Abdomen (GI) - Maklad

Question 1

Eso location and dimensions?

Answer 1

25 cm pharynx to stomach
Starts at 6th cervical vertebra
Pierces diaphragm at 10th thoracic vertebrae
Ends at cardia w/ 11th “”
R border: lesser curve of stomach
L border: acute angle w/ cardiac notch at fundus

Question 2

Eso constrictions?

Answer 2

Incisor teeth: 15 cm
Aortic arch: 22cm
L bronchus X: 27cm
Diaphragm: 40cm

Question 3

Musc of sphincter?

Answer 3

Circ m thickening

Tone Loosens only when vomiting or swallowing

Question 4

Ext sphincter details?

Answer 4

R crus, phrenico-eso ligament
Valve flap of gastric wall (cardiac notch)
Funnel shaped extension of gastric mucosa into eso orifice

Question 5

Eso blood supply?

Answer 5

Arteries: inf thyroid, bronchial, thoracic arch, L inf phrenic, L gastric
Veins: inf thyroid, azygous, hemiazygous, SCV branches, L gastric)

Question 6

Eso lymphatics?

Answer 6

To deep cervical, post mediastinal and L gastric lymph

Question 7

Hiatal hernia cause?

Answer 7

Loose phrenicoligaments

Question 8

Achalasia?

Answer 8

Lower eso sphincter won’t relax, food can’t get to stomach

Question 9

Stomach location?

Answer 9

L upper quad

Epigastrum, L hypochondrum, umbilical regions

Question 10

Stomach functions and contents?

Answer 10

Food blinder, secretes enz, HCl and mucous
Gastrin, somatostatin, IF
1.5L in adult, 30ml in kid

Question 11

Parts of pyloric region?

Answer 11

Antrum, sphincter, canal

Question 12

Borders and surfaces of stomach?

Answer 12

R: liver via lesser omentum
L: by peritoneal fold to diaphragm (gastrophren lig), spleen (“”), post ab wall (greater omentum)

Question 13

Anterior relations of stomach?

Answer 13

Peritoneum of greater sac

Post surface of L lobe of liver, diaphragm and ab wall

Question 14

Post relations of stomach?

Answer 14

Peritoneum of lesser sac

Separates post surface of stomach from: diaphragm, spleen, upper L kidney, L suprarenal

Question 15

Duo specifics?

Answer 15

25 cm long, 5 cm wide
1st and last “ intraperitoneal and mobile
Parts: sup, desc, horiz, asc

Question 16

Relations of each part of duo?

Answer 16

Sup: quad lobe, ant and neck of GB, X behind by portal vein, bile duct and IVC and gastroduodenal a
Desc: trans colon, post surface of R lobe, GB and jej coils
Horiz: ant: mes root, sup mes, vessels, SI coils, post: front of R ureter,
Asc: post: L psoas, ant: mes root, R: aorta, L: L colic flexure

Question 17

Peptic ulcers?

Answer 17

Mucosal erosion more than that of acidic part of GI
Cause: heliobacter pylori
Treatment: antibiotics
If untreated can erode until it perforates the wall and contents leak into peritoneal cav

Question 18

Jej and ilium attachment?

Answer 18

Both intraperitoneal, to wall via mesentery

Question 19

Where does submucosa and mucosa reach max height?

Answer 19

Jej (2.5 m)

Question 20

Ileum details?

Answer 20

More fat, smaller diameter and thinner walls than jej, Circ folds are absent in terminal part

Question 21

Jej vs ileum?

Answer 21

Jej: Deeper red, more vasa recta
Ileum: aggregated lymph follicles

Question 22

What’s intussuception? Volvulus?

Answer 22

Intuss: Fat/mesentary stuck in folds
Volvulus: twisted intestines

Question 23

LI internal stuff?

Answer 23

Semilunar folds

Question 24

What is appendices epiploic? Where’s it NOT located?

Answer 24

It’s peritoneal tags w/ fat in surface, not in cecum, appendix and rectum

Question 25

Cecum? It’s opening?

Answer 25

Sacculated diverticulum

Vermiform appendix

Question 26

Appendix details?

Answer 26

2-12cm long
McBurney’s point: junction of lateral 1/3 and medial 2/3 of line connecting ASIS and umbilicus
Supplied by appendicular artery (off ileocolic artery)

Question 27

What’s suspends the transverse colon?

Answer 27

The transverse mesocolon

Question 28

What does the desc colon end as?

Answer 28

Sigmoid colon