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Anatomy > Chapter 4 Pathology > Flashcards

Chapter 4 Pathology Flashcards

1
Q

Where is transpyloric plane and what are structures?

A

9th costal cartilage anteriorly to L1 posteriorly.

Transects:

  • stomach pylorus
  • superior part of duodenum
  • duodenojejunal flexure
  • gallbladder fundus
  • sup. mesenteric a. origin
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2
Q

Cryptorchidism:

A

absence of one/both testes

due to: failure of testis to descend thru inguinal canal during development

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3
Q

What is the developmental significance of the inguinal canal?

A

MALES:

  • Primordial testis is connected to genital swelling (future scrotum)
  • at same time, vaginal process arises at inguinal canal (evagination of peritoneum)
  • testis will slide thru inguinal canal into scrotum transporting ductus deferens and vessels
  • vaginal process moves down into scrotum transporting muscles, etc that will become wall of scrotum
  • wk 12: testes in pelvis
  • wk 28: testes at deep inguinal ring
  • few days in the inguinal canal
  • 4 wks later, arrive at scrotum
  • stalk of vaginal process closes while distal part on testis remains open as double layered sac of peritoneum called tunica vaginalis

FEMALES:
ovaries descend same way as testis except they remain in pelvic cavity
- ovarian ligament: ovaries and uterus
- round (teres) ligament: uterus and labium

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4
Q

Abnormal closure of vaginal process may lead to:

A

hydrocele of thecord

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5
Q

excess fluid in tunica vaginalis?

A

hydrocele of testis

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6
Q

Contents of rectus sheath:

A
  • rectus abdominis
  • pyramidalis muscle
  • inf. and sup. epigastric vessels
  • lymphatic vessels
  • 5 lower intercostal nerves, including subcostal.
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7
Q

Medial and Median unbilical folds are remnants of:

A

Medial: fetal umbilical arteries

Median: urachal cord

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8
Q

Differences between direct and indirect inguinal hernias:

A

Direct:

  • typically middle aged men
  • weakness in abdominal wall
  • medial to inf. epigastric vessels or inside inguinal triangle
  • doesn’t pass into vaginal process
  • lower risk of strangulation of structure

Indirect:

  • more common
  • both men and woman
  • patent vaginal process
  • passes thru deep inguinal ring within vaginal process
  • higher risk of strangulation of structure
  • commonly passes thru male scrotum or labium in females
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9
Q

Method of hernia repair:

A

cooper’s ligament repair

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10
Q

Zenker’s diverticulum:

A

outpouching of pharyngeal wall above esophagus

  • affect mainly older adults
  • asymptomatic or symptomatic
  • if symptomatic: leads to dysphagia, regurgitation of food, coughing, halitosis
  • complicated by ulceration, bleeding, inflammation
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11
Q

Achalasia (cardiospasm):

A

failure of lower esophageal sphincter to relax during swallowing due to absence of neurons in myenteric plexus

  • can lead to: chagas disease
  • symptoms: dysphagia, retrosternal pain, aperistalsis, LES pressure increase
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12
Q

tracheoesophageal fistula:

A

abnormal connection between esophagus and trachea

due to: failure of separation during embryogenesis

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13
Q

How does vomiting increase blood pH?

A

vomiting prevents H+ from reaching small intestines

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14
Q

Zollinger-Ellison syndrome:

A

gastrinomas secrete excess gastrin leading to hyperacidity

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15
Q

Dumping syndrome:

A

abnormally rapid emptying of stomach

caused by: vagotomy or gastric resection; anything that compromises pyloric function

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16
Q

Gastritis:

A

inflammation of gastric mucosa

  • erosive or nonerosive
  • acute or chronic

due to: toxicity from alcohol or bile, steroids, non-steroids like aspirin, stress

untreated will lead to: ulcer formation or stomach cancer

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17
Q

teritz ligament:

A

suspensory muscle of duodenum; used to located duodenojejunal flexure

18
Q

Decreased blood supply of intestine:

A

occlusion of vasa recta –> ischemia –> necrosis of involved part –> paralytic

19
Q

meckel’s diverticulum:

A

outpocketing of inestines near ileocecal valve

mimics pain of appendicitis

rule of twos or threes used to describe condition: occurs in 2% of children, 2 feet above ileocecal valve, 2 types of ectopic mucosa (gastric and pancreatic), usually occurs in 2 year old children

20
Q

celiac disease (nontropical sprue)

A

hypersensitivity to gluten resulting in malabsorption

results in absence of villi

symptoms include diarrhea, weight loss, flatulence

gluten free diet improves condition

21
Q

tropical sprue:

A

intestinal microbial infection epidemic and endemic in southeast asia and caribbean

symptoms: chronic diarrhea, malabsorption, weight loss

22
Q

typhoid (enteric) fever:

A

salmonella typhi contamination in food, drink, water

spread of bacteria thru intestine to blood and other tissues

symptoms: high fever, bloody diarrhea, “ROSE SPOTS” (rashes), inflammation of peyer’s patches leading to perforation of intestine

23
Q

barium enema (w. double contrast)

A

method used to examine large intestine

  • barium sulfate pumped into large intestines thru anus
  • take x-rays
  • patient defecates
  • air pumped thru anus
  • x-ray again
24
Q

anal suppository:

A

insert suppository in anal canal in newborns and infants = effective way to deliver proper dosage of drug in short time

immediately absorbed thru inferior rectal veins into IVC

25
Q

Rectal examination for males:

A

gives initial idea of prostate gland

26
Q

Hirschsprung disease (congenital megacolon)

A

lack of peristalsis/contraction in lower large intestine; restricted to rectum in 90% of cases

caused by deficiency of cells in meissner’s plexus and myenteric plexus of auerbach

fecal retention

associated with down syndrome and chagas disease

27
Q

Pancreatitis:

A

inflamed pancreas due to acinar cell injury

caused by: biliarytract dsease, alcohol, infections

damage to cells cause release of pancreatic enzymes which lead to autodigestion in acute pancreatitis; amylase levels increase

28
Q

liver injuries:

A
  • easily ruptured
  • hemorrhaging
  • stab wound up to 5th intercostal space on right side may harm liver
29
Q

liver cirrhosis

A

chronic liver disease

  • progressive destruction of liver cells
  • symptoms: fibrosis, inflamed responses, hyperplasia,
  • liver hardens making it difficult for blood in to get in and out
  • portion of blood accumulates in abdominal cavity

types of cirrhosis:

  • cirrhosis due to alcohol, drug, intake
  • following viral hepatitis
  • iron or copper overload of liver
  • 1- antitrypsin deficiency
  • consequence of heart failure

can remove shunts to relieve symptoms of portal hypertension

30
Q

gallstones (cholelithiasis):

A

imbalance of cholesteral and bile salts leading to precipitation of salts and gallstone formation

Common to ppl under 5 F’S criteria:
female, fertile, forty/fifity, fat, fair

31
Q

duodenal atresia:

A

discontinuity of lumen due to failed recanalization

32
Q

cystic fibrosis:

A

inherited caused by gene mutation

cyst formation in pancreas
gi tract and pancreatic enzyme deficiency

33
Q

Cancer in head of pancreas:

A

blocks common bile duct at major duodenal papilla leading to jaundice

34
Q

is liver able to regenerate? liver transplant survival rate?

A

yes; 1 year survival is 70%

35
Q

hepatomegaly

A

enlargement of liver

36
Q

cholecystitis:

A

acute inflammation of gallbladder wall due to cystic duct obstruction by gallstone

37
Q

addison’s disease

A

disorder in which adrenal glands don’t produce enough steroid hormones

38
Q

cushing’s syndrome:

A

high levels of cortisol

39
Q

Ulcerative colitis vs Crohn’s Disease

A

UC: chronic relapsing ulceroinflammatory disease, involving rectum and left colon; continuous

CD: chronice granulomatous inflammatory bowel disease, involve ileum and colon; discontinous

40
Q

diverticulosis and diverticulitis:

A

inflamed/infected pouches in colon

41
Q

colonoscopy vs proctoscopy

A

endoscopic examination of colon

proctoscopy: used to see inside of rectum

Anatomy (6 decks)

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