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Digestive MBChB 2 > Lecture 7; Anatomy of the gut, ANS and blood supply > Flashcards

Lecture 7; Anatomy of the gut, ANS and blood supply Flashcards

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12
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Describe what orientation arteries come off the aorta;

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Anterior aspect only

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13
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Describe the three major arteries that come off the aorta in regards to the abdomen;

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T12; Celiac trunk

L1; Superior mesenteric artery

L3; Inferior mesenteric artery

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14
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Describe the neurovascular supply of the foregut;

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Arterial; Branches of the coelic axis (T12)

Venous drainage; Portal vein (NO CELIAC VEIN)

Nerve plexus; Coeliac PLexus (T12)

Lymphatics; Pre-aortic nodes (T12)

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15
Q

What are some important notes on the foregut;

A
  • Digestive system starts in oral cavity
  • Spleen is NOT foregut
  • Pain is referred to the EPIGASTRIC region
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16
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Whats some notable surface anatomy relations to the stomach;

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Generally; Epigastric, to left of midline

Oesophagus = Costal cartilage 7/8

Fundus = Ribs 5/6

Pylorus ~L1

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17
Q

What does the inner lining of the stomach contain?

A

Rugae to increase SA and motility

18
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Describe the blood supply to the various stomach regions;

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Lesser curviture = Left gastric (celiac trunk) and right gastric (common hepatic) anastomose

Greater curviture = Left gastro-omental (splenic) and right gastro-omental (Gastro-duodenal (from common hepatic)) anastomose

Fundus = Short gastric (Splenic)

19
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Where does the omentum hang off?

A
20
Q

Describe the passage of the duodenum in relation to other structures;

A
21
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Describe which parts of the duodenum are peritoneal and the change in neurovascular supply;

A

1st part = intraperitoneal

2,3,4 = Reteroperitoneal

Halfway aong duodenum it transitions to midgut origin therefore blood, nerves, lymphatics change.

22
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Describe the neurovacular supply of the duodenum;

A

Art;

Sup. half; Superior pancreaticoduodenal branches from duodenal art. -> Celiac trunk

Inf. half; Inferior pancreaticoduodenal branches from SMA

Nerve;

Sup; Celiac plexus @ T12

Inf; SMA @ L1

Venous;

Sup; Direct to portal vein

Inf; Superior mesenteric vein

Lymp;

Sup; Pre-aortic celiac nodes @ T12

Inf; Pre-aortic Sup. Mesenteroc nodes @ L1

23
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Whats the neurovascular supply of the midgut;

A

Art. = SMA @L1

Venous; SMV

Nerve; SMP @L1

Lymph; Pre aortic nodes @L1 (SMN)

24
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Where is pain from the midgut referred to?

A

Umbillical region

25
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Write some notes on the midgut SI;

A
26
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How can you use the arterial pattern to identify the Jejunum and ilium;

A

Jejunum; 1 or 2 aracades with long branches

Ilium; More arcades with many small branches

27
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Describe the neurovascular supply to the jejunum and ilium;

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28
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Where does the midgut to hindgut transition occur?

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29
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Whats the function of the large intestine?

A
30
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What are some gross features of the large intestine;

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31
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Describe the surface anatomy in relation to LI;

A
32
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Describe the arterial supply of the large intestine;

A

Midgut/ SMA @ L1

  • Ceacal and appendicular art, from ilioceacal
  • Ascending colon = Right colic a.
  • Proximal 2/3 trans colon = middle and marginal a.

Hindgut/IMA @ L3 =

  • Distal 1/3 trans colon = Marginal and left colic. a
  • Descending colon = Left colic a.
  • Sigmoid colon = Sigmoid art.

marginal art = anastamotic point b/w sup and inf mesenteric art.

33
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Describe the neurovascular supply of the hindgut;

A

Art. = IMA @L3

Venous; IMV

Nerve; IMP @L3

Lymph; Pre aortic nodes @L3 (IMN)

34
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Where does the rectum start?

A
35
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Describe the transition to the anal canal from the rectum;

A

Pierces pelvic diaphragm at tip of coccyx to become anal canal

36
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Describe the peritoneal nature of the anal canal;

A
  • Sup. 1/3 = Viscera; peritoneum on Ant. and Post.
  • Middle 1/3 = Peritoneum on ant. only
  • Inf 1/3 = Infraperitoneal
37
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Describe the art. supply of the anus;

A

Sup. rectal = IMA @ L3 (majority)

Middle = Branch of internal iliac

Inferior rectal = Branch of pudendal

38
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Describe the portal system anastomoses that occurs from the rectal veins;

A
39
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Describe the ANS of the gut;

A
40
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Whats an important note about the PSNS to the gut?

A
41
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Describe the sympathetic supply to the gut regions;

A

Foregut -> Celiac plexus -> Greater splanchnic (T5-9)

Midgut->SMP->Lesser splanchnic (T10-11)

Hindgut->IMN & Sup. hypogastric-> Lumbar/sacral splachnic (L1-2)

42
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Describe how the pain of an appendicitis varies;

A
  • Inflammed appendix
  • Afferent sympathetics refer back to T10-11 dermatome (Broad pain around the umbilical region)
  • Appendix inflammes and englarges touching the parietal peritoneum on the body wall (Somatic sensory supply)
  • Pain now felt as acute and localised to R. inguanal

Digestive MBChB 2 (31 decks)

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