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Colin GI > GA GI Organs > Flashcards

GA GI Organs Flashcards

1
Q

At what spine segment level is the esophagus?

A

T10-T11

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2
Q

At what spine segment level is the stomach?

A

T11

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3
Q

At what spine segment level is the pylorus?

A

L1

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4
Q

What important ligament is attached to the esophagus and what is its function?

A

The phrenico-esophageal ligament
(Phrenic = diaphragm)

Binds the esophagus to the diaphragm

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5
Q

What two nerves travel with the esophagus as it descends through the diaphragm?

A

The Anterior and Posterior Vagal trunks

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6
Q

What happens with a Cervical Esphageal Constriction, what structures are involved?

A

Cervical Esophageal Constriction is a result of the closing of the Upper Esophageal Sphincter (which is controlled by the Cricopharyngeus Muscle

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7
Q

What happens with a Thoracic Esophageal Constriction, what structures are involved?

A

Thoracic Esophageal Constriction occurs as a result of contact with the Left Main Bronchus and the Aorta

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8
Q

What happens with a Diaphragmatic Esophageal Constriction, what structures are involved?

A

Diaphragmatic Esophageal Constriction occurs as a result of contact with the diaphragm as the esophagus passes through the Esophageal Hiatus at T10.

Also occurs as a result of complications with the Lower Esophageal Sphincter

Implicated in Hiatal Hernias

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9
Q

What is a Paraesophageal Hiatal Hernia?

A

Hiatal Hernia is when abdominal structures enter the thorax (commonly occurs on the left side)

Paraesophageal Hiatal Hernias occur when the FUNDUS of the stomach protrudes into the thorax adjacent to the esophagus

Note the Gastroesophageal Junction is normal and there is lesser chance of developing GERD with this particular form of Hiatal Hernia

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10
Q

What is a Sliding Hiatal Hernia?

A

Hiatal Hernia is when abdominal structures enter the thorax (commonly occurs on the left side)

Sliding Hiatal Hernias occur when the CARDIA of the stomach protrudes into the thorax, causing the stomach to have an Hour Glass shape

This is the most common form of Hiatal Hernia and results in the displacement of the Gastoresophageal Junction superiorly.

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11
Q

What are the 5 parts of the stomach?

A 
Cardia
Fundus
Body
Pyloric Antrum
Pyloric Canal
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12
Q

What structure(s) will you find anteriorly to the stomach?

A

Left Lobe of the Liver
Diaphragm
Anterior Abdominal Wall

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13
Q

What structure(s) will you find infero-laterally to the stomach?

A

The transverse Colon

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14
Q

What structure(s) will you find posteriorly to the stomach?

A 
Left Kidney
Left Suprarenal Gland
Pancreas
Spleen
Diaphragm
Omental Bursa (lesser sac)
    - Stomach serves as the anterior wall of the lesser 
       sac
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15
Q

What two ligaments are found attached to the stomach and what is their purpose?

A

Gastrohepatic Ligament - Connects lesser curvature of the stomach to the Liver
- Gastric vessels follow this ligament (including the Left Gastric A

Gastrocolic Ligament - Connects the greater curvature of the stomach to the transverse colon

  • The Gastroepiploic vessels follow this ligament
  • Also this ligament is part of the Greater Omentum
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16
Q

What is a Gastric Ulcer?

A

When the acid of the stomach pierces through the wall of the stomach

70% of stomach ulcers are related to H pylori bacteria

Complications can arise if the ulcer occurs at the lesser curvature of the stomach where leaking acid can cause damage to the Left Gastric A., causing hemorrhage.

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17
Q

What is a Peptic/Duodenal Ulcer?

A

Acid from the stomach breaches through the wall of the pylorus or the duodenum

90% of Peptic/Duodenal Ulcers are related to H pylori bacteria

65% of cases have the ulcer on the posterior side of the 1st part of the duodenum, which can cause hemorrhage by damaging the Gastroduodenal A.

If anterior wall is breached, the pancreas can be affected

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18
Q

What is the purpose of a vagatomy?

A

Vagatomy is when the vagus is surgically severed

Parasympathetic innervation from the vagus nerve to the parietal cells of the Body and Fundus of the stomach promote acid secretion.

Thus Vagatomies are used as a treatment for ulcers by blocking parasympathetic promotion of acid secretion.

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19
Q

What are the 3 types of Vagotomies and how are they different?

A

Truncal Vagotomy: Surgical section of vagal trunk; not preferred as this would sever innervation to other abdominal organs besides the stomach

Selective Gastric Vagotomy: Surgical section of vagus nerve, completely denervating the stomach (without compromising the function of other abdominal organs)

Selective Proximal Vagotomy: Surgical section of nerves specifically innervating parietal cells, without compromising other autonomic functions of the stomach (such as motility)

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20
Q

What is the Hepatoduodenal Ligament and what is its function?

A

Hepatoduodenal Ligament connects the Duodenum to the Liver (resides in the 1st part of the Duodenum)

It is important because it contains:
Proper Hepatic A.
Hepatic Portal V.
Common Bile Duct

It also marks the entrance to the Lesser Sac

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21
Q

What is the Major Duodenal Papilla, where is it located, and what is its function?

A

Major Duodenal Papilla is the opening found in the 2nd part of the duodenum where Bile and Pancreatic secretions enter the small intestine

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22
Q

What vessels surround the 3rd part of the Duodenum?

A

Posteriorly there is the Inferior Vena Cava

Anteriorly there is the Superior Mesenteric A. and the Superior Mesenteric V.

Note: Superior Mesenteric A. can cause a bowel obstruction at the 3rd part of the Duodenum

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23
Q

What structure holds the 4th part of the duodenum in place?

A

The Suspensory M., aka The Ligament of Treitz

Connects the 4th Part of the Duodenum to the Right Crus of the Diaphragm (where the esophagus passes through)

Ligament of Treitz is clinicallt significant in that it is the barrier that separates upper and lower GI.

24
Q

What are the 3 segments of the small intestine in order?

A

Duodenum
Jejunum
Ileum

25
Q

Which abdominal quadrant is most of the Jejunum found?

A

The Left Upper Quadrant (LUQ)

26
Q

Which abdominal quadrant is most of the Ileum found?

A

The Right Lower Quadrant (RLQ)

27
Q

What features should be found when identifying the Jejunum?

A

The Vasa Recta (vessels just outside of the intestinal wall) are LONG

The Arcades (vessels forming loops inferior to vasa recta) are FEW and form LARGE LOOPS

Plicae Circulares (Circular folds on the inside wall of the intestine) are LARGE, TALL, and CLOSELY PACKED

Peyers Patches (Lymphoid Nodules on the inside of intestinal wall) are FEW

28
Q

What features should be found when identifying the Ileum?

A

The Vasa Recta (vessels just outside of the intestinal wall) are SHORT

The Arcades (vessels fromin loops inferior to vasa recta) are MANY SHORT LOOPS

Plicae Circulares (circular folds on the inside of the intestinal wall) are LOW AND SPARSE or even ABSENT

Peyers Patches (Lymphoid Nodules on the inside of the intestinal wall) are MANY

29
Q

What is a Meckel Diverticulum?

A

AKA the Ileal Diverticulum - most common congenital anomaly of GI tract

Typically asymptomatic, unless ectopic gastric or pancreatic tissue are contained

It is a TRUE diverticulum (meaning it contains all tissue layers; mucosa, submucosa, and muscularis)

The diverticulum is a persistent vitelline/embryonic omphalo-mesentreic duct

Most common pathologic lead point for Intussusception

30
Q

What is Intussusception?

A

When a proximal segment of the bowel is telescoping into a distal segment of the bowel

Common at the Ileocecal junction

Look for “Target Sign” on Ultrasound

31
Q

What is the line of muscles that follows along the midline of the large intestine?

A

Tenia Coli

32
Q

What do you call the pouches of fat on either side of the Tenia Coli?

A

Omental Appendices

33
Q

What are the outcropings that pattern along the large intestine called?

A

Haustra

34
Q

What is Volvulus?

A

Volvulus is when the colon twists and rotates to form a loop that can cause constipation, ischemia and necrosis.

Midgut Volvulus is more common in infants

Sigmoid Colon Volvulus are more common in elderly

Shows up as a coffee bean sign on X-ray

35
Q

What structure separates the Right and Left ANATOMIC Lobes of the Liver and what is its function?

A

The Falciform Ligament, it attaches the liver to the anterior abdominal wall

36
Q

What are the 2 accessory lobes, where are they located, and what is significant about each?

A

They are the Quadrate Lobe and the Caudate Lobe, both are found on the Right lobe of the liver.

The Quadrate lobe, while physically part of the right lobe, is FUNCTIONALLY part of the left lobe (Left Hemi-liver)

The Caudate Lobe, while physically part of the right lobe, is functionally SEPARATE from both the Left and Right lobe.

37
Q

What are the 4 main ligaments of the Liver?

A

Hepatoduodenal Ligament
Round Ligament
Falciform Ligament
Ligamentum Venosum

38
Q

What is the Round ligament a remnant of?

A

Round ligament is the remnant of the umbilical vein

39
Q

What is the Ligamentum Venosum a remnant of?

A

The Ligamentum Venosum is a remnant of the ductus venosus

40
Q

What separates the Left and Right FUNCTIONAL lobes of the liver?

A

Cantlie Line (line from fundus of gallbladder to diaphragm)

41
Q

Which Segments of the liver belong to which functional lobe?

A

Segments II, III, and IV belong to the LEFT FUNCTIONAL lobe

Segments V, VI, VII, and VIII belong to the RIGHT FUNCTIONAL lobe

Segment I is the Caudate Accessory lobe and it is functionally separate from the left and right functional lobes.

42
Q

What are the three parts of the Gallbladder?

A

Fundus
Body
Neck

43
Q

What are the Two ducts that drain bile from the gallbladder into the duodenum?

A

Cystic Duct

Common Bile Duct

44
Q

What is the hole that allows bile and pancreatic secretions enter the duodenum called, and which segment of the duodenum is it located?

A

Ampulla of Vater (or the Hepatopancreatic Ampulla)

Second part of the duodenum

45
Q

What is Cholelithiasis?

A

Gallstone

46
Q

What is Cholecystitis?

A

Gallstone obstructing the cystic duct, causing inflammation in the Gallbladder

47
Q

What are the 4 F’s describing typical Cholecystitis patients?

A

Female
Fourty
Fertile (has had children)
Fat

48
Q

What is Murphy’s sign and what does a positive result tell you?

A

RUQ palpation during inhalation

If patient suddenly stops inhaling due to pain, Murphy’s sign is positive, telling us patient has cholecystitis

49
Q

What is Choledocolithiasis?

A

Gallstone obstructing the common bile duct

50
Q

What is Gallstone Ileus?

A

If a gallstone is causing excessive inflammation of gallbladder, the gallbladder can adhere to the duodenum.

The gallstone can then perforate through the fused gallbladder/duodenum wall, travel all the way down through the small intestine and block the ileocecal junction.

51
Q

What structure(s) are anterior to the spleen?

A

Stomach

52
Q

What structure(s) are lateral to the spleen?

A

Diaphragm

Ribs (9-11)

53
Q

What structure(s) are medial to the spleen?

A

Left kidney

54
Q

What structure(s) are inferior to the spleen?

A

Left colic flexure (transition point from tranverse colon to descending colon)

55
Q

What ligaments are attached to the spleen and what is important about each?

A

Splenorenal Ligament - Connects the Spleen witht he left kidney.
- Carries the Splenic artery; the major blood supply for the spleen

Gastrosplenic Ligament - Connects the Spleen with the stomach
- Carries the Short Gastric arteries (branch off the Splenic A.); Supply the Fundus of the stomach and superior portion of the Spleen

Colin GI (10 decks)

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