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Flashcards in Abdomen 3 Deck (181)
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1
Q

What is the oesophagus?

A

Muscular tube that extends from the pharynx to the stomach

2
Q

What are the 3 constrictions of the oesophagus?

A

Cervical

Thoracic

Diaphragmatic

3
Q

What is the vertebral level of the oesophageal hiatus in the diaphragm?

A

T10

4
Q

What is A?

A

Trachea

5
Q

What is B?

A

Oesophagus

6
Q

What is C?

A

Thoracic duct

7
Q

What is D?

A

Left subclavien vein

8
Q

What is E?

A

Aortic arch

9
Q

What is F?

A

Left bronchi

10
Q

What is G?

A

Thoracic aorta

11
Q

What is H?

A

Pericardium (cut edge)

12
Q

What is I?

A

Oesophageal hiatus

13
Q

What is J?

A

Left crus of diaphragm

14
Q

What is K?

A

Aortic hiatus

15
Q

What is L?

A

Chyle cistern

16
Q

What is M?

A

Inferior vena cava

17
Q

What is N?

A

Right crus of diaphragm

18
Q

What is O?

A

Thoracic duct

19
Q

What is P?

A

Oesophagus

20
Q

What is Q?

A

Left bronchi

21
Q

What is R?

A

Tracheobronchial lymph nodes

22
Q

List the structures that traverse the oesophageal opening?

A

Oesophagus

Left inferior phrenic artery

Left gastric artery

Lymphatics

23
Q

What is the blood supply of the abdominal part of the oesophagus?

A

Branches of left gastric artery

24
Q

What is the venous drainage of the abdominal part of the oesophagus?

A

Left gastric vein

25
Q

What is the lymphatic drainage of the abdominal oesophagus?

A

Left gastric lymph nodes then to celiac lymph nodes

26
Q

What is the relationship between the oesophagus and portal hypertension?

A

Lower end of oesophagus is important site for portosystemic anastomoses

In portal hypertension, anastomoses opens and forms venous dilations called oesophageal varices

Their rupature causes severe haematemesis

27
Q

What is the stomach?

A

Muscular bag

28
Q

What are the 2 orifices of the stomach?

A

Cardial orifice

Pyloric orifice

29
Q

What are the 2 curvatures of the stomach?

A

Greater curvature

Lesser curvature

30
Q

What are the 2 surfaces of the stomach?

A

Anterior

Posterior

31
Q

What is A?

A

Duodenum

32
Q

What is B?

A

Pyloric canal

33
Q

What is C?

A

Body of stomach

34
Q

What is D?

A

Fundus

35
Q

What is the pyloric sphincter?

A

Band of smooth muscle between the pyloris and duodenum

36
Q

What is the function of the pyloric sphincter?

A

Controls flow of partically digested food between stomach and duodenum

Stops acid entering duodenum

37
Q

The pyloric sphincter is formed from the thickening of which layer of the gut tube?

A

Circular layer of smooth muscle (muscularis externa)

38
Q

Where does the lesser omentum extend from?

A

Lesser curvature of the stomach to the liver

39
Q

Where does the greater omentum extend from?

A

Greater curvature of stomach to transverse colon

40
Q

What is A?

A

Pyloric sphincter

41
Q

What is B?

A

Gastric canal

42
Q
A
43
Q

What is C?

A

Cardiac orifice

44
Q

What is D?

A

Gastric folds (rugae)

45
Q

What is E?

A

Pyloric antrum

46
Q

What is F?

A

Pyloric canal

47
Q

What are gastric folds/rugae formed from?

A

Gastric mucosa

48
Q

In which portions of the stomac are gastric folds most apparent?

A

Pyloric region

Greater curvature

49
Q

Which sphincter controls the discharge of food from the stomach to the duodenum?

A

Pyloric sphincter

50
Q

What is the collective name of the structures that the stomach lies on?

A

Stomach bed

51
Q

What structures from the stomach bed?

A

Left dome of diaphragm

Transverse mesocolon

Spleen

Left kidney

Left suprarenal gland

Colon

Pancreas

Splenic artery

52
Q

What is A?

A

Right gastric artery

53
Q

What is B?

A

Left gastric artery

54
Q

What is C?

A

Splenic artery

55
Q

What is D?

A

Left gastro-omental artery

56
Q

What is E?

A

Right gastric-omental artery

57
Q

What is the venous drainage of the stomach via?

A

Portal system

58
Q

What is A?

A

Portal vein

59
Q

What is B?

A

Left gastric vein

60
Q

What is C?

A

Superior mesenteric vein

61
Q

What is D?

A

Inferior mesenteric vein

62
Q

What is E?

A

Splenic vein

63
Q

What is F?

A

Right gastric artery

64
Q

Where do the primary lymph nodes of the stomach eventually drain to?

A

Celiac lymph nodes

65
Q

What is A?

A

Celiac lymph nodes

66
Q

What is B?

A

Superior and inferior pyloric lymph nodes

67
Q

What is C?

A

Pancreaticoduodenal lymph nodes

68
Q

What is D?

A

Gastric-omental lymph nodes

69
Q

What is E?

A

Splenic lymph nodes

70
Q

What is F?

A

Pancreaticosplenic lymph nodes

71
Q

What is G?

A

Gastric lymph nodes

72
Q

What effect does the vagus nerve have on the pylorus?

A

Opens the pyloric sphincter

73
Q

What effect does the vagus nerve have on gastric secretion?

A

Increases

74
Q

What nerve is key in controlling gastric motility?

A

Vagus nerve

75
Q

Where does the small intestine extend from?

A

Pylorus of the stomach to the ileocecal junction

76
Q

What are the 3 parts of the small intestine?

A

Duodenum

Jejenum

Ileum

77
Q

Which part of the small intestine recieves the opening of the bile and pancreatic duct?

A

Descending (2nd part) of duodenum

78
Q

Where is the foregut/midgut boundary in the small intestine?

A

Between descending and inferior duodenum

79
Q

How is the duodenum peritonised?

A

Bulb is intraperitoneal, rest is retroperitoneal

80
Q

How is the jejenum peritonised?

A

Intraperitoneal

81
Q

How is the ileum peritonised?

A

Intraperitonised

82
Q

Which part of the small intestine is the shortest, widest and most fixed?

A

Duodenum

83
Q

How does the colour differ between the jejenum and ileum?

A

Jejenum - deeper red

Ileum - paler pink

84
Q

How does the wall differ between the jejenum and ileum?

A

Jejenum - thick and heavy

Ileum - thin and light

85
Q

How does the vascularitiy differ between the jejenum and ileum?

A

Jejenum - greater

Ileum - less

86
Q

How does the vaso recta differ between the jejenum and ileum?

A

Jejenum - long

Ileum - short

87
Q

How does the arcades differ between the jejenum and ileum?

A

Jejenum - few large loops

Ileum - many short loops

88
Q

How does the fat in mesentery differ between the jejenum and ileum?

A

Jejenum - less

Ileum - more

89
Q

How does the circular folds differ between the jejenum and ileum?

A

Jejenum - large, tall and closely packed

Ileum - low and sparse, absent in distal part

90
Q

What is A?

A

Ileum

91
Q

What is B?

A

Duodenum

92
Q

What is C?

A

Jejenum

93
Q

Explain how the morphology of the small intestine changes between the jejenum and ileum?

A

There is no step transition, but the morphology gradually alters with either end looking quite different

94
Q

Which of A and B is jejenum and which is ileum?

A

A is ileum

B is jejenum

95
Q

What are arterial arcades?

A

Arterial loops or arches

96
Q

Do arcades in jejenum or ileum have many loops?

A

Ileum

97
Q

Which part of the autonomic nervous system stimulates reduction in the secretions and motility of the intestine and also acts as a vasoconstrictor?

A

Sympathetic

98
Q

What features distinguish the large intestine from the small intestine?

A

Teniae coli

Haustra

Omental appendices

Caliber (internal diameter much larger)

99
Q

What are teniae coli?

A

3 seperate longitudinal ribbons of smooth muscle on the outside of the colon

100
Q

What are haustra?

A

Small pouches caused by sacculation

101
Q

What are omental appendices?

A

Small pouches of the peritoneum filled with fat

102
Q
A
103
Q

How is the caecum peritonised?

A

Intraperitoneal

104
Q

How is the ascending colon peritonised?

A

Retroperitoneal

105
Q

How is the transverse colon peritonised?

A

Intraperitoneal

106
Q

How is the descending colon peritonised?

A

Retroperitoneal

107
Q

How is the sigmoid peritonised?

A

Intraperitoneal

108
Q

What is A?

A

Caecum

109
Q

What is B?

A

Ascending colon

110
Q

What is C?

A

Transverse colon

111
Q

What is D?

A

Descending colon

112
Q

What is E?

A

Sigmoid colon

113
Q

What does the superior mesenteric artery branch into to supply the colon?

A

Ileocolic artery

Right colic artery

Middle colic artery

Marginal artery (connects superior to inferior mesenteric artery)

114
Q

What artery connects the superior to the inferior mesenteric artery?

A

Marginal artery

115
Q

What does the inferior mesenteric archery branch into to supply the colon?

A

Left colic artery

Sigmoid arteries

116
Q

In which abdominal region is the caecum and appendix located?

A

Right iliac region

117
Q

What is A?

A

Frenulum of ileocecal valve

118
Q

What is B?

A

Orifice of appendix

119
Q

What is C?

A

Terminal ileum

120
Q

What is D?

A

Ileocaecal valve

121
Q

What is E?

A

Ileocaecal orifice

122
Q

What is F?

A

Haustrum of ascending colon

123
Q

Which 2 structures open into the cavity of caecum?

A

Appendix and ileum

124
Q

What is strange about the anatomical location of the appendix?

A

Base of appendix is consistently located, but the tail has anatomical variation

125
Q

What is McBurnery’s point and why is it useful clinically?

A

Point of most pain in acute appendicitis

126
Q

Where does the rectum pierce the pelvic floor?

A

Ano-rectal junction where it becomes the anal canal

127
Q

What is the arterial supply, venous drainage, and peritonisation of the superior 1/3 of the rectum?

A

Artery - superior rectal artery

Vein - superior rectal vein

Peritonisation - front and sides

128
Q

What is the arterial supply, venous drainage, and peritonisation of the middle 1/3 of rectum?

A

Artery - right and left middle rectal arteries

Vein - right and left middle rectal veins

Peritonisation - front

129
Q

What is the arterial supply, venous drainage, and peritonisation of the inferior 1/3 of rectum?

A

Artery - right and left middle rectal arteries

Vein - right and left middle rectal veins

Peritonisation - none

130
Q

What is A?

A

Superior rectal artery

131
Q

What is B?

A

Middle rectal artery

132
Q

What is C?

A

Inferior rectum artery

133
Q

What is the role of the pelvic floor in maintaining continence?

A

Automatically gently contracted to prevent leakage

134
Q

What structures, other than the pelvic floor, are involved in faecal continence?

A

Internal anal sphincter

External anal sphincter

135
Q

What is the significance of understanding the differences between visceral and somatic innveration of the anal canal?

A

Above pectinate line is autonomic, below is somatic

136
Q

What lymphatics drain above the pectinate line of the rectum?

A

Internal iliac lymph nodes

137
Q

What lymphatics drain below the pectinate line of the rectum?

A

Superficial inguinal lymph nodes

138
Q

What is A?

A

Internal anal sphincter

139
Q

What is B?

A

External anal sphincter

140
Q

What are the main peritoneal folds?

A

Greater omentum

Lesser omentum

Mesentery

141
Q

The hepatoduodenal and hepatogastric ligaments are parts of what omentum?

A

Lesser

142
Q

What is the falciform ligament?

A

Attaches liver to anterior abdomen wall

and seperates left and right lobes of the liver

143
Q

What lies within the free border of the falciform ligament?

A

Ligamentum teres in free border

144
Q

What embryological structure is the ligamentum teres a remnant of?

A

Left umbilical vein

145
Q

How many layers of peritoneum are present in the greater omentum?

A

4

Is it a souble sheet of peritoneum folded in on itself

146
Q

What is the greater omentum often called?

A

Abdominal policeman

147
Q

What functions of the greater omentum cause it to be known as the abdominal policeman?

A

Role in fighting intra-abdominal infections

148
Q

What are paracolic gutters?

A

Spaces between colon and abdominal wall

149
Q

Where are paracolic gutters found in relation to the colon?

A

Lateral

150
Q

What is the clinical significance of knowing about paracolic gutters?

A

Determine flow of ascitic fluid

151
Q

List 3 abdominal viscera which lie in the free edge of a double layer of peritoneum described as a mesentery?

A

Transverse colon

Sigmoid colon

Appendix

152
Q

What muscle types forms the muscularis externa of the oesophagus?

A

Upper 1/3 is skeletal muscle

Lower 2/3 is smooth muscle

153
Q
A
154
Q

What kind of epithelium is in the oesophagus?

A

Stratified squamous

155
Q

What type of muscle makes up the muscularis mucosae of the oesophagus?

A

Smooth muscle

156
Q

What are the large folds present in the wall of the stomach?

A

Rugae

157
Q

What secretory cells are present in gastric pits?

A

Gastric cells (also known as G cells)

158
Q

What structure is this?

A

Oesophagus

159
Q

What structure is this?

A

Stomach

160
Q

What are the large folds that can be seen extending into the lumen of the small intestine called?

A

Villi

161
Q

What structure is this?

A

Small intestine

162
Q

What are the numerous finger like processes cut in different planes on villi of the small intestine?

A

Microvilli

163
Q

What is the epithelium of the small intestine?

A

Simple columnar

164
Q

What type of muscle is the muscularis mucosae of the small intestine?

A

Smooth

165
Q

Where along the gut tube do glands extend down beyond the muscularis mucosae into the submucosa (they do not normally do this)?

A

Brunner’s cells (found only in duodenum)

166
Q

What are the white bits that appear to be empty spaces in the small intestine histology?

A

Contents of secretory cells

They are goblet cells

167
Q

What do goblet cells secrete?

A

Mucus

168
Q

What types of cells are present in the surface epithelium of the small intestine?

A

Enterocytes (absorptive cells) with scattered goblet cells

169
Q

What are Payer’s patches and where are they found?

A

Small masses of lymphatic tissue found in the ileum

170
Q

What is the predominant cell present in the epithelium of the colon?

A

Enterocytes

171
Q

What structure is this?

A

Colon

172
Q

What structure is this?

A

Recto-anal junction

173
Q

What indicates the change from the rectum to anal canal in this image?

A

Stratified squamous changing to simple columnar

174
Q

What is the transpyloric plane?

A

Imaginary horizontal plane

175
Q

How would you locate the transpyloric plane on a patient?

A

Halfway between jugular notch and upper border of symphysis pubis

Or 9th costal cartilage

176
Q

List the structures present in the transpyloric plane?

A

Pylorus of stomach

Hila of kidneys

Beginning of duodenum

Neck of pancreas

Superior mesenteric artery from aorta

177
Q

What is the vertebral level of the transpyloric plane?

A

L1

178
Q

What is the vertebral level of the highest point of the iliac crest?

A

L4

179
Q

What organ is being examined in 1, 2 and 3?

A

1 - stomach

2 - small intestine

3 - colon

180
Q

What is 1, 2, 3 and 4?

A

1 - Liver

2 - right kidney

3 - jejenum

4 - transverse colon

181
Q

What is 1, 2, 3 and 4?

A

1 - spleen

2 - liver

3 - stomach

4 - aorta