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GI - A > Wet Room 2 > Flashcards

Wet Room 2 Flashcards

1
Q

Give a brief description of the oesophagus

A

Muscular tube -25cm long and extends from the pharynx to the stomach.
The abdominal part of the oesophagus is only about 1.25cm long

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2
Q

What are the 3 constrictions of the oesophagus?

A

Cervical
Thoracic
Diaphragmatic

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3
Q

What is the vertebral level of the oesophageal opening (hiatus) in the diaphragm?

A

T10

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4
Q

List the structures that traverse the oesophageal opening

A

Oesophagus
Vagal trunks
Oesophageal branches of the left gastric vessels
Lymphatic vessels

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5
Q

what is the blood supply of the oesophagus?

A

Branches of the left gastric artery

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6
Q

What is the venous drainage of the oesophagus?

A

Left gastric vein

This drains into the portal venous system

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7
Q

What is the lymphatic drainage of the oesophagus?

A

Left gastric lymph nodes

These drain into the celiac lymph nodes

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8
Q

Where is the portosystemic anastomosis in the oesophagus and what is its clinical significance?

A

The lower end of the oesophagus is one of the important sites for portosystemic anastmoses.

In portal hypertension, the anastomoses open and forms venous dilatations called oesophageal varices.

Their rupture causes severe and dangerous haematemesis

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9
Q

What is the stomach?

A

The stomach is a muscular bag forming the widest and most distensible part of the digestive tube.

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10
Q

What are the two orifices of the stomach?

A

Cardial Orifice

Pyloric Orifice

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11
Q

What are the two curvatures of the stomach?

A

The Greater Curvature

The Lesser Curvature

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12
Q

What are the two surfaces of the stomach?

A

Anterior

Posterior

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13
Q

What is the pyloric sphincter?

A

Thickening of the circular layer of smooth muscle

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14
Q

What is the function of the pyloric sphincter?

A

Controls discharge of the stomach contents through the pyloric orifice

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15
Q

The pyloric sphincter is formed from the thickening of which layer of gut tube?

A

Circular muscle layer of the muscularis externa

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16
Q

Some children are born with which congenital disease of the pyloric sphincter?

A

Congenital pyloric stenosis

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17
Q

The lesser omentum extends between which two points?

A

lesser curvature of the stomach to the liver

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18
Q

The greater omentum extends between which two structures?

A

Greater curvature of the stomach to the transverse colon.

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19
Q

What are the gastric folds/ rugae formed from and what portions of the stomach are they most apparent?

A

Gastric mucosa

Pyloric Part
Greater Curvature

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20
Q

The stomach lies of several structures in the abdominal cavity.
These structures form the stomach bed (posterior wall of the omental bursa)
List them

A 
Left dome of the diaphragm
Left kidney
Spleen
Suprarenal gland
Splenic artery
Colon 
Pancreas
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21
Q

What are the 3 main branches of the celiac trunk?

A

Left gastric artery
Common Hepatic artery
Splenic artery

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22
Q

What is the venous drainage of the stomach?

A

Venous drainage is, of course, via the portal system

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23
Q

The 4 primary lymph node groups of the stomach drain into what group of nodes?

A

Celiac Lymph nodes

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24
Q

What area of the stomach are gastric cancers most likely to occur?

A

The greater curvature.

On this account the lymphatic drainage of stomach assumes importance.

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25
Q

The vagus nerve is key in controlling gastric motility.
What is the effect of increased vagal stimulation on:
a) The pylorus?
b) Gastric secretion?

A

a) Starts/ Increases contraction

b) Increased

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26
Q

The arrangement of vagal branches to the stomach allows for highly selective vagotomy to be used to treat over- active gastric acid secretion.
Which areas are usually denervated and which areas are preserved?

A

The fundus and body are denervated

Supply to the antrum is preserved so that essential gastric motility is preserved.

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27
Q

Where does the small intestine extend from?

A

Extends from the pylorus of the stomach to the ileocecal junction

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28
Q

What are the 3 parts of the small intestine?

A

Duodenum
Jejunum
Ileum

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29
Q

Which part of the small intestine receives the opening of the bile and pancreatic duct?

A

Duodenum

30
Q

Where is the foregut/midgut boundary in the small intestine?

A

Entry of the bile duct into the duodenum

31
Q

How are the different parts of the small intestine peritonised?

A 
Duodenum = Reteroperitoneum
Jejunum = Intraperitoneum
Ileum = Intraperitoneum
32
Q

Which part of the small intestine is the shortest, widest and most fixed part?

A

Duodenum

33
Q

How does the colour of the jejunum and ileum differ?

A 
Jejunum = deeper red
Ileum = paler pink
34
Q

How does the wall of the jejunum and ileum differ?

A 
Jejunum = Thick + Heavy
Ileum = Thi and light
35
Q

How does the vascularity of the jejunum and ileum differ?

A 
Jejunum = Greater
Ileum = Less
36
Q

How does the vasa recta differ for the jejunum and the ileum?

A 
Jejunum = long
Ileum = Short
37
Q

How do the arcades of the jejunum and ileum differ?

A 
Jejunum = a few large loops
Ileum = many short loops
38
Q

how does the fat in the mesentery differ between the jejunum and ileum?

A 
Jejunum = less
Ileum = many
39
Q

How do the circular folds differ in the jejunum and the ileum?

A 
Jejunum = large, tall and closely packed
Ileum = Smaller, absent in terminal part
40
Q

Where is the transition from jejunum to ileum?

A

There is no step-transition between jejunum and ileum, rather the morphology gradually alters, but either end is quite different

41
Q

Which part of the autonomic nervous system (sympathetic or parasympathetic) do stimulations reduce the secretion and motility of the intestine and also acts as a vasoconstrictor

A

Sympathetic

42
Q

What features can distinguish the large intestine from the small intestine?

A

Teniae coli
Haustra
Omental appendices

43
Q

How are the parts of the large intestine peritonised?

A 
Caecum = Intraperitoneum
Ascending colon = Reteroperitoneum
Transverse colon = Intraperitoneum
Descending colon = Reteroperitoneum
Sigmoid Colon = Intraperitoneum
44
Q

In which abdominal region is the caecum and appendix located?

A

Right inguinal

45
Q

What is McBurney’s point?

A

Point of maximum tenderness in appendicitis

46
Q

What is the most common position for the appendix?

A

Rectocecal

47
Q

What is the arterial supply, venous drainage and peritonisation of the Superior 1/3 or the rectum?

A

Arterial supply = Superior rectal
Venous drainage = Superior vein (portal system)
Peritonisation = Intraperitoneum

48
Q

What is the arterial supply, venous drainage and peritonisation of the middle 1/3 of the rectum?

A

Arterial supply = Middle rectum
Venous drainage = Middle vein (systemic circulation)
Peritonisation = Retroperitoneum

49
Q

What is the arterial supply, venous drainage and peritonisation of the Inferior 1/3 of the rectum?

A

Arterial supply = Inferior rectal
Venous drainage = Inferior vein (systemic circulation)
Peritonisation = None

50
Q

What is the role of the pelvic floor in maintaining faecal continence?

A

Increases intra-abdominal pressure

51
Q

What other structures are involved in faecal continence other than the pelvic floor?

A

External and internal sphincter

52
Q

The hepatoduodenal and hepatogastric ligaments are parts of which omentum?

A

Lesser omentum

53
Q

What structure in the free edge of the falciform ligament is a remnant of an embryonic blood vessel?
What is the name of this vessel in the embryo?

A

The round ligament of the liver

Left umbilical vein

54
Q

How many layers of peritoneum are present in the greater momentum?

A

4

55
Q

The greater momentum is often called the abdominal policeman. What functions of this structure lead to this term being used?

A

Role in fighting intra-abdominal infection

56
Q

What are the paracolic gutters?

A

Spaces between ascending and descending colon and abdominal wall
They are found lateral to the large intestine.
Infections can gather in these spaces

57
Q

List 3 abdominal viscera which lie in the free edge of a double layer of peritoneum described as the mesentery

A

Appendix
Colon
Small intestine

58
Q

What muscle type’s form the muscularis externa?

A

Circular and longditudinal

59
Q

What type of muscle is the muscularis mucosae?

A

Smooth

60
Q

What are the large folds present in the wall of the stomach?

A

Ruggae

61
Q

What secretory cells are present in the gastric pits?

A

surface mucous cells

62
Q

What kind of epithelium is found in the oesophagus?

A

Stratified squamous

63
Q

What kind of epithelium is found in the small intestine?

A

Simple columnar

64
Q

Where, along the gut tube, do glands extend down beyond the muscularis mucosae?

A

Duodenum and Oesophagus

65
Q

What is the predominant cell present in the surface epithelium?

A

Goblet cells

66
Q

What is the epithelium in the rectum?

A

stratified squamous

67
Q

List the structures present in the transpyloric plane

A 
Pylorus of the stomach
Neck of pancreas
Fundus of gall bladder
Spleen
Hilum of R+L Kidney
68
Q

In a barium meal which organ is examined?

A

Stomach

69
Q

In a barium meal follow through which organ is being examined?

A

Small intestine

70
Q

In a barium enema which organ is being examined?

A

Colon

71
Q

What are the 4 groups of lymph nodes that drain the stomach?

A

Right and left gastric
Right and left gastroomental
Suprepyloric and subpyloric
Splenic

GI - A (8 decks)

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