Anatomy 1 (Lectures 1 and 2) Flashcards Preview

Study Notes - Gastroenterology > Anatomy 1 (Lectures 1 and 2) > Flashcards

Flashcards in Anatomy 1 (Lectures 1 and 2) Deck (100):
1

Parts of the GI tract (11)

Oral cavity
Pharynx
oesophagus
stomach
small intestine
large 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?

Masseter
Temporalis
Medial 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 5
3rd division

10

CN V3 course:
CNS part
Intracranial part
Base of skull foramen part
Extra-cranial part of course

Pons
Inferior to the edge of the tentorium cerebelli between the posterior and middle cranial fossa
foramen oval of sphenoid bone
From 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 palate
Soft palate (made up of arches)
Upper dental arch
Lower dental arch
Palatine tonsils
tongue
uvula
gingivae

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 tongue
general 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 part
Intracranial part
Base of skull foramen part
Extra-cranial part of course

Pons
Inferior to the edge of the tentorium cerebella between the posterior and middle cranial fossae
Formane rotundum in sphenoid bone
From foramen rotunda towards structures they supply

25

CN VII course (special sensory, sensory, motor and parasympathetic):
CNS part
Intracranial part
Base of skull foramen part
Extra-cranial part of course

junction between the pons and medulla
Directly into internal acoustic meatus in the posterior cranial fossa
Passes through the temporal bone through the internal acoustic meatus and stylomastoid foramen
most 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 tongue
Parasypathetic 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 part
Intracranial part
Base of skull foramen part
Extra-cranial part of course

Medulla
Directly 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 palate
posterior wall of oropharynx
parasympathetic secretomotor to parotid salivary glands

30

3 pairs of salivary glands

Parotid
Submandibular
Sublingual

31

4 pairs of extrinsic muscles of the tongue?

Palatoglossus
Styloglossus
Hypoglossus
Geniolossus (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?

4
Modify 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 part
Intracranial part
Base of skull foramen part
Extra-cranial part of course

Medulla
Passes anteriorly towards hypoglossal canal in the posterior cranial fossa
Hypoglossal cancal (anterior wall of formate magnum)
Descneds in neck lateral to cartoid sheath
At level of hyoid bone it passes anteriorly towards the lateral aspect of the tongue
Supplies most of the muscles of the tongue

36

What muscles form the external layer of the pharynx
what 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 = anatomical
Lower = 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 aorta
Left main bronchus

50

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

Result of passing through the diaphragm
Lower oesophageal sphincter

51

What leads to the lower oesophageal sphincter

Contraction of diaphragm
intrabdominal pressure slightly higher than intragastric pressure
Oblique 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

Cardia
Fundus
Body
Pyloric 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)
Rectum
Anal canal
Anus

60

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

Hepatic flexture
Splenic flexture

61

What are the 3 parts the abdominal organs are split into

Foregut
Midgut
Hindgut
(based on embryological origins)

62

Organs of the foregut

Oesophagus to mid-duodenum
liver
gallbladder
spleen
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 artery
Venous drainage from common vein
Lymphatic drainage from shared route
Nerve supply via common route

66

9 regions of the abdomen

Right/ left hypochondrium
Epigastric
Right/ left lumbar (flank)
Umbilical
Right/ let inguinal (iliac fossa)
Pubic (suprapubic)

67

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

Mid-clavicular
Subcostal
Trans-tubercular

68

4 quadrants of the abdomen

UQ
LUQ
RLQ
LLQ

69

Muscles of the abdomen (4)

Rectus Abdominis
External oblique
Internal oblique
transversus abdominis
parietal peritoneum

70

When do the abdominal muscles contract to "guard"

to protect the abdominal organs when injury threatens
Peritonitis

71

2 parts of the peritoneum

Parietal
Visceral (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. liver
Retroperitoneal 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 omentum
Lesser omentum
Messentery
(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-L1
Enter 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 organs
How much of the digestive tract does each supply?

CNX (vagus nerve) - up tot he distal end of the transverse colon
Pelvic 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 aorta

carried 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 region
Midgut = umbilical region
Hindgut = 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)