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gastroenterology Flashcards

(105 cards)

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1
Q

state the four quadrants of the abdomen

A

right upper quadrant
left upper quadrant
right lower quadrant
left lower quadrant

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2
Q

what is the horizontal plane that divides the quadrants

A

transumbilical plane

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3
Q

what is the vertical plane that divides the quadrants

A

median plane

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4
Q

state the 9 regions of the abdomen

A 
right hypochondriac 
epigastric 
left hypochondriac 
right lumbar (lateral)
umbilical 
left lumbar (lateral)
right inguinal (groin)
hypogastric (pubic)
left inguinal (groin)
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5
Q

what are the vertical lines which divide the regions

A

mid clavicular lines

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6
Q

what are the horizontal lines which divide the regions

A

subcostal

transtubercular

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7
Q

what dermatome is the umbilicus in

A

T10

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8
Q

what is the vertebral level of the umbilicus

A

between l3 and l4

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9
Q

state the 4 muscles in the abdomen

A

external obliques
internal obliques
transversus abdominis
rectus abdominus

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10
Q

what direction do the external obliques run

A

inwards and lateral

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11
Q

what direction do the internal obliques run

A

out and lateral

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12
Q

what direction do the transversus abdominis run

A

horizontal

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13
Q

what direction do the rectus abdominis run

A

vertical

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14
Q

the aponeurosis of which three muscles form the rectus sheath

A

external oblique
internal oblique
tranversus abdominis

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15
Q

what two muscles lie within the rectus sheath

A

rectus abdominis

pyramidalis mucles

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16
Q

what is the line where the posterior layer of the rectus sheath ends called

A

curved arcus tendinous

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17
Q

what do the superior arteries arise from

A

distal aspect of internal thoracic arteries

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18
Q

where do the superior veins drain to

A

internal thoracic veins

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19
Q

what do the inferior arteries arise from

A

tributaries from the abdominal aorta

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20
Q

where do the inferior veins drain to

A

external iliac veins

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21
Q

define caput medusa

A

formation of dilated abdominal wall veins which extend from the umbilicus

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22
Q

the inguinal ligament is formed from the aponeurosis of which muscle

A

external oblique

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23
Q

the superficial inguinal ring is a break in the aponeurosis of what muscle layer?

A

external oblique

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24
Q

what are the borders of the inguinal canal

A

anterior wall: medially - aponeurosis of external oblique, laterally - internal oblique muscles
posterior wall: transversalis fascia
roof: transversals fascia, internal oblique, transverse abdominus
floor: inguinal ligament , lacunar ligament

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25
state the layers of the spermatic cord
internal spermatic fascia cremasteric fascia creamaster muscle external spermatic fascia
26
define an indirect hernia
results from a congenital weakness in the deep inguinal ring, allowing abdominal contents to enter into the inguinal canal lateral to the inferior epigastric vessels, and even out the deep inguinal ring
27
define a direct hernia
abdominal contents do not pass through the deep inguinal ring, but simply push through a weak spot in the muscles making up the posterior wall of the inguinal canal, allowing contents to enter the canal and, again, even pass through the superficial inguinal ring
28
define a femoral hernia
occur below the inguinal ligament, when abdominal contents pass into the weak area of the posterior wall of the femoral canal medial to the inferior epigastric vessels
29
define umbilical hernia
occur when the abdominal contents pass through a weakness at the site of the passage of the umbilical cord through the abdominal wall.
30
state the muscles of the posterior abdominal wall
iliacus quadratus lobotum psoas major psoas minor
31
what is the action of the iliacus
flex the hip joint
32
what is the action of the quadratus lobortum
lateral flexion of trunk to same side
33
what is the action of psoas major
flex hip joint, pull trunk and pelvis forward, medial rotator of hip
34
what is the action of psoas minor
weak flexor of lumbar spine
35
what are the three main openings in the diaphragm and what vertebral level do these occur at
IVC foramen - T8 esophagus hiatus - T10 abdominal aorta - T12
36
what is the route of the foregut
runs from the mouth to the duodenum (including liver, gall bladder, spleen and pancreas)
37
what is the route of the midgut
runs from the opening of bile duct to duodenum to the proximal 2/3rd of transverse colon
38
what is the route of the hindgut
runs from the distal 1/3rd of transverse colon to anal canal
39
what artery supply the foregut
celiac trunk
40
what artery supply the midgut
SMA
41
what artery supply the hindgut
IMA
42
at which vertebral level does the Celiac trunk Come off at
T12
43
at which vertebral level does the SMA Come off at
L1
44
at which vertebral level does the IMA Come off at
L3
45
name the three branches of the celiac trunk
left gastric artery, common hepatic artery, splenic artery
46
at what vertebral level does the abdominal aorta divide into 2 common iliac arteries
L4/L5
47
what vessels merge to form the IVC
common iliac arteries
48
the portal vein is formed by union of which 2 major veins of the abdominal cavity
SM vein | IM vein
49
what are the 4 sites of portal-systemic anastomoses
anorectal junction gastroesophageal junction umbilicus retroperitoneal
50
state the sympathetic nerve supply to the viscera
abdominopelvic splanchnic nerves (greater, lesser and least) prevertebral sympathetic ganglia abdominal aortic plexuses
51
state the parasympathetic nerve supply of the viscera
anterior and posterior vagal trunks (vagus nerve - 10th cranial nerve) pelvic splanchnic nerves (S2,S3 and s4)
52
state where the various parts of the gut pain are referred to
``` foregut = epigastric region midgut = umbilical area hindgut = suprapubic region ```
53
where do the kidneys lie
on posterior wall at the level of T12-L3 vertebrae
54
identify the 3 main structures at hilum of kidney
renal artery renal vein uretra
55
where does the head of the pancreas sit
duodenal curve
56
what structures compose the small intestine
duodenum jejunum ileum
57
what is the name given to the peritoneal lining the body wall
parietal
58
what is the name given to the peritoneal lining the viscera
visceral
59
what layer of the peritoneum is more sensitive to pressure, pain, heat and cold
parietal
60
state the retroperitoneal organs
``` SAD PUCKER suprarenal (adrenal) gland aorta/ ivc duodenum (2nd/3rd part) pancreas (except tail) ureters colon (asc and desc) kidneys oesophagus rectum ```
61
what are the lesser and greater sacs and where do they live
lesser sac = part sequestered behind stomach | greater sac = remainder of cavity
62
through which passage do the lesser and greater sac communicate
epiploic foramen
63
describe the boundaries of the epiploic foramen
free border of the lesser momentum lesser sac/ omental bursa
64
what is the falciform ligament and what structures lie within its free border
it is a peritoneal ligament that consists of a double layer of peritoneum that connects an organ with another organ or to the abdominal wall, liver connects to anterior abdominal wall
65
what structure in the free edge of the falciform ligament is a remnant of an embryonic blood vessels
round ligament of liver
66
list 3 abdominal viscera which lie in the free edge of a double layer of peritoneum describe as the mesentery
sigmoid colon transverse colon rectum
67
what is the transpyloric plane
horizontal plane located halfway suprarenal notch of the manubrium and upper border of the symphysis of pubis at L1
68
what costal cartilage is the surface marking of the gall bladder
9th
69
what does the large intestine include
caecum, appendix, and colon (ascending, transverse, descending, sigmoid)
70
what are the four parts of the stomach
fundus body pyloric part duodenum
71
what is the pyloric sphincter
band of smooth muscle at the junction between the pylorus of the stomach and the duodenum of small intestine
72
what are the gastric folds/rugae formed from
mucosa and submucosa
73
what are the 4 main veins draining the stomach
1. left gastric which drains into the hepatic portal vein 2. right gastric which drains into the hepatic portal vein 3. left gastroepiploic which drains first to the splenic vein then to the hepatic portal vein 4. right gastroepiploic which drains first to the superior mesenteric vein then to the hepatic portal vein
74
what is the name of the small opening in the duodenum where pancreatic and bile fluids enter the gut tube
ampulla of vater
75
what is the sphincter that controls the ampulla of water called
sphincter of oddi
76
which major blood vessel supplies the jejunum and ileum
superior mesenteric artery
77
what 3 features help distinguish the large intestine
teniae coli epiploic appendages haustra
78
what is mcburneys point
the site of max tenderness in appendicitis
79
what is the pectinate line
divides upper 2/3rds and lower 1/3rd of anal canal - irregular circle
80
state the 4 distinct functional layers of GI tract
1. mucosa - 3 layers - epithelium - lamina propria - muscular mucosa (interna) 2. submucosa 3. muscular externa - 2 layers - circular muscle - longitudinal muscle 4. serosa (or adventia)
81
state the 4 basic mucosal types
protective secretory absorptive absorptive/ protective
82
what kind of epithelium lines the oesophagus
stratifies squamous non-keratinised epithelium
83
what is the epithelial lining of the stomach
simple columnar epithelial cells
84
what secretory cells are present in the gastric glands
parietal and chief cells
85
what kind of cells are found in the small intestine and what do they secrete
crypts, secrete mucus
86
what is the distinguishing factor for duodenum
presence of brunners glands
87
what is the function of brunners glands
s ecrete alkaline based mucus to protect the duodenal lining from the acid secreted from the stomach
88
what cells are found in the small intestine
peyers patches
89
name the four lobes of the liver
left lobe right lobe caudate lobe quadrate lobe
90
what is meant by the term 'bare area' of the liver
large triangular area of the liver which has no peritoneal covering
91
the round ligament of the liver is the remnant of which embryological structure
umbilical vein
92
what is portages hepatis
deep fissure in the inferior surface of the liver through which all neurovascular structures (except hepatic vein) and hepatic ducts enter or leave liver
93
name structures present in the porta hepatitis
``` portal vein hepatic artery hepatic nerve plexus hepatic ducts lymphatic vessels ```
94
what structures are in the portal triad
hepatic artery bile duct portal vein
95
where does the central vein drain to
hepatic vein which drains to IVC
96
what does the extrahepatic biliary apparatus consist of
``` right and left hepatic ducts common hepatic duct gallbladder cystic duct bile duct or common bile duct ```
97
describe calots triangle
triangular space formed by cystic duct, common hepatic duct and inferior surface of liver - the triangle contains cystic artery
98
state the 4 parts of the pancreas
neck head tail body
99
how is the pancreas peritonised
``` tail = intraperitoneal rest = retroperitoneal ```
100
name the structures in the hilum of the spleen
gastrosplenic ligament splenic artery splenic vein
101
what is the function of the spleen
storage of RBCs immune response haemopoiesis phagocytosis
102
describe the main histological features of the liver
cells are arranged in sheets and converging towards the central vein at the corner of the lobule connective tissue encloses portal areas which contain blood vessels and ducts (portal tracts or portal triad)
103
describe the main histological features of the pancreas
islets of langerhans composed of clumps of small poorly stained cells pure serous acini composed of large strongly stained cells small lobules surrounded by connective tissue septa
104
what does white pulp contain
lymphoid tissue
105
what does red pulp contain
venous sinuses (mainly RBC)

anatomy (12 decks)

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