Foregut

Question 1

Meckel’s diverticulum

Answer 1

embryological remnant of the yolk sac that does not close; could have feces coming out belly button or notice it’s always wet; have to rule this out in apendicitis

Question 2

omphalocele

Answer 2

failure of GI tract to retract into the abdominal cavity results in failure of the abdominal wall to close; needs surgical correction

Question 3

Foramen of winslow aka epiploic foramen

Answer 3

the opening beneath the free edge (right side) of the ventral mesentery or lesser omentum

Question 4

greater omentum

Answer 4

aprom mostly made of fat for protection and energy

Question 5

How is the connection with the posterior wall maintained?

Answer 5

transverse mesocolon

Question 6

intraperitoneal

Answer 6

organs that are wrapped in visceral peritoneum; free floating in abdomen

Question 7

retroperitoneal

Answer 7

organs outside of the peritoneum

Question 8

primary retroperitoneal

Answer 8

Organs that developed against the back wall behind the peritoneum

Question 9

Secondary retroperitoneal

Answer 9

organs that started w/ vesceral peritoneum but lost it when theym moved back

Question 10

__ umbilical vein and ___ umbilical arteries

Answer 10

1 umbilical vein 2 umbilical arteries. the arteries are the medial umbilical folds

Question 11

What structure is the obliterated umbilical vein?

Answer 11

ligamentum teres - the free edge of the falciform ligament

Question 12

falciform ligament is ?

Answer 12

ventral mesentery

Question 13

the lesser omentum or ventral mesentery is made up of what two ligaments?

Answer 13

hepatogastric and hepatoduodenal ligament

Question 14

what portion of the stomach empties into the sphinctor?

Answer 14

pylorus

Question 15

cardiac sphincter

Answer 15

where the esophagus meets the stomach

Question 16

foregut blood supply is from what a.?

Answer 16

celiac trunk: 3 main branches being l. gastric, splenic and common hepatic

Question 17

left gastric supplies

Answer 17

left side of lesser curvature of stomach

Question 18

splenic a supplies

Answer 18

spleen and branches to supply fundus of stomach and left side of greater curvature (l. gastroepiploic)

Question 19

common hepatic supplies

Answer 19

divides into hepatic proper and gastroduodenal. hepatic proper into r. and l. hepatic, r. hepatic branches to cystic to supply gallbladder. gastroduodenal gives off r. gastroepiploic. hepatic proper gives off right gastric to supply r. side of lesser curvature

Question 20

Describe the parasympathetic innervation of CN X

Answer 20

the vagus nerves form a plexus on the esophagus then branch to anterior and posterior trunks which catch rides on blood vessels to the organs; (post ganglionics are w/i organ)

Question 21

What all does CN X supply parasympathetics to?

Answer 21

mid gut and hind gut -

all of the gut down to the splenic flexure

Question 22

What give parasympathetic innervation to the hindgut?

Answer 22

S2-4

Question 23

What provides sympathetics to the abdominal organs through the preaortic ganglia?

Answer 23

thoracic and lumbar splanchnics

Question 24

thoracic splanchnics

Answer 24

(greater, lesser, least) enter through the diaphragm and synapse on preaortic ganglia, and postganlgionics catch a ride of the blood vessels

Question 25

lumbar splanchnics

Answer 25

sympathetics come off chain ganglia

Question 26

pelvic splanchnics

Answer 26

parasympathetics

Question 27

Parasympathetics of S2-4 come off as what?

Answer 27

pelvic splanchnic nerves

Question 28

Describe the path of the parasympathetics of S2-4

Answer 28

the hypogastric plexus (continuation of preaortics in pelvis) sends preganglionics along inferior mes as pelvic splanchnics to supply the descending and sigmoid colon and rectum which is where the postganglionics are

Question 29

What is the largest collection of sympathetics in the preaortic ganglia?

Answer 29

celiac ganglia - right beside celiac trunk

Question 30

R. and L hypogastric nerves

Answer 30

send sympathetics to the pelvic organs and how you get parasympathetics S2-4 out of the pelvis

Question 31

atrophic gastritis

Answer 31

stomach is smooth instead of rugated and have problems w/ no HA production

Question 32

pyloric stenosis

Answer 32

hypertrophied pylorus; pathonumonic feature is projectile vomiting and feels like walnut in empigastrium

Question 33

What regulates discharge of food bolus into the duodenum?

Answer 33

pyloric sphincter

Question 34

Quatrate and caudate lobe belong to which lobe of the liver?

Answer 34

left - supplied by left hepatic a.

Question 35

Where do hepatic veins drain?

Answer 35

into IVC

Question 36

What makes up the portal triad/porta hepatis?

Answer 36

hepatic a.; portal vein; bile duct

Question 37

ligamentum venosum is a remnant of what?

Answer 37

ductus venosus; bypass around the liver

Question 38

ligamentum teres is a remant of what

Answer 38

umbilical vein

Question 39

Where is the portal triad located?

Answer 39

in the hepatoduodenal ligament which is the free margin of the lesser omentum/ventral mes

Question 40

what surrounds the portal triad?

Answer 40

autonomic nerves that are going up into the liver

Question 41

what type of organ is the pancreas?

Answer 41

mostly retroperitoneal

Question 42

what type of organ is the duodenum?

Answer 42

the c loop is intraperitoneal then becomes retroperitoneal (so head of it you can move around)

Question 43

Where does the head of the pancreas sit?

Answer 43

C loop of duodenum

Question 44

Where is the sup. mes. a. located in terms of parts of the pancreas?

Answer 44

b/w the body and uncinate process

Question 45

the uncinate process of the pancreas (deep to vessels) is made from what?

Answer 45

ventral pancreatic bud

Question 46

What is a good predisposition for gallstones?

Answer 46

5 fs: fare, fat, female, flatulent, fertile

Question 47

Where does the bile duct drain?

Answer 47

into the C loop of duodenum through ampula of vater

Question 48

What does the bile duct join with to drain into ampula of vater ?

Answer 48

main pancreatic duct

Question 49

Where is the ampula of vater

Answer 49

always distal to opening of the accessory pancreatic duct

Question 50

What surrounds the ampula of vater?

Answer 50

sphincter of Oddi

Question 51

Why is cancer of the pancrease so bad?

Answer 51

it can grow w/i pain b/c lots of room; hard to palpate b/c deep;

Question 52

how would you get painless jaundice w/ pancreatic cancer?

Answer 52

a tumor in the head of pancreas can obstruct the bile duct so bilirubin would dump into circulation (jaudice from gallstone is painful)

Question 53

How could you get ischemia from cancer of the pancreas?

Answer 53

cancer in head of pancraeas could occule the mesenteric vessels causing down stream ischemia

Question 54

diaphragm

Answer 54

somatic muscle w/ central tendon; attached at costal margin all the way around from zyphoid to T12

Question 55

where do the greater/lesser/least splnachnic nerves travel through the diaphragm?

Answer 55

through the muscle itself (along w/ phrenic n. and sympathetic chains)

Question 56

What are the 3 hiati and their order in the diaphragm?

Answer 56

IVC foramen (highest), esophageal hiatus then aortic hiatus

Question 57

what travels through the esophageal hiatus?

Answer 57

esophagus and vagus nerves

Question 58

what travels through the aortic hiatus?

Answer 58

aorta and azygous system and thoracic duct

Question 59

what ligaments surround the aortic hiatus?

Answer 59

r. crus and left crus

Question 60

medial and lateral arcuate ligaments

Answer 60

medial: for psoas major lateral: for quadratus lumborum

Question 61

hiatal hernia

Answer 61

if esophageal hiatus is lax and cardiac region of stomach protrude up through it and lose the ability to retain stomach acids