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GI > anatomy of bleeding in the GI tract and abdominal vasculature > Flashcards

anatomy of bleeding in the GI tract and abdominal vasculature Flashcards

1
Q

what makes up the large intestine ?

A

> the colon - caecum, ascending, hepatic flexure, transverse, splenic flexure, descending, sigmoid
the rectum
the anal canal
the anus

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2
Q

what are the function of the large intestine ?

A
  • immune defence(via commensal bacteria)
  • absorption (of water and electrolytes)
  • excretion of formed stool
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3
Q

sigmoid colon anatomical features

A
  • lies in the left iliac fossa
  • has a long mesentery (sigmoid mesocolon) so therefore is highly mobile > making it more at risk of volvulus (twisting around itself resulting in bowel obstruction)
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4
Q

intraperitoneal parts of the colon

A

caecum
appendix
transverse colon
sigmoid colon

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5
Q

retroperitoneal parts of the colon

A

ascending colon

descending

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6
Q

what is the splenic flexure inferior to ?

A

the spleen

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7
Q

what is the hepatic flexure inferior to ?

A

the liver

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8
Q

anatomical features of the paracolic gutters

A
  • there are two paracolic gutters
  • they can be found at the lateral edge of ascending and descending colon and abdominal wall
  • they are part of the greater sac of peritoneal cavity
  • they are potential sites for pus collection
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9
Q

what are the taeniae coli ?

A

3 distinct longitudinal bands of thickened smooth muscle

> haustra are formed by tonic contraction of the taeniae coli

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10
Q

anatomical features of the caecum and appendix

A
  • both lie in the right iliac fossa
  • appendix is often retrocaecal
  • the appendiceal orifice lies on the posteromedial wall of the caecum - corresponds to McBurney’s point (anterior abdominal wall, 1/3 between ASIS to umbilicus)
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11
Q

what are the three midline branches that break off the abdominal aorta and what do they supply ?

A
  • celiac trunk (foregut organs)
  • SMA (midgut organs)
  • IMA (hindgut organs)
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12
Q

what do the lateral branches of the abdominal aorta supply ?

A

kidneys, adrenal glands, gonads, body wall

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13
Q

what does the abdominal aorta bifurcate into ?

A

common iliac arteries

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14
Q

what parts of the colon does the SMA supply ?

A

MIDGUT ORGANS

appendicular,
ileocolic,
right colic,
middle colic,
inferior pancreaticoduodenal,
and the SMA also contains the jejunal and ileal arteries
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15
Q

what does the IMA supply ?

A

HINDGUT ORGANS

left colic,
sigmoid colic,
superior rectal

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16
Q

what is the Drummond artery ?

A

a marginal artery that is an arterial anastomoses between the branches of the SMA and IMA

17
Q

what supplies the rectum and the anal canal ?

A
  • IMA for organs above the pectinate line

- internal iliac artery supplies the rest

18
Q

how might haematemesis occur ?

A

> peptic ulcer of the stomach or duodenum erodes through the mucosa and so it starts to fill with blood

or

> bleeding from oesophageal varices due to abnormal dilated veins

19
Q

what are the two main venous systems of the body ?

A

hepatic portal venous

and

systemic venous system

20
Q

what does the hepatic portal venous system drain do ?

A

drains venous blood from absorptive parts of the GI tract and associated organs to the liver

21
Q

what does the systemic venous system drain do ?

A

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

22
Q

what are the venous systems of the GI tract ?

A

inferior vena cava, hepatic portal vein, splenic vein, SMV and IMV

23
Q

what does the IVC drain ?

A

cleaned blood from the hepatic veins to the RA

24
Q

what does the hepatic portal vein drain ?

A

drains blood form foregut, midgut and handout structures to the liver for first pass metabolism

25
Q

what does the splenic vein drain ?

A

drains blood from foregut structures to hepatic portal vein

26
Q

what does SMV drain ?

A

drains midgut structures to hepatic vein

27
Q

what does IMV drain ?

A

drains hindgut to splenic vein

28
Q

where would you find the portal systemic anastomoses ?

A

> distal end of the oesophagus
rectum / anal canal
skin around the umbilicus

29
Q

how is blood drained from the rectum and anal canal ?

A
  • via the superior rectal vein (to the inferior mesenteric vein), the middle rectal vein and the inferior rectal vein (to the internal iliac vein)
30
Q

how does portal hypertension occur ?

A

when blood is diverted through collateral veins back to the systemic venous system when BP in the portal venous system is raised

31
Q

what are the clinical presentations of portal HPT ?

A

oesophageal varices,

caput medusae, rectal varices (not to be confused with piles_

GI (39 decks)

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