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?

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
What does IVC do?
Drains cleaned blood from hepatic veins into RA
26
What does HPV do?
Drains blood from foregut, midgut and hindgut to liver for first pass metabolism
27
What do splenic veins drain?
Blood from foregut organs to the HPV
28
What does SMV drain?
Blood from midgut structures to HPV
29
What does IMV drain?
Blood from hindgut structures to splenic vein
30
How many sites of venous anastamoses between sympathetic and portal venous systems?
3 | called the Portal systemic anastamoses
31
What happens at portal systemic anastamoses?
Presence of small collateral veins mean blood can flow both ways into systemic or portal venous system
32
Features of portal systemic anastamoses?
No valves in these veins | V little blood between these collateral veins
33
What is portal hypertension?
What happens to collateral veins if BP in portal venous system is raised
34
What is the clinical term given to increased BP?
Portal hypertension | result of liver pathology
35
What happens in portal hypertension?
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