Fiser ABSITE Ch. 30 Stomach Flashcards
What is the stomach transit time?
3-4 hours
Where does peristalsis occur in the stomach?
only in the distal stomach
What are the branches of the Celiac trunk?
left gastric, common hepatic, splenic
Left gastroepiploic and short gastrics are branches of what artery?
splenic
What is the blood supply of the greater curvature of the stomach?
right and left gastroepiploics, short gastrics
What is the blood supply of the lesser curvature of the stomach?
right and left gastrics
The right gastric is a branch of what artery?
common hepatic
What is the blood supply of the pylorus?
gastroduodenal artery
What is the mucosa of the stomach lined with?
simple columnar epithelium
What is the first enzyme in proteolysis and what cell secretes it?
Pepsinogen, secreted by chief cells
What do the parietal cells secrete?
H+ and intrinsic factor
What 2 things do Brunner’s glands in the duodenum secrete?
pepsinogen and alkaline mucus
Antrectomy with gastroduodenal anastomosis?
Billroth I
Antrectomy with gastrojejunal anastomosis?
Billroth II
____ ulcer is a vascular malformation in the stomach
Dieulafoy’s
____ disease is mucous cell hyperplasia, increased rugal folds of the stomach.
Menetrier’s
What is the tx for gastric volvulus?
reductiona and Nissen
Associated with type II (paraesophageal) hernia _ Nausea without vomiting; severe pain.
Gastric volvulus
Where is the tear usually located in a Mallory-Weiss tear?
near lesser curvature of the stomach near GE junction
What is the result of a vagotomy
vagal denervation all forms increase liquid emptying -> vagally mediated receptive relaxation is removed, results in increased gastric pressure that accelerates liquid emptying
In complete vagotomy (truncal or selective) there is decreased emptying of solids. In highly selective vagotomy there is normal emptying of solids. Addition of what procedure to either results in increased solid emptying?
Pyloroplasty
What is the most common problem following vagotomy (30-50%)?
diarrhea
Upper GI bleed and having trouble localizing source with EGD. What can be done next?
tagged RBC scan
What is the biggest risk factor for rebleeding of an upper GI bleed at the time of EGD?
spurting blood vessel
In a pt with liver failure, what is the most likely source of an upper GI bleed?
esophageal varices
What is the tx for a bleeding esophageal varices?
EGD with sclerotherapy or TIPS, not OR
What location of duodenal ulcers usually perforate? what location bleed from GDA?
anterior ulcers perforate, posterior ulcers bleed from GDA
Describe the incision and closure of a Heineke-Mikulicz pyloroplasty.
longitudunal incision of the plyloric sphincter followed by a transverse closure