Lecture 9 - Alimentary 1 Flashcards

1
Q

What does the oral cavity consist of?

A

Vestibule and oral cavity proper

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2
Q

What does the vestibule consist of?

A

Space between lips/cheek and teeth/alveolar arches

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3
Q

What are the three divisions of the pharynx (be able to spell)

A

nasopharynx
oropharynx
laryngopharynx

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4
Q

Where does the nasopharynx extend?

A

choana (posterior opening of nose) to soft palate

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5
Q

Where does the oropharynx extend?

A

soft palate to epliglottis

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6
Q

Where does the laryngopharynx extend?

A

epiglottis to the top of the trachea

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7
Q

What does the wall of the pharynx consist of (2)?

A

mucosa and three vertically overlapping constrictor muscles

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8
Q

How are the regions of the gut divided?

A

By basis of arterial supply

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9
Q

What does the foregut consist of (4)?

A

Oesophagus, stomach, duodenum to just below greater duodenal papilla and organs which develop in mesentaries of the foregut

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10
Q

Which organs developed in the mesentaries of the foregut (4)

A

Liver, pancreas, gall bladder and ducts, spleen

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11
Q

What does the midgut comprise of (7)

A

duodenum from just below the greater duodenal papilla, jujunem, ileum, caecum, appendix, ascending colon, right two thirds of transverse colon

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12
Q

What does the hindgut consist of (5)

A

left one third of the transverse colon, descending colon, sigmoid colon, rectum and most of the anal canal

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13
Q

What four layers comprise the microstructure of the alimentary tract proper?

A

Mucosa, submucosa, external muscle, adventitia

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14
Q

What does the mucosa comprise of? (4)

A

Epithelium, glands, lamina propria, muscularis mucosa

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15
Q

What does the submucosa comprise of?

A

Connective tissue

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16
Q

What are the two types of muscle in the external muscle?

A

Inner circular and outer longitudinal

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17
Q

What is the adventitia connected to?

A

Either the surrounding fascia or the serosa (peritoneum)

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18
Q

Which direction is proximal vs distal?

A

Mouth vs anus

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19
Q

What is the oesophagus?

A

A muscular tube passing through the neck, thorax, and abdomen

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20
Q

What does the oesophagus connect?

A

The pharynx to the stomach

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21
Q

Trace the anatomical path of the oesophagus

A

C6 through superior and posterior mediastinum, through diaphragm about 2-3cm from midline at T10 (posterior to the central tendon of the diaphragm) and through the right crus to enter cardia of the stomach at T11

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22
Q

What is the relationship of the oesophagus to the aorta?

A

Lateral and anterior to the aorta

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23
Q

What is the oesophagus posterior to in relationship to the mediastinum ( 4)

A

Trachea, bronchi, pericardium and left atrium

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24
Q

What is the oesophagus anterior to in relationship to the mediastinum?

A

The vertebral column

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25
Q

What is the oesophagus medial to from T5-6 down?

A

thoracic duct, azygos and descending aorta

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26
Q

What is the lining epithelium made of in humans?

A

Non-keratinised stratified squamous

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27
Q

What is visible in prosections when the surrounding fascia of the mediastinum has been removed?

A

The outer longitudinal layer of external muscle

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28
Q

What gives the oeseophagus its characteristic appearance of longitudinal streaks?

A

The outer longitudinal layers of external muscle

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29
Q

What forms a plexus on the oesophagus?

A

The left and right vagus nerves

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30
Q

What does the plexus on the oesophagus go on to form?

A

Left and right vagal TRUNKS in the lower abdomen which pass through the diaphragm with the oesophagus

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31
Q

What is the posterior attachment of the abdominal oesophagus to the diaphragm

A

Gastrophrenic ligament

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32
Q

Where does the abdominal part of the oesophagus (1cm) run?

A

In a groove on the posterior surface of the liver to the cardia of the stomach

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33
Q

What is provides the contrast in the x-rays?

A

Barium swallow

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34
Q

Where are the four constrictions in the lumen?

A
  1. Commencement - upper oeseophageal sphincter or the cricopharyngeus
  2. Level of arch of the aorta
  3. level of left main bronchus
  4. Oesophageal hiatus - lower spincter
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35
Q

What does the lower oesophageal sphincter comprise of?

A

Specialised CIRCULAR muscle in the wall of oeseophagus at the level of the diaphragm and around the abdominal oesophagus

36
Q

What maintains the tone of the lower oesophageal sphincter?

A

Myenteric plexus

37
Q

When does the lower oesophageal sphincter relax?

A

During swallowing and vomiting

38
Q

What does the muscle of the right crus form?

A

External sphincter of the oesophagus

39
Q

What is the function of the external sphincter of the oesophagus?

A

Tightens during inspiration or when intraabdominal pressure is increased to prevent gastrooesophageal reflux

40
Q

In early development, what is attached to the posterior body wall by the dorsal mesentery?

A

The entire abdominal part of the gut tube

41
Q

In early development, what is attached to the anterior body wall by the ventral mesentery

A

The stomach and the foregut

42
Q

Which organs/systems form in the ventral mesentery during early development (3)

A

The liver, biliary system and ventral pancreas

43
Q

What does the ventral mesentery anterior to the liver form during early development

A

falciform ligament (supporting structure of the liver)

44
Q

During early development what forms the lesser omentum

A

The part of the ventral mesentery which is between the liver anteriorly and the stomach posteriorly

45
Q

What does the dorsal mesentery form during early development? (4)

A

Mesentery, mesoappendix, transverse mesocolon, sigmoid mesocolon

46
Q

What organs form within the dorsal mesentery during early development (2)

A

Dorsal pancreas and spleen

47
Q

What is fixation of the intestines?

A

Where regions destined to be retroperitoneal, the dorsal mesentery fuses with the posterior wall and is subsequently obliterated

48
Q

The dorsal and ventral pancreas fuse during development true or false?

A

True

49
Q

Why are the post natal positions of the organs very different to early development?

A

Due to complex rotation and rearrangement

50
Q

What is the greater omentum?

A

A double fold of peritoneum

51
Q

What is the greater omentum attached to

A

The greater curvature of the stomach and the first part of the duodenum

52
Q

What is the greater omentum continuous with?

A

Gastrosplenic or gastrolienal ligament - The ligament that attaches the stomach to the spleen

53
Q

What is the greater omentum also attached to?

A

The transverse mesocolon

54
Q

The greater omentum adheres to the organs under normal circumstances true or false?

A

False

55
Q

What does the greater omentum hang down to cover?

A

The anterior surface of most of the abdominal organs

56
Q

Fully formed omentum has mesothelium on the posterior surface only, true or false?

A

False, it has mesothelium on both surfaces

57
Q

What is the defining characteristic of fully formed greater omentum?

A

It is shiny (mesothelium) with fatty regions separated by translucent fat free regions, grainy appearance

58
Q

How does the appearance of the greater omentum differ to the mesentery

A

Mesentery has a more even distribution of fat (but also has mesothelium on both posterior and anteriorsurfaces)

59
Q

What can you also recognised in unembalmed greater omentum?

A

Macrophages which appear as whitish, opaque ‘milk spots’

60
Q

Give the development of the greater omentum in a fetus (4)

A

Initially a bag-like structure
Inner layers fuse
Then disappear to give a single structure
Transverse mesocolon becomes attached to posterior surface of the greater omentum

61
Q

What is the function of the greater omentum (2)?

A

Protective via macrophages and other immune cells, also adheres to areas of peritoneal damage and inflammation

62
Q

Where does the lesser omentum extend?

A

From the lesser curvature of the stomach and the first part of the duodenum to the posterior surface of the liver

63
Q

What does the lesser omentum terminate as and on what side?

A

A free edge on the right

64
Q

Where does the free edge extend?

A

From the duodenum to the posterior liver

65
Q

What runs through the lesser omentum just to the left of the free edge? (5)

A

Hepatic artery, portal vein, bile duct, lymph vessels and nerves

66
Q

What is the lesser sac or omental bursa

A

The space posterior to the stomach and lesser omentum

67
Q

What does the omental bursa allow for?

A

Movement and expansion of the stomach

68
Q

What is the greater sac?

A

The rest of the peritoneal cavity that is not the omental bursa/lesser sac

69
Q

What is the epiploic or omental foramen

A

The opening behind the free edge of the lesser omentum

70
Q

What connects the greater and lesser sacs?

A

The omental or epiploic foramen

71
Q

What is at the posterior wall of the omental bursa?

A

The stomach bed

72
Q

What does the stomach bed include (5)

A

Upper pole of left kidney and left suprarenal, diaphragm, part of spleen, pancreas, part of transverse mesocolon

73
Q

Stomach bed includes retroperitoneal structures true or false?

A

True

74
Q

The stomach is highly distensable true or false,?

A

True

75
Q

What is the function of the stomach (2)

A

Food storage and digestion

76
Q

What doe the stomach consist of (4)

A

Cardia, fundus, body and pyloric part

77
Q

What does the pyloric part of the stomach consist of (3)?

A

Antrum, canal and sphincter

78
Q

What are some other non-main features of the stomach (4)

A

Cardiac notch, angular incisure, lesser curvature and greater curvature

79
Q

The cardia and fundus are fairly mobile, true or false?

A

False

80
Q

What are the temporary, internal longitudinal folds of the stomach called?

A

Rugae

81
Q

What are the anterior relationships of the stomach? (2)

A

Liver, diaphragm

82
Q

What are the posterior relationships of the stomach (2)?

A

Omental bursa and the structures of the stomach bed

83
Q

Where is the cardiac orifice of the stomach anatomically?

A

The 7th costal cartilage which attaches at the xiphosternal joint and is 3cm left of the midline

84
Q

Where is the pyloric sphincter surface anatomy wise

A

Roughly at the level of the transpyloric plane (halfway between the suprasternal notch and pubic symphysis)

85
Q

What is the function of stomach mucosa?

A

To produce mucus in the cardia and pyloric part

86
Q

Which parts of the stomach (2) produce digestive enzymes and HCl

A

fundus and body