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GI Week 1 > Lecture 2: Alimentary Structures > Flashcards

Lecture 2: Alimentary Structures Flashcards

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1
Q

What are alimentary structures?

A

Structures that relate to NOURISHMENT or SUSTENANCE

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2
Q

What are the only places that are ectodermly derived in the GI tube?

A

Oral cavity

Inferior 1/3 of the anal canal (below the pectinate line)

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3
Q

What do the regions of the gut tube (foregut, midgut, hindgut) have that serves to distinguish them from one another?

A
  1. Arterial blood supply
  2. Innervation
  3. Relationships to mesentery
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4
Q

Where does the bile duct enter the duodenum?

A

At the separation between foregut and midgut

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5
Q

How do you separate regions of gut tube?

A

Foregut is the point of entry of bile duct into duodenum

Midgut to hindgut is proximal 2/3 and distal 1/3 of transverse colon

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6
Q

Is the spleen part of gut tube?

A

No because it is mesoderm derived

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7
Q

What is in the foregut?

A 
Celiac trunk
1. Esophagus,
2. stomach
3. duodenum (1st and 2nd parts)
4. liver
5. pancreas
6. biliary apparatus
7. gall bladder
Below are derivatives of gut tube but not part of GI tract per se
8. Pharyngeal pouches
9. Lungs
10. Thyroid
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8
Q

What innervates the foregut?

A
  1. Parasympathetic = Vagus nerve

2. Sympathetic = T5-T9

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9
Q

What innervates the midgut?

A
  1. Parasympathetic = vagus nerve

2. Sympathetic = T10-T12

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10
Q

What innervates the hindgut?

A
  1. Parasympathetic = Pelvic (splanchnic) nerves (S2-4)

2. Sympathetic = L1-L3

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11
Q

What is the purpose of enteric ganglia?

A

Ganglia located within the walls of the gut tube

Goal in life of sympathetics are to synapse here

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12
Q

What is the significance of the sympathetic innervation of the gut tube?

A

Visceral pain will be referred to the T1-L3 dermatomes
Pain from abdominal viscera is carried back to the CNS by sympathetic nerves and is referred to dermatomes of the body wall that match the sympathetic innervation
Pain is POORLY LOCALIZED

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13
Q

Where is pain of the umbilicus referred to?

A

Small intestine

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14
Q

What is the referred pain to appendix?

A

T10

McBurney’s point

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15
Q

What is secondarily retroperitoneal?

A
  1. pancreas
  2. duodenum
  3. ascending colon
  4. descending colon
    Significant for imaging
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16
Q

What are some synonyms for ventral mesentery remnant?

A

Omentum

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17
Q

Where does esophagus begin?

A

C6
Cervical Constriction
Cricopharyngeus muscle
Narrowing of the esophagus

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18
Q

Where is the level of the thoracic constriction of the diaphragm?

A

T4
There the bronchus bifurcates
Where aortic arch is

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19
Q

Where is the level of diaphragmatic constriction?

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A

T10

Caused by lower sphincter

20
Q

Where are the three significant constrictions /narrowings of the esophagus?

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A
  1. Cervical
  2. Thoracic
    • aortic arch
    • left atrium/left mainstem bronchus
  3. Diphragmatic
21
Q

What is the muscle makeup of the esophagus?

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A
  1. Upper 5% = voluntary skeletal muscle
  2. Middle 45%
    • mixture of skeletal and mostly SMOOTH
  3. Distal 50%
    • involuntary smooth muscle
22
Q

What innervates all the muscles of the esophagus?

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A

Smooth and skeletal all by the vagus nerve

23
Q

What is the role of the stomach?

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A

Food blender
Food reservoir
Holds 2-3 L of food

24
Q

What are the glandular regions of the stomach?

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A
  1. cardiac
  2. fundus
  3. ANTRUM (pylorus?)
    HISTOLOGICAL
25
What are the anatomic divisions?
1. Cardiac 2. fundus 3. body 4. pylorus
26
What is important about epiploic foramen?
It is where the vasculature and lymphatics pass through
27
What are the muscle layers in the stomach?
1. Outer longitudinal 2. Middle circular 3. Innermost oblique
28
What are the rugae?
Folds in the stomach
29
What is the Z line?
The line separating esophagus to stomach Juncture where epithelial change is evident (from esophagus to stomach) T11
30
What is the squamo-colunar junction of esophagus?
Right above the Zline | Site of physiologic inferior esophageal sphincter
31
What will be found in the omental bursa (lesser sac)?
Pancreas and duodenum
32
What are the three branches of the celiac trunk?
1. common hepatic artery 2. splenic artery 3. left gastric artery
33
What is the portal triad?
1. common bile duct 2. common hepatic artery 3. portal vein
34
What supplies the lesser curvature of the stomach?
1. left gastric artery (from celica trunk 2. right gastric artery from hepatic artery? Dual blood supply
35
What supplies the greater curvature of the stomach?
1. Right gastroepiploic artery (gastroduodenal artery)) 2. Left gastroepiploic artery (splenic artery) 3. Short gastric artery Dual blood supply
36
Where does the left vagus nerve end up?
Anterior vagal trunk
37
Where does right vagus nerve end up?
Posterior vagal trunk
38
Where do the bile and pancreatic secretions drain into?
The 2nd part of the duodenal at the MAJOR DUODENAL PAPILLA (Vater?)
39
What are the key characteristics of the jejunum?
It is much more rugged and has much more curves
40
What are the key characteristics of the ileum?
Smoother | Peyer’s patches
41
What is the blood supply of jejunum?
1. simple arcades | 2. Long vasa recta
42
What is the blood supply of the ileum?
1. Complex arcades | 2. Short vasa recta
43
What are the key characteristics of the colon?
1. Taenia coli (the longitudinal strip of muscle in the colon) 2. Haustra (which are the bumps you see in the colon) 3. Fat droplets that are seen around colon
44
What are the divisions of the SMA?
1. ileocolic artery 2. Right colic artery 3. Middle colic artery All have ascending and descending branches
45
What are the marginal arteries?
The ascending and descending branches of the 3 main divisions of the SMA
46
What are the divisions of the IMA?
1. Left colic artery 2. Sigmoid arteries 3. Superior rectal artery
47
Where are the marginal arteries the weakest?
At the 2/3 junction of transverse junction

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