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GIGU Exam 1 > Abdominal Midgut And Hindgut > Flashcards

Abdominal Midgut And Hindgut Flashcards

1
Q

Jejunum characteristics

A

Contains mucosal folds = plicae circulares Fat increases is mesentery from distal to proximal A: arterial arcades with long vasa recta form SMA

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2
Q

Ileum characteristics

A

distal 3/5 of si Small plicae circulares A: compound arterial arcades with short vasa recta from SMA

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3
Q

SMA

A

Superior Mesenteric A.

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4
Q

Colon features

A

3 bands of longitudinal SM = Tenia coli Make haustra that have fatty appendages attached (appendices epiplocae)

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5
Q

Cecum

A

Blind pouch with the ideal papilla (projecting into ileum) + ileocecal valve

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6
Q

Sigmoid

A

Joins the rectum at S3

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7
Q

Appendix

A

Small diverticulum or pouch form the cecum Has lymphoid nodules (for immune system) regenerate healthy bacteria

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8
Q

Rectum

A

Retro peritoneal In pelvic cavity, 3 transverse rectal foldings (superior, middle, inferior) Simple cuboidal

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9
Q

Anal Canal

A

Has 2 anal sphincters INTERNAL= SM EXTERNAL = Skeletal muscle Has anal columns, valves, and sinuses PECTINATE Line = inferior of the anal valve STRAT SQ

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10
Q

What does the SMA supply

A
  1. Ascending Colon 2. Transverse Colon 3. SI + Duodenum 4. Cecum 5. Pancreas
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11
Q

What does the IMA supply

A
  1. Descending colon 2. Sigmoid Colon 3. Superior Rectum
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12
Q

What anastomoses from the SMA

A

Inferior Pancreaticoduodenal Arteries and Gastroduodenal arteries

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13
Q

SMA path

A

At L1 from Aorta Post to pancreas and ant to inferior duodenum 20% becomes the Right Hepatic A.

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14
Q

What does the SMA branch off to 4

A
  1. Jejunal and Ileal A.s (+ Ileocecal A.) 2. Ileocolic A. 3. Right Colic A. (Ascending colon) 4. Middle Colic A. (Transverse colon) * also the Ant/Post Inferior Pancreaticoduodenal A.
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15
Q

What does the IMA branch off to 3

A
  1. Left Colic A. (Descending colon) 2. Sigmoidal Colic A. 3. Superior Rectal A.
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16
Q

The Marginal Artery of Drummond

A

Artery formed by the many anastomoses of the IMA and SMA and provides an alternative route for any vessel obstruction or ischemia to the LI Runs along inner margin of LI

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17
Q

What supplies the superior rectum

A

Superior Rectal A. From the IMA

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18
Q

What supplies the Middle Rectum

A

Middle Rectal A. From the Internal Iliac A.

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19
Q

What supplies the Inferior Rectum

A

Inferior Rectal A. From the Internal Pudendal A.

20
Q

Portal Systemic Anastomoses happen at 3 locations where are they

A
  1. Gastroesophageal plexus 2. Umbilicus 3. Rectal Venous Plexus * these can choose to go to systemic IVC if they want
21
Q

Varacies in the Portal Venous Anastomoses can occur from what

A

Hepatic HTN, decreased BF in the Liver

22
Q

Autonomics of the Midgut + Hindgut SYPATHETIC

A

Pre-ganglionic And don’t synapse at the sympathetic chain They go to one of 4 ganglion at a chain by the aorta 1. Thoracic Splanchnic T5-T12 2. Lumbar Splanchnic L1-L5 3. Sacral Splanchnic S1-S5

23
Q

Sympathetic Thoracic Splanchnic Neurons go to what ganglion

A
  1. Greater : Celiac Ganglia (T5-T9) (some go to the SMA) 2. Lesser : SMA Ganglia (T10-T11) = they go to Stomach, Pancreas, Liver, Gallbladder, SI, A.C, T.C. 3. Least : Aorticorenal Gangia (T12) = goes to Kidney and Suprarenal Glands
24
Q

Sympathetic Lumbar Splanchnic Neurons go to what ganglion

A

To SMA, IMA, and Hypogastric Ganglia = D.C. and S.C. and Rectum,Anus

25
Q

Sympathetic Sacral Splanchnic Neurons go to what ganglion

A

To Hypogastric Ganglia = Rectum and Anus and Pelvic organs (think reproduction)

26
Q

Parasympathetic neurons go to where and what are they 2

A
  1. Vagus N: goes through the SMA ganglion to the organs where it synapses (SI, A.C, T.C, cecum, appendix) 2. Pelvic Splanchnic N : from sacral spinal nerves through the Hypogastric plexus, SYNAPSE on the ORGANS (D.C., S.C., Rectum, Anus)
27
Q

Pelvic Splanchnic Nerves What Where Joins what plexus in the process

A

Parasympathetic from S2-S4—-> goes through the Inferior Hypogastric Plexus Synapses on: 1. Descending Colon 2. Sigmoid Colon 3. Rectum + Anal Canal 4. Urogenital Organs 5. Perineum organs

28
Q

Abdominal Somatic Afferent Pathway

A

Pain from irritated Parietal peritoneum of an organ = pain in the area of the skin that attached to the peritoneum =Acute, well localized = sensitive to stretch EX: Inflamed liver irritates the diaphragmatic peritoneum —-> afferent nerves from this peritoneum go to the C3-C5 (phrenic) —-> you have pain in the area above liver + area on top of shoulder

29
Q

Visceral Afferent Pathway

A

Pain from the organ itself = pain from organ travel with Splanchnic n to spinal cord = poor localization = Radiates to dermatomes that the organ gets visceral Afferents from EX: Stomach pain: Greater Splanchnic N carries info and you feel it at T5-T9 dermatome

30
Q

Where do the Ant/Post Superior Pancreaticoduodenal As come from

A

The Gastroduodenal A

31
Q

3 arteries that anastomoses in the rectum

A

Sup + Mid + Inf Rectal Arteries

32
Q

What is joined to make the Hepatic Portal Vein

A

The SMV and the Splanchnic V

33
Q

IMV goes to what

A

The Liver (hepatic portal vein)

34
Q

SMV goes to what

A

The liver into the portal triad (Hepatic Portal Vein)

35
Q

Hepatic Veins

A

From liver to the IVC to heart

36
Q

Central vein makes a

A

Hepatic lobule Portal triads= makes the border of the lobule

37
Q

What is the portal triad

A
  1. Hepatic A 2. Hepatic V 3. Bile Ductile Bile and blood flow in opposite directions
38
Q

Hepatic lobules have plates separated by

A

Sinusoids Each angle of the lobule is a portal triad

39
Q

How does bile flow

A

Bile flows from the bile canaliculi between hepatocytes and there tight junctions ——> Canals of Hering (cuboidal cells =CHOLANGIOCYTES)——> Bile Ductles (found in the portal triad)——> merge and enlarge —-> Right and left hepatic Ducts——> Biliary Tree (common hepatic duct)

40
Q

What lines the biliary tree (cystic, hepatic, bile ducts)

A

Cuboidal Cholangiocytes Cystic duct has some mucous cells Ducts have Muscularis that is thin and thicker at sphincter

41
Q

Hepatic Sinusoids are and have what cells

A

Capillaries that are gapping open and holes going through the hepatocytes (portal and arterial blood) = bring in toxins and stuff that needs to be metabolized Kupffer Cells : macrophages for RBCs Hepatic Stellate Cells : have small lips droplet that stores VIT A and other fat soluble vitamins

42
Q

Where are Kupffer cells found

A

Hepatic Sinusoids

43
Q

Perisinusoidal Space

A

Hepatocytes have microvilli that are enclosed into a space right outside the capillary = nutrients and substances are bathed on the microvilli + increased SA =proper uptake of proteins and toxins and other substances

44
Q

Periportal Space

A

In between the portal triad and the angle of the hepatocyte lobule = excess fluid in the perisinusoidal space is collected here And drained by lymph Also has Ito cells (HEPATIC STELLATE CELLS) to collect vitamins and fat

45
Q

Portal Lobule

A

The center is now the portal triad The three corners are the central vein = where all bile from the three lobules it connect to flows To see how much area has bile production in a patient

46
Q

Hepatic Acinus

A

Diamond shaped Two hepatocytes (hexagons) connected by 2 portal triads on 2 corners and zones created based on how far their line of connection is from the central vein = measures blood flow = O2 concentration ——>makes every zone have different metabolic function and hepatic enzymes

47
Q

Which zone will have the most damage is there is liver bleeding or GI bleed

A

Zone 3 Zone three in normal patient gets the least amount of blood and also least amount of toxins

GIGU Exam 1 (19 decks)

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