Foregut, Midgut & Hindgut Flashcards

1
Q

Where does the Oesophagus start and end?

A

Distal laryngopharynx @C6/7

Ends at cardia of stomach @T11

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2
Q

How long is the Oesophagus?

A

40cm from incisors to stomach. (Important when inserting tubes)

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3
Q

Describe the right crus of diaphragm

A

Loop of muscle; forms lower oesophageal sphincter (Not a ‘true’ anatomical sphincter, because it is not a ring of muscle). @T11-12

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4
Q

How does the epithelium change between the lower oesophagus and stomach?

A

Stratified squamous in oesophagus

Columnar epithelium in stomach

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5
Q

What are mesenteries?

A

Mesenteries (ventral & dorsal) are double-layered folds of peritoneum attaching the gut tube to the body wall.

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6
Q

Of the foregut, midgut and hindgut, which have dorsal or ventral mesenteries, or both?

A

Foregut - Dorsal and Ventral

Mid and Hindgut - Dorsal ONLY

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7
Q

Describe the lesser omentum

A

Peritoneum between the stomach & liver

Composed of 2 Ligaments: Hepatoduodenal and Hepatogastric

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8
Q

Describe the greater omentum

A

The peritoneum hanging off the greater curvature of stomach

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9
Q

The Hepatoduodenal ligament contains which 3 structures?

A

Portal Vein
Hepatic Artery
Common Bile Duct

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10
Q

Peritoneal folds develop from…

They differentiate into…

A

Develop from Dorsal and Ventral mesenteries

Omenta, Mesenteries and Ligaments

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11
Q

Name the omenta of the peritoneal cavity

A
Greater Omentum 
(From dorsal mesentery)

Lesser Omentum
(From ventral mesentery)

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12
Q

Name the mesenteries of the peritoneal cavity

A

Mesentery
(Suspends small bowel)

Transverse Mesocolon
(Suspends transverse colon)

Sigmoid Mesocolon
(Suspends sigmoid colon)

Mesoappendix
(suspends appendix)

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13
Q

Name the ligaments of the peritoneal cavity

A

Hepatoduodenal
(Part of lesser omentum)

Hepatogastric
(Part of lesser omentum)

Splenorenal & Gastrosplenic Ligs.
(From spleen to kidney / from stomach to spleen)

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14
Q

What level does the coeliac trunk come off at?

A

T12

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15
Q

What level does the SMA come off at?

A

L1

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16
Q

What level does the IMA come off at?

A

L3

17
Q

What branches off the coeliac trunk?

A

Common Hepatic, Left Gastric & Splenic arteries

18
Q

What could damage the gastroduodenal artery?

A

Peptic Ulcers

Especially posterior to 1st part of duodenum.

19
Q

Name the retroperitoneal organs

A
S: suprarenal (adrenal) gland
A: aorta/IVC
D: duodenum (second and third part)
P: pancreas (except tail)
U: ureters
C: colon (ascending and descending)
K: kidneys
E: (o)esophagus
R: rectum
20
Q

Name the intraperitoneal organs

A
S = Stomach
A = Appendix
L = Liver
T = Transverse colon
D = duodenum (only the 1st part)
S = Small intestines
P = Pancreas (only the tail)
R = Rectum (only the upper 3rd)
S = Sigmoid colon
S = Spleen
21
Q

Describe the duodenum anatomically.

A

The duodenum is C-shaped and is retroperitoneal (except for the 1st part)
Composed of 4 Parts

22
Q

What ligament is a useful landmark for the duodeno-jejunal flexure

A

Ligament of Treitz
Marker point for ‘upper’ vs ‘lower’ GI bleed
Suspends the 4th pt. (ascending part) of the duodenum to the posterior abdominal wall.

23
Q

Where does the arterial supply for the pancreas and and duodenum come from?

A

Superior Pancreaticoduodenal artery (from CT)

anastamoses with Inferior Pancreaticoduodenal artery (from SMA).

24
Q

Where does the caecum sit?

A

Right Iliac Fossa

25
Q

What is Teniae Coli?

A

Longitudinal muscle of colon

Sits in 3 bands that begin at caecum (appendix) and end by covering the rectum

26
Q

What are the pouches of the large intestine called?

A

Haustra

27
Q

What position is the appendix normally in?

A

Retrocaecal in 60% of people.

28
Q

What is Intussusception?

A

Proximal segment of bowel telescopes into an adjacent distal segment
Typically in ileocecal junction

29
Q

Describe the appendix

A

Blind ended sac

Has own mesentery and artery (SMA -> Ileocolic a. -> Appendicular a.)

30
Q

Why is the hepatorenal recess important to consider in a supine patient, with peritonitis?

A

Infections can spread from under the diaphragm to pelvic cavity and vice versa via Paracolic Gutters.

31
Q

Describe the arterial supply of the hindgut (route).

A

IMA -> Left colic, Sigmoidal (Join the Marginal A.)
and Superior Rectal

SMA, IMA and Internal Iliac anastamose (Marginal artery)

32
Q

Where are the 3 important Portosystemic Anastomoses? What are the clinically significant conditions related to these?

A

Lower End of the Oesophagus (!Oesophageal Varices)
Lower part of Anal Canal (!Anorectal Varices)
Umbilical Region of Anterior Abdo Wall (!Caput Medusae)

33
Q

What are Haemorrhoids?

A

Prolapsed varicosity of internal venous plexus from excessive straining during defecation.
NOT Anorectal Varices!

34
Q

What positions are Haemorrhoids classically reported on the Anus?

A

3, 7 and 11 o’clock

35
Q

Describe what you might see in a barium contract test, if the patient had colon carcinoma?

A

Apple core sign

36
Q

Where do GI structures’ lymph drain to?

A

Thoracic duct and cisterna chyli