Workbook 2 Flashcards
What does small intestine include?
Duodenum, jejunum, ileum
What does large intestine include?
Caecum, appendix and the colon - ascending, transverse and descending
What are the 3 constrictions of the oesophagus?
Cervical, thoracic and diaphragmatic
Describe the oesophagus
25cm long and is a muscular tube
From pharynx to stomach
What is the vertebral level of the oesophageal opening?
T10
What other structures pass through the diaphragm at oesophageal opening?
Oesophagus
Right vagus nerve
Left vagus nerve
Left gastric artery/vein
What is the blood supply of the oesophagus?
Left gastric artery - branch of coeliac trunk
Describe the venous drainage of oesophagus
Left gastric vein - portal
Azygous vein - systemic
Describe the lymphatic drainage of the oesophagus
Superior third - deep cervical nodes
Middle - superior and posterior mediastinal nodes
Lower - left gastric and coeliac nodes
What is important about the lower end of the oesophagus?
Important site for portosystemic anastomoses
In portal hypertension then can get oesophageal varices
What are the parts of the stomach?
Fundus
Body
Antrum
Pyloric
Where does lesser omentum extend from and to?
Lesser curvature of stomach to the liver
Where does the greater omentum extend from and to?
Greater curvature of the stomach to transverse colon
What is the pyloric sphincter?
Ring of smooth muscle contracting stomach to the duodenum
Controls movement of partially digested food
What are the gastric folds/rugae formed from?
Gastric mucosa
In what parts of the stomach are the rugae more apparent?
Body and antrum
Name the three branches of the coeliac trunk
Left gastric artery
Splenic artery
Common hepatic artery
What are the arteries supplying the stomach?
Left gastric artery
Right gastric artery
Splenic artery
Common hepatic artery
Left gastro-omental artery
Right gastro-omental artery
What are the 4 main vessels draining the stomach?
Left and right gastric veins - hepatic portal vein
Right gastro-omental vein - superior mesenteric vein
Left gastro-omental vein - splenic vein
What are the main group of lymph nodes that drain the stomach?
Gastric nodes
Describe the innervation of the stomach
Parasympathetic - vagus nerve
Sympathetic - greater splanchnic nerve from coeliac plexus T6-9
How many parts does the duodenum have?
4 parts
What organ sits in the C shape of the duodenum?
Pancreas
How is duodenum peritonised?
1st part is intra
Rest is retroperitoneal
What is the opening in duodenum where bile and pancreatic fluids enter?
Ampulla of Vater
What 2 structures come together at the ampulla of Vater?
Common bile duct
Main pancreatic duct
What is the sphincter that controls the movement of bile and pancreatic fluids into duodenum?
Sphincter of Oddi
What are some distinguishing features about the jejunum?
Deeper red, thick + heavy, greater vascularity, longer vasa recta, few large loops in arcade and less fat in mesentery
What are some distinguishing features about the ileum?
Pale pink, light + thin, less vascularity, shorter vasa recta, many short loops in arcade and more fat in the mesentery
What major blood vessel supplies the jejunum and ileum?
Superior mesenteric artery
Where does nerve supply of jejunum and ileum come from?
Superior mesenteric plexus
What are 3 distinguished features of the large intestine?
Teniae Coli
Omental appendices - fatty projections
Haustra
How is the large intestine peritonised?
Intra - Caecum, transverse colon and sigmoid colon
Retro - Ascending and Descending colon
What are the flexures of the large intestine called?
Right hepatic flexure
Left splenic flexure
Where are the midgut and hindgut boundaries of the large intestine?
Midgut - up to 2/3 of transverse colon
Hindgut - proximal 1/3 of the transverse colon to rectum
Which region is the appendix and the caecum located?
Right inguinal region
Where does the rectum pierce the pelvic floor?
At the ano-rectal junction
Where becomes anal canal
Describe arterial and venous supply/drainage of the rectum?
Superior 1/3 - superior rectal artery and vein
Middle 1/3 - Middle rectal artery and vein
Lower 1/3 - Inferior rectal artery and vein
What is the lymph drainage of the rectum?
Para-rectal lymph nodes
What helps control faecal continence?
Pelvic floor
Internal and external sphincters
Describe the pectinate line
Divides upper 2/3rds and the lower 1/3rdr of the rectum
Describe the liver
Sits in upper right quadrant of the body
Is reddish brown, soft and very friable
What are the 4 lobes of the liver?
Right and Left
Quadrate and Caudate
What lobes of the liver can not be seen from the front?
Quadrate and Caudate
What is the liver encapsulated in?
Fibrous layer called a capsule
What is the bare area of the liver?
Live is in contact with diaphragm so no peritoneum
What is the porta hepatis?
Hilum of the liver
What are the structures present in the porta hepatis?
Hepatic portal artery
Hepatic portal vein
Hepatic nerve plexus
Hepatic duct
Lymphatic vessels
What are the structures in the portal triad?
Hepatic artery
Portal vein
Bile ducts
Where does the central vein drain to?
Inferior vena cava
What does the extrahepatic biliary apparatus consist of?
Common bile duct
Cystic duct
Gall bladder
Left hepatic duct
Right hepatic duct
Where is bile produced and stored?
Produced - liver
Stored - gallbladder
What is the function of bile?
Emulsification
Describe Calot’s triangle
Triangular space formed by Cystic duct, common hepatic duct and inferior surface of the liver
Triangle contains the cystic artery
What is the function of the pancreas?
Exocrine - secretes digestive enzymes
Endocrine - secretes hormones
What are the 4 parts of the pancreas?
Head, neck, body and tail
How is the pancreas peritonised?
Retroperitoneal - apart from tail
Which vein is formed posterior to the neck of pancreas?
Superior mesenteric vein
What is the arterial supply of the pancreas?
Coeliac trunk and superior mesenteric artery
What is the venous drainage of the pancreas?
Splenic or superior mesenteric veins into the portal system
What is the nerve supply of the pancreas?
Coeliac plexus and superior mesenteric plexus
What is the lymph drainage of the pancreas?
Pre-aortic at T12 to L1
What is the spleen?
Largest single mass of lymphoid tissue in the body
Acts as filter for blood and plays role in immune response
If perforated will bleed heavily
How is the spleen peritonised?
Intraperitoneal
Name the structures in the hilum of the spleen
Splenic artery
Splenic vein
Splenic lymphatic vessel
