Abdomen pathologies Flashcards
oesophageal varices
anastomosis bw oesophageal branch of LEFT GASTRIC VEIN and oesophageal branch of AZYGOUS VEIN is wat gets distended
consequence of portal hypertension, commonly due to cirrhosis (which is due to alcohol); patients have a strong tendency to develop bleeding.
FOREGUT:
from abdominal oesophagus to major duodenal papilla
MIDGUT
from major duodenal papilla to 2/3 distal colon
HINDGUT
from 2/3 distal colon to upper half way of anal canal
where does pain refer to for foregut?
epigastrium – T7-9 mainly T8
where does pain refer to for midgut?
umbilicus – T10
where does pain refer to for hindgut?
– T11-L1 mainly T12
4 anatomic constrictions of oesophagus
Pharynx joins oesophagus
arch of aorta crosses it
left main broncus crosses it
diagphragm
constrictions of oesophagus at pharynx join
C6. 15 cm away from teeth
constrictions of oesophagus at arch of aorta
T4. 22 cm away from teeth
constrictions of oesophagus at left main broncus
T5. 27 cm away from teeth
constrictions of oesophagus at diaphragm
T10
layers of stomach
• 3 muscle coats- innermost is oblique, longitudinal layer and circular
rectal varices
get hemorrhoids
anastomosis bw Superior rectal vein (portal) n
Middle & inferior rectal veins (systemic)
Umbilical varices ( get caput medusae)
anastomosis bw Paraumbilical veins (portal) n Superficial epigastric vein (systemic)
PUD
gastric ulcer can cause bleeding of which artery?
splenic
PUD
duodenal ulcer can cause bleeding of which artery?
– Gastroduodenal artery
Duodenal ulcer most likely to form in
first part of duodenum
causes of defective gastric acid secretion
surgical removal of stomach
autoimmune gastritis (achlorhydria =absence of HCL in stomach)
pernicious anaemia
neurological disturbance
umbilical varices -wat veins?
Paraumbilical veins (portal) Superficial epigastric vein (systemic)
umbilical varices -wat veins?
caput medusae
Paraumbilical veins (portal) Superficial epigastric vein (systemic)
rectal varices -wat veins?
hemorroids
superior rectal vein (portal)
Middle & inferior rectal veins (systmeic
in varices- wat is the clinical presentation
hematemesis
melena
• The functional lower esophageal sphincter stops which disease process from occurring in the esophagus?
• The functional lower esophageal sphincter stops which disease process from occurring in the esophagus?
– Prevents metaplasia seen in Barrett’s esophagus
mcburneys pnt tenderness
=acute appendicitis
mcburneys pnt tenderness aka mcburnys sign
=acute appendicitis
direct inguinal hernia
medial to inferior epigastric vessels
• Organ goes through peritoneum and transversalis fascia (in inguinal triangle) to enter inguinal canal (usually only goes trhough medial third of inguinal canal)
indirect inguinal hernia
lateral to inferior epigastric vessels
• Organ goes through deep inguinal ring into inguinal canal
wen lying down fluid accumulates in
hepatorenal (Morrison’s) pouch
phrenicocolic ligament
Morrison’s pouch and the pouch of Douglas are connected on the right side by the right paracolic gutter; they are not connected on the left by the left paracolic gutter due to the presence of the phrenicocolic ligament which blocks this expressway. Thus, a perforated gastric ulcer would cause gastric fluid to go down the right side. If the perforation was below the phrenicocolic ligament on the left, the leaking contents would go down the left paracolic gutter.
CHOLEDOCHOLITHIASIS
gallstones in common bile duct
CHOLANGITIS/ASCENDING CHOLANGITIS
infection and inflammation of the bile ducts
CHOLECYSTITIS/ACUTE CHOLECYSTITIS
inflammation of gallbladder
CHOLELITHIASIS
formation of gall stone in gall bladder
in acute appendicitis can get
grey-turner sign- bruising on each flank
cullens sign- bruising around umbilicus
Courvoisier’s sign
painlessly distended gallbladder- in pancreatic cancer
strong RIF (right iliac fossa aka right iliac region) pain
appendicitis
appendicitis signs
McBurney’s sign (mcburneys pnt=2/3 from umbilicus , and one third from ASIS), Rovsing’s sign, and rebound tenderness.
constipation
pass stools less than 2 times per week
with straining more than 25% of the time
hard stool and incomplete evacuation
gastroperesis (wat dan had)
main cause: diabetic autonomic neuropathy
