GI Flashcards
(168 cards)
1
Q
What are the 4 quadrants of the abdomen?
A
Right upper, right lower, left upper and left lower
2
Q
What are the 9 regions of the abdomen? Where are they located?
A
Right and left hypochondium (right and left upper)
Epigastrium (upper middle)
Right and left lumbar (right and left middle)
Periumbilical (centre)
Right and left iliac fossa (right and left lower)
Hypogastrium (lower middle)
3
Q
What are the lines used to divide the 9 regions?
A
Right and left midclavicular planes, transtubecular plane and subcostal plane
4
Q
What organs are present in the right hypochondriac region?
A
liver, kidney and gallbladder
5
Q
What organs are present in the epigastric region?
A
liver, stomach and oesophagus
6
Q
What organs are present in the left hypochondriac region?
A
stomach and spleen
7
Q
What organs are present in the right lumbar region?
A
ascending colon, gallbladder and liver
8
Q
What organs are present in the periumbilical region?
A
small intestine, pancreas and stomach
9
Q
What organs are present in the left lumbar region?
A
descending colon, left kidney and small intestine
10
Q
What organs are present in the right iliac fossa?
A
appendix, caecum and small intestine
11
Q
What organs are present in the hypogastrium?
A
prostate, rectum and ovaries
12
Q
What organs are present in the left iliac fossa?
A
descending colon and sigmoid colon
13
Q
What are the 4 muscles of the anterior abdominal wall?
A
external oblique, internal oblique, transversus abdominus and rectus abdominus
14
Q
What is the external oblique innervated by?
A
T7-12
15
Q
What is the internal oblique innervated by?
A
T-12 & lumbar nerve (L1)
16
Q
What is the transversus abdominus innervated by?
A
T7-12 & L1
17
Q
What is the rectus abdominus innervated by?
A
T7-12
18
Q
What is the innermost of the anterior abdominal muscles?
A
transversus abdominus
19
Q
What lies on top of the transversus abdominus?
A
internal oblique, then external oblique on top
20
Q
What is the midline aponeurosis of the trunk called?
A
Linea alba
21
Q
What is the rectus sheath? Which muscles does it involve?
A
Aponeurosis of the transversus abdominus, internal oblique and external oblique muscles
22
Q
What vertebral level is the umbilicus?
A
L3/L4
23
Q
What thoracic spinal segments innervate the anterior abdominal wall?
A
T7-11
24
Q
What is the dermatome level of the sternal angle?
A
T2
25
What is the dermatome level of the nipple?
T4
26
What is the dermatome level of the umbilicus?
T10
27
How long is the inguinal canal?
approx. 4cm
28
The inguinal ligament is attached to which 2 bony points of the hip bone?
pubic tubercle and anterior superior iliac spine
29
What forms the anterior wall of the inguinal canal?
aponeurosis of external oblique and internal oblique
30
What forms the posterior wall of the inguinal canal?
transversalis fascia and conjoint tendon
31
What forms the roof of the inguinal canal?
internal oblique and transversus abdominus
32
What forms the floor of the inguinal canal?
inguinal ligament and lacunar ligament
33
What are the the names of the openings in the inguinal canal and where do they lie?
deep inguinal ring lies superiorly and superficial inguinal ring lies inferiorly
34
What does the superficial inguinal ring lie lateral to?
pubic tubercle
35
What do the epigastric vessels branch into inferiorly?
External iliac vessels
36
What do the epigastric vessels branch into superiorly?
internal thoracic vessels
37
What are the contents of the male inguinal canal?
spermatic cord, genital branch of genitofemoral nerve, ilioinguinal nerve and testicular artery
38
What are the contents of the female inguinal canal?
round ligament, genital branch of genitofemoral nerve, ilioinguinal nerve and uterine arteries
39
What are the most common type of hernias?
Inguinal hernias
40
What 4 histological layers are present throughout the entirety of the gut tube? (from inside to outside)
mucousa, submucosa, muscularis propria and serosa
41
What three layers are present in the mucosa of the gut tube?
epithelium, lamina propria and muscularis mucosa
42
What type of mucosa is protective? Where is it found?
stratified squamous
| found in oral cavity, oesophagus and nasal canal
43
What type of mucosa is secretory? Where is it found?
simple columnar with tubular glands
| found only in stomach
44
What type of mucosa is absorptive? Where is it found?
villi with short glands (crypts)
| found in small intestine
45
What type of mucosa is absorptive/protective? Where is it found?
closely packed straight glands with goblet cells
| found in large intestine
46
What are the 2 subdivisions of the peritoneum?
visceral (surrounding organs) and parietal (lining abdominal wall)
47
What is the peritoneal cavity?
continuous area between parietal peritoneum lining abdominal wall an visceral peritoneum surrounding abdominal organs
48
What are the two divisions of the peritoneal cavity?
greater and lesser sac
49
Through which foramen do the greater and lesser sacs communicate?
epiplioc foramen
50
Where is the epiploic foramen located?
just below the neck of the gallbladder
51
What organs are described as being retroperitoneal? (think SAD PUCKER)
suprarenal glands, aorta/IVC, duodenum (not first part), pancreas, ureters, colon (asc & desc), kidneys, esophagus and rectum
52
What organs are described as being intraperitoneal?
stomach, spleen, liver and transverse colon
53
What fluid is present in the peritoneal cavity?
peritoneal fluid
54
What is meant when an organ is retroperitoneal?
only covered by visceral peritoneum on it's anterior surface
55
What is meant when an organ is intraperitoneal?
completely surrounded by visceral peritoneum
56
Which layer of the peritoneum is more sensitive to pain?
parietal
57
How many organs are within the peritoneal cavity?
NONE
58
What is the greater omentum? What are its attachments
large curtain-like fold of visceral peritoneum that hangs down from the stomach.
It's attached from the greater curvature of the stomach to the transverse colon
59
What is the lesser omentum? What are its attachments?
A double layer of peritoneum
| It's attached from the lesser curvature of the stomach to the liver
60
What are the muscles of the posterior abdominal wall?
psoas major, psoas minor, iliacus and quadratus lumborum
61
What are the organs of the posterior abdominal wall?
kidneys, ascending and descending colon
62
What are the main vessels of the posterior abdominal wall?
Aorta and IVC
63
What are the nerves of the posterior abdominal wall?
subcostal and lumbar
64
What are the 3 major openings in the diaphragm?
caval, aortic and oesophageal
65
At what vertebral level is the caval opening?
T8
66
At what vertebral level is the oesophageal opening?
T10
67
At what vertebral level is the aortic hiatus?
T12
68
What are the 3 main branches of the aorta supplying the gut tube?
superior mesenteric, inferior mesenteric and celiac trunk
69
At what vertebral level does the aortia bifurcate to 2 common iliac arteries?
L4
70
At what level does the superior mesenteric artery occur?
L1
71
At what level does the inferior mesenteric artery occur?
L3
72
At what level does the celiac trunk occur?
T12
73
Name 2 foregut structures
Stomach and abdominal part of oesophagus
74
Name 2 midgut structures
Caecum and appendix
75
Name 2 hindgut structures
desc. colon and sigmoid colon
76
What is the artery supplying the foregut?
Celiac trunk
77
What is the artery supplying the midgut?
Superior mesenteric artery
78
What is the artery supplying the hindgut?
Inferior mesenteric artery
79
What additional organs derived from the midgut are not part of the gut tube?
spleen, liver, pancreas and gallbladder
80
What 2 veins join to form the hepatic portal vein?
superior mesenteric and splenic veins
81
What are the 4 sites of portocaval anastomosis?
Distal oesophagus, anal canal, paraumbilical region and retroperitoneal region
82
What does parasympethetic innervation do to GI secretion?
increases
83
What does parasympathetic innervation do to GI motility?
increases
84
What does parasympathetic innervation to do blood vessels?
vasoconstricts
85
What is the effect of a vagotomy on gastric secretion?
reduces secretion
86
At what vertebral levels do the kidneys lie?
T12-L3
87
Why does the right kidney lie slightly lower than the left?
it sits underneath the liver
88
What are the 3 structures entering/leaving the hilum of the kidney?
Renal vein, renal artery and pelvis of ureter
89
What is the anterior to posterior arrangement of the structures in the hilum of the kidney?
Vein -> artery -> pelvis
90
What are ureters?
muscular ducts carrying urine from kidneys to urinary bladder
91
What is the term used to describe the expanded upper part of the ureter?
renal pelvis
92
What are the 3 constrictions of the oesophagus called?
cervical, thoracic and diaphragmatic
93
What structures go through the oesophageal hiatus?
oesophagus, vagal trunk, branches of left gastric vessels and lymphatic vessels
94
What is the lymphatic drainage of the abdominal aorta?
left gastric nodes
95
What are the two curvatures of the stomach called?
lesser and greater curves
96
What are the 2 orifices of the stomach called?
cardiac and pyloric
97
What are the 2 surfaces of the stomach called?
anterior and posterior
98
What is the pyloric sphincter? What is its function?
a band of smooth muscle at junction between pylorus and duodenum, it controls the discharge of stomach contents into the duodenum.
99
The pyloric sphincter is formed by the thickening of which layer of the gut tube?
muscularis externa (circular)
100
What structures form the stomach bed?
```
left dome of diaphragm
pancreas
spleen
left kidney
colon
adrenal gland
```
101
What 4 groups of lymph nodes drain the stomach?
superior gastric, suprapyloric, pancreaticolineal and inferior gastric
102
What do the lymph nodes draining the stomach eventually drain into?
celiac lymph nodes
103
What are the 3 parts of the small intestine?
Duodenum, jejunum and ileum
104
Which part of the small intestine receives the opening of the bile and pancreatic duct?
duodenum
105
What is the foregut/midgut boundary in the small intestine?
2nd part of duodenum
106
How is the small intestine peritonised?
1st part duodenum - intraperitoneal
2nd part duodenum - retroperitoneal
jejunum and ileum - intraperitoneal (mesentery)
107
What part of small intestine is shortest, widest and most fixed part?
duodenum
108
Give examples of some of the distinguishing characteristics of the jejunum and ileum
jejunum is deeper red (greater vascularity), wall is thicker and heavier and it contains less fat in its mesentery.
Ileum is paler pink, it is thin and light and it contains more fat in its mesentery.
109
Arterial arcades (arterial loops) are more common in the jejunum or ileum?
Ileum
110
What features of the large intestine distinguish it from the small intestine?
```
teniae coli (3 longitudinal bands of smooth muscle)
haustra (sacculations of colon between teniae)
omental appendices (small fatty projections)
```
111
How is the large intestine peritonised?
```
caecum - intra
asc colon - retro
transverse - intra (mesentery)
desc - retro
sigmoid - intra (mesentery)
```
112
What is the midgut/hingut boundary of the colon?
2/3rds along transverse colon
113
What 2 structures open onto the caecum?
ileum (terminal) and caecum
114
What is McBurney's point? What is its clinical significance?
1/3rd of the distance from the anterior superior iliac spine to the umbilicus
Its the site of maximum tenderness in acute appendicitis
115
What is the arterial supply to the 3 parts of the rectum?
Superior 1/3 - superior rectal artery
| Middle and inferior 1/3rds - middle rectal artery
116
What is the venous drainage of the 3 parts of the rectum?
superior 1/3 - superior rectal vein
middle 1/3 - middle rectal vein
inferior 1/3 - inferior rectal vein
117
What 3 structures are involved in maintaining faecal continence?
pelvic floor, anal sphincter and rectum
118
What is the arterial supply of the stomach?
branches of celiac artery - R and L gastric arteries
119
What is the arterial supply of the 1st part of duodenum?
branch of celiac artery - superior pancreaticoduodenal artery
120
What is the arterial supply of the 2nd part of duodenum?
branch of celiac artery - inferior pancreaticoduodenal artery
121
What is the arterial supply of the jejunum and ileum?
superior mesenteric artery
122
What is the arterial supply of he caecum and ascending colon?
superior mesenteric artery
123
What is the arterial supply of the right 2/3rds transverse colon?
superior mesenteric artery
124
What is the arterial supply of the left 1/3rd transverse colon?
inferior mesenteric artery
125
What is the arterial supply of the sigmoid colon?
inferior mesenteric artery
126
What is the falciform ligament? What does it separate?
a ligament attaching liver to anterior body wall
| separates right and left lobes of liver
127
What structure in the falciform ligament is a remnant of an embryonic blood vessel?
round ligament is a remnant of the fetal umbilical vein of the liver
128
How many layers of peritoneum are present in the greater omentum?
4 (double layer folded onto itself)
129
Why is the greater omentum often called the 'abdominal policeman'?
It fights inra-abdominal infection, contains macrophages
130
What are paracolic gutters? what are their clinical significance?
spaces between colon and abdominal wall
| allow passage for infection fluids from different compartments of the abdomen
131
What type of muscle is found in the oesophagus?
Superior 1/3rd - skeletal
Middle 1/3rd - skeletal and smooth
Inferior 1/3rd - smooth
132
What type of epithelium is found in the oesophagus?
non-cornified stratified squamous
133
What is the function of the rugae (folds) in the stomach?
allows the stomach to expand as it fills
134
What are gastric pits? What secretory cells are found in them?
They are indentations in the stomach
| Surface mucous cells are secreted
135
What are the large folds extending into the lumen of the small intestine called?
plicae
136
What are the finger like processes in the small intestine called?
villi
137
What kind of surface epithelium are found in the villi?
columnar
138
What kind of muscle is found in the small intestine?
smooth
139
What are the cells that looks like 'spaces' in the surface epithelium of the small intestine? What do they secrete?
goblet cells, they secrete mucous
140
What is the transpyloric plane?
horizontal line, halfway between the jugular notch and the pubic symphysis
141
What 5 structures lie in the transpyloric plane?
```
pylorus of stomach
2nd part duodenum
neck of pancreas
sphincter of oddi
fundus of oddi
```
142
How is the spleen peritonised?
intraperitoneal, except its hilum
143
Does the spleen move with respiration?
yes, descends on inspiration
144
What are the 3 structures in the hilum of the spleen?
splenic artery, splenic vein and lymph vessels
145
What are the 4 main functions of the spleen?
storage of RBCs, storage of platelets, storage of WBCs and phagocytosis
146
What organ must a surgeon take care not to damage whilst removing a spleen?
pancreas
147
How is the duodenum related to the pancreas?
wrapped around its head
148
How is the pancreas peritonised?
retroperitoneal
149
What vein is formed posterior to the neck of the pancreas?
hepatic portal vein
150
Into which part of the duodenum does the pancreatic duct open?
2nd part
151
What are the 4 lobes of the liver?
right, left, caudate and quadrate
152
Is the caudate lobe superior or inferior to the quadrate lobe?
superior
153
What does the porta hepatis of the liver contain?
the portal triad - hepatic artery, portal vein and bile duct
154
What fold of peritoneum is folded around the portal triad?
lesser omentum
155
What does the extrahepatic biliary apparatus consist of?
right and left hepatic ducts, gallbladder, common hepatic duct, cystic duct and bile duct
156
Where is bile produced?
The liver
157
Where is bile stored?
the gallbladder
158
Where does bile enter the gut tube?
2nd part of duodenum
159
What two ducts join to form the common hepatic duct?
right and left hepatic ducts
160
What duct joins the common hepatic duct? What does this form?
Cystic duct joins common hepatic duct to form the bile duct
161
What duct does the common bile duct join?
main pancreatic duct
162
What is Calot's triangle?
triangular space formed by the cystic duct, common hepatic duct and inferior surface of the liver
163
What does Calot's triangle contain?
the cystic artery
164
What is the narrowing at the end of the common bile duct called?
Sphincter of Oddi
165
What are the 3 main histological features of the pancreas?
Islets of langerhans, pure serous acini and small lobules
166
What are the 2 main histological features of the liver?
cells arranged in sheets and converging towards centre
| portal areas containing blood vessels and ducts
167
What are the 2 main histological features of the spleen? What do they contain?
White pulp - lymphoid aggregation
| Red pulp - vascular anastomosing cords of cells
168
Which ribs are closely related to the spleen?
9, 10 and 11
