Study guide: Digestive system Flashcards
The digestive system consists of what two parts?
accessory glands
alimentary canal
The accessory glands include?
salivary gland
liver
gallbladder
pancreas
What secretes digestive enzymes into the alimentary canal?
accessory gland
What is a musculomembraneous tube that extends from mouth to anus?
Alimentary canal
How long is the alimentary canal?
29-30 feet long
What are the component parts of the alimentary canal?
mouth pharynx/esophagus stomach small intestines large intestines
Where is the food masticated and turned into bolus?
Mouth
What are the organs of swallowing?
pharanx/esophagus
Where does the digestive process begin?
stomach
Where is the digestive process completed?
small intestines
What is the organ of egestion and water absorption?
Large intestines
What is the 1st division of the digestive system?
mouth
The cavity of the mouth is divided into?
oral vestibule
oral cavity
What is the space between the teeth and cheeks?
oral vestibule
What is the mouth proper, the space within the dental arches?
oral cavity
The roof of the oral cavity is formed by?
hard and soft palates
The floor of the oral cavity is formed by?
the tongue which communicates with pharynx via oropharynx
What is the anteriormost portion of the roof of the oral cavity?
hard palate
The hard palate is formed by?
horizontal palates of the maxillae and palatine bones
The height of the hard palate is determined by?
angulation of the inner surface of the alveolar process
The angle is _____ when the palate is high and is ____ when the palate is low?
less, greater
What begins behind the last molar and is suspended from the posterior border of the hard palate?
soft palate
What is a movable musculomembranous structure the functions as a partial septum between the mouth and pharynx?
soft palate
Small pendulous process?
uvula
What projects forward to the sides of the base of the tongue?
anterior arches
What projects posteriorly to blend with the posterolateral walls of the pharynx?
posterior arches
The triangular space between the anterior and posterior arches is occupied by?
palatine tonsils
What is situated on the floor of the oral cavity?
tongue
The tongues base is directed _____ and its apex is directed ______?
posteriorly, anteriorly
The _____ is freely movable?
tongue
What is composed of numerous muscles and is covered with a mucous membrane?
tongue
What glands are narrow, elongated and the smallest pair?
sublingual
What glands are located on the floor of the mouth beneath the sublingual fold?
sublingual glands
What serves as a passage for air, food?
Pharynx
What is considered part of the respiratory system and digestive system?
Pharynx
What is a musculomembranous tubular structure situated in front of the vertebrae and behind the nose, mouth and larynx?
Pharynx
What is 5” long?
Pharynx
The pharynx is at the level of ?
6th and 7th cervical vertebra
The pharyngeal cavity is subdivided into?
Nasal, oral and laryngeal portion
What lies posteriorly above the soft and hard palates?
nasopharynx
The ___muscles of the tongue form the greater part of the oral floor?
Extrinsic
This part of the floor lies under the free anterior and lateral portions of the tongue called?
sublingual space
The frenulum of the tongue is?
vertical band or a fold of mucous membranes
Mucous membrane is elevated into a crestlike ridge called?
Sublingual fold
The ____ serve the function of mastication?
teeth
The 3 pairs of salivary gland produce how much saliva each day?
1L
What are the 3 salivary glands?
parotid, submandibular, sublingual
Each salivary gland is composed of?
numerous lobes containing small lobules
What is the largest salivary gland that consists of a flattened superficial portion and is also wedge-shaped?
parotid gland
What runs anteriorly and medially to open into the oral vestibule opposite the second upper molar?
parotid duct
Hanging from the posterior aspect of the soft palate is a small conical process called?
uvula
Located on the roof and posterior wall of the nasopharynx between the orifices of the auditory tubes, the mucosa contains a mass of lymphoid tissue known as?
pharyngeal tonsil (adenoids)
What is a common condition in children?
hypertrophy
What is a portion extending from the soft palate to the level of the hyoid bone?
oropharynx
What lies posterior to the larynx?
laryngeal pharynx
An increase in intrathoracic pressure produced by forcible expiration effort against the closed glottis?
Valsalva maneuver
What is the organ of voice?
larynx
What serves as the air passage between the pharynx and trachea?
larynx
what is a moveable tubular structure and is 1.5” long?
Larynx
Thin leaf-shaped ______ is situated behind the roof of the tongue and hyoid bone?
epiglottis
What forms the laryngeal prominence?
thyroid cartilage
A pouchlike fossa called?
piriform recess
The superior pairs of folds are?
vestibular folds
Lower two folds are separated from each other by a median fissure called?
rima epiglottis
What is a long muscular tube that carries food and saliva from the laryngopharynx to the stomach?
esophagus
An adult esophagus is how big?
24 cm long (10”) and 1.9 cm in diameter (3/4”)
The esophagus begins at the inferior border of the cricoid cartilage at the level of?
C6
The esophagus terminates at the cardiac opening of the stomach?
T11
The esophagus has a wall composed of how many layers?
4
What are the 4 layers of the esophagus?
Fibrous layer
muscular layer
submucosal layer
mucosal layer
The esophagus lies in what plane?
MSP
The ____esophagus begins at its first natural constriction, the _____ constriction?
cervical, pharyngoesophageal
What occurs at the junction to the pharynx?
pharyngoesophageal constriction
The cervical portion of the esophagus is ____ long stretching from ____ to _____?
3-5cm
C6-T11
The thoracic esophagus measures?
18-22cm (7-8.7”)
The thoracic esophagus features how many constrictions?
2
The first constriction occurs where the aortic arch and left mainstem bronchus cross the esophagus is called?
aortobronchial constriction
The abdominal esophagus measures?
3-6cm long(1.2-2.4”)
What begins at the final natural narrowing, the diaphragmatic constriction?
abdominal esophagus
The Esophagus passes through the diaphragm at the?
esophageal hiatus
The esophageal hiatus is at the level of?
T10
The esophagogastric junction is at the level of?
T11
The expanded portion of the terminal esophagus which lies in the abdomen is called?
cardiac antrum
The ____is at its junction with the pharynx and functions to prevent air from entering the esophagus during respiration?
Upperesophageal sphincter (UES)
The _____ is the dilated, saclike portion of the digestive tract extending between the esophagus and small intestines?
stomach
The stomach is divided into what four parts?
cardia
fundus
body
pyloric portion
What part of the stomach surrounds the esophageal opening?
cardia
What is the superior portion of the stomach that expands superiorly and fills the dome of the left hemidiaphragm?
fundus
When upright the fundus is filled with?
gas
What descends from the fundus and begins at the level of the cardiac notch?
body of stomach
Inner mucosal layer of the body of the stomach contains numerous longitudinal folds called?
rugae
The body of the stomach ends at the vertical plane passing through?
angular notch
What communicates with the duodenal bulb?
Pyloric canal
The right border of the stomach is marked by?
lesser curvature
The left and inferior borders of the stomach are marked by?
greater curvature
The greater curvature is how much longer than the lesser curvature?
4-5xs longer
The esophagus joins the stomach at the esophagogastric junction through an opening termed?
Cardiac orifice
The muscle controlling the cardiac orifices is called?
cardiac sphincter
The opening between the stomach and small intestines is called?
pyloric orifice
The muscle controlling the pyloric orifice is?
Pyloric sphincter
The stomach is almost horizontal and high in what patients?
hypersthenic
The stomach is vertical and low in what patients?
asthenic
85% of the population is what body habitus?
sthenic/hyposthenic
This serves as a storage area for food until it can be digested further?
Stomach
What is secreted to break food down chemically?
acids, enzymes and other chemicals
Food is mechanically broken down through?
churning and peristalsis
Food that has been mechanically and chemically altered in the stomach is transported to the duodenum as a material called?
chyme
What extends from the pyloric sphincter of the stomach to the ileocecal valve?
Small intestines
The small intestines join the large intestines at what angle?
right
What is the length of an adult’s small intestines?
22ft
The mucosa of the small intestine contains a series of fingerlike projections called?
villi
The small intestines are divided into what 3 portions?
Duodenum, Jejunum, illeum
How big is the duodenum?
8-10” long
The 4 regions of the duodenum are?
1st (superior), 2nd (descending), 3rd (horizontal/inferior), 4th (ascending)
The segment of the 1st portion of the duodenum is?
duodenal bulb
The 2nd portion of the duodenum is how long?
3-4”
The common bile duct and pancreatic duct usually form the?
hepatopancreatic ampulla
The 3rd portion of the duodenum passes towards the left at a slight superior inclination for a distance of?
2.5”
The 4th portion of the duodenum joins the jejunum at a sharp curve called?
duodenojejunal flexure
What is the most fixed part of the small intestine and normally lies in the upper part of the umbilical region?
duodenal loop
The upper 2/5 of the small intestines is?
jejunum
The lower 3/5 of the small intestines is referred to as?
ileum
What begins in the right iliac region where it joins the ileum of the small intestine?
Large intestines
The large intestine has four main parts?
cecum
colon
rectum
anal canal
The large intestine is how long?
5 ft long
The muscular portion of the intestinal wall contains an external band of longitudinal muscle that forms into 3 thickened bands called?
taeniae coli
One band of the taeniae coli is positioned____ and two are positioned _____?
anteriorly and posteriorly
These taeniae coli bands create a pulling muscle tone that forms a series of pouches called?
haustra
What is the main function of large intestines?
Reabsorption of fluids and elimination of waste products
What is the pouchlike portion of the large intestine that is below the junction of the ileum and colon?
cecum
How big is the cecum?
2.5” long and 3” diameter
The ____ is attached to the posteromedial side of the cecum?
vermiform appendix
The ___ is a narrow worm-like tube that is about 3” long
appendix
What is below the junction of the ascending colon and cecum?
ileocecal valve
The ____ is subdivided into ascending, transverse, descending and sigmoid portions?
colon
What passes superiorly from its junction with the cecum to the undersurface of the liver?
ascending colon
The Ascending colon joins the transverse portion at an angled called?
right colic flexure
What is the longest and most movable part of the colon?
transverse colon
The transverse portion makes a sharp curve called?
Left colic flexure
what passes inferiorly and medially to its junction with the sigmoid portion?
descending colon
The sigmoid colon curves to form an s-shaped loop and ends in the rectum at the level of?
3rd sacral segment
What extends from the sigmoid colon to the anal canal?
rectum
The ___terminates at the anus which is the external aperture of the large intestines?
Anal canal
The rectum is how long?
6”
Above the anal canal is a dilatation called?
rectal ampulla
The rectum and anal canal have____ AP curves?
2
The large intestine is positioned around the periphery of the abdomen and may require more images in what patients?
hypersthenic
The large intestine is bunched together and positioned low in the abdomen is seen in what patients?
asthenic
The largest gland in the body is an irregularly wedged-shaped gland?
Liver
The liver base is on the ____ and its apex is directed anteriorly and to the ____.
Right, left
The deepest point of the liver is?
inferior aspect above the right kidney
The diaphragmatic surface of the liver is____?
convex
The visceral surface of the liver is_____?
concave
At the falciform ligament, the liver is divided into a large ___ lobe and a smaller _____ lobe?
right, left
What lobe is on the posterior surface?
caudate lobe
What lobe is on the inferior surface?
quadrate lobe
The hilum of the liver is called?
porta hepatis
What is situated transversely between two minor lobes?
porta hepatis
What conveys blood into the liver?
portal vein and hepatic artery
The portal vein ends in?
sinusoids
The hepatic artery ends in?
capillaries
In addition to the usual arterial blood supply, the liver receives blood from?
portal system
The ____ convey the blood from the liver sinusoids to the inferior vena cava?
Hepatic veins
The function of the liver?
Formation of bile
aid in emulsification and assimilation of fats
elimination for waste products of RBC destruction
The liver secretes bile at the rate of?
1-3 pints each day
The two main hepatic ducts emerge to form the?
common hepatic duct
The common hepatic duct unites with the cystic duct to form the?
common bile duct
How long is the hepatic and cystic duct?
1.5” long
The common bile duct passes inferiorly for a distance of?
3”
The common bile duct joins the pancreatic duct into a large chamber known as?
hepatopancreatic ampulla (ampulla of vater)
The distal end of the common bile duct is controlled by?
choledochal sphincter
The hepatopancreatic ampulla opens on an elevation on the duodenal mucosa known as?
major duodenal pailla
What is a thin-walled, pear-shaped musculomembranous sac?
gallbladder
The gallbladder has the capacity of ?
2 oz
The gallbladder concentrates bile through?
absorption of water content
The gallbladder stores bile during?
interdigestive periods
The gallbladder evacuates bile during?
digestion
The muscular contraction of the gallbladder is activated by a hormone called?
cholecystokinins
This hormone is secreted by the duodenal mucosa and is released into the blood when fatty or acid chyme passes into intestines?
cholecystokinins
The gallbladder consists of?
narrow neck, body and fundus
The gallbladder lies in an____ plane?
oblique plane
The gallbladder that is high and well away from the midline is seen in what body habitus?
hypersthenic patients
The gallbladder that is low and near the spine is seen in what body habitus?
asthenic patients
What is an elongated gland situated across the posterior abdominal wall?
pancreas
How big is the pancreas?
5.5” long
The pancreas consists of?
head, neck, body and tail
What is the pancreas broadest portion of the organ?
head of pancreas
What passes transversely behind the stomach and front of the left kidney?
body and tail of pancreas
The pancreas is what kind of gland?
exocrine and endocrine
What portion of the pancreas produced pancreatic juice?
exocrine
Which portion of the pancreas consists of islet cells?
endocrine
The cells of the pancreas produces the hormone ____ and ____?
insulin and glucagon
The spleen belongs to what system?
lymphatic
What is a glandlike but ductless organ that produces lymphocytes and stores and removes dead or dying RBC?
Spleen
How big is the spleen?
5” long, 3” wide and 1.5” thick
The spleen is situated obliquely in what quadrant?
left upper quadrant
BE
barium enema
CTC
Ct colongraphy
ERCP
Endoscopic retrograde cholangiopancreatography
LES
Lower esophageal sphincter
MBSS
Modified Barium swallow study
MPR
multiplanar reconstruction
TEA
top of ear attachment
UES
Upper esophageal sphincter
UGI
upper gastrointestinal
VC
virtual colonoscopy
VFSS
videofluoroscopic swallow study
What is the first division of the digestive system?
mouth
Which salivary gland is the largest?
parotid
Which salivary gland is the smallest?
Sublingual
Which salivary glands are located along the lateral aspect of the mandibular ramus?
Parotid
Which salivary duct opens into the oral vestibule opposite the second upper molar?
Parotid
Which curvature is located on the right (medial) border of the stomach?
Lesser
Which area is most superior part of the stomach?
fundus
Which area is the most inferior part of the stomach?
pylorus
The distal esophagus empties its contents into which of the following?
cardiac antrum
Which opening is located between the stomach and small intestines?
pyloric orifice
Which opening is at the distal end of the small intestines?
ileocecal orifice
Which structure is the proximal part of the small intestines?
duodenum
which structure is the distal part of the small intestines?
ileum
Which abdominal region does the large intestine orginate?
Right iliac
Which structure is the proximal part of the large intestintes?
cecum
Which part of the large intestines is located between the ascending and descending parts of the colon?
transverse colon
Which structure is located between the ascending colon and transverse colon?
right colic flexure
Where in the large intestines is the left colic flexure?
between the transverse colon and descending colon
Which structure is the pouchlike part of the large intestine situated below the junction of the ileum and the colon?
cecum
Where in the large intestine is the sigmoid located?
between the descending colon and rectum
Approximately how long does it usually take the first part of the barium meal to reach the ileocecal valve?
2-3 hrs
Approximately how long does it usually take a barium meal to reach the rectum?
24 hrs
Which two imaging modalies are most commonly used to examine the alimentary canal after the introduction of a barium product?
fluoroscopy and radiology
which type of contrast medium is most commonly used for examining the upper GI tract?
barium sulfate suspension
To demonstrate swallowing function best, in which position should the patient be placed to begin the fluoroscopic phase of single contrast examinations of the esophagus?
upright
Which two recumbent oblique positions can be used to demonstrate best an unobstructed image of a barium filled esophagus between the vertebrae and the heart?
RAO/LPO
Which of the following is a major advantage of double contrast UGI examination over single contrast examination?
small lesions on the mucosal lining are better demonstrated
Which description refers to the biphasis GI examination?
combination single contrast and double contrast study of the upper GI tract
Which body habitus produces the greatest visceral movement when a patient is moved from the prone position to upright?
asthenic
For the PA projection as part of the UGI examination why should lower lung fields be included on a 14x17” plate?
demonstrate a Hiatal hernia
for double contrast UGI examination which projection produces the best image of a gas filled duodenal bulb and pyloric canal?
AP obl projection, recumbent LPO position
For the single contrast UGI examination which projection produces the best image of a barium filled pyloric canal and duodenal bulb in patients who habitus approximates the sthenic type?
PA oblique projection, RAO position
For the UGI examinatinos with the patient recumbent, which projection best stimulates gastric peristalsis to demonstrate the pyloric canal and duodenal bulb?
PA oblique projection, RAO position
Which breathing procedure should the patient perform when UGI images are exposed?
suspended expiration
For the double contrast UGI examinatino with the patient recumbent, which projection produces the best image of a gas filled fundus?
PA oblique projection, RAO postion
For the UGI examination with the patient recumbent which projection best demonstrates the right retrogastric space?
Right lateral projection
For the AP projection with the patient supine (UGI Exam) which procedure should be performed to demonstrate best diaphragmatic herniation (hiatel hernia)?
tilt the table and patient into a full Trendelenburg position
To which level of the patient should the central ray be directed for the PA oblique projection RAO position as part of the UGI exam?
L1-L2
Which exam of the alimentary canal requires that a series of images be taken at specific time intervals after the ingestion of contrast medium?
small bowel series
for small bowel series of a patient with hypomotility of the small intestines which procedure should be performed to accelerate peristalsis?
have patient drink a glass of iced water
Which structure when visualized on an image as part of a small bowel series, usually indicates the completion of the exam?
cecum
What is the proper sequence for filling the large intestine with barium when performing a BE?
rectum, sigmoid, descending colon, transverse colon, ascending colon
Which instructions should be given to the patient if cramping is experienced during filling of the large intestine for a BE?
concentrate on deep oral breathing
Before the enema tip is inserted during a BE, why should a small amount of barium sulfate mixture be allowed to run into a waste basin?
to remove air from the tube
Which procedure should be accomplished when inserting the enema tip for a BE?
ensure tip inserted no more that 3.5-4”
For the PA projection during a BE what is the advantage of placing the x-ray table and patient in a slight Trendelenburg position?
to help separate overlapping loops of the distal bowels
Which structures of hte large intestine are of primary interest with AP axial or PA axial projections during a BE?
sigmoid and rectum
How many degrees and in which direction should the central ray be directed for the PA axial projection during a BE?
30-40 degrees caudal
Which structure of the large intestines is of primary interest for the PA oblique projection RAO position during an BE exam?
right colic flexure
Which two oblique projections can be performed to demonstrate best the left colic flexure during a BE?
PA Oblique projection, LAO position Or AP Oblique projection RPO position
Which structure of the large intestine is best demonstrated if the patient is rotated 45 degrees from a supine position to move the right side of the abdomen away from the x-ray table during a BE?
Right colic flexure
For the right lateral decubitus position as part of a BE which procedure should be done to ensure that the ascending colon is demonstrated in the image?
elevate patient on a radiolucent support
Which BE projection requires a 10x12” lengthwise exposure field or CR plate be centered to the level of the ASIS?
Lateral projection
Which BE projection does not require colic flexures to be included in the image?
lateral projection
