Upper Gastrointestinal Tract Flashcards

(109 cards)

1
Q

What structure is the oral cavity continuous with?

A

Pharynx

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2
Q

What is the oral cavity divided into?

A

Oral vestibule- behind the lips, continuous with oral cavity proper

Oral cavity proper- median to teeth

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3
Q

What circular muscle surrounds orifice of mouth?

A

Orbicularis oris - helps out lips

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4
Q

What muscle is lateral to the orbicularis oris?

A

Buccinator muscle - helps blow out cheeks

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5
Q

Where is saliva produced/

A

Parotid gland

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6
Q

Why is buccinator muscle an important landmark?

A

Parotid duct transports saliva over masseter muscle to enter into oral cavity by travelling through buccinator muscle

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7
Q

What does the floor of the oral cavity consist of?

A

Mylohyoid muscle (superficial) runs from mandible to hyoid bone (floating bone)

Geniohyoid muscle (superior to mylohyoid)

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8
Q
A
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9
Q

What forms the roof of the oral cavity?

A
Hard palate (bone- roof of mouth)
Soft palate (posterior)
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10
Q

What is the horizontal plane extending from maxilla?

A

Palatine process of maxillary bone

Has a suture- horizontal plate of palatine bone

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11
Q

What structure is a part of the soft palate and what does it consist of?

A

Uvula

Made of muscle -> Musculus uvulae
Red mucus membrane around it- covering whole of oral cavity and pharynx

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12
Q

What structure is exposed on protraction of the tongue?

A

Palatoglossal fold- under it is palatoglossal muscle

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13
Q

What structure is posterior to the palatoglossal fold?

A

Palatopharyngeal fold

Under it is palatopharyngeas muscle

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14
Q

What structure is between the palatoglossal and palatopharyngeas folds?

A

Palatine tonsil

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15
Q

Tensor veli palatini muscle and levator veli palatini muscle

A

Tensor- tenses soft palate

Levator- elevates soft palate

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16
Q

What innervates the muscles of the soft palate? Are there any exceptions?

A

Vagus nerve EXCEPT tensor veli palatini (supplied by mandibular division of trigeminal nerve)

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17
Q

Identify vagus nerve

A

First identify nearby common carotid artery
Lateral to it is internal jugular vein
In between them is vagus nerve

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18
Q
A
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19
Q

What structure is this

A

Root of tongue

attached to hyoid bone and mandible

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20
Q

What structure is this

A

Dorsum of tongue

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21
Q

What two parts is the tongue divided into?

A

Anterior 2/3 (oral)

Posterior 1/3 (pharyngeal)

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22
Q

What structure is this

A

Thyroid cartilage

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23
Q

What structure is this

A

Thyroid glands

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24
Q

What is the V shaped structure on the dorsal surface of the tongue?

A

Terminal sulcus

defines boundary between oral and pharyngeal parts of tongue

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25
Foramen cecum
Thyroid gland started embryological development at this point, then descends a shallow depression in the posterior dorsal midline of the tongue that is the remnant of the more cranial part of the embryonic duct from which the thyroid gland developed.
26
What connects foramen cecum to thyroid gland in embryos?
Thyroid glossal duct- atrophies after birth but can remain open as a thyroid glossal cyst in children
27
Identify this nerve
Lingual branch of mandibular division of trigeminal nerve
28
What sits here?
Trigeminal ganglion
29
What nerve gives sensation to oral part of tongue
Lingual branch of mandibular division of trigeminal nerve
30
What nerve travels with lingual nerve to send sensations of taste to brain?
Chorda tympani- branch of facial nerve
31
What nerve supplies sensation of taste and general sensation to pharyngeal part of tongue
Glossopharyngeal nerve (cranial nerve 9)
32
What structure is this
Parotid gland | Posterior to masseter muscle
33
What two vessels run through surface of parotid gland?
External carotid and retromandibular vein
34
What is this vessel and what structure is it going into?
Parotid duct going into buccinator muscle
35
Once in the oral cavity what is opposite the parotid duct?
2nd molar tooth upper jaw
36
What structure is this
Submandibular gland
37
What structure opens up in the mouth lateral to the frenulum?
Submandibular duct
38
Identify the structure
Frenulum
39
Identify the structure
Sublingual salivary glands
40
What are the 3 salivary glands?
Parotid glands Submandibular glands Sublingual glands
41
Pharynx
Fibromuscular tube that runs behind and is continuous with the nasal cavity, oral cavity and larynx
42
Identify the structures- what 3 parts is the pharynx divided into?
43
What is this structure?
Choanae- opening of nasal cavity (posterior nasal aperture)
44
Where does nasopharynx run from and to?
From just below sphenoid sinus to tip of uvula
45
Where does oropharynx run from and to?
From tip of uvula to epiglottis
46
What is epiglottis attached to?
Thyroid cartilage
47
What tube is the pointer in?
Trachea and top of larynx- anterior to oesophagus
48
What small depressions are anterior to epiglottis?
Valleculae where saliva will pool and food passes through to stimulate epiglottis and close larynx
49
What is this structure?
Larynx (voicebox) just under epiglottis
50
What is this area?
Piriform recess a small cavity or pocket between the lateral walls of the pharynx on each side and the upper part of the larynx.
51
What can get stuck in the piriform recess?
Food, eg fish bones
52
Vocal cords aka larynx
53
What are the 3 circular pharyngeal muscles and what do they do?
Superior constrictor Middle constrictor Inferior constrictor - 2 parts (superior component fibres attach to thyroid cartilage and inferior component fibres attach to cricoid cartilage) The circular muscles contract sequentially from superior to inferior to constrict the lumen and propel the bolus of food inferiorly into the oesophagus.
54
Where does oesophagus run from and to?
From pharyngoesophageal junction at C6 to stomach
55
What is this space
Oropharynx (just before laryngopharynx)
56
Where is the main point that the oesophagus becomes constricted?
Cricoid cartilage | can also get constricted at the point where aorta arches and bronchus
57
What are these structures?
Anterior vagal plexus- branches of vagus nerve supplying oesophagus
58
Thoracic duct
Lymphatic duct that drains all lymph back into veinous system
59
At what point does oesophagus go through diaphragm?
T10 Through oesophageal hiatus
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What is the point where the stomach is closest to the oesophagus?
Cardia
62
Pylorus
Valve that opens and closes during digestion. This allows partly digested food and other stomach contents to pass from the stomach to the small intestine. Controls gastric emptying into duodenum
63
Where is the cardiac notch?
64
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What is the spaghetti string structure hanging from the greater curvature of the stomach?
Greater omentum
66
Function of greater omentum
If infection in abdomen, in bowl area, greater omentum can slowly migrate and enclose it to stop spread of infection
67
What is this structure
Transverse colon Attached to posterior surface of greater omentum
68
What structure is attached to lesser curvature of stomach?
Lesser omentum (goes to liver)
69
What are these in the stomach?
Rugae
70
Cranial cavities
Oral cavity is continuous with nasal cavity via the pharynx. Pharynx is continuous and posterior to the nasal cavity, oral cavity and larynx.  Pharynx is continuous inferiorly with the oesophagus (food pipe) Larynx (voice box) is continuous inferiorly with the trachea (wind pipe)
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Buccal region
(cheeks) Movable lateral walls Buccinator muscle Continuous with lips (orbicularis oris) Buccal fat pad assists in suckling
76
Remember that the buccinator muscle is a muscle of facial expression, not a muscle of mastication!
77
Saliva function
Keeps mucous membrane moist Lubricate oral cavity Initiate digestion of starch Prevent teeth decay
78
Three salivary glands Empty via ducts into oral cavity 1. Parotid gland 2. Submandibular gland 3. Sublingual gland
79
Innervation to salivary glands
Parasympathetic to submandibular and sublingual glands supplied by presynaptic parasympathetic fibres -> conveyed from the lingual nerve (branch of mandibular (CVN3) by the chorda tympani nerve (branch of facial nerve) to the submandibular ganglion. Here they synapse with post synaptic parasympathetic fibres and run to the glands.
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The parotid gland Parasympathetic supply
Presynaptic parasympathetic from glossopharyngeal nerve to otic ganglion. Post synaptic parasympathetic travel in auricular temporal nerve (branch of mandibular nerve) to parotid gland.
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What is root of tongue attached to?
Mandible and hyoid bone
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Note nerve supply Maxillary Nerve (CNV2) Eustachian tube
86
NERVE SUPPLY: glossopharyngeal nerve (CN IX) note tonsil and valleculae location
87
NERVE SUPPLY: Vagus nerve (CN X) Epiglottis location
88
Pharyngeal blood supply: Upper pharynx Lower pharynx Palatine tonsil
89
What lymphatic node drains palatine tonsils?
Jugulodigastric lymph node
90
Oesophagus
Muscular tube: 25 cm Extends from pharyngo-oesophageal junction (C6) to cardiac orifice of stomach (T11) Functions to transport food from pharynx to stomach  Pierces diaphragm at oesophageal hiatus (T10)  Two sphincters 1. Upper oesophageal sphincter (UES) - Inferior constrictor muscle 2. Lower oesophageal sphincter (LES) - GORD
91
Constrictions of oesophagus
A.B.C.D. A: Arch of aorta B. Bronchus (left) C. Cricoid cartilage (junction between oesophagus and pharynx) D. Diaphragmatic hiatus
92
Oesophageal layers
93
Arterial supply of oesophagus
Upper third: Inferior thyroid artery Middle third: Thoracic aorta Lower third: Left gastric artery
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Innervation of oesophagus
Oesophageal plexus arise from: 1. Vagus nerve (CN X): - Parasympathetic fibres - General sensation fibres 2. Nerves from cervical and thoracic sympathetic trunk - Sympathetic fibres - Pain fibres
95
Oesophageal lymphatics
Very complex Important in oesophageal cancer BIDIRECTIONAL: - Upwards to deep cervical lymph nodes - Downwards to juxta-oesophageal nodes
96
Function of stomach
Storage of ingested food. Regulate rate of emptying into small intestines. Mechanical and chemical breakdown of food.
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Histological layers of stomach
98
Stomach openings
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3 layers of stomach muscular structure
1. Inner oblique layer: mechanical break down food. 2. Middle circular layer: thickest at pylorus forming pyloric sphincter. 3. Outer Longitudinal layer: moving bolus towards pylorus through muscular shortening
100
What are the features of the stomach's inner mucosa?
Gastric canal Gastric Rugae/folds
101
Peptic ulcer
Open lesion in mucosa lining. Location: Oesophageal Gastric Duodenal Causes: H. pylori NSAID (nonsteroidal anti-inflammatory drugs) Stress
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Development of GI tract
103
Blood supply of: Foregut Midgut Hindgut
Foregut- COELIAC TRUNK Midgut- SUPERIOR MESENTERIC ARTERY Hindgut- INFERIOR MESENTERIC ARTERY
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3 main branches from coeliac trunk
Common hepatic artery Left splenic artery Splenic artery
105
Arteries of stomach
106
Parasympathetic innervation of stomach
Vagus Nerve (CN X) increases rate of digestion when stimulated - > Secretomotor to gastric glands - > Motor to smooth muscular walls of GIT (peristalsis) Right vagus -> posterior vagal trunk (posterior aspect of stomach supplied) Left vagus -> anterior vagal trunk (anterior surface of stomach supplied) due to stomach rotation
107
Sympathetic innervation of stomach
Greater splanchnic nerve (T5 – T9) cause pyloric sphincter to contract reducing rate of gastric emptying Motor to pyloric sphincter Referred pain: Pain fibres hitchhike with splanchnic nerve Pain from foregut referred to epigastric region Convergent nerve roots result in the concept of referred pain. Foregut innervation - greater splanchnic nerve
108
Lymphatics of stomach
Follow blood vessels All lymph eventually passes into coeliac nodes Important for cancer spread: gastrectomy