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Anatomy Year 2 - Robbie > GI class 3 - wet lab > Flashcards

GI class 3 - wet lab Flashcards

1
Q

how long is the oesophagus?

A

25cm

extends from pharynx to stomach

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2
Q

what are the three constrictions of the oesophagus?

A

cervical

thoracic

diaphragmatic

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3
Q

what is the vertebral level of the oesophageal opening (hiatus) in the diaphragm?

A

T10

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4
Q

list the structures that traverse (go through) the oesophageal opening

A

oesophagus

right and left vagus nerves

oesophageal branches of the left gastric artery/vein

left inferior phrenic vessels

lymphatics

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5
Q

what is the blood supply of the abdominal part of the oesophagus?

A

branches of the left gastric artery

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6
Q

what is the venous drainage of the abdominal part of the oesophagus?

A

gastric vein (to portal circulation)

azygous vein (to systemic circulation)

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7
Q

what is the lymphatic drainage of the abdominal part of the oesophagus?

A

left gastric nodes

left and right paracardinal nodes

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8
Q

what are oesophageal varices?

A

the lower end of the oesophagus is one of the important sites for portosystemic anastomoses

in portal hypertension, the anastomoses open and forms venous dilations called oesophageal varices

their rupture causes severe and dangerous haematemesis (vomiting of blood)

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9
Q

the stomach is a muscular bag forming the widest and most distensible part of the digestive tube

it has how many orifices or openings, curvatures and surfaces?

A

2 orifices or openings

2 curvatures

2 surfaces

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10
Q

what are the 2 orifices of the stomach

A

cardiac

pyloric

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11
Q

what are the 2 curvatures of the stomach?

A

greater

lesser

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12
Q

what are the 2 surfaces of the stomach

A

anterior

posterior

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13
Q

a

A

fundus

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14
Q

b

A

body

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15
Q

c

A

oesophagus

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16
Q

d

A

antrum

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17
Q

e

A

cardia

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18
Q

f

A

pylorus

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19
Q

g

A

duodenum

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20
Q

what is the pyloric sphincter?

A

a band of smooth msucle at the junction between the pylorus of the stomach and the duodenum of the small intestine

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21
Q

what is the function of the pyloric sphincter

A

controls flow of partially digested food from the stomach to the small intestine

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22
Q

the pyloric sphincted is formed from the thickening of which layer of gut tube?

A

muscularis externa - circular layer

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23
Q

some children are born with congenita ____________

A

pyloric stenosis

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24
Q

the lesser omentum extends from _______ curvature to _____________

A

lesser curvature

to the liver

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25
Q

the greater curvature extends from the _______ curvature to the ________

A

posterior abdominal wall

but along the way it attaches to transverse colon, spleen and diaphragm

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26
Q

what is the epiploic foramen?

A

it is the passage of communication between the greater and lesser sac

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27
Q

what are the gastric folds/rugae formed from?

A

coiled sections of tissue/gastric mucosa

exist in the mucosal and submucosal layers of the stomach

folds in the stomach lining

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28
Q

in which portions of the atomach are the gastric rugae most apparent?

A

greater curvature

pyloric

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29
Q

which sphincter contorls the discharge of food form the stomach to the duodenum?

A

pyloric sphincter

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30
Q

sotmach lies on several structures in the abdominal cavity

these structures form the stomach bed (posterior wall of the omental bursa or lesser sac)

they are:

A
  1. left dome of the diaphragm
  2. pancreas
  3. spleen
  4. left suprarenal gland
  5. part of the kidney (left)
  6. colon
  7. splenich artery
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31
Q

a

A

right gastric artery

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32
Q

b

A

left gastric artery

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33
Q

c

A

splenic artery

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34
Q

d

A

right gastroepoploic artery

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35
Q

e

A

left gastroepiploic artery

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36
Q

what is the venous drainage of the stomach?

A

via the portal system

portal vein, superior mesenteric vein, inferior mesenteric vein and splenic vein

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37
Q

the complex arrangement of the arterial supply to the stomach means that the lymphatic drinage is also complex

the sotmach is drained by what four groups of lymph nodes?

A
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38
Q

all the 4 primary nodes that drain the stomach eventually drain into which group of lymph nodes?

A

coeliac/gastric and gastric omental

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39
Q

gastric carcinoma (cancer) is common and occurs where?

A

along the greater curvature

on this account the lymphatic drainage of the stomach assumes importance

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40
Q

what is the nerve supply of the sotmach controlling motility?

A

vagus nerve

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41
Q

what is the effect of increased vagal stimulation on:

the pylorus

gastric secretion

A

causes it to relax

increases it

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42
Q

what does the arrangement of vagal branches of the sotmach allow for?

A

highly selective vagotomy to be used to treat over-active gastric acid secretion

this denervates (loss of nerve supply) the fundus and the body, decreasing secretion, while the supply to the antrum remains so preserving essential gastric motiliy

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43
Q

where does the small intestine extend form and to?

A

pylorus of the stomach to the ileocecal junction

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44
Q

what are the three parts of the small intestine?

A

duodenum

jejunum

ileum

45
Q

which part of the small intestine receives the opening of the bile and pancreatic duct?

A

duodenum

2nd part

46
Q

where is the foregut/midgut boundary in the small intestine?

A

at the opening of the bile duct

47
Q

how are the different parts of the small intestine peritonised?

A

duodenum - first part is intraperitoneal but the rest retroperitoneal

jejunum - intraperitoneal

ileum - intraperitoneal

48
Q

which part of the small intestine is the shortest, widest and most fixed part?

A

duodenum

49
Q

distinguishing characteristics between jejunum and ileum:

colour

A

jejunum - deeper red

ileum - paler pink

50
Q

distinguishing characteristics between jejunum and ileum:

wall

A

jejunum - thick and heavy

ileum - thin and light

51
Q

distinguishing characteristics between jejunum and ileum:

vascularity

A

jejunum - greater

ileum - less

52
Q

distinguishing characteristics between jejunum and ileum:

vasa recta

(straight arteries coming off from arcades in the mesentery of the jejunum and ileum, and heading toward the intestines. The arcades are anastomoses of the jejunal and ileal arteries, branches of superior mesenteric artery)

A

jejunum - long

ileum - short

53
Q

distinguishing characteristics between jejunum and ileum:

arcades

(vasa recta are straight arteries coming off from arcades in the mesentery of the jejunum and ileum, and heading toward the intestines. The arcades are anastomoses of the jejunal and ileal arteries, branches of superior mesenteric artery)

A

jejunum - a few large loops

ileum - many short loops

54
Q

distinguishing characteristics between jejunum and ileum:

fat in mesentery

A

jejunum - less

ileum - more

55
Q

distinguishing characteristics between jejunum and ileum:

circular folds

A

jejunum - large, tall and closely packed

ileum - low and sparce, absent in distal part

56
Q

distinguishing characteristics between jejunum and ileum:

peyers patches

(small masses of lymphatic tissue found throughout the ileum region of the small intestine. Also known as aggregated lymphoid nodules, they form an important part of the immune system by monitoring intestinal bacteria populations and preventing the growth of pathogenic bacteria in the intestines)

A

jejunum - less

ileum - more

57
Q

what is the order of the small intestine parts?

A
58
Q

is there a step-transition form the jejunum to the ileum?

A

no

rather the morphology gradually alters, but either end is quite different

59
Q

arterial arcades (arterial loops or arches) of jejunum and ileum

in which part do the arterial arcades have many loop?

A

ileum

60
Q

which part of the autonomic nervous system (sympathetic or parasympathetic) stimuations reduces teh secretion and motility of the intestine and also actsas a vasoconstrictor?

A

sympathetic

61
Q

what features allow the large intestine to be distinguished from the small intestine?

A

omental appendices

haustra or sacculations

teniae coli

62
Q

retroperitoneal or intraperitoneal?

caecum

A

retroperitoneal

63
Q

retroperitoneal or intraperitoneal?

ascending colon

A

retroperitoneal

64
Q

retroperitoneal or intraperitoneal?

transverse

colon

A

intraperitoneal

65
Q

retroperitoneal or intraperitoneal?

descending colon

A

retroperitoneal

66
Q

retroperitoneal or intraperitoneal?

sigmoid colon

A

intraperitoneal

67
Q

what are the 2 flexures of the colon called?

A
68
Q

what is the midgut/hindgut boundary?

A

2/3 along transverse colon

69
Q

in which abdominal region is the caecum and appendix located?

A

right iliac

70
Q

what two structures open into the cavity of the caecum?

A

ileum

appendix

71
Q

is the base of the appendix consistently located?

A

yes

but the tail is quite variable

72
Q

what is McBurneys point and why is it useful clinically?

A

its the point of maximum tenderness of the appendix

73
Q

where does the rectum pierce the pelvic floor?

A

ano-rectal junction

becomes anal canal which is located in the perineum (the area between the anus and the scrotum or vulva)

74
Q

what is the arterial supply of the rectum and anal canal:

superior 1/3

middle 1/3

inferior 1/3

A

superior 1/3 - superior rectal artery

middle 1/3 - middle rectal artery

inferior 1/3 - inferior rectal artery

75
Q

what is the venous drainage of the rectum and anal canal:

superior 1/3

middle 1/3

inferior 1/3

A

superior 1/3 - superior rectal vein

middle 1/3 - middle rectal vein

inferior 1/3 - inferior rectal vein

76
Q

what is the peritonisation of the rectum and anal canal:

superior 1/3

middle 1/3

inferior 1/3

A

superior 1/3 - intraperitoneal

middle 1/3 - retroperitoneal

inferior 1/3 - none

77
Q

what is the role of the pelvic floor in maintaining faecal continence?

A

levator ani is normally constricted to keep anal canal closed and defication/allow delay of emptying

The levator ani is a broad, thin muscle, situated on either side of the pelvis. It is formed from three muscle components: the pubococcygeus, the iliococcygeus, and the puborectalis. It is attached to the inner surface of each side of the lesser pelvis, and these unite to form the greater part of the pelvic floor

78
Q

what other strucutres are involved in faecal continence?

A

internal sphincter

external sphincter

79
Q

what is the significance of understanding the differences between visceral and somatic innervation of the anal canal?

A

for voluntary and unvoluntary control

80
Q

the hepatoduodenal and hepatogastric ligaments are parts of what omentum?

A

the lesser omentum

81
Q

what is the falciform ligament and what structures lie within its free border?

A

a ligament that attaches the liver to the front body wall

round ligament of the liver

82
Q

what structure in the free edge of the falciform ligament is a remnant of an embryonic blood vessle? what is the name of this vessel in the embryo?

A

the ligamentum teres (round ligament)

remnanty of the umbilical vein

83
Q

how many layers of the peritoneum are present in the greater omentum?

A

4

84
Q

the greater omentum is often called the abdominal policeman

what functions of this strucutre lead to this term being used?

A

role in immunity and it can migrate to infected viscera or the site of surgical disturbance

85
Q

what are paracolic gutters?

A

spaces between the colon and the abdominal wall

86
Q

where are the paracolic gutters found in relation to the large intestine?

A

beside (lateral) ascending (caecum) and descending colon

87
Q

what is the clinical significance of the paracolic gutters?

A

as if fluid accumulates in the peritoneal cavity it will gather hear due to gravity

88
Q

list 3 abdominal viscera which lie in the free edge of a double layer of peritoneum described as a mesentery

A

sigmoid colon

transverse colon

appendix

89
Q

what muscle type form the muscularis externa in oesophagus?

A

smooth msucle lower 1/3

skeletal muscle top 1/3

mixed in middle 1/3

90
Q

what is the surface epitheliumo f the oesophagus?

A

stratified squamous

91
Q

what type of muscle is the muscularis mucosae (interna)?

A

smooth muscle

92
Q

what are the large folds present in the wall of the stomach?

A

rugae

93
Q

what secretory cells are present in the gastric pits of the stomach?

A

cheif cells

parietal cells

mucous neck cells

94
Q

what are the large folds that you see extending into the lumen of the small intestine called?

A

villi

95
Q

when looking at one of these large folds, superimposed on each large fold are numberous finger like processes cut in different plnes - what are these processes called?

A

micro-villi

96
Q

what is the surface epithelium in the small intesitne?

A

simple columnar

97
Q

in the small intestine, what type of muscle is the muscularis mucosae?

A

smooth muscle

98
Q

glands in the lamina propria do not extend down beyond the muscularis mucosae

where along the gut tibe do glands extend down beyond the muscularis mucosae into the submucosa?

A

oesophagus - mucous

duodenum - brinners

99
Q

what appear to be spaces can be seen scattered between the cells of the surface epithelium, these are actially the contents of secretory cells

what are the cells called and what do they secrete

A

goblet cells and mucous

100
Q

what type of cells are present in the surface epithelium

A

simple columnar

101
Q

where are payers pathces mainly

A

submucos

mostly seen in the ileum

102
Q

what is the predominant cell present in the surface epithelium of the colon

A

simple columnar absoprive cells/enterocytes

103
Q

what is the change of epithelium seen i the recto-anal junction?

A

simple columnar to stratified squamous epithelium

104
Q

what is the transpyloric plane?

A

an imaginary horozontal plane, located halfway between the suprasternal notch of the manubrium and the upper border of the symphysis pubis at the level of L1

105
Q

how would you locate the transpyloric plane on a patient?

A

midway between xiphisternum and umbilicus

106
Q

list structures present in the transpyloric plane

A

pylorus of the stomach

duodenum

neck of the pancreas

L1

fundus of gallbladder

107
Q

images following a barium meal, barium meall follow-through and barium enema are shown

braium meal 1 - which organ is examined?

barium meal follow-through 2 - which organ is examined

barium enema 3 - which organ is examined

A

1 - stomach

2 - small intestine

3 - large intestine

108
Q

image A

name 1, 2, 3 and 4

A

1 - liver

2 - right kidmey

3 - ileum

4 - transverse colon

109
Q

image B

name 1, 2, 3 and 4

A

1 - spleen

2 - liver

3 - stomach

4 - aorta

Anatomy Year 2 - Robbie (17 decks)

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