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Block 1 > CAI > Flashcards

CAI Flashcards

1
Q

Why is Hepatorenal recess important to consider in supine pt with peritonitis?

A

This is one of the deepest, most superior areas where fluid can collect. Between liver and kidney

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2
Q

What are the major anatomical differences between the Jejunum, and Ileum? 4

A

Jejunum has

  • Wider lumen
  • Thicker wall
  • Fewer arterial cascades
  • Longer Vasa Recta
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3
Q

What is a Paracolic Gutter?

A

Routes for fluid movement/infection spread due to the peritoneal foldings creating valleys within the peritoneal cavity. Particularly on either side of the ascending and descending colon.

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4
Q

Why does the pain felt with Appendicitis change as the condition worsens?

A
  • Initially Visceral sensory nerve pain due to inflammation. Midgut organ so pain sensed in umbilical region.
  • As Inflamed appendix is enlarged it comes to contact with parietal peritoneum which is somatically innervated.
  • Somatic pain is well-defined and localised to point in Right Iliac Fossa - McBurney’s point.
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5
Q

Rule of 2s with Meckel’s Diverticulum?

A
  • Prevalence 2% of pop
  • 2ft of ileocaecal junction
  • 2in in length
  • 2x more prevalent in males
  • ~2% pt develop complication
  • Appears problematic usually within 2 years of life
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6
Q

What ligament suspends the 4th Part of the duodenum & marks the duodenal-jejunal flexure?

A
  • Ligament of Treitz

Surgically this pt. marks where an ‘upper’ vs. ‘lower’ GI bleed is found

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7
Q

Define Watershed Area

A

Medical term, Regions of body that receive dual blood supply from distal branches of two large arteries

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8
Q

Why can upper Gi cancers cause a left supraclavicular lymphadenopathy? (Virchow’s node)

A

GI cancers can spread to the para-aortic nodes, (next to aorta) which can then spread to cisterna chyli, into thoracic duct and into nodes surrounding the left subclavian vein. Suggests metastasised lymph node from GI tract

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9
Q

What is the Arterial Supply to the the Foregut, Midgut, and Hindgut? What vertebral levels do they arise at?

A

Foregut - Coeliac Trunk - T12
Midgut - Superior Mesenteric Artery - L1
Hindgut - Inferior Mesenteric Artery - L3

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10
Q

What are Porto-Systemic Anastomoses?

A

Connections between venous drainage in a shared area towards both the heart and liver.

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11
Q

What three anatomical areas are clinically relevant when considering Porto-Systemic Circulation in Abdominal Regions?

A
  • Lower end of Oesophagus (Yum)
  • Umbilical Region of Anterior Abdominal Wall (Tum)
  • Lower part of Anal Canal (Bum)
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12
Q

What is the difference between anorectal varies and haemorrhoids?

A

Anorectal varies are due to liver issues causing dilation and tortuousness of veins in the rectum.
Haemorrhoids are congestion of venous cushions due to straining at defecation. 3,7,11 - Can be seen with naked eye

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13
Q

If patient has internal (classic) haemorrhoids, will they hurt?
What about with external haemorrhoids?
Why?

A

Internal haemorrhoids do not hurt

External haemorrhoids do hurt as this region of the anus is somatically innervated.

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14
Q

What is the Morula and how does it form?

A

The Morula is an early stage of embryo development, Day 3 - Formed by a series of mitotic divisions of the fertilised ovum to produce distinct identical cells within a solid sphere.

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15
Q

Which tissue layer initially surrounds the morula and why must this tissue layer eventually break down?

A

Zona Pellucida, must break down in order to allow blastocyst attachment to endometrium

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16
Q

What is the blastocyst?

A

Developmental stage with fluid filled cavity (blastocoele), with Inner cell mass (embryoblast), and Trophoblast

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17
Q

Which tissue layer (hint: it is an epithelium) must the blastocyst adhere to prior to implantation?

A

Uterine Epithelium / Endometrium

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18
Q

Which two layers of cells form the bilaminar embryonic disc? From which cells of the blastocyst are they derived?

A

Epiblast and Hypoblast

Derived from Embryoblast / Inner cell mass

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19
Q

Which embryonic cellular mass assists with the implantation of the embryo into the endometrium?

A

Syncytiotrophoblast

20
Q

Which fluid filled sacs sit above and below the bilaminar embryonic disc? What are the functions of these sacs?

A
  • Above Epiblast - Amniotic Cavity - Fills with amniotic fluid
  • Below Hypoblast - Primary Yolk sac - Provides nutrients until placenta functional
21
Q

Where does the extraembryonic mesoderm (mesenchyme) form? What is the extracellular matrix?

A

Between the former epiblast and hypoblast to form the trilaminar disc

22
Q

What is the chorionic cavity? Within which tissue layer does it form and what does it allow the embryonic disc to do?

A
  • Fluid filled cavity surrounding embryo, except where connects to connecting stalk
  • Forms between the trophoblast
  • Allows the Embryonic Disc to fold freely
23
Q

What region does the prochordal (prechordal) plate sit within?

A

Cephalic End of Disc

24
Q

Within which region does the cloaca plate sit within?

A

Caudal end of disc

25
Q

What cells make up the trilaminar disc?

A
  • Embryonic Ectoderm (Was epiblast)
  • Intraembryonic Mesoderm
  • Embryonic Endoderm (Was hypoblast)
26
Q

What is the Primitive streak?

A

Raised area of epiblast (future ectoderm); extends from the cloaca to the primitive node

27
Q

What is the Primitive Groove?

A

An indentation in the centre of the primitive streak; marks the region where cells are rapidly migrating downwards to form the three layered disc

28
Q

What is the notochord? What Embryonic Layer does it arise in?

A
  • The notochord develops within the Mesoderm layer and creates a semi-longitudinal axis in the embryo
  • Provides rigidity to embryonic disc
  • Folding occurs around this axis
29
Q

Describe the main tissue derivatives of Endoderm

A
  • Gut tube, liver, Pancreas, Bladder, Lungs
30
Q

Describe the main tissue derivatives of Ectoderm

A
  • Surface Ectoderm - Epidermis, Tooth enamel, Lens, Internal Ear
  • Neural tube - CNS, Retina, Posterior Pituitary
  • Neural Crest - Adrenal Medulla, Facial Bones
31
Q

Describe the main Tissue Derivatives of Mesoderm

A

Paraxial Mesoderm - Skeletal Muscle of limbs, Skeleton, Dermis, Connective tissue
Intermediate Mesoderm - Urogenital System
Lateral Plate Mesoderm - Serous membranes, smooth muscle and connective tissue of viscera

32
Q

What is a somite? What tissues does it form?

A

Differentiated paraxial mesoderm cells in pairs on either side of the notochord.
Develop into sclerotome (Vertebrae + ribs), Dermatome (Dermis of Doral skin + Innervation), Myotome (Skeletal muscles of body wall and limbs)

33
Q

What are the normal functions of epithelia? What types of clinical problem can be associated with epithelial malfunction or damage?

A

Protection from physical and chemical damage

- Throat infection, Heal ulceration, Mastitis, Blistering, UV-based Damage

34
Q

In which directions does the embryonic disc fold?

A

Longitudinally and Laterally

35
Q

Where is the amniotic cavity located in relation to the embryo after folding?

A

Surrounding the embryo outside

36
Q

Longitudinal Folding brings about Reversal; What happens During Reversal?

A
  • Moves diaphragm, heart, brain and mouth into their final positions.
  • Rapid growth of Neural tissue also results in pushing Mouth and Anus under the embryo into its final positions
37
Q

During Folding what happens to the yolk sac?

A

Yolk sac becomes located inside the gut tube, amniotic cavity pinches connection of yolk sac and gut to form vitello-intestinal/vitelline duct.

38
Q

Which tissue of the embryonic disc forms the lining of the gut tube?

A

Mesoderm

39
Q

Why is the gut tube positioned as it is? What problems might occur if it was in a different position?

A
  • To allow degree of movement within the peritoneal cavity of the abdomen
  • Minimises risk of gut tube twisting in on itself and occluding its own blood supply / Compressing itself
40
Q

How are dorsal and ventral mesentery arranged throughout the gut tube?

A

All gut tube has Doral mesentery

Foregut also has ventral mesentery

41
Q

What happens during gut tube development? 3

A
  • Rapidly growing gut tube faster than body cavity and herniates through umbilicus
  • Body cavity grows more rapidly and pulls gut tube back into abdominal cavity
  • Rotates 270degrees anticlockwise around the axis of the superior mesenteric artery
42
Q

What defects can occur during gut tube development

A
  • Omphalocele

- Gastroschisis

43
Q

What is Omphalocele

A

Where the gut tube does not fully return to the abdomen during development. Still covered in amniotic membrane

44
Q

What is Gastroschisis

A

Gut tube returns to abdominal cavity but then later herniates through abdominal wall - Not surrounded by amniotic membrane

45
Q

What is a volvulus?

A

When a portion of the gut tube twists on itself/ its mesentery. Resulting in obstruction/lack of blood supply

46
Q

What is the Cloaca? What problem(s) can occur if the urorectal septum does not form properly?

A
  • Cloaca is the common waste outflow in the embryo, draining both faeces and urine
  • Imperforate Septum (Anus sealed over by cloacal membrane)

Block 1 (4 decks)

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