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GIT Anatomy > Stomach & SI > Flashcards

Stomach & SI Flashcards

See clinical correlates - Anatomy 4

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1
Q

What does the celiac trunk supply

A

Foregut & spleen

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2
Q

What does the celiac trunk give rise to (3)

A
  1. Common hepatic artery
  2. Splenic artery
  3. Left gastric artery
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3
Q

What is the parasympathetic innervation of the celiac trunk

A

Vagus nerve - CN X

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4
Q

What is the sympathetic innervation of the celiac trunk

A

PRE-GANGLIONIC

Thoracic splanchnic nerves (T5 - T9)

POST-GANGLIONIC CELL BODIES

Celiac ganglion

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5
Q

Name the 2 main branches of the common hepatic artery

A

Gastroduodenal

Proper hepatic artery

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6
Q

3 branches of the gastroduodenal artery

A
  1. R gastro-omental
  2. Supraduodenal
  3. Superior pancreaticoduodenal - ant & post
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7
Q

3 branches of the proper hepatic artery

Where does it run

A
  1. R gastric
  2. L hepatic
  3. R hepatic -> Cystic

Proper hepatic artery runs through the hepatoduodenal ligament - free edge of lesser omentum

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8
Q

3 branches of the splenic artery

Where does it run

A
  1. Short gastric
  2. Left gastric omental
  3. Dorsal, greater and inferior pancreatic

Runs along superior border of pancreas to spleen

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9
Q

Branch of the left gastric artery

Where does it run

A

Oesophageal branches

Descends along lesser curvature of stomach

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10
Q

What does the superior mesenteric artery supply

A

Midgut

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11
Q

What is the parasympathetic innervation of the sup mesenteric a.

A

Vagus nerve (CN X)

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12
Q

What is the sympathetic innervation of the sup mesenteric a.

A

PRE-GANGLIONIC

Thoracic splanchnic nerves (T9 - T12)

POST-GANGLIONIC CELL BODIES

Sup mesenteric ganglion

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13
Q

5 branches of the sup mesenteric a.

A
  1. Inferior pancreaticoduodenal
  2. Intestinal
  3. Middle colic
  4. Right colic
  5. Ileocolic
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14
Q

Inf pancreaticoduodenal supplies

A

Duodenum distal to papillae

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15
Q

Intestinal supplies

A

Vasa rectae (15-18 branches)

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16
Q
  1. What does the middle colic form part of
  2. clinical anastomosis with
A
  1. Marginal artery of Drummond
  2. Inferior mesenteric a.
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17
Q

Right colic supplies

A

Ascending colon

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18
Q

Ileocolic supplies

A

Appendicular artery

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19
Q

3 branches of the inferior mesenteric a.

A
  1. Left colic
  2. Sigmoid
  3. Superior rectal
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20
Q

Parasympathetic innervation of the inferior mesenteric a.

A

Pelvic splanchnic nerves

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21
Q

Sympathetic innervation of the inferior mesenteric a.

A

PRE-GANGLIONIC

Lumbar splanchnic nerves (L1-L2)

POST-GANGLIONIC CELL BODIES

Inferior mesenteric ganglion

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22
Q

What does the left colic form part of

Clinical anastomosis with

A

Marginal artery of Drummond

Superior mesenteric a.

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23
Q

Superior rectal supplies

A

Proximal 2/3rds of rectum

(terminal branch)

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24
Q

Anterior view of the supracolic viscera ex situ, with the lesser omentum removed

A
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25
Q

Where does the oesophagus travel through the oesophageal hiatus of the diaphragm

A

T10

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26
Q

How is the oesophagus attached to the diaphragm

A

By the phrenico-oesophageal ligament

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27
Q

Where does the oesophagus terminate

A

Cardial orifice of the stomach

  • Inferior oesophageal sphincter - PHYSIOLOGICAL
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28
Q

Arterial supply to the oesophagus

A

Oesophageal branches from the left gastric artery

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29
Q

Venous drainage of the oesophagus

A

LEFT GASTRIC VEIN

Portal venous system

OESOPHAGEAL VEINS

Systemic venous system via azygos vein

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30
Q

Lymphatics of the oesophagus

A

Left gastric lymph nodes -> celiac lymph nodes

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31
Q

Parasympathetic innervation of oesophagus

A

Vagus (CN X)

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32
Q

Sympathetic innervation of oesophagus

A

Greater splanchnic nerve (T5-T9)

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33
Q

Where is the cardia (1) when supine

A

T11

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34
Q

What is the fundus (2)

A

Dilated part - gas or sometimes fluid

35
Q

What does the body have (3)

A

2 curvatures

36
Q

What controls the outflow of chyme

What is it divided into

A

Pylorus

PYLORIC ANTRUM - Chamber

PYLORIC CANAL - outflow region

37
Q

Gastric rugae

temporary vs permanent

A

Longitudinal folds of mucosa

Can be temporary - diminish as stomach distends

Can be permanent - form gastric canal

38
Q

Gastric canal

A

Groove that appears along the lesser curvature during swallowing

39
Q

Pyloric sphincter

A

Circular band of SM

Junction between stomach and SI

  • Embryological clinical correlate - congenital hypertrophic pyloric stenosis
40
Q

Arterial supply of stomach via

A

CELIAC TRUNK

41
Q

Arterial supply of lesser curvature (2)

A
  1. Left gastric (
  2. Right gastric (
42
Q

Arterial supply of greater curvature (2)

A
  1. Left gastro-omental (
  2. Right gastro-omental (
43
Q

Arterial supply of fundus

A

Short/posterior gastric arteries (

44
Q

Venous drainage of right gastric v.

A

Hepatic portal vein

45
Q

Venous drainage of left gastric v.

A

Hepatic portal vein

46
Q

Venous drainage of right gastro-omental v.

A

Superior mesenteric vein

47
Q

Venous drainage of left gastro-omental v.

A

Splenic vein

48
Q

Venous drainage of short gastric v.

A

Splenic vein

49
Q

Drainage of prepyloric vein

A

Right gastric vein

50
Q

Summary of Stomach

A
51
Q

Infracolic viscera - below transverse colon

A

SMALL COLON

  • Duodenum - part
  • Jejunum
  • Ileum

LARGE COLON

  • Ascending
  • Transverse
  • Descending
  • Sigmoid

CECUM

  • Appendix

RECTUM

  • Anal canal
52
Q

Abdominal viscera - anterior view ex situ

A
53
Q

What is the duodenum in relation to the small colon

A

First section

Shortest

widest

most fixed

54
Q

Superior part of duodenum - intraperitoneal (mobile)

A
  • Duodenal cap/ampulla is continuous with the pylorus of the stomach (approx L1)
  • Hepatoduodenal ligament connects superiorly
  • Greater omentum connects inferiorly
  • Supplied by celiac trunk
55
Q
  1. Descending part - Retroperitoneal (immobile and covered by transverse mesocolon)
A
  • Relationship to HEAD of pancreas & gallbladder
  • Lies right of midline (approx L2) & is anterior to the hilum of the right kidney
  • Supplied by the coeliac trunk and superior mesenteric artery
  • Major & minor duodenal papilla
56
Q

Major duodenal papilla

A
  • Elevation of mucosa protruding into duodenum and is larger due to the hepatopancreatic ampulla and sphincter internally within the head of the pancreas
  • Opening of common bile duct and main pancreatic duct
  • Releases pancreatic juice and bile
57
Q

Minor duodenal papilla

A
  • Where the accessory pancreatic duct opens
  • Releases pancreatic juices only
  • Located 2cm superior to the major duodenal papilla
58
Q
  1. Transvers/inferior/horizontal part
A
  • Secondarily retroperitoneal
  • Crosses posteriorly under superior mesenteric artery and vein
  • Passes anteriorly over the IVC
  • Closely related to the uncinate process of the pancreas and the root of the mesentery
  • Lies at the level of L3 and crosses from right to left
  • Longest section of the duodenum
  • supplied by superior mesenteric artery
59
Q
  1. Ascending
A
  • Mostly retroperitoneal
  • Terminates at the duodenojejunal flexure
  • Closely related to abdominal aorta
  • Ascends back up to L2
  • Supplied by superior mesenteric artery
  • Supported by LIGAMENT OF TREITZ
60
Q

Histologically, what does the duodenum contain

A

Submucosal Brunner’s glands

61
Q

What does the ligament of Treitz (suspensory ligament of the duodenum) do

A
  • Connects the duodenum to the diaphragm and the posterior abdominal wall
  • Facilitates with the movement of the intestinal content
  • Marks the duodenojejunal flexure - junction between duodenum and jejunum
  • clinically divides GIT
  • Upper GIT bleed is PROXIMAL - blood appearing in vomit, stool would be dark and tarry
  • Lower GIT bleed is DISTAL - blood would only appear in stool
62
Q

What do circular folds create

A

A large internal SA

  • Plicae circulares
63
Q

Dual arterial supply of the duodenum

A
  1. From the CELIAC TRUNK
    - Ant & post
    - Superior to pancreaticoduodenal arteries (yellow)
  2. From the GASTRODUODENAL ARTERY
    - Supraduodenal artery (blue)
  3. From the SUPERIOR MESENTERIC ARTERY
    - Ant & post
    - inferior pancreaticoduodenal arteries
64
Q

Summary of duodenum

A
65
Q

What section of the SI is the jejunum

A

2nd

66
Q

What section of the SI is the ileum

A

3rd/last

67
Q

Where is the jejunum mostly found

A

Left upper quadrant (LUQ)

68
Q

What does the jejunum account for length wise

A

Accounts for proximal 2/5ths - 2.5m

69
Q

Is the jejunum intraperitoneal or extraperitoneal

A

INTRAPERITONEAL - highly mobile and attached to the posterior abdominal wall by the root of the mesentery

70
Q

What about the jejunum helps it to absorb nutrients

A

Specialised epithelial lining for absorbing nutrients that have been digested

Gradual change - no clear delineation of when ileum begins

71
Q

Where is the ileum mostly found

A

Right lower quadrant (RLQ)

72
Q

How much of the SI does the ileum account for

A

Distal 3/5ths - 3.5m

73
Q

Is the ileum intraperitoneal or extraperitoneal

A

INTRAPERITONEAL - mesentery proper acts as a conduit for neurovasculature

74
Q

Function of ileum

A

Absorb any products of digestion that the jejunum missed

75
Q

What is prominent in the ileum

A

Peyers patches

76
Q

Embryological clinical correlate of ileum

A

Meckel’s diverticulum

77
Q

Jejunum vs Ileum - COLOUR

A

J - deeper red

I - pale pink

78
Q

Jejunum vs Ileum - DIAMETER

A

J - 2-4cm

I - 2-3cm

79
Q

Jejunum vs Ileum - WALL

A

J - thick and heavy

I - thin and light

80
Q

Jejunum vs Ileum - VASCULARITY

A

JEJUNUM

  • greater density
  • long vasa recta
  • few large arterial arcades

ILEUM

  • lesser density
  • short vasa recta
  • many short arterial arcades
81
Q

Jejunum vs Ileum - MESENTERIC FAT

A

J - less

I - plenty

82
Q

Jejunum vs Ileum - CIRCULAR FOLDS

A

J - large, tall, closely packed

I - low and sparse, possibly absent

83
Q

Jejunum vs Ileum - PEYER’S PATCHES

A

J - few

I - many

84
Q

Summary of jejunum and ileum

A

GIT Anatomy (8 decks)

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