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GI I > Abdominal viscera > Flashcards

Abdominal viscera Flashcards

1
Q

What is the funciton of the esophagus

A

msucular tube to move food from pharynx to stomach

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2
Q

Where does the esophagus enter the abdomen

A

TV10

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3
Q

where does the esophagus enter stomach

A

TV11

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4
Q

What does the phrenicoesophageal ligament do

A

attach esophagus to diaphragm to allow for independent movement

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5
Q

what structure helps prevent herniation of esophagus into the thorax

A

the phrenicoesophageal ligament

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6
Q

What are the constrictions of the esophagus

A

cervical- cricopharyngeus muscles
thoracic- arch of aorta and left primary bronchus
diaphragmatic- diaphragm forms physiological ingerior esophageal sphincter

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7
Q

what does the diaphragmatic constriction of the esophagus prevent against

A

reflux of food and acid into the esophagus

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8
Q

What aa supply the esophagus

A

left gastric a

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9
Q

where does the left gastric vein drain into

A

hepatic portal vein

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10
Q

wehre do the esophagela veins drain into

A

SVC

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11
Q

where do esophageal lymph drain to

A

left gastric lymph nodes–> celiac lymph nodes

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12
Q

where are hiatal hernias

A

herniation of esophagus and or stomach through esophageal hiatus of diaphragm

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13
Q

what is a paraesophageal hiatal hernia

A

fundus of stomach herniates thorugh esophageal hiatus anterior to esophagus

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14
Q

what is caused by a weakening of the phrenicoesophageal ligaments

A

sliding of the cardia and fundus of stomach to herniate into thorax

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15
Q

what is the function of the stomach

A

accumulates and digests food materials

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16
Q

what quadrant is the stomach found int

A

left upper

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17
Q

what factors influence position of stomach

A

fullness, body type and gender

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18
Q

what is superior to stomach

A

diaphragm

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19
Q

what is anteiror to stomach

A

ventral body wall, diaphragm and left lobe of the liver

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20
Q

what is posterior and inferior to the stomach

A

omental bursa and stomach bed

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21
Q

what structure make up the stomach bed

A

diaphragm, spleen, left kidney and suprarenal gland, pancreas and transverse colon with its mesocolon

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22
Q

What are the curvatures of the stomach

A 
greater curvature (left border of stomach)
lesser curvature (right border of stomach)
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23
Q

what are the regions of the stomach

A

cardia, fundus, body and pyloric region

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24
Q

where is the cardia region of the stomach located

A

anterior to TV11

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25
Q

where is the fundus of the stomach

A

separated from esophagus by cardiac notch

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26
Q

where is the body of the stomach

A

between fundus and pyloric antrum

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27
Q

where is the pyloric antrum, canal and pylorus

A

antrum is the funnel shaped outflow where the canal is the narrow inferior part and the pylorus is the part with pyloric sphincter
LV1/LV2

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28
Q

What is the structure of the stomach wall

A

serosa, msucular layer and mucosa

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29
Q

describe the layers of the muscular layer of the stomach

A

outer longitudinal layer of smooth m
inner circular layer of smooth m (pyloric sphincter
innermost oblique layer of smooth muscle

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30
Q

how is the mucosa aranged in stomach

A

gastric folds called rugae

most prevalent along greater curvature and form gastric canal along lesser curvature

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31
Q

What are the associated mesenteries with the stomach

A

lesser and greater omentum

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32
Q

what arterieis supply stomach

A

2 arches Gastric arterial arch with right gastric a and left gastric a
gatroepiploic arch with right gastroepiploic a and left gastroepiploic a

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33
Q

what aa supply the fundus region of stomach

A

short gastric branches of splenic a

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34
Q

where do vv drain from stomach

A

portal vein

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35
Q

where is the lymphatic drainage from stomach

A

gastric lymph nodes along lesser curvature go to celiac lymph
gastroepiploic nodes along greater curvature go to celiac lymph

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36
Q

What is the function of the duodenum

A

absoprtion of nutrients

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37
Q

what are the general features of the duodenum

A

first portion of small intestine (12 in long)

c shaped to course around head of pancreas

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38
Q

what are the divisions of the duodenum

A

4 parts

superior descending, horizontal and ascending

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39
Q

which part of teh duodenum is known as duodenal bulb

A

first superior part

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40
Q

which part of the duodenum is peritonealized

A

the first superior part

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41
Q

at what level is the superior part of the duodenum

A

LV1

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42
Q

at what level is the second or descending part of the duodenum

A

LV1 to LV3 and is retroperitoneal

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43
Q

In the second part of duodenum there are two papillae, what are they and funtion

A

major duodenal papilla opens to hepatopancreatic ampulla

minor duodenal papilla opens for accessory pancreatic duct

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44
Q

at what level is the third or horizontal part of duodenum

A

right to left at LV3

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45
Q

at what level is the fourth or ascending part of duodenum

A

LV3 to LV2

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46
Q

where is the duodenojejunal flexure

A

where duodenum is continuous with jejunum

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47
Q

what ligament supports the duodenojejunal flexure

A

suspensory ligament of Treitz

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48
Q

What is anterior, superior, posterior and inferior to the first part of duodenum

A

anterior superior is the gallbladder and liver
posterior is the common bile duct and gastroduodenal a, portal vein
inferior is the head of pancrea

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49
Q

what lays anterior, posterior and medial to the descending part of the duodenum

A

anterior- liver gallbladder, transverse colon and SI
posterior, R kidney, renal vessesl and IVC
medial- pancreas, gastroduodenal a, bile and pancreatic ducts

50
Q

what lays anteiror, posterior and superior to the third or horizontal part of duodenum

A

anterior- superior mesenteric vessels and root of mesentery
posterior- right psoas major, IVC, aorta, right gonadal vessels
superior- head and uncinate process of pancreas

51
Q

what lays anterior and posterior to the ascending part of the duodenum

A

anterior- root of mesentery and SI

posterior- aorta, left psoas major

52
Q

What are the internal strcutures of duodenum

A

villi- folds of mucosa which increase SA

plica circularis- folds of mucosa and submucosa

53
Q

What is a paraduodenal hernia

A

inconstant folds of peritoneum that surround the third and fourth parts of duodenum
small intestin can herniate into folds

54
Q

Why is surgery to repair paraduodenal hernias dangerous

A

careful not to injure the inferior mesenteric vessels

55
Q

what structures anastomose around the duodenum

A

celiac trunk and SMA

56
Q

What aa supply duodenum

A

celiac trunk via gastroduodenal a that branch into
supraduodenal (duodenal bulb)
retroduodenal (1st part)
superior pancreaticoduodenal aa (ant and post)
SMA via inferior pancreaticoduodenal aa

57
Q

where do the veins around duodenum drain to

A

portal vein

58
Q

where to lymph from duodenum drain

A

anterior to pancreaticoduodenal nodes to pyloric to celiac lymph nodes
posterior to the superior mesenteric nodes

59
Q

What are peptic ulcers

A

lesions of mucosa of stomach of duodenum

gastric is stomach, duodenal is in duodenum

60
Q

What are the most common peptic ulcers

A

duodenal ulvers

61
Q

What occurs with perforatin ulcers

A

stomach contents and gas escape into peritoneal sac causing diffuse peritonitis

62
Q

posterior perforating ulcers of stomach can involce what other structures

A

pancreas or splenic aa

63
Q

perforating duodenal ulcers erode what

A

gastroduodenal a

64
Q

is the jejunoileum peritonealized or retroperitoneal

A

peritronealized

65
Q

What portion of the jejunoileum is jejunum and what part ileum

A

jejunum is 2/5 in LUQ and ileum is 3/5 in RLQ

66
Q

What is the mesentery proper

A

the root of the mesentery where it attaches to the posterior body wall

67
Q

where does mesentery proper extend from and to

A

from left side of LV2 to the right sacroiliac joint

68
Q

What structures does the mesentery proper cross over

A

duodenum, aorta, IVC, ureter, psoas major, right gonadal vv

69
Q

describe ways the jejunum is different than the ileum

A

thicker wall of muscles and wider diameter
more plica circulares
increased vascularity and deeper red coloration
less mesenteric fat
few peyers patches (lymph)

70
Q

What a supplies the jejunoileum and name branches as well

A

Superior mesenteric a, jejunal ileal and ileocolic branches that form arterial arcades and vasa recta

71
Q

Where do the veins of jejuneileum drain to

A

the hepatic portal v

72
Q

What could result from a loss of blood supply to part of the bowel

A

paralytic ileus(obstructed intestine)

73
Q

describe the path of lymphatic drainage of the jejune ileum

A

juxta-intestinal nodes–>mesenteric nodes–>superior mesenteric nodes

74
Q

What is the function of the large intestine

A

absorption of water and formation of storage of fecal material

75
Q

what are the separate structures that make up the large intestine

A

cecum, appendix, ascending colon, transverse colon, descending colon, sigmoid colon, rectum and anal canal

76
Q

what are the external features of the large intestine

A

larger diameter
tenia coli
haustra
omental appendages

77
Q

what are the internal features of the cecum through rectosigmoidal junction

A

plica semilunares

the mucosa is devoid of villi

78
Q

are the cecum and appendix peritonealized or retroperitoneal

A

peritonealized

79
Q

What prevents reflux from cecum to ileum

A

there is no sphincter but contraction of terminal ileum prevents reflux

80
Q

what is the most common position of the appendix

A

retrocecum

81
Q

what dermatome is the reffered pain for apendicitis

A

T10

82
Q

Infection of appendix will cause pain to radiate where on the body

A

sharp pain in RLQ

83
Q

What a supplies the cecum

A

Ileocolic branch of superior mesenteric artery

anterior and posterior cecal branches and the appendicular branch

84
Q

where does the vein drain to from the cecum

A

the hepatic portal vein

85
Q

describe path of lymph from cecum

A

ileocolic lymph nodes–> superior mesenteric lymph

86
Q

what is the hepatic flexure? splenic flexure?

A

hepatic is the right colic flexure

and splenic is the left colic flexure

87
Q

What ligament attaches to the splenic or left colic flexure

A

the phrenicocolic ligament

88
Q

Where is the right paracolic gutter and where is the left?

A

right is between the ascending colon and body wall

left is between descending colon and body wall

89
Q

Which part of the colon is the peritonealized

A

the transverse and sigmoid

90
Q

What type of peritonealization is the ascending and descending colons

A

secondarily retroperitonealized

91
Q

why is fusion fascia significant clinically

A

provides a plane of separation to remove colon from posterior body wall without damaging any vasculature

92
Q

What are the borders of the ascending colon

A

anterior is the SI and greater omentum
posterior is the wall and kidney
medial is the SI
lateral is transversus abdominis

93
Q

what are the borders of the transverse colon

A

anterior- anterior body wall
posterior- transverse mesocolon
superior- liver, gall bladder, stomach, spleen
inferior- SI

94
Q

what are the borders of the descending colon

A

anterior- SI
posterior- posterior wall
medial- SI
lateral- transversus abdominis

95
Q

What is the general blood supply formation of the colon

A

marginal a is formed from SMA and IMA

96
Q

What branches come off SMA? IMA?

A

SMA: ileocolic, right colic and middle
IMA: left colic and sigmoidal

97
Q

describe the lymph drainage of colon

A

right paracolic nodes-> right middle colic nodes->superior mesenterc nodes
left paracolic nodes->left colic nodes -> inferior mesenteric lymph nodes

98
Q

At what level is the rectosigmoidal junction

A

SV3

99
Q

What happens to the teniae coli at the rectum

A

spread out as continuous layer of longitudinal muscle

100
Q

Are there epiploic fatty appendages at the rectum

A

no

101
Q

what is the anorectal flexure and the sacral flexure

A

sacral- follows curve of sacrum

anorectal flexure- posteroinferior angulation as rectum passes through pelvic diaphragm

102
Q

What are the chracterisitics of the internal part of the rectum

A

transverse rectal folds (2 left and 1 right) that are mucosa and submucosa and muscle
Ampulla which is the dilated portion of termial rectum that maintains fecal continence

103
Q

what a supply rectum and what vv drain it

A

superior and middle rectal aa

drain via superior and middle rectal vv

104
Q

describe the lymph drainage of rectum

A

pararectal nodes drain superior recta a to inferior mesenteric nodes
while othere pararectal nodes drain along middle rectal a to the internal iliac nodes

105
Q

What innervation goes to the internal anal sphincter

A

SANs L1L2 to cause constriction

PANS S2-S4 for relaxation

106
Q

Where does the internal anal sphincter surround? external?

A

internal is around superior 2/3 anal canal

external is inferior 2/3 anal canal

107
Q

What innervates the external anal sphincter

A

voluntary inn by inferior rectal n

108
Q

What are anal columns

A

vertical folds of mucosa containing superior rectal vessels

109
Q

what are anal sinuses

A

small recesses at base of anal columns

110
Q

what are anal valves

A

folds of epithelium connecting caudal ends of rectal colum

111
Q

what forms the pectinate line

A

anal valves

112
Q

what changes across the border of the pectinate line

A

venous drainage
lymph drainage
nerves
epithelial lining

113
Q

describe the change in venous supply across the pectinate line

A

superior drain to superior and middle rectal vv

inferior drains to inferior rectal vv

114
Q

describe the change in lymph drainage across pectinate line

A

superior- internal iliac lymph

inferior- superficial inguinal lymph

115
Q

describe the nerve supply across pectinate line

A

superior is autonomic

inferior is somatic

116
Q

describe the change in epithelium across pectinate line

A

superior is typical GI lining

inferior is stratified squamous

117
Q

describe arterial supply across pectinate line

A

superior rectal a is superior
inferior rectal a is inferior
middle rectal a forms anastomoses between superior and inferior

118
Q

where does the external rectal venous plexus drain to

A

inferior rectal v

119
Q

what causes internal hemorrhoids

A

dilated vv of internal rectal venous plexus
painless
bright red bleeding
could signify portal hypertension

120
Q

What are external hemorrhoids

A

dilated veins of external rectal venous plexus (inferior rectal vv)

121
Q

what are risk factors for external hemorrhoids

A

pregnancy, constipation, increased intra-abdominal pressure

painful

GI I (14 decks)

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