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Gastrointestinal > Gastrointestinal anatomy > Flashcards

Gastrointestinal anatomy Flashcards

1
Q

Name all of the parts of the GI tract from proximal to distal

A 
Mouth/oral cavity 
Oesophagus
Stomach
Duodenum
Jejunum
Ileum
Caecum & appendix
Ascending colon
Hepatic flexure
Transverse colon
Splenic flexure
Descending colon
Sigmoid colon
Rectum
Anus
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2
Q

Which organs in the GI tract are foregut organs?

A 
Oesophagus
Stomach
Mid-duodenum
Liver
Spleen
Gallbladder
1/2 of pancreas
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3
Q

Which organs in the GI tract are midgut organs?

A

1/2 of duodenum
Small intestine
Proximal 2/3 of transverse colon
1/2 of pancreas

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4
Q

Which organs in the GI tract are hindgut organs?

A

Distal 1/3 of transverse colon
Sigmoid colon
Rectum
Proximal 1/2 of anal canal

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5
Q

What is the peritoneal cavity?

A

A thin, enclosed space containing a little peritoneal fluid secreted by the peritoneum

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6
Q

What is the peritoneum?

A

A sensitive, semi-permeable membrane

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7
Q

What name is given to the surgical procedure of opening the abdominal cavity?

A

Laparotomy

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8
Q

When undertaking paracentesis, why must the placement of the needle be lateral to the rectus sheath?

A

To avoid the inferior epigastric vessels which run in the anterior abdominal wall, deep to the rectus sheath

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9
Q

What is the deep inguinal ring?

A

The entrance to the inguinal canal

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10
Q

What is the inguinal canal?

A

A passage in the anterior abdominal wall which in men conveys the spermatic cord and in women the round ligament

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11
Q

What is the falciform ligament?

A

Attaches the liver to the anterior abdominal wall, lies between the right and left lobe of the liver

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12
Q

What two structures does the greater omentum connect?

A

The stomach to the transverse colon

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13
Q

What two structures does the lesser omentum connect?

A

The stomach to the liver

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14
Q

Which structure lies within the “free edge” of the lesser omentum?

A

The portal triad

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15
Q

How does the greater sac communicate with the lesser sac?

A

Through the omental foramen

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16
Q

What is the enteric nervous system?

A

An extensive network of nerves found only within the walls of the GI tract

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17
Q

Where do the sympathetic nerve fibres exit the spinal cord to reach the abdominal organs?

A

T5-L2

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18
Q

Where do the sympathetic nerve fibres supplying the abdominal organs synapse?

A

Prevertebral ganglia, located anterior to the aorta at the exit points of the major branches of the aorta

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19
Q

What nerves do the sympathetic nerves exit the sympathetic chain within?

A

Abdominopelvic splanchnic nerves

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20
Q

What are the names of the prevertebral ganglia within the abdomen?

A

Celiac ganglion
Superior mesenteric ganglion
Inferior mesenteric ganglion

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21
Q

How do postsynaptic sympathetic nerve fibres travel to the abdominal organs?

A

They travel on the surface of the arterial branches leaving the abdominal aorta

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22
Q

What are periarterial plexuses?

A

Nerve plexuses around the arteries consisting of sympathetic, parasympathetic and visceral afferents

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23
Q

What is unique about the nerve supply to the adrenal glands?

A

The sympathetic nerve fibres do not synapse at the prevertebral ganglia - instead, the presynaptic fibres are carried to the adrenal gland where they synapse directly onto the cells

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24
Q

At which level of the spinal cord do the sympathetic nerve fibres destined for the adrenal gland leave at?

A

T10-L1

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25
Q

Where do the presynaptic parasympathetic nerve fibres within the vagus nerve enter the abdominal cavity?

A

The surface of the oesophagus - “vagal trunks”

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26
Q

Up to which structure do parasympathetic nerve fibres supply in the GI tract?

A

Up to the distal end of the transverse colon

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27
Q

What parasympathetic nerve supply is there for the distal end of the transverse colon and down to the anal canal?

A

Pelvic splanchnic nerves S2, 3, 4

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28
Q

Where do pain fibres from foregut structures enter the spinal cord?

A

T6-T9

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29
Q

Where do pain fibres from midgut structures enter the spinal cord?

A

T8-T12

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30
Q

Where do pain fibres from hindgut organs enter the spinal cord?

A

T10-L2

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31
Q

What artery is the inferior epigastric artery a branch of?

A

External iliac

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32
Q

Where is the deep inguinal ring located?

A

Halfway between the ASIS and pubic tubercle

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33
Q

What three vessels make up the portal triad?

A

Hepatic artery
Hepatic portal vein
Common bile duct

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34
Q

What are the three initial branches of the celiac trunk?

A

Left gastric artery
Hepatic artery
Splenic artery

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35
Q

Which artery, originating from the celiac trunk, has a particularly tortuous course?

A

Splenic artery

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36
Q

Where is the spleen located?

A

It is an intraperitoneal organ located within the left hypochondrium

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37
Q

Which structure lies anterior to the spleen?

A

Stomach

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38
Q

Which structure lies medial to the spleen?

A

Left kidney

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39
Q

Which ribs protect the spleen?

A

Ribs 9-11

40
Q

What is the blood supply to the stomach?

A

Mainly the right and left gastric arteries running along the lesser curvature
Right and left gastro-omental arteries running along the greater curvature

41
Q

What percentage of the blood supply to the liver does the hepatic artery account for?

A

20-25%

42
Q

What is the main blood supply to the liver?

A

Hepatic portal vein

43
Q

How many segments does the liver have?

A

8

44
Q

How many main hepatic veins are there that drain into the IVC?

A

3

45
Q

What is the significance of the lack of valves in the IVC?

A

Any rise in central venous pressure, e.g. congestive cardiac failure, causes the liver to become engorged with blood resulting in hepatomegaly

46
Q

What are the four lobes of the liver?

A

Right, left, caudate, quadrate

47
Q

What structure lies posteriorly & inferiorly to the liver?

A

Gallbladder

48
Q

Which structures lie posterior to the liver?

A

Right kidney, right adrenal gland, IVC and abdominal aorta

49
Q

When a patient is bedridden, which part of the peritoneal cavity might fill with fluid or pus from an abcess?

A

Hepatorenal recess

50
Q

What is the ligamentum teres or round ligament?

A

A remnant of the embryological umbilical vein

51
Q

What is the blood supply to the gall bladder?

A

The cystic artery, a branch of the right hepatic artery (in approx. 75% of people)

52
Q

What structure lies posterior to the gall bladder?

A

Duodenum

53
Q

Where do the pain afferents from the gall bladder enter the spinal cord?

A

T6-T9

54
Q

The common bile duct is formed from the union of which two structures?

A

Cystic duct and common hepatic duct

55
Q

Where does the bile duct drain into?

A

The second part of the duodenum

56
Q

What is endoscopic retrograde cholangiopancreatography (ERCP)?

A

Investigation used to study the biliary tree and pancreas and treat certain associated pathologies
Using an endoscope, radio-opaque dye is injected into the major duodenal papilla and radiographic images taken of the dye-filled biliary tree

57
Q

Where does the bile duct descend to reach the second part of the duodenum?

A

Posterior to the first part of the duodenum and into a groove in the posterior aspect of the pancreas

58
Q

Where do the pancreatic duct and the common bile duct both drain into?

A

Ampulla of Vater

59
Q

Which structure controls the drainage of products from the biliary tree into the duodenum?

A

Sphincer of Oddi/major duodenal papilla

60
Q

What does the uncinate process of the pancreas lie posterior to?

A

The superior mesenteric vessels

61
Q

Where is the pancreas?

A

Retroperitoneal organ

Lies transversely across the posterior abdomen at the level of T12 and L1

62
Q

What lies posterior to the pancreas?

A

Kidneys and adrenal glands, IVC, bile duct, abdominal aorta, superior mesenteric vessels (except uncinate process)

63
Q

What lies anteriorly to the pancreas?

A

Stomach

64
Q

What is the blood supply to the pancreas?

A

Pancreatic artery - a branch of the splenic artery

Gastroduodenal artery - becomes the superior & inferior pancreaticoduodenal artery

65
Q

Which part of the duodenum is partially intraperitoneal, and where lies the rest of it?

A

1st part is partially intraperitoneal

2nd, 3rd and 4th parts are retroperitoneal

66
Q

What structure do the vessels supplying the jejunum and ileum lie within?

A

The mesentery

67
Q

What is the name given to the specialised lymphatic vessels of the small intestine which absorb chylomicrons?

A

Lacteals

68
Q

What are the main groups of lymph nodes draining the abdominal organs?

A 
Celiac (draining foregut organs)
Superior mesenteric (draining midgut organs)
Inferior mesenteric (draining hindgut organs)
Lumbar (draining kidneys, posterior abdominal wall, pelvis and lower limbs)
69
Q

What is the main function of the rectum, anal canal and anus?

A

To excrete formed stool/faeces

70
Q

What are the three requirements for faecal continence?

A

A “holding area” i.e. the rectum
Normal visceral afferent fibres to sense fullness of rectum
Functioning muscle sphincters

71
Q

Which anatomical cavity does the rectum lie within?

A

The pelvis

72
Q

Which anatomical cavity do the anus & anal canal lie within?

A

Perineum

73
Q

What is the levator ani?

A

Pelvic floor muscles

74
Q

What is the rectosigmoid junction?

A

The point at which the sigmoid colon becomes the rectum at the level of S3

75
Q

At which point does the rectum become the anal canal?

A

Just anterior to the tip of the coccyx, just prior to passing through the levator ani muscle

76
Q

What is the rectal ampulla and where does it lie?

A

Dilated distal part of the rectum, used for holding faeces

Lies immediately superior to the levator ani muscle

77
Q

What is the nerve supply to the levator ani muscle?

A

The “nerve to levator ani”, a branch of the sacral plexus

78
Q

Which part of the levator ani muscle is particularly important in maintaining faecal continence and why?

A

Puborectalis muscle

Contraction of this muscle decreases the anorectal angle - it acts like a sphincter

79
Q

Which type of muscle does the internal anal sphincter consist of?

A

Smooth muscle

80
Q

Which type of muscle does the external anal sphincter consist of?

A

Skeletal muscle

81
Q

Where does the internal anal sphincter surround in relation to the anal canal?

A

Superior 2/3 of anal canal

82
Q

Where does the external anal sphincter surround in relation to the anal canal?

A

Inferior 2/3

83
Q

Which nerve stimulates contraction of the external anal sphincter?

A

Pudendal nerve

84
Q

Contraction of the internal anal sphincter is stimulated by which nerve supply?

A

Sympathetic

85
Q

What do the somatic motor nerve fibres in the pudendal nerve and levator ani muscle do and where in the spinal cord do they exit?

A

Pudendal (S2, S3, S4)
Nerve to levator ani (S3, S4)
Stimulate the external anal sphincter and puborectalis to contract

86
Q

What do the visceral afferent nerve fibres from the rectum run alongside and where do they enter the spinal cord?

A

Parasympathetic nerve fibres

Enter spinal cord at S2, S3, S4

87
Q

What do the visceral afferent nerve fibres from the rectum do?

A

They sense ischaemia, stretch and fullness of rectal ampulla

88
Q

What is the pectinate line?

A

Marks the junction between the endoderm and ectoderm from embryological development
Marks the difference between the two types of tissue in the anal canal - columnar epithelium superiorly, stratified squamous epithelium inferiorly

89
Q

Which structures do the internal iliac lymph nodes drain?

A

Inferior pelvic structures

90
Q

Which structures do the external iliac lymph nodes drain?

A

Superior pelvic structures

Lower limb

91
Q

Where do the common iliac nodes drain from and to?

A

Drain from the external and internal iliac nodes

Drain to the lumbar nodes

92
Q

Which artery supplies the proximal 1/2 of the anal canal?

A

Superior rectal artery - a branch of the IMA

93
Q

Which artery supplies the distal 1/2 of the anal canal?

A

The middle and inferior rectal arteries - branches of the internal iliac artery

94
Q

What is a haemorrhoid?

A

The prolapse of the internal and external rectal venous plexus
This is not related to portal hypertension

95
Q

What are the ischioanal fossae?

A

Structures consisting of fat and loose connective tissue which lie on either side of the anal canal

Gastrointestinal (17 decks)

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