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DIG > Overview of the Digestive Tract and Peritoneal Coverings > Flashcards

Overview of the Digestive Tract and Peritoneal Coverings Flashcards

1
Q

What are the 5 phases of digestion?

A

1 - Ingestion.

2 - Fragmentation.

3 - Digestion.

4 - Absorption.

5 - Elimination.

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2
Q

Where does the oral cavity extend from / to?

A

From the lips to the oropharynx.

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3
Q

What are the two regions of the oral cavity?

A

The vestibule and the oral cavity proper.

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4
Q

What are the boundaries of the vestibule of the oral cavity?

A

Externally: Lips and cheeks (buccinators muscles).

Internally: Teeth and gums.

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5
Q

What are the boundaries of the oral cavity proper?

A

Anteriolaterally: Dental arches.

Floor: Anterior 2/3 tongue, mylohyoid muscles and geniohyoid muscles.

Roof: Hard and soft palate.

Posteriorly: Oropharyngeal isthmus.

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6
Q

List 4 intrinsic muscles of the tongue.

A

1 - Superior longitudinal.

2 - Vertical.

3 - Transverse,

4 - Inferior longitudinal.

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7
Q

List 4 extrinsic muscles of the tongue.

A

1 - Palatoglossus.

2 - Styloglossus.

3 - Hypoglossus.

4 - Genioglossus.

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8
Q

Which nerves supply the extrinsic and intrinsic muscles of the tongue?

A

All muscles are supplied by the hypoglossal (XII) cranial nerve except for the palatoglossus muscle, which is supplied by the vagus (X) nerve.

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9
Q

Describe the sensory innervation of the tongue.

A

Anterior 2/3:

  • General sensation by mandibular nerve via lingual nerve.
  • Taste sensation by facial nerve via chorda tympani.

Posterior 1/3:
- General and taste sensation via glossopharyngeal nerve.

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10
Q

What are the 4 layers of the gut tube?

A

1 - Mucosa.

2 - Submucosa.

3 - Muscularis externa.

4 - Serosa.

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11
Q

Which 4 tissues are contained within the mucosa of the gut tube?

A

1 - Epithelia.

2 - Basement membrane.

3 - Lamina propria.

4 - Muscularis mucosae.

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12
Q

Which 6 tissues are contained within the submucosa of the gut tube?

A

1 - Connective tissue.

2 - Blood vessels.

3 - Lymphatics.

4 - Autonomic nerves (myenteric and submucosal).

5 - Glands.

6 - Lymphoid tissue.

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13
Q

Describe the layers of the muscularis externa.

Where does its innervation come from?

Where is it located?

A
  • Inner = circular.
  • Outer = longitudinal.
  • Innervation from myenteric plexus.
  • Located between layers of blood vessels between the submucosa and serosa.
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14
Q

Which 5 tissues are contained within the serosa?

A

1 - Loose connective tissue.

2 - Blood vessles.

3 - Lymphatics.

4 - Adipose.

5 - Simple squamous epithelium covering.

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15
Q

What are the 3 regions of the gut?

Where does each region start and end?

From which arteries is the arterial supply of each of these regions derived?

A

1 - Foregut:

  • Abdominal oesophagus to descending duodenum (D2/4).
  • Coeliac artery.

2 - Midgut:

  • Descending duodenum (D2/4) to distal 1/3 of transverse colon.
  • Superior mesenteric artery.

3 - Hindgut:

  • Distal 1/3 of transverse colon to mid anal canal.
  • Inferior mesenteric artery.
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16
Q

Summarise the venous drainage of the GI tract.

A
  • Foregut: Hepatic portal vein and splenic vein.
  • Midgut: Superior mesenteric vein.
  • Hindgut: Inferior mesenteric vein.
  • Inferior mesenteric vein drains into splenic vein.
  • Splenic vein and superior mesenteric vein unite to form the hepatic portal vein.
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17
Q

Describe the lymphatic drainage of the foregut.

A

Lymph drains through coeliac lymph nodes.

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18
Q

Describe the lymphatic drainage of the midgut.

A

Lymph drains through superior mesenteric lymph nodes.

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19
Q

Describe the lymphatic drainage of the hindgut.

A

Lymph drains through inferior mesenteric lymph nodes.

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20
Q

Describe the innervation of the foregut.

A
  • Parasympathetic: Vagus nerve.
  • Sympathetic: Greater thoracic splanchnic nerves (T6-T10)
  • Coeliac plexus.
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21
Q

Describe the innervation of the midgut.

A
  • Parasympathetic: Vagus nerve.
  • Sympathetic: Lesser thoracic splanchnic nerves (T9-T11,L1).
  • Superior mesenteric plexus.
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22
Q

Describe the innervation of the hindgut.

A
  • Parasympathetic: Pelvic splanchnic nerves (S2-S4).
  • Sympathetic: Upperlumbar splanchnic nerves (L1-L2).
  • Inferior mesenteric plexus.
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23
Q

Where does the oesophagus extend from / to?

A

From the laryngeal pharynx (C6) to the stomach (T11).

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24
Q

What are the 3 regions of the oesophagus?

A

1 - Cervical.

2 - Thoracic.

3 - Abdominal.

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25
Q

Which artery supplies the cervical region of the oesophagus?

A

The inferior thyroid artery.

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26
Q

Which artery supplies the thoracic region of the oesophagus?

A

The descending thoracic aorta.

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27
Q

Which artery supplies the abdominal region of the oesophagus?

A

The left gastric artery.

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28
Q

Which vein drains the cervical region of the oesophagus?

A

The inferior thyroid veins.

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29
Q

Which vein drains the thoracic region of the oesophagus?

A

The azygous veins.

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30
Q

Which vein drains the abdominal region of the oesophagus?

A

The left gastric vein (a tributary of the HPV).

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31
Q

Which nerve gives the oesophagus its parasympathetic innervation?

A

The vagus nerve.

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32
Q

Where do the sympathetic fibres that innervate the oesophagus originate?

A

The cervical and thoracic sympathetic trunk.

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33
Q

Which nerve forms the oesophageal plexus?

What does the plexus converge into?

A

The vagus nerve.

The anterior and posterior vagal trunks.

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34
Q

Which type of epithelium lines the oesophagus?

Which condition is characterised by a change in the type of epithelium lining the oesophagus?

A
  • Non keratinised stratified squamous epithelium.

- Barrett’s oesophagus / metaplasia (can be caused by GORD).

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35
Q

In which layer of the oesophagus are the mucus secreting glands located?

A

In the submucosa.

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36
Q

How does the distribution of skeletal muscle and smooth muscle change down the length of the oesophagus?

A
  • Upper 1/3 is skeletal muscle.
  • Middle 1/3 is mixed.
  • Lower 1/3 is smooth muscle.
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37
Q

Where is the stomach located?

A

In the left upper abdomen.

*Changes with volume, body position and phase of respiration.

38
Q

What are the 5 regions of the stomach?

A

1 - Cardia.

2 - Fundus.

3 - Body.

4 - Antrum.

5 - Pylorus.

39
Q

Describe the arterial supply to the stomach.

A
  • All branches of the coeliac artery:
  • Left gastric artery - lesser curvature.
  • Splenic artery:
  • Short gastric arteries - fundus.
  • Left gastro-omental artery - greater curvature.

• Common hepatic artery:

  • Right gastric artery - lesser curvature.
  • Gastroduodenal artery - greater curvature.
40
Q

Where do the veins that drain blood from the stomach drain into?

A

The portal circulation.

41
Q

List the regions of the duodenum.

A
  • D1 - Superior part.
  • D2 - Descending part.
  • D3 - Inferior part.
  • D4 - Ascending part.
42
Q

What are the two main arteries that supply the duodenum?

A

The coeliac artery and the superior mesenteric artery.

43
Q

What are the two main veins that drain the duodenum?

A
  • Prepyloric vein.

- Superior and inferior pancreatoduodenal veins.

44
Q

Where is the liver located?

A
  • Spans the right upper quadrant, the epigastrium and the left upper quadrant.
  • Inferior to the diaphragm.
45
Q

Describe the lymphatic drainage of the liver.

A
  • Coeliac lymph nodes.
  • Parasternal lymph nodes.
  • Anterior abdominal wall.
46
Q

List the regions pf the gallbladder.

A

1 - Fundus.

2 - Body.

3 - Neck.

4 - Cystic duct.

47
Q

Where does the gallbladder lie?

A

In the gallbladder fossa, on the visceral surface of the liver.

48
Q

List the regions of the pancreas.

A

1 - Head.

2 - Neck.

3 - Body.

4 - Tail.

49
Q

Where is the pancreas located?

A

Anterior to the inferior vena cava and abdominal aorta.

  • Posterior to the stomach .
50
Q

Which molecules trigger the secretion of exocrine secretions of the pancreas?

A

Secretin and cholecystokinin.

51
Q

What triggers the release of secretin and cholecystokinin?

A

The presence of food in the duodenum.

52
Q

What is drained by the main pancreatic duct?

A

The tail, neck and head of the pancreas.

53
Q

Which structures unite to form the hepatopancreatic ampulla?

What is the hepatopancreatic ampulla also known as?

A
  • The main pancreatic duct and the common bile duct.

- The ampulla of Vater.

54
Q

What does the hepatopancreatic ampulla open onto?

A

The major duodenal papilla (D2).

55
Q

What is ERCP used for and what does it stand for?

A

Enables examination of the pancreatic and bile ducts.

Endoscopic retrograde cholangiopancreatography

56
Q

What is the name of the sphincter that surrounds the opening of the hepatopancreatic ampulla?

A

Sphincter of Oddi (hepatopancreatic sphincter).

57
Q

What is drained by the accessory pancreatic duct?

A

The head and uncinate process of the pancreas.

58
Q

What does the accessory pancreatic duct open onto?

A

The minor duodenal papilla.

59
Q

List all cells found in the islets of Langerhan and their secretions.

A

1 - Alpha - Glucagon.

2 - Beta - Insulin.

3 - Delta - Somatostatin.

4 - PP - Pancreatic Polypeptide.

60
Q

List 4 secretions of acinar cells.

A

1 - Bicarbonate ions.

2 - Inactive proteases.

3 - Inactive lipases.

4 - Inactive amylase.

61
Q

Where does the jejunum start?

A

At the duodenojejunal flexure.

62
Q

Where does the ileum end?

A

At the ileocaecal junction.

63
Q

Describe the arterial supply to the jejunum.

A

Jejunal arteries (from the superior mesenteric artery).

64
Q

Describe the arterial supply to the ileum.

A

Ileal arteries and the ileal branch of the ileocolic artery (from the superior mesenteric artery.)

65
Q

What does the large intestine absorb?

A

Water and electrolytes.

66
Q

List the 9 segments of the large intestine in order, including flexures.

A

1 - Caecum (and appendix).

2 - Ascending colon.

3 - Hepatic / right colonic flexure.

4 - Transverse colon.

5 - Splenic / left colonic flexure.

6 - Descending colon.

7 - Sigmoid colon.

8 - Rectum.

9 - Anal canal.

67
Q

What are taeniae coli?

A

Condensed longitudinal muscle that run the length of the large intestine.

68
Q

Which artery is the source of the large intestine’s arterial supply?

A

The superior mesenteric artery.

69
Q

Which artery supplies the appendix?

Which artery is this a branch of?

A
  • The appendicular artery.

- A branch of the ileocolic artery.

70
Q

Which artery supplies the caecum?

Which artery is this a branch of?

A
  • Anterior and posterior caecal arteries.

- Branches of the ileocolic artery.

71
Q

Which artery supplies the ascending colon?

Which artery is this a branch of?

A
  • The right colic artery.

- The superior mesenteric artery.

72
Q

Which artery is the ileocolic artery a branch of?

A

The superior mesenteric artery.

73
Q

Which artery supplies the proximal 2/3 of the transverse colon?

Which artery is this a branch of?

A
  • The middle colic artery.

- The superior mesenteric artery.

74
Q

Which artery supplies the distal 1/3 of the transverse colon and descending colon?

Which artery is this a branch of?

A
  • The left colic artery.

- The inferior mesenteric artery.

75
Q

Which arteries supply the sigmoid colon?

Which arteries are these a branch of?

A
  • Sigmoid arteries.

- The inferior mesenteric artery.

76
Q

Which artery supplies the upper rectum?

Which artery is this a branch of?

A
  • The superior rectal artery.

- The inferior mesenteric artery.

77
Q

Which artery joins the branches of the superior and inferior mesenteric arteries?

A

The marginal artery.

78
Q

Where does the anal canal extend from and to?

A

From the rectal ampulla to the anus.

79
Q

How many sphincters does the anal canal have?

What are they called and how do they differ?

A
  • 2: The internal and external anal sphincters.

- The internal anal sphincter is smooth muscle whereas the external anal sphincter is skeletal muscle.

80
Q

Which arteries supply the rectum and anal canal?

A

The superior, middle and inferior rectal arteries.

81
Q

Where is the peritoneal cavity?

A

Between the parietal and visceral peritoneum.

82
Q

What are the divisions of the peritoneal cavity?

A

The lesser and greater sacs.

83
Q

Where does the greater sac of the peritoneal cavity extend from and to?

A

From the diaphragm into the pelvic cavity.

84
Q

What is the omental foramen?

A

The foramen between the greater sac and the lesser sac of the peritoneum.

85
Q

What are the functions of the greater omentum?

A
  • To attach the greater curvature of the stomach (and D1) to the transverse colon.
  • To seal off and localise infection.
86
Q

Which vessels supply the greater omentum?

A

Right and left gastro-omental vessels.

87
Q

What are the functions of the lesser omentum?

Which ligaments comprise the lesser omentum?

A
  • To attach the lesser curvature of the stomach (and D1) to the inferior liver.
  • To seal off and localise infection.
  • Hepatogastric ligament (stomach).
  • Hepatoduodenal ligament (D1).
88
Q

What is the function of mesentery?

A

To attach viscera to the posterior abdominal wall.

89
Q

What does mesentery carry?

A

Blood vessels, nerves and lymphatics.

90
Q

What is the function of peritoneal ligaments?

A
  • To connect organs to other organs and to the body wall.

- Peritoneal ligaments form part of the omentum.

DIG (20 decks)

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