GI Week 2 Workbook + quiz Flashcards
3 constrictions of oesophagus
cervical
thoracic
diaphragmatic
What structures pass through the diaphragm at the oesophageal
opening? x5
- Oesophagus
- Oesophageal branches of left gastric artery and vein
- Left and right vagus nerves
- Lymphatics
- Phreno oesophageal ligament
blood supply to abdominal oesophagus x2
oesophageal branches of left gastric artery from celiac artery
branches of left inferior phrenic artery
venous drainage to abdominal oesophagus x2
-drains into plexuses to the left gastric vein and abdominal azygous
lymph drainage of abdominal oesophagus
celiac nodes
what forma pyloric sphincter
thickening of circular smooth muscle in muscularis externa
What layers are the gastric folds/rugae formed from?
mucosa and submucosa layers
What are the 4 main veins draining the stomach?
- Left gastric- hepatic portal vein.
- Right gastric- hepatic portal vein.
- Left gastro-omental- splenic vein then to the hepatic portal
vein. - Right gastro-omental- superior mesenteric vein then to the
hepatic portal vein.
where dp nodes of stomach drain to
celiac nodes
nerve supply to stomach
parasympathetic- vagus
sympathetic- celiac plexus (T6-T9) via the greater splanchnic nerves
what else does vagus do in stomach
carry sensations of pain, fullness, and nausea
How many parts does the duodenum have?
4
What organ sits within the C shape of the duodenum?
pancreas
name for opening in the duodenum where pancreatic and bile fluids enter the
gut tube
what controls it
major papilla of vater
sphincter of oddi
what 2 structures come together at major papilla of vater
pancreatic duct
common bile duct
jejunum vs ileum
thickness
colour
fat
lymph
vasa recta length
jejunum:
thicker
red
less
less
long
ileum:
thinner
pink
more
more- payers patches
short
in general jejunum is bigger and thicker but has t exceptions seen above
Which major blood vessel supplies the jejunum and ileum?
Superior mesenteric
Where do the veins surrounding the jejunum and ileum drain to?
Superior mesenteric
Which set of lymph nodes does lymph drain to from here?
Superior mesenteric to pre aortic
3 features of large intestine
tenia coli- bands of longitudinal smooth muscle on the colon
omental appendages- fatty pouches
haustra- bulges
What two structures open into the caecum?
ileum
appendix
What is McBurney’s point
Site of max tenderness during acute apendicitis
arterial supply of ascending colon x2
Ileocolic
right colic arteries
venous supply of ascending colon x2
iliocolic
right colic veins
arterial supply of transverse colon x3
right, left and middle colic
venous supply of transverse colon x2
superior mesenteric
middle colic
arterial supply of descending colon x2
left colic
sigmoid arteries
venous drainage of descending colon x1
inferior mesenteric
arterial supply of sigmoid colon x1
sigmoid artery
venous supply of sigmoid colon
inferior mesenteric
blood and lymph supply of rectum: superior 1/3
and peritonisation
rectal artery
rectal vein
pararectal lymph
node
intra
blood and lymph supply of rectum: middle 1/3
and peritonisation
middle rectal artery
systemic internal ileac vein
internal iliac lymph
retro
blood and lymph supply of rectum: inferior 1/3
and peritonisation
inferior rectal artery
systemic internal iliac vein
internal iliac nodes
extra
What is the role of the pelvic floor in maintaining faecal continence?
Muscles allow controlled emptying
What other structures are involved in faecal continence? x3
internal anal sphincter
external anal sphincter
rectal ampulla
What is the pectinate line?
the junction between endoderm and ectoderm
- cone shaped limit of anal values
Name the four lobes of the liver:
- Left
- right
- quadrate
- caudate
Which lobes of the liver cannot be seen from the front?
caudate and quadrate
The liver is encapsulated with a…..
fibrous layer
known as a capsule.
The fibrous layer is innervated by…
lower intercostal nerves
What is meant by the term ‘bare area’ of the liver?
No peritoneal- direct contact with diaphragm
What is the porta hepatis?
deep fissure in the visceral surface of the liver through which all
the neurovascular structures (except hepatic veins) and also hepatic ducts enter or leave
5 structures present in the porta hepatis:
- Portal vein
- Right and left hepatic artery
3.hepatic nerve plexus - Right and left hepatic duct
- lymph
What structures are in the portal triad?
- hepatic artery
- common bile duct
- portal vein
Where does the central vein drain to?
hepatic vein
The extrahepatic biliary apparatus consists of x5
- R +L hepatic duct
- common bile duct
- Common hepatic duct
- Gall bladder
- Cystic duct
Where is bile produced?
liver
Where is bile stored?
gallbladder
Where does bile enter the gut tube?
Through the common bile duct into the ascending duodenum at the sphincter of Odd
what is Calot’s triangle made of
and contain
cystic duct,
common hepatic duct
inferior surface of liver
contains cystic artery.
what actually makes up the ampulla of vater
pancreatic duct and biliary system
Which vein is formed posterior to the neck of the pancreas?
Hepatic portal
Into which part of the duodenum does the pancreatic duct open?
descending
blood supply to pancreas
Arterial supply: coeliac trunk and the superior mesenteric artery.
Venous drainage: drain into the splenic or superior mesenteric veins (into the portal system)
nerve supply to pancreas x2
coeliac plexus
and the superior mesenteric plexus.
lymph drainage to pancreas x2
pre-aortic nodes at T12
and to Pre-aortic nodes at L1.
In which region of the abdominal cavity is the spleen located?
Left hypochondriac
Name the structures in the hilum of spleen:
- Splenic artery
- Splenic vein
3.spleenic lymph
Functions of the spleen x4:
- Storage of RBC’s
- recycle RBC
- immunity- phagocyte proliferation
- Phagocytosis
coeliac trunk: whats the red artery
coeliac trunk
coeliac trunk: whats the blue artery
what does it supply
left gastric
stomach
coeliac trunk: whats the green artery
what does it supply
splenic
stomach, pancreas, and spleen.
coeliac trunk: whats the yellow artery
common hepatic
liver
SMA: whats the red artery
superior mesenteric
SMA: whats the blue artery
what does it supply
jejunal arteries and ileam
SMA: whats the yellow artery
what does it supply
iliocolic
ascending colon, appendix, cecum, and ileum
SMA: whats the green artery
what does it supply
right colic
ascending colon
SMA: whats the purple artery
what does it supply
middle colic
2/3 transverse colon
IMA: whats the grey anastamose
marginal artery- combining SMA and IMA
IMA: whats the dark green artery
what does it supply
left colic
last 1/3 of transverse colon
all of descending colon
IMA: whats the light green artery
what does it supply
sigmoid artery
descending and sigmoid colon
IMA: whats the blue artery
superior rectal
where does venous drainage go in the gut
to hepatic portal vein to liver
then eventually IVC
whats the purple vein
hepatic veins
whats the dark and light red veins
dark = left renal vein
light = right renal vein
hepatic vs hepatic portal vein
hepatic portal carries nutrient rich blood TO the liver for filtering
hepatic carries filtered blood AWAY from liver to IVC
identify:
a) orange
b) purple
c) light blue
lables
a) hepatic artery
b) hepatic portal vein- to LIVER
c) hepatic vein- to IVC
whats the blue vein
left common iliac
whats the dark and lightblue artery
dark = right gastro epiploic
light = left gastro epiploic
whats the dark blue lobe
caudate
whats the grey bit
bare area
whats the green thing
gall bladder
whats the light blue bit
quadrate lobe
whats the red bit
porta hepatis
whats the dark and light purple lobes
dark = right lobe
light = left lobe
whats the light and dark blue bits
light = falciform ligament
dark = =round ligament
whats the red and blue bits
red = right hepatic duct
blue = left hepatic duct
whats the purple bit
common hepatic duct
whats the dark green bit
cystic duct
whats the light green bit
common bile duct
what are the dark and light purple bits
dark= main pancreatic duct
light = accesory pancreatic duct
whats B
IVC
What veins join to form vein C
superior mesenteric and splenic veins
What organ is related posteriorly at the impression on the liver D
transverse colon
whats E
What embryological structure is E a remnant of
round ligament
umbilical vein
What structure is related posteriorly at the region labelled G?
stomach
Which artery is the cystic artery most commonly a branch of
right hepatic
what arteries supply what curvature of the stomach
lesser curvature = left gastric
greater curvature = left gastro-EPIPLOIC
what is a is a derivative of the dorsal mesogastrium
greater omentum
what artery supplies the post wall at the first part of the duodenum
gastro-duodenal
Which of the following is NOT in contact with the spleen?
Select one:
a. Stomach
b. Diaphragm
c. Pancreas
d. Colon
e. Duodenum
duodenum
To which group of lymph nodes does lymph from the caecum drain
sup mesenteric pre aortic
whats B
Left renal vein
What type of investigation is shown in the image below
. Endoscopic retrograde cholagio pancreatography
