DMH-A Flashcards
(157 cards)
1
Q
Subcostal nerve
A
Ventral rami of T12
2
Q
Lumbar plexus
A
Ventral rami of L1-L4
Supply abdominal wall, anteromedial thigh, inguinal region
3
Q
Nerves of lumbar plexus
A
Iliohypogastric
Ilioinguinal
Lateral femoral cutaneous
Genitofemoral
Femoral
Obturator
4
Q
Iliohypogastric nerve supplies..
A
Abdominal muscles and suprapubic area
5
Q
Ilioinguinal nerve supplies…
A
Abdominal muscles and inguinal area
6
Q
Lateral femoral cutaneous nerve supplies…
A
Skin of lateral thigh
7
Q
Genitofemoral nerve supplies…
A
Inguinal area
8
Q
Femoral nerve supplies…
A
Anterior thigh
9
Q
Obturator nerve supplies…
A
Medial thigh
10
Q
Caval opening
A
Around level of T8
Allows for passage of IVC through diaphragm
11
Q
Esophageal hiatus
A
Level of T8
Allows entrance of esophagus
12
Q
Aortic hiatus
A
Level of T12
Passage of aorta and thoracic duct
13
Q
Arterial supply of inferior diaphragmatic surface
A
Inferior phrenic artery
14
Q
Arcuate line and rectus sheath
A
Rectus sheath formed by oblique and transverse abdominus muscles that cover rectus muscle
Above arcuate line, sheath covers entire rectus
Below arcuate line, sheath does not cover posterior portion of rectus
15
Q
Arteries of anterior abdominal wall
A
Superior and inferior epigastric arteries
Deep circumflex artery - Br of external iliac
Superficial circumflex iliac artery - Br of femoral
Superficial epigastric - Br of femoral
16
Q
Origin of iliohypogastric and ilioinguinal nerve
A
L1
17
Q
Genital branch of genitofemoral nerve
A
Innervates cremaster muscle in spermatic cord
18
Q
Constituents of spermatic cord
A
Processus vaginalis
Ductus deferens
Testicular artery and vein
Lymphatics
Autonomic nerves
Genital branch of genitofemoral nerve
19
Q
Indirect inguinal hernia
A
Hernia that passes through deep inguinal ring
Lateral to inferior epigastric artery
More common
20
Q
Direct inguinal hernia
A
Bulge directly through abdominal wall medial to inferior epigastric artery
Through hesselbachs triangle
Medial to inferior epigastric artery
More common in adults
21
Q
Forgut develops into
A
Pharynx
Esophagus
Stomach
Upper duodenum
22
Q
Stomach rotation
A
90 degree rotation about cranio-caudal axis
- Right vagal trunk –> posterior
- Left vagal trunk –> anterior
Stomach tipping
23
Q
Stomach rotation and mesenteries
A
Dorsal mesentery expands into greater omentum
Ventral mesentary forms lesser omentum
24
Q
Stomach rotation and duodenum
A
Becomes C shaped
Moves against posterior abdominal wall, loses mesentery
25
Molecular regulation of Gut development
HOX genes
Sonic hedgehog --\> HOX activation
26
Foregut arterial supply
Celiac artery
27
MIdgut develops into
Lower duodenum
Jejunum
Ilieum
Cecum
Ascending colon
Proximal half of transverse colon
28
Rapid elongation of midgut and physiological herniation
6th week
90 degree CC rotation
Cephalic limb = duodenum, jejunum, 2/3 ileum
Caudal loopp = distal ileum, cecum, ascending colon, 2/3 T. colon
29
Return of intestines
180 degree rotation
DEscent of cecum and appendix = final gut orientation
30
Hidgut develops into
Distal transverse colon
Descending colon
Sigmoid colon
Rectum
Superior part of anal canal
31
Hindgut arterial supply
IMA
32
Cloacal partitioning
Urinary and GI originally open into same area
Cloaca divides to form urogenital and rectum (urorectal septum)
Anal membrane breakdown by week 8
Upper 2/3 of rectum = endoderm
Lower 1/3 rectum = ectoderm
33
Function of peritoneal membranes
Convey vessels and nerves to organs
Provide support
Allow for movement
34
Parietal peritoneum
Associated with body wall
Somatic sensory nerves
Sharp localized pain if irritated
35
Visceral peritoneum
Associated with abdominal organs
Sensory nerves with nerves that supply organs
Referred pain via dermatomes if irritated
36
Peritoneal organs
Suspended by mesentary
Stomach
Liver
Small intestine
Transverse colon
Sigmoid colon
Spleen
37
Retroperitoneal organs
Suspended only by anterior mesentery
Duodenum
Pancreas
Ascending/Descending colon
Kidneys
38
Liver ligaments
Falciform
Coronary
R/L Triangular
39
Thoracic esophagus blood supply
Multiple branches of thoracic aorta
40
Abdominal esophagus blood supply
Left gastric artery
Left inferior phrenic artery
41
Thoracic esophagus venous system
Azygous/hemiazygous --\> IVC
42
Abdominal esophagus venous system
Left gastric vein --\> portal vein
43
Esophagus innervation
Parasympathetic via anterior/posterior vagal trunks
Sympathetic via thoracic sympathetic trunk --\> greater splanchnic nerve
44
Muscle layers of stomach
Outer longitudinal
Middle circular
Innermost olique - create gastric canal on lesser curvature
45
Stomach relations - anterior
Left lobe of liver
Diaphragm
Anterior abdominal wall
46
Stomach relations - posterior
Lesser sac
Pancreas
47
Arterial supply of stomach
Branches of celiac trunk
Left gastric --\> lesser curvature --\> right gastric
Celiac trunk --\> common h --\> gastro duodenal --\> right gastro-omental --\> left gastro-omental --\> splenic
48
Venous drainage of stomach
Parallels arteries
R/L gastric veins --\> portal vein
Short gastric and L gastro-omental --\> Splenic vein --\> portal vein
49
Parasympathetic innervation and results of stomach
Anterior and posterior vagal trunks
Gastric acid secretion
Peristalsis
Gladnular secretion
Pyloric relaxation
Vasodilation
50
Sympathetic innervation of stomach and actions
T6-T9 via greater splanchnic nerve through celiac plexus
Vasoconstriction
Contraction of pyloric sphincter
Inhibition of secretion and peristalsis
51
Descending part of duodenum
Receives bile duct and main pancreatic duct --\> hepatopancreatic ampulla that opens on major duodenal papilla
Minor duodenal papilla --\> opening of accessory pancreatic duct
52
Horizontal part of duodenum location
Posterior abdominal wall around L3
53
Duodenal arterial supply
Celiac trunk --\> common hepatic --\> gastroduodenal --\> superior pancreatodeuodenal
Aorta --\> SMA --\> inferior pancreatoduodenal
54
Venous drainage of duodenum
Venous counterparts of arteries drain into hepatic portal vein
55
Innervation of duodenum
Parasympathetic from vagus
T5-9 sympathetic via celiac and superior mesenteric plxuses
56
Blood supply of jejunum/ileum
SMA --\> ilial and jejunal arteries
Terminal ileum receives blood supply from ileocolic branch of SMA
57
Large intestince special characteristics
Teniae coli - thickened bands of longitudinal smooth muscle
Omental appendices
Haustra
58
Blood supply of Large intestine
SMA and IMA branches
59
Ascending colon/RCF blood supply
Aorta --\> SMA --\> right colic
60
Transverse colon blood supply
Aorta --\> SMA --\> middle colic artery
Also Left and right colic arteries
61
Descending colon blood supply
Aorta --\> IMA --\> Left colic
62
Sigmoid colon blood supply
Aorta --\> IMA --\> sigmoid arteries
63
Parasympathetic innervation of Large intestine
Start to left colic flexure (splenic flexure) = vagus
Large intestine distal to splenic flexure is sacral parasympathetics
64
Sympathetic innervation of large intestine
T10-L1 to splenic flexure
L1/2 from splenic flexure to rectum
65
Rectum vasculature
Aorta --\> IMA --\> Superior rectal artery
Aorta --\> iliac arteries --\> internal iliac --\> R/L middle rectal arteries
Pudendal --\> inferior rectal artery
66
Sphincters of anal canal
Internal anal sphincter - involuntary
External anal spchinter - voluntary
67
Defecation
Feces enters rectal ampulla --\> stretch causes internal anal sphincter relaxation --\> need voluntary relaxation of external anal sphincter for defecation
68
Above pectinate line
Superior rectal artery/vein
Visceral motor and sensory innervation
Lymph --\> internal iliac lymh nodes
69
Below pectinate line
Inferior rectal artery/vein
Somatic motor/sensory innervation
Lymph --\> Superficial inguinal lymph nodes
70
UC localization
Distal colon
71
Crohns disease localization
Anywhere along GI tract (mainly SI and colon)
72
Main pancreatic duct
Begins in tail of pancreas and joins with bile duct to form hepatopancreatic ampulla
73
Accessory pancreatic duct
Drains uncinate process
Opens into duodenum at minor duodenal papilla
74
Blood supply of pancreas
Derived from splenic
Pancreatic branches of gastroduodenal, SMA
Superior/inferior pancreaticoduodenal = head of pancreas
75
Innervation of pancreas
Sympathetic - Thoracic splanchnic nerve
Para - Vagus nerve
76
Innervation of liver
Hepatic nerve plexus
Vagus nerve
Sympathetic T7-10
77
Hepatic duct system
Liver cells secrete bile --\> bile canaliculi --\> bile ducts --\> L/R hepatic duct --\> exit at porta hepatis --\> common hepatic duct --\> +cystic duct = common bile duct
78
Lymph drainage of stomach, SI, Duodenum, Pancreas
Celiac and superior mesenteric nodes --\> cisterna chili
79
LArge intestine lymph drainage
Superior and inferior mesenteric nodes
80
Rectum lymph drainage
Inferior mesenteric, pararectal, sacral nodes
81
Anal canal lymph drainage
Above pectinate line: Internal iliac lymph nodes
Below pectinate line: Superficial inguinal lymph nodes
82
Portal systemic anastomoses
Gastroesophageal
Anorectal
Paraumbilical
Retroperitoneal
83
Name and function
Filiform papillae
Improve friction
84
Name and function
Circumvallate papillae
Carry taste buds
85
Fungiform papillae
Carry taste buds
86
Taste buds
87
Lingual tonsils
Note tonsillar crypt and lymphoid follicles
88
Palatine tonsil
89
Tooth
Dentin
Pulp cavity
90
Ameloblast
Secrete enamel
Lost on tooth eruption
91
Odontoblasts
Secrete dentin
92
Salivary glands
93
Blue arrows
Green arrow
Serous demilune
Serous acini
Mucous acini
94
Serous cell secretion
Amylase
Lysozyme
Transport fluid, ions, Ig
95
Mucous cell secretion
Mucin
96
Transepithelial transport of Ig in salivary glands
IgM/IgA
Ag binds to receptor on basolateral surface --\> endocytosed --\> travel across cell --\> exocytosed --\> in secretion
97
Identify yellow area and green area
Yellow - Intercalated duct
Green - striated duct
98
Picture overall
Arrows pointing to?
Salivary gland
Striated ducts
99
Excretory duct
100
Parotid glands mainly...
Serous
101
Sublingual glands mainly....
Mucous
102
Submandibular glands mainly...
Mixed serous/mucous
103
Lip
104
Organ
Name layers
Esophagus
Epithelium
Lamina propria
Muscularis mucosa
Submucosa
M propria (inner circular, outer longitudinal)
Adventitia
105
Esophagus stomach junction
106
Cardiac glands of stomach
107
Pyloric glands of stomach
108
Gastric glands of stomach
109
Chief cells location and secretion
Located in gastric glands of stomach
Secrete pepsinogen
110
Parietal cell location and secretion
Located in gastric gland area of stomach
Secrete HCl via carbonic anhydrase reactions
111
Parietal cells and B12
Parietal cells secrete intrinsic factor which is needed for B12 absorption
No B12 = pernicious anemia
112
Enteroendocrine cells
Secrete hormones that influence gut function
Neutrophilic cytoplasm, secretory granules in basal cytoplasm
Secrete gastrin --\> stimulates motility and parietal HCl production
113
Superficial fascia (Scarpas) equivalent in testes
Dartos muscle
114
External oblique muscle equivalent in testes
External spermatic fascia
115
Internal oblique muscle equivalent in testes
Cremaster muscle
116
Transversalis fascia equivalent in testes
Internal spermatic fascia
117
Peritoneum equivalent in testes
Tunica vaginalis
118
Contents of male inguinal canal
Spermatic cord
Ilioinguinal n
119
Contents of female inguinal canal
Round ligament of uterus
Ilioinguinal nerve
120
Femoral hernia
Hernia sac passes directly through femoral ring/canal into thigh
More common in females
121
Ligamentum teres = ?
Obliterated umbilical vein
122
Median umbilical fold of posterior abdominal wall = ?
Urachus
123
Medial umbilical fold = ?
Obliterated umbilical artery
124
Lateral umbilical fold = ?
Inferior epigastric artery
125
Hesselbachs triangle
Inguinal ligament
Linea alba
Inferior epigastric artery
126
Lumbar plexus nerve from L1
Ilioinguinal
Iliohypogastric
127
Origin of Genitofemoral nerve
L1
L2
128
Origin of lateral femoral cutaneous
L2
L3
129
Origin of femoral nerve
L2
L3
L4
130
Obturator nerve origin
L2
L3
L4
131
Pain from small intestine felt where?
Periumbilical region
132
Paraumbilical anastamoses
Between paraumbilical vein and peigastric vein
133
Esophageal anastamoses
Left gastric and azygous veins
134
Retroperitoneal venous anastamoses
Veins of retroperitoneal organs/abdominal wall veins
135
Rectal venous anastamoses
Between superior and middle/inferior rectal veins
136
Epithelial cells of small intestine
Enterocyte
Paneth cell
Goblet cells
Enteroendocrine cells
137
Intestinal paneth cell secretion
Lysozyme
Anti microbials
138
Intestinal enteroendocrine cell secretion
CCK
GIP
Secretin
139
Intestinal enterocyte function
Absorption
Immune
Digestion
140
Distinguishing feature of duodenum?
Significant amount of submucosal glands
141
Distal differences of intestine histology
Increasing number of goblet cells
Decreased size of villi
Increased number of lymphoid follicles
142
Stem cell location in stomach vs intestine
Stomach - upper level of crypts
Intestine - base of crypts
143
Paneth cell location in colon
Proximal only (Ascending)
144
Goblet cell and enteroendocrine cell numbers in colon
Many goblet cells
Few enteroendocrine cells
145
Organ?
Notable structures?
Duodenum
Diffuse submucosal glands
146
Small intestine
Note paneth cells in cluster at bottom
147
Jejunum
148
Colon
Glands do not bifurcate
149
Colon
150
Structures? Associated with?
Peyers patches
Ileum
151
Which papilla have taste buds?
Circumvallate (side)
Foliate (side)
Fungiform (top)
FILIFORM DO NOT HAVE TASTE BUDS
152
Medial inguinal fossa is between....
Medial and lateral umbilical folds
Lateral - inferior epigastric arteries
Medial - obliterated umbilical artery
153
Vagus nerve supplies what part of GI tract
All of GI until end of transverse colon (Structures supplied by Celiac trunk and SMA, NOT IMA)
Parasympathetics supply rest
154
Liver develops in which mesentery
Ventral
155
Spleen and pancreas develop in which mesentary
Dorsal
156
Location of odontoblasts and function
Location - pulp cavity
Function - Secrete dentin
157
