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GIT Anatomy > Upper GIT > Flashcards

Upper GIT Flashcards

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1
Q

List the layers of tissue in the GI tract

A
  • serosa
  • muscularis externa
  • submucosa
  • mucosa
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2
Q

What is the embryological origin of the upper GIT?

A

Foregut

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3
Q

List teh muscles of the oral cavity (and their innervation)

A
  • walls of the oral cavity are comprised of the buccinator, which holds the cheek against the alveolar arches
  • the floor is comprised of the mylohyoid and geniohyoid, which together help depress the mandible to open the mouth
    The innervation of these muscles is VII, V, C1 resp
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4
Q

Describe teh surfaces of the tongue

A
  • superior or oral part: covered in hundreds of papillae
    • inferior, covered in mucosal folds, site of frenulum
    • pharyngeal, composed of lymphoid tissue, site of lingual tonsil
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5
Q

Distinguish and describe intrinsic and extrinsic tongue muscles

A
  • intrinsic: refers to muscles that originate and insert within the tongue e.g. , work to lengthen and shorten, curl and flatten the tongue
  • extrinsic: refers to muscles originating from structures outside the tongue, and insert within the tongue. Includes mylohyoid and geniohyoid as well as…
    • styloglossus: retracts tongue
    • palatoglossus: elevates back of tongue, moves arches towards midline, depresses soft palate
    • hyoglossus: depresses tongue
    • genioglossus(most superior): depresses central part and protrudes anterior part
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6
Q

List the functions of the extrinsic tongue muscles

A
  • styloglossus: retracts tongue
    • palatoglossus: elevates back of tongue, moves arches towards midline, depresses soft palate
    • hyoglossus: depresses tongue
    • genioglossus(most superior): depresses central part and protrudes anterior part
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7
Q

List the salivary glands and their innervation

A
  • sublingual and submandibular (sits outside oral cavity floor), innervated by CN VII
  • parotid gland, innervated by CN IX
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8
Q

Describe the pharynx, and the blockagae of food from nasal cavity and larynx

A
  • the common pathway for food via the oesophagus, and air via the trachea
  • spans base of skull to C6
  • food is blocked
    • from nasal cavity by soft palate
    • from larynx by epiglottis
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9
Q

List and describe the two layers of striated muscle in the pharynx

A
  • constrictors (superior middle and inferior) - the external layer, contracts sequentially to push food bolus down to oesophagus for swallowing
    • superior attaches to pterygomandibular ligament: site for administration of inferior alveolar nerve block
  • longitudinal muscles/internal layer: palat0/salpingo/stylopharyngeus, elevate the pharynx
    • salpingo: eustachian tube and constrictors
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10
Q

Describe the sites of constriction in the oesophagus and their clinical significance

A

The oesophagus has three constrictions, as it passes various anatomical structures:
- at junction with pharynx i.e. upper sphincter - cervical C6/7
- crossing with aortic arch and L main bronchus - T3/4 / bronchoaortic
- passing oesophageal hiatus: diaphragmatic - T10/11

Clinical significance:
- common site of damage
- foreign bodies
- passing endoscope
- estimating distance of nasogastric tube

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11
Q

List the three portions of the oesophagus

A

There are three parts to the oesophagus:
- cervical: C6 to jugular notch
- thoracic: jugular notch to oesophageal hiatus, longest portion
- abdominal: hiatus to cardia, shortest portion

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12
Q

List some anatomical structures close to the cervical and thoracic oesophagus

A

Anatomical relationships:
- cervical: posterior to the trachea, lateral: carotid sheath (Artery, IJ vein, vagus n.)
- thoracic: in posterior mediastinum i.e. posterior to the heart, left atrium; anterior and right to aorta

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13
Q

Describe the musculature of the oesophagus

A

The regions of the oesophagus have unique musculature, blood supply and lymphatics:
- upper third is striated muscle
- middle third is a mix
- lower third is smooth muscle

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14
Q

Describe the arterial supply of the oesophagus

A
  • upper third of the oesophagus is supplied by inferior thyroid arteries (branch of thyrocervical trunk, branch of subclavian)
  • middle third is supplied by oesophageal arteries (2-5 unpaired), branches of the thoracic aorta
  • lower third is supplied by left gastric artery (branch of coeliac trunk, branch of abdominal aorta)
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15
Q

Describe the venous drainage of the oesophagus

A
  • upper third is drained by inferior thyroid veins, which drain into brachiocephalic veins and SVC
  • middle third is drained by oesophageal veins, which drain into azygos vein and into SVC
  • lower third is drained by left gastric vein, which drains into portal vein
  • note that oesophageal and left gastric vein anastomose
  • NOTE ALSO: portal hypertension and oesophageal varices (As a consequence of anastomoses)
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16
Q

Describe the lymphatic drainage of the oesophagus

A
  • upper third drained by deep cervical nodes
  • middle third drained by superior and posterior mediastinal nodes
  • lower third drained by left gastric nodes and coeliac nodes
  • clinical significance: cancer of the lower third often spreads to coeliac nodes and all regions that drain into the coeliac nodes i.e. stomach, duodenum, spleen, omenta
17
Q

Describe the sources of oesophagus innervation

A

Two main sources of innervation
- oesophageal plexus
- vagal trunks (vagus nerve – parasympathetic, and somatic motor in upper oesophagus)
- cervical and thoracic sympathetic trunks (sympathetic)
- enteric nervous system, see [[Anatomy B5 - Lecture 2]]

18
Q

Describe the LOS and its role

A
  • a high pressure zone between
    • the positive pressure of the abdomen
    • negative pressure of the thorax
  • Both the oesophageal muscle and diaphragm play a a role in LOS to move contents into stomach
  • Note the “Z” line at squamo-columnar junction
  • Malfunction of LOS: GORD
  • No voluntary control as opposed to UOS
19
Q

Descrube the regions and composition of the stomach

A
  • is comprised of four parts: cardia, fundus, body or corpus, and pyloric region - which can be further divided into antrum and canal
  • two borders: greater and lesser curvature
  • two openings: cardial orifice or entrance, pylorus or exit
  • three muscle layers from outer surface: longitudinal, circular and oblique - different direction fibres help move in different ways to move food
    • longitudinal is more superficial
    • followed by circular
    • oblique is deepest
20
Q

Describe the parts and broad function of the duodenum and pancreas

A
  • The duodenum has a ‘c’ shape and is comprised of four parts: superior, descending, inferior, ascending (in that order)
  • pancreas also has four parts: head neck body and tail
  • it has exocrine function: excretes through main and accessory ducts
  • it also has endocrine function: produces insulin and glucagon
  • outflow: ampulla of Vater, surrounded by sphincter of Oddi, inserts into greater duodenal papilla and opens into duodenum-
21
Q

List the main arteries of the GIT

A
  • foregut is supplied by celiac trunk
  • midgut is supplied by superior mesenteric artery
  • hindgut is supplied by inferior mesenteric artery
22
Q

Breakdown the major arteries of the upper GIT and their branches

A
  • celiac trunk
    • left gastric artery
    • splenic artery (tortuous to accommodate for stomach movement inferior to it)
      • pancreatic
      • L gastroepiploic/gastro-omental (anastomoses with R counterpart)
      • short gastrics
  • common hepatic artery
    • right gastric
    • proper hepatic
    • gastroduodenal (R omental)
23
Q

Describe the main veins of the GIT and their drainage

A
  • ‘special K’: Portal vein, into which drains
    • SMV (continuous with portal vein)
    • Splenic vein, which enters SMV
    • IMV, which drains into splenic, into SMV, ultimately into portal vein
  • Note also pancreaticoduodenal, gastric, pancreatic veins
24
Q

Describe the broad innervation of the GIT

A
  • sympathetic: thoracic splanchnic nerves
  • parasympathetic: vagal trunks: anterior and posterior
  • enteric
25
Q

Describe the broad lymphatic drainage of the upper GIT

A
  • celiac lymph nodes mainly, to celiac trunk
  • also: pancreaticosplenic, gasto-omental, gastric, mesenteric, pyloric, and pancreaticoduodenal

GIT Anatomy (5 decks)

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