Papilla (Vater’s)
- Common Bile Duct
- Main Pancreatic Duct (Wirsung’s)
- guarded by Sphincter of Oddi
-
Minor Duodenal Papilla (Schner or Santorini’s)
- Accessory Pancreatic Duct (Santorini’s)
Which vessels are in close proximity to the inferior horizontal part of the duodenum and why is this significant?
Superior Mesenteric Artery and Aorta
- can compress an overfilled duodenum after a large meal, causing ileus, or bowel obstruction
What vessels supply the duodenum and head of pancreas?
How are they significant embryologically?
- Common Hepatic A. > Gastroduodenal A. (sup. horiz. part)
- Gastroduodenal A. > Superior Pancreaticoduodenal A. > Ant./Post. Branches
- Superior Mesenteric A. > Inferior Pancreaticoduodenal A. > Ant./Post. Branches
- Lesser Riolan Anastomosis/Arch between branches of both pancreaticoduodenal arteries is the embryological border between fore-/midgut
How is venous blood drained from the duodenum (and head of pancreas) ?
Pancreaticoduodenal Veins > Superior Mesenteric Vein > Portal Vein
What are the circular ridges of mucosa within the duodenum?
Folds of Kerckring
What is found along the medial wall of the descending part of the duodenum above/below the major duodenal papilla?
Longitudinal Fold(s) of mucosa
What innervates the duodenum?
Parasympathetic: Vagus N.
Sympathetic: Lesser/Greater Splanchnic Ns.
How is lymph drained from the duodenum?
anterior vessels > ** Pancreaticoduodenal / Pyloric Nodes**
posterior vessels > Superior Mesenteric Nodes
What is the blood supply of the palatine tonsil?
- Ascending Palatine A. < Facial A. < ECA
- Descending Palatine A. < Maxillary A. < ECA
- Ascending Pharyngeal A. < ECA
- Lingual A. < ECA
What are the roof and floor of the isthmus of the fauces?
roof - soft palate + muscle aponeurosis
floor - follicular part of tongue + lingual tonsil
What is the motor innervation for the tongues muscles?
CN XII Hypoglossal Nerve
What are the general and special sensory innervation of the papillary part of the tongue?
And of the follicular part?
And the root?
Papillary:
- General: Lingual Nerve
- Special: Chorda Tympani
Follicular:
- General + Special: Glossopharyngeal CN XII
Root:
- General + Special: Vagus CN X
