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Gastrointestinal - step > Anatomy > Flashcards

Anatomy Flashcards

1
Q

please define retroperitoneal structure

A

gi structures and non gi structures that do not have a mesentery ie not in the peritoneum

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2
Q

list the retroperitoneal structures

A 
upper esophagus
duodenum (2-4th)
all but tail of pancreas
kidneys
adrenals
ascending and descending colon
aorta
IVC
ureters
rectum - partially
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3
Q

SAD PUCKER

A 
retroperitoneal sturcutres
S - suprarenals
A - aorta and IVC
D - duodenum (2-4th)
P - all except tail
U - ureters
C - ascending and descending colong
K - kidneys
E - upper esophagus
R - rectum (partially(
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4
Q

what happens when a retroperitoneal structure gets damaged

A

will see bleeding or gas accumulation in the retroperitoneal space

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5
Q

falciform ligament connects what to what?

A

anterior liver to anterio abdominal wall

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6
Q

hepatoduodenal connets what to what?

A

liver to duodenum

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7
Q

gastrohepatic ligament connects what to what?

A

liver to lesser curvature of stomach

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8
Q

gastrocolic ligament connects what to what?

A

greater curvature to transverse colon

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9
Q

gastrosplenic ligament connects what to what?

A

greater curvature to spleen

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10
Q

what two ligaments come off the greater curvature of the stomach

A

gastrocolic

gastrosplenic

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11
Q

what does the splenorenal ligmanet connet?

A

spleen to posterior abdominal wall

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12
Q

what structures are in the falciform ligament

A

ligamentum teres hepatics - fetal umbilical vein

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13
Q

what is the ligamentum teres hepatis

A

remnant of the fetal umbilical vein

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14
Q

what structures are in the hepatoduodenal ligmanet?

A

portal triad: portal vein, hepatic artery, common bile duct

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15
Q

what structures are in the gasrohepatic ligament

A

gastric arteries

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16
Q

what structures are in the gastrocolic ligament

A

gastroepiploic arteries

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17
Q

define: epiploic

A

pertaining to the omentum

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18
Q

what structures are in the gastrosplenic ligament

A

short gastrics, left gastroepiploic vessels

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19
Q

what structures are in the splenorenal ligament

A

splenic artery and vein and tail of pancreas

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20
Q

what is the falciform ligament a derivative of

A

ventral mesentery

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21
Q

what is the pringle maneuver

A

the hepatoduodenal ligament may be compressed between thumb and indx finger by placing in the omental foramen to control bleeding

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22
Q

what is the omental foramen

A

the falciform ligament -

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23
Q

who cares about the omental foramen

A

separates the greater and lesser sacs and may be used in the pringle maneuver to comples the portal triad in bleeding

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24
Q

what separates the greater and lesser sac on the right

A

gastroheparic ligament

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25
Q

what can be cut in surgery in order to access the lesser sav

A

the gastrohepatic ligament

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26
Q

what is part of the greater omentum

A

the gastrocolic ligament

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27
Q

what esprates the greater and lesser sac on the left

A

the gastrosplenic ligament

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28
Q

please list the borders of the greater and lesse sac

A

the omental foramen/hepatoduodenal ligament
gastrosplenic on left
gastrohepatic on right

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29
Q

see histology section for abdominal aorta branches

A

oopsee

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30
Q

what are the branches of the celiac artery;

A

left gastric
splenic
common hepatic

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31
Q

what vesels supply the stomach

A

left gastric - right gastric - proper hepatic
splenic - short gastrics ( in gastrosplenic ligament) and left gastroepiploic
common hepatic - gastroduodenal - right gastroepiploid - left gastroepiplice - splenic

32
Q

describe how the common hepatic branches

A

celiac trunk - common hepatic - a) proper hepatic b) anterior superior pancreaticoduodenal c) gastroduodenal –> two brances a) posterior superior pancreaticoduodenal and b) right gastroepiploic (in the gastrocolic ligament)

33
Q

where is the weakest anastomoses in the stomachs blood supplt

A

short gastrics ffrom splenic arteries @ fundus

34
Q

where are the stong anastomese in the stomachs blood supply

A

left and right gastrics

right and left gastroepiploics

35
Q

list vessels involved in esophageal varices

A

portal: left gastric
systemic: esophageal

36
Q

list vessels involed in caput medusa

A

portal: paraumbilical
systemic: epigastric veins of anterior abdominal wall

37
Q

list vessels involved in anal varices

A

portal: superior rectal
systemic: inferior and middle rectal

38
Q

who cares about portal/systemic anastomoses

A

portal hypertension – esophageal varices (left gastric and esophageal veins), caput medusa (paraumbilical and epigastrics), anal varices/not internal hemorrhoids (superior rectal with inferior and middle rectal veins)

39
Q

how do you treat portal hypertension

A

transjuular intrahepatic portosystemic shunt TIPS between the portal vein and hepatic vein – relives portal hypertension bu shunting blood to the systemic circulation by passing the lvier

40
Q

what forms the pectinate line

A

where hindgut and ectoderm meet

41
Q

derivs aove pectinate line = ?

A

hindgut

42
Q

derivs below pectinate line =?

A

ectoderm

43
Q

innervation above vrs below pectinate line

A

above - visceral - not painful

below - somatic - painful

44
Q

what diseases are associated with location ABOVE pectinate line

A

internal hemorrhoids - not painful

adenocarcinoma

45
Q

what diseases are associated with locale BELOW the pectinate line?

A

external hemorrhoids - painful
squamous cell carcinoma
anal fissures

46
Q

describe arterial supply above and below pectinate line

A

above: inferior mesenteric –> superior rectal artery
below: internal iliac – internal pudenal – inferior rectal artery

47
Q

describe venous supply above and below pectinate line

A

above: superior rectal vein – inferior mesenteric vein – portal system
below: inferior rectal vein – internal pudendal vein – internal iliac vein – common iliac vein – IVC

48
Q

list innevation permitting pain for external hemmorhoids

A

inferior rectal branch of pudendal nerve; pain if thrombosed

49
Q

list lymphatic drainage for above and below pectinate line

A

above: internal iliac lymph nodes
below: superficial inguinal lymph nodes

50
Q

describe an anal fissure

A

below pectinate line, ectoderm
tear in the anal mucosa below the pectinate line. pain while pooping, blood on the toilet paper, located posteriorly since this area is poorly perfused
Ps!

51
Q

what part of the hepatocyte is apical side

A

near bile

52
Q

what part of hepatocyte is basal side

A

faces sinusoids

53
Q

where is zone one?

A

periportal zone

54
Q

where is zone tow?

A

inbtween portal and central vein

55
Q

where is zone three?

A

pericentral vein/centrilobular

56
Q

where does yellow fever strike?

A

zone two - intermediate

57
Q

where do Hep viruses strike?

A

zone 1; periportal - close to blood supply

58
Q

where do ingested toxins strike? like cocaine

A

zone 1; periporal - close to blood supply

59
Q

where does OH hepatitis occur?

A

zone 3; pericentral vein/centrilobular; near P450 system

60
Q

where does metabolic injury occur in liver?

A

zone 3; pericentral vein/centrilobular; near P450 system

61
Q

what portion of liver is first affected by iscahemia

A

zone 3: pericentral vein/centrilobular; near P450 system

62
Q

list the ducts that come together by the time the common bile duct reaches the duodenum

A

left and right hepatic ducts
cystic duct
main pancreatic duct (from ventral bud) @ ampulla of vader

63
Q

what happens when gallstones reach confluence of the common bile and pancreatic ucts

A

at the ampullan of vater - blocks giving a DOUBLE DUCT SIGN ie cholangitis and pancreatitis

64
Q

what is a double duct sign

A

gall stone at the ampulla of vater blocking the common bile duct and main pancreatic duct – cholangitis and pancreatitis

65
Q

painless jaundice

A

tumor in the head of the pancrease causing obstruction fo common bile duct alone

66
Q

list the structures found in the femoral triangle

A

LATERAL - NAVEL - MEDIAL

lateral - nerve, artery, vein, empty space, lymph - medial

67
Q

borders of the femoral triangle please

A

inguinal ligament - superiorly
sartorisu - laterally
adductor longus - medially

68
Q

what is in the femoral triangle

A

femoral nav

lateral: nerve, artery vein: medial

69
Q

what is the femoral sheath

A

fascial tube 3-4 cm below the infuilnal ligament

70
Q

what is in the femoral sheath

A

femora vein, arter and canal (deep infulinal lymph nodes ) but not the gemoral nerve

71
Q

where are the deep infuinal lymph nodes located?

A

in the femoral sheath

72
Q

what is in the femoral triangle but not the femoral sheath?

A

the femoral nerve. sheath only has femoral artery, vein and deep inguinal lymph nodes.

73
Q

list the layers from external to internal laterally inguinal cnal sstyle

A

inguinal ligament – aponeurosis of external obluiqeu muscle – internal oblique muscel – transversu sabdominis muscle – transversalis fascia – extrapeironeal tissue - vessels and ligaments – parietal pertoneum

74
Q

what makes up the conjoined tendon

A

transversalis muscle and internal oblique come together near midline and this is fascia that covers it

75
Q

list the layers of the spermatic cord from external to internal

A

external spermatic fascia/external oblique
cremasteric muscle and fascia/internal oblique
internal spermatic fascia/transversalis fascia

76
Q

what si the medial umbilical ligament from

A

umbilical arter

77
Q

what is the median umbilical ligament from

A

allantois/urachus

Gastrointestinal - step (10 decks)

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