Clinical Anatomy of Bleeding in the GI tract Flashcards

1
Q

What is large intestine made up of?

A

Colon
Rectum
Anal canal
Anus

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2
Q

Functions of large intestine?

A
  • Defence against commensal bacteria
  • Absorption of H2O and electrolytes
  • Excretion of formed stool
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3
Q

How many paracolic gutters?

A

2 (left and right)

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4
Q

Where are paracolic gutters?

A

-Between the lateral edge of ascending and descending colon and abdominal wall
-They are parts of the greater sac of peritoneal cavity
(similiar to sub-phrenic recesses)

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5
Q

What are paracolic gutters a potential site for?

A

Collection of pus

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6
Q

What are teniae colo?

A

3 distinct longitudinal bands of thickened smooth muscle running from caecum to distal end of sigmoid colon

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7
Q

Where do the caecum and appendix lie?

A

Left iliac fossa

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8
Q

Where is McBurney’s point?

A

On anterior abdominal wall

1/3 of the way between right ASIS to umbilicus

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9
Q

Where does sigmoid colon lie?

A

Left iliac fossa

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10
Q

Where does abdominal aorta lie?

A

It is a midline retroperitoneal structure

Lies anterior to vertebral bodies and to the left of IVC

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11
Q

3 midline branches of the abdominal aorta?

A

Celiac trunk (foregut)
Superior mesenteric artery (midgut)
Inferior mesenteric Artery (hindgut)

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12
Q

The lateral branches of the abdominal aorta supply?

A

Kidneys/adrenal glands
Gonads (ovaries/testes)
Body wall

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13
Q

What does abdominal aorta bifurcate into?

A

Common iliacs which further bifurcate into internal and external iliacs

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14
Q

What exists between the branches of the SMA and the IMA?

A

Arterial anastamoses

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15
Q

What can arterial anastamoses help prevent and how?

A

Intestinal ischaemia

Providing an alternative route by which blood can travel

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16
Q

What supplies organs of hindgut?

A

IMA

17
Q

What is haematemesis?

A

Vomiting up blood

18
Q

Fancy term for vomiting up blood?

A

Haematemesis

19
Q

Where could haematemesis be coming from?

Peptic ulcer version

A

Peptic ulcer in wall of stomach or duodenum>

Erodes through mucosa

Stomach or duodenum fills with blood

20
Q

Why would my patient be vomiting blood?

A
  • Peptic ulcer eroding through mucosa

- Bleeding from oesphageal varices

21
Q

Process of bleeding from oesphageal varices?

A

Bleeding from oesphageal varices >Abnormal dilated veins> thin walled therefore potential ruptures> fill oesphagus with blood

22
Q

2 main venous systems?

A

Hepatic portal venous system

Systemic venous system

23
Q

Where does Hepatic portal venous system drain blood from?

A

Venous blood from absorptive parts of GI tract and associated organs to liver for cleaning

24
Q

Where does Systemic venous system drain from?

A

Drains venous blood from all other organs and tissues into superior/inferior vena cavae

25
Q

What does IVC do?

A

Drains cleaned blood from hepatic veins into RA

26
Q

What does HPV do?

A

Drains blood from foregut, midgut and hindgut to liver for first pass metabolism

27
Q

What do splenic veins drain?

A

Blood from foregut organs to the HPV

28
Q

What does SMV drain?

A

Blood from midgut structures to HPV

29
Q

What does IMV drain?

A

Blood from hindgut structures to splenic vein

30
Q

How many sites of venous anastamoses between sympathetic and portal venous systems?

A

3

called the Portal systemic anastamoses

31
Q

What happens at portal systemic anastamoses?

A

Presence of small collateral veins mean blood can flow both ways into systemic or portal venous system

32
Q

Features of portal systemic anastamoses?

A

No valves in these veins

V little blood between these collateral veins

33
Q

What is portal hypertension?

A

What happens to collateral veins if BP in portal venous system is raised

34
Q

What is the clinical term given to increased BP?

A

Portal hypertension

result of liver pathology

35
Q

What happens in portal hypertension?

A

Blood is diverted through collateral veins back to systemic venous system.
These veins consequently have a much larger volume of blood than usual- therefore dilate= varicose veins