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GI Anatomy > Practical 1 > Flashcards

Practical 1 Flashcards

0
Q

Where does the oesophagus enter the abdomen?

A

T10 through the muscular part of the diaphragm

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1
Q

Where does the oesophagus begin?

A

C6, continuous with laryngopharynx

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2
Q

What is the oesophagus next to in the abdomen?

A

Liver anteriorly, left crus of diaphragm posteriorly

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3
Q

What is at the junction where the oesophagus reaches the stomach?

A

Oesophagastric sphincter- muscle from right crus, mucous membrane flap and folds at lower end on oesophagus

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4
Q

Where are there oesophageal constrictions?

A
  • as it passes through cricopharyngeus muscle
  • as it passes posterior to aortic arch&left main bronchus
  • as it passes through diaphragm
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5
Q

Describe the blood supply of the oesophagus

A

Upper 1/3- inferior thyroid artery
Middle 1/3- thoracic aorta branches
Lower 1/3- left gastric artery

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6
Q

What is the venous drainage of the oesophagus?

A

Upper 1/3- inferior thyroid veins
Middle 1/3- azygous vein
Lower 1/3- left gastric vein

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7
Q

Describe the autonomic supply of the upper 1/3 of oesophagus

A

Recurrent laryngeal= PNS

Sympathetic trunk= SNS

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8
Q

Describe the lymphatic drainage of the oesophagus

A

Upper 1/3- deep cervical nodes
Middle 1/3- superior and posterior mediastinal nodes
Lower 1/3- nodes along L gastric artery and celiac nodes

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9
Q

What are the three possible horizontal planes used to split up the abdomen

A

Transpyloric (L1) or subcostal (below L3)

Transtubercular

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10
Q

Name the two vertical planes used to divide the abdomen

A

Right and left midclavicular

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11
Q

What’s the greater omentum?

A

Layer of peritoneum that is attached to greater curvature of stomach and hangs down as an apron over abdominal organs
Fat deposition, immune functions and infection&wound isolation

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12
Q

Name the abdomen region where the stomach lies

A

Left hypochondriac and epigastric

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13
Q

What does the small intestine consist of?

A

Duodenum, jejunum, ileum

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14
Q

What does the large intestine consist of?

A

Caecum, colon, rectum, anal canal

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15
Q

Name the parts of the colon

A

Ascending, transverse, descending, sigmoid

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16
Q

Where is the transverse colon found?

A

In the umbilical region

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17
Q

Where is the sigmoid colon found?

A

Left iliac fossa and hypogastric region

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18
Q

Where is the spleen found?

A

Left hypochondrium beneath the diaphragm (by posterior parts of 9-11th ribs)

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19
Q

Where is the pancreas found?

A

Within the c shaped loop of the duodenum

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20
Q

What’s the caecum?

A

Dilated portion of large intestine

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21
Q

What comes off the caecum?

A

Vermiform appendix

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22
Q

What’s found in the pelvic cavity?

A

Small intestines, sigmoid colon, rectum, urinary bladder, reproductive organs

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23
Q

What is the peritoneum?

A

Serous membrane which lines the walls of the abdominopelvic cavity and invests the abdominopelvic organs

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25
Q

Names 7 retroperitoneal structures

A

Kidneys, duodenum, abdominal aorta, ascending and descending colon, pancreas, oesophagus

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26
Q

Name 3 intraperitoneal structures

A

Stomach, small intestine, transverse colon

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27
Q

What structure does the spleen develop in?

A

Dorsal mesogastrium

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28
Q

What structure does the liver develop in?

A

Ventral mesogastrium

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29
Q

What is the area of the stomach called where the oesophagus joins it?

A

Cardiac orifice

30
Q

What is the area of the stomach called where the duodenum leaves it? What vertebral level?

A

Pyloric orifice- L1

31
Q

What is found on the lowest part of the lesser curvature of the stomach?

A

The angular notch (incisura angularis)

32
Q

What is the fundus?

A

Dome shaped part of the stomach above the level of the cardiac orifice, usually full of gas to dark on an x-ray

33
Q

What surrounds the tubular pyloric canal?

A

Pyloric sphincter (thick circular smooth muscle)

34
Q

Describe the muscular wall of the stomach and its significance

A

Different from rest of gut tube as has three layers of muscle:
Outer longitudinal
Middle circular
Inner oblique
for the physical breakdown of food and the controlled movement of chyme

35
Q

Where is the lesser omentum found?

A

Part of ventral mesogastrium between lesser curvature of stomach and visceral surface of liver

36
Q

Where is the falciform ligament found?

A

Part of ventral mesogastrium between liver and anterior abdominal wall

37
Q

What is the ligament found between the liver and the anterior abdominal wall?

A

Falciform ligament

38
Q

What three ligaments are formed by the dorsal mesogastrium?

A

Greater omentum, gastrosplenic ligament and splenorenal ligament.

39
Q

Where is the greater omentum attached?

A

Greater curvature of the stomach

40
Q

Where is the splenorenal ligament found?

A

Between spleen and posterior abdominal wall

41
Q

What are the ridges on the inside of the stomach called?

A

Ruggae= folding of mucous membrane and submucosa

42
Q

At what level does the celiac artery arise from the aorta?

A

T12, just below the diaphragm

43
Q

What does the celiac artery branch into?

A

Left gastric, splenic and common hepatic artery

44
Q

What does the L gastric artery supply?

A

The lower part of the oesophagus and the lesser curvature of the stomach, going between the layers of the lesser omentum

45
Q

Describe the route of the splenic artery

A

Tortuous course along the posterior abdominal wall to supply the spleen, passing between two layers of the splenorenal ligament. After the spleen it forms the short gastric arteries->fundus of stomach and left gastroepiploic artery->greater curvature of the stomach and greater omentum

46
Q

What does the common hepatic artery split into?

A

3 branches:
Hepatic artery proper
R gastric artery
Gastroduodenal artery

47
Q

Describe the course of the R gastric artery

A

Branches from the common hepatic artery and supplies the lesser curvature of the stomach via the lesser omentum. Anastomoses with L gastric artery

48
Q

Describe the gastroduodenal artery path and branches

A

Gastroduodenal is a branch of the common hepatic artery (from the celiac trunk)
Passes to the superior part of the duodenum and gives rise to the R gastroepiploic artery and superior pancreaticoduodenal arteries

49
Q

What is the venous drainage of the stomach?

A

Via veins that accompany the corresponding arteries that drain to the hepatic portal vein

50
Q

What are the 4 main groups of lymph nodes for the stomach?

A

Left gastric, pyloric, pancreaticosplenic and R gastroepiploic nodes

51
Q

Describe the sympathetic supply of the stomach

A

T6-T9-> celiac ganglia of celiac plexus-> stomach

52
Q

What does sympathetic stimulation of the stomach achieve?

A

Vasoconstriction of gastric blood vessels, inhibition of gastric musculature and secretory glands, stimulates pyloric sphincter

53
Q

Describe the parasympathetic supply of the stomach

A

Vagal supply (CN X)
L vagus-> anterior trunk-> anterior stomach
R vagus-> posterior trunk->posterior stomach and celiac plexus

54
Q

Describe the parasympathetic supply of the liver

A

Derived from both anterior and posterior trunks of the vagus, pass between layers of lesser omentum to join the hepatic plexus

55
Q

Describe the functions of the afferent fibres from the stomach

A

Pain travels with sympathetic afferents

Reflex activity to do with mechanical and metabolic stimuli travel with parasympathetic afferents

56
Q

Describe the position of the cardiac orifice

A

Behind the 7th costal cartilage to the L of the midline

57
Q

Describe the location of the pyloric orifice

A

R of the midline on the transpyloric plane (L1)

58
Q

What is the highest point of the fundus of the stomach?

A

5th intercostal space

59
Q

Name the parts of the duodenum

A

Superior, descending, horizontal, ascending (C shaped)

60
Q

Which part of the duodenum is retroperitoneal?

A

Distal 2/3rds of the 1st part and the rest is retroperitoneal
Proximal 1/3 of 1st part is within the lesser omentum and passes behind the liver and gall bladder

61
Q

Where do the bile duct, gastroduodenal artery and HPV pass in relation to the 1st part of the duodenum?

A

Behind the retroperitoneal portion

62
Q

What is the descending part of the duodenum in close proximity to?

A

The pancreas and R kidney

63
Q

Where do the bile duct and main pancreatic duct open into the gut tube? What does this also mark?

A

At the major duodenal papilla

Marks the boundary between embryonic foregut and midgut

64
Q

At what level does the horizontal part of the duodenum pass?

A

L3

65
Q

What are the circular folds of the duodenum called? Function?

A

Plicae circulares. Slows passage of food and increases SA for absorption via the miscrovilli and villi

66
Q

How do you visualise the interior of the duodenum?

A

Either via Xray and barium meal or by endoscope

67
Q

Describe the blood supply of the duodenum

A

Proximal region before major duodenal papilla= celiac artery->superior pancreaticoduodenal a.
Distal region= superior mesenteric artery-> inferior pancreatico duodenal a.

68
Q

What is the venous drainage of the duodenum?

A

Via superior mesenteric v. splenic v. or directly to hepatic portal vein

69
Q

What are the different types of hiatus hernia and their differences?

A 
Sliding= oesophagus and stomach migrate upwards through diaphragm and can move up and down. Over 50 and obese
Paraoesophageal= stomach pushed up next to oesophagus through diaphragm
70
Q

What structures are at risk from surgery to repair a hiatus hernia?

A

Phrenic nerve and artery

GI Anatomy (5 decks)

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