Anatomy 1 and 2 - Taste, Chewing, Swallowing and Abdo Pain Flashcards Preview

1st Year - Gastroenterology > Anatomy 1 and 2 - Taste, Chewing, Swallowing and Abdo Pain > Flashcards

Flashcards in Anatomy 1 and 2 - Taste, Chewing, Swallowing and Abdo Pain Deck (100):
1

Parts of the GI tract (11)

Oral cavityPharynxoesophagusstomachsmall intestinelarge intestine (including rectum and anal canal)accessory organs (tongue, salivary glands, pancreas, liver, and gallbladder)

2

What joint is involved in opening the mouth

The temperomandibular joint (TMJ)

3

3 pairs of jaws "closing" muscles names?

MasseterTemporalisMedial pterygoid

4

Where does the masseter stretch?

From angle of mandible to zygomatic arch

5

Where does the temporalis run?

From coronoid process of mandible to temporal fossa

6

Where does the Medial Pterygoid run?

From angle of mandible (medial side) to pterygoid plates of sphenoid bone

7

What is the 1 pair of jaw opening muscle and where does it run

lateral pterygoid Condyle of mandible to pterygoid plates of sphenoid bone

8

What supplies all the jaw muscles

Mandibular division of trigeminal nerve - CN V3

9

What cranial nerve number is the trigeminal nerve and what division is the mandibular division?

CN 53rd division

10

CN V3 course:CNS partIntracranial partBase of skull foramen partExtra-cranial part of course

PonsInferior to the edge of the tentorium cerebelli between the posterior and middle cranial fossaforamen oval of sphenoid boneFrom foramen oval towards structures they supply

11

What part of the mouth is particularly sensitive to touch

the posterior wall of the oropharynx

12

What is aspiration?

Inhalation of liquid or solid matter into the lungs (different from choking)

13

What are the arches of the soft palate made from?

Skeletal muscle covered in mucosa

14

Surface anatomy of the mouth (8)

Hard palateSoft palate (made up of arches)Upper dental archLower dental archPalatine tonsilstongueuvulagingivae

15

What 2 parts can the tongue be divided into and how much of each tongue is classed as what

Anterior 2/3rds (horizontal and in oral cavity)Posterior 1/3rd (vertical and not in oral cavity)

16

What supplies the:general sensory parts of the tongue?Special sensory areas of the tonguegeneral and sensory supply of posterior 3rd of tongue

CN V3 (3rd division of trigeminal nerve)CN VII (facial nerve)CN IX (glossopharyngeal)

17

What gives general sensation to the gingiva of oral cavity and palate (superior half)

CN V2

18

What gives general sensation to the gingiva of oral cavity and floor of mouth (inferior half)

CN V3

19

What is the gag reflex

A protective reflex that prevents foreign bodies from entering the pharynx or larynx

20

Sensory part of gag reflex

CN IX

21

Motor part of gag reflex

CNIX and CNX

22

What CN's does spraying a local anaesthetic block the sensory action potentials of

CN V2, CN V3, CN VII and CN IX

23

What does the gag reflex cause that helps close off the entry to the body

Constrict the pharynx

24

CN V2 course:CNS partIntracranial partBase of skull foramen partExtra-cranial part of course

PonsInferior to the edge of the tentorium cerebella between the posterior and middle cranial fossaeFormane rotundum in sphenoid boneFrom foramen rotunda towards structures they supply

25

CN VII course (special sensory, sensory, motor and parasympathetic):CNS partIntracranial partBase of skull foramen partExtra-cranial part of course

junction between the pons and medulla Directly into internal acoustic meatus in the posterior cranial fossaPasses through the temporal bone through the internal acoustic meatus and stylomastoid foramenmost fibres pass through he stylomastoid foramen

26

What branch of CN VII connects to the lingual nerve branch of CN V3?

The chorda tympani

27

What does the chorda tympani contain?

Taste axons for the anterior 2/3rds of the tongueParasypathetic axons for salivary glands

28

where does the chorda tympani branch off of CN VII

At the stylomastoid foramen

29

CN IX course (special sensory, sensory, motor, visceral afferent and parasympathetic):CNS partIntracranial partBase of skull foramen partExtra-cranial part of course

MedullaDirectly towards jugular foramen in the posterior cranial fossa Jugular foramen at the junction between the temporal bone and occipital bone Axons mainly pass to or from the tongue and palateposterior wall of oropharynxparasympathetic secretomotor to parotid salivary glands

30

3 pairs of salivary glands

ParotidSubmandibularSublingual

31

4 pairs of extrinsic muscles of the tongue?

PalatoglossusStyloglossusHypoglossusGeniolossus (check powerpoint for positions of these)

32

What is the function of the extrinsic muscles of the tongue

To change the position of the tongue during mastication, swallowing and speech

33

How many intrinsic muscles does the tongue have and what do these do?

4Modify the shape of the tongue during function

34

What CN are the muscles of the tongue supplied by

CN XII (except palatoglossus)

35

CN XII course (motor):CNS partIntracranial partBase of skull foramen partExtra-cranial part of course

MedullaPasses anteriorly towards hypoglossal canal in the posterior cranial fossaHypoglossal cancal (anterior wall of formate magnum)Descneds in neck lateral to cartoid sheathAt level of hyoid bone it passes anteriorly towards the lateral aspect of the tongueSupplies most of the muscles of the tongue

36

What muscles form the external layer of the pharynxwhat type of muscles are these

Superior, middle and inferior constrictor (circular)Skeletal (and striated) - we decide we want to swallow but once we have made that decision, we cannot control the muscles

37

What nerve supplies the pharynx

CN X

38

Look at diagram of the pharynx (posterior and anterior)

...

39

What muscles make up the inner layer of the pharynx

Longitudinal muscles

40

What is the purpose of the longitudinal muscles of the pharynx

To elevate the larynx and pharynx (attach to larynx, contract to shorten pharynx, raise the larynx close to the laryngeal inlet)

41

What are the steps of swallowing a food bolus?

Tongue pushes bolus of food towards oropharynx (voluntary)Soft palate elevated, larynx elevated (involuntary skeletal muscles)Circular layer of pharyngeal constrictor muscles contracts (involuntary)Bolus of food enters oesophagus and travels inferiorly by peristalsis (involuntary)

42

What is the inferior pharyngeal constrictor called?

Cricopharyngeus (forms the upper oesophageal sphincter)

43

what muscle and what relevant cranial nerve prevents drooling

Orbicularis oris CN VII

44

What type of muscles are the muscles involved in swallowing (orbicularis Doris, tongue muscles, pharyngeal constrictor muscles, longitudinal layer of of pharyngeal muscles)

Skeletal muscles The initiation of swallowing is voluntary

45

On a barium swallow, what would causes a cervical constriction

Contraction of the cricopharyngeus

46

At what spinal feel is the cricopharyngeus muscle?

C6

47

What type of sphincter is the upper and lower (out of physiological or anatomical)

Upper = anatomicalLower = physiological (isn't actually anatomically there although a number of factors combine to create a sphincteric effect)

48

Is the oesophagus anterior/ posterior to the heart

Posterior

49

On a barium swallow, what causes thoracic constriction(s) of the oesophagus

Arch of aortaLeft main bronchus

50

On a barium swallow, what causes the diaphragmatic construction of the oesophagus

Result of passing through the diaphragmLower oesophageal sphincter

51

What leads to the lower oesophageal sphincter

Contraction of diaphragmintrabdominal pressure slightly higher than intragastric pressureOblique angle at which the oesophagus enters the cardia of the stomach

52

What does the oesophageal sphincter help reduce the occurrence of

Reflux (presence of a hiatus hernia will reduce effectiveness and can lead to symptoms of reflux)

53

Where does the lower oesophageal sphincter lie

Immediately superior to gastro-oesophageal junction (here there will be an abrupt change in type of mucosa lining the wall causing the z-line)

54

What regions of the abdomen does the stomach mainly lie in when the patient is supine

Th left hypochondrium, epigastric and umbilical regions

55

Parts of stomach

CardiaFundusBodyPyloric antrum pylorus

56

Name for series of ridges in stomach

Rugae

57

What notch marks the dividing line between the body of the stomach and pyloric antrum

Incisura angularis

58

Parts of the small intestines?

Duodenum (short), jejunum (about 3m), ileum (about 4m)

59

Parts of the large intestine

Colon (caecum, appendix, ascending colon, transverse colon, descending colon, sigmoid colon)RectumAnal canalAnus

60

Name for turn between the transverse and ascending colon?Turn between transverse and descending colon?

Hepatic flextureSplenic flexture

61

What are the 3 parts the abdominal organs are split into

ForegutMidgutHindgut(based on embryological origins)

62

Organs of the foregut

Oesophagus to mid-duodenumlivergallbladderspleen 1/2 of pancreas

63

Organs of midgut

Mid-duodenum to proximal 2/3rds of transverse colon 1/2 of pancreas

64

Organs of the hindgut

distal 1/3rd of the transverse colon to proximal 1/2 of the anal canal

65

What are all the organs in each of the regions of the abdomen (divided best on embryological origin) supply by the same

Arterial blood from common arteryVenous drainage from common veinLymphatic drainage from shared routeNerve supply via common route

66

9 regions of the abdomen

Right/ left hypochondriumEpigastricRight/ left lumbar (flank)UmbilicalRight/ let inguinal (iliac fossa)Pubic (suprapubic)

67

Where are the lines drawn to divide the abdomen into 9 regions

Mid-clavicularSubcostalTrans-tubercular

68

4 quadrants of the abdomen

UQLUQRLQLLQ

69

Muscles of the abdomen (4)

Rectus AbdominisExternal obliqueInternal obliquetransversus abdominisparietal peritoneum

70

When do the abdominal muscles contract to "guard"

to protect the abdominal organs when injury threatensPeritonitis

71

2 parts of the peritoneum

ParietalVisceral (both parts are continuous with each other)

72

Does peritoneum contain nerves

Yes, also secretes a small amount of lubricating fluid

73

In terms of the peritoneum,how are organs classified?

Intraperitoneal (almost completely covered in visceral peritoneum, minimally mobile) e.g. liverRetroperitoneal e.g. pancreas and kidneys (only has visceral peritoneum on its anterior surface - located in the retroperitoneum)With a messentery (e.g. parts of intestines, covered in visceral peritoneum which wraps itself behind the organ to form a double layer, mesentery suspends the organ fro the posterior abdominal wall = very mobile)

74

What is are the name of 3 condensations of the peritoneum?

Greater omentumLesser omentumMessentery(double layers that attach organs to each other and to the abdominal wall)

75

What do the omenta do?

Divide the peritoneal cavity into a greater sac and a much smaller lesser sac

76

How do the 2 peritoneal sacs communicate

throughs the omental foramen

77

What lies on the free edge of the lesser omentum

The portal triad

78

What pouches (which are part of the greater sac) are formed when the inferior aspect of the peritoneum "drapes over" the superior aspect of the pelvic organs?

Rectovesical (in males)Rectouterine (pouch of douglas) and uterovesical (In females)

79

Ascites

Excess fluid within the peritoneal cavity

80

How is ascites fluid drained

Through paracentesis/ abdominocentesis

81

During paracentesis, where is the needle placed and why?

Lateral to the rectus sheath to avoid the inferior epigastric artery which ascends deep to the rectus abdomens after it iris from the external iliac just medial to the deep inguinal ring)

82

What are the characteristics of visceral pain

Hard to localise and dull, achy and nauseating (visceral includes visceral peritoneum)

83

Characteristics of somatic pain

Easier to localise and sharp and stabbing

84

What may colicky pain be caused by

A GI obstruction as peristalsis comes in waves

85

How do the sympathetic nerves get from the CNS to the abdominal organs

Leave the spinal cord between levels T5 and L2 and enter the sympathetic chains (but don't synapse) Leave the sympathetic chains within the abdominopelvic splanchnic nerves Synpase at prevertebral ganglia which are located anterior to the aorta at the exit points of the major branches of the abdominal aorta

86

Where does the postsynaptic sympathetic nerve fibres pass?What do they form along with other nerve fibres?

From the prevertebral ganglia onto the surface of the arterial branches leaving the abdominal aorta They form periarterial plexuses as they hitch a ride with the arteries and their branches towards (or away from) the smooth muscles and glands of the organs

87

What is the course of the sympathetic nerves that supply the adrenal gland

Leave the spinal cord at T10-L1Enter the abdominopelvic splanchnic nerves (do not synapse at the prevertberal ganglia) and instead are carried with periarterial plexuses to the adrenal gland and synapse directly onto cells

88

What are the 2 ways by which the parasympathetic nerves get from the CNS to the abdominal organsHow much of the digestive tract does each supply?

CNX (vagus nerve) - up tot he distal end of the transverse colonPelvic Splanchnic nerves (S2,3,4) - smooth muscle/ glands of the descending colon to anal canal

89

How does the vagus nerve provide parasympathetic nerve fibres to the abdominal organs

presynaptic parasympathetic nerve fibres enter abdominal cavity on surface of the oesophagus (“vagal trunks”)travel into the periarterial plexuses around the abdominal aortacarried to the walls of the organs where they synapse in ganglia

90

Where does pain from the foregut, midgut and handgun tend to be felt

Foregut = epigastric regionMidgut = umbilical regionHindgut = pubic region

91

How do visceral afferent nerve fibres get from the abdominal organs to the CNS

Pain fibres from the bast majority of the abdominal organs run alongside sympathetic fibres back to the spinal cord

92

Where do visceral afferent nerve fibres from the foregut structures enter the spinal cord

At approx. T6-T9

93

Where do visceral afferent nerve fibres from the midgut structures enter the spinal cord

T8-T12

94

Where do visceral afferent nerve fibres from the hindgut structures enter the spinal cord

T10 - L2

95

Where does pain from the organs tend to be perceived

In the dermatomes of the levels at which they enter the spinal cord (bit of overlap) - type of referred pain

96

What pain can be felt in the right shoulder

Liver/ gallbladder pain

97

What pain can be felt in the centre of the back

Stomach pain/ pancreatic pain

98

Where is kidney and ureter pain felt

From groin right up back

99

Where is appendicitis pain felt

In centre and then travels to right bottom corner as it irritates the peritoneum

100

Where areThe somatic motor, somatic sensory and sympathetic nerve fibres supplying the structures of the abdominal part of the “body wall” are conveyed within?

The thoracoabdominal nerves (7th - 11th intercostal nerves -Travel anteriorly, then leave the intercostal spaces, travel in the plane between the internal oblique and transversus abdominis, as thoracoabdominal nerves)Subcostal nerve (T12 anterior ramus)Iliohypogastric nerve (half of L1 anterior rams)Ilioinguinal nerve (other half of L1 anterior ramus)