Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 3 - Met3a > Gut Anatomy and Clinical Application > Flashcards

Gut Anatomy and Clinical Application Flashcards

1
Q

What is deglutination

A
  • Complex movement involving skeletal and smooth muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 4 phases of swallowing

A
  • Oral preparation
  • Oral transit - voluntary
  • Pharyngeal - involuntary
  • Oesophageal - involuntary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What nerves do the oral phase involve

A

CN V, VII, XI, X, XII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the 4 phases of swallowing

A
  • Oral preparation - mastication of the food to form a food bolus
  • Oral transit - voluntary - to back of oraopharyxi - tongue used to move bolus of food
  • Pharyngeal - involuntary
  • Oesophageal - involuntary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How long is the oesophagus

A

25cm approximatley in length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the three main parts of the oesphagus

A

Cervical
- cricopharyngeus to the throacic inlet (T4)

Thoracic
- Thoracic inlet to hiatus

Abdominal
- short segement before the gastro oesphageal junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What spinal level is the throacic inlet

A

T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where does narrowing of the oesphagus happen

A
  • Arch of the aorta
  • left main bronchus
  • diaphragmatic hiatus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What three arterial vessels make up the oesopagus blood supply and what part of the oesphagus do they supply

A

Cervical oesophagus
- branches from the inferior thyroid artery

Thoracic oesophagus
- thoracic aortic branhces ( come of the aorta directly)

abdominal
- Coeliac plexus (from the left gastric artery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the venous supply of the oesophagus

A

Cervical
- inferior thyroid veins - drain into the SVC eventually

thoracic
- azygous system

abdominal
- left gastric vein will drain into the portal system (site of portosystemic anastomose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where does the oesphagus go through the diaphragm

A

T10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what forms the oesophageal hiatus

A
  • fibres from the right crux of the diaphragm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What structures pass through the oesophageal hiatus

A
  • Oesophagus
  • vagus nerve
  • left gastric vessels
  • lymphatics frmo the lower third of the oesophagus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where is the aortic opening in the diaphragm

A

T12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where is the caval opening the diaphragm

A

T8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what goes through the aortic opening and T12 in the diaphragm

A
  • aorta
  • thoracic duct
  • azygous vein
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What goes through the caval opening at T8 in the diaphragm

A
  • inferior vena cava

- right phrenic nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what level does the vena cava go through the diaphragm

A

T8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What type of sphincter is the oesophageal sphincter

A
  • physiological sphincter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does the oesophageal sphincter do

A

Prevents reflux of food in the stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what muscle is the oesophageal sphincter made out of

A
  • Smooth muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the symptoms of a hiatus hernia

A
  • reflux
  • bloating
  • sore throat
  • hoarse voice
  • feeling of a lump stuck in the back of the throat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what does oesphagitis lead to

A

Barrets oesophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the types of hiatus hernia

A
  • Sliding hiatal hernia - part of it slides up into the thorax
  • paraoesphageal hiatal hernia - there is a herniated part of the stomach which reamins in the thorax
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the more dangerous hiatal hernia

A
  • paraoesphageal hiatal hernia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

describe the arterial anatomy

A
  • phrenic arteries
  • coeliac trunk (T12) - splits into left gastric, common hepatic and splenic artery (also supplies pancreatic branches)
  • superior mesenteric artery (L1)
  • inferior mesenteric artery (L3)

laterally

  • superrenal
  • renal (L2)

inferior
- gonadal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What sections is the stomach made out of

A
  • Fundus - passes superior to the level of the gastrooesphageal junction
  • Cardia
  • Body
  • pylorus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the aterial supply of the stomach

A
  • Left and right gastric pass along the lesser curvature of the stomach
  • left and right gastro-epiploic pass on the great curvature of the stomach
  • directly from the splenic artery there are short gastric arteries that supply the fundus of the stomach
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q 
where does the 
- left gastric 
- right gastric 
- left gastro-epiploic 
- right gastro-epiploic 
originate from
A
  • left gastric = coeliac trunk
  • right gastric = hepatic artery
  • left gastro-epiploic - splenic artery
  • right gastro-epiploic - from the hepatic artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the 4 parts of the duodenum

A
  • 1st – Superior
  • 2nd – Descending
  • 3rd – Inferior
  • 4th - Ascending
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what parts of the duondeum are retroperiotneal

A
  • 2nd – Descending
  • 3rd – Inferior
  • 4th - Ascending
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

describe the blood supply of the dudenum

A
  • strong blood supply and branches are closely realted
  • gastroduodenal artery from the right hepatic artery passes behind the 1st section
  • this gives rise to the superior pancreaticduodenal artery
  • there are recurrent branches from the inferior pancreaticduodenal artery from the superior mesenterci artery
33
Q

blood supply from the duodenum also supplies the

A
  • this blood supply also supplies the head of the pancreas
34
Q

where does the bile duct enter

A
  • major duodenal papilla
35
Q

Describe how the gall bladder works

A
  • left and right hepatic branches combine
  • these form the common hepatic ducts
  • the cystic duct from the gall bladder joints
  • this forms the common bile duct
  • the common bile duct goes into the pancreas
  • pancreatic duct then joints just before the major duodneal papilla
  • this then drains into the duodenum
36
Q

describe the embrology of the abdomen

A 
Fore gut 
- celiac trunk 
Mid gut 
- superior mesenteric artery 
Hind gut 
- inferior mesenteric artery
37
Q

What defines the section of the foregut

A

Mouth to the Major duodenal papilla (2nd part)

38
Q

What defines the section of the midgut

A

2nd part duodenum to the 2/3 along transverse colon

39
Q

What defines the section of the hundgut

A

2/3 along transverse colon to the Upper anal canal

40
Q

where do foregut structures present with pain

A

Epigastric region

  • pancreatitis
  • gastritis
  • billary colic
41
Q

Where do midgut structures present with pain

A

Umbilicus reigon

  • appendicits
  • small bowel obstruction
42
Q

Where do hind gut structures present with pain

A

Supa pubic region

  • sigmoid diverticulitis
  • colonic obstruction
43
Q

If the abdomina pain is somatic what does it mean and what does it feel like

A

Peritoneum

  • well localised
  • stabbing/sharp
  • mutiple nerve fibres
44
Q

If the pain is visceral waht does it mean and what does it feel like

A

Organs

  • dull
  • difficult to differentiate
  • less sensitive to direct trauma
  • low density of innervation
  • poorly localised
45
Q

where do the blood vessels travel

A
  • Mesentary
46
Q

what branches makes up the superior mesenteric artery

A
  • illeo-colic
  • middle colic
  • right colic
  • marginal branches
  • illeal branches
  • jejunal branches
47
Q

What branches make up the inferior mesenteric artery

A
  • left colic
  • sigmoid
  • superior rectal
48
Q

what is the watershed area

A
  • area where the marginal arteriesa re

- this is where the blood supply is often compromised

49
Q

What happens if you lose blood supply to the proximal part of the superior mesenteric artery

A
  • mesenteric ischaemia
50
Q

What are the symptoms of mesenteric ischaemia

A
  • sudden onset pain
  • thromboembolic cause
  • total blood supply loss
  • severe pain
  • management is operative
51
Q

What happens if you loose blood supply to the more distal part in the mesenteric arteries

A

ischaemic colitis

52
Q

what are the symptoms of ischaemic colitis

A
  • hours onset
  • cause is multifactoral
  • transient blood supply loss
  • symptoms include diarrhoea, PR bleeding, pain
  • management is either conservative or operative
53
Q

desscribe the rectal blood supply

A

Superior 1/3

  • Superior rectal artery
  • Inferior mesenteric artery

Middle 1/3

  • Middle rectal artery
  • Internal iliac artery

Inferior 1/3

  • Inferior rectal artery
  • Internal pudendal artery (iliac artery)
54
Q

What is calots triangle

A
  • Triangle between the inferior surface of the liver, cystic duct and common hepatic duct
55
Q

What goes through calots triangle

A

Cystic artery - can cause significnat bleeding

56
Q

Why do you look for calots triangle

A
  • want to avoid clipping too low on the cystic duct and clipping onto the bile duct
57
Q

which patients have oesophageal varices

A
  • patients with portal hypertension
58
Q

how does liver disease lead to bleeding varices

A
  • A cirrhosised liver can cause an increase in resistance
  • this casues an increase in hypertension
  • this backs up along the left gastric vein which anatomises with the azygous vein
  • due to the hypertension the blood no longer goes along the liver and instead passes along the left gastric vein to the azygous vein and drains through the vena cava
  • this isnt desgined for this and the veins become stretched and dialted and oesphageal varices form
59
Q

what are the 5 sites of porto systemic circulation

A

Lower 1/3 of oesophagus

  • left gastric
  • azygus

Umbilicus

  • umbillical veins
  • superior/inferior epigastric veins

Upper anal canal

  • superior rectal vein
  • middle/inferior rectal veins

Bare area of the liver

  • hepatic/portal veins
  • inferior phrenic veins

retroperiotneum

60
Q

What causes caput medusae

A
  • Anastomoses of the superficial veins of the abdominal wall with the ligamentum teres
61
Q

What artery passes posteriorly to the duodenum

A
  • gastroduodenal - ulcers are common in the duodenum and if they perforate posteriorly into the duodenum then they can cause gastroduodenal bleeding
62
Q

Name the symptoms, imaging and management for someone with anterior and posterior duodneal ulcers

A

Anterior

  • Pain - release gastric contents
  • pneumoperitoneum imaging
  • operative management

posterior

  • pain and bleeding
  • normal on imaging
  • management - endoscopic, IR, operative
63
Q

What is acute cholecystitis

A
  • stone becomes impacted in hartmanns pouch
  • gallbladder can become inflammated
  • can become infected by a bacterial secondary infection
64
Q

What is the pain like in billary colic

A
  • pain after eating

- pain radiates to the back due to referred pain from the midgut

65
Q

How does cholecystitis develop (in hartmanns pouch)

A
  • Billary colic where the stone blocks the cystic duct
  • this if the obstruction becomes infected can form a mucocele (obstruction infection)

if there is a simple infection of the gall bladder it is called a cholecystitis

66
Q

How does cholangitis develop develop in

A
  • there is an obstruction in the billary duct
  • this causes obstructive jaundice
  • this leds to cholangitis
67
Q

asymptomatic gallstones should not be..

A

treated

68
Q

Describe the pain of chronic cholelithiasis

A
  • recurrent biliary pain usually less than 3 hours
69
Q

describe the pain of acute cholecystitis

A
  • Sharp to dull biliary pain usually greater than 6 hours
  • fever
  • murphy’s sign
  • nausea
  • vomitting
70
Q

describe the pain of choledocholithiasis

A
  • abdominal pain in the upper or middle right upper abdominal quadrant
  • billary pain
  • fever
  • jaundice
  • loss of appetite
  • nausea and vomitting
71
Q

describe the pain of cholangitis

A

biliary pain

  • fever
  • jaundice
  • chills
  • clay-coloured stools
  • dark urine
  • nausea adn vomitting
72
Q

What is charcots triad

A
  • sign used for cholangitis
73
Q

What three symptoms make up charcots triad

A
  • Jaundice
  • RUQ pain
  • Fever / Rigors
74
Q

What makes up reynolds pentad (cholangitis)

A
  • Jaundice
  • RUQ pain
  • Fever / Rigors
  • confusion
  • hypotension
75
Q

describe the pain in appendicitis

A

Migratory RIF pain - starts in the umbilicus and localises

76
Q

What can cause appendicitis

A

Obstruction of an appendix

  • lymphangitis
  • appendicolith
  • foreign body
  • worms
77
Q

What can cause increased pressure in the appendix wall

A
  • venous stasis
  • thrombosis
  • lymphatic obstruction
  • swelling
78
Q

What are the borders of calot’s triangles

A
  • cystic artery
  • cystic duct
  • hepatic duct

Year 3 - Met3a (43 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions