Anatomy Flashcards
(121 cards)
1
Q
What are the functions of the pancreas?
A
Exocrine = acinar cells release pancreatic digestive enzymes into the main pancreatic duct. Endocrine = Islets of Langerhans - releases insulin and glucagon into the bloodstream
2
Q
Where is the gallbladder situated and where does the bile flow?
A
Posterior liver and anterior duodenum. The bile flows out of the bile duct (in a spiral valve), the narrowing could potentially be a site for gallstones
3
Q
What are the main salivary glands and where do the come from and enter?
A
Parotid - across face out 2nd molar
Submandibular - enters at floor of mouth via lingual caruncle
Sublingual - in the floor of mouth and via several ducts superiorly
4
Q
What are the sphincters involved in the drainage of the biliary system?
A
the pancreatic duct sphincters
the bile duct sphincters
the sphincters of Oddi
5
Q
What are the planes that separate the 9 regions?
A
Subcostal plane
Transtubecular plane
6
Q
What causes acute pancreatitis?
A
Obstruction (gallstone). Bile and pancreatic juice reflux into the main pancreatic duct.
This could lead to a haemorrhage and accumulation in the retroperitoneal space.
7
Q
Where does the oesophagus begin and end?
A
C6 to the cardia of stomach
8
Q
What are the differences between the Jejunum and ileum? (6)
A
Colour --> J = dark red -- I = lighter pink Wall --> J = thick and heavy -- I = thin and light Vascularity --> J = more vascular -- I = less Mesenteric Fat --> J = less -- I = more Circular folds (L. Plicae Circularis) --> J = large, tall and close -- I = low and spare (absent distally) Lymphoid tissue (Peyer's patches) --> J - not -- I = does
9
Q
What divides the lower and upper GI tract?
A
Ileocaecal junction
10
Q
What peritoneal pouches do males have?
A
Rectovesical pouch
11
Q
Describe the route of the biliary tree form the liver and gallbladder to the duodenum
A
the right and left hepatic duct join to form the common hepatic duct. the common hepatic duct joins the cystic duct to form the bile duct which join the main pancreatic duct as it enters the duodenum
12
Q
What are the muscles of mastication?
A
Temporalis muscle - close
Masseter muscle - close
Medial pterygoid - close?
Lateral pterygoid - open?
13
Q
What is the removal of a gallbladder called and what needs to be identified?
A
Cholesystectomy.
The cystic duct and artery
14
Q
Where does pain from the duodenum present?
A
Epigastric
15
Q
What can cause jaundice?
A
Extra hepatic obstruction (post hepatic) jaundice
- Obstruction (gallstone)
- Back up into the liver
- Overspill into the blood
16
Q
What is meant by retroperitoneal and what organs fit that description?
A
Only the anterior surface is covered by visceral peritoneum
Kidneys, adrenal glands, pancreas and descending and ascending colon.
17
Q
How would visceral pain present?
A
dull, achy, nauseating and hard to localise
18
Q
What is the location of the pancreas?
A
Transverse of posterior abdomen.
retroperitoneal
sits in the C of the duodenum
19
Q
Where does the duodenum begin and end?
A
The pyloric sphincter to the duodenojejunal flexure
20
Q
What ligaments are within the lesser omentum?
A
The hepatoduodenal ligament (free edge) - contains the portal triad
the hepatogastric ligament
21
Q
Abdominocentesis - what to watch out for
A
lateral to the rectus sheath and avoiding the inferior epigastric artery (runs from external iliac artery to deep inguinal ring)
22
Q
Where does the spleen sit?
A
Under ribs 9-11, between the diaphragm, stomach, splenic flexure and left kidney.
23
Q
What innervates the muscles of the tongue and what’s the one exception?
A
CNXII
Palatoglossus
24
Q
Name the 2 signs of haemorrhage and accumulation in the retroperitoneal space.
A
Cullen’s sign (umbilicus)
Grey-turner’s sign (R&L flanks)
25
Describe the route of the bile duct to the duodenum
The bile duct enters the posterior groove of the pancreas and joins the main pancreatic duct to form the ampulla of Vater (hepatopancreatic). They drain not the 2nd part of the duodenum through the major duodenal papilla.
26
What is the end of the ileum?
The ileocaecal junction
27
What are the main lymph nodes of the GI tract?
```
Celiac (foregut)
Superior mesenteric (midgut)
Inferior mesenteric (hindgut)
Lumbar (kidneys, pos abdo wall, pelvis and lower limbs)
```
28
What is the start of the jejunum?
The duodenaljejunal flexure
29
Name the extrinsic muscles of the tongue
Palatoglossus
Genioglossus
Styloglossus
Hyoglossus
30
Where does pancreatic pain present?
epigastric and umbilical
| can radiate to back
31
Thoracic duct drains how much of the body to where and the rest goes?
3/4 body to the left venous angle
| 1/4 body goes to the right lymphatic duct into the right venous angel
32
What organs are in the foregut?
Oesophagus to mid duodenum, spleen, liver and 1/2 pancreas
33
What is within the perineal cavity?
fluid to allow the gut to move (lubrication)
34
What nerves supply the organs w/in the abdominal cavity (including visceral peritoneum)?
Visceral afferents
Enteric nervous system
Autonomic nervous system (P- speed, S - slow)
35
What are the three main mesentarys?
The mesentery proper
transverse and sigmoid mesocolon
mesoappendix
36
What is in the head?
Orla Cavity
| Pharynx
37
Name the papillae on the tongue and which one doesn't have taste buds
Foliate papillae
Valate Papillae
Fungiform papillae
Filiform papilla - no taste bugs only for temp, touch, etc
38
What are the four parts of the duodenum and what is the exception?
the superior cap - part intraperitoneal (exception as rest are retroperitoneal)
descending
horizontal
ascending
39
What is the function of the spleen?
breaks down RBC to form bilirubin
40
Describe the lesser omeuntem layers, attachments and features.
2 layers
Attaches to the lesser curvature of the stomach and the duodenum to the liver
Has a free edge and 2 ligaments
41
Describe the innervation, function and attachment of the longitudinal muscles of the oesophagus.
CNX & IX
Shortens the pharynx and raises the larynx to close it
Attached to the larynx
42
What veins don't have valves?
Hepatic veins and IVC
43
what is the innervation for the superior and inferior parts of the oral cavity
Superior - CNV2
| Inferior - CNV3
44
What organs are in the hindgut?
Distal 1/3rd of the transverse colon to the proximal 1/2 anal canal.
45
What nerves supply the abdominal wall (from skint parietal peritoneum)?
Somatic sensory
Somatic motor
Sympathetic
46
What is the split of the tongue anatomically?
Posterior 1/3rd and anterior 2/3rds
47
Name the 4 anatomical sections and the ligament associated.
The right lobe, the left lobe, the caudate lobe and the quadrate lobe.
The falciform ligament runs between and the round ligament is the remains of the umbilical cord
48
What do the central veins do?
They collect cleaned blood
49
What does the omenta create and how do they communicate?
Create the greater and lesser sacs that communicate through the omental foramen of Wirchow
50
What are the three sections of the small intestine called?
Duodenum
Jejunum
Ileum
51
What is the lining of the GI tract?
Mucosa (epithelium and lamina propria) and muscle in the walls.
52
Describe the innervation, function, attachment and lining of the circular muscles of the oesophagus.
CN X
Contract sequentially to push food bolus down the oesophagus
All attach to the midline raphe
Lined w/ non-keratinised stratified squamous epithelium
53
What are the sections of the pancreas?
Head + uncinate process, Neck, Body and Tail
54
Describe the route taken by the parasympathetic nerves to supply the GI tract and abdominal organs up to the distal end of the transverse colon?
Presynaptic parasympathetic nerve fibres (CNX) enter abdominal cavity on the surface of the oesophagus (vagal trunks). join to the peri-arterial plexus and carried to the walls where they synapse in ganglia.
55
What is the name of the tonsils you can see in the mouth?
Palatine Tonsils
56
What are the three categories of organs in the gut called and what do the organs in them share?
Foregut, midgut and hindgut
arteries and veins - similar names
nerves - common paths
lymph - similar paths
57
What is jaundice?
Yellowing of the sclera and skin caused by an increased level of bilirubin in the blood.
58
What is the location, orientation and innervation of the posterior 1/3rd of the tongue?
Oropharynx, vertical, CNIX for taste and sensation
59
Within the greater sac there are 2 recesses, what are they called and what is the clinical relevance?
the hepato-renal recess (Morison's) - one of the lowest points in a supine patient and any excess fluid can be drained from here
the sub-phrenic recess
60
Name the 8 areas of the stomach.
```
Cardia
Fundus
Lesser curvature
Greater curvature
Pyloric antrum
Pyloric sphincter
Incisura angularis
Body
```
61
Liver lobes supply?
Central vein in the middle of each and interlobular portal triad in each corner
62
Name the 9 regions of the abdomen
```
R&L hypogastric
R&L lumbar
R&L inguinal
epigastic
umbilical
pubic
```
63
What is the gastrointestinal tract?
A tube from oral cavity to anus
64
What is the venous supply to the small intestines and what is absorbed? (J&I)
The jejunal and ileal arteries into the superior mesenteric vein into the hepatic portal vein
Protein and carbohydrates
65
What does colicky pain mean?
comes in waves much like peristalsis possibly obstruction?
66
What effect does parasympathetic nerves have on smooth muscle of duodenum?
Relaxation
67
How do you identify the 8 functional sections?
like a fist (clockwise with the thumb behind
68
What would appendicitis present?
originally umbilical as appendix mid gut (T8-12) Then irritates the parietal peritoneum on the right iliac fossa and moves locally on appendix
69
What are the 2 different muscles of the pharynx?
External layer = Circular overlapping constricting
muscles
Internal layer = longitudinal
70
What does the duodenum secrete?
Peptide hormones - e.g. CCK and gastrin
71
What is the function, location, features of the liver?
receives nutrients, stores glycogen and secretes bile...
the largest organ in the body and has the hepatic flexure on the colon where it sits.
in the RUQ protected by ribs 7-11
72
What is ERCP
endoscopic retrograde cholangiopancreatography
| cannula placed into the major duodenal papilla and radio-opaque dye injected back into the biliary tree.
73
What is in the pelvis?
Rectum
| Anal Canal
74
What is the parietal peritoneum?
thin, transparent, semi-permeable, serous membrane.
lines the abdominopelvic cavity and organs
It is Continuous - creating a parietal and visceral with a cavity in-between.
75
What is the function of the pancreas?
excretes digestive enzymes into the 2nd part of the duodenum
76
What is the route of the superior mesenteric vessels?
Leave aorta at L1 behind pancreas neck and invfront of pancreas uncinated process then enter mesentery
77
What is the TMJ and what are the features of it?
Temporomandibular joint
Head of condylar process sits in the mandibular fossa.
jaw lock is the condylar process goes in front of the articular process?
78
What effect does sympathetic nerves have on smooth muscle of duodenum?
Contraction
79
How many muscles does the tongue have and what for?
4 pairs extrinsic muscles = to change the position of the tongue.
4 pairs of intrinsic muscles = to change the shape if the tongue
80
Describe the greater omentum layers, attachments and features.
4 layers
attaches to the greater curvature of the stomach and the transverse colon
hangs like an apron
81
What is the lower oesophageal sphincter and what is it caused by?
Physiological sphincter
1. contraction of the diaphragm
2. oblique angle entering stomach
3. intra-abdominal pressure > intra-gastric pressure
82
How would parietal pain present?
sharp and stabbing and localised
83
What does each segment of the liver have?
Branch of hepatic artery
Branch of hepatic portal vein
Bile drainage (to bile duct)
Venous drainage (to IVC)
84
What are the body wall nerves? (4)
Thoraco-abdominal nerves = continuation of intercostal nerves 7-11 that travel anterior then inferiorly between transverse abdomnius and internal oblique
Subcostal (T12 anterior ramus)
Iliohypogastirc (half of L1 anterior ramus)
Ilioinguinal (other half of L1 anterior ramus)
85
What organs are in the mid gut?
1/2 pancreas, from mid duodenum to the proximal 2/3rd of the transverse colon
86
What is the circopharyngeus and where is it?
Upper oesophageal sphincter at level C6
87
What effect does the parasympathetic nervous system have on the GI tract?
speeds up
88
What effect does the sympathetic nervous system have on the GI tract?
slows down
89
Are the muscles involved in swallowing skeletal?
Yes, as initiation is voluntary but the sequence is incontrollable.
90
Gag reflex -> innervation of posterior wall and aim of a gag reflex
Movement CNIX & X
Sensation CNIX
To constrict the pharynx and close it off `
91
What are the three constriction throughout the oesophagus?
Cervical constriction at C6
Thoracic constriction at arch of aorta and left main bronchus
Diaphragmatic constriction
92
What is the function of bile?
normal absorption of fats from small intestine
| helps absorb fats into the intestinal cells
93
What parasympathetic nerves supply the smooth muscle and glands of descending colon to the anal canal?
Pelvic splanchnic nerves (S2,3,4)
94
What is the location, orientation and innervation of the anterior 2/3rds of the tongue?
Orla cavity, horizontal, CNVII for taste and CNV3 for sensation
95
What is in the chest?
Oesophagus
96
What type of blood supply does the liver have and how?
A dual blood supply - 20-25% from the R&L hepatic artery (branches form the hepatic artery proper) 75-80% from the hepatic portal vein.
97
Where does Gallbladder pain present?
Foregut organ - T6-T9 - epigastric
| if irritation to diaphragm then possible right shoulder pain referral
98
What is in the lower GI tract?
Large intestine (caecum, appendix, colon, rectum), anal canal and anus
99
What is a sphincter?
Where smooth muscle encircles an entire lumen.
100
What is the Z line?
The difference in mucosa between the stomach and the oesophagus.
101
How many muscles are involved in mastication and how many of them open and close the jaw?
4 muscles
| 3 close and 1 opens
102
What other ligaments are in the abdomen to know?
Gastrosplenic ligament
| Splenorenal ligament
103
What levels do the organ come from for each gut category and therefore where will the pain present?
FOREGUT = T6-T9 = epigastric
MIDGUT = T8-T12 = umbilical
HINDGUT = T10 - L2 = pubic
(pain presentation due to dermatomes)
104
What is meant by intra-peritoneal and what organs fit the description?
Almost completely covered by visceral peritoneum and is minimally mobile
Liver, Gallbladder, Spleen, Stomach, Transverse colon, and some of the small intestine
105
From outside in, name the muscles in the abdomen wall.
```
(rectus abdominus)
external oblique
internal oblique
transverse abdominus
parietal peritoneum
```
106
Describe the Coeliac trunk function and location.
1st of 3 midline branches from the abdominal aorta at levels T12 and supplies the foregut organs
107
What is in the upper GI tract?
Oral cavity, pharynx, oesophagus, stomach, small intestine
108
What is the biliary tree?
the liver, gallbladder and bile ducts and how they connect.
109
What is the function of the gallbladder?
storage and concentration of bile
110
What is bilirubin?
A natural by product of the breakdown of RBC's (spleen)and is used to form bile in the liver.
111
What is in the portal triad (anterior to posterior)?
Bile duct, Hepatic artery proper, Hepatic portal vein
112
What the fold in the stomach called?
Rugae
113
What is in the neck?
Pharynx
| Oesophagus
114
What peritoneal pouches do females have?
Vescio-uterine pouch
| Recto-uterine pouch (pouch of Douglas)
115
What is in the abdomen?
Stomach
Small intestine
Large intestine
Most accessory organs
116
Describe the route that the sympathetic nerves take to the abdominal organs.
Leave the spinal cord at T5 - L2 and enter the sympathetic chain and doesn't synapse. leave the chains through the abdominopelvic splanchnic nerves and synapse at the pre-vertebral ganglia near the major branches off of the abdominal aorta and piggy back with them in a peri-arterial plexus with the parasympathetic and visceral afferents
117
What is the only part of the Oral cavity lined with Keratin
Gingivae and hard palate
118
Describe the route taken by the except and where to.
The adrenal gland is the exception
Leave the spinal cord at T10-L1. Enter the abdominopelvic splanchnic nerves but DON'T synapse . piggy backs and synapses directly only to the cells at the adrenal gland
119
What is in the perineum?
Anus
120
Describe the 4 steps of swallowing
1. Close lips (prevent drooling) = orbicularis oris - CN VII
2. Tongue (CNXII) pushes food back
3. Sequential contraction of pharyngeal contractors (CNX) to push inferiorly
4. Longitudinal muscles (CNX&IX) contract to shorten and prevent aspiration
121
What is a mesentery?
A double layer of visceral peritoneum that suspends organs from the posterior wall. is very mobile.
has a core of connective tissue, blood lymph and lymph nodes, nerves and fat.
