Clinical Anatomy of bleeding in GI tract Flashcards
What are the 4 main contents of the large intestine? Label the diagram

1. Colon
2. Rectum
3. Anal Canal
4. Anus
What are the contents of the colon? (6) Label the diagram

1. Appendix
2. Caecum
3. Ascending colon
4. Transverse “
5. Descending “
6. Sigmoid “
Describe the relationships of the following structures with the peritoneum
- Transverse colon
- Ascending & Descending colon
- Sigmoid colon
- Caecum
- Intraperitoneal
- secondary retroperitoneal
- Intraperitoneal
- Intraperitoneal
Define the paracolic gutters.
Spaces found between the ascending/descending colon and the abdominal wall.
Forms part of the greater sac of the peritoneal cavity
What are the 3 distinguishing features of the colon?

- Teniae coli- 3 longitudinal bands of smooth muscle running throughout the whole colon.
- Omental appendices- fatty projections
- Haustra- small pouches formed by sac formation
The caecum and ileum both lie in what region of the pubic area?
Right ilac fossa
What anatomical structure is found in Mcburney’s point?
Appendiceal orifice
The _ colon is found in the left ilac fossa.
Sigmoid
While the sigmoid colon is very mobile as it surrounded by a _, it can twist around itself, formally known as sigmoid _
Mesentery
Volvulus - can result in bowel obstruction/infection
What are the three midline branches of the abdominal aorta and which parts of the gut do each of them supply?

1. Celiac trunk- Foregut
2. Superior mesenteric artery- midgut
3. Inferior mesenteric artery- hindgut
After its midline branches, the abdominal aorta bifurcates into the _ ilacs, before branching into the _ and _ ilac arteries.
Common- this occurs at L4.
Internal & External
The superior mesenteric artery is found at which vertebral level?
L1
The superior mesenteric artery branches into what?

- Inferior pancreato-duodenal artery
- Middle colic artery
- Right colic “
- Ileocolic branches
- Appendicular artery
- Jejunal & ileal artery
Compared to the ileum, the jejunum has a longer vasa rectae and larger and fewer arcades. T/F?
True
What are the branches of the inferior mesenteric artery? What vetebral level is the inferior mesenteric found at?

- Left colic artery
- Sigmoid arteries
- Superior rectal artery
L3
What does the Marginal artery of Drummond refer to? Why is it signifacant?
Area of anastamoses between the superior and inferior mesenteric artery.
Can help prevent intestinal ischaemia, by providing an alternative route to the occluded area.
Identify the vessel shown in this images

Superior mesenteric artery
Identify the vessel shown in this image.

Inferior mesenteric
The rectum and anal canal is mainly supplied by which artery?
Superior rectal
Hingut- extends to proximal half of anal canal.
Remainder of GI tract supplied by internal ilac artery
What are the two main venous systems of the body?
- Hepatic portal venous system (hepatic portal vein)
- Systemic venous system (SVC,IVC)
The IVC drains blood from the _ vein, while the HPV drains blood from the _ .
- Hepatic veins
- Foregut, hindgut, midgut structures
Which veins are responsible for draining blood from the foregut, midgut and hindgut structures into the HPV?
- Foregut- Splenic vein
- Midgut- Superior mesenteric vein
- Hindgut- Inferior mesenteric vein- drains blood to Splenic vein first which then drains into HPV.
What are the 3 important areas of portal-systemic anastamoses?
- Distal end of oesophagus
- Inferior part drains into HPV
- Superior part drains- Azygous vein
- Skin around umbilicus- paraumbilical and epigastric vein.
- Paraumbilical- drains to HPV
- Epigastric- drains to caval system
- Rectum/anal canal
- Rectum & superior anal canal- drain to Inferior mesenteric vein
- Inferior part of GI tract- drain to internal ilac vein
Define portal hypertension
Eleavation of BP in portal system
What are 3 common clinical presentations that suggest portal hypertension?
- Oesophageal varices
- Caput medusae- dilated para-umbilical & epigastric veins
- Rectal varices
What is haematemesis?
Vomiting blood (haem-at-emesis)
Can be caused by either
- PUD
- Oesophageal varices