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Jess GI > Overview and basic histology > Flashcards

Overview and basic histology Flashcards

1
Q

What is a bolus?

A

A mass of chewed food

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2
Q

Which parts of the esophagus are voluntary and involuntary?

A

Upper 1/3: Voluntary (also contains skeletal muscle)

Lower 2/:3: Involuntary, purely peristalsis (smooth muscle)

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3
Q

What is Barett’s esophagus? What is the epithelial change?

A

A pre-malignant shift from stratified squamous epithelia to simple columnar due to constant acid reflux (GERD)

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4
Q

What’s achalasia?

A

A condition where muscles of the lower part of the esophagus fail to relax (LES doesn’t close), preventing food from passaging into the stomach and leading to a to a backup of food within oesophagus

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5
Q

Name 3 causes of Barett’s esophagus?

A
  1. LES isn’t working
  2. Dysphagia and achalasia
  3. Esophageal varices or hernia
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6
Q

Name the 7 accessory digestive organs

A

Teeth, tongue, gall bladder, salivary glands (parotid, submandibular, sublingual), spleen, liver and pancreas

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7
Q

What hormone stimulates the contraction of the gall bladder? What secretes and stimulates this hormone?

A

Cholecystokinin is stimulated by the introduction of HCl, amino acids or fatty acids in the stomach or duodenum and is secreted from enterocytes in the duodenum - it then triggers contraction of the gall bladder so bile is released into the duodenum via the cystic duct

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8
Q

What cell lines the ducts of the biliary tract and what is its role?

A

Cholangiocytes which modify the bile

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9
Q

Which neural systems play a part in controlling the GI tract?

A

Somatic motor system for ingestion and excretion, Autonomic NS for everything else with the Parasympathetic system being the most significant

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10
Q

Name the possible epithelia that line the GI tract their locations and function

A

Simple columnar - intestine
Glandular epithelia - stomach
*Both aid in secretion and absorption

Stratified squamous non keratinized - mouth and rectum
Provides moisture and protection

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11
Q

Which nervous system is in the submucosa? What is it derived from? Name 3 things that it controls.

A

Submucosal Nerve plexus/Messner plexus: derived from myenteric nerve plexus

Controls:

  1. Glandular secretions
  2. Regulates local blood flow
  3. Alters electrolyte and water transport
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12
Q

What separates the circular and longitudinal layers of muscle? What is it derived from and what does it control?

A

The Myenteric or Auerbach’s plexus; Derived from plexus of parasympathetic nerves around SMA

Controls GI tract motility/peristalsis

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13
Q

Which areas are covered primarily with serosa and others with adventitia? Why?

A

Intraperitoneal regions are covered with serosa (visceral peritoneum): it secretes fluid that lubricates the outside of the GI tract

Retroperitoneal regions requiring anchoring are covered with adventitia

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14
Q

Which specific organs/regions are surrounded by adventitia?

A

Oral cavity, thoracic esophagus, ascending colon, descending colon, rectum

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15
Q

What are the boundaries of the abdomen?

A

Superior: diaphragm
Inferior: Pelvic inlet
Lateral: serous membranes

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16
Q

What are the 4 quadrants of the stomach? Which significant abdominal organs lie in each quadrant?

A

R Upper: Liver, gallbladder
R Lower: Appendix
L Upper: Stomach, spleen
L Lower: descending colon, sigmoid colon

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17
Q

Where is McBurney’s point and what is its significance in appendicitis?

A

Location: 1/3 along a line from the R ASIS to the umbilicus

Significance:
In appendicitis the nervous system is first stimulated by irritation in the visceral layer - so it localizes the pain as coming from where the organ was embryonically derived. As the condition worsens the parietal layer also becomes irritated. At this point, the brain is now able to localize the pain as closer to the appendix’s adult position. Therefore, as the condition worsens the pain will travel towards McBurney’s point

18
Q

What is the mesentery and what is its significance?

A

Double layer of the peritoneum: allows for blood, nerves and lymphatic access to the organs since vessels cannot directly penetrate the peritoneum

19
Q

List the 3 types of mesentery

A
  1. Mesentery proper
  2. Trasverse mesocolon mesentery
  3. Sigmoid mesocolon mesentery
20
Q

What is the parietal cavity and what is its significance?

A

Between parietal and visceral peritoneum: contains fluid that lubricates the GI tract allowing for movement during digestion

Inflammation and infection can lead to increased production of fluid that puts pressure on the organs

21
Q

What does intraperitoneal and retroperitoneal mean? Which important organs/structures are in which regions? (and which structures are ‘in-between’?)

A

Intraperitoneal: Completely surrounded by visceral peritoneum, suspended by mesenteries
-Stomach, spleen, jejunum, ileum, caecum, appendix, transverse colon, sigmoid colon

Retroperitoneal: behind the peritoneum, not suspended by mesenteries
-kidney, adrenal glands, ureters, IVC, abdominal aorta

“Inbetween”/somewhat covered by visceral peritoneum: duodenum, ascending colon, descending colon, pancreas

22
Q

What is Peritonitis and what does it commonly result from?

A

Inflammation and infection of the peritoneum, commonly the result of: burst appendix, penetrating wound, perforated duodenal ulcer

23
Q

What landmarks mark the beginning of the abdominal aorta?

A

Aortic hiatus of the diaphragm, T12

24
Q

What are the 3 major trunks/arteries that branch off the abdominal aorta that supply the gut? List them in order of superior-inferior

A
  1. Celiac Trunk: foregut
  2. Superior mesenteric artery: midgut
  3. Inferior mesenteric artery: hindgut
25
Q

What are the 3 major branches of the Celiac Trunk? Which branches go left and right, and what do they collectively supply (7)?

A
  1. L gastric artery
  2. Splenic artery (goes L)
  3. Common hepatic artery (goes R)

Collectively: supplies the stomach, spleen, liver, gall bladder, abdominal esophagus, pancreas and duodenum

26
Q

What does the L gastric artery give rise to and anastomose with?

A

Gives rise to oesophageal branches, then continues anteriorly along lesser curvature of stomach and anastomoses with the R gastric artery

27
Q

What is the splenic artery’s pathway and what structure contains the vessel during its course?

A

Travels L towards spleen, posterior to the stomach within the splenorenal ligament. Has a tortuous appearance

28
Q

In addition to supplying the spleen what are 3 other important vessels the splenic artery gives rise to? What do they supply?

A
  1. L gastroepiploic: greater curvature of stomach
  2. Short gastrics: fundus of stomach
  3. Pancreatic branches: body and tail of pancreas
29
Q

Why is the common hepatic artery so essential and what are its 2 terminal branches?

A

It is the sole arterial supply to the liver, gives rise to the proper hepatic and gastroduodenal arteries

30
Q

Where does the proper hepatic artery travel through? What 3 branches does it give off and what do they supply?

A

Ascends through the lesser omentum towards the liver:

  1. R gastric: pylorus and lesser curvature of stomach
  2. R and L hepatic: respective lobes of liver
  3. Cystic: gall bladder
31
Q

Where does the gastroduodenal artery travel through? What are its 2 branches and what do they mainly supply?

A

Posterior to the superior portion of the duodenum:

  1. R gastroepiploic: greater curvature of stomach and greater omentum
  2. Superior pancreaticoduodenal: head of pancreas
32
Q

What are the borders and contents of the triangle of calot? Which surgery requires knowledge of this landmark?

A

Borders:
Superior - liver
Medial - common hepatic duct
Lateral - cystic duct

Contents: Cystic artery, R hepatic artery, accessory ducts

Important in a cholecystectomy: removal of gall bladder

33
Q

What organs are supplied by the superior mesenteric artery? Which vertebral level does this vessel begin at?

A

L1: Distal duodenum, jejunum, ileum, colon -> splenic flexure

34
Q

Name the 5 major arterial branches that come off the SMA

A
  1. Jejunal branches
  2. Ileal branches
  3. Ileocolic branch: terminal part of ileum and first part of ascending colon
  4. R and middle colic artery
35
Q

Describe the structure that provides anastomoses between the arterial branches of the SMA and IMA, where is it located?

A

Anastomoses is provided by the ‘marginal artery of drummond’, found along the mesenteric border of the large intestine (a continuous arterial circle along the inner border of the colon)

36
Q

What structures does the Inferior mesenteric artery supply? Which vertebral level does this vessel begin at?

A

L3: Colon (past splenic fixure); descending colon, sigmoid colon, superior rectum

37
Q

Name the 3 major arterial branches that come off the IMA

A
  1. L colic artery
  2. Sigmoidal arteries
  3. Superior rectal artery; (rectum and upper half of anal canal)
38
Q

List the 3 major veins that drain the gut (and which structures they drain), where does the entire venous drainage then lead to?

A
  1. SMV: bulk of SI
  2. IMV: distal colon
  3. Splenic vein

All drain into the liver via the portal vein (where the blood is detoxified and metabolized). Blood is then returned to the heart via the IVC

39
Q

What is chyle and when might it have a ‘milky appearance’?

A

Chyle is GI lymphatic drainage which can appear milky after there has been absorption of fatty material

40
Q

Which artery is likely to be affected in a duodenal ulcer and why?

A

Duodenal ulcers erode posteriorly, directly making contact with the gastroduodenal artery - causing it to bleed

41
Q

Where are the ‘paracolic gutters’ and what is their significance?

A

Paracolic gutters are depressions formed between lateral margins of the intestine and posterolateral abdominal walls. Infection/pus/fluid can easily spread around regions of the peritoneal cavities via the gutters in the direction of gravity. An accumulation of fluid may require drainage

42
Q

GALT (gut associated lymphoid tissue) is generally diffusely situated, name three areas in the GIT where GALT is nodular

A
  1. Peyer’s patches in the ileum
  2. Tonsils
  3. Appendix

Jess GI (17 decks)

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