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Flashcards in Metabolism Anatomy Deck (101):
1

What happens to blood from the digestive system?

Collected in the hepatic portal vein then transmitted to the liver for processing before it enters the systemic circulation via the hepatic veins to the inferior vena cava

2

What are the boundaries of the oral cavity?

Anterior = lips
Posterior = palate down to epiglottis (vertically)
Roof = hard and soft palate
Floor = tongue

3

Describe the hard palate

Made of the palatine process of the maxilla and the horizontal plate of the palatine bone

4

Describe the soft palate

Made of fibrous tissue with muscle fibres from the muscles that move it (levator palatine, tensor palatine and musculus uvulae)

5

What is the vestibule?

Space between the teeth and the cheek

6

What is the oral cavity proper?

Occupied mostly by the tongue

7

What is the frenulum?

A fold of mucosa that attaches the tongue to the mouth floor

8

Where does the palatine tonsil lie?

In the fossa formed between two folds of mucous membrane which project down from the soft palate (palatoglossus and palatopharygeus arches)

9

Where is the parotid gland located?

Occupies the triangular space made by the ramusof the mandible, the external ear and the upper SCML muscle

10

Where is the submandibular gland located?

In the diagastric (submandibular) triangle which takes a U shape around the posterior border of the mylohyoid muscle

11

Describe the sublingual gland

Group of small lands in the mouth floor either side of the tongue, they open with separate ducts on the plica sublingualis

12

What is the plica sublingualis?

Fold of mucous membrane between the tongue and the body of the mandible

13

How many teeth does an adult have?

32 permanent teeth; 2 incisors, 1 canine, 2premolars and 3 molars on each side of the jaw (x4)

14

How are the teeth attached to the mouth?

Via the periodontal membrane; attaches the tooth to the socket in the alveolar part of the mandible

15

What is the auriculo-temporal nerve?

Branch of the mandibular nerve (V3) which carries sensory and secreto-motor fibres to the parotid gland

16

Describe the nerve supply to the parotid gland

Supplied by the auriculo-temporal nerve (branch of V3) which has sensory fibres that are supplied via V3 and parasympathetic secreto-motor fibres that are supplied by the glossopharyngeal nerve (CN IX) through the lesser petrosal nerve which synapses in the otic ganglion before joining the auriculotemporal nerve

17

What is the chorda tympani?

Branch of facial nerve (CN VII) that conveys taste sensation from the anterior 2/3rds of the tongue and carries secreto-motor (parasympathetic) innervation to the submandibular and sublingual glands

18

Describe the nerve supply to the submandibular gland and sublingual gland

Chorda tympani (branch of facial nerve, CN VII) carries secreto-motor (parasympathetic) fibres to the gland; joins the lingual nerve for a distance and then separates to go to the submandibular ganglion and then post-synaptic fibres from this ganglion innervate these two glands

19

Describe the body of the tongue

Anterior 2/3rds form the body of the tongue, and this is covered by mucosa that is derived from the ectoderm

20

Describe the root of the tongue

Posterior 1/3 forms the root of the tongue and is covered by mucosa derived from the endoderm

21

What is the sulcus terminalis of the tongue?

Forms the boundary between the anterior and posterior of the tongue (root and body) and it is V-shaped

22

What is the foramen cecum of the tongue?

The most posterior point of the sulcus terminalis (boundary between the body and root of the tongue)

23

Name the intrinsic muscles of the tongue

Superior longitudinal, inferior longitudinal, vertical and transverse

24

What is the function of the intrinsic muscles of the tongue?

Help in changing the shape of the tongue and moving the tip in different directions

25

What is the function of the extrinsic muscles of the tongue?

Attach the tongue to the bony structures around it and move the tongue during swallowing or sticking out

26

Name the extrinsic muscles of the tongue

Styloglossus - muscle to the styloid process
Genioglossus - muscle to the mandible (genu=chin)
Hyoglossus - muscle to hyoid bone
Palatoglossus - muscle to palate (move tongue during swallowing or sticking out)

27

What is the function of the palatoglossus?

Move the tongue during swallowing or sticking out

28

What is the nerve supply to the intrinsic and extrinsic muscles of the tongue?

Hypoglossal nerve (CN XII) which is a purely motor nerve EXCEPT for nerve supply to palatoglossus which is innervated by vagus nerve (CN X)

29

Where does the hypoglossal nerve travel?

Beneath the tongue

30

Describe the superior constrictor muscle of the pharynx

Originates from the medial pterygoid plate and the pterygomandibular raphe

31

Describe the middle constrictor muscle of the pharynx

Arises from the angle between the lesser and greater horns of the hyoid bone

32

Describe the inferior constrictor muscle of the pharynx

Arises from the oblique line on the lateral surface of the thyroid cartilage and the fascia covering the cricothyroid muscle

33

What is the midline pharyngeal raphe?

Formed by the 3 constrictor muscles of the pharynx

34

What is the nasopharynx?

From the base of the skull to the level of the soft palate

35

What is the oropharynx?

From the soft palate to the base of the tongue

36

What is the laryngopharynx (hypopharynx)?

Space above and behind the laryngeal opening

37

What are the four muscles of mastication?

Temporalis, masseter, medial pterygoid and lateral pterygoid

38

Which muscles of mastication act to close the mouth?

Temporalis, masseter and medial pterygoid

39

Which muscle of mastication acts to open the mouth?

Lateral pterygoid

40

What is the nerve supply to the muscles of mastication?

V3 (mandibular branch of trigeminal nerve)

41

What is the bony attachment of the inferior part of the tongue?

Hyoid bone

42

Name the suprahyoid muscles

Stylohyoid, digastric, geniohyoid and mylohyoid

43

Name the infrahyoid muscles

Sternohyoid, sternothyroid, thyrohyoid and omohyoid

44

Describe the role of the hyoid muscles in the early phases of swallowing

Contraction of mylohyoid and digrastic muscles (suprahyoids) --> raises hyoid bone and tongue --> pushes food against palate --> contraction of geniohyoid (suprahyoid) increases oropharynx lumen to receive food --> contraction of stylohyoid (suprahyoid) pulls hyoid bone and tongue further up and back to squeeze bolus down the laryngopharynx

45

Describe the composition of smooth muscle in the oesophagus

Has an inner circular layer of muscle and an outer longitudinal one. Upper third of oesophagus has striated skeletal muscle and the lower two thirds are made of smooth muscle

46

Where is the upper oesophageal sphincter and what is its function?

Found between the oesophagus and pharynx and it allows the passage of contents (intermittently opens and closes)

47

Where is the lower oesophageal sphincter and what is its function?

Found at the lowest end of the oesophagus where it meets the stomach and prevents the stomach contents from travelling back up the oesophagus

48

How is reflux prevented anatomically?

LOS is contracted permanently between meals, and the abdominal part of the oesophagus has a collapsed lumen all of the time under the effect of the intra-abdominal pressure

49

Where does the oesophagus lie in relation to the trachea?

Posterior to the trachea

50

Where does the oesophagus lie in relation to the vertebral column and the heart?

Oesophagus is anterior (in front of) the vertebral column but posterior to the heart

51

What is the transpyloric plane and where is it found?

The superior imaginary horizontal line of the 9 abdominal regions and it is located at the level of L1

52

What is the transtubercular plane and where is it found?

The inferior imaginary horizontal line of the 9 abdominal regions and it is located at the level of L5

53

Name the 9 regions of the abdomen

Right hypochondrium, epigastric, left hypochondrium
Right lumbar, umbilical, left lumbar
Right iliac, hypogastric/suprapubic, left iliac

54

Name the three anterolateral muscles of the abdomen from superficial to deep

External oblique, internal oblique, transverse abdominis

55

What is the anterior vertical muscle of the abdomen?

Rectus abdominis

56

What is the rectus sheath?

Aponeurosis (tendinous sheet) that encloses the rectus abdominis muscle and is formed by the external oblique, internal oblique and transverse abdominis muscles

57

What are the tendinous intersections in the abdomen?

Bands of tendons that divide the rectus abdominis muscle into the typical six pack

58

What is the linea alba?

Vertical midline tendinous intersection in the rectus abdominis muscle

59

How can you distinguish between the internal and external oblique muscles of the abdomen?

Internal oblique is directed towards the pack pockets and the external oblique is directed towards the front pockets

60

What is the action of the rectus abdominis muscle?

Flexion of the spine (bending forwards)

61

What is the action of the internal and external oblique muscles of the abdomen?

Sideways leaning

62

What are the three layers of muscle in the stomach, from superficial to deep?

Longitudinal muscle, circular muscle, oblique muscle layer

63

What are rugae?

A series of ridges produced by folding of the stomach wall

64

What ligament represents the obliterated umbilical vein?

Ligamentum teres hepatis

65

What are intraperitoneal organs?

Organs which are completely surrounded by the visceral peritoneal layer

66

What are retroperitoneal organs?

Organs that sit on the posterior abdominal wall and are NOT completely surrounded by peritoneum

67

Name the intraperitoneal structures of the GI tract

Stomach, jejunum, ileum, transverse and sigmoid colon

68

Name the retroperitoneal structures of the GI tract

Duodenum, ascending and descending colon

69

What are the divisions of the peritoneal cavity?

Lesser sac (omental bursa) is a small region that lies posterior to the stomach and the greater sac comprises the rest of the cavity

70

What is mesentery?

A double layer of peritoneum that attaches an organ to the posterior abdominal wall and allows passage of neurovascular supply to and from the organ

71

What is the mesentery of the colon called?

Mesocolon

72

What are omentum?

Peritoneum that passes from the stomach to an adjacent organ

73

Describe the lesser omentum

Connects the lesser curve of the stomach to the liver above and is two layers thick

74

Describe the greater omentum

Connects the greater curve of the stomach to the transverse colon below and is two layers of peritoneum (therefore 4 layers in total)

75

At what spinal level is the coeliac trunk found?

T12

76

What does the coeliac trunk supply?

Foregut structures, including liver and gall bladder, the stomach and lower oesophagus the spleen and part of the duodenum and pancreas.

77

What does the superior mesenteric artery supply?

Midgut structures: the intestine from the lower part of the duodenum to the left colic flexure and the pancreas

78

What does the inferior mesenteric artery supply?

Hindgut structures: large intestine from the left colic (or splenic) flexure to the upper part of the rectum, which includes the descending colon, the sigmoid colon, and part of the rectum

79

At what spinal level is the superior mesenteric artery found?

L1

80

At what spinal level is the inferior mesenteric artery found?

L3

81

What are the three branches of the coeliac trunk

Splenic artery, left gastric artery and the common hepatic artery

82

What are the four branches of the superior mesenteric artery?

Jejunal arteries, ileocolic artery, right colic artery and middle colic artery

83

What are the three branches of the inferior mesenteric artery?

Left colic artery, sigmoidal arteries and superior rectal artery

84

Which arteries supply the lesser curvature of the stomach?

Left and right gastric arteries

85

Which arteries supply the greater curvature of the stomach?

Left and right gastroepiploic arteries

86

What are short gastric arteries?

Branches of the splenic artery and supply the fundus region of the stomach

87

Describe the blood supply to the small intestines

SMA gives 15-18 branches to supply the small bowel. These branches unite to form loops or arches = arterial arcades within the small bowel mesentery. The arcades give rise to straight arteries = vasa recta

88

What differences are there between the arcades and the vasa recta of the jejunum and of the ileum?

The ileum has far more layers of arterial arcades before vasa recta are given off

89

How is the hepatic portal vein formed?

Inputs from the splenic vein (and inferior mesenteric vein branching from splenic) and the superior mesenteric vein

90

What is the function of the splenic vein?

Drains foregut

91

What is the function of the inferior mesenteric vein?

Drains midgut

92

What is the function of superior mesenteric vein?

Drains hindgut

93

What happens to the hepatic portal vein as it enters the liver?

Splits into left and right

94

Name the four parts of the duodenum

Superior, descending, horizontal and ascending

95

Describe the major duodenal papilla

Where the pancreatic duct and common bile ducts insert into the duodenum

96

Describe the minor duodenal papilla

Where the accessory pancreatic duct opens into the duodenum (superior to the major duodenal papilla)

97

Describe the common hepatic duct

Formed from the left and right hepatic ducts

98

Describe the cystic duct

The duct that stems from the gallbladder and joins to the common hepatic duct to form the common bile duct

99

Describe the common bile duct

Formed from the merging of the cystic duct and common hepatic duct

100

Describe the hepatopancreatic ampulla

Where the bile duct units with the pancreatic duct --> this opens into the major duodenal papilla

101

How are secretions into the duodenum controlled?

By the sphincter of Oddi