DSA: Organs of the GI Tract Flashcards
The thoracic esophagus pierces the diaphragm at _____ through the esophageal hiatus slightly left of midline
It turns sharply left to enter the stomach at the cardiac orifice about vertebra level _____
T10
T11
What are the 3 constrictions of the esophagus and what forms them?
Cervical constriction aka UES (crycopharyngeus m.)
Thoracic aka bronchoaortic constriction (L main bronchus + aortic arch)
Diaphragmatic constriction (R crus of diaphragm)
Describe para-esophageal hiatal hernia. Does the patient experience regurg?
Cardia of stomach is normal position, but peritoneum and fundus protrude anterior to esophagus
No regurgitation!
Describe sliding hiatal hernia. Does the patient experience regurg?
Esophagus, cardia, fundus protrude through hiatus
Yes there is regurgitation, worse with lying down
Which is more common, sliding or paraesophageal hiatal hernia?
Sliding hiatal hernia
In which quadrant(s) of the abdomen would you find the stomach?
Most commonly in right and left UQs
The left end of the stomach (fundus) is typically fixed at vertebral level ____, and the right end (pylorus) is fixed at _____
The area between is variable
T10-11; L1
Anterior relationships of stomach
Anterior abdominal wall
Diaphgram
L lobe of liver
Posterior relationships of stomach
Diaphragm Spleen (posterior and lateral) L suprarenal gland L upper kidney Pancreas Transverse colon (inferior and lateral) Transverse mesocolon Omental bursa (lesser sac)
The duodenum begins at the pylorus at the level of ____ and ends at the _______ flexure (junction) at L2
L1; duodenojejunal
The duodenum is subdivided into how many parts? Are the intraperitoneal or retroperitoneal?
4: superior, descending, horizontal/inferior, and ascending
First part (superior) is intraperitoneal; 2-4th are retroperitoneal
Which anatomical region of the duodenum is common for ulcerations and subsequent bleeding to occur?
Duodenal bulb
The hepatoduodenal ligament is associated with the ____ part of the duodenum and contains the portal triad.
What is contained in the portal triad?
1st
Portal vein
Hepatic artery
Bile duct
The head of what organ sits just inferior to the 1st part of the duodenum?
Pancreas
The bile duct and pancreatic ducts enter the ____ part of the duodenum at the _____ _____
2nd; duodenal papilla
A tumor in the head of the pancreas would likely block what important anatomical structure?
Common bile duct
Medial, anterior, and posterior relationships of the 2nd part of the duodenum
Medial: head of pancreas
Anterior: gallbladder (fundus), R lobe of liver, transverse colon
Posterior: right kidney and ureter
The superior mesenteric artery and vein, as well as the root of the mesentery, cross anteriorly over which part of the duodenum?
3rd part
Superior and anterior relationships of 3rd part of duodenum
Superior: head of pancreas
Anterior: jejunum
Vascular compression disorder referring to compression of left renal vein between superior mesenteric artery and aorta leading to renal venous HTN, rupture of veins in collecting system, and hematuria
Nutcracker syndrome
Posterior and anterior relationships of 4th part of duodenum
Posterior: left margin of aorta, inferior mesenteric vein, and psoas muscle
Anterior: root of mesentery and jejunum
The 4th part of the duodenum is held in place by what structure?
Suspensory ligament of duodenum = ligament of Treitz
Anchors 4th part ot right crus of diaphragm
In which abdominal quadrant would you find the jejunum
LUQ
In which quadrant would you find the ileum
RLQ