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Upper Gastrointestinal Tract Flashcards

1
Q

What structure is the oral cavity continuous with?

A

Pharynx

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2
Q

What is the oral cavity divided into?

A

Oral vestibule- behind the lips, continuous with oral cavity proper

Oral cavity proper- median to teeth

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3
Q

What circular muscle surrounds orifice of mouth?

A

Orbicularis oris - helps out lips

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4
Q

What muscle is lateral to the orbicularis oris?

A

Buccinator muscle - helps blow out cheeks

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5
Q

Where is saliva produced/

A

Parotid gland

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6
Q

Why is buccinator muscle an important landmark?

A

Parotid duct transports saliva over masseter muscle to enter into oral cavity by travelling through buccinator muscle

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7
Q

What does the floor of the oral cavity consist of?

A

Mylohyoid muscle (superficial) runs from mandible to hyoid bone (floating bone)

Geniohyoid muscle (superior to mylohyoid)

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8
Q
A
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9
Q

What forms the roof of the oral cavity?

A 
Hard palate (bone- roof of mouth)
Soft palate (posterior)
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10
Q

What is the horizontal plane extending from maxilla?

A

Palatine process of maxillary bone

Has a suture- horizontal plate of palatine bone

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11
Q

What structure is a part of the soft palate and what does it consist of?

A

Uvula

Made of muscle -> Musculus uvulae
Red mucus membrane around it- covering whole of oral cavity and pharynx

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12
Q

What structure is exposed on protraction of the tongue?

A

Palatoglossal fold- under it is palatoglossal muscle

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13
Q

What structure is posterior to the palatoglossal fold?

A

Palatopharyngeal fold

Under it is palatopharyngeas muscle

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14
Q

What structure is between the palatoglossal and palatopharyngeas folds?

A

Palatine tonsil

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15
Q

Tensor veli palatini muscle and levator veli palatini muscle

A

Tensor- tenses soft palate

Levator- elevates soft palate

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16
Q

What innervates the muscles of the soft palate? Are there any exceptions?

A

Vagus nerve EXCEPT tensor veli palatini (supplied by mandibular division of trigeminal nerve)

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17
Q

Identify vagus nerve

A

First identify nearby common carotid artery
Lateral to it is internal jugular vein
In between them is vagus nerve

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18
Q
A
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19
Q

What structure is this

A

Root of tongue

attached to hyoid bone and mandible

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20
Q

What structure is this

A

Dorsum of tongue

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21
Q

What two parts is the tongue divided into?

A

Anterior 2/3 (oral)

Posterior 1/3 (pharyngeal)

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22
Q

What structure is this

A

Thyroid cartilage

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23
Q

What structure is this

A

Thyroid glands

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24
Q

What is the V shaped structure on the dorsal surface of the tongue?

A

Terminal sulcus

defines boundary between oral and pharyngeal parts of tongue

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25
Q

Foramen cecum

A

Thyroid gland started embryological development at this point, then descends

a shallow depression in the posterior dorsal midline of the tongue that is the remnant of the more cranial part of the embryonic duct from which the thyroid gland developed.

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26
Q

What connects foramen cecum to thyroid gland in embryos?

A

Thyroid glossal duct- atrophies after birth but can remain open as a thyroid glossal cyst in children

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27
Q

Identify this nerve

A

Lingual branch of mandibular division of trigeminal nerve

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28
Q

What sits here?

A

Trigeminal ganglion

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29
Q

What nerve gives sensation to oral part of tongue

A

Lingual branch of mandibular division of trigeminal nerve

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30
Q

What nerve travels with lingual nerve to send sensations of taste to brain?

A

Chorda tympani- branch of facial nerve

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31
Q

What nerve supplies sensation of taste and general sensation to pharyngeal part of tongue

A

Glossopharyngeal nerve (cranial nerve 9)

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32
Q

What structure is this

A

Parotid gland

Posterior to masseter muscle

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33
Q

What two vessels run through surface of parotid gland?

A

External carotid and retromandibular vein

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34
Q

What is this vessel and what structure is it going into?

A

Parotid duct going into buccinator muscle

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35
Q

Once in the oral cavity what is opposite the parotid duct?

A

2nd molar tooth upper jaw

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36
Q

What structure is this

A

Submandibular gland

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37
Q

What structure opens up in the mouth lateral to the frenulum?

A

Submandibular duct

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38
Q

Identify the structure

A

Frenulum

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39
Q

Identify the structure

A

Sublingual salivary glands

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40
Q

What are the 3 salivary glands?

A

Parotid glands
Submandibular glands
Sublingual glands

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41
Q

Pharynx

A

Fibromuscular tube that runs behind and is continuous with the nasal cavity, oral cavity and larynx

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42
Q

Identify the structures- what 3 parts is the pharynx divided into?

A
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43
Q

What is this structure?

A

Choanae- opening of nasal cavity (posterior nasal aperture)

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44
Q

Where does nasopharynx run from and to?

A

From just below sphenoid sinus to tip of uvula

45
Q

Where does oropharynx run from and to?

A

From tip of uvula to epiglottis

46
Q

What is epiglottis attached to?

A

Thyroid cartilage

47
Q

What tube is the pointer in?

A

Trachea and top of larynx- anterior to oesophagus

48
Q

What small depressions are anterior to epiglottis?

A

Valleculae where saliva will pool and food passes through to stimulate epiglottis and close larynx

49
Q

What is this structure?

A

Larynx (voicebox) just under epiglottis

50
Q

What is this area?

A

Piriform recess

a small cavity or pocket between the lateral walls of the pharynx on each side and the upper part of the larynx.

51
Q

What can get stuck in the piriform recess?

A

Food, eg fish bones

52
Q
A

Vocal cords aka larynx

53
Q

What are the 3 circular pharyngeal muscles and what do they do?

A

Superior constrictor
Middle constrictor
Inferior constrictor - 2 parts (superior component fibres attach to thyroid cartilage and inferior component fibres attach to cricoid cartilage)

The circular muscles contract sequentially from superior to inferior to constrict the lumen and propel the bolus of food inferiorly into the oesophagus.

54
Q

Where does oesophagus run from and to?

A

From pharyngoesophageal junction at C6 to stomach

55
Q

What is this space

A

Oropharynx (just before laryngopharynx)

56
Q

Where is the main point that the oesophagus becomes constricted?

A

Cricoid cartilage

can also get constricted at the point where aorta arches and bronchus

57
Q

What are these structures?

A

Anterior vagal plexus- branches of vagus nerve supplying oesophagus

58
Q

Thoracic duct

A

Lymphatic duct that drains all lymph back into veinous system

59
Q

At what point does oesophagus go through diaphragm?

A

T10

Through oesophageal hiatus

61
Q

What is the point where the stomach is closest to the oesophagus?

62
Q

Pylorus

A

Valve that opens and closes during digestion. This allows partly digested food and other stomach contents to pass from the stomach to the small intestine.

Controls gastric emptying into duodenum

63
Q

Where is the cardiac notch?

65
Q

What is the spaghetti string structure hanging from the greater curvature of the stomach?

A

Greater omentum

66
Q

Function of greater omentum

A

If infection in abdomen, in bowl area, greater omentum can slowly migrate and enclose it to stop spread of infection

67
Q

What is this structure

A

Transverse colon

Attached to posterior surface of greater omentum

68
Q

What structure is attached to lesser curvature of stomach?

A

Lesser omentum (goes to liver)

69
Q

What are these in the stomach?

70
Q

Cranial cavities

A

Oral cavity is continuous with nasal cavity via the pharynx.
Pharynx is continuous and posterior to the nasal cavity, oral cavity and larynx.
Pharynx is continuous inferiorly with the oesophagus (food pipe)
Larynx (voice box) is continuous inferiorly with the trachea (wind pipe)

75
Q

Buccal region

A

(cheeks)

Movable lateral walls
Buccinator muscle
Continuous with lips (orbicularis oris)
Buccal fat pad assists in suckling

76
Q
A

Remember that the buccinator muscle is a muscle of facial expression, not a muscle of mastication!

77
Q

Saliva function

A

Keeps mucous membrane moist
Lubricate oral cavity
Initiate digestion of starch
Prevent teeth decay

78
Q
A

Three salivary glands
Empty via ducts into oral cavity

  1. Parotid gland
  2. Submandibular gland
  3. Sublingual gland
79
Q

Innervation to salivary glands

A

Parasympathetic to submandibular and sublingual glands supplied by presynaptic parasympathetic fibres -> conveyed from the lingual nerve (branch of mandibular (CVN3) by the chorda tympani nerve (branch of facial nerve) to the submandibular ganglion.

Here they synapse with post synaptic parasympathetic fibres and run to the glands.

81
Q

The parotid gland Parasympathetic supply

A

Presynaptic parasympathetic from glossopharyngeal nerve to otic ganglion. Post synaptic parasympathetic travel in auricular temporal nerve (branch of mandibular nerve) to parotid gland.

83
Q

What is root of tongue attached to?

A

Mandible and hyoid bone

85
Q
A

Note nerve supply Maxillary Nerve (CNV2)

Eustachian tube

86
Q
A

NERVE SUPPLY: glossopharyngeal nerve (CN IX)

note tonsil and valleculae location

87
Q
A

NERVE SUPPLY: Vagus nerve (CN X)

Epiglottis location

88
Q

Pharyngeal blood supply:
Upper pharynx
Lower pharynx
Palatine tonsil

89
Q

What lymphatic node drains palatine tonsils?

A

Jugulodigastric lymph node

90
Q

Oesophagus

A

Muscular tube: 25 cm

Extends from pharyngo-oesophageal junction (C6) to cardiac orifice of stomach (T11)

Functions to transport food from pharynx to stomach

Pierces diaphragm at oesophageal hiatus (T10)

Two sphincters

  1. Upper oesophageal sphincter (UES)
    - Inferior constrictor muscle
  2. Lower oesophageal sphincter (LES)
    - GORD
91
Q

Constrictions of oesophagus

A

A.B.C.D.
A: Arch of aorta

B. Bronchus (left)

C. Cricoid cartilage (junction between oesophagus and pharynx)

D. Diaphragmatic hiatus

92
Q

Oesophageal layers

93
Q

Arterial supply of oesophagus

A

Upper third: Inferior thyroid artery

Middle third: Thoracic aorta

Lower third: Left gastric artery

94
Q

Innervation of oesophagus

A

Oesophageal plexus arise from:

  1. Vagus nerve (CN X):
    - Parasympathetic fibres
    - General sensation fibres
  2. Nerves from cervical and thoracic sympathetic trunk
    - Sympathetic fibres
    - Pain fibres
95
Q

Oesophageal lymphatics

A

Very complex

Important in oesophageal cancer

BIDIRECTIONAL:

  • Upwards to deep cervical lymph nodes
  • Downwards to juxta-oesophageal nodes
96
Q

Function of stomach

A

Storage of ingested food.

Regulate rate of emptying into small intestines.

Mechanical and chemical breakdown of food.

97
Q

Histological layers of stomach

98
Q

Stomach openings

99
Q

3 layers of stomach muscular structure

A
  1. Inner oblique layer: mechanical break down food.
  2. Middle circular layer: thickest at pylorus forming pyloric sphincter.
  3. Outer Longitudinal layer: moving bolus towards pylorus through muscular shortening
100
Q

What are the features of the stomach’s inner mucosa?

A

Gastric canal

Gastric Rugae/folds

101
Q

Peptic ulcer

A

Open lesion in mucosa lining.

Location:
Oesophageal
Gastric
Duodenal

Causes:
H. pylori
NSAID (nonsteroidal anti-inflammatory drugs)
Stress

102
Q

Development of GI tract

103
Q

Blood supply of:
Foregut
Midgut
Hindgut

A

Foregut- COELIAC TRUNK

Midgut- SUPERIOR MESENTERIC ARTERY

Hindgut- INFERIOR MESENTERIC ARTERY

104
Q

3 main branches from coeliac trunk

A

Common hepatic artery

Left splenic artery

Splenic artery

105
Q

Arteries of stomach

106
Q

Parasympathetic innervation of stomach

A

Vagus Nerve (CN X) increases rate of digestion when stimulated

  • > Secretomotor to gastric glands
  • > Motor to smooth muscular walls of GIT (peristalsis)

Right vagus -> posterior vagal trunk (posterior aspect of stomach supplied)
Left vagus -> anterior vagal trunk (anterior surface of stomach supplied)
due to stomach rotation

107
Q

Sympathetic innervation of stomach

A

Greater splanchnic nerve (T5 – T9) cause pyloric sphincter to contract reducing rate of gastric emptying
Motor to pyloric sphincter

Referred pain:
Pain fibres hitchhike with splanchnic nerve
Pain from foregut referred to epigastric region

Convergent nerve roots result in the concept of referred pain.

Foregut innervation - greater splanchnic nerve

108
Q

Lymphatics of stomach

A

Follow blood vessels
All lymph eventually passes into coeliac nodes
Important for cancer spread: gastrectomy

Anatomy (13 decks)

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