Abdomen 4 Flashcards

1
Q

How long is the oesophagus?

A

25cm

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2
Q

What are the functions of the oesophagus?

A

Functions to transport food from pharynx to
stomach

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3
Q

Where does the oesophagus extend from?

A

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

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4
Q

Where does the oesophagus pierce the diaphragm at?

A

Pierces diaphragm at oesophageal hiatus (T10)

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5
Q

What are the 2 anti-reflux barrier sphincters?

A
  1. Upper esophageal sphincter
  2. Lower oesophageal sphincter
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6
Q

What is the upper oesophageal sphincter?

A

Anatomical sphincter composed off
Cricopharyngeus muscle

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7
Q

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

A

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

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8
Q

What are the 4 oesophageal layers?

A
  1. Mucosa
  2. Submucosa
  3. Muscularis externa
  4. Adventitia(proximal)/ serosa(very distal end)
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9
Q

Where are the constrictions of oesophagus?

A

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

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10
Q

What is the function of the stomach?

A

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

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11
Q

What is the cardia part of the stomach?

A

Opening of oesophagus into stomach

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12
Q

What shape is the fundus?

A

Dome shaped

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13
Q

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

A

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

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14
Q

What does the sphincter of the cardiac orifice prevent?

A

Cardiac
sphincter
prevents
backflow of
food and
digestive
enzymes to
oesophagus

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15
Q

What does the pyloric sphincter open into?

A

Opens into duodenum

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16
Q

What is the gastric canal?

A

Temporary groove formed when swallowing

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17
Q

What are gastric rugae/folds?

A

Folds in gastric mucosa

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18
Q

What do gastric rugae allow the stomach to do?

A

Allows stomach to expanad

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19
Q

What is an example of 3 gastric glands?

A
  1. Cardiac glands: mucus
  2. Fundic glands: Hydrochloric acid
  3. Pyloric glands: gastrin
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20
Q

What is the mucosa of the stomach made up of?

A

Columnar epithelium

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21
Q

What is the submoca made up of?

A

Meissner’s(submucosal) plexus

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22
Q

What is the Auerbach’s plexus made of?

A

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

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23
Q

What is the serosa continuous with?

A

Serosa continuous with peritoneum

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24
Q

Where does the duodenum receives chyme from?

A

Chyme from pyloric part of
stomach.

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25
Q

Where does the duodenum receive bile from via?

A

Bile from liver and gallbladder via common bile
duct

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26
Q

Where does the duodenum receive enzyme from and via what?

A

Enzymes from pancreas via main and accessory
pancreatic duct

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27
Q

What are the 4 divisions of the duodenum?

A
  1. First part/Superior
  2. Second part/Descending
  3. Third part/Inferior/Horizontal
  4. Fourth part/Ascending
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28
Q

Is the duodenal cap within the peritoneum?

A

Yes its intraperitoneal

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29
Q

Is the distal portion of the duodenum in the peritonem?

A

No it is retroperitoneal

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30
Q

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

A

Common site of duodenal ulcers

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31
Q

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

A

Clinical consequence, as gastroduodenal
artery runs posteriorly

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32
Q

What is the first part of the duodenum suspended from?

A

Suspended from mesentery (hepatoduodenal
ligament)

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33
Q

What is the duodenum the most common site for?

A

Most common site for diverticula

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34
Q

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

A
  1. Hepatopancreatic ampulla
  2. Accessory pancreatic duct
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35
Q

What does the hepatopancreatic ampulla mark division of?

A

Marks division of foregut and midgut

36
Q

What vertebrae level is the third part of the duodenum?

A

Level of L3

37
Q

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

A

Crossed by superior mesenteric artery and vein

38
Q

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

A

Joins jejunum at duodenojejunal
flexure

39
Q

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

A

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

40
Q

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

A

Posterior to stomach

41
Q

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

A

Transpyloric plane passes through neck (L1)

42
Q

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

A

Pancreatic juice: acinar cells

43
Q

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

A

Enters duodenum through main and
accessory ducts

44
Q

What is the endocrine function of the pancreas?

A

Glucagon and insulin: Pancreatic islets of
Langerhans

45
Q

What is a whipple’s procedure?

A

Pancreaticoduodenectomy

46
Q

Why would we carry out a Pancreaticoduodenectomy?

A

If there’s cancer in the head of the pancreas

47
Q

What is removed in a Pancreaticoduodenectomy?

A
  1. Head of pancreas
  2. Duodenum
  3. Gallbladder
  4. Bile duct
48
Q

What is the spleen protected by?

A

Protected by 9th-11th ribs

49
Q

What is the function of the spleen?

A

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

50
Q

What are the contents of the hilum of the spleen?

A

Splenic artery and vein

51
Q

What do the splenic artery and vein run in?

A

Run in splenorenal ligament

52
Q

What may cause splenomegaly?

A

May be caused by portal hypertension

53
Q

Where may the spleen be palpable in splenomegaly?

A

May be palpable in right iliac fossa

54
Q

How can splenomegaly be treated?

A

Can treat with splenectomy

55
Q

What is the arterial supply of structures in the foregut?

A

Coeliac trunk

56
Q

What is the arterial supply of structures in the midgut?

A

Superior mesenteric artery

57
Q

What is the arterial supply of structures in the hindgut?

A

Inferior mesenteric artery

58
Q

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

A

Arises directly from aorta (T12)

59
Q

What are the 3 main branches of the coeliac trunk?

A

-Left gastric
-Common hepatic
-Splenic

60
Q

What is the left gastric artery a branch of?

A

Branch of coeliac trunk

61
Q

What does the left gastric artery run along?

A

Runs along lesser curvature in lesser
omentum

62
Q

What artery supplies the lower oesophagus?

A

Left gastric artery

63
Q

What is the right gastric artery a branch of?

A

Branch of hepatic artery proper

64
Q

What does the right gastric artery run along?

A

Runs along lesser curvature in
lesser omentum

65
Q

What are the short gastric arteries branches of?

A

Branches of splenic artery

66
Q

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

A

Branch of splenic artery

67
Q

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

A

Runs along Greater curvature in greater omentum

68
Q

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

A

Branch of gastroduodenal artery

69
Q

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

A

Runs along greater curvature in greater omentum

70
Q

What is the arterial supply to pancreas and duodenum?

A
  1. Splenic artery
  2. Gastroduodenal artery
  3. Inferior pancreaticoduodenal artery
  4. Superior pancreaticoduodenal artery
71
Q

What do the lymphatic vessels of the stomach follow?

A

Follow blood vessels

72
Q

What do all lymph eventually pass in the stomach?

A

All lymph eventually passes into coeliac nodes

73
Q

Why are the lymphatics of the stomach important?

A

Important for cancer spread: gastrectomy

74
Q

How do the lymphatics of duodenum follow arteries superiorly?

A

Follows arteries
superiorly from superior
pancreaticoduodenal to
gastroduodenal to
coeliac nodes

75
Q

How do the lymphatics of duodenum follow arteries inferiorly?

A

Follows arteries inferiorly
from inferior
pancreaticoduodenal to
superior mesenteric
nodes

76
Q

What is the vagus nerve to gastric glands?

A

Secretomotor to gastric glands

77
Q

What cells does the vagus nerve innervate in the foregut?

A

Innervates secretory cells

78
Q

What does the vagus nerve motor to of the foregut?

A

Motor to smooth muscular walls of GIT (peristalsis)

79
Q

What sphincter does the vagus nerve relax?

A

Relaxes pyloric sphincter

80
Q

What trunk does the right vagus nerve innervate?

A

Posterior vagal trunk

81
Q

What trunk does the left vagus nerve innervate?

A

Anterior vagal trunk

82
Q

What do the greater splanchnic nerves do to blood vessels?

A

Vasoconstriction

83
Q

What do greater splanchnic nerves inhibit

A

Inhibits peristalsis

84
Q

What are greater splanchnic nerves motor to?

A

Motor to pyloric sphincter

85
Q

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

A

Pain fibers (visceral afferent) hitchhike with splanchnic nerves

86
Q

What is pain from foregut referred to?

A

Pain from foregut referred to epigastric region

87
Q

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

A

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