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MSS - GI Exam 1 > Exam 1 Comprehensive Review > Flashcards

Exam 1 Comprehensive Review Flashcards

1
Q

xiphoid

A

T10

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2
Q

umbilicus

A

IV disc LV3-4

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3
Q

linea semilunares

A

lateral rectus sheath

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4
Q

9 regions of abdomen

A

epigastric, umbilicus, pubic

L/R - hypochondriac, lateral, inguinal

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5
Q

planes of 9 regions

A

2 vertical midclavicular

subcostal LV3, transtubercular LV5

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6
Q

transpyloric

A

LV1

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7
Q

subcostal

A

LV3

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8
Q

transumbilical

A

LV3/4

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9
Q

supracristal

A

LV4

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10
Q

transtubercular

A

LV5

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11
Q

interspinous

A

SV1

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12
Q

kidney location

A

in upper quadrants

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13
Q

bony structures of abdominal wall

A

LV1-5
ribs 7-12
pelvic girdle
sternum

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14
Q

deep fascia layers

A

transversalis
subserous
peritoneum

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15
Q

superficial layers

A

campers fatty
scarpas membranous

scarpas to fundiform ligament**

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16
Q

arcuate line

A

where rectus sheath changes

above - internal oblique splits to AP
below - all 3 layers A and transversalis P

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17
Q

attachment external abdominal oblique

A

O: outer surface ribs 5-12
I: anterior iliac crest, aponeurosis to linea alba

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18
Q

action external abdominal oblique

A

flex vertebral column, compress abdomen, lateral flexion and rotation OPPOSITE

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19
Q

innervation of external abdominal oblique

A

intercostal
subcostal
iliohypogastric

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20
Q

attachment of internal abdominal oblique

A

O: thoracolumbar fascia, A iliac crest, lateral inguinal ligament
I: inferior border ribs 9-12, aponeurosis to linea alba

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21
Q

action of internal abdominal oblique

A

flex vertebral column, compress abdomen, lateral flexion and rotation SAME

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22
Q

innervation of internal abdominal oblique

A

intercostal
subcostal
iliohypogastric
ilioinguinal

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23
Q

cremaster muscle

A

from internal abdominal oblique

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24
Q

attachments of transversus abdominus

A

O: inner surface ribs 7-12, thoracolumbar fascia, anterior iliac crest, lateral inguinal ligament
I: aponeurosis to linea alba

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25
Q

action of transversus abdominus

A

compress abdomen

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26
Q

innervation of transversus abdominus

A

intercostal
subcostal
iliohypogastric
ilioinguinal

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27
Q

attachments of rectus abdominus

A

O: pubic symphysis and crest
I: costal cartilage 5-7, xiphoid

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28
Q

action of rectus abdominus

A

flex vertebral column

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29
Q

innervation of rectus abdominus

A

ventral rami T6-12
intercostal
subcostal

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30
Q

attachments of pyramidalis

A

O: pubic bone; out to rectus abdominus
I: linea alba

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31
Q

action of pyramidalis

A

tense linea alba

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32
Q

innervation of pyramidalis

A

subcostal

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33
Q

median umbilical fold

A

used to be urachus

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34
Q

medial umbilical fold

A

occluded umbilical arteries

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35
Q

lateral umbilical fold

A

inferior epigastric vessels

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36
Q

supravesical fossa

A

median to medial umbilical

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37
Q

medial inguinal fossa

A

medial to lateral umbilical

direct hernias

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38
Q

lateral inguinal fossa

A

lateral to the lateral umbilical

indirect hernias

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39
Q

T10 dermatome

A

umbilicus

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40
Q

L1 dermatome

A

iliac crest, ASIS, inguinal

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41
Q

subcostal nerve

A

anterior rami T12

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42
Q

thoracoabdominal nerves

A

anterior rami T7-11

used to be intercostal nerves

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43
Q

ilioinguinal nerve

A

anterior rami L1

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44
Q

iliohypogastric nerve

A

anterior rami L1

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45
Q

inferior epigastric artery

A

from external iliac deep to inguinal canal

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46
Q

superficial epigastric atrery

A

from external iliac superficial to inguinal canal

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47
Q

superficial circumflex iliac artery

A

from external iliac lateral to inguinal canal

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48
Q

superficial lymph drain to abdomen?

A

above transumbilical - axillary lymph nodes and some to parasternal

below transumbilical - superficial inguinal lymph nodes

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49
Q

inguinal ligament

A

inferior external abdominal oblique aponeurosis

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50
Q

lacunar ligament

A

deep medial fibers of ingunial ligament that attach to superior pubic ramus

medial border of femoral canal

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51
Q

pectineal ligament

A

most lateral of lacunar ligament fibers that runs along the pecten pubis

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52
Q

reflected inguinal ligament

A

superior fibers of inguinal ligament that cross linea alba and blend with contralateral external oblique aponeurosis

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53
Q

contents of inguinal canal

A

male - spermatic cord
female - round ligament of uterus

also ingunial nerve

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54
Q

lateral crus

A

to pubic tubercle

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55
Q

medial crus

A

to pubic crest

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56
Q

intercrural fibers

A

between lateal and medial crus

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57
Q

boundaries of inguinal canal

A

anterior - external oblique aponeurosis

posterior - transversalis fascia

superior - transversalis fascia, musculoaponeurotic arches of int oblique and transversu abdominus, medial crus

inferior - iliopubic tract, inguinal ligament, lacunar ligament

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58
Q

conjoint tendon

A

reinforce medial inguinal canal

-attachments of internal oblique and transversus abdominus aponeurosis to form form this common tendon

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59
Q

gubernaculum

A

pulls testis in males and round ligament of uterus in females through the inguinal canal

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60
Q

spermatic cord

A 
vas deferens
testicular artery
artery of vas deferens
cremasteric artery
lymph vessels
genital branch of genitofemoral nerve
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61
Q

cremaster muscle innervation

A

genital branch of genitofemoral nerve (L1-2)

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62
Q

covering of spermatic cord

A

internal spermatic fascia - transversalis fascia
cremasteric fascia - internal abdominal oblique
external spermatic fascia - external oblique aponeurosis

tunica vaginalis - serous cavity around testis

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63
Q

more common inguinal hernia

A

indirect

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64
Q

canal of nuck

A

in females - processus vaginalis fails to close and forms pouch that can form cysts

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65
Q

indirect hernia

A

caused by failure of closure of processus vaginalis
lateral to inferior epigastric vessels

through deep inguinal ring

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66
Q

direct hernia

A

acquired, weakness of superficial inguinal ring
medial to inferior epigastric vessels

medial inguinal fossa (hasselbachs triangle)

does not extend to scrotum

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67
Q

parietal peritoneum

A

lots of pain fibers

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68
Q

visceral peritoneum

A

pain travels with autonomics

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69
Q

primary retroperitoneal

A

bladder, kidney, ureters

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70
Q

secondary retroperitoneal

A

ascending/descending colon
duodenum 2 and 3
pancreas

have fusion fascia

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71
Q

fusion fascia

A

easily separated during surgery

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72
Q

round ligament of liver

A

obliterated umbilical vein

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73
Q

lesser omentum

A

hepatogastric and hepatoduodenal ligament

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74
Q

what encloses triad

A

hepatoduodenal ligament

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75
Q

triangular ligaments

A

where ends of A and P coronary ligaments meet

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76
Q

greater omentum

A

gastrocolic
gastrosplenic
gastrophrenic

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77
Q

phrenicocolic ligament

A

diaphragm to left colic flexure

supports spleen**

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78
Q

mesoesophagus

A

to last inch of esophagus

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79
Q

splenorenal ligament

A

spleen to posterior body wall

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80
Q

boundaries of epiploic foramen

A

anterior - hepatoduodenal ligament
posterior - IVC
superior - liver
inferior - 1st part duodenum

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81
Q

peritonitis

A

well localized

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82
Q

peritoneal adhesions

A

inflammation causes it to stick together with fibrin

can cause chronic pain

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83
Q

lesser sac

A

posterior to stomach and mesenteries

-superior and inferior recess

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84
Q

greater sac

A

anterior to stomach and mesenteries

-supracolic and infracolic compartment

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85
Q

infracolic compartment

A

left and right by mesentery proper

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86
Q

paracolic gutters

A

right and left

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87
Q

peritoneal dialysis

A

vessels and lymphatics of peritoneum make it good for dialysis

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88
Q

infracolic compartment flow

A

left freely to pelvis

right closed off by cecum and mesentery proper

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89
Q

paracolic gutter flow

A

right freely to hepatorenal and subphrenic recess

left bound by phrenicocolic ligament

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90
Q

paracolic gutter flow inferior

A

both freely to pelvis

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91
Q

subphrenic recess

A

between liver and diaphragm

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92
Q

hepatorenal recess

A

between liver and right kidney

fluid likes to pool here

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93
Q

celiac trunk

A

T12

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94
Q

SMA

A

L1

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95
Q

IMA

A

L3

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96
Q

supplied by celiac trunk

A

esophagus, liver, gallbladder, stomach, spleen, pancreas, duodenum first half

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97
Q

supplied by SMA

A

2nd half duodenum to proximal transverse colon

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98
Q

supplied by IMA

A

distal transverse colon to anus

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99
Q

branches of celiac trunk

A

left gastric artery
common hepatic artery
splenic artery

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100
Q

branches of SMA

A 
middle colic
jejunal branches
ilieal branches
right colic
ileocolic - ileal, appendicular, AP cecal, ascending colic
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101
Q

branches of IMA

A

left colic
sigmoidal
superior rectal

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102
Q

formation of HPV

A

splenic and IMV merge

join SMV to form HPV

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103
Q

esophageal varices

A

left gastric vein to esophageal veins

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104
Q

caput medusa

A

superior and inferior epigastric veins to paraumbilical veins

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105
Q

hemorrhoids

A

medial/inferior rectal veins to superior rectal veins

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106
Q

retroperitoneal anastomosis

A

gonadal/renal vein to ileocolic, right, middle, left colic veins

don’t see clinically

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107
Q

esophagus enter abdomen

A

TV10

enters stomach TV11

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108
Q

phrenicoesophageal ligaments

A

loose diaphragm to esophagus

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109
Q

Z-line

A

gastro-esophageal junction

-stratified squamous to columnar epithelium

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110
Q

constriction of esophagus

A

cervical - cricopharyngenous muscle
thoracic - aortic arch
diaphragmatic

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111
Q

paraesophageal hernia

A

fundus region of stomach

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112
Q

sliding hernia

A

cardiac region of stomach

congenitally short esophagus

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113
Q

gastrectomy

A

partial possible because of collateral arterial flow

however, lymph drainage is difficult to get rid of

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114
Q

cardia region of stomach

A

TV11

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115
Q

pylorus of stomach

A

LV1-2

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116
Q

ulcer of stomach

A

can erode to splenic vessels

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117
Q

gastric canal

A

rugae parallel along lesser curve of stomach

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118
Q

pyloric sphincter

A

sympathetic innervation

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119
Q

blood supply of stomach

A

all three branches of celiac trunk

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120
Q

duodenum 1

A

superior LV1

peritonealized (hepatoduodenal ligament)

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121
Q

duodenum 2

A

descending LV1-3
retroperitoneal
major and minor papilla

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122
Q

duodenum 3

A

transverse LV3

retroperitoneal

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123
Q

duodenum 4

A

ascending LV3-2

beginning retro, end peritonealized

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124
Q

duodenal ulcer

A

gastroduodenal artery

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125
Q

suspensory ligament of treitz

A

supports duodenojejunal flexure

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126
Q

paraduodenal hernias

A

folds of peritoneum around 3 and 4 of duodenum

  • small intestine can herniate
  • surgery care for inferior mesenteric vessels
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127
Q

jejunum vs. ileum

A

jejunum - thicker, more plica, more vascular

ileum - more fat, more peyers patches (lymph)

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128
Q

paralytic ileus

A

obstruction due to blood occlusion

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129
Q

tenia coli

A

longitudinal muscle on large intestine

pulls colon into haustra (sacs)

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130
Q

cecum and appendix

A

peritonealized in RLQ

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131
Q

appendicitis

A

pain T10 dermatome to RLQ

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132
Q

hepatic flexure

A

right colic

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133
Q

splenic flexure

A

right colic

-supported by phrenicocolic ligament

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134
Q

ampulla of rectum

A

terminal portion

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135
Q

internal sphincter

A

sympathetic constriction

PS relaxation

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136
Q

external sphincter

A

skeletal m.

inferior rectal nerve

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137
Q

pectinate line

A

endo/ectoderm split in anus

-at base of anal columns

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138
Q

internal hemorrhoids

A

dilated internal venous plexus

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139
Q

external hemorrhoids

A

dilated external venous plexus

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140
Q

spleen

A

LUQ

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141
Q

accessory spleen

A

in gastrosplenic ligament

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142
Q

duct of wirsung

A

main pancreatic duct
-tail body head
merges with common bile duct
to form hepatopancreatic ampulla of vater

143
Q

sphincter of oddi

A

of hepatopancratic ampulla of vater

144
Q

pancreatitis

A

commonly caused by gallstone obstruction

-bile reflux

145
Q

pancreatic cancer

A

can obstruct bile duct

-secondary jaundice

146
Q

liver

A

RUQ

can regenerate until cirrhosis

147
Q

porta hepatis

A

hilum of liver

148
Q

bare area of liver

A

liver contacts diphragm

-phrenic nerve pain to neck

149
Q

portal triad

A

proper hepatic artery A/L
bile duct A/R
HPV P

150
Q

drainage of hepatorenal recess

A

incision at 12th rib

151
Q

functional lobes of liver

A

caudate and quadrate are left

-determined by branches of hepatic artery

152
Q

liver lobule

A

6 hepatocytes around 1 central vein

  • periphery - triad
  • center is central vein

blood to center
bile to periphery

153
Q

liver blood supply

A

most HPV

some celiac trunk proper hepatic a.

154
Q

liver biopsy

A

10th ICS midaxillary

155
Q

gallbladder level

A

9th ICS MCL on right

156
Q

cholecystenteric fistula

A

chronic inflammation

-hap to duodenum or transverse colon

157
Q

parotid gland

A 
serous
salivary amylase (carbs)
158
Q

submandibular gland

A

mixed

159
Q

sublingual gland

A

mucous

160
Q

minor salivary gland

A

mucous

161
Q

vermillion zone

A

lips - colored portion

dermal papillae

162
Q

decidious teeth

A

20 as child

163
Q

adult teeth

A

20 succedaneous

12 molars

164
Q

crown

A

of tooth

above gingiva

165
Q

ameloblast

A

regenerate enamel

166
Q

odontoblas

A

regenerate dentin

167
Q

peridontal ligament

A

dense collagen CT binds tooth to socket

168
Q

gingiva

A

type 1 collagen

attaches via hemidesmosomes (forms barrier)

169
Q

hard palate

A

A - adipose

P - minor salivary glands

170
Q

soft palate

A

skeletal m.

minor salivary glands

171
Q

uvula

A

extension of soft palate

172
Q

tongue muscle

A

extrinsic to outside of tongue

intrinsic:
superior long
inferior long
vertical
transverse
173
Q

glands of nuhn

A

mucous on tongue

174
Q

von ebners glands

A

serous on tongue

175
Q

sulcus terminalis

A

seperates A/P tongue

-has foramen cecum

176
Q

filiform papillae

A

scrapers
no taste buds
stratified squamous cornified

177
Q

fungiform papillae

A

taste buds dorsal

178
Q

circumvallate papillae

A

taste buds lateral

8-12 anterior to sulcus terminalis
von ebners open

179
Q

foliate papillae

A

posterolateral tongue

nenoate taste buds

180
Q

taste buds

A

basal progenitor cells
sustentacular supportive cells
gustatory neuroepithelial cells

181
Q

5 tastes

A

salt and sour - ion channels

sweet, bitter, savory (umami) - membrane receptors

182
Q

sweet taste

A

tip of tongue

183
Q

salty taste

A

tip of tongue and lateral

184
Q

sour taste

A

lateral middle tongue

185
Q

bitter and umami taste

A

posterior middle tongue

186
Q

intraembryonic body cavity

A

lateral plate mesoderm

187
Q

body wall defects

A

ventral body wall fails to fuse

188
Q

ectopic cordis

A

thorax body wall defect

189
Q

gastroschisis

A

abdomen body wall defect

190
Q

cantrells pentology

A 
ectopic cordis
cleft sternum
gastroschisis
diaphragmatic hernia
congenital heart defects
191
Q

ventral mesentery

A

caudal foregut to proximal duodenum

  • lesser omentum
  • falciform
  • coronary/triangular
192
Q

septum transversum

A

somites C345

-forms diaphragm (part)

193
Q

pleuropericardial membrane

A

separate pleural and pericardial cavity

194
Q

pleuroperitoneal membrane

A

separate pleural and peritoneal cavity

195
Q

formation of diaphragm

A

septum transversum - central tendon and muscle

pleuroperitoneal membrane - central tendon

196
Q

innervation of diaphragm

A

motor - phrenic

sensory -phrenic central tendon, intercostal muscles

197
Q

bochdalek hernia

A

posterolateral
incomplete pleuroperitoneal membrane

lungs and heart compressed
-hypoplasia

198
Q

morgagni hernia

A

parasternal
anterior defect in muscular portion

small, sometimes not detected

199
Q

eventration fo diaphragm

A

weakness due to failed myotome migration

-abdominal visceral balloon into thoracic cavity

200
Q

endoderm

A

epithelium and glands of gut tube

201
Q

mesodoerm

A

CT and smooth m. of gut tube

202
Q

ectoderm

A

epithelium at ends of gut tube

203
Q

stomodeum

A

oral cavity

204
Q

proctodeum

A

anus

205
Q

initial closure of gut tube?

A

rostral - oropharyngeal membrane

caudal- cloacal membrane

206
Q

stenosis

A

narrowing

207
Q

atresia

A

completely blocked off

208
Q

esophagus development

A

week 5 lumen obliterates

-week 8 recanalizes

209
Q

congenital hiatal hernia

A

esophagus doesnt lengthen

210
Q

transesophageal fistula

A

trachea to esophagus opening

211
Q

stomach development

A

rotates 90 clockwise longitudinally
rotates A/P axis 45

stretches dorsal mesentery (greater omentum)
-omental bursa

212
Q

pyloric stenosis

A

hyperptrophy of smooth m. around pyloric sphincter

213
Q

spleen formation

A

from mesenchymal cells in two layers of mesogastrium

-rotation puts spleen to left

214
Q

liver formation

A

liver bud from part 2 duodenum

-endoderm - parenchyma; mesoderm - stroma

215
Q

gallbladder formation

A

evagination of bile duct

216
Q

pancreas formation

A

from 2nd portion of duoenum
ventral bud from liver bud
dorsal bud from dorsal duodenum

rotation of duodenum fuses the two buds

217
Q

accessory pancreatic tissue

A

abnormal migration

can degrade tissue

218
Q

annular pancreas

A

bifid pancreatic bud - encircles duodenum

219
Q

maternal diabetes

A

hypertrophy insulin secreting cells

increased rate of insulin production

220
Q

duodenum formation

A

1 and 2 foregut

3 and 4 midgut

221
Q

duodenal stenosis

A

failure to recanalize
mainly 3rd part

green colored - stenosis distal to 2nd part
white colored - proxinal to 2nd part

222
Q

midgut formation

A

remains in communication with yolk sac
-via vitelline duct

week 5 midgut loop

week 6 herniation

rotation 270 counterclockwise twists mesentery proper and ascending/descending colon 2 retroperitoneal

week 10-12 retraction of herniated loop

  • jejunum first
  • cecum last (RUQ than descends)
223
Q

appendix formation

A

after midgut returns to abdomen

as cecum descends

224
Q

omphalocele

A

failure of midgut to retract to abdomen

-tissue covered by amniotic membrane**

225
Q

gastroschisis

A

gut herniates through weakness in body wall

  • typically lateral to umbilicus (to right)
  • not covered by amniotic membrane**

true ventral body wall defect

226
Q

umbilical hernia

A

gut herniates into umbilical cord after returning to abdominal cavity

-covered by skin/subQ tissue

227
Q

meckels diverticulum

A

persistence of vitelline duct

  • forms diverticulum
  • sometimes fistula (poopy belly button)

rule of 2’s:

  • 2% population
  • 2x more in males
  • within distal 2 feet ileum
  • 2 inches long
  • 2% symptomatic before age 2** (like appendicitis)
  • 2 types of tissue (gastric/pancreatic)
228
Q

malrotation of gut

A

volvulus and potential loss of blood supply

volvulus - twisting of intestine

229
Q

cloaca

A

distal most portion of gut tube
-endoderm lined cavity

cloacal membrane ruptures week 7

230
Q

urorectal septum

A

separates claca into urogenital sinus and anorectal canal

231
Q

hirschprungs disease

A

congenital megacolon

  • failure of neural crest cells to migrate into large intestine or rectum
  • absense of PS ganglia
232
Q

fistulas and atresias of cloaca

A

improper formation of urorectal septum

fistula - abnormal urorectal septum formation

233
Q

4 layers of gut tube

A

mucosa
submucosa
muscularis externa
adventitia

234
Q

layers of mucosa

A

epithelium
lamina propria
muscularis mucosae - inner circ/ outer long

235
Q

muscularis mucosa

A

third layer of mucosa

in stomach sometimes has 3rd oblique layer of muscles

236
Q

submucosa

A

layer of CT with some elastic fibers

has meissners plexus (PS)
vessels, lymph, nerves

237
Q

muscularis externa

A

inner circ
outer long

auerbachs plexus between layers (PS)

238
Q

adventitia

A

outermost coat of dense CT

-often blends with CT

239
Q

serosa

A

single layer of mesothelial cells

entire coat is serosa

240
Q

epithelial

A

endoderm

241
Q

absorption in stomach

A 
some salts
water
glucose
alcohol
drugs
242
Q

anatomical vs histological regions of stomach

A

anatomy - body, fundus, cardium, pylorus

histo - histo fundus (body and fundus), cardium, pylorus

243
Q

jejunum

A

2/5

244
Q

ileum

A

3/5

245
Q

large intestine

A

water reabsorption

dehydration of chyme

246
Q

pectinate line

A

simple columnar epithelium to stratified squamous wet epithelium

247
Q

epithelium of esophagus

A

stratified squamous non-cornified

248
Q

lamina propria of esophagus

A

peg downward
papilla upward

scattered lymph
cardiac esophageal glands (mucous)

249
Q

muscularis mucosa of esophagus

A

well developed with some elastic fibers

250
Q

submucosa of esophagus

A

longitudinal folds

star shaped lumen

251
Q

muscularis externa as go down GI tract?

A

upper esophagus - skeletal muscle

lower esophagus - smooth muscle

252
Q

esophagus

A

has adventitia but no serosa

253
Q

cardioesophageal junction

A

stratified squamous to simple columnar epithelium

254
Q

stomach epithelium

A

thick mucosa
simple columnar epithelium
mucous cells not goblet cells

255
Q

gastric pits

A

invaginations of epithelium of stomach

256
Q

muscularis externa layers

A

inner oblique
middle circ
outer long

257
Q

outer tunic of stomach

A

serosal layer

258
Q

cardiac region of stomach

A

surface mucous cells
undifferentiated cells

cardiac gastric glands empty to base of each pit

259
Q

fundic region of stomach

A

gastric pit that had 3-7 glands

gland cells:
mucous neck cells
parietal cells
zymogenic chief cells
enteroendocrine cells (argentaffin cells)
260
Q

pyloric region

A

short coiled glands

mucous secreting cells
gastrin producing cells

261
Q

pyloric sphincter

A

hypertrophied the middle layer of muscularis externa (circular)

262
Q

surface mucous cells

A

neutral mucous

263
Q

mucous neck cells

A

acidic mucus

264
Q

parietal cells

A

HCl, activiate enzymes
intrinsic factor - B12 absorption

pink to red stain

265
Q

chief cells

A

produce pepsin and lipase

pale stain

266
Q

enteroendocrine cells

A 
secrete:
gastrin
somatostatin
VIP
serotonin
GIP
267
Q

3 magnitudes of folding in small intestine

A

microvilli
villi
plica circulares

268
Q

microvilli

A

cytoplasmic projections of cell membrane

269
Q

villi

A

evagination of mucosa with lamina propria core

270
Q

villus in different areas of small intestine

A

duodenum - broad short leaf like
jejunum - tongue like
ileum - tall, narrow, finger like

271
Q

plica circulares

A

circular folds of entire mucosa - core of submucosa

begin in proximal duodenum

absent in distal half of ileum

272
Q

brunners glands

A

submucosa duodenal glands

273
Q

inestinal crypts

A

in small intestines

-similar to gastric glands

274
Q

enteroendocrine secretions of the small intestine

A 
incretins
GIPs
serotonin
somatostatin
motilin
CCK
neurotensin
VIP
substance P
endorphins
275
Q

paneth cells

A

in base of intestinal crypts
-large acidophilic granules

lysozymes and peptide defensins

276
Q

M cells

A

in epithelium

transport antigens to APCs

277
Q

lamina propria of small intestine

A

lymphoid tissue - peyers patches

lots in lieum with lots of M cells as well

278
Q

serosa in small intestine

A

jejunum and ileum have serosa with mesentery

279
Q

large intestine

A

lacks villi

280
Q

crypts of lieberkuhn

A

intestinal crypts in large intestine

longer, more closely packed

paneth absent

281
Q

large intestine epithelium

A 
simple columnar (like small intestine)
goblet cells more numerous
282
Q

plica circulares in large intestines

A

not present in large intestine
-have plica semilunares

produce haustra

283
Q

muscularis externa of colon

A

incomplete

outer longitudinal layer is in bands
tenia coli

284
Q

appendices epiploicae

A

adipose attachments to colon

285
Q

rectum muscularis externa

A

complete again

286
Q

rectum serosa

A

present on upper 1/3

absent from lower rectum / anal canal

287
Q

plica transversalis

A

transverse folds of mucosa in rectum

288
Q

rectal columns

A

longitudinal folds in mucous membrane in the rectum

289
Q

anal canal CT in submucosa

A

subepithelial circumanal glands

longitudinal thin walled veins

290
Q

muscularis externa of anal canal

A

internal - internal anal sphincter

external sphincter from skeletal muscle

291
Q

ileocecal junction

A

separated by muscle from the muscularis externa

292
Q

caudal anal canal

A

anal verge

changes to stratified squamous epithelium, keratinized

sweat glands
hair follicles
sebaceous glands

293
Q

anal verge

A

epithelium of canal becomes continuous with perineal skin

294
Q

pancreas level

A

LV2

retroperitoneal

295
Q

development of pancreas

A

endoderm

ventral and dorsal buds

296
Q

injured during splenectomy

A

pancreatic tail

lies at TV12

297
Q

venous drainage of pancreas

A

head and body - A P arcades

body and tail - splenic veins

298
Q

exocrine pancreas

A

acinar cells - amylase, lipase, trypsinogen
ductal cells - water and electrolytes
centroacinar and intercalated duct cells -bicarb

299
Q

final digestive juice from pancreas

A

alkaline, isosmotic

enzymes activated by acid in duodenum

300
Q

endocrine pancreas

A

islets of langerhans

301
Q

alpha cells

A

glucagon

302
Q

beta cells

A

insulin, amylin

303
Q

delta cells

A

somatostatin

304
Q

PP cells

A

pancreatic polypeptide

305
Q

delta 1

A

VIP

306
Q

EC beta cells

A

secretin motilin substance P

307
Q

epsilon cells

A

ghrelin

308
Q

ghrelin

A

stimulates appetite

309
Q

islet acinar axis

A

paracrine relationships

each islet is like mini organ with blood supply

310
Q

renal arteries level

A

LV1 LV2

right longer than left

311
Q

nutcracker syndrome

A

left renal vein pinched

between SMA and aorta

312
Q

suprarenal gland

A

primary retroperitoneal

cortisol, aldosterone, androgens, E, NE

313
Q

arterial supply of suprarenal gland

A

superior suprarenal a from inferior phrenic a
middle suprarenal a from aorta
inferior suprarenal a from renal a

314
Q

left suprarenal vein

A

to left renal vein

315
Q

median arcuate ligament

A

at TV12 - between right and left crus

-forms aortic hiatus

316
Q

medial arcuate ligament

A

over psoas major

317
Q

lateral arcuate ligament

A

over quadratus lumborum

318
Q

lumbocostal triangle

A

muscle weakness between costal and lumbar portions of diaphragm

common site of herniation

319
Q

caval hiatus

A

TV8

IVC and right phrenic nerve

320
Q

esophageal hiatus

A

TV10

esophagus, A/P vagal trunks, left gastric a

321
Q

aortic hiatus

A

TV12

aorta and thoracic duct

322
Q

diaphragm innervation

A

motor - phrenic

sensory - phrenic, intercostal

323
Q

diaphragm pain referred to

A

C345 dermatomes

324
Q

left inferior phrenic vein

A

merges with suprarenal v to left renal v to IVC

325
Q

psoas major attachments

A

O: TV12-LV5 and IV discs
I: lesser trochanter

326
Q

psoas major innervation

A

ventral rami L1-3

327
Q

psoas minor innervation

A

ventral rami L1

328
Q

iliacus innervation

A

femoral nerve

329
Q

quadratus lumborum innervation

A

ventral rami T12-L4

330
Q

psoas sign

A

pain with thigh extension

indicate abdominal infection

331
Q

subcostal nerve

A

T12

332
Q

lumbar plexus

A

ventral rami L1-5

333
Q

iliohypogastric nerve

A

L1

334
Q

ilioinguinal nerve

A

L1

335
Q

femoral nerve

A

L2-4

336
Q

lateral cutaneous nerve of thigh

A

L2-3

337
Q

genitofemoral nerve

A

L1-2

338
Q

obturator nerve

A

L2-4

339
Q

lumbosacral trunk

A

L4-5

340
Q

division of aorta

A

LV4

341
Q

inferior phrenic artery level

A

TV12

342
Q

celiac trunk level

A

TV12

343
Q

SMA level

A

LV1

344
Q

middle suprarenal artery level

A

LV1

345
Q

renal artery level

A

LV1 LV2

346
Q

gonadal artery level

A

LV2

347
Q

IMA level

A

LV3

348
Q

median sacral artery level

A

LV4

349
Q

common iliac level

A

LV4

divides at LV5 to external and internal

350
Q

anterior midline arteries

A

celiac
SMA
IMA

unpaired visceral

351
Q

lateral arteries

A

suprarenal
renal
gonadal

paired visceral

352
Q

posterolateral arteries

A

subcostal
inferior phrenic
lumbar

paired parietal

353
Q

common iliac veins to IVC

A

LV5

MSS - GI Exam 1 (11 decks)

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