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Flashcards in Anatomy 2 Deck (54)
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1
Q

What is the peritoneum?

A

Transparent serous membrane that covers the body wall and organs. Two layers are parietal and visceral.

2
Q

What is the space in-between the two layers of the peritoneum?

A

Peritoneal cavity (potential space containing fluid which allows movement)

3
Q

What are the two major divisions of the peritoneal cavity?

A

Lesser and greater sac, which communicate to each other via the episodic Foramen

4
Q

Where is the epiploic foramen?

A

Immediately posterior to the free margin of the lesser omentum

5
Q

What is omentum?

A

They are double folds of peritoneum connecting the stomach to other abdominal organs.

There is a lesser and a greater

6
Q

What are the different types of peritonisation of an organ?

A
  • Intraperitoneal -> completely surrounded
  • Retroperitoneal -> only covered on anterior surface, so is attaches to posterior wall (can also only be partially pertonised)
  • Extraperitoneal -> not covered by peritoneum
7
Q

Name the retroperitoneal organs/structures

A
S - suprarenal 
A - aorta - IVC
D - duodenum (2nd-4th)
P - pancrease
U - ureters
C - colon (ascend./descend.)
K - kidneys
E - oesophagus (lower 2/3)
R - rectum
8
Q

Name four intraperitoneal organs/structures

A
  • Stomach
  • Small intestine (ileum, jejunum)
  • Liver, gallbladder
  • Spleen
9
Q

Which parietal layer is more sensitive to pressure, pain, heat and cold?

A

Parietal

10
Q

Which nerves innervate the parietal layer?

A

Phrenic and thoracoabdominal nerves (T7-L1)

11
Q

What are the attachments of the greater omentum?

A

Greater curvature of the stomach to transverse colon

12
Q

What are the attachments of the lesser omentum?

A

Lesser curvature of the stomach to the liver

13
Q

What structures travels in between the double folds ?

A

Arterial branches to gain access to peritonised organs

14
Q

What are the types of double layers of peritoneum?

A

Mesentery (connect structure to abdominal wall and omenta

15
Q

What is the clinical significance of the greater omentum?

A

The lower L and R margins are free and it moves about the abdominal cavity in response to peristaltic movements.

In infection (esp. appendicitis) inflammatory exudate causes omentum to adhere to the sit of infection, and wrap tided around infected organ. This localises against serous defuse peritonitis.

16
Q

Describe peritoneal pain from each peritoneal layer

A

Pain from parietal peritoneum innervated by T7-L1, so pain here is somatic and localised. Sensitive to stretching.

Visceral pain is innervate by autonomic nerves; often referred and is dull and poorly localised. Usually referred to midline are GI tract is a midline structure receiving bilateral nerve supply.

17
Q

What are the muscles of the posterior abdominal wall?

A
  • Iliacus - flat triangular muscle in the iliac fossa
  • Psoas major
  • Quadratus lumborum
18
Q

What are the main vessels of the posterior abdominal wall?

A

Aorta and IVC

19
Q

What organs are attaches to the posterior abdominal wall?

A
  • Kidneys
  • Spleen
  • Adrenal gland
20
Q

What are the three branches of the abdominal aorta?

A
  • Coeliac trunk - T12
  • Superior mesenteric aa - L1
  • Inferior mesenteric aa - L3
21
Q

What are the nerve of the posterior abdominal wall?

A

Lumbar plexus (L1-L4) and subcostal T12

22
Q

At what level is the IVC formed in the abdomen?

A

L5

23
Q

At wha level does the abdominal aorta divided into two common iliac arteries?

A

L4

24
Q

What are the three major openings in the diaphragm and at what level do they arise?

A
  1. IVC hiatus - T8
  2. Oesophageal hiatus - T10
  3. Aorta hiatus - T12
25
Q

List the structures of the foregut

A
  • Abdominal part of oesophagus
  • Stomach
  • 1/3 of duodenum

(Liver, spleen, pancreas not part of gut tube)

26
Q

List the structure of the midgut

A
  • 2/3 duodenum
  • Jejunum
  • Ileum
  • Caecum
  • Ascending colon
  • 2/3rd transverse colon

(Appendix not part of gut tube)

27
Q

List the structure of the hindgut

A
  • 1/3 transverse colon
  • Descending colon
  • Sigmoid colon
  • Rectum
  • 1st part of anal canal
28
Q

What artery supplies the foregut?

A

Coeliac trunk

29
Q

What artery supplies the midgut?

A

Superior mesenteric artery

30
Q

What artery supplies the hindgut?

A

Inferior mesenteric artery

31
Q

What branches does the coeliac artery give off?

A
  • Common hepatic artery
  • Splenic artery
  • L gastric artery
32
Q

What is a portal system?

A

Any system of blood vessels which has a capillary network at each end. It collects poorly oxygenated, nutrient rich blood form the abdomen and delivers it to the liver.

33
Q

What are the tributary veins of the portal vein

A

Superior mesenteric vein and splenic vein (inferior mesenteric vein drain into splenic)

34
Q

How does the venous blood from structures in the outside abdominal cavity drain?

A

They drain via the systemic venous system, and the portal venous system communicated with the systemic venous system through portosystemic (portocaval) anastomoses

35
Q

How main portosystemic (portocaval) anastomoses are there?

A

4

36
Q

What are the different portsystemic (portocaval) anastomoses?

A
  1. In distal oesophagus
  2. Rectal - between rectal veins and inferior mesogastric veins
  3. Paraumbilical
  4. Colic veins (on colon) with retroperitoneal veins
37
Q

What is the significance of the portocaval anastomoses?

A

Provides alternative routes of circulation when there is a blockage in the liver or portal vein -> blood can still reach the heart without having to through the liver

38
Q

What is the sympathetic supply to abdominal viscera?

A
  • Abdominalpelvic splanchnic nerves
  • Prevertebral sympathetic ganglia
  • Abdominal aortic plexus
39
Q

What are nerve of the abdominal splanchnic nerves (sympathetic)?

A
  • Greater - T5-9
  • Lesser - T10-11
  • Least - T12
40
Q

What is the parasympathetic supply to the abdominal viscera?

A
  • Vagus nerve

* Pelvic splanchnic nerves (S2-4)

41
Q

What is the effect of parasympathetic and sympathetic nerves on GI secretion?

A
  • Para -> increase

* Sym. -> Inhibited

42
Q

What is the effect of parasympathetic and sympathetic nerves on peristalsis or GI motility?

A
  • Para -> Increase

* Sym. -> inhibited

43
Q

What is the effect of parasympathetic and sympathetic nerves on blood vessels?

A
  • Para -> vasodilate

* Sym -> vasoconstrict

44
Q

What is the effect of vagotomy on gastric secretion?

A

Decrease

45
Q

What is the functional difference between Abdominalpelvic splanchnic nerves and pelvic splanchnic nerves?

A

Abdominalpelvic splanchnic nerves are sympathetic and pelvic splanchnic nerves are parasympathetic

46
Q

What is the chief difference in the arrangement of ganglia in the sympathetic and parasympathetic nervous system?

A

Sympathetic synapse in sympathetic chain, or just before viscera, and parasympathetic synapse on the viscera

47
Q

Where does the portal vein form?

A

Behind the neck of the pancreas (L2)

48
Q

What are the effects on venous enlargement of the portocaval shunts during portal obstruction?

A
  • Anorectal junction -> haemorrhoids or piles
  • Gastroesophageal junction -> oesophagus varices
  • Around the umbilicus -> caput medusae
49
Q

Describe the lymphatic drainage of the GI tract

A

The thoracic duct receives most of the lymph from abdominal wall and organs

Lymph nodes form groups around the major arteries and abdominal aorta

50
Q

What are the three terminal groups of lumbar nodes and what do they drain?

A
  1. Pre-aortic - (coeliac, superior and inferior mesen. nodes) - drains organs supplied by anterior beaches of aorta
  2. Lateral aortic - drains organs supplied by lateral arctic branches
  3. Retro-aortic - drains the posterior abdominal wall
51
Q

What are the lumbar lymph nodes?

A

The paraaortic lymph nodes (also known as periaortic, and lumbar) are a group of lymph nodes that lie in front of the lumbar vertebrae near the aorta. These lymph nodes receive drainage from the gastrointestinal tract and the abdominal organs

52
Q

Which group of lymph nodes drain the foregut structures?

A

Coeliac group

53
Q

Which group of lymph nodes drain the midgut structures?

A

Superior mesenteric group

54
Q

Which group of lymph nodes drain the hindgut structures?

A

Inferior mesenteric group