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Anatomy Topnotch > 8. Gallbladder and Colon > Flashcards

8. Gallbladder and Colon Flashcards

1
Q

primary fx of the gallbladder is

A

to concentrate and store bile which is produced by the liver.

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2
Q

the stored bile is then released from the gallbladder in response to

A

cholecystokinin

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3
Q

anterior and superior to the gallbladder

A

inferior border of the liver and the anterior abdominal wall.

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4
Q

posterior to the gallbladder

A

transverse colon and the proximal duodenum.

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5
Q

inferior to the gallbladder

A

biliary tree and remaining parts of the duodenum.

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6
Q

The gallbladder has a storage capacity of

A

30-50 mL

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7
Q

gallbladder parts

A

fundus
body
neck

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8
Q

the rounded, distal portion of the gallbladder. It projects into the inferior surface of the liver in the mid-clavicular line

A

fundus

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9
Q

largest part of the gallbladder. It lies adjacent to the posteroinferior aspect of the liver, transverse colon and superior part of the duodenum.

A

body

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10
Q

the gallbladder tapers to become continuous with the cystic duct, leading into the biliary tree.

A

neck

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11
Q

contains a mucosal fold, known as Hartmann’s Pouch. This is a common location for gallstones to become lodged, causing cholestasis.

A

neck of the gallbladder

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12
Q

is a series of gastrointestinal ducts allowing newly synthesised bile from the liver to be concentrated and stored in the gallbladder (prior to release into the duodenum).

A

biliary tree

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13
Q

common hepatic duct runs along the

A

hepatic vein

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14
Q

arterial supply of the gallbladder

A

cystic artery (b. of right hepatic artery)

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15
Q

venous drainage of the gallbladder

A

Neck: cystic veins -> portal vein

Fundus , body: hepatic sinusoids

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16
Q

innervation of the gallbladder

A
  • coeliac plexus carries sympathetic and sensory fibres

* vagus nerve delivers parasympathetic innervation.

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17
Q

lymph drainage of the gallbladder

A

Neck: cystic lymph nodes -> hepatic LN -> celiac LN

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18
Q

uncomplicated gallstones

A

cholelithiasis

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19
Q

typically right upper quadrant pain following a fatty meal as gallstones obstruct the cystic duct during contraction of the gallbladder. Not associated with systemic upset

A

biliary colic

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20
Q

inflammation of the gallbladder. Pain is often associated with nausea, vomiting or fever

A

cholecystitis

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21
Q

gallstone within the common bile duct. Often causes deranged liver function tests.

A

choledocholithiasis

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22
Q

infection of the common bile duct often secondary to choledocholithiasis. Typically presents with right upper quadrant pain, fever and jaundice (Charcot’s Triad)

A

cholangtis

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23
Q

Charcot’s triad

A

right upper quadrant pain, fever and jaundice

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24
Q

surgical removal of the gallbladder

A

cholecystectomy

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25
Q

triangle of Calot boundaries

A
  1. liver -superior
  2. cystic duct - inferior
  3. common hepatic duct - medial
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26
Q

cystic artery originates from

A

right hepatic artery

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27
Q

common site of impacted gallstone

(+) referred pain in the epigastric region

A

hepatopancreatic ampulla

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28
Q

stimulation of visceral pain fibers that innervate GIT structure results in dull, aching, poorly localized pain
that is referred over ___-

A

T5 to L1 dermatome

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29
Q

Valve of houston is associated with what organ

A

rectum

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30
Q

Anatomically, the colon can be divided into four parts

A

ascending, transverse, descending and sigmoid.

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31
Q

the colon averages ___ cm in length

A

150 cm

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32
Q

marks the start of the transverse colon.

A

right colic flexure/ right hepatic flexure

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33
Q

at the left colic flexure/splenic flexure the colon is attached to the diaphragm by this ligament

A

phrenicolic ligament

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34
Q

is the least fixed part of the colon, and is variable in position (it can dip into the pelvis in tall, thin individuals).

A

transverse colon

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35
Q

unlike the ascending and descending colon, the transverse colon is

A

intraperitoneal

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36
Q

transverse colon is enclosed by

A

transvese mesocolon

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37
Q

left colic flexure is the start of

A

descending colon

38
Q

sigmoid colon ave length

A

40 cm

39
Q

sigmoid colon is located in this area of the abdomen

A

LLQ

40
Q

sigmoid colon extends from

A

left iliac fossa to S3

41
Q

The sigmoid colon is attached to the posterior pelvic wall by

A

a mesentery - sigmoid mesocolon

42
Q

are two spaces between the ascending/descending colon and the posterolateral abdominal wall.

A

paracolic gutters

43
Q

These structures are clinically important, as they allow material that has been released from inflamed or infected abdominal organs to accumulate elsewhere in the abdomen.

A

paracolic gutters

44
Q

small pouches of peritoneum, filled with fat,

attached to the surface of the large intestine

A

omental appendices

45
Q

Running longitudinally along the surface of the large bowel are three strips of muscle, known as the

A

taenia coli (mesocolic, free and omental coli.)

46
Q

Ascending colon and proximal 2/3 of the transverse colon

–derived from the

A

midgut

47
Q

Distal 1/3 of the transverse colon, descending colon and sigmoid colon

A

hindgut

48
Q

midgut-derived structures are supplied by the

A

superior mesenteric artery

49
Q

hindgut-derived structures

are supplied by the

A

inferior mesenteric artery

50
Q

ascending colon receives arterial supply from

A

branches of the superior mesenteric artery; the ileocolic and right colic arteries.

ileocolic artery gives rise to colic, anterior cecal and posterior cecal branches – all of which supply the ascending colon.

51
Q

transverse colon is derived from

A

both midgut and hindgut

52
Q

transverse colon is derived from both the midgut and hindgut, and so it’s arterial supply are

A
  • Right colic artery (from the superior mesenteric artery)
  • Middle colic artery (from the superior mesenteric artery)
  • Left colic artery (from the inferior mesenteric artery)
53
Q

arterial supply of the descending colon

A

the left colic artery (b. of inferior mesenteric artery )

54
Q

The sigmoid colon receives arterial supply via

A

sigmoid arteries (branches of the inferior mesenteric artery).

55
Q

is a clinically important vessel that provides collateral supply to the colon – thereby maintaining arterial supply in the case of occlusion or stenosis of one of the major vessels.

A

Marginal Artery of Drummond

56
Q

As the terminal vessels of the superior mesenteric and inferior mesenteric artery approach the colon, they split into many branches, which anastomose with each other. These anastomoses form a continuous arterial channel which extends the length of the colon called

A

marginal artery

57
Q

Long, straight arterial branches arise from the marginal artery to supply the colon,called

A

vasa recta

58
Q

venous drainage of the ascending colon

A

ileocolic and right colic veins–> superior mesenteric vein.

59
Q

venous drainage of the transverse colon

A

middle colic vein, –> superior mesenteric vein.

60
Q

venous drainage of the descending colon

A

left colic vein–> inferior mesenteric vein.

61
Q

venous drainage of the sigmoid colon

A

drained by the sigmoid veins into the inferior mesenteric vein.

62
Q

The superior mesenteric and inferior mesenteric veins ultimately empty into the

A

hepatic portal vein

63
Q

Midgut-derived structures (ascending colon and proximal 2/3 of the transverse colon) receive their sympathetic, parasympathetic and sensory supply via

A

nerves from the superior mesenteric plexus.

64
Q

Hindgut-derived structures (distal 1/3 of the transverse colon, descending colon and sigmoid colon) receive their sympathetic, parasympathetic and sensory supply via nerves from the

A

inferior mesenteric plexus
•Parasympathetic innervation via the pelvic splanchnic nerves
•Sympathetic innervation via the lumbar splanchnic nerves.

65
Q

The lymphatic drainage of the ascending and transverse colon is into the

A

superior mesenteric nodes

66
Q

Lymphatic: The descending colon and sigmoid drain into the

A

inferior mesenteric nodes.

67
Q

Most of the lymph from the superior mesenteric and inferior mesenteric nodes passes into the intestinal lymph trunks, and on to the cisterna chyli – where it ultimately empties into the

A

thoracic duct

68
Q

sacculations of the large intestine

A

haustra

69
Q

fatty tags of the large intestine

A

appendices epiploicae

70
Q

transverse colon

caliber

A

38 cm

71
Q

sigmoid colon

caliber

A

25-38 cm

72
Q

caliber

descending colon

A

25 cm

73
Q

rectum

caliber

A

13 cm

74
Q

ascending colon caliber

A

13 cm

75
Q

anal colon

caliber

A

4 cm

76
Q

blood supple of the cecum

A

SMA-> ileocolic a. -> anterior/posterior cecal a.

77
Q

venous drainage of cecum

A

anteiror/posterior cecal v. -> ileocolic v. -> SMV

78
Q

The appendix originates from the

A

posteromedial aspect of the cecum

79
Q

appendix is supported by

A

mesoappendix, a fold of mesentery which suspends the appendix from the terminal ileum.

80
Q

position of the free-end of the appendix is highly variable and can be categorised into seven main locations depending on its relationship to the ileum, caecum or pelvis

A

Pre-ileal – anterior to the terminal ileum – 1 or 2 o’clock.
Post-ileal – posterior to the terminal ileum – 1 or 2 o’clock.
Sub-ileal – parallel with the terminal ileum – 3 o’clock.
Pelvic – descending over the pelvic brim – 5 o’clock.
Subcecal – below the cecum – 6 o’clock.
Paracecal – alongside the lateral border of the cecum – 10 o’clock.
Retrocecal – behind the cecum – 11 o’clock.

81
Q

the most common position of the appendix

A

retrocecal

82
Q

The appendix is derived from the embryologic

A

midgut

83
Q

the vascular supply of the appendix

A

SMA -> ileocolic a -> appendicular artery

84
Q

the venous drainage of the appendix

A

appendicular vein

85
Q

lymphatic drainage of the appendix

A

ileocolic lymph nodes (which surround the ileocolic artery).

86
Q

etiology of appendicitis

A

In the young –increase in lymphoid tissue size, which occludes the lumen.

From 30 years old onwards – blocked due a faecolith.

87
Q

this nerve maybe injured in appendectomy

A

iliohypogastric nerve -> weakening of anterior abdominal wall

88
Q
  • the sigmoid colon twists around the sigmoid mesocolon and may become obstructed
  • patient experience left sided colicky pain, abdominal distention, hematochezia (compromise of sigmoid arteries)
A

sigmoid volvulus

89
Q

refers to a diverticula that are not inflamed

A

diverticulosus

90
Q
  • inflamed diverticula, contents may irritate the parietal peritoneum, resulting in pain that is localized to the LLQ
  • may have hematochezia
A

diverticulitis

Anatomy Topnotch (26 decks)

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