GI Anatomy 2 Flashcards

(111 cards)

1
Q

What are the 2 major lobes of the liver?

A

Right and left

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2
Q

What are the 2 minor lobes of the liver?

A

Caudate and quadrate

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3
Q

What do the common hepatic duct and cystic duct join to form?

A

Common bile duct

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4
Q

What is the ampulla of Vater formed from?

A

Common bile duct and pancreatic duct

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5
Q

Where is the ampulla of Vater located?

A

Major duodenal pailla (Sphincter of Oddi)

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6
Q

Which lobe of the liver is largest?

A

Right lobe

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7
Q

What is the ligament between the right and left lobes of the liver?

A

Falciform ligament

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8
Q

What is at the bottom of the falciform ligament?

A

Round ligament

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9
Q

Which is more superior: caudate or quadrate lobe?

A

Quadrate lobe

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10
Q

Which vessel in next to the bare area?

A

IVC

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11
Q

What surrounds the bare area?

A

Coronary ligament

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12
Q

What divides the liver into hexagonal lobules?

A

Septa

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13
Q

What is located at each corner of hexagonal lobule?

A

Portal triad

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14
Q

What is in the centre of each hexagonal lobule?

A

Central vein

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15
Q

Where do the central veins drain?

A

Hepatic veins -> IVC

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16
Q

What radiates out from central veins?

A

Hepatic cords

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17
Q

What are hepatic cords composed of?

A

Hepatocytes

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18
Q

Where are hepatocytes found?

A

Hepatic cords

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19
Q

What are the spaces between hepatic cords called?

A

Hepatic sinusoids

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20
Q

What lies between cells within each hepatic cord?

A

Bile canaliculus

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21
Q

What do bile canaliculi do?

A

Thin tubes which collect bile secreted by hepatocytes, merge and eventually form common hepatic duct

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22
Q

What are the 6 components of bile?

A
Bile acids
Lecithin
Cholesterol
Bile pigments
Toxic metals
Bicarbonate
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23
Q

What is bicarbonate secreted by?

A

Duct cells

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24
Q

What do bile acids, lecithin and cholesterol do?

A

Solubilise fat

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25
What does bicarbonate do?
Neutralisation of acid chyme when it enters duodenum
26
What are bile pigments?
Breakdown product of haemoglobin from old/damaged erythrocytes
27
What happens to bilirubin?
Extracted from blood by hepatocytes and secreted into bile
28
Why is it faeces are brown?
Bilirubin modified by bacterial enzymes into brown pigments
29
What happens to reabsorbed bilirubin?
Excreted in urine (yellow urine)
30
What happens to bile acids before secretion?
Bile acids conjugated with glycine or taurine into bile salts (increase solubility)
31
What are the 3 layers in the wall of the gall bladder?
Mucosa (rugae) Muscularis Serosa
32
What controls the release of bile and pancreatic juice into the duodenum?
Sphincter of Oddi
33
What happens when the Sphincter of Oddi is contracted (closed)?
Bile forced back into gallbladder
34
What is CCK?
Cholecystokinin
35
How does CCK affect the Sphincter of Oddi?
Fat in duodenum = release of CCK | CCK -> relaxes Sphincter of Oddi and gallbladder contracts
36
How long is the small intestine approx?
6m
37
What are the main roles of the duodenum?
Gastric acid neutralisation Digestion Iron absorption
38
What is the main role of the jejunum?
Nutrient absorption
39
What is the main role of the ileum?
NaCl/H2O absorption | Chyme dehydration
40
What enhances the surface area of the small intestine?
Circular folds (plicae) Villi Microvilli
41
What is the epithelial lining of the small intestine?
Simple columnar epithelium
42
What other feature does the small intestine apparent from villi?
Goblet cells | Crypts of Lieberkuhn
43
What do the villus cells absorb?
``` NaCl Monosaccharides Peptides Amino acids Fats Minerals Vitamins Water ```
44
What do the crypt cells in the small intestine do?
Secretes Cl and water
45
How much water does the small intestine secrete per day?
1500ml H2O per day
46
Where does the H2O secretion in the small intestine come from?
Crypts of Lieberkuhn
47
How/why is H2O secreted in the small intestine?
Secreted passively as a consequence of active secretion of chloride into intestinal lumen
48
Why is H2O secretion important for normal digestive processes?
Maintains luminal contents in liquid state Promotes mixing of nutrients with digestive enzymes Aids nutrient presentation to absorbing surface Dilutes and washes away potential injurious substances
49
Why happens to the water that is excreted by the crypts?
Normally reabsorbed by villi
50
What is the transporter than transports Cl into the epithelial cells in the small intestine?
Na-Cl-K transporter
51
What is the channel called that helps Cl out of the epithelial cells in the small intestine?
CFTR channel (cystic fibrosis transmembrane conductance regulator)
52
What happens in CF to CFTR?
No CFTR, chloride trapped in cells, no water pushed out either
53
What does adenylate cyclase do?
Converts ATP to cAMP
54
What are the two distinct types of movement in the small intestine?
Segmentation | Peristalsis
55
What occurs during segmentation in the small intestine?
Contraction and relaxation of short intestinal segments | Mixing of chyme with digestive enzymes
56
What does segmentation do in the small intestine?
Contraction moves chyme into adjacent areas of relaxation, relaxed areas then contrast and push chyme back = provides thorough mixing of contents with digestive enzymes
57
How are segmental contractions in the small intestine initiated?
Depolarisation generated by pacemaker cells in longitudinal muscle layer (by intestinal basic electrical rhythm (BER))
58
What is BER?
Basic electrical rhythm
59
What determines the frequency of segmentation?
BER
60
What happens to BER as you move down the intestine?
It decreases
61
What type of innervation increases contraction in the small intestine?
Parasympathetic NS (vagus)
62
What type of innervation decreases contraction in the small intestine?
Sympathetic NS
63
Does the autonomic NS have an effect on BER?
No
64
When does peristalsis occur?
After segmentation has stopped and the following the absorption of nutrients
65
What does MMC stand for?
Migrating motility complex (MMC)
66
What is MMC?
Pattern of peristaltic activity travelling down small intestine, as one MMC ends another begins
67
When does MMC finish and segmentation begin?
Arrival of food in the stomach
68
What does MMC act to do?
Move undigested material into large intestine | Limit bacterial colonisation of small intestine
69
What hormone is involved in the initiation of MMC?
Motilin
70
If the intestinal smooth muscle is distended by a bolus of chyme, what is the muscle on either side doing?
Muscle on oral side = contracts | Muscle on anal side = relaxes
71
What is the movement of muscle on either side of the bolus of chyme mediated by?
Neurons in myenteric plexus
72
How does gastric emptying affect segmentation activity in the ileum?
Gastric emptying = increase in segmentation activity in ileum
73
How else does gastric emptying affect the bowels?
Opening of ileocaecal valve (sphincter) Entry of chyme into large intestine Distention of colon Reflex contraction of ileocaecal sphincter which prevents backflux into small intestine
74
What is the first part of the large intestine?
Ileum -> ileocaecal valve -> caecum -> appendix
75
Which layer of muscle is incomplete in the large intestine?
Longitudinal muscle
76
What are the three bands that extend the entire length of the colon?
Teniae coli
77
What do the contractions of tenure coli produce?
Haustra (pouches)
78
What is the epithelium of the large intestine?
Simple columnar epithelium with large straight crypts lined with large number of goblet cells
79
What do the goblets cells of the large intestine provide?
Lubrication for movement of faeces
80
What is the epithelium of the rectum?
Simple columnar epithelium
81
What is thicker in the rectum?
Muscularis externa
82
What type of muscle is the external anal sphincter and what is controlled by?
Skeletal muscle under voluntary control
83
What is the epithelium of the anal canal?
Simple columnar -> stratified squamous
84
How does the large intestine absorb water?
Osmotically as it actively transports sodium from lumen into blood
85
Why does the large intestine absorb water?
To dehydrate the chyme into solid faecal pellets
86
What happens due to the long residence time in the colon?
Bacterial colonisation
87
What is found in the large intestine?
Short chain fatty acids, vitamin K, gas (nitrogen, CO2, hydrogen, methane, hydrogen sulphate)
88
What type of muscle is the internal anal sphincter and what is it controlled by?
Smooth muscle under autonomic control
89
What is the urge to defaecate caused by?
Defaecation reflex caused by distention of rectal wall produced by MMC of faecal material into the rectum -> mechnoceptors cause defaecation reflex
90
What innervation is the defaecation reflex controlled by?
Parasympathetic control via pelvic splanchnic nerves
91
What are associated symptoms of constipation?
Headaches, nausea, loss of appetite, abdominal distention
92
How does enterotoxigenic bacteria (E.coli) cause diarrhoea?
Produce protein enterotoxins which maximally turn on intestinal chloride secretion from crypt cells and increase H20 secretion
93
How do enterotoxigenic bacteria maximally turn on intestinal chloride secretion?
Act by elevating intracellular second messengers e.g. cAMP, cGMP, calcium
94
How do you treat secretory diarrhoea?
Oral rehydration therapy
95
How does oral rehydration therapy work for diarrhoea?
Enterotoxins don't damage villous cells, give sodium/glucose solution which drives H2O reabsorption and rehydrates, need to drink more to wash away infection
96
What is the epithelium in the oesophagus?
Stratified squamous non-keratinised epithelium
97
What are the features of oesophagus histology?
Stratified squamous non-keratinised epithelium Submucosa shows mucous glands Muscular layers - upper 1/3 skeletal, middle 1/3 smooth, lower 1/3 smooth
98
What are the features of stomach histology?
Simple columnar epithelium Parietal cells (stain pink) Chief cells at base of gland Gastric glands in mucosa (above mucosae)
99
What are the features of small intestine histology?
Villi Crypts of Lieberkuhn Lymphoid aggregations = Peyer's patches
100
What are the specific features of duodenum histology?
Brunner's glands in submucosa
101
What are the specific features of ileum histology?
Villi | Peyer's patches (large purple blobs)
102
What are Paneth cells for and where are they found?
Immune response | Small intestine
103
What are the features of large intestine histology?
``` Thick mucosa Crypts Mucous secreting cells No villi Tenia coli ```
104
Which part of the pancreas is the endocrine part and is there acini?
Islets of Langerhans | No acini
105
Are there acini in the exocrine part of the pancreas?
Yes
106
What are salivary glands made up of?
Secretory acini and ducts
107
What are the two types of secretions from the salivary glands?
Serous and mucous
108
Which salivary gland has mainly mucous acini?
Sublingual gland
109
Which salivary gland has mainly serous acini?
Parotid gland
110
Which salivary gland has a mix of both mucous and serous acini?
Submandibular gland
111
Which type of acini secretes more lightly coloured?
Mucous acini