Anatomy of the GI Tract

Question 1

What’s the mnemonic for retroperitoneal structures?

Answer 1

SAD PUCKER

Question 2

What does SAD PUCKER stand for?

Answer 2

Suprarenal (adrenal glands)
Aorta and IVC
Duodenum (2nd-4th parts)
Pancreas (except tail)
Ureters
Colon (except transverse)
Kidneys
Esophagus (thoracic portion)
Rectum (partially)

Question 3

What are the 3 main anterior-pointing branches of the abdominal aorta?

Answer 3

1. Celiac
2. SMA
3. IMA

Question 4

What level is the celiac artery?

Answer 4

T12

Question 5

What level is the SMA?

Answer 5

L1

Question 6

What level is the IMA?

Answer 6

L3

Question 7

What 3 arteries branch out laterally at T12?

Answer 7

1. Inferior phrenic
2. Superior suprarenal
3. Middle suprarenal

Question 8

What 3 arteries branch out at the level of L1?

Answer 8

1. Inferior suprarenal
2. Renal
3. Gonadal

Question 9

Where does the abdominal aorta bifurcate into the R&L common iliacs?

Answer 9

L4 “Bifourcation”

Question 10

What are the 3 branches of the celiac trunk?

Answer 10

1. Hepatic
2. Splenic
3. L gastric

Question 11

What can posterior duodenal ulcers do that is dangerous?

Answer 11

Penetrate the gastroduodenal artery, causing hemorrhage

Question 12

What can anterior duodenal ulcers do that is dangerous?

Answer 12

Perforate into the anterior abdominal cavity, leading to pneumoperitoneum

Question 13

What’s the definition of a hernia?

Answer 13

A protrusion of peritoneum through an opening, usually at a site of weakness

Question 14

What are two complications of hernias?

Answer 14

1. Incarceration (not reducible back in)

2. Strangulation

Question 15

What’s a sliding hiatal hernia?

Answer 15

The gastroesophageal junction is displaced upward “hourglass stomach”

Question 16

What’s a paraesophageal hernia?

Answer 16

Fundus protrudes into the thorax

Question 17

What’s the path of an indirect inguinal hernia?

Answer 17

• Internal (deep) ring lateral to inferior epigastric vessels
• External (superficial) ring
• Into the scrotum

Question 18

Which type of hernia is often in INfants owing to failure of processus vaginalis to close?

Answer 18

INdirect

Question 19

What’s the path of a direct inguinal hernia?

Answer 19

• Hesselbach triangle
• Parietal peritoneum medial to inferior epigastric vessels but lateral to the rectus abdominus
• External (superficial) ring ONLY

Question 20

What fascia is usually weak in older men, leading to direct inguinal hernias?

Answer 20

Transversalis fascia

Question 21

What 3 things make up Hesselbach’s triangle?

Answer 21

1. Inferior epigastric vessels
2. Lateral border of rectus abdominus
3. Inguinal ligament

Question 22

What are the 4 parts of the stomach?

Answer 22

1. Cardia
2. Fundus
3. Body
4. Antrum

Question 23

Where is the pyloric sphincter?

Answer 23

Between the stomach and duodenum

Question 24

Where are carbs absorbed?

Answer 24

Stomach

Question 25

Where is iron absorbed?

Answer 25

Duodenum "Iron dude"

Question 26

Where is folate absorbed?

Answer 26

Entire small intestine (duodenum, jejunum, ileum) "small bowl makes a fool"

Question 27

Where is B12 absorbed?

Answer 27

Terminal ileum

Question 28

What 2 structures form the common bile duct?

Answer 28

1. Cystic duct | 2. Common hepatic duct

Question 29

What other structure joins the common bile duct before entering the duodenum?

Answer 29

The pancreatic duct

Question 30

What ampulla does the common bile duct enter the duodenum through?

Answer 30

The ampulla of Vater

Question 31

What sphincter surrounds the ampulla of Vater?

Answer 31

The sphincter of Oddi

Question 32

What are the 4 anatomical parts of the gallbladder?

Answer 32

1. Fundus 2. Body 3. Infundibulum 4. Neck

Question 33

Which artery supplies the gallbladder?

Answer 33

Cystic artery

Question 34

What is the cystic artery a branch of?

Answer 34

The R hepatic artery

Question 35

What hormone coordinates release of bile and gallbladder contraction + relaxation of sphincter of Oddi?

Answer 35

CCK

Question 36

What is cholangitis?

Answer 36

Ascending infection of the bile ducts

Question 37

What's the Charcot triad of cholangitis?

Answer 37

1. Fever 2. Jaundice 3. RUQ pain