anatomy

Question 1

perforation to posterior stomach wall (i.e. gastric ulcer)

Answer 1

spilling of gastric contents into lesser sac
peritonitis
pancreatitis

(pancreas is in close proximity to the posterior stomach)

Question 2

muscular layers of the stomach

Answer 2

1. inner oblique
2. middle circular
3. outer longitudinal

x3 layers compared to the x2 of small intestine and esophagus

Question 3

is the duodenum intra or retro?

Answer 3

1st (superior) portion is intra - within the hepatoduodenal ligament

rest is retro

Question 4

plicae

Answer 4

semilunar folds found in the lining of the small intestine
facilitate absorption
(NOT found in the duodenal cap)

Question 5

duodenal cap

Answer 5

first part of the duodenum
slightly dilated
no plicae

Question 6

where does the foregut transform into the midgut?

Answer 6

at the major duodenal papilla/papilla of Vater (exit for hepatopancreatic duct/Duct of Wirsung)
where the common pancreatic and bile ducts drain
surrounded by the sphincter of Oddi

Question 7

duodenum innervation

Answer 7

since it’s both foregut and midgut

celiac and superior mesenteric

Question 8

where do the superior mesenteric vessels run?

Answer 8

come off of the aorta underneath the pancreas and run anterior to the 3rd part (horizontal) duodenum

Question 9

structural significance of the 4th part of duodenum

Answer 9

anchored to the diaphragm by the ligament of Treitz

Question 10

jejunum vs ileum

Answer 10

jejunum
-plicae (folds) - more absorption
-longer vasa recta
-longer arcades

ileum
-no plicae
-shorter vasa recta
-shorter arcades
-Peyer’s patches (lymphatic tissue)

Question 11

arterial anastomosis of the duodenum

Answer 11

superior pancreaticduodenal artery (from gastroduodenal –> common hepatic)

AND

inferior pancreaticduodenal artery (branch of superior mesenteric)

b/c remember: duodenum is both foregut and midgut - blood supply is split

Question 12

x2 flexures of the colon

Answer 12

R colic flexure AKA heptatic flexure
L colic flexure AKA splenic flexure

Question 13

omental appendages

Answer 13

pieces of the omentum that hang off of the colon

Question 14

what veins drain into the hepatic portal vein?

Answer 14

splenic vein
superior mesenteric vein
inferior mesenteric vein (superior rectal vein)

Question 15

explain GI lymph drainage:

Answer 15

follows arterial distribution

e.g. all foregut lymph drains into celiac group