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Questions and Answers
What is the name of the professor teaching the MEDI7100 Anatomy Practical Clinical Science 1 course?
What is the name of the professor teaching the MEDI7100 Anatomy Practical Clinical Science 1 course?
What is the recommended resource for those new to Anatomy?
What is the recommended resource for those new to Anatomy?
What is the URL to access Gray's Anatomy for Students?
What is the URL to access Gray's Anatomy for Students?
What is the name of the video atlas recommended by the university?
What is the name of the video atlas recommended by the university?
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What is the URL to access Snell's Clinical Anatomy by Systems?
What is the URL to access Snell's Clinical Anatomy by Systems?
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What is the title of the course being taught by Professor Mark Midwinter and A/Prof Frederik Steyn?
What is the title of the course being taught by Professor Mark Midwinter and A/Prof Frederik Steyn?
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What is the recommended way to access the resources mentioned in the course?
What is the recommended way to access the resources mentioned in the course?
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What is the title of the section that follows the Core Knowledge section?
What is the title of the section that follows the Core Knowledge section?
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What is the primary focus of the MEDI7100 practical?
What is the primary focus of the MEDI7100 practical?
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Which of the following bones is NOT part of the skeleton of the mouth?
Which of the following bones is NOT part of the skeleton of the mouth?
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What is the clinical relevance of the oesophageal hiatus in the diaphragm?
What is the clinical relevance of the oesophageal hiatus in the diaphragm?
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What is the primary function of the salivary glands?
What is the primary function of the salivary glands?
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What is the thoracic duct in relation to the oesophagus?
What is the thoracic duct in relation to the oesophagus?
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What is the primary focus of the section on Applied Clinical Anatomy?
What is the primary focus of the section on Applied Clinical Anatomy?
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What is the pharynx in relation to the oesophagus?
What is the pharynx in relation to the oesophagus?
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Which of the following is NOT a part of the upper GI tract?
Which of the following is NOT a part of the upper GI tract?
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What is the pharynx composed of?
What is the pharynx composed of?
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What is the function of the pharyngeal plexus?
What is the function of the pharyngeal plexus?
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Which of the following is NOT a circular muscle of the pharynx?
Which of the following is NOT a circular muscle of the pharynx?
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Where does the parotid duct enter the oral cavity?
Where does the parotid duct enter the oral cavity?
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What is the main function of the salivary glands?
What is the main function of the salivary glands?
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Which cranial nerve is involved in the formation of the pharyngeal plexus?
Which cranial nerve is involved in the formation of the pharyngeal plexus?
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What is the location of the parotid gland?
What is the location of the parotid gland?
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What is the function of the circular muscles of the pharynx?
What is the function of the circular muscles of the pharynx?
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What is the name of the junction between the esophagus and stomach?
What is the name of the junction between the esophagus and stomach?
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Which of the following is NOT a part of the stomach?
Which of the following is NOT a part of the stomach?
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What is the name of the foldings in the stomach mucosa?
What is the name of the foldings in the stomach mucosa?
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What is the name of the opening between the greater omentum and the lesser omentum?
What is the name of the opening between the greater omentum and the lesser omentum?
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Which of the following is the most superior part of the stomach?
Which of the following is the most superior part of the stomach?
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What is the name of the muscle that separates the stomach from the duodenum?
What is the name of the muscle that separates the stomach from the duodenum?
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Which CT phase is used to demonstrate the key anatomical features of the stomach?
Which CT phase is used to demonstrate the key anatomical features of the stomach?
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What is the name of the part of the stomach that is closest to the pylorus?
What is the name of the part of the stomach that is closest to the pylorus?
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What is the function of the palatine tonsils?
What is the function of the palatine tonsils?
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What is the primary function of the intrinsic muscles of the tongue?
What is the primary function of the intrinsic muscles of the tongue?
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Which nerve innervates all the extrinsic muscles of the tongue except one?
Which nerve innervates all the extrinsic muscles of the tongue except one?
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What is the result of a lesion of the hypoglossal nerve in a patient?
What is the result of a lesion of the hypoglossal nerve in a patient?
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What is the attachment point of the genioglossus muscle?
What is the attachment point of the genioglossus muscle?
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What is the function of the genioglossus muscle?
What is the function of the genioglossus muscle?
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How are the intrinsic muscles of the tongue arranged?
How are the intrinsic muscles of the tongue arranged?
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What is the significance of the soft palate's control mechanism?
What is the significance of the soft palate's control mechanism?
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What is the primary focus of the MEDI7100 practical?
What is the primary focus of the MEDI7100 practical?
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Which bone is part of the skeleton of the mouth?
Which bone is part of the skeleton of the mouth?
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What is the relationship between the pharynx and the oesophagus?
What is the relationship between the pharynx and the oesophagus?
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What is the clinical relevance of the oesophageal hiatus in the diaphragm?
What is the clinical relevance of the oesophageal hiatus in the diaphragm?
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What is the primary focus of the section on Applied Clinical Anatomy?
What is the primary focus of the section on Applied Clinical Anatomy?
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Which of the following is a part of the upper GI tract?
Which of the following is a part of the upper GI tract?
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What is the name of the junction between the oesophagus and stomach?
What is the name of the junction between the oesophagus and stomach?
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What is the function of the palate?
What is the function of the palate?
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What is the origin of the left gastroepiploic artery?
What is the origin of the left gastroepiploic artery?
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What is the name of the ligament that attaches the greater omentum to the spleen?
What is the name of the ligament that attaches the greater omentum to the spleen?
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What is the embryological origin of the greater omentum?
What is the embryological origin of the greater omentum?
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What is the name of the ligament that attaches the spleen to the left kidney and diaphragm?
What is the name of the ligament that attaches the spleen to the left kidney and diaphragm?
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What is the name of the artery that joins the right gastroepiploic artery?
What is the name of the artery that joins the right gastroepiploic artery?
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What is the location of the short gastric arteries?
What is the location of the short gastric arteries?
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What is the name of the structure that attaches to the stomach and liver?
What is the name of the structure that attaches to the stomach and liver?
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What is the embryological origin of the spleen?
What is the embryological origin of the spleen?
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Which part of the mandible is located on the medial aspect of the ramus?
Which part of the mandible is located on the medial aspect of the ramus?
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What is the main muscle of the floor of the mouth that attaches to the mylohyoid line?
What is the main muscle of the floor of the mouth that attaches to the mylohyoid line?
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How many primary teeth are found in a child?
How many primary teeth are found in a child?
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What is the function of the alveolar margin of the mandible?
What is the function of the alveolar margin of the mandible?
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Which of the following bones does not articulate with any other bone directly?
Which of the following bones does not articulate with any other bone directly?
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What is the name of the small tongue of bone that guards the mandibular foramen?
What is the name of the small tongue of bone that guards the mandibular foramen?
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How many teeth are found in each quadrant of the adult mouth?
How many teeth are found in each quadrant of the adult mouth?
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What is the name of the calcified tissue that covers the pulp of the tooth?
What is the name of the calcified tissue that covers the pulp of the tooth?
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What is the composition of the pharynx?
What is the composition of the pharynx?
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What is the function of the circular muscles of the pharynx?
What is the function of the circular muscles of the pharynx?
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Which nerve supplies the pharynx?
Which nerve supplies the pharynx?
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Where is the parotid gland located?
Where is the parotid gland located?
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How many parts does the parotid gland have?
How many parts does the parotid gland have?
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Where does the parotid duct enter the oral cavity?
Where does the parotid duct enter the oral cavity?
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What is the orientation of the circular muscles of the pharynx?
What is the orientation of the circular muscles of the pharynx?
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Which muscle is NOT part of the pharynx?
Which muscle is NOT part of the pharynx?
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What is the primary purpose of obtaining an AP supine, PA erect, and erect chest X-ray in the acute setting?
What is the primary purpose of obtaining an AP supine, PA erect, and erect chest X-ray in the acute setting?
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What is the ABDO X mnemonic used for?
What is the ABDO X mnemonic used for?
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What is the name of the abnormality seen in the liver variant shown in image C?
What is the name of the abnormality seen in the liver variant shown in image C?
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What is the location of free gas accumulation in pneumoperitoneum?
What is the location of free gas accumulation in pneumoperitoneum?
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What is the name of the resource that contains many short lectures on image interpretation and diagnostic case examples?
What is the name of the resource that contains many short lectures on image interpretation and diagnostic case examples?
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What is the significance of noting the inferior margin of the liver in relation to the right kidney?
What is the significance of noting the inferior margin of the liver in relation to the right kidney?
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What is the clinical scenario in which pneumoperitoneum occurred in the case shown?
What is the clinical scenario in which pneumoperitoneum occurred in the case shown?
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What is the purpose of interpreting AXR in a systematic approach?
What is the purpose of interpreting AXR in a systematic approach?
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What is the primary function of the palatine tonsils?
What is the primary function of the palatine tonsils?
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Which muscle protrudes the tongue?
Which muscle protrudes the tongue?
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What happens to a patient's tongue if they have a lesion of the hypoglossal nerve?
What happens to a patient's tongue if they have a lesion of the hypoglossal nerve?
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What is the significance of the soft palate's control mechanism?
What is the significance of the soft palate's control mechanism?
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What is the difference between the intrinsic and extrinsic muscles of the tongue?
What is the difference between the intrinsic and extrinsic muscles of the tongue?
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What is the arrangement of the intrinsic muscles of the tongue?
What is the arrangement of the intrinsic muscles of the tongue?
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Which cranial nerve innervates all the extrinsic muscles of the tongue except one?
Which cranial nerve innervates all the extrinsic muscles of the tongue except one?
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What is the function of the muscles that make up the two arches of the soft palate?
What is the function of the muscles that make up the two arches of the soft palate?
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In a transoesophageal echocardiogram, what is the advantage of the transducer's position in the oesophagus?
In a transoesophageal echocardiogram, what is the advantage of the transducer's position in the oesophagus?
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What is the blood supply of the oesophagus mainly derived from?
What is the blood supply of the oesophagus mainly derived from?
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What is the significance of the anastomosis of the veins of the lower oesophagus with the left gastric vein?
What is the significance of the anastomosis of the veins of the lower oesophagus with the left gastric vein?
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What forms a plexus on the surface of the oesophagus?
What forms a plexus on the surface of the oesophagus?
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At what level do the vagal trunks form?
At what level do the vagal trunks form?
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What is the relationship between the oesophagus and the descending aorta?
What is the relationship between the oesophagus and the descending aorta?
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What is the name of the procedure where the transducer is placed in the oesophagus to view the heart?
What is the name of the procedure where the transducer is placed in the oesophagus to view the heart?
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What is the significance of oesophageal varices?
What is the significance of oesophageal varices?
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Which of the following bones is part of the skeleton of the mouth?
Which of the following bones is part of the skeleton of the mouth?
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What is the primary function of the salivary glands?
What is the primary function of the salivary glands?
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What is the relationship between the pharynx and the oesophagus?
What is the relationship between the pharynx and the oesophagus?
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What is the primary focus of the section on Applied Clinical Anatomy?
What is the primary focus of the section on Applied Clinical Anatomy?
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Which of the following is a part of the upper GI tract?
Which of the following is a part of the upper GI tract?
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What is the name of the junction between the oesophagus and stomach?
What is the name of the junction between the oesophagus and stomach?
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What is the function of the palate?
What is the function of the palate?
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What is the clinical relevance of the oesophageal hiatus in the diaphragm?
What is the clinical relevance of the oesophageal hiatus in the diaphragm?
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What is a common complication of treatment for oesophageal problems?
What is a common complication of treatment for oesophageal problems?
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What is a common problem seen by GPs, emergency doctors, dentists, pharmacists, and nurses?
What is a common problem seen by GPs, emergency doctors, dentists, pharmacists, and nurses?
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What can be severely impacted by fungal infections in the mouth?
What can be severely impacted by fungal infections in the mouth?
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What is a major malignant tumour that can occur in the mouth?
What is a major malignant tumour that can occur in the mouth?
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What is an important consideration when providing care for patients with oral health problems?
What is an important consideration when providing care for patients with oral health problems?
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What is the focus of the section on Applied Clinical Anatomy?
What is the focus of the section on Applied Clinical Anatomy?
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What is a common challenge in providing care for patients with oral health problems?
What is a common challenge in providing care for patients with oral health problems?
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What is the relationship between the pharynx and the oesophagus?
What is the relationship between the pharynx and the oesophagus?
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What type of muscle fibers are found at the top of the oesophagus?
What type of muscle fibers are found at the top of the oesophagus?
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What is the name of the muscle that acts as a sphincter at the top of the oesophagus?
What is the name of the muscle that acts as a sphincter at the top of the oesophagus?
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What is the name of the outpouching that can occur in the oesophagus, just above the cricopharyngeus muscle?
What is the name of the outpouching that can occur in the oesophagus, just above the cricopharyngeus muscle?
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What is the relationship between the oesophagus and the trachea in the thorax?
What is the relationship between the oesophagus and the trachea in the thorax?
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What is the structure that the oesophagus is closely related to below the tracheal bifurcation?
What is the structure that the oesophagus is closely related to below the tracheal bifurcation?
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What is the transition of muscle type in the oesophagus?
What is the transition of muscle type in the oesophagus?
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What is the location of the cricopharyngeus muscle in relation to the larynx?
What is the location of the cricopharyngeus muscle in relation to the larynx?
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What is the muscle layer arrangement in the oesophagus?
What is the muscle layer arrangement in the oesophagus?
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Study Notes
The Upper GI Tract (Mouth to Stomach)
- The upper GI tract includes the mouth, pharynx, oesophagus, and stomach.
Pharynx
- The pharynx is a muscular tube suspended from the base of the skull.
- It has three circular muscles: superior constrictor, middle constrictor, and inferior constrictor.
- These muscles are open anteriorly, so they are not complete circular muscles.
- The pharynx also has three vertical muscles: stylopharyngeus, palatopharyngeus, and salpingopharyngeus.
- The nerve supply to the pharynx is from the vagus and glossopharyngeal nerves (cranial nerves X and IX), which form the pharyngeal plexus.
Salivary Glands
- The parotid gland is a salivary gland that occupies the space between the mastoid process and external acoustic meatus behind, and the ramus of the mandible in front.
- The parotid gland is divided into two nominal parts (superficial and deep) by the facial nerve.
- The parotid duct runs forward from the superficial part of the gland to pierce the buccinator and enter the oral cavity adjacent to the upper 2nd molar tooth.
Tongue
- The tongue has intrinsic muscles that change its shape and extrinsic muscles that change its position.
- The intrinsic muscles are in 3 dimensions – longitudinal, transverse, and vertical.
- All extrinsic muscles except the palatoglossus are innervated by the hypoglossal nerve (cranial nerve XII).
- The genioglossus is attached anteriorly to the genial tubercles on the posterior surface of the mental process of the mandible (the chin) and protrudes the tongue.
Oesophagus
- The oesophagus is a muscular tube that progresses down from the pharynx.
- It is situated in the thorax and has relations to structures such as the aorta and thoracic duct.
- The oesophageal hiatus in the diaphragm is a critical region that is clinically relevant.
Stomach
- The stomach is a muscular sac that has several key anatomical regions: the fundus, cardia, curvatures (greater and lesser), antrum, and pylorus.
- The CT studies demonstrate the normal appearance of the stomach, including the curvatures of the stomach and the anatomy of the duodenum.
- The mucosa of the stomach forms large folds – rugae.
- The epiploic foramen and its relations are demonstrated on axial CT.
The Upper GI Tract (Mouth to Stomach)
Mouth and Mandible
- The mandible consists of the body, ramus, angle, and coronoid and condylar processes
- The mandibular foramen is on the medial aspect of the ramus, guarded by the lingula of the mandible
- The mylohyoid line is a roughened, slightly raised ridge on the inside of the body of the mandible where the mylohyoid muscle attaches
- The alveolar margin of the mandible carries the teeth of the lower jaw
- The mental foramen and mental symphysis are also important features of the mandible
Teeth
- Each tooth is composed of specialized connective tissue (pulp) covered by three calcified tissues: dentine, enamel, and cementum
- There are 20 primary teeth in a child and 32 secondary or permanent teeth in an adult
- Teeth are divided into 4 quadrants with 8 teeth in each in the adult: 2 incisors, 1 canine, 2 premolars, and 3 molars (including the wisdom tooth)
Hyoid, Muscles of Mastication, and Tongue
- The hyoid bone does not articulate with any other bone directly
- The pharynx consists of a muscular tube suspended from the base of the skull
- The pharynx has three circular muscles: superior, middle, and inferior constrictors, which are open anteriorly
- There are also three vertical muscles: stylopharyngeus, palatopharyngeus, and salpingopharyngeus
- The nerve supply to the pharynx is from the vagus and glossopharyngeal nerves (cranial nerves X and IX respectively), which form the pharyngeal plexus
Salivary Glands
- The parotid gland occupies the space between the mastoid process and external acoustic meatus behind, and the ramus of the mandible in front
- The parotid gland is divided into two nominal parts (superficial and deep) by the facial nerve
- The parotid duct runs forward from the superficial part of the gland to pierce the buccinator and enter the oral cavity adjacent to the upper 2nd molar tooth
Pharynx and Oesophagus
- The pharynx progresses down to become the oesophagus
- The oesophagus is suspended from the base of the skull and passes through the oesophageal hiatus in the diaphragm
- The oesophagus is related to structures such as the aorta and thoracic duct in the thorax
Stomach
- The stomach has parts, blood supply, and innervation that need to be examined in detail
- The lesser omentum attaches to the stomach and liver (also known as the gastrohepatic ligament)
- The greater omentum is essentially continuous around the greater curvature of the stomach
- The gastrosplenic ligament is a fold of peritoneum that attaches the stomach to the spleen
Imaging Protocols
- AXR (abdominal X-ray) is used to assess intestinal distension and air fluid levels
- Erect CXR (chest X-ray) allows detection of pneumoperitoneum, as free gas accumulates under the hemidiaphragm
- A systematic approach to interpretation of AXR is useful, using the ABDO X mnemonic
The Upper GI Tract (Mouth to Stomach)
Mouth
- The mouth includes the skeleton (maxilla, mandible, palatine bones), tongue, salivary glands, palate, and floor of the mouth.
Pharynx and Oesophagus
- The pharynx progresses down to become the oesophagus.
- The oesophagus starts behind the cricoid cartilage of the larynx, surrounded by the cricopharyngeus muscle (skeletal muscle) that acts as a sphincter.
- There is a relatively weak spot (Killian's dehiscence) between the cricopharyngeus muscle and the rest of the inferior constrictor, where a diverticulum (outpouching) called Zenker's diverticulum may form.
Oesophagus Structure and Relations
- The oesophagus has an inner circular muscle layer and an outer longitudinal muscle layer, transitioning from skeletal muscle at the top to smooth muscle at the lower end.
- The oesophagus descends into the thorax behind the trachea, closely related to the posterior wall of the trachea.
- Below the tracheal bifurcation, the oesophagus is closely applied to the back of the left atrium of the heart.
- The descending aorta "swings" in behind the oesophagus in the posterior mediastinum.
Oesophagus Blood Supply
- The blood supply of the oesophagus comes from three main sources:
- Branches of the inferior thyroid arteries in the root of the neck.
- Branches from the bronchial arteries and direct oesophageal branches from the descending aorta in the thorax.
- A branch of the left gastric artery supplies the lower oesophagus.
Oesophagus Innervation and Porto-Systemic Anastomosis
- The left and right vagus nerves form a plexus on the surface of the oesophagus, eventually merging into two vagal trunks.
- An anastomosis of the veins of the lower oesophagus with the left gastric vein is one of the important porto-systemic anastomoses, relevant in portal hypertension.
Palatine Tonsils and Soft Palate
- The palatine tonsils are masses of lymphoid tissue.
- The muscles that make up the two arches are active in closing off the oral cavity from the pharynx and moving the soft palate down like a trapdoor.
Tongue
- The intrinsic muscles of the tongue change its shape, while the extrinsic muscles change its position.
- All extrinsic muscles except the palatoglossus are innervated by the hypoglossal nerve (cranial nerve XII).
- The genioglossus muscle protrudes the tongue and is attached anteriorly to the genial tubercles on the posterior surface of the mental process of the mandible (the chin).
Oral Health
- Oral health problems are common and can range from fungal infections to major malignant tumours involving the mandible, maxilla, tongue, lips, or face.
- These problems can impact the ability to eat, drink, and provide airway, and require working with the anatomy to provide these essential functions.
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Description
Anatomy practical quiz covering the upper GI tract from mouth to stomach, part of Clinical Science 1 course at University of Queensland.