Alimentary System Overview 2 Flashcards
1
Q
What are the 9 regions of the GIT?
A
- R Hypochondrium
- Epigastrium
- L Hypochondrium
- R Lumbar
- Periumbilical
- L Lumbar
- R Iliac fossa
- Hypogastrium
- L Iliac fossa
2
Q
What ailments can affect the foregut?
A
- Peptic ulcer
- Gastric disease
- Biliary disease
- Pancreatic disease
- Hepatic disease
3
Q
What ailments can affect the midgut?
A
- Appendicitis
- Small bowel obstruction
- Proximal colon cancer
4
Q
What ailments can affect the hindgut?
A
- Large bowel obstruction
- Diverticular disease
- Carcinoma of the colon
5
Q
What is the oesophagus?
A
Muscular tube that normally has 3 constrictions
6
Q
How long is the oesophagus?
A
25cm
7
Q
What are the constrictions of the oesophagus?
A
- Cervical
- Thoracic
- Diaphragmatic
8
Q
Where is the cervical constriction of the oesophagus?
A
15cm from the incisor teeth
9
Q
What is the thoracic constriction of the oesophagus crossed by?
A
- Arch of the aorta (22.5 cm from incisor teeth)
- Left main bronchus (27.5 cm form incisor teeth)
10
Q
What is the diaphragmatic constriction of the oesophagus?
A
Where it passes through the oesophageal hiatus of the diaphragm (40cm from the incisor teeth)
11
Q
Why is awareness of the constrictions of the oesophagus important?
A
For passing instruments through the oesophagus into the stomach
12
Q
What are the parts of the stomach?
A
- Cardia
- Fundus
- Body
- Pyloric part
13
Q
What are the curvatures of the stomach?
A
- Greater
- Lesser
14
Q
What is the pyloric sphincter in charge of?
A
Control of discharge of stomach contents into the duodenum
15
Q
What does the stomach bed consist of?
A
- Diaphragm
- Spleen
- Left kidney
- Adrenal gland
- Splenic artery
- Pancreas
- Transverse mesocolon
- Colon
16
Q
Congenital pyloric stenosis
A
Thickening of smooth muscle in the pylorus
17
Q
What is the portal triad of the liver?
A
- Hepatic artery
- Portal vein
- Bile duct
18
Q
What is the surface anatomy of the liver?
A
Lies deep to ribs 7-11 on the right side
19
Q
Where is the portal triad of the liver found?
A
Lesser omentum
20
Q
What do the biliary ducts do?
A
Carry bile form the liver to the gallbladder
21
Q
Where is bile produced?
A
Liver
22
Q
Where is bile concentrated and stored?
A
Gall bladder
23
Q
How much bile can the gallbladder store?
A
Up to 50ml
24
Q
What is the artery of the gallbladder?
A
Cystic artery
25
Where does the cystic artery lie?
Lies in the triangle of calot
26
What is the triangle of calot?
Triangle between common hepatic duct, cystic duct and visceral surface of liver
27
What is the pancreas?
Accessory digestive gland
28
What does the pancreas produce as an exocrine gland?
Pancreatic juice
29
What does the pancreas produce as an endocrine gland?
Insulin and glucagon
30
Where does the pancreas lie?
Lies along the transpyloric plane (L1/L2)
31
What are the parts of the pancreas?
- Head
- Neck
- Body
- Tail
32
Where is the portal vein formed?
Behind the neck of the pancreas
33
How does the pancreas lie in relation to the peritoneum?
Retroperitoneal
34
What is the spleen?
Mobile haemo-lymphoid organ
35
Where is the spleen located?
Left hypochondrium
36
How is the spleen covered?
Entirely covered by the peritoneum except at the hilum
37
What is the surface anatomy of the spleen?
Ribs 9-11 on the left side
38
What is the most frequently injured abdominal organ?
Spleen
39
Splenomegaly
Abnormal enlargement of spleen
40
What are some causes of splenomegaly?
- Anaemia
| - Typhoid fever
41
What is the blood supply of the foregut?
Celiac trunk
42
What is the origin of the celiac trunk?
Abdominal aorta (T12)
43
What are the main branches of the celiac trunk?
- Left gastric artery
- Hepatic artery
- Splenic artery
44
What does the left gastric artery run along?
The lesser curvature of the stomach
45
What does the hepatic artery supply?
Liver and the gallbladder
46
What does the splenic artery run along?
Runs retroperitoneally along the superior margin of the pancreas
47
What constitutes midgut structures?
- Small intestine including most of the duodenum
- Cecum
- Appendix
- Ascending colon
- Right 1/2-2/3rds of the transverse colon
48
What is the duodenum?
Shortest, widest and most fixed part of the small intestine
49
What does the 2nd part of the duodenum receive?
- Bile
| - Pancreatic duct
50
Duodenal ulcer
Inflammatory erosions of the duodenal wall (mostly 1st part)
51
Colour of jejunum
Deep red
52
Wall of jejunum
Thick and heavy
53
Vascularity of jejunum
Grater than ileum
54
Vasa recta of jejunum
Long
55
Arcades of jejunum
A few large loops
56
Lymphois nodules (peyers patches) of jejunum
Few
57
Fat in mesentery of jujunum
Less than ileum
58
Colour of ileum
Pale pink
59
Wall of ileum
Thin and light
60
Vascularity of ileum
Less than jejunum
61
Vasa recta of ileum
Short
62
Arcades of ileum
Many short loops
63
Lymphoid nodules (peyers patches) of ileum
Many
64
Fat in mesentery of ileum
More than jejunum
65
What is the blood supply of the midgut?
Superior mesenteric artery
66
What is the origin of the superior mesenteric artery?
Branch of the abdominal aorta at L1
67
What are the main branches of the superior mesenteric artery?
Jejunal and ileal arteries
68
What branches other than the main branches of the superior mesenteric artery are there?
- Middle colic
- Right colic
- Iliocolic
69
What crosses the superior mesenteric artery anteriorly?
Splenic vein and neck of pancreas
70
What constitutes hindgut structures?
- Left 1/3rd of transverse colon
- Descending colon
- Sigmoid colon
- Rectum
- Upper part of anal canal
71
What is the artery of the hindgut?
Inferior mesenteric artery
72
What epithelium is part of the hindgut?
Urinary bladder and most of the urethra
73
How can the large intestine be distinguished from the small intestine?
- Omental appendices
- Haustra or sacculations
- Teniae coli
74
Omental appendices
Small, fatty peritoneal like projections
75
Teniae coli
Thickened bands of smooth muscle
76
What is the appendix?
Blind intestinal diverticulum with masses of lymphatic tissue
77
What is the position of the appendix?
Variable in position but most common is retrocecal
78
Macburneys point
Site of maximum tenderness in acute appendicitis
79
What is the origin of the inferior mesenteric artery?
Anterior branch of abdominal aorta L3
80
What are the branches of the inferior mesenteric artery?
- Left colic
- Sigmoid arteries
- Superior rectal artery
81
What is the terminal branch of the inferior mesenteric artery?
Superior rectal artery
82
What is the rectum?
Pelvic part of the gut tube
83
Where does the recto-sigmoid junction lie?
Anterior to S3 vertebra
84
What is the anal canal made up of?
External and internal anal sphincters
85
What structure is palpated only in females during a rectal examination?
Cervix
86
What structures are palpated only in males during a rectal examination?
- Prostate
| - Seminal gland
87
What structures are palpated in both sexes during a rectal examination?
- Ischial spines and tuberosities
- Enlarged internal iliac lymph nodes/ swelling in the ischioanal fossa
- Sacrum
- Coccyx
- Collections in rectovesical (male) and rectouterine fossa (female)
88
What parasympathetic innervation of the abdominal organs are there?
- Vagus nerve (10th cranial nerve)
| - Pelvic splanchnic nerves (S2,S3,S4)
89
What sympathetic innervation of the abdominal organs are there?
-Abdominopelvic splanchnic nerves (greater T5-T9, lesser T10-T11 and least T12)
-Prevertebral sympathetic ganglia
Abdominal aortic plexus
90
What is the venous drainage of the abdominal part of the GIT?
Portal vein
91
What does the portal vein do?
-Collects poorly oxygenated but nutrient rich blood from the abdominal part of the GIT including the spleen, pancreas and gall bladder and carries it to the liver
92
How is the portal vein formed?
By the union of splenic vein with the superior mesenteric vein
93
What is the location of the portal vein?
Behind the neck of the pancreas (L2)
94
What are common sites of porto-systemic anastomoses?
- Anorectal junction
- Gastroesophageal junction
- Around the umbilicus
95
What are porto-systemic anastomoses at the snorectal junction known as?
Haemorrhoids or piles
96
What are porto-systemic anastomoses at the gastroeophageal junction known as?
Oesophageal varices
97
What are porto-systemic anastaomoses around the umbilicus known as?
Caput medusae
98
What are portocaval shunts?
Venous enlargements during portal obstruction
99
What is the lymphatic drainage of the GIT?
The thoracic duct receives most of the lymph from the abdominal wall and abdominal organs
100
How do lymphatic vessels run?
Run with their corresponding arteries
101
What do lymphatic nodes form?
Groups around the major arteries and abdominal aorta
102
What are the 3 terminal groups included in lumbar nodes?
- Pre-aortic
- Lateral aortic
- Retro-aortic
103
What nodes are pre-aortic?
- Celiac
| - Superior and inferior mesenteric
104
What do pre-aortic nodes do?
Drains organs supplied by the anterior branches of aorta
105
What do lateral aortic nodes do?
Drains organs supplied by lateral aortic branches
106
What do retro-aortic nodes do?
Drains the posterior abdominal wall
107
What group of nodes is associated with foregut structures?
Celiac group
108
What group of nodes is associated with midgut structures?
Superior mesenteric group
109
What group of nodes is associated with hindgut structures?
Inferior mesenteric group
