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GI > Anatomy Review > Flashcards

Anatomy Review Flashcards

1
Q

What vertebral levels does the esophagus span?

A

CVI to TXI.

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2
Q

At what level does the esophagus pass through the diaphragm?

A

TX.

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3
Q

What four places can the esophagus be compressed?

A

1) Junction of esophagus and pharynx in the neck
2) Arch of the aorta
3) Left main bronchus
4) Esophageal hiatus in diaphragm

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4
Q

Arterial Supply of the Esophagus

A

Esophageal arteries arising from the aorta, bronchial arteries, left inferior phraneic, and left gastric artery

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5
Q

Venous Drainage of Esophagus

A

Small vessels returning to the azygos vein, hemiazygos vein, and esophageal branches to the left gastric vein.

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6
Q

Lymphatic Drainage of the Esophagus

A

Posterior mediastinal and left gastric nodes

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7
Q

Innervation of the Esophagus

A

Muscle - branchial efferents of vagus nerves
Smooth muscle - parasympathetic efferents from vagus nerves; synapse in myenteric and submucosal plexi
Sensory (visceral) efferents from vagus

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8
Q

What do the ventral and dorsal vagal trunks correspond to?

A

The left and right vagus nerves, respectively.

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9
Q

Esophageal Cancer

A

Tumor location determines where cancer will spread
Spreads quickly to lymphatics, draining to lymph nodes in the neck and around the celiac artery
Dx by barium swallow/endoscopy

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10
Q

Esophageal Rupture

A

Fatal if untreated.
Usually occurs in lower 1/3 with a rise in interluminal pressure caused by vomiting secondary to failure of cricopharyngeal muscle to relax
Tears typically occur on the left and are associated with a large left pleural effusion that contains gastric contents
Tx: surgery

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11
Q

Innervation of the Parietal Peritoneum

A

Somatic afferents of associated spinal nerves; sensitive to well-localized pain

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12
Q

Innervation of the Visceral Peritoneum

A

Visceral afferents that accompany autonomic nerves back to CNS; activation can result in poorly localized, referred pain.

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13
Q

Boundaries of the Omental (Epiploic) Foramen

A

Portal Triad (Hepatic artery, bile duct, portal vein) anteriorly and IVC posteriorly.

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14
Q

Effects of Large Surface Area of the Peritoneum

A

1) Facilitates the spread of disease to bowels

2) Can be used for certain treatments

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15
Q

Ventriculoperitoneal Shunts

A

Used to treat obstructive hydrocephalus (blockage of lateral, 3rd, or 4th ventricles and increased ICP).
Placement of a fine bone catheter through the skull into the ventricles and placing the extracranial part of the tube beneath the scalp and skin of the chest wall and then passing it into the parietal cavity. CSF drains into the parietal cavity, where it can be absorbed.

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16
Q

Dialysis

A

Tx of renal failure

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17
Q

Peritoneal Dialysis

A

Peritoneum is used as a dialysis membrane for fluid and electrolyte exchange.
A small tube is inserted through the abdominal wall and dialysis fluid is injected into the peritoneal cavity. Fluid is drained once dialysis is complete.

18
Q

Peritoneal Spread of Disease

A

Malignancies and infections can spread throughout the abdomen.
However, intra-abdominal infection tends to remain below the diaphragm.

19
Q

Perforated Bowel

A

Can lead to release of gas into peritoneal cavity.

20
Q

Greater Omentum

A

“Policeman of the abdomen” - migrates to any area of inflammation to wall it off. Adheres to diseased organs.
Ovarian carcinoma can spread via the greater omentum.

21
Q

Four Anatomic Divisions of the Stomach

A

1) Cardia
2) Fundus (above cardiac oriface)
3) Body
4) Pyloris

22
Q

Greater Curvature

A

Attachment of the gastrosplenic ligament and greater omentum

23
Q

Lesser Curvature

A

Attachment point of lesser omentum

24
Q

Arterial Supply of the Stomach

A 
Left gastric from celiac trunk
R. gastric from hepatic artery
R. gastro-omental from the gastroduodenal
L. gastro-omental from the splenic
Posterior gastric from the splenic
25
Q

Venous Drainage of the Stomach

A

R. & L. gastric veins drain the lesser curvature
Short gastric veins to the splenic vein drain the fundus and l. greater curvature
L. gastro-omental drains the greater curvature

26
Q

Lymphatic Drainage of the Stomach

A

Celiac nodes

27
Q

Where do most duodenal ulcers occur?

A

The superior part (duodenal cap)

28
Q

Descending Duodenum

A

Crossed by the transverse colon
R. kidney is posterior to it
Contains major duodenal papilla (common entrance of the bile/pancreatic ducts)

29
Q

3rd part of duodenum

A

Anterior to IVC, aorta, and vertebral column

30
Q

4th Part of Duodenum

A

Can pass upward on aorta

31
Q

Arterial Supply of Duodenum

A

Gastroduodenal (From hepatic)
Supraduodenal artery from the gastroduodenal
duodenal branches from the posterior superior pancreaticoduodenal artery (from gastroduodenal)
Duodenal branches from the anterior inferior pancreaticoduodenal (SMA)

32
Q

Important Takehome on Duodenal Blood Supply

A

DUAL BLOOD SUPPLY from Celiac and SMA; good for surgeries if one needs clamped off.

33
Q

Venous drainage of Duodenum

A

SMA

34
Q

Lymphatic Drainage Duodenum

A

Celiac/SM nodes

35
Q

Blood Supply of Jejunum/Ileum

A

Superior Mesenteric Artery gives off jejunal/ilial branches

Lymph drains here too.

36
Q

Duodenal Ulceration

A 
Occur anteriorly (can affect periotneum and show subdiaphragmatic gas) or posteriorly (gastroduodenal or posterior superior pancreaticoduodenal artery).
Can be caused by Heliobacter pylori.
Tx:H2-receptor antagonists to reduce H+ production; may need surgical intervention
37
Q

Meckel’s Diverticulum

A

Remnant of the vitelline duct which extends into the umbilical cord of an embryo.
Sx: ulceration and bleeding
2% of the population, 2 inches, 2x more likely in boys, 2 years old, 2 tissue types (Stomach and pancreas).

38
Q

Carcinoma of the Stomach

A

Chronic gastric inflammation, pernicious anemia, and polyps predispose someone to it.
Sx: vague epigastric pain, early fullness with eating, obstruction, bleeding.
Dx: barium and radiology or endoscopy; US for spread to liver
Tx: surgery

39
Q

Blood Supply to Large Intestine

A

Ascending and 1st 2/3 of transverse: SMA branches (R. colic, middle colic, ileocolic)
Last 1/3 of transverse and descending: IMA (left colic, sigmoid)

40
Q

Lymphatic Drainage of Large Intestine

A

Ascending and 1st 2/3 of transverse - SMA nodes

Rest - IMA

41
Q

McBurney’s Point

A

Line between ASIS and umbilicus; indicative of appendictis

42
Q

Appendicitis

A

An abdominal emergency. Occurs when the appendix is obstructed by enlarged lymph nodes; bacteria proliferate and invade the appendix wall.
Sx: tenderness in R. groin (pain at McBurney’s), fever, nausea, vomiting
Tx: appendectomy

GI (6 decks)

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