Digestive System Flashcards
(120 cards)
1
Q
formed by the palate
A
Roof
2
Q
formed by the tongue and the mucosa supported by the Geniohyoid and Mylohyoid muscles
A
Floor
3
Q
formed by the outer fleshy wall (cheeks
and lips) and an inner bony wall (teeth and gums)
A
Lateral and Anterior walls
4
Q
between the
walls
A
ORAL VESTIBULE
5
Q
area
inside the teeth and gums
A
ORAL CAVITY PROPER
6
Q
protect
the anterior opening
A
Lips (labia)
7
Q
form the
lateral walls
A
Cheeks
8
Q
forms
the anterior roof
A
Hard palate
9
Q
forms
the posterior roof
A
Soft palate
10
Q
fleshy
projection of the
soft palate
A
Uvula
11
Q
fibromuscular fold extending from the posterior border
of the hard palate; contains skeletal muscles and ends posteriorly at the Uvula
A
Soft Palate
12
Q
Helps with swallowing
A
soft pallete
13
Q
tenses soft palate
opens auditory tube
Mandibular branch of CN V
A
TENSOR VELI PALATINI
14
Q
elevates soft palate
opens auditory tube
A
LEVATOR VELI PALATINI
15
Q
elevates uvula
A
MUSCULUS UVULAE
16
Q
elevates pharynx
closes nasopharynx
Vagus N via Pharyngeal plexus
A
PALATOPHARYNGEUS
17
Q
causes deviation of the Uvula toward the OPPOSITE SIDE OF THE LESION because of paralysis of the Musculus Uvulae ms
A
LESION of the VAGUS NERVE
18
Q
• Mobile; muscular organ • Involved with: mastication gustation deglutition articulation oral cleansing
A
Tongue
19
Q
Mass of striated muscle (voluntary) covered with mucous membrane
A
Tongue
20
Q
Anterior 2/3 –
A
Mouth
21
Q
Posterior 1/3 –
A
Pharynx
22
Q
inferior, relatively fixed part
attached to hyoid and mandible; post
3rd
A
Root
23
Q
ant 3rd
A
Body
24
Q
pointed anterior
A
Apex
25
other Parts and Surfaces of the Tongue
Dorsum
| Inferior
26
Inferior surface is smooth
and is reflected from the
tongue to the floor of the
mouth
• Connected by _ of
the tongue
Frenulum
27
* SUBMANDIBULAR GLAND
* SUBLINGUAL GLAND
* PAROTID GLAND
SALIVARY GLANDS
28
• Clear, tasteless, odorless viscid fluid secreted by the Salivary glands
* Keeps the mucous membrane of the mouth moist
* Lubricates the food during mastication
* Begins digestion of starches
Saliva
29
below the mandible
Submandibular Gland
30
related
| superficially to Mylohyoid
Superficial
31
located between
Hyoglossus and Styloglossus
medially and Mylohyoid
laterally
Deep
32
• Located in the floor of the mouth between the mucous membrane
above and the Mylohyoid muscle below
* Surrounds the terminal portion of the Submandibular duct
* Mixed secretion predominantly Mucus
* Its duct opens into the floor of the mouth
Sublingual Gland
33
For quick transmucosal absorption of a drug – for example, when
Nitroglycerin is used as a vasodilator in Angina Pectoris (chest pain),
the pill is PUT UNDER the TONGUE where the thin mucosa allows
the absorbed drug to enter the deep lingual veins
Sublingual absorption of Drugs
34
• Largest salivary gland
```
• Occupies the Retromandibular
space between the ramus of
the mandible front and the
mastoid process and the
Sternocleidomastoid muscle
behind
```
parotid gland
35
inflammation of parotid gland
paratitis
36
Straight muscular tube
esophagus
37
```
• 23 – 25 cm long
• Extends from pharynx to
stomach
• Propels swallowed food to
stomach
```
esophagus
38
```
• Contains mucous glands for
lubrication
• Follows the curve of the
vertebral column as it
descends thru the neck and
posterior mediastinum
• Enters stomach at cardia
```
esophagus
39
esophagus Propels swallowed food to
| stomach through
Peristalsis
40
```
Located at inferior end of
esophagus
• Within esophagogastric
junction
• Contracts and relaxes
• When one is not eating, ES is
closed to prevent reflux of
food or stomach juices to
esophagus
• Food momentarily stops
here before entering
stomach
```
Esophageal sphincter
41
segments
Cervical Segment
Thoracic Segment
Mid thoracic
Lower thoracic
42
1. At the esophageal inlet, where the pharynx
joins the esophagus, behind the cricoid
cartilage (14-16 cm from the incisor teeth).
PHARYNGO-ESOPHAGEAL CONSTRICTION
43
2. Where its anterior surface is crossed by the
aortic arch and the left bronchus (25-27 cm
from the incisor teeth).
=THORACIC (AORTOBRONCHIAL)
| CONSTRICTION
44
3. Where it pierces the diaphragm (36-38 cm
| from the incisor teeth).
= DIAPHRAGMATIC CONSTRICTION
45
Glistening, transparent serous membrane
Peritoneum
46
– lining the internal surface of the abdominopelvic wall
Parietal peritoneum
47
– investing organs / viscera
Visceral peritoneum
48
* Sensitive to pressure , pain, heat and cold
* pain is generally localized
• Served by the same blood, lymphatic vasculature and somatic nerve
supply as the region of the wall it lines
Parietal
49
* Insensitive to touch, heat, cold
* stimulated primarily by stretching
* pain is poorly localized
• Served by the same blood, lymphatic vasculature and same visceral
nerve supply as the organs it covers
Visceral
50
covered with visceral peritoneum
Intraperitoneal organs
51
```
– outside ,
external or posterior to the parietal peritoneum; partially covered
with peritoneum (usually on one surface)
```
Extraperitoneal, Retroperitoneal and Subperitoneal
52
Inflammation and infection of the peritoneum and commonly
occurs due to ruptured appendix, a penetrating abdominal wound, a
perforated ulcer or poor sterile technique during surgery
Peritonitis
53
Occur after abdominal surgery whereby scar tissue forms and limits
the normal movement of the viscera
Peritoneal adhesions
54
The surgical separation of adhesions is termed as
ADHESIOTOMY
55
Accumulation of fluid in the peritoneal cavity due to peritonitis from
congestion of the venous drainage of the abdomen
common in hepatitis
Ascites and Paracentesis
56
Surgical puncture of the peritoneal cavity for aspiration or drainage
of fluid is called as
PARACENTESIS
57
STOMACH capacity
• 1.5 liter capacity
•
• Acts as food blender and reservoir
•
• Enzymatic digestion
58
Stomach is Divided into 4 parts:
Cardia
Body
Fundus
Pylorus
59
near the gastroesophageal junction
Cardia
60
dilated superior part
Fundus
61
major part, lies between fundus and pyloric antrum
Body
62
```
distal part; divisible into pyloric antrum (wide part) and
pyloric canal (narrow part)
```
Pylorus
63
forms the shorter concave border of the stomach;
the angular incisure / notch is the sharp indentation approximates the
junction of the body and pyloric part of the stomach
Lesser curvature
64
forms the longer convex border of the stomach
Greater curvature
65
Gastric ulcers – most often occur within the body of the stomach
along the lesser curvature above the incisura angularis
Gastric ulcers
66
most commonly found in the pylorus
Carcinomas of the stomach
67
* First & shortest part of the small intestine
| * Widest and fixed part
Duodenum
68
• C – shaped, about 10 inches long ( 25 cm )
Duodenum
69
Duodenum division most important part
descending part because the head of the pancreas is there
70
most often occur on the anterior wall of the first
| part of the duodenum followed by the posterior wall
Duodenal ulcers
71
occur most often with ulcers on the
anterior wall; less often with ulcers on the posterior wall (may
erode the gastroduodenal artery causing severe hemorrhage and
perforate into the pancreas
Perforation of the duodenum
72
vomiting of blood,
Hematemesis
73
blood in the stool,
Hematochezia
74
• 25 %
• Male to female ratio = 1:1
• Increased risk with blood type A
• Bleeding from left gastric art; perforation
• Burning epigastric pain soon after eating; pain increases with food
intake; relieved by antacids
Gastric ulcer
75
• 75 %
• Male to female ratio = 2:1
• Increased risk with blood type O
• Bleeding from gastroduodenal artery; perforation
• Burning epigastric pain 1 – 3 hrs after eating; pain decreases with
food intake; relieved by antacids; patient wakes at night because of
pain
Duodenal ulcers
76
```
• Jejunum starts at
duodenojejunal flexure
• 6-7 m long
• 2/5 jejunum, 3/5 ileum
• Coiled
• Covered by greater
omentum
• No clear line of demarcation
• Localization is of surgical
importance
```
Jejunum and Ileum
77
```
• Latin jejunus = EMPTY
• Often empty
• Thicker
• More vascular
• Redder
• Lies in umbilical region
• Circular folds [ plica circulares or
valves of Kerckring] of mucous
membranes are large and well
developed
```
Jejunum
78
```
• Thin
• Less vascular
• Less red
• Lies in hypogastric and right
inguinal region
• Plicae circulares are small in
superior ileum and absent in
terminal ileum
• Lymph follicles are aggregated as
```
Peyer patches located at the anti-
mesenteric side
• Site of an outpouching called
Meckel’s diverticulum
• Ends at ileocecal junction
Ileum
79
```
• Most common malformation of
GIT
• In 1 -2 % of popln
• Fingerlike pouch
• Remnant of embryonic yolk stalk
• Same layers as wall of ileum
• May contain gastric epithelium
and secrete acid cause ulcer
• 3 -6 cm long
• Fr antimesenteric border of ileum
• Within 50 cm of ileocecal junction
• When inflammed , mimics acute
appendicitis
```
Meckel’s Diverticulum
80
MESENTERY
• Double layer of peritoneum w/c encloses an organ and
connects it to abdominal wall
• Contains fat, lymph nodes, BV, nerves going to viscus
• Named after viscus it attaches
• Stomach – mesogastrium
• Transverse colon – transverse mesocolon
• Sigmoid colon – mesosigmoid
• Ovary - mesovarium
• Most mobile parts of intestine
• Transverse colon, small intestine
• None in retroperitoneal viscus
• Ascending colon , kidney, parts of duodenum
MESENTERY
81
• Suspends jejunum &
ileum
• Fan shaped
MESENTERY
82
• vermiform [ L. vermis,
wormlike]
• blind intestinal
diverticlum
```
• 6 - 10 cm long
• arises from
posteromedial aspect of
cecum below ileocecal
junction
• mesoappendix -
triangular mesentery
```
Apendix
83
64%
| most common
retrocecal
84
32%
Pelvic
85
Symptoms: RLQ pain
| McBurney’s point
Acute Appendicitis
86
= visceral referred pain, T10
1. RLQ tenderness
87
= stretching of psoas by R thigh extension causes pain
Psoas sign
88
= stretching of obt. internus by internal rotation causes
| pain
Obturator sign
89
```
• Consists of:
• cecum
• ascending colon
• transverse colon
• descending
colon
•sigmoid colon
```
COLON
90
• - 3 thickened band of muscle
Taenia coli
91
• - sacculations between taenia
Haustra
92
• - fatty projections of omentum
Appendices
93
• - larger
Internal diameter
94
```
• 1st part of LI
• continuous w/ ascending
colon
• about 7.5 cm
• at RLQ
• lies in iliac fossa inferior to
terminal ileum
• palpable at abd wall if
distended w/ gas or feces
• enveloped by peritoneum
• can be lifted freely
```
cecum
95
• circular muscle poorly
developed around orifice
• not a true sphincter
```
- ICV does not control
passage of
intestinal contents
from ileum into the
cecum
• - ICV does not prevent
reflux of intestinal
contents from cecum
back to ileum
```
ILEOCECAL VALVE
96
-15 cm long
- passes superiorly on right side
- turns to left below liver as R colic flexure or
hepatic flexure
- narrower than cecum
- lies retroperitoneally on the R side of posterior
abdominal wall
- covered by peritoneum anteriorly and on its sides
ASCENDING COLON
97
- 45 cm long
- largest, most mobile
- crosses abdomen from R colic flexure to L colic flexure
- L colic flexure [splenic flexure]= more superior, more acute,
less mobile compared to R, below spleen
- transverse mesocolon [mesentery]= loops down to pelvis
- variable in position
TRANSVERSE COLON
98
Posterior surface has no peritoneum
More deeply placed
- from left colic flexure to sigmoid
- on left side
- retroperitoneal
- has a short mesentery
- has a paracolic gutter on its side
DESCENDING COLON
99
• 25 cm long
•Descends to left hypochondraic and lumbar regions
• From lower part of lateral border of L kidney to psoas
major and quadratum lumborum to iliac crest
• Curves down and medially in front of iliacus and
psoas major muscle
• Ends at sigmoid colon at the inlet of lesser pelvis (iliac
crest)
DESCENDING COLON
100
- S shaped loop
- 40 cm
- connects desc colon and rectum
- has long mesentery, thus, has considerable degree of
freedom
- termination of taenia coli = indicates rectosigmoid jxn
- omental appendices = long
SIGMOID COLON
101
COLON CANCER
- may involve any segment
Diagnostic tests:
1] Barium enema = xray of colon
2] Colonoscopy = direct visualization
3] CT Scan with Oral and IV contrast
102
COLON CANCER
| Symptoms:
1] decreased size of stools
2] constipation
3] blood in stools
103
Treatment for colon cancer:
- colon containing the cancerous mass is resected
| including its arterial and venous drainage
104
Ascending colon cancer =
Transverse colon cancer =
R hemicolectomy
- ligate ileocolic, R colic and middle colic vessels
Transverse colectomy
- ligate middle colic, R and L colic vessels
105
- long mesentery - very
mobile
-can be visualized w/ sigmoidoscope -
25 cm from anus
SIGMOID COLON
106
-common site of large intestinal obstruction as:
1] Volvulus - twisting of mesosigmoid
2] Cancer - most common site
3] Diverticulitis- connects to UB form fistula
4] Fecal impaction - among elderly
107
BIGGEST IN COLON
TRANSVERS
108
Not part of abdominal
after the sigmoid colon
rectum
109
elevates anus
levator ani
110
part of the levator ani called the
_____ sling pulls the
anorectal junction anteriorly
puborectalis
111
-terminal dilated part
w/c is very distensible
-where feces is held
before it is expelled
Rectal ampulla
112
holds pheses in one area
Valves of Houston
113
Rectal / Digital (finger) examination
• Performed by inserting a gloved, lubricated finger
into the rectum; using the other hand to press on
the lower abdomen or pelvic area
• Palpate for lumps, tumors, enlargements, tissue
hardening, hemorrhoids, enlarged lymph nodes,
swellings in ischioanal fossae, tenderness of an
inflamed appendicits
114
Can be detected by COLONOSCOPY, which is an examination of the
inside of colon and rectum using an elongated flexible lighted
endoscope / colonoscope inserted into the rectum
rectal cancer
115
above pectinate line
voluntary
116
above pectinate line
involuntary
117
• VERTICAL FOLDS OF THE
| MUCOUS MEMBRANE
ANAL COLUMNS
118
• HORIZONTAL FOLDS THAT
JOINS OR LINKS ADJOINING
ANAL COLUMNS
ANAL VALVES
119
LINE FORMED BY THE
ANAL VALVES AROUND
THE CIRCUMFERENCE
OF THE ANAL CANAL
pectinate line
120
2 types of hemorrhoids
internal
| external
