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Block 4 SBOD > 10/21 Abdomen IV > Flashcards

10/21 Abdomen IV Flashcards

1
Q

name and locate the four parts of the duodenum

A

1st: superior, transpyloric plane
2nd: descending, alond R side of LV1/LV2/LV3
3rd: inferior, 3LV level
4th: ascending, goes up to LV2

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2
Q

features of 1st part of duodenum

A 
gastroduodenal A
ant to bile duct
inf to quadrate lobe
sup to head of pancreas
peritonealized, in the hepatoduodenal ligament
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3
Q

features of 2nd part of duodenum

A 
retroperitoneal
post to transverse colon
ant to hilum of r kidney
articulates w/ head of pancreas
*major duodenal papilla*
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4
Q

what marks the transition between foregut and midgut

A

major duodenal papilla, in 2nd part of duodenum

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5
Q

features of the 3rd part of duodenum

A 
retroperitoneal
articulates w/ head of pancreas
deep to root of mesentary
deep to superior mesenteric vessels
ant to IVC and abdom aorta
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6
Q

features of 4th part of the duodenum

A

retroperitoneal

suspensory ligament of duodenum/ligament of treitz attaches to diagphragm, marks duodenal/jejunal jxn

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7
Q

clinical significance: ligament of treitz

A

a proximal bleed will show up in vomit

a distal bleed will show up in stool

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8
Q

jejunum/ileum

A

intraperitoneal
suspended by mesentary (root travels from LV2 to righ iliac fossa, midline cross denotes jejunum to ileum
superior mesenteric vessels

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9
Q

clinical significant of location of superior mesenteric a

A

crosses anterior to the L renal v, originates deep to the neck of the pancreas, compressable

SMA syndrome and Nutcracker syndrome

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10
Q

SMA syndrome

A

compression of 3rd part of duodenum between superior mesenteric a and aorta

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11
Q

nutcracker syndrome

A

compression of L renal v between super mesenteric a and aorta, impeding venous return from L gonadal v

(ad)renal HTN,
varicocele left testicle (or left labia majora)
improved by laying down

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12
Q

visible characteristic of jejunum

A

vasa recta, less fat

more superior

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13
Q

visible characteristic of jejunum

A

arterial arcade, no windows, lots of fat

more inferior

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14
Q

cecum

A

cont with ascending colon
ileocecal jxn, ileocecal valve
appendix hands inferiorly in mesoappendix

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15
Q

appendix

A

in its own mesoappendix
appendicular a, from ileocolic a
ClinSig: pain projects at McBurney’s point, 1/3 of the way between r ASIS and umbilicus

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16
Q

colon

A 
taeniae coli (longitudinal bands) for peristalsis
epiplotic appendages (fat tags)
17
Q

ascending colon

A

goes up until R colic flexure/hepatic flexure
deep to liver
retroperitoneal

18
Q

transverse colon

A

transition from midgut to hindgut to left of midline (2/3 of the way along the transverse colon), turns down at left colic flexure/splenic flexure
suspended by transverse mesocolon

19
Q

desceding colon

A

retroperitoneal

20
Q

things in mid/hindgut that are actually intraperitoneal

A 
1st part of duodenum
jejunum
ileum
appendix
transverse colon
21
Q

midgut general

A

major duodenal papilla —>—>—>2/3 transverse colon

superior mesenteric a (L1), intestinal branches within mesentary proper

22
Q

hindgut general

A

last 1/3 of transverse colon —>—>rectum

inferior mesenteric a (L3), origin is retroperitoneal

23
Q

margina A of drummond

clinical significance

A

major anastomoses between mid and hind gut

weak point/water shed area/L colic feature: if compromised marginal A, ischemia here first

24
Q

four main branches off superior mesenteric a

A

ant/post inferior pancreaticoduodenal aa
middle colic
r colic
ileocolic (loops on itself)

25
Q

three main branches of inferior mesenteric a

A

L colic
sigmoid
superior rectal

26
Q

caval system

A

venous drainage to IVC from UG and co.

27
Q

hepatic portal system

A

venous drainage for ALL of fore/mid/hindgut
coalesces into portal v –> liver

portal V is always anterior to IVC

28
Q

portal system

A

stomach/intestinal capillaries
hepatic portal v
liver sinusoid capillaries

29
Q

three caval-portal anastomotic connections

A 
azygous (C) and esphageal (P)
superficial abdominal vv (C) and paraumbilical (P)
interior rectal (C) and superior rectal (P)
30
Q

clinical significance of portal-caval anastomoses

A

under normal conditions, pressure is = across systems

HTN of one system will cause blood to backflow and buildup in areas of lower pressure

Tx: shunt btwn hepatic portal v (inf to liver) to IVC to bypass the liver

presents as: esophageal varices, internal hemmorrhoids, caput medusae

Block 4 SBOD (4 decks)

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