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GI > Anatomy of Bleeding in the GI Tract > Flashcards

Anatomy of Bleeding in the GI Tract Flashcards

1
Q

large intestine components

A

colon
rectum
anal canal
anus

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2
Q

colon components

A 
caecum 
appendix 
ascending colon 
transverse colon
descending colon 
sigmoid colon
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3
Q

functions of the large intestine

A

defence- commensal bacteria
absorption- H20 and electrolytes
excretion- of formed stool

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4
Q

paracolic gutters locations

A

left and right

between lateral edge of ascending and descending colon and abdominal wall

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5
Q

what are the paracolic gutters part of?

A

peritoneal cavity

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6
Q

importance of parabolic gutters

A

potential sites for pus collection

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7
Q

distinguishing features of colon

A

omental appendices
tenure coli
haustra

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8
Q

omental appendices

A

small, fatty projections

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9
Q

teniae coli

A

3 distinct longitudinal bands of thickened smooth muscle, running from caecum to distal end of sigmoid colon
come together at the appendix

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10
Q

haustra

A

formed by tonic contraction of the teniae coli

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11
Q

caecum and appendix location

A

both lie in the right iliac fossa but location of the appendix is variable (most often retrocaecal)

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12
Q

what does the variation of the position of the appendix account for?

A

the different ways in which patients can present with appendicitis

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13
Q

where is the appendiceal orifice?

A

on posteromedial wall of caecum

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14
Q

what does the appendiceal orifice correspond to?

A

McBurney’s point (1/3 of the way between ASIS to umbilicus)

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15
Q

where does the sigmoid colon lie?

A

in the left iliac fossa

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16
Q

sigmoid colon

A

has a long mesentery which gives it a considerable degree of movement but also means it is at risk of twisting around itself

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17
Q

sigmoid volvulus

A

when the sigmoid colon twists round on itself resulting in bile obstruction
bowel at risk of infarction if left untreated

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18
Q

location of abdominal aorta

A

midline, retroperitoneal structure

lies anterior to vertebral bodies and to left of IVC

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19
Q

3 midline branches of abdominal aorta

A

celiac trunk
superior mesenteric artery
inferior mesenteric artery

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20
Q

what supplies the foregut organs?

A

celiac trunk

21
Q

what supplies the midgut organs?

A

superior mesenteric artery

22
Q

what supplies the inferior mesenteric artery?

A

hindgut organs

23
Q

what do the lateral branches of the abdominal aorta supply?

A 
kidneys/ adrenal glands 
gonads (testes/ovaries) 
body wall (posterolateral)
24
Q

what does the abdominal aorta bifurcate into?

A

common iliacs

25
Q

what do the common iliacs further bifurcate into?

A

internal and external iliacs

26
Q

branches of the superior mesenteric artery

A 
appendicular 
ileocolic branches 
right colic artery 
middle colic artery 
inferior pancreaticoduodenal
27
Q

jejunal arteries

A

longer vasa rectae

larger and fewer arcades

28
Q

ileal arteries

A

shorter vasa rectae

smaller and many arcades

29
Q

branches of the inferior mesenteric artery

A

left colic artery
sigmoid arteries
superior rectal artery

30
Q

marginal artery of Drummond

A

arterial anastomoses between the branches of the SMA and the IMA
depending on the health of these and the speed at which obstruction occurs, these could help prevent intestinal ischaemia by providing an alternative (collateral) route by which blood can travel

31
Q

blood supply to rectum and anal canal

A 
superior rectal artery, a branch of IMA 
internal iliac artery
middle rectal artery 
inferior rectal artery 
there is an anastomoses between these vessels
32
Q

where does the hindgut extend to?

A

the proximal half of the anal canal (the pectinate line)

33
Q

hepatic portal venous system

A

drains venous blood from absorptive parts of the GI tract and associated organs to the liver for ‘cleaning’

34
Q

systemic venous system

A

drains venous blood from all other organs and tissues into the superior or inferior vena cava

35
Q

inferior vena cava (retroperitoneal)

A

drains cleaned blood from the hepatic veins into the right atrium

36
Q

hepatic portal vein

A

drains blood from the foregut, midgut and hindgut structures to the liver for first pass metabolism

37
Q

splenic vein

A

drains blood from foregut structures to hepatic portal vein

38
Q

superior mesenteric vein

A

drains blood from midgut structures to hepatic portal vein

39
Q

inferior mesenteric vein

A

drains blood from hindgut structures to splenic vein

40
Q

portal-systemic anastamosis

A

at these sites, the presence of small collateral veins means blood can flow both ways
no valves
normally little blood flow

41
Q

three sites of portal-systemic anastomoses

A

skin around umbilicus
distal end of oesophagus
rectum/ anal canal

42
Q

skin around umbilicus

A

connection between para-umbilical veins and small epigastric veins
para-umbilical veins to hepatic portal vein along the round ligament of liver
epigastric veins drain to caval system

43
Q

distal end of oesophagus

A

inferior part drains to the hepatic portal vein

superior part drains to the azygous vein

44
Q

rectum/anal canal

A

rectum and superior anal canal drains to inferior mesenteric vein
inferior part of GI tract drains to the internal iliac veins

45
Q

portal hypertension

A

elevation of blood pressure in the portal system

46
Q

what can cause portal hypertension?

A 
liver pathology (cirrhosis) 
tumour compressing HPV
47
Q

what does portal hypertension lead to?

A

reversal of blood flow

larger volume of blood flow to these anastomotic areas causes them to become varicosed

48
Q

clinical presentation of portal hypertension

A

oesophageal varices
caput medusae
rectal varices

49
Q

causes of haematemesis

A

bleeding from oesophageal varices

peptic ulcer in wall of stomach or duodenum

GI (9 decks)

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