Chapter 5: Stomach Flashcards

1
Q

Most proximal portion of the stomach immediately distal to the GEJ

A

Cardia

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2
Q

Most superior portion of the stomach

A

Fundus

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3
Q

Largest portion of the stomach

A

Corpus/Body

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4
Q

Extends from the fundus to the pylorus

A

Corpus/Body

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5
Q

Begins at the angularis incisura as a wider area that leads into a narrower pyloric canal and sphincter

A

Antrum

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6
Q

Part of the stomach that includes the pyloric sphincter

A

Pylorus

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7
Q

Cells that produce pepsinogen in response to food and acethylcholine

A

Chief cells

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8
Q

pH level wherein pepsinogen is activated to pepsin

A

<5 pH

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9
Q

Cells that secretes HCl and Intrinsic Factor

A

Parietal/Oxyntic cells

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10
Q

Secretes mucous and HCO3-

A

Mucous neck cells

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11
Q

Secrete gastrin

A

G cells

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12
Q

Secrete somatostatin

A

D cells

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13
Q

Secrete serotonin

A

Enterochromaffin cells/Kulchitsky cells

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14
Q

Secrete histamine

A

Enterochromaffin-like cells

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15
Q

Supplies the proximal portion of the lesser curvature

Originates from the celiac trunk

A

Left gastric artery

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16
Q

Supplies the distal portion of the lesser curvature

Originates from the common or proper hepatic artery

A

Right gastric artery

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17
Q

Supplies the proximal portion of the greater curvature

Originates from the splenic artery

A

Left gastroepiploic artery

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18
Q

Supplies the distal portion of the greater curvature and the pylorus
Originates from gastroduodenal artery

A

Right gastroepiploic artery

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19
Q

Contribute to the supply of proximal stomach

A

Short gastric arteries

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20
Q

Supplies the acetylcholine-mediated, parasympathetic innervation of the stomach

A

Vagus nerve

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21
Q

Supplies sympathetic innervation of the stomach

A

Celiac plexus

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22
Q

Enteric nervous system is composed of the following plexuses

A

Auerbach’s and Meissner’s plexuses

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23
Q

Left vagus nerve runs ______ to the stomach

A

anterior

24
Q

Right vagus nerve runs ______ to the stomach

A

posterior

25
Q

Etiologies of stress-induced gastritis

A

Sepsis
Shock
Severe burn

26
Q

Most common type of peptic ulcer disease

A

Duodenal ulcers

27
Q

Food tends to exacerbate the epigastric pain in this type of ulcer

A

Gastric ulcer

28
Q

Food relieves the pain in this type of ulcer

A

Duodenal ulcer

29
Q

Most common type of gastric ulcer

A

Type 1

30
Q

Gastric ulcer found in the distal portion of the lesser curvature

A

Type 1

31
Q

Gastric ulcer found in the prepyloric or pyloric region

A

Type 3

32
Q

Gastric ulcer found in the proximal portion of the lesser curvature

A

Type 4

33
Q

Gastric ulcer found in the distal portion of lesser curvature and is associated with duodenal ulcer

A

Type 2

34
Q

Indications for surgical management of PUD

A

Refractory or recurrent disease

Complications (perforation, obstruction, uncontrolled bleeding)

35
Q

Rare disorder caused by gastrin-secreting tumor

A

Zollinger-Ellison Syndrome

36
Q

Gastrinoma triangle

A

Pancreatic neck
Porta hepatis
3rd portion of the duodenum

37
Q

Gastrin levels confirming the diagnosis of ZES

A

> 1000 pg/mL

Increase in gastrin level >200 pg/mL after a secretin challenge

38
Q

Clinical triad of ZES

A

Hypersecretion of HCl
Severe PUD
Gastrinoma

39
Q

Most commonly performed operation for GERD that involves a 360 degrees wrap

A

Nissen fundoplication

40
Q

Operation for GERD that includes 180 degrees wrap

A

Toupet

41
Q

Operation for GERD that includes 270 degrees wrap performed through the chest

A

Belsey Mark IV

42
Q

Most common complication from anti-reflux procedures

A

Pneumothorax

43
Q

Most common form of gastric cancer

A

Gastric adenocarcinoma

44
Q

Diffuse neoplasm involving the entire stomach to give a ‘leather bottle’ appearance

A

Linitis plastica

45
Q

Treatment for gastric adenocarcinoma

A

Surgical resection with a 6-cm resection margin

46
Q

Treatment for gastric adenocarcinoma in the proximal stomach

A

Total gastrectomy

47
Q

Treatment for gastric adenocarcinoma in the distal stomach

A

Subtotal gastrectomy with negative margins

48
Q

Submucosal, mesenchymal tumors arising from the interstitial cells of Cajal

A

Gastrointestinal Stromal Tumors (GIST)

49
Q

Mutation found in GIST

A

Gain of function tyrosine kinase mutation (KIT proto-oncogene)

50
Q

Non-Hodgkin’s lymphoma associated with H. pylori infection

A

Gastric MALToma

51
Q

Indications for bariatric surgery

A

BMI > 40 kg/m2 or

BMI >35 kg/m2 with a comorbid condition

52
Q

What GI hormones are involved in the regulation of insulin release?

A

Gastric inhibitory peptide

CCK

53
Q

A 69-year old man is diagnosed with gastric adenocarcinoma. What are the most common symptoms?

A

Weight loss, early satiety, abdominal pain

54
Q

A 55-year old woman is found to have PUD without increase HCL secretion. What types of gastric ulcers may be present?

A

Types I or IV

55
Q

What type of gastric ulcer is often not responsive to highly selective vagotomy?

A

Type III

56
Q

What is the strongest layer of the GI tract wall?

A

Submucosa

57
Q

What technique is used for laparascopic band placement during which the gastrohepatic ligament is divided, a plane between the right diaphragmatic crus, and the overlying fat pad is dissected?

A

Pars flaccida technique