Abdomen 4 Flashcards by syed kamran

How long is the oesophagus?

25cm

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What are the functions of the oesophagus?

Functions to transport food from pharynx to
stomach

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Where does the oesophagus extend from?

Extends from pharyngo-oesophageal junction
(C6) to cardiac orifice of stomach (T11)

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Where does the oesophagus pierce the diaphragm at?

Pierces diaphragm at oesophageal hiatus (T10)

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What are the 2 anti-reflux barrier sphincters?

Upper esophageal sphincter
Lower oesophageal sphincter

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What is the upper oesophageal sphincter?

Anatomical sphincter composed off
Cricopharyngeus muscle

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What can a malfunction of the lower oesophageal sphincter result in?

Malfunction of sphincter:
Gastrooesophageal reflux disorder (GORD)
may lead to Barrett’s oesophagus

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What are the 4 oesophageal layers?

Mucosa
Submucosa
Muscularis externa
Adventitia(proximal)/ serosa(very distal end)

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Where are the constrictions of oesophagus?

ABCD
A-Arch of aorta
B-Bronchus
C-Cricoid cartilage
D-Diaphragmatic hiatus

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What is the function of the stomach?

-Storage of ingested food
-Mechanical and chemical breakdown of food
-Regulate rate of emptying into small intestines

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What is the cardia part of the stomach?

Opening of oesophagus into stomach

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What shape is the fundus?

Dome shaped

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What colour does the fundus appear on an x-ray and why?

-Black on an x-ray as its full of gas

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What does the sphincter of the cardiac orifice prevent?

Cardiac
sphincter
prevents
backflow of
food and
digestive
enzymes to
oesophagus

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What does the pyloric sphincter open into?

Opens into duodenum

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What is the gastric canal?

Temporary groove formed when swallowing

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What are gastric rugae/folds?

Folds in gastric mucosa

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What do gastric rugae allow the stomach to do?

Allows stomach to expanad

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What is an example of 3 gastric glands?

Cardiac glands: mucus
Fundic glands: Hydrochloric acid
Pyloric glands: gastrin

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What is the mucosa of the stomach made up of?

Columnar epithelium

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What is the submoca made up of?

Meissner’s(submucosal) plexus

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What is the Auerbach’s plexus made of?

Muscularis externa:
-Oblique layer
-Circular layer
-Longitudinal layer

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What is the serosa continuous with?

Serosa continuous with peritoneum

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Where does the duodenum receives chyme from?

Chyme from pyloric part of
stomach.

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Where does the duodenum receive bile from via?

Bile from liver and gallbladder via common bile duct

Where does the duodenum receive enzyme from and via what?

Enzymes from pancreas via main and accessory pancreatic duct

What are the 4 divisions of the duodenum?

1. First part/Superior 2. Second part/Descending 3. Third part/Inferior/Horizontal 4. Fourth part/Ascending

Is the duodenal cap within the peritoneum?

Yes its intraperitoneal

Is the distal portion of the duodenum in the peritonem?

No it is retroperitoneal

What is the first part of the duodenum a common site of?

Common site of duodenal ulcers

Why are there clinical consequences of duodenal ulcers in the first part?

Clinical consequence, as gastroduodenal artery runs posteriorly

What is the first part of the duodenum suspended from?

Suspended from mesentery (hepatoduodenal ligament)

What is the duodenum the most common site for?

Most common site for diverticula

What is the second part of the duodenum the opening of?

1. Hepatopancreatic ampulla 2. Accessory pancreatic duct

What does the hepatopancreatic ampulla mark division of?

Marks division of foregut and midgut

What vertebrae level is the third part of the duodenum?

Level of L3

What vasculature is the third part of the duodenum crossed by?

Crossed by superior mesenteric artery and vein

What does the duodenum join at the fourth part of the duodenum?

Joins jejunum at duodenojejunal flexure

What ligaments is the fourth part of the duodenum held by?

Held in place by ligament of Treitz (suspensory ligament of the duodenum)

What is the relative position of the pancreas to the stomach?

Posterior to stomach

What part of the pancreas does the transpyloric plane pass through and at what vertebrae level?

Transpyloric plane passes through neck (L1)

What is the exocrine function of the pancreas and what cells produce it?

Pancreatic juice: acinar cells

How do the pancreatic juices from the pancreas enter the duodenum?

Enters duodenum through main and accessory ducts

What is the endocrine function of the pancreas?

Glucagon and insulin: Pancreatic islets of Langerhans

What is a whipple's procedure?

Pancreaticoduodenectomy

Why would we carry out a Pancreaticoduodenectomy?

If there's cancer in the head of the pancreas

What is removed in a Pancreaticoduodenectomy?

1. Head of pancreas 2. Duodenum 3. Gallbladder 4. Bile duct

What is the spleen protected by?

Protected by 9th-11th ribs

What is the function of the spleen?

-White cell proliferation -Immune surveillance -Filters and stores red blood cells and platelets

What are the contents of the hilum of the spleen?

Splenic artery and vein

What do the splenic artery and vein run in?

Run in splenorenal ligament

What may cause splenomegaly?

May be caused by portal hypertension

Where may the spleen be palpable in splenomegaly?

May be palpable in right iliac fossa

How can splenomegaly be treated?

Can treat with splenectomy

What is the arterial supply of structures in the foregut?

Coeliac trunk

What is the arterial supply of structures in the midgut?

Superior mesenteric artery

What is the arterial supply of structures in the hindgut?

Inferior mesenteric artery

Where does the coeliac trunk arise and at what vertebrae level?

Arises directly from aorta (T12)

What are the 3 main branches of the coeliac trunk?

-Left gastric -Common hepatic -Splenic

What is the left gastric artery a branch of?

Branch of coeliac trunk

What does the left gastric artery run along?

Runs along lesser curvature in lesser omentum

What artery supplies the lower oesophagus?

Left gastric artery

What is the right gastric artery a branch of?

Branch of hepatic artery proper

What does the right gastric artery run along?

Runs along lesser curvature in lesser omentum

What are the short gastric arteries branches of?

Branches of splenic artery

What is the left gastro-omental/gastroepoploic artery a branch of?

Branch of splenic artery

What does the left gastro-omental/gastroepiploic artery run along?

Runs along Greater curvature in greater omentum

What is the right gastro-omental/gastroepiploic artery a branch of?

Branch of gastroduodenal artery

What does the right gastro-omental/gastroepiploic run along?

Runs along greater curvature in greater omentum

What is the arterial supply to pancreas and duodenum?

1. Splenic artery 2. Gastroduodenal artery 3. Inferior pancreaticoduodenal artery 4. Superior pancreaticoduodenal artery

What do the lymphatic vessels of the stomach follow?

Follow blood vessels

What do all lymph eventually pass in the stomach?

All lymph eventually passes into coeliac nodes

Why are the lymphatics of the stomach important?

Important for cancer spread: gastrectomy

How do the lymphatics of duodenum follow arteries superiorly?

Follows arteries superiorly from superior pancreaticoduodenal to gastroduodenal to coeliac nodes

How do the lymphatics of duodenum follow arteries inferiorly?

Follows arteries inferiorly from inferior pancreaticoduodenal to superior mesenteric nodes

What is the vagus nerve to gastric glands?

Secretomotor to gastric glands

What cells does the vagus nerve innervate in the foregut?

Innervates secretory cells

What does the vagus nerve motor to of the foregut?

Motor to smooth muscular walls of GIT (peristalsis)

What sphincter does the vagus nerve relax?

Relaxes pyloric sphincter

What trunk does the right vagus nerve innervate?

Posterior vagal trunk

What trunk does the left vagus nerve innervate?

Anterior vagal trunk

What do the greater splanchnic nerves do to blood vessels?

Vasoconstriction

What do greater splanchnic nerves inhibit

Inhibits peristalsis

What are greater splanchnic nerves motor to?

Motor to pyloric sphincter

What do pain fibers(visceral afferents) hitchhike with in the foregut?

Pain fibers (visceral afferent) hitchhike with splanchnic nerves

What is pain from foregut referred to?

Pain from foregut referred to epigastric region

What is the course from the preganglionic sympathetic fibres to the coeliac plexus?

Preganglionic sympathetic fibres (T5-T9)-->enters sympathetic chain-->Greater thoracic splanchnic nerve-->Coeliac plexus

Abdomen 4 Flashcards

(87 cards)