5 DSA Organs of The GI Tract Flashcards
At what level does the esophagus enter the diaphragm
T10
At what level does the esophagus enter the stomach
T11 at the cardiac orifice
The upper esophageal sphincter is the
Cricopharyngeus m
What are the constrictions of the esophagus
Cervical constriction (upper esophageal sphincter)
Thoracic (broncho-aortic constriction)
Diaphragmatic constriction
What is a hiatal hernia
When portions of the stomach push through the diaphragm
What are the 2 types of hiatal hernias
Para-esophageal and sliding
Which hiatal hernia is characterized by regurgitation
Sliding, and this type is more common
During a para-esophageal hiatal hernia, what do we find piercing the diaphram
Peritoneum and fundus
During a sliding hiatal hernia, what do we find piercing the diaphragm
Esophagus, cardia, fundus
Which hiatal hernia is exacerbated upon bending over or laying down
Sliding
what are the portions of the stomach from esophagus to duodenum
cardia –> fundus –> body –> pyloric antrum –> pyloric canal –> pylorus –> duodenum
what is touching the anterior portions of the stomach
left lobe of liver (along lesser curvature) diaphragm (along greater curvature) anterior wall (along lower greater curvature)
what touches the posterior surface of the stomach
diaphragm, spleen, left adrenal gland, left kidney, pancreas, transverse colon, transverse mesocolon, lesser sac
what are the parts of the small intestine
duodenum, jejunum, ileum
what are the parts of duodenum
1st (superior)
2nd (descending)
3rd (horizontal or inferior)
4th (ascending)
what parts of the duodenum are retroperitoneal? what are the other parts?
2-4 are retroperitoneal, 1 is intraperitoneal
when you get posterior duodenal ulcers, what artery can be affected
gastroduodenal A is posterior to the first part of the duodenum
where does the bile duct and the mean pancreatic duct meet
hepatopancreatic ampulla
where does the bile duct and the pancreatic duct enter the duodena?
at the duodenal papilla towards the end of the 2nd portion of the duodenum
where is the 4th part of the duodenum anchored to? by what?
right crus of the diaphragm; the suspensory ligament of the duodenum (of Treitz)
tumors in what portion of the pancreas can block the bile duct
the head
what portion of the bile duct does not everyone have
accessory pancreatic duct
what is nutcracker syndrome
a syndrome where the left renal vein can be compressed between the SMA and aorta. this can lead to renal venous hypertension and hematuria
what portion of the SI is characterized with thick and heavy walls
jejunum
what portion of the SI has less circular folds
ileum
what portion of the SI has more lymph nodes
ileum
what level is the R colic flexure
L1
what is the most common anomaly of the SI
meckels diverticulum
what is meckel’s diverticulum
it is a remnant of the vitelline duct
what does meckel’s diverticulum look like
appendicitis
what levels does the mesentery occupy
L2-5
what are the muscles which form haustrae (pockets) in the LI
taenia coli
what is the L colic flexure also called
splenic flexure
what are the regions of the colon
cecum (beginning) appendix ascending colon right colic (hepatic) flexure transverse colon left colic (splenic) flexure descending colon sigmoid colon rectum anal canal
what are epicloicae or omental appendices
tags of fat that are characteristic of the LI
what portion of the LI has no eplicloic appendages
cecum
what is the opening of the ileum to the cecum
illeal papilla
what peritoneal classification are the LI poritons
Ascending - 2° retroperitoneal
transverse - intraperitoneal
descending - 2° retroperitoneal
sigmoid - intraperitoneal
where is diverticulosis most commonly found
sigmoid colon
what is volvulus of sigmoid colon
twisting of the colon causing constipation, possible fecal compaction, possible ischemia, and possible necrosis
what peritoneum status is the rectum
retro- and sub-peritoneal
is the spleen retro or intraperitoneal
intra
where is the spleen
parallels L ribs 9-11
what ligaments are on the spleen
gastrosplenic and splenorenal
where is the pancreas located
L1-2
what portions of the pancreas are retroperitoneal
head, neck, body, but NOT the tail
if there is an accessory pancreatic duct where does it enter
superior to the duodenal papilla
what ligament splits the liver in 2
falciform
what are the anatomic lobes of the liver
left, right, caudate (superior), quadrate (inferior)
what re the functional lobes of the liver
Segment I - caudate lobe Segment II - left posterior lateral (L) Segment III - left anterior lateral (L) Segment IV - left medial segment (L) Segment V - right anterior medial (R) Segment VI - right anterior lateral (R) Segment VII - right posterior lateral (R) Segment VIII - right posterior medial (R)
what line divides the functional left and right liver
cantlie
what determines the functional liver lobes
branching of the portal vein and the hepatic A
what portion of the liver has a left functional lobe and right anatomical lobe
part 4
the round ligament of the liver is a remnant of what
L umbilical V
what ligaments form the lesser omentum
hepatoduodenal and hepatogastric ligaments
what surface transmits the portal triad
porta hepatis (fissure between quadrate and caudate lobes)
what is the portal triad made of
proper hepatic A
portal V
bile duct
what is the ligamentum teres
oblirerated umbilical v
what is the ligamentum venosum
obliterated ductus venosus which used to connect the umbilical vein to the IVC
what two things meeting form the common bile duct
cytstic duct + common hepatic duct (L + R hepatic ducts)
what are the portions the gallbladder
fundus (most inferior)
body
neck (where the cystic duct forms)
what are gallstones called
cholelithiasis (made of cholesterol)
where can gallstones become lodged
cystic duct (main), hepatic duct, hepatopancreatic ampulla
what sign is positive for a blockage of the cystic duct
murphys sign
where would pain be felt for a cystic duct blockage
right ribs, also referred to back and epigastric
what can a block of the hepatopancreatic ampulla cause
block the bile and pancreatic ducts, bile can backup into pancreas and cause pancreatitis, jaundice
where are adhesions between the gallbladder likely to form
transverse colon, duodenum, diaphragm
when a stone enters the superior duodenum, where is it likely to cause issues
ileocecal junction
What is annular pancreas
Pancreas wraps around the 2nd portion of the duodenum
- can cause bilous vomiting if below the papilla
- low birth weight
