Gastrointestinal Anatomy Outcomes Flashcards
(173 cards)
1
Q
Where is the temporomandibular joint?
A
Between the articular surface of the temporal bone and the condylar processes of the mandible.
2
Q
Describe the muscles of mastication that open the jaw.
A
The lateral pterygoid is the only muscle responsible for opening the jaw.
3
Q
Describe the muscles of mastication that close the jaw.
A
Temporalis, masseter, and medial pterygoid.
4
Q
What innervates the muscles of mastication?
A
The mandibular division of the trigeminal nerve - CN V3.
5
Q
Describe the medial pterygoid.
A
Muscle of mastication. CLOSES jaw. From the angle of the mandible (medial side) to the pterygoid plates of the sphenoid bone.
6
Q
Describe the lateral pterygoid.
A
Muscle of mastication. OPENS jaw.
From the condyle of the mandible to the pterygoid plates of the sphenoid bone.
7
Q
Describe the temporalis muscle.
A
Muscle of mastication. CLOSES jaw. From the coronoid process of the mandible to the temporal fossa.
8
Q
Describe the masseter muscle.
A
Muscle of mastication. CLOSES jaw. From the angle of the mandible to the zygomatic arch.
9
Q
Major features of the oral cavity?
A
Hard palate superiorly. Pharynx posteriorly. Tongue inside. Mandible and teeth anteriorly. Muscle of the floor of the mouth, hyoid bone & epiglottis inferiorly.
10
Q
Describe the anterior anatomy of the tongue.
A
Anterior 2/3rds = horizontal part. In the oral cavity, responsible for taste (CNVII) - foliate, vallate & fungiform papillae. General sensory (CNV3)- filiform papillae: touch, temperature etc.
11
Q
Describe the posterior anatomy of the tongue
A
Posterior 1/3rd = vertical part. In the oropharynx. Enables taste and general sensation (CNIX)
12
Q
Which nerve provides innervation to the lingual nerve branch of the anterior 2/3rds of the tongue?
A
Chorda tympani branch of CN VII: connects to the lingual nerve branch of CN V3 providing taste to the anterior 2/3rd of the tongue. Parasympathetic.
13
Q
which parasympathetic nerve supplies secretomotor innervation to the submandibular salivary gland?
A
CN VII parasympathetic axons.
14
Q
which parasympathetic nerve supplies secretomotor innervation to the sublingual salivary gland?
A
CN VII.
15
Q
what provides the superior half of the oral cavity with general sensation?
A
CN V2
16
Q
What provides the inferior half of the oral cavity with general sensation?
A
CN V3
17
Q
Describe the components of the gag reflex.
A
protective reflex against foreign body entry into the pharynx/larynx.
Sensory part carried out by CN IX.
Motor part carried out by CN IX and CN X.
Pharynx constricts, attempting to close off entry.
18
Q
Describe parotid gland.
A
Parotid duct crosses the face & secretes into the mouth by the upper 2nd molar.
19
Q
Describe submandibular gland.
A
Submandibular duct enters the floor of the mouth & secretes via the lingual caruncle.
20
Q
Describe the sublingual gland.
A
Lays in floor of mouth secretes via several ducts superiorly.
21
Q
Extrinsic muscles of the tongue.
A
Change tongue position. 4 pairs: hyoglossus, styloglossus, genioglossus, palatoglossus. All innervated by CN XII, EXCEPT PALATOGLOSSUS.
22
Q
Intrinsic muscles of the tongue
A
4 pairs. Modify shape of tongue. Innervated by CN XII.
23
Q
Function of the pharynx.
A
Contracts sequentially - peristaltic.
24
Q
Describe pharynx structure.
A
External layer of circular constrictor muscles, voluntary & overlap each other. Innervated by CN X.
25
Describe inner longitudinal muscles of the pharynx.
Inner layer - supplied mainly by CN X and IX. Elevate pharynx & larynx.
26
Function of longitudinal muscles of the pharynx.
Contract to shorten pharynx.
| Raise the larynx to close over the laryngeal inlet.
27
Enteric Nervous system
Extensive nerve network.
Found only in walls of GI tract.
Independent of other parts of the nervous system - but can be influenced by autonomic motor nerves.
28
Lower oesophageal sphincter.
Physiological rather than anatomical sphincter. Due to contraction of diaphragm, slightly higher intra-abdominal pressure than intragastric & the oblique angle at which the oesophagus enters the cardia of the stomach.
29
Presence of this reduces effectiveness of lower oesophageal sphincter.
Hiatus hernia.
30
Anatomical location of lower oesophageal sphincter.
Immediately superior to gastro-oesophageal junction. Abrupt change in type of mucosa lining the wall - z-line.
31
areas of the stomach.
Cardia, fundus (superior), greater curvature, body, pyloric antrum, lesser curvature. Pyloric sphincter.
32
Anatomical location of the stomach.
Mainly in the left hypochondrium, epigastric & umbilical regions when supine.
33
Anatomical relations of the stomach.
Lesser omentum superiorly.
Greater omentum inferiorly.
Left hemi-diaphragm superiorly.
34
Composition of the small intestine
Duodenum, jejunum, ileum.
35
Large intestine
colon, rectum anal canal, anus
36
Colon
Caecum, appendix, ascending colon, transverse colon, descending colon, sigmoid colon.
37
foregut organs
Oesophagus, stomach, mid-duodenum, liver, gallbladder, spleen, 1/2 of pancreas.
38
Midgut organs
Mid-duodenum to proximal 2/3 of transverse colon, 1/2 of pancreas
39
Hindgut organs
distal 1/3rd of transverse colon to proximal 1/2 anal canal.
40
nine areas of the abdomen
```
R&L hypochondrium
L&R lumbar
L& R inguinal
Epigastric
Umbilical
Pubic
```
41
muscles of the anterolateral abdominal wall
Rectus abdominis
External oblique
Internal oblique
Transversus abdominus
42
Peritoneal Cavity
The peritoneal cavity lies between the visceral & parietal layers of the peritoneum.
43
Peritoneum
Peritoneum is a thin, transparent, semi-permeable continuous membrane. Lines walls of the abdominopelvic cavity & organs.
44
intraperitoneal organs
almost completely covered in visceral peritoneum, minimally mobile.
45
Intraperitoneal organs with a mesentery
Covered in visceral peritoneum which wraps behind the organ to form a double layer - mesentery.
46
Mesentery
Suspends an organ from the posterior abdominal wall - very mobile.
47
retroperitoneal organs
only has visceral peritoneum on its anterior surface, located in the retroperitoneum.
48
omentum
double layer of peritoneum that passes from stomach to adjacent organs
49
peritoneal ligaments
double layer of peritoneum connecting organs to one another or the body wall.
50
greater omentum
four layered, hangs like an apron. Attaches greater curvature of stomach to transverse colon.
51
Lesser omentum
Double layered, runs between the lesser curvature of the stomach & duodenum to the liver. Has a free edge.
52
Greater and lesser sacs.
omenta divide peritoneal cavity into a greater and lesser sac.
Lesser sac is much smaller, two sacs communicate through ommental foramen.
53
Lies at the free edge of the lesser omentum
Portal triad.
54
peritoneum drapes over the superior aspect of pelvic organs to form pouches. how do they differ in males & females?
One pouch in the male - RECTOVESICAL POUCH.
Two pouches in the female - VESICO-UTERINE & RECTO-UTERINE POUCH.
55
Pouch of douglas
Recto-uterine pouch
56
abdominocentesis/paracentesis
needle placed lateral to the rectus sheath to drain ascetic fluid from the peritoneal cavity
57
Inferior epigastric artery
ascends in the anterior abdominal wall deep to rectus abdominis,
Arises from the external iliac, medial to the deep inguinal ring.
58
Biliary tree
set of tubes connecting liver to the 2nd part of the duodenum.
59
Liver
Largest organ in the body. Receives nutrients absorbed from GI tract.
60
Liver surface anatomy
mainly located in RUQ, protected by ribs 7-11, location changes in breathing.
61
anatomical lobes of liver
right, left, caudate and quadrate lobes
62
porta hepatis
site of entrance for portal triad structures
63
Functional lobes of the liver allow for what
segmentectomy: branch of hepatic artery, hepatic portal vein, bile drainage (bile duct), venous drainage (to IVC).
64
how many hepatic veins join together before entering the IVC.
Hepatic veins join together as 3 veins before entering the IVC.
65
Portal triad
Hepatic portal vein, hepatic artery proper, the bile duct.
66
First of three midline branches of the aorta, retroperitoneal, leaves aorta at T12 vertebral level.
Supplies organs of the foregut.
Coeliac trunk
67
trifurcates into 3 branches: splenic artery, left gastric artery & common hepatic artery.
Coeliac trunk
68
Intraperitoneal organ within the left hypochondrium. Protected by ribs 9-11
Spleen
69
Artery with a very tortuous course that runs along the superior border of the pancreas.
Splenic artery.
70
Functions within the haematological system to break down red blood cells to produce bilirubin.
Spleen
71
Blood supply to the stomach
R&L gastric arteries, run along juncture of lesser curvature & lesser omentum & anastomose together.
R&L gastro-omental arteries, run along the junction of greater curvature & greater omentum & anastomose together.
Minor: posterior gastric arteries & short gastric arteries.
72
Blood supply to the liver
R & L hepatic arteries - branches of the hepatic artery proper.
20-25% of blood received by liver.
Majority from the hepatic portal vein.
73
2 clinically important areas of the peritoneal cavity related to the liver.
Hepatorenal recess (Morrison's pouch) and sub-phrenic recess.
74
Where are the hepatorenal and sub-phrenic recesses located?
Hepatorenal recess is posterior to the liver, and subphrenic is anterior.
Both lie within the peritoneal cavity.
75
One of the lowest parts of the peritoneal cavity when the patient is supine
Hepatorenal recess.
76
Pus from an abscess in the subphrenic recess can drain into where when a patient is bedridden?
Hepatorenal recess
77
Hepatic portal vein drains blood from where to the liver, for first pass metabolism?
Foregut, midgut & hindgut.
78
Splenic vein & superior mesenteric vein form what?
Hepatic portal vein.
79
Drains blood from the hindgut to the splenic vein
Inferior mesenteric vein.
80
Drains foregut
Splenic vein
81
Drains midgut
Superior mesenteric vein
82
Drains hindgut to splenic vein
Inferior mesenteric
83
Retroperitoneal, drains cleaned blood from hepatic veins into the right atrium.
Inferior vena cava
84
Lies on the posterior aspect of the liver (often firmly attached).
Gallbladder
85
Stores & concentrates bile in between meals.
Gallbldder
86
Bile flows in and out of the gallbladder via the
cystic duct
87
Blood supply to the gallbladder is via the ?
cystic artery (usually a branch of the right hepatic artery)
88
Cystic artery is located where
cystohepatic triangle of calot
89
Foregut organ - early pain will present in the epigastric region. May also present in the right hypochrondrium with or w/o referral to the right shoulder. Visceral afferents enter the spinal cord between T6-T9.
Gallbladder
90
Surgical removal of the gallbladder
cholecystectomy
91
Bilirubin is used to form bile where?
In the liver
92
Biliary tree
transports bile. R & L hepatic ducts unite to form - common hepatic duct.
Common hepatic duct unite with cystic duct to form the common bile duct.
93
Begins at the pyloric sphincter. 4 parts: superior (partly intraperitoneal), descending (retroperitoneal), horizontal (retroperitoneal) and ascending (retroperitoneal).
Duodenum
94
Anatomical sphincter controlling the flow of chyme from the stomach to the duodenum. Smooth muscle - autonomic nerves.
Pyloric sphincter.
95
Ends at the duodenojejunal flexure. Secretes a number of peptide hormones into the blood - gastrin, CCK.
Duodenum
96
Pain from an ulcer of this structure tends to present at the epigastric region.
Duodenum
97
Retroperitoneal organ which lie transversely across the posterior abdomen.
Pancreas.
98
Has: head (with uncinate process), neck, body, tail.
Pancreas
99
The head of this structure is described as being surrounded by the "c-shape" formed by the duodenum.
Pancreas
100
Lies posteriorly to the stomach. Retroperitoneal.
Pancreas.
101
Secretes pancreatic digestive enzymes into the min pancreatic duct.
Exocrine acinar cell.
102
Secretes insulin & glucagon into the bloodstream.
Endocrine islets of langerhans.
103
Bile duct travels into a groove on the posterior aspect of the pancreas, joins with the main pancreatic duct to form?
Ampulla of Vater.
104
Where does the ampulla of vater drain?
Into the 2nd part of the duodenum.
105
smooth muscle sphincters of the biliary system
Bile duct sphincter, pancreatic duct sphincter, sphincter of Oddi.
106
Investigation used to study the biliary tree & pancreas. Also able to treat some associated pathologies.
ERCP
107
Bile is diverted into the pancreas leading to irritation & inflammation due to what?
Blockage of the ampulla by a gallstone causing pancreatitis.
108
Foregut AND midgut organ. Pain can present in epigastric region and/or umbilical region. May radiate to patients back
Pancreas
109
Grey turner's and Cullen's sign arise due to what
Vascular haemorrhage in acute pancreatitis, leading to blood/fluid accumulation in the retroperitonea space.
110
duodenum, jejunum, ileum
small intestines
111
foregut organs of the small intestines
1st and 2nd parts of the duodenum
112
Midgut organs of the small intestines
Jejunum, ileum and duodenum (EXCEPT 1st & 2nd parts)
113
peyer's patches present where in the small intestine
lymphoid tissue present in the ileum
114
Arterial blood supply of jejunum and ileum
superior mesenteric artery via jejunal and ileal arteries
115
Venous drainage from jejunum & ileum
Jejunal and ileal veins to superior mesenteric vein, to the hepatic portal vein.
116
Leaves aorta at L1, posterior to the neck of the pancreas. Travel inferiorly, anterior to the uncinate process of the pancreas to enter the mesentery proper.
superior mesenteric vessels
117
Lymph nodes of foregut organs
coeliac
118
Lymph nodes of midgut organs
superior mesenteric
119
Lymph nodes of hindgut organs
inferior mesenteric
120
Lymph nodes of kidneys, posterior abdominal wall, pelvis & lower limbs.
Lumbar
121
Major lymphatic drainage angle
thoracic duct at the left venous angle
122
Drains lymph from right (1/4) of the body
Right lymphatic duct at the right venous angle.
123
intraperitoneal and secondarily retroperitoneal organ, which has its own mesentery. Inferior to liver and spleen.
Colon
124
L & R - lie between the lateral edges of the ascending & descending colon, and the abdominal wall.
R& L paracolic gutters.
R- ascending
L- descending
125
the paracolic gutters are part of what
the greater sac of the peritoneal cavity.
126
omental appendices, teniae coli, haustra.
Colon
127
3 distinct longitudinal bands of thickened smooth muscle, running from the caecum to the distal end of the sigmoid colon & come together at the appendix.
Teniae coli
128
small fatty projections of the colon
omental appendices
129
formed by tonic contraction of the teniae coli
haustra
130
Most common position of the appendix
retrocaecal
131
McBurney's point
1/3 of the way between the right ASIS to the umbilicus. Supposedly maximum tenderness in appendicitis
132
Lies in the left iliac fossa. Long mesentery.
Sigmoid colon
133
Long mesentery of sigmoid colon increases risk of what
sigmoid volvulus - bowel obstruction & infarction
134
midline retroperitoneal structure, lies anterior to the vertebral bodies & to the left of the IVC.
Abdominal aorta
135
Lateral branches of abdominal aorta
Renal arteries, gonadal arteries, lumbar arteries.
136
abdominal aorta bifurcates into what?
The internal and external iliacs
137
Branches of the superior mesenteric artery
jejunal and ileal arteries, appendicular, ileocolic, right colic, middle colic, inferior pancreaticoduodenal,
138
vasa rectae and arcades of jejunum
long vasa rectae
| Larger and fewer arcades
139
vasa rectae and arcades of ileum
Short vasa rectae, small and many arcades
140
branches of inferior mesenteric artery
left colic, sigmoid arteries, superior rectal artery.
141
arterial anastomoses between branches of SMA and IMA
marginal artery of drummond
142
Blood supply to rectum and anal canal
superior rectal artery, branch of IMA
143
Epigastric veins drain where?
caval system
144
Para-umbilical veins drain to the hepatic portal vein along what
the round ligament of the liver.
145
superior part of the distal end of the oesophagus drains to what?
Azygous vein
146
inferior part of the distal end of the oesophagus drains to what?
Hepatic portal vein
147
rectum and superior anal canal drains to what?
inferior mesenteric vein
148
inferior part of the GI tract drains to?
Internal iliac veins
149
What senses "fullness of the rectum"?
Visceral afferent nerve fibres.
150
What responds to "fullness" of the rectum?
Functioning muscle sphincters around the distal end of the GI tract.
151
Lies within the bony pelvis, continuous with the abdominal cavity. Lie between the pelvic inlet & pelvic floor.
Pelvic cavity
152
Contains pelvic organs & supporting tissues. Rectum is located within.
Pelvic cavity
153
skeletal muscle that forms the pelvic floor
levator ani muscle.
154
Sigmoid colon become the rectum here
Anterior to S3 at the rectosigmoid junction.
155
Rectum becomes the anal canal here
anterior to the tip of the coccyx, just prior to passing through the levator ani muscle
156
Rectum is where?
| Anal canal & anus are where?
Pelvis.
| Perineum
157
Lies immediately superior to the levator ani muscle.
| Walls relax to accommodate faecal material
Rectal ampulla
158
covers the superior rectum
peritoneum
159
in males, lies anterior to inferior rectum
Prostate gland
160
in females, lies anterior to inferior/middle rectum.
Vagina & cervix
161
Provides continual support for pelvic organs - tonically contracted most of the time.
levator ani muscle
162
Muscle must relax to allow defecation and urination
levator ani muscle
163
part of the levator ani muscle, particularly important for maintaining faecal continence
puborectalis
164
internal anal sphincter muscle?
smooth muscle - involuntary. Contraction stimulated by sympathetic nerves.
165
external anal sphincter muscle?
skeletal muscle - voluntary. Contraction stimulated by pudendal nerve.
166
Branch of the sacral plexus, supplies the external anal sphincter
pudendal nerve
167
marks the junction between the part of the embryo which formed the GI tract & part which formed the skin.
Pectinate line
168
lymph drainage of inferior pelvic structure
internal iliac nodes
169
lymph drainage of lower limb & more superior pelvic structures.
External iliac nodes
170
drains lymph from external and internal iliac nodes.
common iliac nodes
171
lymph draining from common iliac nodes drains to where?
lumbar nodes.
172
Lie on each side of the anal canal, filled with fat & loose connective tissue. Two fossae which communicate with each other posteriorly.
Ischioanal fossae
173
Infection within the ischioanal fossa
ischioanal abscess
