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GI- Week 2 > Ach: GI Tract Anatomy and Vessels > Flashcards

Ach: GI Tract Anatomy and Vessels Flashcards

1
Q

What is the cardiac orifice?

A

The location where the stomach receives food mixed w/ saliva (at the T10 level)

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2
Q

What are the structural features of the stomach?

A 
Greater curvature
Lesser curvature
Fundus
Cardia
Body
Pylorus
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3
Q

What does the greater omentum attach to?

A

greater curvature

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4
Q

What does the lesser omentum attach to?

A

lesser curvature

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5
Q

Where is the fundus located in relationship to the esophagus?

A

ABOVE the entry of the esophagus at the LEFT 5th intercostal space

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6
Q

Where is the cardiac sphincter located? What does it do?

A

In the cardiac orifice

Prevents regurgitation of material into the esophagus

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7
Q

What are the components of the pylorus?

A

Pyloric antrum
pyloric canal
pyloric sphincter

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8
Q

What does the pyloric sphincer do and what is it?

A

A think ring of muscle that is normally in tonic contraction that controls how much chyme enters the duodenum

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9
Q

What are rugae?

A

folds of mucosa inside the stomach that increase the SA for absorption

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10
Q

What are acquired hiatal hernias? Who do they commonly affect?

A

Weakening and widening of the esophageal hiatus of the diaphragm. Often in MIDDLE AGED folks.

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11
Q

What is a sliding hiatal hernia?

A

The gastroesophageal region slides into the thorax through a lax esophageal hiatus leading to regurgitation of stomach acid.

**Most common, occurs to 99% of people

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12
Q

What is a paraesophageal hiatal hernia (rolling)?

A

A putch of peritoneum, that often contains the FUNDUS fo the stomach, that extends through the esophageal hiatus ANTERIOR to the esophagus

Pain, nausea, vomitting

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13
Q

Which type of hernia is NOT associated w/ regurgitation of acid?

A

Paraesophageal hiatal hernia

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14
Q

What are the three components of the small intestine?

A

duodenum
jejunum
ileum

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15
Q

How much of the small intestine can you take out and still be compatible w/ life?

A

1/2

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16
Q

What part of the small intestine is INTRAPERITONEAL?

A

FIRST PART of the DUODENUM taht is covered on the anterior and posterior surfaces w/ peritoneum

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17
Q

What suspends the ileum and jejunum from the posterior abdominal wall?

A

Mesentery and other peritoneal organs

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18
Q

What part of the small intestine is C shaped and is molded around the head of the pancreas?

A

Duopdenum

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19
Q

What attaches to the upper and lower border of the omentum?

A

Lesser omentum to UPPER border

Greater omentum to LOWER border

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20
Q

What is the duodenal cap/bulb?

A

Radiological shadowing visible on xray that is a common site for peptic ulcers

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21
Q

What is a peptic ulcer?

A

Erosion of mucous membrane of stomach or duodenum that occurs ONLY in tissues that have contact w/ gastric juices

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22
Q

Where do most common ulcers occur and why is this bad?

A

duodenal cap

Erosion of the wall in this area can perforate the wall and erode the pancreas or gastroduodenal artery leading to a massive hemorrhage

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23
Q

What are the four pats of the duodenum and which ones are retroperitoneal?

A

Second, third and fourth are retroperitoneal, but the last part of the fourth ascending portion is connected to the jejunum

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24
Q

What suspends the fourth part of the duodenum from the right crus of the diaphragm?

A

suspensory ligament

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25
Q

What part of the duodenum recieves the openings of the bile duct and pancreatic duct?

A

second part

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26
Q

Where does the jejunum begin?

A

duodenojejunal flexure

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27
Q

where does the ileum end?

A

ileocecal junction

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28
Q

How does the jejunum differ from the ileum?

A

Jejunum is often EMPTY and often THICKER, redder, more vascular in a live person

circular folds of mucosa are LARGE and well developed in the upper jejunum and gradually disappear by the terminal ileum

FEWER arterial arcades in the mesentery of the jejunum, but more numerous, shorter and complex in the ileum

Areas of the mesentery are fat free

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29
Q

Lymphatic nodules- ileum or jejunum?

A

Ileum AKA peyer’s patches

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30
Q

What are the teniae coli?

A

outer longitudinal muscle fibers that are confined to three parallel bands in the large intestine

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31
Q

What are haustra?

A

sacculations between teniae

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32
Q

what are appendices epiploicae?

A

small sacs of fat covered w/ peritoneum

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33
Q

What structrues are located at the ileocecal junction?

A

cecum
ileocecal valve gaurding the ileocecal orifice

appendix

34
Q

What is the cecum?

A

blind sac covered by peritoneum

Terminal ileum and appendix enter here

35
Q

What is hte appendix?

A

blind ended tube taht is usually retrocecal in position and has a short mesentery

36
Q

What is McBurney’s point?

A

Junction of the lateral and middle thirds of a line joining the ASIS to the umbilicas….

Base of the appendix is usually LATERAL to this point

37
Q

What is appendicitis?

A

inflammation of the appendix

38
Q

What happens when the appendix ruptures?

A

peritonitis results and an appendectomy is necessary

39
Q

What is the ascending colon?

A

cecum–> right colic flexure

40
Q

Where does the ascending colon ascend?

A

retroperitoneally in the RIGHT paracolic groove of the posterior abdominal wall

41
Q

Transverse colon extends from…

A

right and left colic flexures

42
Q

What is the mesentery of the transverse colon?

A

transverse mesocolon is fused to the posetrior surface of the greater omentum and suspends it form the posterior abdominal wall near the pancreas

43
Q

Descending colon extends from…

A

left colic flexure to the brim of the pelvis where is joins the sigmoid colon

44
Q

Where does the descending colon lie?

A

retroperitoneally in the left paracolic groove

45
Q

What is the mesentery of the sigmoid colon?

A

sigmoid mesocolon

sigmoid colon extends to the rectum at S3

46
Q

What is ulcerative colitis?

A

severe inflammation and ulceration of the colon and rectum

47
Q

what is a total colectomy?

A

a treatment for ulcerative colitis

48
Q

What are colostomies?

A

creates an opening between various parts of the colon and the anterior abdominal wall creating an artificial anus

49
Q

What is a diverticulum?

A

Abnormal pouch that forms in the wall of the colon cause dby increased intracolonic pressure pushing against a weak wall.

Most often found in the sigmoid colon.

50
Q

What is diverticulitis?

A

What diverticulum become inflamed

51
Q

Blood supply to the GI tract is returned by veins to the…

A

portal vein

52
Q

The celiac trunk arises from the abdominal aorta (T12) and immediately divides into what three branches?

A
  1. Left gastric (to the lesser curvature of the stomach)
  2. common hepatic (head towards the liver)
  3. Splenic (hilus of the spleen)
53
Q

What are the branches of the left gastric artery?

A

esophageal branches enter the THORAX and anastamose w/ esophagaeal branches from the thoracic aorta

54
Q

What are the branches of the common hepatic artery?

A
  1. Hepatic artery proper:

2. Gastroduodenal artery

55
Q

What arteries branch off the hepatic artery proper?

A 
right gastric (lesser curvature)
left hepatic (left lobe of the liver)
right hepatic (right lobe of liver)
cystic artery (arises from right hepatic to supply the gallbladder)
56
Q

What arteries branch off the gastroduodenal artery?

A

supraduodenal (duodenum)
superior pancreaticoduodenal
right gastro-omental (greater curvature)

57
Q

What are the branches of the splenic artery?

A

pancreatic
short gastric (fundus)
left gastro-omental (lesser curvature)

58
Q

Where does the superior mesenteric artery arise from?

A

abdominal aorta right below the celiac trunk

59
Q

Where is the superior mesenteric artery located?

A

Enters the mesentery of the small bowel between the uncinate process and the body of the pancreas.

The main trunk passes toward the ileocelcecal junction and gives off branches to the small intestine and large bowel.

60
Q

What are the SMA branches to the small intestine?

A

inferior pancreaticuoduodenal arteries
jejunal
ileal

61
Q

What are the SMA branches to the large bowel?

A

ileocolic
right colic
middle colic (transverse mesocolon

62
Q

The inferior mesenteric artery arises from…

A

abomdinal aorta above the bifurcation at L3

63
Q

Where is the IMA located?

A

Arises retroperitoneally and runs down to the left pelvic brim.

64
Q

What does the IMA supply?

A

Gut from the left colic flexure distally to the lower rectum

65
Q

What are the branches of the IMA?

A

left colic artery
sigmoid arteries (2-4 to sigmoid colon)
superior rectal artery (termination of IMA)

66
Q

Which branch of the IMA anastomses w/ the middle colic of the SMA?

A

left colic artery

67
Q

What is the marginal artery?

A

Single arterial trunk that begins at the ileocolic jxn and ends where it anastomoses w/ the superior rectal artery.

68
Q

What forms an anastomosis between the colic arteries (branches of hte SMA and IMA) and runs in the concave margin of hte large intestine?

A

marginal artery

69
Q

Wha tis a portal system?

A

two sets of capillaries through which blood flows between the L ventricle and R atrium

70
Q

What are the components of the hepatic portal system?

A

Short gastric, L gastroepiploic and pancreatic veins>
Splenic veins (drain the foregut)>
pass posterior to the pancreas and receive the inferior mesenteric veins>
joins the superior mesenteric vein>
forms the portal vein

71
Q

Where does the portal vein begin?

A

L2 level anterior to the IVC

72
Q

The portal vein passes between what layers to enter the liver?

A

Layers of the hepatoduodenal ligament

73
Q

What are direct tributaties of the portal vein?

A 
splenic vein
superior mesenteric vein
L and R gasttric vein
cystic vein
paraumbilical vines
74
Q

What happens to the portal vein near the porta hepatis?

A

Portal vein divides into the L and R branches that accompany the hepatic arteries and hepatic ducts

75
Q

What does the ligamentum venosum connect?

A

L portal vein to IVC (remanant of fetal ductus venosus)

76
Q

Where are esophageal varices usually located?

A

In the portal systemic anastomses in tributatries of hte azygos and hemiazygos veins

77
Q

What is caput medusae?

A

engorgement of epigastric veins that produces varicose veins around the umbilicus

78
Q

Where are internal hemorrhoids usually located?

A

superior rectal vein w/ middle and inferior rectal veins

79
Q

What is portal hypertension?

A

An increase in pressure and engorgement of vessels of hte portal venous system resulting from obstruction of the portal circulation.

  • w/in liver= tumor, cirrhosis
  • outside liver= compression of portal vein (tumor)
80
Q

What are the clinical maifestations of portal hypertension?

A
  1. ascites
  2. GI bleeding
  3. splenomegaly (increased pressure enlarges spleen)
  4. caput madusae
81
Q

What is ascites?

A

an increase in P produces fluid in the peritoneal cavity

82
Q

What are the cisterna chyli?

A

receive lymph from the abdomen

GI- Week 2 (11 decks)

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