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Y2 S1 Anatomy > GIT anatomy > Flashcards

GIT anatomy Flashcards

1
Q

What are the 9 regions of the abdomen?

A
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2
Q

What are the 12 structures crossed by the Transpyloric Plane? and what level is it at?

A

At the L1 vertebra level:
Structures:
- Pylorus (end of stomach)
- Pancreatic neck
- Duodenojejunal flexure
- Fundus of gallbladder
- 9th costal cartilage
- Hila of kidneys
- Origin of portal vein
- Transverse mesocolon
- 2nd part of Duodenum
- Superior mesenteric artery origin
- Hilum of spleen
- Termination of spinal cord

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3
Q

Describe the arcuate line and what you’d see superior and inferior to it

A

Arcuate line -> at the end of the rectal sheath

Hernias more common below the arcuate line because don’t have rectal sheath to protect

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4
Q

What are the 3 umbilical folds?

A

Median:
- Urachus (embryological)
Medial:
- Umbilical arteries (no longer patent)
Lateral:
- Inferior epigastric vessels (still patent) - DONT break this in surgery

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5
Q

What are the borders of the inguinal canal?

A

Roof:
- Transversalis fasci
- Internal oblique
- Transversus abdominus
Anterior wall:
- Aponeurosis of external oblique
- Internal oblique
Posterior Wall:
- Transversalis fascia
Floor:
- Inguinal ligament
- Lacunar ligament

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6
Q

Which layer of the spermatic cord doesn’t get pulled down with the descent of the testes?

A
  • Transversus abdominus
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7
Q

what are the Inguinal Canal Contents? (think of 3s)

A

3 Arteries:
- Artery to vas deferens
- Testicular artery
- Cremasteric artery
3 Nerves:
- Genital branch of genitofemoral nerve
- Iliolingual nerve
- Sympathetic fibres
3 Fascias:
- External spermatic fascia
- Cremasteric fascia
- Internal spermatic fascia (transversalis fascia)
3 Others:
- Pampiniform venous plexus
- Ductus deferens
- Lymphatics

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8
Q

what are the 2 types of inguinal hernias? describe their relation to the inferior epigastric vessel

A

Direct:
- medial to the inferior epigastric vessel
Indirect:
- lateral to the inferior epigastric vessel

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9
Q

what is the presenting symptom of inguinal hernias and what is the way to differentiate between direct and indirect?

A

Presenting symptoms:
- lump in groin -> minimises when lying down
How to differentiate:
- if you press down on the deep ring and the hernia still protrudes, it is direct.

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10
Q

How do you differentiate between the inguinal and femoral hernia?

A
  • Inguinal is superomedial to pubic tubercle
  • whereas femoral is inferolateral to pubic tubercle
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11
Q

What is the pathophys of Testicular torsion?

A

Testicle rotated around spermatic cord -> blocks blood flow to testicle // can lead to necrosis

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12
Q

What are the symptoms of Testicular Torsion?

A
  • sudden sever pain in scrotum and affected side of lower abdomen
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13
Q

What are causes of Testicular torsion?

A
  • testicle not strongly attached to scrotum at birth
  • minor trauma around scrotum
  • vigorous physical activity
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14
Q

What is the treatment of testicular torsion?

A

immediate surgical detorsion

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15
Q

What is Bell Clapper syndrome?

A
  • your testicles hang in your scrotum and swing freely, like a clapper in a bell
  • this happens because gubernaculum is absent
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16
Q

What is the greater sac? where is it? what are the compartments of it?

A

= largest part of the peritoneal cavity
- it is anterior and inferior in the abdomen
- it has supracolic and infracolic compartments

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17
Q

What are the borders of the Lesser Sac (Omental bursa)?

A

Anterior:
- Liver
- Gastrocolic ligament
- Lesser omentum
Left:
- Kindey + adrenal gland
Right:
- Epiploic foramen
- lesser omentum
- greater sac
Posterior:
- Pancreas

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18
Q

Epiploic foramen of Winslow. what is it? what are its borders?

A

= passage between the lesser and greater sac
Anterior border:
- Hepatoduodenal ligament (contains portal tria)
Posterior:
- IVC
Superior:
- Liver
Inferior:
- Duodenum & hepatic artery

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19
Q

Peritoneal cavity in the pelvis. what is its importance? for males and females?

A

= peritoneal space where fluid can accumulate when upright
Males:
- Rectovesical pouch (bw rectum and bladder)
Females:
- Rectouterine pouch (pouch of Douglas) (bw rectum and uterus)
- Vesicouterine pouch (bw bladder and uterus)

In men, the peritoneal cavity is completely closed but in women, the uterine tubes open up the cavity -> potential site of infection

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20
Q

What are omenta?

A

= folds of peritoneum that attach organs to each other

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21
Q

What is mesentery?

A

a fold of membrane that attaches the intestine to the wall around the stomach area and holds it in place

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22
Q

Describe the greater omentum. what type of mesentery? how many layers? where is it?

A

= dorsal mesentery
- 4 Layers
- from greater curvature of the stomach -> descends over t. colon, jejunum, ileum -> ascends back up to the t. colon

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23
Q

describe the lesser omentum. what type of mesentery? where is it attached? what is it formed from?

A

= ventral mesentery
- attached to lesser curvature of the stomach & liver
- formed from hepatogastric and hepatoduodenal ligament

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24
Q

What is the arterial supply of the foregut and its vertebral level?

A
  • Celiac trunk
  • T12
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25
Q

What supplies the midgut and its vertebral level?

A
  • Superior mesenteric artery (SMA)
  • L1
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26
Q

What supplies the hindgut and its vertebral level?

A
  • Inferior mesenteric artery (IMA)
  • L3
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27
Q

What arteries does the Celiac trunk give rise to and what organs do they supply? and what does the celiac trunk branch from?

A

Celiac trunk from the Abdominal Aorta
Give rise to:
- Left gastric artery -> stomach, adjacent portion of the oesophagus
- Splenic artery -> spleen, stomach, pancreas
- Common hepatic artery -> liver, stomach, gallbladder, duodenum, pancreas

28
Q

What organs does the SMA supply?

A
  • Pancreas
  • small intestine
  • appendix
  • first 2/3rds of large intestine
29
Q

What does the IMA supply?

A
  • last third of large intestine
30
Q

Describe an Abdominal Aortic Aneurysm. what is the most common type? what type is considered a medical emergency and whats not? and what are the presentations of the medical emergency one?

A

Aneurysm = abnormal swelling or bulge in blood vessel
Most common = Infrarenal (between the Renal artery and IMA)
- also Unruptured AAA and Ruptured AAA (med emergency)
- Ruptured AAA presents with severe pain, hypotension, pulsatile abdominal mass

31
Q

What is a peptic ulcer and what can it be caused by?

A

= defect in muscularis mucosa layer of GIT -> extends into further layers
Cause:
- H.pylori
- NSAIDs

32
Q

Where do gastric ulcers and duodenal ulcers occur? what arteries can they potentially affect?

A

Gastric:
- Splenic artery (posterior)
- Left and right gastric artery (lesser curvature)
- L/R gastroepiploic artery (greater curvature)
Duodenal:
- gastroduodenal artery

33
Q

What are the branches of L gastric artery which arises from the celiac trunk? what does each supply?

A
34
Q

What are the branches of the splenic artery which arises from the celiac trunk? what does each supply?

A
35
Q

What are the branches of the Common hepatic artery which arises from the celiac trunk? what does each supply?

A
36
Q

What are the branches that arise from the SMA and what do they supply?

A
37
Q

What is Nutcracker Syndrome?

A
  • SMA passes anteriorly to left renal vein, the unicate process and 3rd part of the duodenum
  • because of this, an aneurysm can compress the left renal vein -> Nutcracker Syndrome
38
Q

What are the jejunal and ileal arteries?

A

Jejunum:
- longer vasa recta with fewer gaps
Ileum:
- shorter vasa recta with more gaps

39
Q

What branches arise from the IMA and what does they supply?

A
40
Q

IMA branches diagram

A
41
Q

What is systemic venous drainage and what does it drain?

A
  • IVC drains all structures below diaphragm EXCEPT spleen, pancreas, gallbladder and abdominal part of GI tract. The others are drained by the Portal Venous System
  • IVC is also retroperitoneal
42
Q

What is the difference between Hydrocele and Varicocele and what are they?

A

Hydrocele:
= fluid accumulation w/in tunica vaginalis in scrotum
- Clin presentation -> TRANSILLUMINATES, painless swelling
Varicocele:
= pampiniform plexus of scrotum is engorged due to obstruction of spermatic vein (left side more affected)
- Clin presentation -> does NOT TRANSILLUMINATE, feels like a bag of worms on palpation

43
Q

Describe the portal venous system. What union forms portal vein?

A

= carries blood from GI viscera into liver for metabolism and nutrient sequestration
- Portal vein = union of SMV and splenic vein (IMV drains into splenic)

44
Q

What are the main veins of GIT and branches and what does it drain?

A
45
Q

What is Portal Hypertension? causes?

A

= increased pressure within the portal venous system
Pre-hepatic:
- Portal vein thrombosis (a blood clot within blood vessels that limits the flow of blood)
Intrahepatic:
- Cirrhosis (a type of liver damage where healthy cells are replaced by scar tissue)
Post-hepatic:
- hepatic outflow obstruction

46
Q

Presentation of portal hypertension?

A
  • Dilated blood vessels in Oesophagus and rectal
  • Splenomegaly (enlarged spleen)
  • Ascites (fluid collection in abdomen spaces)
47
Q

Veins of GIT diagram

A
48
Q

Nerves of GIT diagram

A
49
Q

Table summary of GIT nerves

A
50
Q

Greater splanchnic nerves
- Type of innervation
- Origin
- Synapse
- Target

A
  • Sympathetic
  • T5 - T10
  • Celaic ganglion
  • Foregut derivatives
51
Q

Lesser splanchnic nerves
- Type of innervation
- Origin
- Synapse
- Target

A
  • Sympathetic
  • T10 - T11
  • Celiac & superior mesenteric ganglion
  • Midgut derivatives
52
Q

Least splanchnics
- Type of innervation
- Origin
- Synapse
- Target

A
  • Sympathetic
  • T12
  • Aorticorenal ganglion
  • Kidney and suprarenal gland
53
Q

Sacral splanchnics
- Type of innervation
- Origin
- Synapse
- Target

A
  • Sympathetic
  • L1 - L2
  • Hypogastric plexus
  • Pelvic viscera
54
Q

Lumbar splanchnics
- Type of innervation
- Origin
- Synapse
- Target

A
  • Sympathetic
  • L1 - L2
  • Inferior mesenteric ganglion
  • Hindgut derivatives
55
Q

Vagus nerve
- Type of innervation
- Origin
- Synapse
- Target

A
  • Parasympathetic
  • Brainstem medulla
  • synapses at target organ
  • Pharynx & larynx muscles, abdominal viscera
56
Q

Pelvic splanchnics
- Type of innervation
- Origin
- Synapse
- Target

A
  • Parasympathetic
  • Anterior rami S2-S4
  • synapses at target organ
  • Hundgut derivatives (past splenic flexure)
57
Q

Pudendal nerve
- Type of innervation
- Origin
- Synapse
- Target

A
  • Somatic
  • Anterior rami S2-S4
  • none
  • Pelvic muscles and anal sphincter
58
Q

Autonomics diagram

A
59
Q

What are the 6 different sphincters and what is their muscle type?

A

https://www.google.com/url?sa=i&url=https%3A%2F%2Fquizlet.com%2Fau%2F286529590%2Fgut-physiology-flash-cards%2F&psig=AOvVaw2QvW36tgAyF50JeqNTKu8q&ust=1717310088704000&source=images&cd=vfe&opi=89978449&ved=0CBUQjRxqFwoTCKiHz-DkuYYDFQAAAAAdAAAAABAE

60
Q

Oesophagus neurovasculature. what is their innervation, arterial supply, venous drainage, lymphatics

A
61
Q

Stomach neurovasculature. what is their innervation, arterial supply, venous drainage, lymphatics

A
62
Q

Duodenum neurovasculature. what is their innervation, arterial supply, venous drainage, lymphatics

A
63
Q

Jejunum and Ileum neurovasculature. what is their innervation, arterial supply, venous drainage, lymphatics

A
64
Q

What is Celiac disease and its clinical presentations?

A
  • Autoantibodies targetting TTG (tissue transglutaminase)
    Clinical presentations:
  • Steatorrhea (foul smelling, floaty stools)
  • Malabsorption symptoms -> weight loss
  • abdom pain, diarrhoea, etc
65
Q

Colorectal cancer clinical presentation

A
  • Altered bowel habit
  • rectal bleeding
  • weight loss
  • iron-deficiency anaemia

Y2 S1 Anatomy (3 decks)

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