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Finals anatomy and physiology > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

What is the peritoneal cavity?

A

A potential space between the parietal and visceral peritoneum

It normally contains only a thin film of peritoneal fluid, which consists of water, electrolytes, leukocytes and antibodies. This fluid acts as a lubricant, enabling free movement of the abdominal viscera, and the antibodies in the fluid fight infection.

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2
Q

What is a subphrenic abscess

A

An accumulation of pus in the left or right subphrenic space

They are more common on the right side due to the increased frequency of appendicitis and ruptured duodenal ulcers

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3
Q

Lowest point of male peritoneal cavity?

A

rectovesical pouch, peritoneum is closed

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4
Q

Lowest point of female peritoneal cavity?

A

two lowest points = rectouterine pouch of douglas and vesicouterine pouch

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5
Q

Clinical significance lowest point of peritoneum and male vs female

A

Lowest point = fluid will collect there due to gravity

Female = peritoneum is open (the uterine tubes open into the peritoneal cavity), providing a potential pathway between the female genital tract and the abdominal cavity.

Clinically, this means that infections of the vagina, uterus, or uterine tubes may result in infection and inflammation of the peritoneum (peritonitis).

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6
Q

Define ascites

A

Ascites refers to an accumulation of excess fluid within the peritoneal cavity

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7
Q

typical cause ascites

other causes

A

portal hypertension (secondary to liver cirrhosis)

malignancy of the GI tract, malnutrition, heart failure, and mechanical injuries which result in internal bleeding

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8
Q

features ascites

A

abdominal distension, abdominal discomfort, nausea, and dyspnoea due to pressure on the lungs from the enlarged abdominal cavity.

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9
Q

What is the parietal peritoneum

A

lines the internal surface of the abdominopelvic wall = somatic mesoderm = sensations well localised to region of abdominal wall that it lines

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10
Q

What is the visceral peritoneum?

A

lines organs - sensations not well localised = Pain from the visceral peritoneum is referred to areas of skin (dermatomes)

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11
Q

What are peritoneal adhesions? causes?

A

Damage as a result of infection, surgery or injury –> inflammation and repair –> formation of fibrous scar tissue –> abnormal attachments between the visceral peritoneum of adjacent organs or between visceral and parietal peritoneum –>

Such adhesions can result in pain and complications such as volvulus, when the intestine becomes twisted around an adhesion resulting in a bowel obstruction.

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12
Q

What are the two types of inguinal hernia? who gets them?

A

Indirect inguinal hernia – where the peritoneal sac enters the inguinal canal through the deep inguinal ring. (can be congenital)

Direct inguinal hernia – where the peritoneal sac enters the inguinal canal through the posterior wall of the inguinal canal. (acquired due to weakening of musculature)

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13
Q

What are the muscular layers of the anterior abdominal wall?

A

SSS EXITT

Skin
Subcutaneous fat
Superficial fascia

Ex external oblique
Internal oblique
Transverse abdominis
Transversalis fascia

Their aponeuroses connect to form rectus abdominis medially

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14
Q

What is the rectus sheath

A

the rectus sheath covers the rectus abdominis muscle

at the lowest part of the abdomen, the rectus sheath only covers the rectus abdominis anteriorally

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15
Q

What is the transpyloric plane?

A

located halfway between the suprasternal notch of the manibrium and the upper border of the symphysis pubis.

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16
Q

What structures lie along the transpyloric plane?

A

Please Feed Him Some Love

P = pylorus of stomach
F = fundus of gall bladder
H = hilum of both kidneys
S = origin of the superior mesenteric artery
L = lower end of spinal cord (L1)

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17
Q

kocher scar

A

open cholecystectomy

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18
Q

mercedes benz scar

A

liver transplant

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19
Q

midline laparotomy

A

intra-abdominal access

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20
Q

paramedian scar

A

intra-abdominal access

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21
Q

transverse scar

A

stoma closure/formation

22
Q

rutherford-morrison scar

A

kidney transplant

23
Q

gridiron scar

A

open appendiectomy

24
Q

lanz scar

A

open appendiectomy

25
Q

pfannenstiel scar

A

gynaecological, obstetric scar

26
Q

pathophysiology of varices

A
  1. cirrhosis of the liver causes a significant increase in the resistance to blood flow through the liver
  2. the increased resistance to blood flow through the liver cause sthe pressure in the hepatic portal venous system to rise (portal hypertension)
  3. gastroesophageal varices form (expanded blood vessels) in an attempt to decompress the rising pressure in the hepatic portal venous system. These can rupture causing massive bleeding
27
Q

What lines divide the abdomen into the 9 sections

A

midclavicular lines
transpyloric plane
intertubecular plane

28
Q

What is a hiatus hernia

A

part of the stomach protrudes into the chest through the oesophageal hiatus in the diaphragm

29
Q

Why is appendicitis pain initially felt centrally

A

The sympathetic afferent fibres of the appendix arise from T10 of the spinal cord – thus explaining why the visceral pain of early appendicitis is felt centrally within the abdomen.

30
Q

most common position for appendix to be in

A

retrocaecal

31
Q

where is mcburneys point?

A

2/3 of the way from umbillicus to anterior superior iliac spine

32
Q

What comprises of the foregut?

major arterial supply?

Parasympathetic supply?

A

oesophagus –> duodenum + liver, pancreas, bile ducts

arterial supply: celiac trunk

parasympathetic: vagus nerve

33
Q

What comprises of the midgut?

major arterial supply?

Parasympathetic supply?

A

distal duodenum –> proximal 2/3 of transverse colon

arterial supply: superior mesenteric artery

Parasympathetic: vagus nerve

34
Q

what comprises of the hindgut?

major arterial supply?

Parasympathetic supply?

A

distal 1/3 of transverse colon –> rectum

aretrial supply : inferior mesenteric artery

Parasympathetic: pelvic splanchnic nerve

35
Q

Blood supply of liver

A
  • hepatic artery proper (25% of blood) derived from coeliac trunk
  • hepatic portal vein (75% of blood) carrying nutrients absorbed from the small intestine
36
Q

Components and path of biliary tree

A

left and right hepatic ducts carry bile from liver –> join to become common hepatic duct –> joins cystic duct and common bile duct. cystic duct allows flow of bile to and from gall bladder. common bile duct carries bile towards intestine. the pancreatic duct also joins the common bile duct at the ampulla vater where they then all drain into the duodenum

37
Q

define cholelithiasis

A

uncomplicated gallstones

38
Q

define biliary colic

A

typically right upper quadrant pain following a fatty meal as gallstones obstruct the cystic duct during contraction of the gallbladder. Not associated with systemic upset

39
Q

define cholecystitis

A

inflammation of the gallbladder. Pain is often associated with nausea, vomiting or fever

40
Q

define choledocholithiasis

A

gallstone within the common bile duct. Often causes deranged liver function tests.

41
Q

Define cholangitis

A

infection of the common bile duct often secondary to choledocholithiasis. Typically presents with right upper quadrant pain, fever and jaundice (Charcot’s Triad)

42
Q

anatomical position of the pancreas

A

positioned at the level of the transpyloric plane (L1)
it is a retroperitoneal organ, located deep within the upper abdomen in the epigastrium and left hypochondrium regions.

43
Q

complication of splenic rupture

A

profuse bleeding into peritoneal cavity –> requires splennectomy if this is the case

44
Q

what does cortex of adrenal glands do?

A

secretes two cholesterol derived hormones – corticosteroids and androgens

45
Q

Layers of adrenal cortex and what they secrete?

A

From superficial to deep: acronym GFR
Zona glomerulosa – produces and secretes mineralocorticoids such as aldosterone.

Zona fasciculata – produces and secretes corticosteroids such as cortisol. It also secretes a small amount of androgens.

Zona reticularis – produces and secretes androgens such as dehydroepiandrosterone (DHES). It also secretes a small amount of corticosteroids.

46
Q

What does the adrenal medulla do?

A

It contains chromaffin cells, which secrete catecholamines (such as adrenaline) into the bloodstream in response to stress.

47
Q

what is a pheochromocytoma

A

A tumour of the adrenal medulla or preganglionic sympathetic neurones. It secretes adrenaline and noradrenaline uncontrollably, causing blood pressure to greatly increase. Patients may present with palpitations, headaches and diaphoresis (profuse sweating).

48
Q

At what spinal level does the aorta terminate and into what?

A

It terminates at the level of L4 by bifurcating into the left and right common iliac arteries

49
Q

Branches of the aortic arch?

A

1) left and right aortic sinuses –> coronoary arteries
2) branchiocephalic trunk –> right common carotid and right subclavian arteries
3) left common carotid (supplies left side of head and neck)
4) left subclavian artery (supplies left upper limb)

50
Q

which are the retroperitoneal organs?

A

SAD PUCKER

Suprarenal (adrenal glands)
Aorta and inferior vena cava
Duodenum (2nd and 3rd segments)

Pancreas
Ureters
Colon (ascending and decending)
Kidneys
Esophagus
Rectum

Finals anatomy and physiology (11 decks)

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