GI tract Flashcards
(95 cards)
1
Q
length of oesophagus
A
about 25 cm
2
Q
muscle of oesophagus
A
upper 1/3 = skeletal
lower 2/3 = smooth
3
Q
start of oesophagus
A
C6/7 at upper oesophageal sphincter
4
Q
route of oesophagus
A
posterior to trachea, tracheal bifurcation and left atrium
passes through diaphragm at T10
associated with vagus nerves
5
Q
stomach start point
A
abdominal oesophagus enters stomach in the cardia region = upper oesophageal sphincter
about T10
6
Q
parts of stomach
A
entry with oesophagus = cardia rounded bit to right = fundus main body greater curvature around the right and lesser curvature to the left pyloric antrum and canal at base
7
Q
parts of pyloric region
A
antrum, canal sphincter
8
Q
greater omentum and stomach
A
attaches the stomach to the transverse colon
9
Q
lesser omentum and stomach
A
attaches the stomach and duodenum to the liver
10
Q
pyloric stenosis
A
narrowing of pylorus, food can’t enter duodenum
projectile vomiting, found early in children
11
Q
gastric ulceration
A
loss of protective mucus surrounding stomach tissue
acid breaks down stomach tissue
can be caused by the infection helicobactor pylori
12
Q
sphincter of duodenum with stomach
A
pyloric sphincter
13
Q
spinal levels of duodenum,
A
L1-3
14
Q
position of duodenum with peritonum
A
first part is mobile, attached to the lesser omentum
remainder is retroperitoneal
15
Q
entry of pancreatic and bile duct into duodenum
A
enter in descending part
flow controlled by sphincter of oddi
16
Q
anchoring of duodenojejunal junction
A
anchored by suspensory ligament of duodenum to right diaphragmatic crus
17
Q
parts of the oesophagus
A
cervical (starts at level of cricoid), thoracic (mediastinum), abdominal (after diaphragm)
18
Q
liver divisons
A
4 anatomical lobes
19
Q
separation of liver lobes
A
anterior = R/L lobes separated by the falciform ligament posterior = fissure of ligamentum teres/venosum
20
Q
names of liver lobes
A
right, left, caudate, quadrate
21
Q
position of liver
A
RUQ
superior = diaphragm, inferior = costal margin
22
Q
what is the porta hepatis
A
entry/exit point for the hepatic portal vein, bile duct and hepatic artery
23
Q
blood supply to liver
A
hepatic artery and hepatic portal vein provide blood flow to liver
drain to the hepatic vein into the IVC
24
Q
bile formation
A
formed in the liver
secreted via bile ductules into right and left hepatic ducts
hepatic ducts join at porta hepatis to form the common hepatic duct
25
gall bladder function
stores and concentrates bile
| connected to common hepatic duct by cystic duct, which from the common bile duct
26
bile drain into duodenum
pancreatic duct and common pile duct join the second part of the duodenum at the ampulla of vater
27
what does the free edge of the lesser omentum contain
common bile duct, hepatic artery and hepatic portal vein
28
pancreas position in peritoneum
retroperitoneal
29
parts of pancreas
head, body, tail
30
pancreas and duodenum
pancreatic head within the duodenal curvature, neck behind duodenum, tail in contact with spleen
31
pancreatic duct
combines with common bile duct to enter the duodenum
| enters at the major duodenal papilla
32
small intestine parts
duodenum
jejunum = surrounded by mesentery, numerous mucosal folds
ileum = enters into the caecum, suspended by mesentery (narrower than other regions)
33
anatomical relationship of stomach
```
anterior = abdominal wall, diaphragm, left lobe of liver
posterior = separated by sac from pancreas, left kidney and gland, spleen, aorta, transverse colon
superior = diaphragm
```
34
sotomach innervation
celiac plexus T6-T9 = sympathetic nerves (via greater splanchnic nerve)
vagus is parasympathetic
35
duodenum innervation
supplied with blood vessels
sym = coeliac and superior mesenteric plexus
para = vagus
36
jejunum and ileum position
```
jejunum = umbilical
ileum = hypogastric and pelvis
```
37
mesentery and small intestine
carries blood vessels, autonomic fibres and lymphatic vessels
starts at duodenal - jejunal junction, attaches most to posterior abdominal wall
38
jejunum and ileum innervation
parasym and sym in the myenteric and submucosal plexus
parasym = vagus
sym = coeliac plexus via sympathetic trunks and greater splanchnic nerves
39
large intestine parts
begins at ileo-caceal junction
| caecum, ascending colon, trasnverse colon, descending colon and sigmoid colon
40
large intestine smooth muscle layers
inner circular and outer longitudinal layers of smooth muscle
41
distinguishing features of large intestine
```
taeniae coli (3 flattened, thick, muscular bands that run across the entire wall of the caecum and colon)
haustrae (pouches of mucosa between the taenia coli)
epiploic appendices (fat filled pouches on the outer surface)
```
42
caecum position
right iliac fossa
over ilacus and psoas
projects downwards at the start
peritoenum but no mesentery
43
appendix position
variable around caecum
| most lie behind
44
appendix structure
devoid of taeniae coli, blind ended tube
45
appendicitis
usually bacterial infection
pain = visceral peritoneum, back to T10 dermatome
typically pain at mcburneys point (1/3 between ASIS and belly button)
46
mesentery in colon
attached to transverse and sigmoid, so both intraperitoneal
47
rectum features
begins at S3
retroperitoneal
follows the curve of the sacrum
48
ano-rectal junction
where the rectum passes posterior and inferior to pass through the pelvic floor muscles
49
anal sphincters
```
internal = smooth, autonomic
external = striated, pudendal nerve (sym)
```
50
large intestine innervation
```
parasym = mostly vagus, distal = pelvic splanchnic nerves
sym = T10-L2, lumbar sympathetic chain and the superior hypogastric plexus
```
51
blood supply to foregut
coeliac trunk
52
where does the coeliac trunk come from
abdominal aorta, just underneath diaphragm at T12
53
branches of coeliac trunk
left gastric, splenic, and common hepatic arteries
54
left gastric supplies
oesophagus and anterior/posterior stomach
55
splenic artery supplies
across posterior abdominal wall to supply the spleen an pancreas, also produces all gastric arteries for the stomach
also branches into left gastroepiploic artery
56
common hepatic artery divides into
right gastric, gastro-duodenal and hepatic
57
right gastric artery supplies
anterior/posterior stomach
58
hepatic artery supplies
liver
59
gastroduodenal artery supplies
duodenum (first part)
60
venous drainage of the foregut
follows arteries
| drains into hepatic portal or one of the derivatives
61
venous draining of the stomach
gastroepiploic and short gastric veins drain into splenic vein or superior mesenteric -> portal vein
62
portal vein produced from
superior mesenteric and splenic veins
| inferior mesenteric drain into splenic
63
position of portosystemic anastomoses
```
end of oesophagus
wall of upper anal canal
umbilicus
bare area of liver
retroperitoneal
```
64
what does obstruction of the portal vein cause s
anastomoses vessels widen
| get portal hypertension which produce varicose veins on the abdominal wall
65
splenic vein drains
spleen
stomach fundus
part of pancreas
66
superior mesenteric vein drains
small intestine, caecum, ascending and transverse colon, distal parts of stomach
67
inferior mesenteric artery drains
descending colon, rectum and sigmoid
68
liver and gall bladder blood supply
coeliac trunk -> common hepatic artery
common hepatic artery divides into the hepatic and then cystic and R/L hepatic arteries
cystic -> gall bladder (usually branch of right hepatic)
R/L hepatic -> liver
69
blood supply to pancreas
at the border for foregut/midgut so both coeliac and superior mesenteric
coaelic trunk -> splenic and superior pancreatic/duodenal arteries
superior mesenteric -> inferior pancreatic/duodenal artery
70
superior mesenteric artery originates
abdominal aorta about L1
71
branches of superior mesenteric
inferior pancreatic duodenal
jejunal branches
ileal branches
ileocolic artery -> appendicular and R/L colic
72
superior mesenteric artery supplies
distal duodenum
jejunum and ileum
colon up to 2/3 along transverse - to SPLENIC FLEXURE
73
what are the arterial arcades
series of anastomosing arterial arches between the jejunum and ileum
nearest duodenum = primary loops, vasa recta are long
towards ileocolic artery = secondary and tertiary loops
74
inferior mesenteric origniates
about L3
75
branches of inferior mesenteric
left colic, sigmoid and super rectal branches
76
inferior mesenteric supplies
ascending colon, sigmoid colon and superior part of rectum
| splenic flexure to rectal-anal junction
77
what are the marginal vessels
anastaomosis between superior and inferior mesenteric
also called artery of Drummond
continuous arterial circle along the inner border of the coloin
78
control of gut arterial supply
controlled by sympathetic nerves
| vasoconstrictor neurons with cell bodies win the paravertebral and pre vertebral ganglia
79
lymphatic drainage of abdomen and pelvis
reaches the lumbar and intestinal lymphatic trunks, unite at the cistern chyli forming the thoracic duct
80
GI tract lymph drains into
superior and inferior mesenteric lymph nodes
81
retroperitoneum drains into
lumbar lymph nodes
82
stomach lymph nodes
follow the lesser and greater curvatures
| embryo into the gastric, gastroomental and pyloric lymph nodes -> celiac lymph nodes
83
small intestine lymph nodes
junta intestinal
intermediate mesenteric
superior mesenteric
84
what vessels to lymph vessels follow
arteries
85
large intestine lymph vessels
each part has its own nodes
all drain into superior mesenteric
descending and sigmoid colon into inferior mesenteric nodes
86
liver and gall bladder lymph nodes
cystic and hepatic nodes
87
sequence of drainage of lymph
all lymph drains into the intestinal trunks, then the cisterna chyli and then the thoracic duct
88
sympathetic innervation to gut
celiac, superior mesenteric and inferior mesenteric ganglia from T6-L2 spinal nerves
89
celiac ganglion supplies
```
stomach
blood vessels
liver and bile duct
pancreas
adrenal gland
small intestine
```
90
superior mesenteric ganglion supplies
small intestine
| large intestine
91
inferior mesenteric ganglion supplies
```
distal large intestine
kidney
bladde
rectum
gonads
```
92
parasympathetic nerve supply
vagus to vast majority of organs
| S2-S4 supply to hind gut (distal large intestine, rectum, anus)
93
afferent fibres of the gut
general visceral afferent fibres
| conduct sensory impulses from internal organs to CNS
94
afferent fibres pathway
accompany sympathetic efferent
travel from organ to ganglion, along a splanchnic nerve, into the sympathetic trunk and then into a ventral ramus and the mixed spinal nerve
goes into the dorsal root ganglion
95
afferent fibres also found in
vagus nerve
