GIT-Peritoneum, Stomach, Liver, Biliary Tract & Spleen Flashcards

1
Q

What is another term to describe a single continuous membrane of simple squamous epithelium?

A

Mesothelium

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2
Q

What does the parietal peritoneum lines?

A

Abdominopelvic cavity

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3
Q

What does the visceral peritoneum lines?

A

Covering the organs (e.g. Bowel)

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4
Q

What usually stimulates the visceral peritoneum?

A

Stretching and chemical irritation

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5
Q

Where are pain from foregut, midgut andf hindgut derivatives usually experienced respectiviely?

A

Foregut: Epigastric region
Midgut: Umbilical region
Hindgut: Hypogastric / pubic region

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6
Q

The peritoneal cavity is a ________ within the layer of the peritoneum

A

potential space

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7
Q

In females, there is ____ between vagina > uterine cavity > uterine tubes: potential pathway for _____

A

In females, there is external communication between vagina > uterine cavity > uterine tubes: potential pathway for infection

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8
Q

Omentum is a ____ extension or fold of ____

A

Omentum is a double layered extension or fold of peritoneum

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9
Q

Where does the lesser omentum extend from?

A

Liver to the lesser curvature of the stomach

A double layered peritoneal fold

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10
Q

Where does the greater omentum extend from?

A

Greater curvature of the stomach and the transverse colon

  • wraps around inflammed organ in the abdomen and protects other organs from it
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11
Q

What is a ligament?

A

A fold connecting one organ with another or one organ with any area of the body wall.

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12
Q

Mesentry is a ____ connecting an organ to the ____ it’s also a conduit for ____, nerves and ____ supplying viscera

A

Mesentry is a fold connecting an organ to the posterior abdominal wall it’s also a conduit for vessels, nerves and lympathics supplying viscera

Composed of 2 layers of peritoneum

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13
Q

Peritoneum is a ____, ____ serous. membrane - lines the abdominal cavity & invests the viscera

A

Continuous, transparent

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14
Q

What runs within the lesser omentum near its free edge?

A

Portal vein
Bile duct
Hepatic artery

PBH, same as anterior boundaries of the omental foramen (Portal Triad)

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15
Q

Intraperitoneal: Structures are suspended from the abdomina wall by ____

eg. most of small intestines

A

Mesenteries

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16
Q

Retroperitoneal: Structures e.g. kidneys and great vessels that lie between ____ peritoneum and ____

A

Retroperitoneal: Structures e.g. kidneys and great vessels that lie between parietal peritoneum and** abdominal wall**

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17
Q

What are some organs that became secondarily retroperitoneal?

ORgans that originally had a mesentry, but became secondarily retroperitoneal when the mesentry fused with the body wall.

A

Duodenem (except the first part)
Pancrease (except the tail part)
Colon (except cecum, transverse colon and sigmoid colon)

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18
Q

Omental foramen (Epiploic foramen) is the passage between the ____ and the ____ allowing communication between these two spaces

A

greater sac and lower sac

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19
Q

What are the boundaries of the omental foramen?

A

Anterior: Bile duct, hepatic artery and portal vein (portal triad)
Posterior: IVC and diaphragm
Superior: Caudate lobe of the liver
Inferior: First part of the duodenum

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20
Q

What is another name for the lower sac?

A

Omental bursa

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21
Q

When does the esophagus pierce through the diaphragm?

A

T10

Oesophagus: 10 letters

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22
Q

The stomach lies between the ____ and the ____ in the epigastric, umbilical and ____ regions of the abdomen

A

The stomach lies between the esophagus and the small intestine in the epigastric, umbilical and left hypochondriac regions of the abdomen

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23
Q

What are the four main regions of the stomach?

A

Cardia > Fundus > Body > Pylorus

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24
Q

What are the two orifice of the stomach?

A

Cardiac orifice (Gsatroesophageal junction)
Pyloric orifice

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25
Q

____ receives food from teh oesophagus and is mainly involved in ____ digestion

A

Stomach receives food from the oesophagus and is mainly involved in enzymatic digestion

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26
Q

Briefly describe the realation of the stomach (Anterior, Posterior and Superior)

A

Anterior: Left lobe of the liver and diaphragm anteriorly
Superior: Left dome of diaphragm superiorly
Posterior: Lesser sac (omental bursa) and pancreas posteriorly

Rests on the:
- Spleen
- Left kidney and adrenal
- Splenic artery
- Pancreas
- Transverse mesocolon

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27
Q

The interior of the stomach is lined by gastric mucosa which is thrown into mucosal folds ( ________ ) when contracted

A

Rugae

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28
Q

What does the foregut include and what is the arterial supply?

A

Distal 3rd of esophagus to the 2nd part of the duodenum at the entrance of the bile duct (Major duodenal papilla)

Arterial supply: Coeliac trunk

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29
Q

What does the midgut include and what is the arterial supply?

A

2nd part of the duodenum to two-thirds along transverse colon

Arterial supply: Superior mesentric artery

30
Q

What does the hindgut include and what is the arterial supply?

A

Distal third of transverse colon to the rectum

Arterial supply: Inferior mesentric artery

31
Q

What are the 3 unpaird visceral arteries and their corresponding veryebral level?

A

Celiac (T12)
Superior Mesentric (L1)
Inferior Mesentric (L3)

32
Q

What are the 3 paired visceral arteries?

A

Suprarenal (L1)
Renal (L1)
Gonadal (L2)

33
Q

what are the 3 paired parietal arteries?

A

SUbcoastal artery (L2)
Inferior phrenic (T12)
Lumbar artery (L1-L4)

34
Q

Celiac trunk can be further divided into what arteries?

Supplies foregut

A

Common hepatic artery
Splenic artery
Gastric arteries
* Left and Right gastric arteries
* Left and Right gastro-omental arteries
* Short gastric arteries

35
Q

____ run parallel to the gastric arteries in position and course. ____ are tributaries of ____ vein.

A

Gastric veins run parallel to the gastric arteries in position and course. Right and left gastric veins are tributaries of portal vein.

36
Q

Gastric lymphatic ____ are found along the ____ and ____ curvature of the stomach.

____ nodes
____ nodes

The ____ vessels from these nodes drain into the ____ nodes then to the _____

A

Gastric lymphatic vessels are found along the greater and **lesser **curvature of the stomach.

**Gastric ** nodes
Gastro-omental nodes

The **efferent **vessels from these nodes drain into the celiac nodes then to the thoracic duct

37
Q

The stomach receives sympathetic nerve fibres from ____ to ____ spinal segments

It stimulates ____ sphincter

A

The stomach receives sympathetic nerve fibres from T5 to T9 spinal segments

It stimulates pyloric sphincter

38
Q

The stomach receives parasympathetic nerve fibres from the ____ and ____ nerves

It stimultes ____ movement of the stomach and secretion of ____

A

The stomach receives parasympathetic nerve fibres from the right and left vagus nerves

It stimultes peristalsis movement of the stomach and secretion of gastric glands (secretomotor)

39
Q

____ nerve fibres (preganglionic) pass through the ____ nerves and terminates in the ____ ganglion

____ sympathetic nerves supply the stomach

Stomach is supplied by the ____ fibres which accompany the sympathetic nerve fibres and reach the ____ spinal sensory ganglia.

Visceral referred pain from gastric ulcer is reffered to the ____ region

A

Sympathetic nerve fibres (preganglionic) pass through the greater splanchnic nerves and terminates in the celiac ganglion

Postganglionic sympathetic nerves supply the stomach

Stomach is supplied by the sensory (pain) fibres which accompany the sympathetic nerve fibres and reach the T5-T9 spinal sensory ganglia.

Visceral referred pain from gastric ulcer is reffered to the epigastric region

40
Q

Alcohol often leads to liver _____

A

Liver cirrhosis

41
Q

What is the largest visceral organ in the body?

A

Liver

42
Q

The liver lies primarily in the right ____ and ____ region

A

Right hypochondrium and epigastric region

43
Q

What are the 2 surfaces of the liver and its relation?

A

Diaphragmatic surface of the surface is related to the inferior surface of the diaphragm and is separated by the subphrenic recess (Covered with peritoneum except the bare area)

Visceral surface: Covered by peritoneum except at the bed of gallbladder and porta hepatis

Hepatorenal recess: A peritoneal cavity on the right side between the liver and the right kidney with adrenal gland

44
Q

Liver is attached to the anterior abdominal wall:

What divides the liver into right and left lobes?

A

Falciform ligament

Liver attached to the anterior abdominal wall by the falciform ligament

45
Q

Liver is attached to the stomach:

What attaches the liver and the stomach?

A

Hepatogastric ligament

46
Q

Liver is attached to the diaphragm:

What attaches the diaphragm and liver?

A

Coronary ligaments

47
Q

Functions of the liver:
Secretes ____ which is released into the ____ (____ emulsifies fat)
Involved in ____, fat and ____ metabolism and stores ____
Involved in ________ of the blood by removing ____ and other foreign particles (Detoxification)

A

Secretes bile which is released into the duodenum (bile emulsifies fat)
Involved in carbohydrate, fat and protein metabolism and stores glycogen
Involved in filtration of the blood by removing bacteria and other foreign particles (Detoxification)

48
Q

The right anatomical lobes includes the ____ lobe and ____ lobe

A

Quadrate lobe and Caudate lobe

49
Q

What are some organs the visceral surface is related to?

A

Stomach
Duodenum
Gallbladder
Lesser omentum
Right colic flexure and transverse colon (Colic area)
Right kidney and adrenal gland (renal area)

50
Q

Quadrate lobe and caudate lobe belongs to which function lobe of the liver?

A

Left functional lobe

51
Q

The liver receives blood from:
____ artery (20% to 25%)-A branch of celiac trunk, that carries ____ oxygenated blood from the aorta.

____ vein (75% to 80%) that carries ____ oxygenated but ____ rich blood from the GI tract.

A

The liver receives blood from:
Hepatic artery (20% to 25%)-A branch of celiac trunk, that carries well oxygenated blood from the aorta.

Portal vein (75% to 80%) that carries poorly oxygenated but** nutrient** rich blood from the GI tract.

51
Q

____ of the ____ and ____ divide the liver into 2 functional lobes, right and left.

A

Fossae of the** gallbladder** and Inferior Vena Cava divide the liver into 2 functional lobes, right and left.

52
Q

What forms the portal vein?

A

The union of superior mesenteric vein and splenic vein

53
Q

The portal-systemic anastomoses (PSA) are where veins draining into the ____ vein and the ____ communicate.

A

The portal-systemic anastomoses are where veins draining into the portal vein and the IVC communicate.

54
Q

Portal vein may become dilated if ____ blood flow through the liver is ____ in ____ disease

A

Portal vein may become dilated if portal blood flow through the liver is** obstructed** in liver disease

55
Q

Where are some important sites of the portal-systemic anastomoses?

A

A: Lower Oesophagus
B: Rectum
C: Umbilicus
D: Posterior abdominal wall

56
Q

Haemorrhage is often seen in which 2 PSA?

A

Lower Esophagus
Rectum

Liver or portal obstruction causes these veins to dilate widely, possibly leading to severe venous haemorrhage from esophagus or rectum

57
Q

____ liver cirrhosis caused by destruction of ____ leads to ____. Cirrhosis may be treated by ____ the ____ and ____ systems.

A

Alcoholic liver cirrhosis caused by destruction of hepatocytes leads to portal hypertension. Cirrhosis may be treated by anastomosing the portal and systemic venous systems.

58
Q

Briefly describe the PSA relations at the lower esophagus

Portal systemic anastomoses

A

Systemic: Esophageal vein
Portal: Left gastric vein

59
Q

Briefly describe the PSA relations at the rectum

A

Systemic: Inferior rectal vein
Portal: Superior rectal vein

60
Q

Briefly describe the PSA relations at the umbilicus

A

Systemic: Epigastric vein
Portal: Paraumbilical vein

61
Q

Briefly describe the PSA relations at the posterior abdominal wall

A

Systemic: Retroperitoneal vein
Portal: Visceral vein

62
Q

Where does the gall bladder lie?

A

Its a pear-shaped sac lying on the visceral surface of the right lobe of the liver

63
Q

Gallbladder:
Receives, ____ and stores ____
Has 3 parts: ____, body and ____
____ duct connects the ____ to the ____
Supplied by the ____ artery, a branch of the ____ hepatic artery
Innervated by the sympathetic (from ____ plexus), parasympathetic (vagus) and ____ phrenic nerves (sensory)

A

Gallbladder:
Receives, concentrates and stores bile
Has 3 parts: fundus, body and neck
Cystic duct connects the** neck **to the common bile duct
Supplied by the cystic artery, a branch of the **right ** hepatic artery
Innervated by the sympathetic (from **celiac **plexus), parasympathetic (vagus) and right phrenic nerves (sensory)

64
Q

Where is bile produced / secreted?

A

In the liver by hepatocytes

65
Q

Biliary system:
____ bile secreted by the hepatocytes in the liver to the ____

Right and left hepatic ducts unite to form the ____ which joins the ____ to form the ____

Bile duct lies in front of the ____, and on the right side of the ____ artery in the free margin of the _____

A

Transfers bile secreted by the hepatocytes in the liver to the duodenum

Right and left hepatic ducts unite to form the common hepatic duct which joins the **cystic duct **to form the bile duct

Bile duct lies in front of the portal vein, and on the right side of the hepatic artery in the free margin of the lesser omentum

66
Q

Bile duct joins with main ____ duct and they open into the ampulla of ____ in the ____ wall

The ampulla of ____ opens into the ____ through major ____

A

Bile duct joins with main pancreatic duct and they open into the ampulla of vater in the duodenal wall

The ampulla of vater opens into the duodenum through major duodenal papilla

Ampulla surrounded by a circular muscles whch functions as sphincter of the bile duct

67
Q

What arteries supplies the bile duct?

A

Proximal: Cystic artery
Middle part: Right hepatic artery
Duodenal: Posterior superior pancreatico duodenal and gastroduodenal arteries

68
Q

When there is a gall bladder disease such as inflammation of the gallbladder with resulting swelling, the phrenic nerves get irritated. Where is the pain usually felt?

A
  • Local pain in the right hypochondriac region
  • A dull pain in the right shoulder and neck (referred pain)
69
Q

Spleen:
____ covered with the ____ except its ____ which is in contact with the ____ of the pancreas

Related to the
- Stomach anteriorly
- 9 to 11 ribs and left part of the ____ posteriorly
- Left colic flexure ____
- ____ medially
-____ of pancreas

Connected to the
- ____ curvature of the stomach by the ____ ligament
- ____ kidney by the ____ ligament

A

**Completely **covered with the peritoneum except its hilium which is in contact with the tail of the pancreas

Related to the
- Stomach anteriorly
- 9 to 11 ribs and left part of the diaphragm posteriorly
- Left colic flexure inferiorly
- Left kidney medially
- Tail of pancreas

Connected to the
- Greater curvature of the stomach by the gastrosplenic ligament
- Left kidney by the Splenorenal ligament

70
Q

Briefly describe the blood, venous flow and innervation of the spleen

A

Receives blood from the splenic artery
Drained by the splenic vein
Innervated by the nerves from the celiac plexus

71
Q

What organ may rupture leading to severe intraperitoneal haemorrhage if there is a fracture of the 9 to 11th ribs or a sudden increase in intra-abdominal pressure?

A

Spleen