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anatomical sciences > GI system > Flashcards

GI system Flashcards

1
Q

what is the GI system made up of

A

oral cavity
pharynx
oesophagus
stomach
small interstine
large interstine
rectum
anal canal

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2
Q

what are the GI systems accessory organs

A

teeth
tongue
salivary glands
pancreas
liver
biliary tree and gallbladder

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3
Q

what germ layers make up the GI tract

A

endodermal and mesodermal primary germ layers
derives from the primitive gut tube

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4
Q

what is the epithelial lining derived from

A

embryonic endoderm

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5
Q

what does the epithelial lining give rise to

A

specific secretory cells (the parenchyma) of the glands

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6
Q

what is derived from the splanchnic mesoderm

A

connective tissue for glands (stroma)
cognitive tissue, smooth muscle and peritoneal covering of the wall of the tube

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7
Q

what are the divisions of the embryological GI tract

A

foregut
midgut
hindgut

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8
Q

what does the foregut include

A

pharyngeal gut tube (pharynx)

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9
Q

where is the foregut

A

extends from the mouth to the point where the hepatopancreatic ampulla enters the duodenum

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10
Q

where is the midgut

A

extends from the point where the hepatopancreatic ampulla enters the duodenum to the junction between the proximal 2/3 and the distal 1/3 of the transverse colon

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11
Q

where is the hindgut

A

extends from the junction between the proximal 2/3 and the distal 1/3 of the transverse colon to the anus

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12
Q

what is the gut tube vascularised by

A

branches form the abdominal aorta

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13
Q

how is blood supplied to the foregut

A

by the coeliac trunk

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14
Q

how is blood supplied to the midgut

A

by the superior mesenteric artery

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15
Q

how is blood supplied to the hindgut

A

by the inferior mesenteric artery

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16
Q

what is ischaemic colitis

A

insufficient blood supply to splenic flexure of the colon

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17
Q

where is the he splenic flexure of the colon

A

the bend where the transverse colon and descending colon meet in the upper left part of your abdomen.

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18
Q

what is the role of the hepatic veins

A

Drain venous blood from the major parts of the GI tract through the hepatic portal venous system into the vena cava

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19
Q

what is the role of the hepatic portal vein

A

Receives venous drainage from the abdominal part of the GI tract, pancreas spleen and gallbladder via its tributaries (gastric, splenic and mesenteric veins to the liver

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20
Q

what are the derivative of the foregut

A

pharynx
larynx
oesophagus
stomach
duodenum (proximal half)
liver
biliary tree and gall bladder
pancreas

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21
Q

what are the derivates of the midgut

A

duodenum (distal half)
jejunum
ileum
cecum
ascending colon
transverse colon

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22
Q

what are the derivates of the hindgut

A

transverse colon
descending colon
sigmoid colon
rectum
anal canal

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23
Q

how is a normal physiological umbilical hernia formed

A

the intestinal loops protrude through the umbilical region of the developing fetus to form Physiological umbilical hernia

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24
Q

where do intestinal loops normally go

A

normally return back into the abdominal cavity through a number of rotation and fixations of the gut tube

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25
Q

what is omphalocele

A

failure of the intestinal loops to return back into the abdominal cavity after the physiological herniation

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26
Q

what is eckels (illegal) diverticulum

A

embryological remnant of the vitelline duct of the yolk sac attached close to the ileocecal junction

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27
Q

what is diverticula of the colon

A

small out pocketing pouches from the wall of the colon

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28
Q

what can diverticula of the colon lead to

A

diverticular disease or diverticulitis

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29
Q

what and where is the peritoneum

A

A smooth thin serous membrane which lines the walls of the abdominal cavity and covers some of the visceral

balloon empty in visceral cavity

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30
Q

what are the 2 layers of the peritoneum

A

parietal layer
visceral layer

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31
Q

parietal layer of the peritoneum

A

lines the inner surface of walls of the abdominal cavity

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32
Q

visceral layer

A

invests or covers most of the abdominal viscera

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33
Q

peritoneal cavity

A

the potential space between the parietal and visceral peritoneal layers

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34
Q

intraperitoneal

A

when organs are completely covered by the visceral peritoneum (small intestine)

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35
Q

retroperitoneal

A

when organs lie behind the peritoneum and are partially covered on their anterior surface only (kidney or pancreas)

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36
Q

what connects one abdominal viscera to another or abdominal wall

A

fold of peritoneum
mesenteries

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37
Q

mesenteries

A

double layers of peritoneum
enclose organs and connect them to either the anterior or posterior walls of the abdomen

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38
Q

how do you name mesenteries

A

named according to the organs / structures they connect

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39
Q

greater omentum

A

type of mesenteries
a draping double peritoneal fold that connects the stomach to the transverse colon
policeman of the abdominal cavity

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40
Q

lesser omentum

A

type of mesentery
connects stomach and bit of duodenum to the liver

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41
Q

falciform

A

type of mesentery
connects the liver to the anterior abdominal wall

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42
Q

what are they 2 ligaments of the lesser omentum

A
  • hepatogastric ligament = connects liver to stomach
  • hepatodudenal ligament = connects liver to duodenum
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43
Q

2 peritoneal cavities (sacs)

A
  • omental bursa (lesser sac)
  • greater sac
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44
Q

omental bursa / lesser sac

A
  • Omental bursa (lesser sac)
  • Perioneal cavity in fold of lesser omentum
  • Behind the stomach
  • Water bed of which the stomach is lying
  • Stomach bed
  • Lying anterior to the pancreas and stomach is lying on it
  • Part of the bed of the stomach
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45
Q

greater sac

A

what is remaining of the periotoneal cavity - green and brown = supra colic compartment (green) and infraolic compartment (brown

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46
Q

3 parts of greater sac

A

supra colic compartment and infracolic compartment

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47
Q

how are the lesser and greater sac connected

A

through omental (epiploic) foramen of Winslow

48
Q

anterior boundary of omental (episodic) foramen of Winslow

A

free edge of lesser omentum (hepatodudenal ligament)
within which are
* bile duct
* hepatic artery
* portal vein

49
Q

posterior boundary of omental (episodic) foramen of Winslow

A

inferior vena cave

50
Q

inferior boundary of omental (episodic) foramen of Winslow

A

first part of duodenum

51
Q

superior boundary of omental (episodic) foramen of Winslow

A

caudate lobe of liver

52
Q

regions of Gi tract in abdominal cavity

A

right hypochondrium
left hypochondirum
right flank
left flank
right groin
left groin
epigastric
umbilical
pubic

53
Q

planes of abdominal cavity

A

intertubcular plane
midclavicular plane
subcostal plane

54
Q

parts of the stomach

A

duodenum
pylorus
pyloric canal
pyloric antrum
angular incisure
body
cardia
oesophagus
fundus
cardial notch

55
Q

what supplies blood to the stomach

A

celiac trunk

56
Q

who is the pylorus identified in surgery

A

pre pyloric vein of mayo which ascends over the pylorus is used to identify the pylorus in surgery

57
Q

anatomical lobes of the liver

A

right and left lobes
quadrate and caudate lobes (part of right lobe)

58
Q

what are the right and left lobes separated by

A

Falciform ligament

59
Q

what are the quadrate and caudate lobes seperated by

A

sagittal fissure and transverse porta hepatis

60
Q

why is the caudate lobe regarded as the third liver or lobe

A

as it receives vessels from both branches of the hepatic artery and bile duct and drain directly into the inferior vena cava

61
Q

how many segments is the liver divided into

A

8 segments based on the distributions of the portal triad and hepatic vein

62
Q

Livers dual oxygenated blood supply

A
  • hepatic portal vein (75% of blood -40% more oxygen than systemic veins)
    nourishes the liver parenchyma
    carriers all of the nutrients absorbed by the GI tract
  • hepatic artery - 25% of blood to the liver
63
Q

lymphatic drainage of the liver

A
  • liver is a major lymph producing organ of the body
  • 1/4 to 1/2 of the lymph entering the thoracic duct comes form the liver
  • the lymphatic vessels of the liver drain into the thoracic and right lympthatic ducts via a number of lymph nodes
64
Q

Pancreas position

A
  • elongated accessory digestive gland
  • lie retroperitoneally transversely across the bodies of the L1 and L1 vertebrae at the level of the transpyloric plane on the posterior abdominal wall
  • contains exocrine and endocrine secreting cells
65
Q

Pancreas position

A
  • elongated accessory digestive gland
  • lie retroperitoneally transversely across the bodies of the L1 and L1 vertebrae at the level of the transpyloric plane on the posterior abdominal wall
66
Q

what does the pancreas contain

A

contains exocrine and endocrine secreting cells

67
Q

how is the pancreas divided

A
  • head (with projecting uncinate process)
  • neck
  • body
  • tail
68
Q

2 main ducts of the pancreas

A
  • main pancreatic duct
  • accessory pancreatic duct
69
Q

what forms the hepatopancreatic ampulla of Vater

A
  • main pancreatic duct unites with bile duct = hepatopancreatic ampulla of Vater = opens into the duodenum
70
Q

blood supply to the pancreas

A
  • Derived from branches of the splenic, gastrodudenal and superior mesenteric arteries
71
Q

why are the blood vessels for pancreas ad duodenum the same

A

They have a close relationship
implications = pancreatic cancer surgery (Whipple’s procedure)

72
Q

Lymphatic drainage follow both vessels to what nodes

A

follow blood vessels to drain into superior mesenteric or coeliac lymph nodes via pancreaticosplenic lymph nodes and pyloric lymph nodes

73
Q

where is the nerve supply of the pancreas derived

A

derived from the vagus and abdominopelvis splanchnic nerves

74
Q

Nerve supply of pancreas

A

parasympathetic (via posterior vagal trunk)
sympathetic (T6-10 via splanchnic nerves)
pass along the arteries from the coeliac and superior mesenteric plexus

75
Q

what supplies the pancreatic acing and islet cells

A

parasympathetic (secretomotor) and sympathetic (vasoconstrictor) fibres also supply the pancreatic acing and islet cells

76
Q

what is pancreatic secretion hormonally mediated by

A

Secretin and cholecystokinin of the duodenal epithelium

77
Q

Pancreatic centroacinar cells

A

perform exocrine functions synthesise and secrete the digestive enzymes (amylase, trypsin, chymotrypsin, lipase and nucleases)

78
Q

Pancreatic stellate cells

A

Perform functions relating to tissue repair and destruction of tumour cells

79
Q

what do alpha cells secret in pancreas

A

glucagon

80
Q

what do beta cells secret in pancreas

A

insulin

81
Q

what do data cells secrete in pancreas

A

somatostatin

82
Q

what do F cells secrete in pancreas

A

Pancreatic polypeptide

83
Q

pancreatic islet of langerhans cells

A

alpha cells
beta cells
delta cells
F cells

perform endocrine functions

84
Q

how is the pancreas formed

A

By 2 buds from the endodermal lining of the duodenum

85
Q

what are the 2 buds that form the pancreas

A
  • dorsal pancreatic bud
  • ventral pancreatic bud ( out pocket from bile duct)
86
Q

embryonic development of the pancreas

A
  • 2 buds form pancreas (dorsal pancreatic bud and ventral pancreatic bud)
  • dorsal pancreatic bud moves to the right - due to rotation of the gut tube and ventral pancreatic bud moves dorsally
  • ventral pancreatic bud fuses with the lower part of the dorsal pancreatic bud
  • lies posterior inferior to it
  • the ventral pancreatic bud forms the uncinate process and part of the head of the Pancreas
  • rest of pancreas formed by the dorsal pancreatic bud
  • main pancreatic duct is formed by the distal part of the dorsal pancreatic duct and entire ventral pancreatic duct
  • proximal part of the dorsal pancreatic duct may persist as the accessory pancreatic duct
  • ventral apncreatic pud and duct with the proximal part of the bile duct - 2 ducts fuse together to for the hepatopancreatic ampulla
    8 pancreatic islets and other secretory cells develop form the endodermal tissue cells in 3 month of feral life
87
Q

when does insulin secretion begin

A

5th month of fatal life

88
Q

Annular pancreas

A
  • improper rotation and migration of parts of the tissues of the ventral pancreatic bud with the rotation of the duodenum
  • constrict the duodenum and raise complete obstruction
89
Q

accessory pancreatic tissue

A

ectopic pancreatic tissue may develop either in the oesophagus stomach and duodenum or in the small intestine

90
Q

Blockage of the hepatopancreatic ampulla and pancreatitis

A
  • blockage of hepatopancreatic ampulla by gallstone could lead to pancreatitis due to refill of bile into pancreatic duct
91
Q

endoscopic retrograde cholangiopancreatography

A

procedure using a fibre optic endoscope passed through the mouth oesophagus stomach and duodenum and inject radiographic contrast medium for the diagnosis of both pancreatic and biliary disease

92
Q

type of pancreatic cancer

A
  • exocrine pancreatic cancer - adenoocarcinoa (head of pancreas)
  • endocrine pancreatic cancer (pancratic neuroendocrine tumours)
93
Q

how can pancreatic cancer in the head of pancreas lead to jaundice

A

cancer of the head of the pancreas often compresses and obstructors the bile duct, enlargement of the gallbladder and hepatopancreatic ampulla (close)
= leading to obstructive jaundice

94
Q

how can pancreatic cancer in the neck and body of pancreas lead to jaundice

A

*cancer in neck and body of pancreas = hepatic portal or inferior vena caval obstruction
* extensive lympatic drainage of the pancreas into inaccessible lymph nodes
8 pancreatic cancer - metastasis to the liver early via the hepatic portal vein

95
Q

pancreatectomy

A

Removal of most of the pancreas for treatment of chronic pancreatitis or cancer

96
Q

Whipples procedure

A
  • most common types of surgery
    tumoru in head or neck of pancreas that haven’t yet spread
97
Q

what is the extra hepatic part of the biliary tree made of

A
  • right and left hepatic ducts which joins to form
  • common hepatic duct which receives the cystic duct to form
  • bile duct = unites with the main pancreatic duct to form
  • hepatopancreatic ampulla which opens into the duodenum
98
Q

gall bladder

A

visceral surface of the liver

99
Q

what does the small intestine consist of

A

duodenum
jejunum
ileum

100
Q

duodenum

A
  • fist 25cm and widest part of small intestine
  • c shaped course around the head of the pancreas
  • starts at the junction with pylorus on the right and ends at duodena jejunal flexure on the left
101
Q

4 parts og duodenum

A
  • superior horizontal first part
  • descending ventricle second part
  • inferior horizontal 3rd part
  • ascending vertical 4th part
102
Q

jejunum

A
  • proximal 2/5 of the small intestine following the duodenum
  • left upper quadrant of the infracolic compartment of the abdominal cavity
  • ileum is the distal 3/5 of the small intestine - located right lower quadrant
103
Q

mesenteric border

A

concave margin of a small bowel loop
toward the axis of the root of the mesentery

104
Q

anti mesenteric border

A

the convex margin of small bowel loop
facing away from the axis of the root of the mesentery

105
Q

why is it good to be able to distinguish between mesenteric and anti mesenteric borders of small bowel loops

A

for radiologic diagnosis

106
Q

intra abdominal disease processes

A
  • diverticulosis = mesenteric border
  • mockers diverticulum = anti mesenteric border
107
Q

what does the large intestine consist of

A

cecum
appendix
ascending colon
transverse colon
descending colon
sigmoid colon
recum
anal canal

108
Q

most common location of the appendix

A

retro caecal

109
Q

variations in the position of the appendix

A

retro colic
retro caecal
sub caecal
pelvic
retro ideal
pre ideal

110
Q

what 2 sources is the anal canal developed

A
  • endodermal cloaca of the hindgut (upper 2/3)
  • ectodermal cloaca (proctodaeum ) (lower 1/3)
111
Q

what are the 2 embryonic regions of the anal canal delineated by

A

the pectinate (dentate) line

Above pectinate line = internal iliac lymph nodes
Below line = inguinal lymph nodes

112
Q

clinical significance of the pectinate (dentate) line

A

2 regions of the anal canal differ in their blood and nerve supply and lymphatic drainage above and below the pectinate line

113
Q

what nerves carry the sympathetic and visceral afferent fibres to and from the GI tract

A

splanchnic nerves

114
Q

types of splanchnic nerves

A

Abdominopelvic splanchnic nerve (T5 L2/L3)
lower thoracic splanchnic
* greater splanchnic (T5 - T9/T10)
* lesser splanchnic (T10-T11)
* lumbar splanchnic (L1-L2/3)

115
Q

what carries parasympathetic and visceral afferent fibres to and from the GI tract

A

Vagus nerves
Pelvis splanchnic nerves (s2-s4)

116
Q

what leads to jaundice and pancreatitis in the binary tree and gallbladder

A

gall stones

anatomical sciences (12 decks)

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