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RC Test 3 > B4.083 - GI Anatomy > Flashcards

B4.083 - GI Anatomy Flashcards

1
Q

what is diverticulosis

A

external evagination of colon cucosa

most common in sigmoid colon

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2
Q

is the large intestive intraperitoneal or retroperitoneal

A

it alternates

cecum - intra

ascending - retro

transverse - intra

descending - retro

sigmoid - intra

rectum - extra

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3
Q

what are the top causes of lower GI bleeding

A

40% diverticuli

21% inflammatory bowel disease

10-15% cacer, coagulopathy, anal disease

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4
Q

what is diastasis recti

A

abdominal separation between the right and left side of the rectus abdominus muscle

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5
Q

mesentery

A

a double layered peritoneium connecting intraperitoneal orgnas with the abdominal wall. Neurovasculature is sandwiched between the two layers

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6
Q

what might be wrong if a patient has RLQ pain

A
  1. appendicytis
  2. cholecystitis
  3. crohns
  4. kidney stones
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7
Q

what organs are in RLQ

A

appendix

cecum

pelvic organs

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8
Q

what are all the parts of the GI tract in order

A

mouth

pharynx

esophagus

stomach

small intestine (duodenum, jejunum, ileum)

large intestine (cecum, asc. colon, trans. colon. desc. colon, sigm. colol, rectum)

anal canal

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9
Q

retroperitoneal organs

A

partially covered by peritoneum

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10
Q

where is the lesser sac

A

behind the stomach

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11
Q

what is pyrosis

A

heart burn

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12
Q

how do the internal oblique muslce fibers run

A

superiorly they run 180 to the external obliques but inferiorly start to run more straight across

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13
Q

what is derived from the midgut

A

3rd and 4th portions of duodenum to distal 1/3 or transverse colon

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14
Q

what are the 2 portions of the lesser omentum

A

hepatogastric ligament - attaches from stomach to liver

hepatoduodena ligament - attaches liver to duodenum

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15
Q

what is the trans-umbilical plane

A

passing through the umbilicus at the level of theintervertebral disc between L3 andL4

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16
Q

what happens in testis migration

A

the testis was located inside the abdominal cavity between parietal peritoneum and transversalis fascia (outside peritoneal cavity; testicles are retroperitoneal) they pass through ingunal canal

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17
Q

what is the peritoneal cavity

A

an empty sac with small amount of fluid ~20 ml

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18
Q

what does segemental dermatome overlap mean

A

if one is not working you may have a parasthesia, hypothesia not anasthesia

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19
Q

where is surgery on the abdomen ususally done through

A

linea alba

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20
Q

upper hypogastric dermatome

A

T11

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21
Q

what is the transpyloric plane

A

extrapolated midway between jugular notch and pubic symphysis

commonly transects the pylorus of the stomch in supine or prone position

pass through L1

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22
Q

the neuromuscular bundle that serves the abdominal region runs where

A

in between transversus abdominus and internal oblique

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23
Q

umbilical dermatome

A

T10

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24
Q

direct hernias are common in what group

A

older men

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25
Q

typical volume of peritoneal fluid

A

20 ml

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26
Q

where does the transveres abdominis run from

A

linea alba to pubic crest

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27
Q

where is the transverse mesocolon mesentery attached to

A

transverse colon

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28
Q

where does the inguinal ligament run from

A

the anterior superior iliac crest to the pubic tubercle

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29
Q

what is mostly in lower right quadrant or hypogastrium and inguinal region

A

ileum

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30
Q

what artery from the stomach is used or bypass

A

gastro-omental

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31
Q

milky peritoneal fluid suggests

A

inflammatory condition

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32
Q

good place to go through for surger

A

linea alba

little blood vessels. few nerves

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33
Q

what is the peritoneum

A

a continuous glistening and slippery transparetn serous membrane that lines th abdominopelvic cavity andivests (wraps around) the abdominopelvic viscera (organs)

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34
Q

What types of hernias are noted

A
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35
Q

peritonitis

A

inflammation and infection of peritoneum

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36
Q

compare and contrast jejunum and ileum

A
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37
Q

what are taeniae coli

A

3 longitudinal muscle bands, not present in appendix and rectum in large intestine

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38
Q

what does the lateral umbilical fold cover

A

bilateral inferior epigastric arteries

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39
Q

pain from appendicitis is where

A

periumbilically, if touches peritoneum then will be localized to mcburneys point

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40
Q

what does cloudy, turbid peritoneal fluid suggest

A

infection

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41
Q

small intestinal pain is referred where because its derived from where

A

periumbilical region

midgut

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42
Q

what is a straddle injury

A

Can cause blood within the superficial perineal space and scarpas fascia on anterior bdominal wall

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43
Q

what does the median umbilical fold cover

A

obliterated urachus

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44
Q

where is the deep ring of inguinal canal

A

on the lateral side of the inferior epigastric artery and vein

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45
Q

where does the rectus abdominus from from and to

A

from ribs 4, 5, 7 to the pubic crest

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46
Q

identify the 3 arrows

A

blue - retroperitoneal

black - mesentery

red - intraperitoneal

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47
Q

what does the appendix do

A

trap for heavy particles that are ingested

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48
Q

during portal hypertension what happesn to venous blood flow from esophagus

A

most venous blood flows through lower esophageal region toward azygos veins causing esophageal varices

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49
Q

what art the parts of the duodenum

A

1st part is called duodenal bulb (L1)

Descending L2

Horizontal L3

Ascending L3-L2

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50
Q

what is the sigmoid mesentery attached to

A

sigmoid colon

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51
Q

how are inguinal hernias diagnosed

A

placing a finger into inguinal ring

tell pt to turn head and cough

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52
Q

what structure does an indirect hernia go through

A

deep inguinal ring

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53
Q

what is a verform appendix

A

a blind intestinal diverticulum off cecum, contains lymphoid tissue

position vary - mostly retrocecal

root at McBurney point

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54
Q

what structure does a direct inguinal hernia go through

A

inguinal triangle

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55
Q

what is appendicitis

A

acute inflammation is common in young people

surgical incision at mcburneys point

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56
Q

middle hypogastric dermatome

A

T12

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57
Q

what are indirect inguinal hernia

A

congenital

recapitulates what the testicles do and migrates down

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58
Q

where do all nerves travel to get to dermatomes

A

neurovascular plane

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59
Q

what is the aponeurosis

A

an extension of the epismysium forms the inguinal ligament

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60
Q

what spacial part of the stomach reffers pain to foregut

A

epigastric

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61
Q

what organs are in the RUQ

A

Right lobe of liver

gall bladder

parts of duodenem

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62
Q

what might be wrong if a patient has LLQ pain

A
  1. diverticulitis
  2. irritable bowel syndrome
  3. lactose intolerance
  4. celiac disase
  5. kidney stones
  6. constipation
  7. crohns, ulcerative colitis
  8. inguinal hernia
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63
Q

what kind of hernia is this

A

indirect inguinal hernia

Note: lateral to inferior epigastric vessels

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64
Q

what is teh arcuate line

A

all 3 aponeuroses go anteriorly to the rectus abdominis at 1/3 distance below umbilicus leaving a crescent line

65
Q

where does the umbilicus usually site

A

In teh L3-L4 junction

66
Q

where is The mesentery attached to

A

small intestine

67
Q

what is the median plane

A

passing through the midline of the body, dividing left and right halves

68
Q

gastric ulcer

A

open lesion on stomach mucosa, associated with infections of H. pylori, ulcer erodes arteries case bleeding and even wall performation

69
Q

is the female peritoneal cavity completely sealed?

A

no, fallopian tube opens up

70
Q

what is ileal (meckels) diverticulum

A

the most common congenital anomaly of gut due to a remnant vitelline duct.

May contain 2 ectopic tissues - stomach mucosa (ulcer) and pancreatic

rule of 2s - 2% of population, 2” long, 2ft proximal from ileocecal junction

71
Q

what is an inguinal hernia

A

80-90% of abdominal hernias

the protrusion of parietal peritoneum and/or abdominal viscera through a normal or abmormal opening from the cavity where they dont belong.

72
Q

what is the line on the abdomen separating right from left side

A

linea alba

73
Q

what might be wrong if a patient has lower abdomen pain

A
  1. aortic aneurysm
  2. colitis
  3. diverticulitis
  4. intestinal obstruction
  5. perforated viscus
  6. pelvic inflammatory disease
  7. rectal hematoma
74
Q

components of nerves of anterior wall

A

motor - efferent

sensory - afferent

sympathetic - afferent

75
Q

describe likelihood to develop a hernia and need repair between women and men

A

men are 8x more likely to develp a hernia than women and 20x more likely to need a repair

76
Q

what is the hepatorenal pouch of morison

A

next to liver and kidney only on right side and is the most dependent spot when pt is on their back

77
Q

in what group are indirect hernias more common

A

congenital so babies

78
Q

what is pylorospasm

A

spasmodic contraction of pylorus

food stay in stomach, resulting in stomach overfilling and vomiting

79
Q

what arteries serve the following parts of the stomach:

left lesser curvature

left greater curvature

fundus

right lesser curvature

gastroduodenal

A

left gastric - left lesser curvature

left gastro-omental - left greater curvature

short gastric - fundus

right gastric - right lesser curvature

right gastro-omental - gastroduodenal

80
Q

epigastrium dermatome

A

T7-9

81
Q

what is itussuseption

A

telescoping of one portion of small intestine into other part or ileocecal junction

82
Q

what is the ligament of treitz

A

marks end of diodenum and beginning of jejunum

83
Q

what color is peritoneal fluid normally

A

clear and slightly yellowish

84
Q

describe blood supply and innervation to visceral peritoneum

A

served by same blood and lymphatic vessels and nerves to organ it covers. Not sensitive to genral sensations, sensitive to stretch and chemical irritation. Can be felt as referred pain on body surface.

85
Q

genital area and thigh dermatome

A

ilioinguinal L1

86
Q

what is the obliterated umbilical vein embryonically

A

round ligament

87
Q

how do the fibers of the external oblique run

A

like hands into your pockets

88
Q

what are peritoneal adhesions

A

caused by peritoneum infection, inflammation or surgery

healing of above processes cause fibrous tissue to form and scar between visceral peritoneum or between visceral and parietal peritoneum.

89
Q

women median age of a groin hernia

A

60-79

90
Q

which ligament subdivides the liver

A

the falciform ligament (above umbilicus)

91
Q

what is the greater sac

A

main larger part of peritoneal cavity

92
Q

what is a diaphragmatic hernia

A

Bochdaleks, typiclaly posterior and left sided

93
Q

symptoms of meckels diverticulum

A

bleeding

especially consider for lower GI bleeding in children <2 yo and GI tract obstruction

when inflamed mimics appendicitis

94
Q

peak age range at persentation for indirect inguinal hernia in women

A

40-60 yo

95
Q

mesentery

A

2 layers of peritoneum adhere together connecting intraperitoneal orgnas to abdominal wall.

96
Q

blood vessels serving stomach are all off of what

A

celicac trunk ~T12

97
Q

whats the difference between campers and sparpas fascia

A

campers is more superficial and spans the whole cavity, thickness varies among individuals.

Sarpas exists only below the umbilicus as a membranous layer deep to campers.

98
Q

what is a hiatal hernia

A

protrusion of part of the stomach into the mediastinum through esophagela hiatus

occures more often after middle age

99
Q

what makes up the rectus sheath

A

aponeurosis of external, internal, and transverse abdominal muscles

100
Q

carcinoma of stomach

A

happens more in body or pyloric part. associated with feeling full and vomiting

101
Q

what is a direct inguinal hernia

A

Acquired

goes directly through anterior abdominal wall

102
Q

what is the greater omentum and lesser omentum

A

greater attaches to greater curvature of stomach

lesser attaches to lesser curvature of stomach

stores adipose and adheres to pathology in the area

103
Q

lower hypogastric dermatome

A

L1

104
Q

what are the 2 layers of the peritoneum

A

Parietal - lines the intrnal surface of the walls of the abdominopelvic cavity

Visceral - invests viscera in abdominopelvic cavity

105
Q

what might be wrong is a patient has LUQ pain

A
  1. Dissecting aneurysm
  2. esophagitis
  3. hiatal hernia
  4. esophagel rupture
  5. gastritis
  6. pancreatitis
  7. peptic ulcer disiease
  8. splenic issues
  9. kidney issues
106
Q

what is the “watch dog” of the stomach

A

greater omentum

107
Q

what is kwashiordor

A

starvation ascites, a severe form of malnutrition, cause dby deficiency ni dietary protein. Causes an osmotic imbalance in GI causing swelling of gut

108
Q

what is ileus

A

small bowel motility disorder that mimci obstruction

paralytic ileus

paralysis of small bowel movement mostly due to surgery

stagnation - no peristalsis; fluid/gas distention

causing abnormal distention, nausea, malaise

109
Q

3 major constrictions of esophagus

A

cervical ~15 cm from teeth

thoracic ~22.5 - 27.5 cm from incisor teeth

diaphragmatic ~ at its passing throug esophageal hiatus around T10

110
Q

what are intraperitoneal organs

A

completely covered by peritoneum and has a mesentary

111
Q

what might be wrong if a patient has RUQ pain

A
  1. Dissecting aneurism
  2. Gallbladder disease

* hepatitis

* hepatomegaly

*pancreatitits

*renal infarct

*appendicitis (retroperitieneal)

112
Q

what part of the stomach reffers pain from hindgut

A

suprapubic

113
Q

identify each number

A

1 is the right lobe of the liver,

Number 34 is the second or descending portion of the duodenum, which is the location of the entrance of the pancreatic duct and common bile duct into the small intestine.

114
Q

what is the inguinal ligament

A

Its formed by the inferior edge of external oblique muscle aponeurosis, which thickens as an undercurving fibrous band spanning between ASIS and pubic tubercle

115
Q

pain in duodenum is referred where

A

epigastric region

116
Q

what is the duodenums major papilla function

A

junction of both bile and pancreatic secretions into sphincter of hepatopancrial duct

117
Q

what is an umbilical hernia

A

around umbilicus, common in newborns

118
Q

what does the medial umbilical fold cover

A

obliterated umbilical arteries

119
Q

what are semilunar lines

A

lines that demarcate where the rectus abdominus muscles come into contact with the obliques

120
Q

ascited

A

excess fluid accumulation >50 ml in peritoneal cavity

result from internal bleeding, portal hypertension, cancer metastasis, starvation etc.

121
Q

what is the omental bursa

A

lesser sac (behind lesser omentum)

122
Q

what is derived from foregut

A

from mouth until 1st and 2nd portion of duodenum

123
Q

what is abdominal paracentesis

A

surgical puncture of peritoneal cavity for aspiration or drainage of fluid

124
Q

what is zenkers diverticulum

A

rare phenomena where theres an invagination right at beginning of pharynx

symptoms

dysphagia

regurgitation

halitosis

125
Q

men median age for inguinal hernia

A

50-69

126
Q

what is aponeurosis

A

an extension of epimysium forms inguinal ligament

127
Q

symptoms of hiatal hernia

A

heart burn

difficulty swallowing

nausea, vomiting

128
Q

who typically gets a semilunar hernia

A

mroe in people >40, obese

129
Q

what is an epigastric hernia

A

midline along linea alba above umbilicus

130
Q

green peritoneal fluid

A

ruptured gall bladder, pancreatitis, intestinal perforation

131
Q

red peritoneal fluid, clots and no clots

A

suggests a traumatic tap (clots)

malignancy (no clots)

132
Q

what is mostly in the upper left quadrant or around umbilicus

A

jejunum

133
Q

what is the gastrocolic ligament

A

the portion of greater omentum spanning between greater curvature of stomach and transverse colon

134
Q

pain from gastric or peptic ulcer is referred where

A

epigastric region. Bc afferent fibers from stomach and 1st part of duodenum, via greater splanchnicn nerve to to T7-T8 level DRG, which collect dermatome sensation from there

135
Q

1st part of duodenum is considered

A

intraperitoenial, the rest is retroperitoneal

136
Q

what veins drain the lower esophagus

A

dual drainages

to systemic veins via azygos vein

to liver via hepatic portal vein

137
Q

what is the rectouterine pouch of douglas

A

when pt standing up in between rectum and uterus

138
Q

what is caput medusa

A

seen during hepatic prtal vein hypertension or obstruction causing the embyronic umbilical vein to reopen (and reverse blood flow) and carry blood away from liver onto the anterior abdominal wall veins the superior and inferior epigastric veins.

139
Q

Identify each line

A
140
Q

what folds are below umbilicus

A

Mediam umbilical fold

medial umbilical folds

lateral umbilical folds

141
Q

what is this called

A

caput medusa

142
Q

what organs are found in the LLQ

A

sigmoid colon

143
Q

what is volvulus

A

a loop of bowel and mesentary abnormally twisted on itself

cause obstruction and vascular ischemia

sigmoid is most common - sygmoidiscope can work

cecum second most common

enema can help

144
Q

sparpas fascia may retain fluid underneath during what injury

A

straddle injury

145
Q

what are peptic ulcers

A

duodenal ulcers

inflammatory erosions of duodenal mucosa

erosion of gastroduodenal artery can cause severe bleeding into duodenum, retroperiteneum or lesser sac of peritoneal cavity

146
Q

what is scarpas fascia

A

exists only below umbilicus as a membranous layer deep to campers. Superiorly int attaches to rectus/external oblique epimysium

147
Q

what is campers fascia

A

fat layer that looks like adipocytes. May vary extensively between individuals

148
Q

describe blood supply and nerve innervation to parietal peritoneum

A

served by same blood and lymphatic vessels and nerves in the region that it is adjacent to. Pain is well localized

149
Q

what ligaments are above the umbilicus

A

falciform ligament

round ligament of liver or ligamentum teres

150
Q

what is the lifetime risk of groin hernias in males

A

25% in men but less than 5% in women

151
Q

what organs are in the LUQ

A

spleen

bulk of the stomach

parts of pancreas

left lobe of liver

jejunum and proximal ileum

left kidney

152
Q

who usually gets diastasis recti

A

newborns and pregnant women

153
Q

what is the inguinal ligament formed by

A

inferior edge of external oblique muscle aponeurosis

154
Q

what is derived from hindgut

A

from distal 1/3 of transverse colon on

155
Q

what are the 2 types of hiatal hernia

A

sliding - most, abdominal portion of esophagus + cardia + part of fundus all herniated, regurgitation possible

paraesophageal - cardia remains in normal position, part of fundus herniates, usually no regurgitation

156
Q

what part of the stomach reffers pain from the midgut

A

paraumbilical

157
Q

what is the epicloic foramen of winslow

A

behind portal triad theres a hole that is an opening to lesser sac

158
Q

when might peritoneal fluid volume increase

A

in women around ovulation

RC Test 3 (15 decks)

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