Workbook 2 Flashcards by Sophie Pitcairn

What does small intestine include?

Duodenum, jejunum, ileum

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What does large intestine include?

Caecum, appendix and the colon - ascending, transverse and descending

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What are the 3 constrictions of the oesophagus?

Cervical, thoracic and diaphragmatic

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Describe the oesophagus

25cm long and is a muscular tube
From pharynx to stomach

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What is the vertebral level of the oesophageal opening?

T10

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What other structures pass through the diaphragm at oesophageal opening?

Oesophagus
Right vagus nerve
Left vagus nerve
Left gastric artery/vein

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What is the blood supply of the oesophagus?

Left gastric artery - branch of coeliac trunk

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Describe the venous drainage of oesophagus

Left gastric vein - portal
Azygous vein - systemic

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Describe the lymphatic drainage of the oesophagus

Superior third - deep cervical nodes
Middle - superior and posterior mediastinal nodes
Lower - left gastric and coeliac nodes

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What is important about the lower end of the oesophagus?

Important site for portosystemic anastomoses
In portal hypertension then can get oesophageal varices

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What are the parts of the stomach?

Fundus
Body
Antrum
Pyloric

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Where does lesser omentum extend from and to?

Lesser curvature of stomach to the liver

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Where does the greater omentum extend from and to?

Greater curvature of the stomach to transverse colon

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What is the pyloric sphincter?

Ring of smooth muscle contracting stomach to the duodenum
Controls movement of partially digested food

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What are the gastric folds/rugae formed from?

Gastric mucosa

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In what parts of the stomach are the rugae more apparent?

Body and antrum

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Name the three branches of the coeliac trunk

Left gastric artery
Splenic artery
Common hepatic artery

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What are the arteries supplying the stomach?

Left gastric artery
Right gastric artery
Splenic artery
Common hepatic artery
Left gastro-omental artery
Right gastro-omental artery

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What are the 4 main vessels draining the stomach?

Left and right gastric veins - hepatic portal vein
Right gastro-omental vein - superior mesenteric vein
Left gastro-omental vein - splenic vein

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What are the main group of lymph nodes that drain the stomach?

Gastric nodes

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Describe the innervation of the stomach

Parasympathetic - vagus nerve
Sympathetic - greater splanchnic nerve from coeliac plexus T6-9

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How many parts does the duodenum have?

4 parts

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What organ sits in the C shape of the duodenum?

Pancreas

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How is duodenum peritonised?

1st part is intra
Rest is retroperitoneal

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What is the opening in duodenum where bile and pancreatic fluids enter?

Ampulla of Vater

What 2 structures come together at the ampulla of Vater?

Common bile duct Main pancreatic duct

What is the sphincter that controls the movement of bile and pancreatic fluids into duodenum?

Sphincter of Oddi

What are some distinguishing features about the jejunum?

Deeper red, thick + heavy, greater vascularity, longer vasa recta, few large loops in arcade and less fat in mesentery

What are some distinguishing features about the ileum?

Pale pink, light + thin, less vascularity, shorter vasa recta, many short loops in arcade and more fat in the mesentery

What major blood vessel supplies the jejunum and ileum?

Superior mesenteric artery

Where does nerve supply of jejunum and ileum come from?

Superior mesenteric plexus

What are 3 distinguished features of the large intestine?

Teniae Coli Omental appendices - fatty projections Haustra

How is the large intestine peritonised?

Intra - Caecum, transverse colon and sigmoid colon Retro - Ascending and Descending colon

What are the flexures of the large intestine called?

Right hepatic flexure Left splenic flexure

Where are the midgut and hindgut boundaries of the large intestine?

Midgut - up to 2/3 of transverse colon Hindgut - proximal 1/3 of the transverse colon to rectum

Which region is the appendix and the caecum located?

Right inguinal region

Where does the rectum pierce the pelvic floor?

At the ano-rectal junction Where becomes anal canal

Describe arterial and venous supply/drainage of the rectum?

Superior 1/3 - superior rectal artery and vein Middle 1/3 - Middle rectal artery and vein Lower 1/3 - Inferior rectal artery and vein

What is the lymph drainage of the rectum?

Para-rectal lymph nodes

What helps control faecal continence?

Pelvic floor Internal and external sphincters

Describe the pectinate line

Divides upper 2/3rds and the lower 1/3rdr of the rectum

Describe the liver

Sits in upper right quadrant of the body Is reddish brown, soft and very friable

What are the 4 lobes of the liver?

Right and Left Quadrate and Caudate

What lobes of the liver can not be seen from the front?

Quadrate and Caudate

What is the liver encapsulated in?

Fibrous layer called a capsule

What is the bare area of the liver?

Live is in contact with diaphragm so no peritoneum

What is the porta hepatis?

Hilum of the liver

What are the structures present in the porta hepatis?

Hepatic portal artery Hepatic portal vein Hepatic nerve plexus Hepatic duct Lymphatic vessels

What are the structures in the portal triad?

Hepatic artery Portal vein Bile ducts

Where does the central vein drain to?

Inferior vena cava

What does the extrahepatic biliary apparatus consist of?

Common bile duct Cystic duct Gall bladder Left hepatic duct Right hepatic duct

Where is bile produced and stored?

Produced - liver Stored - gallbladder

What is the function of bile?

Emulsification

Describe Calot's triangle

Triangular space formed by Cystic duct, common hepatic duct and inferior surface of the liver Triangle contains the cystic artery

What is the function of the pancreas?

Exocrine - secretes digestive enzymes Endocrine - secretes hormones

What are the 4 parts of the pancreas?

Head, neck, body and tail

How is the pancreas peritonised?

Retroperitoneal - apart from tail

Which vein is formed posterior to the neck of pancreas?

Superior mesenteric vein

What is the arterial supply of the pancreas?

Coeliac trunk and superior mesenteric artery

What is the venous drainage of the pancreas?

Splenic or superior mesenteric veins into the portal system

What is the nerve supply of the pancreas?

Coeliac plexus and superior mesenteric plexus

What is the lymph drainage of the pancreas?

Pre-aortic at T12 to L1

What is the spleen?

Largest single mass of lymphoid tissue in the body Acts as filter for blood and plays role in immune response If perforated will bleed heavily

How is the spleen peritonised?

Intraperitoneal

Name the structures in the hilum of the spleen

Splenic artery Splenic vein Splenic lymphatic vessel