Lecture 17+18: G.I Tract Flashcards

0
Q

Pain arising from midgut localises where?

A

in the periumbilical region.

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1
Q

Pain arising from foregut derivatives

localises where?

A

in the epigastric region

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2
Q

Pain arising from hindgut derivatives localises where?

A

in the hypogastric region

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6
Q

Intrinsic tongue muscles do what to the tongue? Innervated by what nerve?

A

Alter shape

Hypoglossal nerve

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7
Q

Extrinsic muscles alter what? And innervated by what?

A

Position of tongue

All innervated by Hypoglossal except palatoglossus innervated by vagus

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8
Q

Pharyngeal constrictors Contract wall of pharynx sequentially from superior to inferior to move food bolus from oropharynx to?

A

Oesophagus

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9
Q

Pharyngeal constrictors are innervated by what nerve?

A

Vagus

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10
Q

Which pharyngeal constrictor is more superficial and contracts last?

A

Inferior constrictor

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11
Q

The pharyngeal constrictors both insert onto what structure?

A

Median raphe of pharynx

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12
Q

What is the Innervation of the oesophagus? Superior and inferior portions

A

Superior portion: recurrent laryngeal (somatic)

Inferior portion: vagal trunks + greater splanchnic nerves (smooth).

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13
Q

Name the four parts of the stomach?

A

cardia, fundus, body, pylorus

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14
Q

What is the Innervation of the stomach?

A

Parasympathetic: vagus
Sympathetic: visceral afferent fibres from T6-T9 of greater splanchnic nerve

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15
Q

Viscera, afferent fibres of the stomach refer pain where?

A

Epigastric region

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16
Q

What is the blood supply to the stomach?

A

Left and right gastric artery of the coeliac trunk

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17
Q

What is the venous drainage of the stomach?

A

Gastric veins to the portal hepatic vein

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18
Q

The lesser omentum extends from where?

A

liver to lesser curvature of stomach.

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19
Q

The greater omentum extends from?

A

greater curvature of stomach to pelvis and back up.

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20
Q

Name the three tunica muscular is layers of the stomach?

A

Oblique = inner layer

Circular = middle layer

Longitudinal = external layer

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21
Q

What is the function of the gastric mucosa?

A

Protects stomach wall from gastric juice

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22
Q

What is the function of the gastric folds (rugae)?

A

Allows expansion of stomach up to 2-3L

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23
Q

Wat is the only part of the intestines to have peyers patches?

A

Ileum

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24
Q

What is the iliocaceal junction?

A

Junction between small and large intestines

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25
Q

Ileocaecal valve passively permits one-way movement of chyme from?

A

Ileum to caecum

26
Q

Causes of appendix in young and older people?

A

Young: hyperplasia of lymphoid tissue
Older: obstruction by faecal matter

27
Q

What are the Adult foregut derivatives?

A

Pharynx, tongue, tonsils, salivary glands, oesophagus, stomach,
duodenum (proximal to common bile duct), liver, gallbladder, bile
duct system, pancreas.

28
Q

What are the adult midgut derivatives?

A
Most of 
duodenum 
• Jejenum 
• Ileum 
• Caecum 
• Appendix 
• Ascending colon 
• Right 1⁄2-2/3 transverse colon
29
Q

What are the adult handgun derivatives?

A
  • Distal portion of transverse colon
  • Descending colon
  • Sigmoid colon
  • Rectum
  • Anal canal
  • Epithelium of urinary bladder
  • Most of urethra
30
Q

Where do you feel appendicitis pain?

A

Appendicitis will first present with vague pain in the umbilical region = dermatome of T10 (visceral afferent pain fibres travelling
retrograde with sympathetic fibres).

Once the inflammation spreads to the peritoneum then you will get the sharp pain in the right lower quadrant, particularly over
McBurney’s Point.

31
Q

What is the mesentary?

A

Fan-shaped fold of peritoneum that attaches jejunum and ileum to
posterior abdominal wall.

32
Q

Function of large intestines?

A
  • Absorbs water and important ions from faeces.

* Compacts faeces for delivery to rectum.

33
Q

What are the three main features of the large intestine?

A
  • Teniae coli: 3 longitudinal bands of smooth muscle on colon surface that assist peristalsis
  • Haustra: sacculations of colon created by contracting taeniae coli
  • Omental appendices: small fat accumulations that hang from colon.
34
Q

Teniae coli

A
  • 3 longitudinal bands of smooth muscle.
  • Originate at base of appendix.
  • Broaden & terminate as a continuous longitudinal layer around rectum.
  • Tonic contraction causes sacculations known as “haustra”.
35
Q

Which part of the colon of large intestine absorbs the most water?

A

Ascending colon

36
Q

The start of rectum is at what vertebrae?

A

S3

37
Q

What is the arterial supply of rectum?

A

Inferior mesenteric artery and internal iliac artery

38
Q

Venous drainage of rectum?

A

Superior rectal vein drains back to the inferior mesenteric vein (=> splenic => portal vein).
• Middle rectal veins drains back to internal iliac veins.
• Anatomosis between rectal veins.

39
Q

Innervation of rectum?

A
  • Sympathetic: lumbar splanchnic nerves

* Parasympathetic: pelvic splanchnic nerves

40
Q

Innervation of rectum: visceral afferent fibres

A

Rectum inferior to pelvic pain line so all visceral afferent fibres follow pelvic splanchnic nerves retrogradely back to S2-S4
spinal sensory ganglia.

41
Q

What pelvis muscle plays a major role in maintaining faecal continence?

A

Puborectalis

42
Q

Innervation of internal anal sphincter?

A
smooth involuntary (contraction stimulated by sympathetic fibres; 
parasympathetic fibres from pelvic splanchnic nerves inhibit sympathetic contraction and evoke peristaltic contraction for defaecation)
43
Q

Innervation of external anal Sphincter?

A

skeletal muscle, voluntary,

innervated by inferior anal (rectal) nerve – branch of pudendal nerve.

44
Q

Innervation of sigmoid colon, where parasympathetic Innervation is taken over by pelvic splanchnic nerve rather than vagus

A
  • Lumbar splanchnic nerves deliver sympathetic fibres to descending & sigmoid colons from L1-L2/L3.
  • Pelvic splanchnic nerves deliver parasympathetic fibres to descending & sigmoid colons from S2-S4.
45
Q

Greater splanchnic nerve synapse on what structure on abdominal aorta?

A

Coeliac plexus

46
Q

Lesser splanchnic nerve synapse on what structure on abdominal aorta?

A

Superior mesenteric ganglia

47
Q

Least splanchnic nerve synapse on what structure on abdominal aorta?

A

Superior mesenteric ganglia

48
Q

Lumbar splanchnic nerve synapse on what structure on abdominal aorta?

A

Inferior mesenteric ganglia

49
Q

The liver, pancreas and the stomach are innervated by what splanchnic nerve and at what level?

A

Greater splanchnic T6-T9

50
Q

The spleen is innervated by what splanchnic nerve and at what level?

A

Greater splanchnic T6-T8

51
Q

The small intestines are innervated by what splanchnic nerve and at what level?

A

Greater and lesser splanchnic nerves T8-T10

52
Q

The appendix, cecum and ascending colon are innervated by what splanchnic nerve and at what level?

A

Lesser splanchnic nerve T10

53
Q

The transverse colon is innervated by what splanchnic nerve and at what level?

A

Lesser splanchnic nerve T11

54
Q

the descending colon is innervated by what splanchnic nerve and at what level?

A

Least splanchnic nerve and lumbar splanchnic T12-L1

55
Q

Inferior 1/3 of descending colon is innervated by what splanchnic nerve and at what level?

A

Lumbar splanchnic L2-L3

56
Q

The middle of the sigmoid colon and below is innervated by what splanchnic nerve and at what level?

A

Pelvic splanchnic nerve s2-s4

57
Q

The adrenal glands are innervated by what splanchnic nerves and at what level?

A

Greater, lesser, least and lumbar splanchnic nerves T6-L2

58
Q

The kidneys are innervated by what splanchnic nerve and at what level?

A

Greater, lesser, least and lumbar splanchnic nerves T10-L1