Anatomy Flashcards
The whole of the pancreas is a retroperitoneal structure, T/F?
False. Pancreas except for the tail.
The tail is an intraperitoneal structure.
What part of the Duodenum is intraperitoneal?
The 1st part.
Falciform ligament contains ___ & ___
Ligamentum teres hepatis (a derivative of fetal umbilical vein)
Patent paraumbilical veins
The Portal triad is contained in what ligament?
Hepatoduodenal
Constituent of the Portal triad
(From Left to right)
Common bile duct
Portal vein
Proper hepatic artery
Derivatives of Ventral mesentery are ___ & ___
Falciform ligament and Lesser omentum
The Pringle maneuver involves
Compression of the hepatoduodenal ligament manually or with a vascular clamp in the omental foramen to control bleeding from hepatic inflow source
The pancreatic tail is contained in which ligament?
Splenorenal ligament
Ulcers are in the mucosa only, T/F?
False.
Erosions can extend into the submucosa, inner or outer muscular layer, T/F?
False.
Basal electric rhythm(slow waves) originates in ____ cells?
Interstitial cells of Cajal
The frequency of basal electric rhythm is greatest in what part of the GIT?
Duodenum
What third of the esophagus has striated muscles in it’s histology
Upper 1/3
What epithelium lines the esophagus?
Nonkeratinized stratified squamous epithelium
Defensins, lysozyme, and TNF are secreted by which cells in the duodenum
Paneth cells
There is the presence of villi in the colon histology, T/F?
False.
No villi
Brunner glands are found where?
In the submucosa of the duodenum
Bifurcation of the abdominal aorta is at which Vertebra?
L4
Watershed regions of the colon (which are susceptible to colonic ischemia) are___ & ___
Splenic flexure
Rectosigmoid junction
What is Nutcracker syndrome
Compression of the left renal vein between the SMA and aorta.
Clinical presentations of Nutcracker syndrome are _____, _____, & ____
Abdominal(flank) pain
Gross hematuria (from rupture of thin-walled varicosities)
Left-sided varicocele
Superior mesenteric artery syndrome is characterized by
- intermittent intestinal obstruction symptoms
- primarily postprandial pain
- when the SMA and the aorta compress the transverse(3rd) portion of the duodenum
Superior mesenteric artery syndrome typically occurs in conditions associated with ______
Diminished mesenteric fat (e.g., low body weight/ malnutrition)
Inferior Mesenteric artery branches off the aorta at what vertebra level?
L3
Branches of the Celiac trunk are
Hint: 3
Common hepatic artery
Splenic artery
Left gastric artery
Treatment of Portal hypertension is via
Transjugular Intrahepatic Portosystemic Shunt (TIPS) between the portal vein and hepatic vein - this relieves portal hypertension by shunting blood to the systemic circulation, bypassing the liver
Can TIPS precipitate hepatic encephalopathy?
Yes, due to a decrease in the clearance of ammonia from shunting
Mention the sites of Portosystemic anastomoses and their clinical sign when there is a portal hypertension
- Esophagus - Esophageal varices
- Umbilicus - Caput medusae
- Rectum - Anorectal varies
Inferior mesenteric vein drains into ____
Splenic vein
Internal hemorrhoids are painful, T/F?
False.
Painless b/c they receive visceral innervation
Lymphatic drainage of the rectum above the pectinate line is to ___ Lymph node
Iliac LN
External hemorrhoids are painful, T/F?
True.
B/c they receive somatic innervation via the Pudendal nerve [S2-S4]
Lymphatic drainage of the rectum below the pectinate line is to ___ lymph node
Superficial inguinal LN
Tear in the anoderm below the pectinate line is ___
Anal fissure
The apical surface of the hepatocytes faces the ____ while the basolateral surface faces the _____
Bile canaliculi
Sinusoids
Which cells in the liver are responsible for hepatic fibrosis?
Hepatic stellate (Ito) cells
Role of Hepatic stellate (Ito) cells [in the space of Disse] when;
- quiescent
- activated
When quiescent- store Vitamin A
When activated - produce extracellular matrix
Which zone of the functional unit of the liver (hexagonal lobule) is affected first by Viral hepatitis?
Zone I (Periportal zone)
Which zone of the functional unit of the liver (hexagonal lobule) is affected first by ischemia (least oxygenated)
Zone III ( Pericentral or Centrilobular zone)
Which zone of the functional unit of the liver (hexagonal lobule) is most resistant to circulatory compromise?
Zone I (Periportal zone)
Means best oxygenated.
Which zone of the functional unit of the liver (hexagonal lobule) is the site for alcoholic hepatitis?
Zone III (Pericentral or Centrilobular zone)
Which zone of the functional unit of the liver (hexagonal lobule) is affected by Yellow fever?
Zone II (Intermediate zone)
High concentration of Cytochrome P-450 is seen in which zone of the functional unit of the liver (hexagonal lobule)
Zone III
Which zone of the functional unit of the liver (hexagonal lobule) is most sensitive to metabolic toxins (e.g., ethanol, acetaminophen, CCl4, halothane, rifampin)?
Zone III
Which zone of the functional unit of the liver (hexagonal lobule) is affected by ingested toxins (e.g., cocaine)?
Zone I (Periportal zone)
An enlarged gallbladder with painless jaundice being positive is what sign that can be elicited during P/E?
Courvoisier sign
Courvoisier sign is positive in what condition?
Obstruction of the common bile duct by tumors that arise in the head of the pancreas
Double duct sign is seen in what condition?
Hall stone blocking the confluence of the common bile and pancreatic ducts at the ampulla of Vater causing both cholangitis and pancreatitis, respectively.
Content of the Femoral triangle from lateral to medial
Femoral Nerve, artery, vein
The femoral sheath contains the femoral Nerve, T/F?
False.
The site of protrusion of the indirect hernia is at ____
The Deep (internal) inguinal ring
What is Hernia
Protrusion of peritoneum through an opening, usually at a site of weakness
The Most common type of Hiatal hernia is
Sliding hiatal hernia
The two types of Hiatal hernia
Sliding
Paraesophageal
Which type of hiatal hernia is associated with GERD?
Sliding
Direct inguinal hernia is covered by all 3 layers of spermatic fascia, T/F?
False.
Covered by external operatic fascia.
Indirect inguinal hernia is covered by all 3 layers of operatic fascia, T/F?
True.
The inguinal triangle is also called ______
Boundaries are?
Hesselbach triangle
