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Upper GI anatomy Flashcards

1
Q

What kind of epithelium is the mucosa present in the oral cavity? Which portion is keratinised?

A

stratified squamous epithelium
keratinised: gum, hard palate and dorm of tongue
non-keratinised: lips and cheeks

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2
Q

What are the 2 parts of the oral cavity?

A

vestibule

oral cavity proper

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3
Q

Where is the oral cavity proper?

A

the space internal to the teeth

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4
Q

Where is the vestibule?

A

‘slit-like’ space external to teeth and between the gums

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5
Q

Which muscles is the oral cavity bound by?

A

buccinator muscle

left and right

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6
Q

Which duct pierces the buccinator muscle?

A

Parotid duct

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7
Q

Which other muscle are the buccinator muscles closely associated with?

A

superior constrictor muscles

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8
Q

What do the buccinator and superior constrictor muscles attach to?

A

pterygoid manibular raphe

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9
Q

Which fat pad lies superficially to the buccinator muscle and is often large in babies?

A

buccal fat pad

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10
Q

Which muscles form the floor of the mouth?

A

mylohyoid

geniohyoid

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11
Q

What structure occupies most of the floor of the mouth?

A

Tongue

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12
Q

The roof of the mouth is occupied by the palate which has 2 main parts:

A

soft palate

hard palate

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13
Q

Which 5 muscles compose the soft palate?

A 
musculus uvula
palatoglossus
palatopharyngeus
levator veli palatine
tensor veli palatine
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14
Q

The muscles in the soft palate are all supplied by the vagus nerve, except for the tensor veil palatine which is supplied by what?

A

mandibular division of the trigeminal nerve

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15
Q

Which structure assists in the equalisation of air pressure?

A

Auditory tube

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16
Q

What are the 2 folds present in the back of the oral cavity? Descibe their relative anatomical position.

A

palatoglossal fold - anterior

palatopharyngeal fold - posterior

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17
Q

The hard palate are composed of which 2 bones?

A

maxilla

palatine bone

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18
Q

What do the lesser palatine nerves supply?

A

soft palate
tonsils (palantine)
uvula

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19
Q

What is the tongue important for?

A

speech, mastication, swallowing and taste

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20
Q

What are the main regions of the tongue?

A

dorsum tip, inferior surface and root

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21
Q

The oral and pharyngeal portions of the tongue are separated by what structure?

A

Terminal sulcus

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22
Q

The oral portion of the tongue comprises:

A

the anterior two thirds

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23
Q

The pharyngeal portion of the tongue comprises:

A

the posterior one third

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24
Q

Which nerve supplies general sensation of the oral segment of the tongue?

A

Lingal branch of V3

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25
Q

Which nerve supplies taste sensation of the oral segment of the tongue?

A

Facial nerve

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26
Q

Which nerve supplies general and taste sensation of the pharyngeal segment of the tongue?

A

glossopharyngeal nerve

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27
Q

What does the root of the tongue attach to?

A

hyoid bone and mandible

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28
Q

What are the 3 types of papilla found on the surface of the tongue?

A

fungiform
filiform
valiate

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29
Q

Which 4 extrinsic muscles make up the tongue?

A

palatoglossus
styloglossus
hyoglossus
Genioglossus

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30
Q

What nerve supplies all but the palatoglossus muscle of the tongue?

A

hypoglossal nerve

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31
Q

Which nerve supplies the palatoglossus muscle of the tongue?

A

pharyngeal plexus (of the vagus nerve)

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32
Q

What is the clinical significance of the valleculae?

A

These are mucosal pouches, which are an important landmark for endotracheal intubation

33
Q

What is the blood supply to the tongue?

A

Lingal artery

34
Q

What is the lymphatic drainage of the tongue?

A

deep cervical nodes

35
Q

Which is the largest salivary gland?

36
Q

Where does the parotid gland sit?

A

On the masseter muscle

37
Q

What are the 3 salivary glands?

A

Parotid
sub-mandibular
sub-lingal

38
Q

The duct of which gland opens into the mouth lateral to the frenulum?

A

submandibular gland

39
Q

What is the frenulum?

A

slip of tissue that runs vertically from the floor of the mouth to tongue

40
Q

Where do the sublingual glands lie?

A

On the floor of the oral cavity between the mandible and the genioglossus muscle

41
Q

Where and what is the pharynx?

A

A fibro-muscular tube attached to the base of the skull superiorly and continuous with the oesophagus inferiorly

42
Q

What are the 3 segments of the pharynx?

A

nasopharynx
oropharynx
laryngopharynx

43
Q

What vertebral level does the nasopharynx lie?

44
Q

What vertebral level does the oropharynx lie?

45
Q

What vertebral level does the laryngopharynx lie?

46
Q

What are the structures present in Waldeyer’s ring?

A

2 tubal tonsils
2 palatine tonsils
group of lingual tonsils

47
Q

What is the blood supply for the palatine tonsils?

A

facial artery

48
Q

What is the function of the epiglottis?

A

Contraction during eating to block off the trachea and therefore prevent food from getting stuck causing aspiration

49
Q

The posterior wall of the pharynx is enclosed by which 3 constrictor muscles?

A

superior, middle, inferior

50
Q

Which nerve supplies the constrictor muscles?

51
Q

What is Charcot’s triad? What should be done?

A 
= surgical emergency
includes:
- fever
- RUQ pain
- jaundice

Patients need: Biliary decompression and broad spectrum antibiotics.

ERCP = Endoscopic retrograde cholangiopancreatography
usually after 72 hours of antibiotics
Percutaneous transhepatic cholangiogram and biliary drain

52
Q

Where does the superior mesenteric vein drain into prior to the IVC?

A

SVM first anastomoses with the portal vein

which then drains into the IVC

53
Q

Direct inguinal hernias travel through Hesselach’s triangle. What are its main borders?

A

Superolaterally: epigastric vessels

medially: lateral edge of rectus abdomens
inferiorly: inguinal ligament

54
Q

Which are the retroperitoneal organs?

A 
Suprarenal glands (adrenal) 
Aorta/IVC
Duodenum (2nd and 3rd fragments)
Pancreas
Ureters
Colon (ascending and descending only)
Kidneys
Esophagus 
Rectum
55
Q

What artery is at risk of ulceration with a posterior duodenal ulcer?

A

gastroduodenal artery

56
Q

What is the risk with anterior duodenal ulcers?

A

no risk of haemorrhage since there is no artery overlying the anterior surface?
more at risk of pneumoperitoneum

57
Q

What level is the transplyloric plane?

58
Q

What is found at the transpyloric plane?

A
  • pylorus of stomach
  • left kidney hilum (think L1 = Left one)
  • right hilum of kidney (1.5cm lower than L kidney)
  • fundus of gallbladder
  • neck of pancreas
  • duodeno-jejunal flexure
  • SMA
  • portal vein
  • left and right colic flexure
  • root of the transverse mesocolon
  • D2 of duodenum
  • spleen
59
Q

What is the blood supply to a Meckel’s diverticulum?

A

Vitelline artery

embryological orgin of Meckel’s is the vitello-ileal pouch

60
Q

What is an ANNULAR pancreas?

A

rare condition

the second part of the duodenum is surrounded by a ring of pancreatic tissue

this is continuous with the head of the pancreas.

This portion of the pancreas can constrict the duodenum and block or impair the flow of food to the rest of the intestines.

61
Q

In patients with annular pancreas, where is the mostly likely site of obstruction?

A

D2 (second part) of duodenum

62
Q

At what level does the portal vein begin?

A

L1

begins at the transpyloric plane

63
Q

Into which vein does the IMV drain (usually)?

A

splenic vein

64
Q

Where does the anastomosis between IMV and splenic vein lie?

A

Close to the duodenum near plane of splenic flexure

65
Q

What structure lies most posteriorly at the porta hepatis?

A

portal vein

66
Q

What is the common bile duct?

A

= continuation of common hepatic duct

- formed by union of common hepatic duct and cystic duct

67
Q

What are the contents of the PORTA HEPATIS?

A
  • common hepatic duct
  • hepatic artery
  • portal vein
  • sympathetic and parasympathetic nerves
  • lymphatic drainage of liver (LNs)
68
Q

What are the 3 main ligaments in the liver?

A
  • falciform ligament
  • ligamentum teres
  • ligamentum venosum
69
Q

What is the falciform ligament?

A
  • 2 layer fold peritoneum from the umbilicus to the anterior liver surface
  • splits into the coronary and left triangular ligaments
  • contains ligamentum teres
70
Q

What is the ligamentum teres?

A
  • remnant of umbilical vein

- joins left branch of portal vein in porta hepatis

71
Q

What is the ligamentum venosum?

A

remnant of ductus venosus

72
Q

What is the nerve supply to the liver?

A

SNS and PNS trunks from the coeliac plexus

73
Q

What are the 2 main muscles of the abdominal wall?

A

ANTERIOR
rectus abdominus

POSTERIOR
quadratus lumborum

74
Q

What are the 3 muscular middle layers of the abdominal wall?

A
  • external oblique
  • internal oblique
  • transverse abdominus
75
Q

Where does the external carotid start?

A

immediately lateral to the pharyngeal side wall

76
Q

Where does the external carotid terminate?

A

pierces fascia of parotid gland

then divides into terminal branch within gland

77
Q

Which structure lies posterolaterally to the external carotid at its origin from the common carotid?

A

internal carotid artery

78
Q

What structure separates the subclavian artery and vein?

A

anterior scalene muscle

subclavian vein: anterior
subclavian artery: posterior

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