3. Organs of the GI Tract Flashcards

1
Q

Where is volvulus most likely in infants?

Where is volvulus most likely in the elderly?

A

Infants – midgut volvulus

Elderly – sigmoid volvulus

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2
Q

Where are the four parts of the duodenum in relationship to the vertebrae?

A

Part one is to the right of L1 and on the same level.

Part two descends from L1 to L3.

Part three is directly anterior to L3.

Part four starts at L3 moves left then superiorly to about L2.

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3
Q

What is the name of the mesentery of the sigmoid colon?

A

The sigmoid mesocolon.

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4
Q

What and where is the Cantlie line?

A

An imaginary line on the liver drawn from the fundus of the gallbladder to the diaphragm.

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5
Q

What is a volvulus?

A

A rotation of a loop of bowel, which can cause constipation, necrosis, and ischemia.

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6
Q

What is Meckel’s diverticulum?

A

A 2 inch long “true” diverticulum resulting from a persistent vitelline/omphalomesenteric duct.

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7
Q

What do we call the ridged outpouchings of colon traveling along the tinea coli?

A

Haustra

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8
Q

Which functional segments of the liver are part of the left functional lobe?

A

Segments II, III, and IV.

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9
Q

What runs through the gastrocolic ligament?

A

The gastroepiploic vessels

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10
Q

In which quadrant do we find the majority of the ileum?

A

The right lower quadrant

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11
Q

Where to the superior mesenteric vein and artery pass in front of the duodenum?

A

The third portion of the duodenum.

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12
Q

Where does the hepatoduodenal ligament reside?

A

The hepatoduodenal ligament resides in the first portion of the duodenum.

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13
Q

The esophagus enters the cardial orifice of the stomach at the height of what vertebra?

A

T11

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14
Q

What muscle connects the duodenum to the right crus of the diaphragm?

A

The suspensory muscle of the duodenum

(a.k.a. ligament of Treitz)

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15
Q

How can you find the level of L3 on a physical exam?

A

You can find L3 at the inferior costal margin at the mid axillary line.

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16
Q

What section of the stomach is protruding in a paraesophageal hiatal hernia?

A

The fundus of the stomach

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17
Q

What separates the functional lobes of the liver into right and left?

A

The Cantlie line.

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18
Q

What is the most common site of volvulus in the elderly?

A

The sigmoid colon.

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19
Q

What blood vessel is contained within the gastrosplenic ligament?

A

The short gastric arteries

(Which come off of the splenic artery and supply the fundus of the stomach)

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20
Q

When might Meckel’s diverticulum become pathological?

A

If it becomes populated with ectopic gastric tissue, causing acid production and damaging the small intestine.

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21
Q

Which segment of the left functional liver is a part of the right anatomical lobe of the liver?

A

Functional segment IV. Also called the “left medial division.”

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22
Q

What empties out through the major duodenal papilla?

Where do we see the major duodenal papilla?

A

The common bile duct and the main pancreatic duct.

In the second portion of the duodenum

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23
Q

What ligament attaches the esophagus to the diaphragm?

A

The phrenico-esophageal ligament

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24
Q

The portal vein, bile duct, and proper hepatic artery are housed within what structure?

A

The hepatoduodenal ligament

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25
Q

Where are the cervical, thoracic, and a diaphragmatic constriction point of the esophagus?

A

Cervical – at the upper sphincter due to the cricopharyngeus muscle.

Thoracic – at the contact of the aorta, and the left main bronchus.

Diaphragmatic – passing through the esophageal hiatus at T10

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26
Q

What is the purpose of a technetium scan?

A

Detection of gastric tissue in Meckel’s diverticulum (among other things, I’m sure).

27
Q

What is the clinical significance of the ligament of Treitz (suspensory ligament of the duodenum)?

A

It denotes the change between the upper and lower G.I. Bright red blood in stool comes from a bleed distal to the ligament of Treitz.

28
Q

Which has a denser, shorter vasa recta and smaller, tighter arcades – the jejunum or the ileum?

A

The ileum has a denser, shorter vasa recta and smaller, tighter arcades.

29
Q

What is the name of the large longitudinal band traveling the large intestine?

A

The tinea coli

30
Q

What is the relationship of the duodenum to the peritoneum?

A

The first half of the first part of the duodenum is intraperitoneal, but the rest of the duodenum is retroperitoneal.

31
Q

How does a vagotomy decrease hydrochloric acid production?

A

Hydrochloric acid is produced as a response to parasympathetic innervation by the vagus nerve by the parietal cells of the fundus and body of the stomach. A lesion in the vagus nerve therefore decreases hydrochloric acid production.

32
Q

What two functional segments of the liver are contacted by the gallbladder?

A

The gallbladder is nestled between functional segments IV and V of the liver.

33
Q

The anterior face of the stomach touches what four structures?

A

The left lobe of the liver

The diaphragm

The anterior abdominal wall

The transverse colon on the inferolateral side

34
Q

ANATOMICALLY, what lobe are the quadrate and caudate lobes of the liver attached to?

A

The right anatomic lobe.

35
Q

What two structures does the gastrohepatic ligament run between?

A

The lesser curvature of the stomach and the liver.

36
Q

What is the hepatopancreatic ampulla?

A

It is the common opening in the duodenum for the common bile duct (accepting bile from the cystic duct [gallbladder] and common hepatic duct [liver]) and pancreatic duct.

On the intraluminal side it is called the major duodenal papilla.

37
Q

What structure of the large intestine can be found on the interspinous plane?

A

The lower edge of the cecum.

38
Q

The posterior face of the stomach touches what five structures?

A

The diaphragm

The spleen

The left upper kidney and suprarenal gland

The pancreas

The omental bursa (the stomach forms most of its anterior wall)

39
Q

What portion of the stomach is protruding in a sliding hiatal hernia?

A

The cardia of the stomach

40
Q

What is the function of the ligamentum venosum (ductus venosus) in the fetus?

A

Bypassing the fetal liver, since the blood returning via the umbilical vein from the mother is already detoxified.

41
Q

At what vertebral level is the lower edge of the cecum?

A

S2 (same as the interspinous plane)

42
Q

What two structures does the gastrocolic ligament run between?

A

The greater curvature of the stomach and the transverse colon.

43
Q

Review these structures:

A
44
Q

How might one find the transpyloric plane on a physical exam?

A

Trace up the linea semilunaris until he reached the costal margin. That is of the height of the L1 transpyloric plane.

45
Q

What disease corresponds to a “coffee bean sign on x-ray?”

A

Volvulus

46
Q

What is the embryological origin of the round ligament of the liver?

A

The round ligament of the liver is of the remnant of the umbilical vein, returning blood to the fetus from the mother.

47
Q

What runs with the gastrohepatic ligament?

A

Gastric vessels – especially the left gastric artery

48
Q

In which quadrant do we find the majority of the jejunum?

A

In the left upper quadrant

49
Q

What are the three types of vagotomy?

A

Truncal vagotomy: affects the stomach and other organs of the G.I. tract.

Selective Gastric vagotomy: affects the entire stomach – but only the stomach.

Selective Proximal vagotomy: affects only the region of the stomach damaged by ulcers.

50
Q

How might you find the unnamed T11 plane on a physical exam?

A

Find the midpoint between the linea alba and the linea semilunaris, and trace that up to the costal margin. This will give you the height of the T11 plane.

51
Q

What is the function of the splenorenal ligament, and what vessel runs within the splenorenal ligament?

A

The splenorenal ligament connects the spleen and the kidney.

The splenic artery is contained within the splenorenal ligament.

52
Q

At what vertebral level is the ileocecal junction?

A

L5

53
Q

What is the angular incisure of the stomach?

A

The angular incisure of the stomach is a small notch where the body meets the pyloric canal.

54
Q

Which has more significant, tighter packed circular folds (plicae circulares)?

A

The jejunum.

55
Q

What is the most common location for a duodenal (peptic) ulcer?

A

On the posterior wall of the first part of the duodenum

56
Q

The esophagus passes through the right crus of the diaphragm at the height of what vertebra?

A

T10

57
Q

Where’s the ligament of Treitz located?

A

The fourth portion of the duodenum.

58
Q

What do we call the small outpouchings of fat protruding from the tinea coli?

A

Omental appendices

59
Q

What organ is directly anterior to the spleen?

What ligament connects these organs together?

A

The stomach.

The gastrosplenic ligament.

60
Q

What is a possible complication of a duodenal (peptic) ulcer?

A

Erosion of the posterior wall of the duodenum can damage the gastroduodenal artery – leading to hemorrhage

61
Q

What is the purpose of the falciform ligament?

A

Connects the liver to the anterior abdominal wall.

62
Q

Which type of hiatal hernia is more likely to cause GERD?

A

Sliding hiatal hernia

63
Q

What divides the right and left anatomical lobes of the liver?

A

The falciform ligament

64
Q

Which functional segments of the liver make up the right functional lobe?

A

Segments V, VI, VII, and VIII.