gastrointestinal > gi anatomy yr2 > Flashcards

gi anatomy yr2 Flashcards

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1
Q

what are the 3 main functions of the abdomen

A

house and protect organs
assist in breathing
assist with bodily functions

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2
Q

what are the 6 boundaries of the abdomen

A
  1. costal margin & xiphoid process
  2. lumbar vertebrae
  3. posterior abdominal wall muscles
  4. lower ribs 11 and 12
  5. lateral abdominal wall
  6. anterior abdominal wall
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3
Q

3 cavities

A

thorax
abdomen
pelvic

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4
Q

layers of the abdominal wall from skin inwards

A
  1. skin
  2. superficial fascia fatty layer=camper’s fascia
  3. superficial fascia deeper layer=scarpa’s fascia
  4. parietal peritoneum
  5. extra peritoneal fascia
  6. fascia of muscles
  7. muscles
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5
Q

what 2 types of muscles are in the anterior abdominal wall

A
  • 3 flat muscles: external, interior oblique and transverse abdominus
  • 2 vertical muscles: rectus abdominus and pyramidalis
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6
Q

what line divides the abdomen

A

linea alba

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7
Q

what is the aponeurosis of the external obliques

A

sheet like fibrous membrane or flattened tendon that serves as a fascia to bind muscles to connect

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8
Q

what are the borders of the external oblique

A

-lower 8 ribs of the iliac crest and aponeurosis

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9
Q

what are the borders of the internal oblique

A
  1. thoracolumbar fascia
  2. iliac crest
  3. lateral part of inguinal ligament to inferior border of lower 3 ribs and to aponeurosis/linea alba
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10
Q

what is the transverse abdominis

A
  • deep to ribs
  • thoracolumbar fascia (deep membrane), iliac crest, lateral part of inguinal ligament and costal cartilages of the lower 6 rigs to aponeurosis/ linea alba, pubic crest and pectineal line
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11
Q

order of the abdominal wall

A
  1. external oblique point down
  2. internal oblique point up
  3. transverse abdominis horizontal
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12
Q

what are the 2 deeper muscles

A 
rectus abdominis (6)
pyramidalis
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13
Q

features of the rectus sheath in the upper 3/4

A
  • encloses the rectus abdominus in the internal oblique
  • anterior rectus sheath: external obliqueaponeurosis and ant. lamina inferior oblique
  • posterior rectus sheath: post. lamina of internal oblique and transverse abdominus
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14
Q

features of the rectus sheath in the lower 1/4

A
  • no aponeurosis below rectus sheath as aponeurosis travels infront of it instead
  • ie no posterior aponeurosis
  • as the internal oblique aponeurosis and the TA aponeurosis merge into one and pass superficial
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15
Q

what line does the rectus sheath pass from upper 3/4 to lower 1/4

A

arcuate line

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16
Q

what are the posterior abdominal wall muscles 3

A

psoas major and minor
iliacus
quadratus lumborum

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17
Q

key anatomical features of the vertebrae

A
  • vertebral body
  • vertebral foramen
  • pedicle
  • transverse process
  • superior articular process
  • inferior articular process
  • lamina
  • spinous process
  • mamillary process
  • inferior and superior vertebral notch
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18
Q

blood supply to the anterior abdominal wall

A
  • superior epigastric arteries supply from internal thoracic

- inferior epigastric arteries from external iliac arteries

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19
Q

nerve supply to abdominal wall

A
  • T7-T12 AND L1 spinal nerves
  • pass around the body from posterior to anterior in an inferomedial ie towards inferior and medial direction
  • then give off branches to supply the anterolateral wall muscles
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20
Q

areas of the abdomen

A

right and left hypochondriac region
epigastric region
right and left lumbar region
suprapubic/ hypogastric

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21
Q

what organ pulls the testes and ovaries down from the posterior abdominal wall to the pelvis in development

A

gubernaculum

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22
Q

what does the gubernaculum become in females

A

the round ligament of the uterus

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23
Q

what does the processus vaginalis become

A

the inguinal canal ie the path the testes./ ovaries descended down

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24
Q

where are the superficial and deep inguinal ring

A

deep is in the transversalis fascia

and superficial is through the aponeurosis of the external oblique

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25
what does the inguinal canal convey
the round ligament of the uterus or the spermatic cord
26
layers of the inguinal canal in to out
``` parietal peritoneum extraperitoneal fascia transversalis fascia ta and internal oblique aponeurosis and muscle external oblique aponeurosis and muscle ```
27
what are the external oblique aponeurosis, internal obliqe fascia internal oblique musclee and transversalis fascia called in the spermatic canal
external o aponeurosis= external spermatic fascia internal o fascia= cremasteric fascia internal o muscle=cremaster muscle transversalis fascia= internal spermatic fascia
28
in to out of spermatic cord
``` testes visceral tunica vaginalis cavity of tunica vaginalis parietal tunica vaginalis internal spermatic cremaster muscle cremasteric fascia external spermatic fascia ```
29
contents of the spermatic cord
``` ductus deferens artery to dd testicular artery pamniform plexus cremaster artery genitofemoral nerve sympathetic nerve lymphatic vessels remanants of process vaginalis ```
30
what 2 types of inguinal hernias are there
direct and indirect
31
what is an inguinal hernia
protrusion of a peritoneal sac through a weakened area of the abdominal wall into the inguinal canal
32
what is an indirect hernia
lateral to inferior epigastric vessels so will go through the inguinal canal= more emergency due to strangulation
33
what is a direct hernia
medial to inferior epigastric vessels so won't go through
34
the 2 aponeuroses of inguinal ligament
pubic tubercle and anterior superior iliac spine
35
why can healing take a while for abomen
because the blood supply do not cross over the midline
36
what is the nerve supply to the anterior abdominal wall
segmental arrangment upper 3/4 from the lower intercostal nerves and subcostal nerves lower 3/4 below arcuate line from the lumbar nerves
37
what is the inguinal region and where does it lie
lies between the superior iliac spine and the pubic tubercle-
38
what is the inguinal ligament and what forms it
thickening of the inferior margins of the aponeurosis of the external oblique the inguinal canal is found in the medial part of the inguinal ligament
39
what nerve level is the umbilicus and nipples
nipple=t4 | umbilcus =t10
40
characteristics of indirect and direct hernia - age - site - descent - exam - neck of hernia
indirect direct young old unilateral commonly bilateral scrotum not exam: by reducing the hernia and pressing on the deep inguinal ring by the thumb asking the patient to cough the hernia will bulge medially in direct but will not bulge in indirect. also implulse can be felt in indirect neck: lateral medial to inferior epigastric
41
what is the peritoneum
a single membranous sac lining the abdominopelciv cavity and covers the viscera
42
what 3 types of perioneal may an organ be
intraperitoneal: in the peritoneum mesentry: on a mesentry off retroperitoneal : behind the peritoneum ie based on whether it is behind in front or on the peritoneum
43
what is the omenta
double folds passing from the stomach and duodenum to other organs
44
what do omenta and mesenteries carry in their double folds
arterial branches to peritonised organs
45
label which 3 of these organs are on the peritoneum - kidney - pancreas - ascending colon - transverse colon - liver - spleen - duodenum - caecum - stomach - rectum - sigmoid colon - aorta and ivc - small intestine jejunum and ileum
``` retroperitoneum tail=intraperitoneum but rest= retro retro on a mesentry intraperitoneum intraperitoneum retro (except superior) intra intra retro on a mesentry retro on a mesentry ```
46
draw the spaces of the greater and lesser sacs 7
sub-phrenic space: space superior to liver and diaphragm hepatorenal recess: space inferior to liver and kidney retro-uterine pouch of douglas: between rectum and uterus vesico-uterine pouch: between bladder and uterus supracolic: above greater omentum contains stomach, liver and spleen infracolic: below greater omentum contains smaller intestine and ascending descending colon
47
what is the falciform ligament
also called roung ligament divides liver in half"
48
what is the peritoneal cavity and draw
contains only peritoineal fluid between visceral and parietal peritoneum in 2 sacs linked by a short neck the epiploic foramen greater and lesser omentum sacs lift up greater omentum to greater sac then lift up lesser omentum to lesser sac above stomach lesser curvature=lesser omentum below stomach greater curvature=greater omentum
49
what are the 3 types of double folds
mesentry visceral to abdominal wall omentum: stomach to proximal duodeum ligaments: organs to other organs eg stomach to liver
50
what is the transverse mesocolon
layer of mesentry to transverse colon to posterior wall
51
clinical implications of the lesser sac
is a blind alley so inflammation, infection and fluid can be trapped there and as the pancreas lies posteriorly can lead to fatlity
52
other name for epiploic foramen and what 3 vessels run through
foramen of winslow bile duct hepatic artery portal vein
53
what muscles are the tonsils between
palatoglossal and palatopharyngeal muscles
54
what is the pharynx
a musculofascial half cylinder linking the oral and nasal cavities in the head to the larynx and oesophagus of the neck
55
what is the tongue muscle called
the gengioglossus
56
3 parts of the pharynx
nasopharynx: air oropharynx: food laryngopharynx
57
3 overlapping muscles of the pharynx
superior constrictor middle: stylohyoid ligament and styloid process and stylopharyngeus muscle of swallowing inferior constrictors: attach thyroid to cricoid -inferior constrictor is on the outside
58
constrictions of the osephagus4
1. junction of osephagus with pharynx 2. where oseophagus is crossed by arch of the aorta 3. where oseophagus is compressed by left main bronchus 4. at the oseophageal hiatus
59
what level does the stomach lie at and key features label
``` t1 standing, l2 sitting cardiac notch fundus cardia lesser curvature angular incisure body greater curvature pyloric antrum pyloric canal pyloric sphinctery: thickening of innermembranes rugae: temporary folds of the stomach as expands ```
60
duodenum vertebral levels 4 parts 3 levels
starts at l1 superior then descends to l3 then inferior part then ascends to l2
61
which part of the duodenum receives bile and pancreatic juices/ what is this entrance called
descending over the hilum of kidney receives pancreatic duct and common bile duct entry and duodenal papilla
62
jejunum versus ileum 4 differences
1. pliacae are larger in the jejunum then ileum so jejunum feels fuller 2. jejunum has longer vasa recta so fewer arterial arcades whereas ileum has shorter vasa recta so appears more vascular on mesentery 3. jejunum has less fat than mesentry compared to the ileum 4. jejunum is upper left and ileum is lower right
63
label the large intestines
ileocecal junction, appendix, caecum, taeniae coli, ascending colon (proximal), right colic flexure, hepatic flexure, transverse colon, splenic left colic flexure, omental appendices, haustra of colon, distal descending colon, sigmoid colon, rectum, anal canal
64
what are taminae coli
outer longitudinal 3 bundles at 120 degrees to each other that contract pushing bowel into haustra of colon
65
blood supply to colon
- proximal supplied by right and middle colic artery from sma - distal supplied by inferior m left colic artery
66
what is the pectinate line and 3 differences above and below the line
divides the upper 2/3 of the anal canal from the lower third of anal canal - change from simple columnar to stratified squamous epithelium - above line endoderm and below line ectoderm - superior rectal arteries before line and middle and inferior rectal arteries below line
67
label coeliac trunk branches 3 vertebral level
left gastric common hepatic artery to hepatic artery proper gastroduodenal artery off hepatic splenic artery t12
68
sma 6 branches vertebral level
right and middle colic artery inferior pancreaticduodenal artery ileocolic artery jejunal and ileal arteries l1
69
ima 3 branches and level
superior rectal arteries left colic artery sigmoid arteries
70
venous system of the abdomen label
hepatic portal vein formed by joining of splenic vein and superior mesenteric vein -inferior mesenteric veins joins onto splenic
71
what is portal hypertension and clincal conditions assoc.
hbp of portal system becuase no valves so can push back to leading to haemorrhoids and ano rectal varices, splenomegaly and oseophageal varices due to rising pressure and caput medusa due to umbilical vein hypertension
72
what is mcburney's point
indicates the surface marking of the base of the appendix where it attaches to the caecum pain indicates acute appendicitis also appendectomy 1/3 along line from superior iliac spine of pelvis to umbilicus
73
label the liver anterior
``` inferior border gallbladder costal impressions right and left lobe right triangular ligament coronary ligament (liver reflection) fibrous appendix falciform ligament with round ligament/ ligamentum teres at the end ```
74
posterior liver label and what are the ligaments remanant of
quadrate (inf) and caudate lobe (superior) left sagittal fissure for lig teres and right sagittal fossa for ivc -ligamentum venosum remanant of ductus venosum -ligamentum teres remnant of umbilical vein -gastric impression, esopheageal impression, colic impression, renal impression, bare area - anterior and posterior coronary ligaments -suprarenal impression
75
internal structures of the liver 6
``` portal vein hepatic artery interlobular triad: above 2+ biliary duct sinusoid central vein bile canaliculi ```
76
gallbladder gross anatomy
neck body fundus | cystic duct: bile canaliculi form common hepatic duct that joins cystic duct to form common bile duct
77
pancreatic blood supply and anatomy
superior and inf pancreaticduo supplied head | and splenic supplies tail neck and body
78
2 ducts to the pancreas
accessory duct and principal duct/ major duodenal papilla with hepatopancreatic ampulla forms the opening in pancreas
79
what ribs is the spleen located
ribs 9 to 11 in costodiaphragmatic recess hence fracture ribs spleen rupture
80
blood supply to the foregut ie pancreas, liver, spleen and gall bladder
liver=coeliac trunk pancreas=coeliac and sma spleen= coeliac trunk gallbladder=coeliac as cystic artery off right hepatic proper
81
what ligament do the portal triad pass in and is also the roof of the epiploic foramen
the heaptoduodenal ligament
82
what ligaments enclose the bare area and what spaces do they limit
the anterior and posterior coronary ligament anterior= limits right subphrenic space posterior= limits the hepatorenal space
gastrointestinal
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