Anatomy Overview 2

Question 1

What are the 3 regions of the foregut from right to left?

Answer 1

Right hypochondrium
Epigastrium
Left hypochondrium

Question 2

What are the 3 regions of the midgut from right to left?

Answer 2

Right lumbar
Periumbilical
Left lumbar

Question 3

What are the 3 regions of the hindgut from right to left?

Answer 3

Right iliac fossa
Hypogastrium
Left iliac fossa

Question 4

What are the 3 constrictions of the oesophagus?

Answer 4

Cervical = (pharyngo-oesophageal) 15cm from incisor teeth
Thoracic = (broncho-aortic) crossed by arch of aorta (22cm from IT) and left main bronchus (27.5cm from IT)
Diaphragmatic = where it passes through the oesophageal hiatus of the diaphragm (40cm from IT)

Question 5

What are the 4 main parts of the stomach?

Answer 5

Cardia
Fundus
Body
Pyloric part

Question 6

What is the function of the pyloric sphincter?

Answer 6

Controls discharge of stomach contents into the duodenum

Question 7

What is congenital pyloric stenosis?

Answer 7

Thickening of the smooth muscle in the pylorus

Question 8

What is the function of the biliary ducts?

Answer 8

Carry bile from the liver to the gallbladder

Question 9

Where is bile produced?

Answer 9

Liver

Question 10

Where is bile stored and concentrated?

Answer 10

Gallbladder

Question 11

How much bile can the gallbladder store?

Answer 11

Up to 50ml

Question 12

What artery supplies the gallbladder and where is it found?

Answer 12

Cystic artery

Found in the Triange of Calot

Question 13

What is the Triangle of Calot?

Answer 13

Triangle between common hepatic duct, cystic duct and visceral surface of liver

Question 14

What is the pancreas?

Answer 14

Accessory digestive gland
Exocrine - pancreatic juice
Endocrine - insulin + glucagon

Question 15

Is the pancreas intraperitoneal or retroperitoneal?

Answer 15

Retroperitoneal

Question 16

Where does the pancreas lie?

Answer 16

Along the transpyloric plane (L1/L2)

Question 17

What are the parts of the pancreas?

Answer 17

Head
Neck
Body
Tail

Question 18

Where is the portal vein formed?

Answer 18

Behind the neck of the pancreas

Question 19

What would happen if the tail of the pancreas was damaged while removing the spleen?

Answer 19

Lifelong diabetes mellitus

Question 20

What is the spleen?

Answer 20

Mobile haemo-lymphoid organ

Question 21

What region is the spleen located?

Answer 21

Left hypochondrium

Question 22

What is splenomegaly?

Answer 22

Abnormal enlargement of spleen

Question 23

What supplies the foregut? = origin

Answer 23

Celiac trunk

origin = abdominal aorta (T12)

Question 24

What are the 3 main branches of the celiac trunk?

Answer 24

Left gastric artery - runs along the LC of the stomach
Hepatic artery - supply liver and gallbladder
Splenic artery - runs retroperitoneally along the superior (upper) margin of the pancreas

Question 25

What makes up the midgut?

Answer 25

``` Small intestine Most of duodenum Caecum Appendix Ascending colon Right 1/2 - 2/3 of the transverse colon ```

Question 26

What is the duodenum?

Answer 26

Shortest, widest, most fixed part of the small intestine | 4 parts

Question 27

What part of the duodenum receives bile and pancreatic duct?

Answer 27

2nd

Question 28

What is a duodenal ulcer?

Answer 28

Inflammatory erosions of the duodenal wall (mostly 1st part)

Question 29

What is the difference in colour between jejunum and ileum?

Answer 29

``` Jejunum = deeper red Ileum = pale pink ```

Question 30

What is the difference in wall between jejunum and ileum?

Answer 30

``` Jejunum = thick + heavy Ileum = thin + light ```

Question 31

What is the difference in vascularity between jejunum and ileum?

Answer 31

``` Jejunum = greater Ileum = less ```

Question 32

What is the difference in vasa recta between jejunum and ileum?

Answer 32

``` Jejunum = long Ileum = short ```

Question 33

What is the difference in arcades between jejunum and ileum?

Answer 33

``` Jejunum = a few large loops Ileum = many short loops ```

Question 34

What is the difference in lymphoid nodules between jejunum and ileum?

Answer 34

``` Jejunum = few Ileum = many ```

Question 35

What is the difference in fat in mesentery between jejunum and ileum?

Answer 35

``` Jejunum = less Ileum = more ```

Question 36

What supplies blood to the midgut? + origin

Answer 36

Superior mesenteric artery | origin = branch of abdominal aorta (L1)

Question 37

What is the superior mesenteric artery relations?

Answer 37

Crossed anteriorly by splenic vein and neck of pancreas

Question 38

What are the branches of the superior mesenteric artery?

Answer 38

Jejunal and ileal arteries (main) | Middle colic, right colic and iliocoloic (others)

Question 39

What makes up the hindgut?

Answer 39

``` Left 1/3 of transverse colon Descending colon Sigmoid colon Rectum Upper part of anal canal Epithelium of the urinary bladder and most of the urethra ```

Question 40

What is the artery of the hindgut?

Answer 40

Inferior mesenteric artery

Question 41

Name 3 features that make the large intestine differ from the small intestine

Answer 41

``` Omental appendices (small,fatty, peritoneal like projections) Haustra/sacculations Teniae coli (thickened bands of smooth muscle - longitudinal layer) ```

Question 42

What is the appendix?

Answer 42

Blind intestinal diverticulum with masses of lymphatic tissue

Question 43

What are the 5 different appendix positions? + most common

Answer 43

``` Retrocecal - most common Subcecal Pelvic Postileal Preileal ```

Question 44

What is Macburney's point?

Answer 44

Site of maximum tenderness in acute appendicitis

Question 45

What artery is the hindgut's blood supply? + origin

Answer 45

Inferior mesenteric artery | origin = anterior branch of abdominal aorta (L3)

Question 46

What are the branches of the inferior mesenteric artery?

Answer 46

Left colic Sigmoid arteries Superior rectal artery (terminal branch)

Question 47

What is the rectum?

Answer 47

Pelvic part of the gut tube

Question 48

Where is the recto-sigmoid junction?

Answer 48

Anterior to S3 vertebra

Question 49

What 2 sphincters are in the anal canal? + difference

Answer 49

External (skeletal muscle, somatic nerves) | Internal (smooth muscle, autonomic nerves)

Question 50

What are the innervations of abdominal organs?

Answer 50

``` Autonomic Parasympathetic: - vagus nerve (10th cranial) - pelvic splanchnic (S2,3,4) Sympathetic: - abdominopelvic splanchnic (greater - T5-9, lesser - T10-11 and least - T12) Prevertebral sympathetic ganglia Abdominal aortic plexus ```

Question 51

What vein is responsible for drainage of the abdominal GI tract? + how

Answer 51

Portal vein collects low O2 - high nutrient blood from abdominal GI tract (e.g. spleen, pancreas, gallbladder) and carries it to the liver

Question 52

What forms the portal vein?

Answer 52

Union of splenic vein with the superior mesenteric vein

Question 53

What is the location of the portal vein?

Answer 53

Behind the neck of the pancreas (L2)

Question 54

What are portocaval shunts?

Answer 54

Venous enlargements (varices) during portal obstruction

Question 55

What are 3 sites of portocaval shunts?

Answer 55

Anorectal junction = haemorrhoids/piles Gastroesophageal junction = oesophageal varices Around the umbilicus = caput medusae

Question 56

What receives most of the lymph from the abdominal wall and organs?

Answer 56

Thoracic duct

Question 57

What are the 3 terminal groups of lumbar nodes?

Answer 57

1. Pre-aortic (celiac, superior and inferior mesenteric nodes) - drains organs supplied by the anterior branches of aorta 2. Lateral aortic - drains organs supplied by lateral aortic branches 3. Retro-aortic - drains the posterior abdominal wall