Lower Gi Anatomy

Front 1

what organs are in the foregut

Back 1

oesophagus --> miduodenum

Front 2

midgut

Back 2

mid-duodenum--> 2/3 transverse colon

Front 3

hindgut organs

Back 3

1/3 transverse colon--> 1/2 anal canal

Front 4

purpose of mucosal layers at:
- oesophagus & anus
- stomach
- small int
- large int (colon)

Back 4

OES & ANUS: protective
STOM: secretory
SMALL: absorp (nutrients)
COLON: absorp (water, secretion (mucus)q

Front 5

what the enteric nervous system
where does it innervate

how is it influenced by ANS

Back 5

independent NS within WALLS of GI organs
- control contraction smooth muscle

ANS: par ↑speed, symp ↓speed

Front 6

which 3 sphincters control flow of GI content
- what type of muscle
- loc

Back 6

PYLORIC- stomach exit, smooth m.

INTERNAL anal- sup anal canal, smooth m.

EXTERNAL anal- infer anal canal, skeletal m.

Front 7

what lines internal wall of stomach

Back 7

rugae

Front 8

where does the abdominal aorta bifurcate

Back 8

level of the umbilicus- T4

Front 9

what cells make up the peritoneum

Back 9

simple squamous epethelium - MESOTHELIUM

Front 10

what't the omental foramen

where is it

what lies anterior to it

Back 10

communication between the greater & lesser sacs
posterior free edge of lesser omentum
ANT: hepatoduodenal liagment (containing PORTAL TRIAD)

Front 11

structure and attachments of greater omentum

Back 11

greater curve of stomach --> apron --> folds back on itself --> attaches back onto anterior transverse colon

double layerd mesothelium --> 4 layered omentum

Front 12

what's contained within the mesentery

Back 12

blood vessels
nerves
lymphatics

Front 13

which intraperitoneal pouches are present in the male

Back 13

RECTOVESICAL: between rectum/ bladder

Front 14

which intraperitoneal pouches are present in the female

Back 14

UTEROVESICAL: uteruus/ bladder
RECTOUTERINE: rectum/ uterus

Front 15

where does fluid collect in peritoneal infection

Back 15

male or female pouches
rectovesical (M)
rectouterine or uterovesical (F)

Front 16

name some retroperitoneal organs

Back 16

oesophagus
duodenum (part 2-4)
ascending & descending colon
kidneys, IVC & aorta
anal canal & rectum

Front 17

name some intraperitoneal oragns

Back 17

stomach
1st part duodenum
liver
spleen
pancreas
small int
transverse colon
sigmoid

Front 18

role of the gallbladder

what is it stimulated by

Back 18

stores and concentrates bile (synthesised in liver)

contractions stimulated b y FAT & PROTEIN (mediated by hormone CCK)

Front 19

what sensory nerve supply is to the body wall (abdo muscles) and PARIETAL pleura

what can it sense

characteristic pain

Back 19

SOMATIC sensory
-pressure, PAIN, heat, laceration

PAIN: localised, sharp, stabbing
no referred pain (except inferior surface diaphragm)

Front 20

irritation of the inferior surface of the diaphragm causes what particular pain feature

Back 20

REFERRED pain
C3,4,5 --> shoulder tip pain
dermatomes supplied by those cervical spinal nerves

Front 21

visceral nerve supply (sensory & motor) to smooth muscle of GI tract and VISCERAL peritoneum supplied by which nerve


sensitive to what

characteristic pain

Back 21

CN X VAGUS
- insensitive to touch, heat, laceration
- senses: stretch, ischaemia, inflammation, chemical irritation

PAIN: poorly localised, dull, ache, nausea

Front 22

visceral pain sensation from GI organs or visceral peritoneum can be referred where

Back 22

foregut --> epigastrium
midgut--> umbilius
hindgut --> suprapubic

Front 23

route a somatic pain signal would take

Back 23

1) somatic sensory nerve stimulation - AFFERENTS
2) POSTerior route spinal nerve (crossing over in spinal cord)
3) CNS (thalamus --> cerebral cortex)
4) somatic motor EFFERENTS
5) spinal cord crossing over
6) skeletal muscle effector

Front 24

route visceral pain signal

Back 24

1) sensory visceral afferents
2) vagus sacral spinal ganglia (parasymp carnio-sacral outflow)
3) referred to dermatome

Front 25

describe the pain of appendicitis and how it changes

Back 25

initial STRETCH irritation of VISCERAL peritoneum --> VISCERAL pain referred to umbilical region...

later irritation of PARIETAL peritoneum --> localised SOMATIC pain in RIF

Front 26

at which part does bile from the liver enter the duodenum

Back 26

2nd part of duodenum via major duodenal papilla

Front 27

where can teh fundus of the gallbladder be located

Back 27

costal margin of 9th rib

Front 28

what's in the portal triad

Back 28

hepatic artery
hepatic portal vein
CBD
ANS nerves & lymphatics

Front 29

3 main initial branches off the celiac trunk

Back 29

left gastric------splenic----------hepatic

Front 30

what branch does the splenic artery give

Back 30

left gastro-omental

Front 31

what branches does the hepatic artery give

Back 31

right gastric----gastroduodenal

Front 32

gastroduodenal arises from the hepatic artery of the celiac trunk.

what does this divide to give

Back 32

pancreaticoduodenal ----right gastro-omental

Front 33

coeliac trunk --> hepatic artery
- what does teh hepatic artery divide into

Back 33

cyctic artery ----- R & L hepatic branches

Front 34

how does the hepatic portal vein form

Back 34

IMA drains into splenic
SMA merges with splenic

Front 35

CBD flow into duodenum controlled by what

Back 35

sphincter of oddi

Front 36

lobes of liver and loc

Back 36

R,L, caudate, quadrate

Front 37

what structure divides the L & R liver lobes anteriorly

Back 37

falciform lig --> round lig (embryological remnent)

Front 38

all nutreints except what is conveyed to liver by portanl system for METABOLISM
- what does liver store
- what does it secrete in GI tract

Back 38

except FAT
- stored GLYCOGEN
- synthesises BILE

Front 39

acinar cells of pancreas - role and secretion
langerhans cells of pancreas- role & secretions

Back 39

ACINAR: EXOcrine- pancreatic juices via DUCTS

ISLETS: ENDOcrine- hormones into BLOOD (end-no ducts!)

Front 40

what's a cholecystectomy

Back 40

removal of gallbladder (dissect portal triad)