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GASTROINTESTINAL > GASTROINTESTINAL- Anatomy > Flashcards

GASTROINTESTINAL- Anatomy Flashcards

1
Q

Restroperitoneal structures

A 
SAD PUCKER
Suprarenal glands
Aorta and IVC
Duodenum (2nd through 4th parths)
Pancreas (excepts tail)
Ureters
Colon (descending and ascending)
Kidneys
Esophagus (lower 2/3)
Rectum (partially)
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2
Q

Which is the main characteristics of retroperitoneal structures?

A

Include GI structures that lack mesentery and non GI structures

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3
Q

What could be the results of injuries to retroperitoneal structures?

A

Can cause blood or gas accumulation in retroperitoneal space

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4
Q

Important GI ligaments

A 
Falciform
Hepatoduodenal
Gastrohepatic
Gastrocolic
Gastrosplenic
Splenorenal
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5
Q

What do falciform ligament connects?

A

Liver to anterior abdominal wall

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6
Q

Structure contained in Falciform Ligament?

A

Ligamentum teres hepatis

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7
Q

From where does the Ligamentum teres hepatis derived from?

A

Fetal umbilical vein

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8
Q

From which structure does Falciform ligament derives from?

A

Ventral mesentery

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9
Q

Ligament that connects Liver to duodenum

A

Hepatoduodenal ligament

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10
Q

What structures are contained in Hepatoduodenal ligament?

A

Portal triad: proper hepatic artery, portal vein, common bile duct

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11
Q

What is Pringle maneuver?

A

Ligament may be compressed between thumb and index finger placed in omental foramen to control bleeding

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12
Q

Which structures are border by Hepatoduodenal ligament?

A

Border Omental foramen, which connects the greater and lesser sacs

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13
Q

Structures connected by Gastrohepatic ligament

A

Liver to lesser curvature of stomach

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14
Q

Where does Gastrohepatic ligament is contained?

A

Within lesser omentum

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15
Q

In which structure are Gastric arteries contained?

A

Gastrohepatic ligament

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16
Q

What does Gastrohepatic ligament separates?

A

Separates greater and lesser sacs on the right

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17
Q

What structure may be cut during surgery to access lesser sac?

A

Gastrohepatic ligament

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18
Q

Separates greater and lesser sacs on the right

A

Gastrohepatic ligament

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19
Q

This ligament goes from greater curvature of stomach to Transverse colon

A

Gastrocolic

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20
Q

Structures contained in Gastrocolic ligament

A

Gastroepiploic arteries

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21
Q

Part of greater omentum

A

Gastrocolic ligament

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22
Q

Structures connected by Gastrosplenic ligament

A

Greater curvature and spleen

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23
Q

Which structures are contained in gastrosplenic ligament?

A

Short gastrics, left gastroepiploic vessels

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24
Q

Structures separeted by Gastrosplenic ligament

A

Separates greater and lesser sacs on the left

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25
Q

Separates greater and lesser sacs on the left

A

Gastrosplenic ligament

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26
Q

Ligament that connects Spleen to posterior abdominal wall

A

Splenorenal

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27
Q

What structures are contained in Splenorenal ligaments?

A

Splenic artery and vein, tail of pancreas

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28
Q

Layers of gut wall (inside to outside)

A

MUcosa
Submucosa
Muscularis externa
Serosa

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29
Q

Structures contained in Mucosa

A 
Epithelium (absorption)
Lamina propria (support)
Muscularis mucosa (motility)
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30
Q

Which important structure is contained in Submucosa?

A

Includes subumucosal nerve plexus (Meissner)

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31
Q

Which important structure is contained in Submucosa?

A

Includes subumucosal nerve plexus (Meissner)

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32
Q

Structures included in Muscularis Externa

A

Includes Myenteric nerve plexus (Auerbach)

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33
Q

Characteristic that differentiate Serosa and Adventitia

A

Serosa (When intraperitoneal)

Adventitia (when retroperitoneal)

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34
Q

How much can ulcers extend?

A

Into submucosa, inner or outter muscular layer

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35
Q

Where are erosins found in the layers of gut wall?

A

In the mucosa only

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36
Q

How is the frequency of basal electric rhythm in Stomach?

A

3 waves/ min

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37
Q

Frequency of basal electric rhythm in Duodenum

A

12 waves/min

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38
Q

How are the frequency of basal electric rhythm Ileum?

A

8-9 waves/min

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39
Q

What is the mesothelium?

A

Protective coating; reduction of friction

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40
Q

What is the function of Mesentery?

A

Binding of digestive tract to abdominal wall

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41
Q

Where are the glands that manage the secretion in GI tract?

A

In submucosal layer

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42
Q

Who controls muscle contractions in GI tract?

A

Myenteric plexus

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43
Q

Who manages motility in GI tract?

A

Inner circular layer

Outer longitudinal muscle layer

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44
Q

Where is the control of secretory activity of the GI tract?

A

Submucosal plexus

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45
Q

Manages mucosal motility

A

Muscularis mucosae

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46
Q

Function of Serosa

A

Suport

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47
Q

Epithelium found in esophagus

A

Nonkeratinized stratified squamous epithelium

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48
Q

Hystologic characteristic of Stomach

A

Gastric glands

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49
Q

Hystologic characteristics of Duodenum

A

Villi and microvilli ↑ absorptive surface

Brunner glands and crypts of Lieberkuhn

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50
Q

Where are Brunner glands found?

A

Submucosa of Duodenum

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51
Q

What hystologic characteristics does Jejunum has?

A

Plicae circulares and crypts of Lieberkuhn

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52
Q

Unique hystologic characteristics of Ileum

A

Peyer patches
Largest number of Goblet cells in the small intestine
Plicae circulares and crypts of Lieberkuhn (common to Jejunum)

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53
Q

Where are Peyer patches found?

A

Lamina propia, submucosa of Ileum

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54
Q

Where in Ileum can plicae ciculares be found?

A

Proximal Ileum

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55
Q

characteristics of Colon hystology

A

Has crypts of Lieberkuhn but no villi; numerpus goblet cells

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56
Q

How do you identify the branches that supply GI structures from arteries supplynon non GI structures?

A

Arteries Supplying GI structures branch anteriorly

Arteries supplying non GI structures branch laterally

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57
Q

What is the superior mesenteric artery syndrome?

A

When the transverse portion (third segment) of duodenum is entrapped between SMA and aorta, causing intestinal obstruction

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58
Q

Where can we identify the bifurcation of Abdominal aorta?

A

L4

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59
Q

Where is Celiac trunk?

A

T12

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60
Q

Where is Superior mesenteric Artery?

A

L1

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61
Q

Where is Inferior mesenteric artery?

A

L3

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62
Q

From whom is Median sacral artery a branch?

A

From the point of bifurcation of abdominal aorta

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63
Q

From which structure does Celiac artery comes from?

A

Foregut

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64
Q

Who gives parasympathetic innervation to celiac artery?

A

Vagus

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65
Q

Vertebral level where celiac artery is?

A

T12-L1

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66
Q

Structures supplied by Celiac artery

A

Pharynx to proximal duodenum; liver, gallbladerm pancreas, spleen (mesodem)

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67
Q

Embryonic gut region that forms Superior Mesenteric Artery

A

Midgut

68
Q

Who gives innervation to Superior mesenteric artery?

A

Parasympathetic inervation of Vagus

69
Q

Vertebral level where Superior mesenteric artery is found

A

L1

70
Q

Artery that irrigates distal duodenum to proximal 2/3 of transverse colon

A

Superior mesenteric artery

71
Q

Embryonic structure that gives place to Inferior mesenteric artery

A

Hindgut

72
Q

Who gives parasympathetic innervation to Inferior mesenteric artery?

A

parasympathetic innervation of Pelvic

73
Q

Vertebral level where Inferior mesenteric artery is found

A

L3

74
Q

Structures supplied by Inferior mesenteric artery

A

Distal 1/3 of transverse colon to upper portion of rectum; splenic flexure is a watershed region

75
Q

Branches of celiac trunk

A

Common hepatic
Slenic
Left gastric

76
Q

Who constitutes the main blood supply of the stomach?

A

Celiac trunk

77
Q

What happens if splenic artery is blocked?

A

Short gastric will have poor anastomoses

78
Q

Which are the strong anastomoses in Stomach?

A

Left and right gastroepiploics

Left and right gastrics

79
Q

From whom is Gastroduodenal artery a branch?

A

Common hepatic artery

80
Q

Main branches of Gastroduodenal artery

A

Anterior Superior pancreaticoduodenal artery
Posterior Superior pancreaticoduodenal artery
Right gastroepiploic artery

81
Q

From whom is esophageal branch of?

A

Left gastric artery

82
Q

Main branches of Common hepatic artery

A

Hepatic artery proper
Gastroduodenal artery
Right gastric artery

83
Q

Branches of Splenic artery

A

Left gastroepiploicartery

Short gastric arteries

84
Q

When Superior epigastric (internal thoracic/ mamary) is blocked, which anastomose compensate?

A

Inferior epigastric (external iliac) and viceversa

85
Q

When Superior pancreaticoduodenal (celiac trunk) is blocked, which anastomose compensate?

A

Inferior pancreaticoduodenal (SMA)

86
Q

When Middle colic (SMA) is blocked, which anastomose compensate?

A

Left colic (IMA)

87
Q

When superior rectal (IMA) is blocked, which anastomose compensate?

A

Middle and inferior rectal (internal iliac)

88
Q

When superior rectal (IMA) is blocked, which anastomose compensate?

A

Middle and inferior rectal (internal iliac)

89
Q

Name portosystemic anastomoses

A

Esophagus
Umbilicus
Rectum

90
Q

Clinical sign of patologic blood flow in portal HTN directed to esophagus

A

Esophageal varices

91
Q

Which veins have anastomosis with esophageal that cause esophageal varices during portal HTN?

A

Left gastric ↔ Esophageal

92
Q

Clinical sign of patologic blood flow in portal HTN directed to umbilicus

A

Caput medusae

93
Q

Which veins have anastomosis with paraumbilical that cause caput meduasae during portal HTN?

A

Parumbilical ↔ Small epigastric veins of the anterior abdominal wall

94
Q

Clinical sign of patologic blood flow in portal HTN directed to Rectum

A

Anorectal varices (not internal hemorroids)

95
Q

Which veins have anastomosis with superior rectal that cause anorectal varices during portal HTN?

A

Superior Rectal ↔ middle and inferior rectal

96
Q

Which veins are commonly seen in portal hypertension?

A

Gut, butt and caput

97
Q

Which is the surgical treatment for portal HTN?

A

Transjugular intrahepatic portosystemic shunt (TIPS)

98
Q

How does TIPs work?

A

Between the portal and hepatic vein percutaneously relieves portal hypertension by shunting blood to the systemic circulation

99
Q

Where is Pectinate line?

A

Formed where endoderm (hindgut) meets ectoderm

100
Q

What forms Pectinate line?

A

Formed where endoderm (hindgut) meets ectoderm

101
Q

Alternative name for Pectinate line

A

Dentate line

102
Q

Alternative name for Pectinate line

A

Dentate line

103
Q

Diseases that could appear above pectinate line

A

Internal hemorrhoids

Adenocarcinoma

104
Q

Who gives tha arterial supply above pectinate line?

A

Superior rectal artery

105
Q

From whom is superior rectal artery a branch?

A

IMA

106
Q

How is the drainage of structures above the pectinate line?

A

Superior rectal vein → Inferior mesenteric vein → portal system

107
Q

Which hemorhoids are painful?

A

External hemorrhoids

108
Q

Why internal hemorrhoids aren’t painful?

A

Receive visceral innervation and are therefore no painful

109
Q

Who gives the lymphatic drainage to structures above pectinante line?

A

Deep nodes

110
Q

Diseases found below pectinate line

A

External hemorrhoids
Anal fissures
Squamous cell carcinoma

111
Q

Who gives arterial supply below pectinate line?

A

Inferior rectal artery (branch of internal pudendal artery)

112
Q

Who gives the venous drainage below pectinate line?

A

Inferior rectal vein → Internal pudendal vein → IVC

113
Q

Who gives the venous drainage below pectinate line?

A

Inferior rectal vein → Internal pudendal vein → IVC

114
Q

Why external hemorrhoids are painful?

A

Receive somatic innervation (inferior rectal branch of pudendal nerve)

115
Q

Lymphatic drainage for below pectinate line

A

Superficial inguinal nodes

116
Q

What does Apical surface of hepatocytes faces?

A

Faces bile canaliculi

117
Q

What does Basolateral surface of hepatocytes faces?

A

Sinusoids

118
Q

Where is Zone 1 of hepatocytes?

A

periportal zone

119
Q

Which hepetic zone is affected first by viral hepatitis?

A

Zone I

120
Q

Ingested toxins like cocaine affect first this hepatic zone

A

Zone I

121
Q

Name for Hepatocytes zone II

A

Intermediate zone

122
Q

Where is Hepatic zone III?

A

Pericentral vein (centrilobulillar) zone

123
Q

Which is the first hepatic zone affected by ischemia?

A

Zone III

124
Q

Which hepatic zone contains cytocrome P450 system?

A

Zone III

125
Q

Hepatic zone most sensitive to metabolic toxins

A

Zone III

126
Q

Which hepatic zone is the site for alcoholic hepatitis?

A

Zone III

127
Q

How is the flow for central hepatic vein?

A

To hepatic veins and systemic circulation

128
Q

Which hepatic structure manages lymphatic drainage?

A

Space of Disse

129
Q

Liver Macrophages

A

Kupffer cell

130
Q

How is microscopic blood flow in Liver?

A

From zone I to III

Portal triad to Central vein

131
Q

How is microscopic bile flow in liver?

A

From zone III to I

Central vein to Portal triad

132
Q

Portal triad

A

Bile duct
Branch of portal vein
Branch of hepatic artery

133
Q

Which risk do gallstones can cause when reach the common channel?

A

Reach ampulla of Vater and can block both the bilr and pancreatic ducts

134
Q

Risk of tummors that arise in the head of pancreas (near the duodenum)

A

Can cause obstruction of the common bile duct

135
Q

How is the vessel organization in femoral region

A

Lateral to medial: NAVEL

Nerve- Artery-Vein-Empty space Lymphatics

136
Q

What does femoral triangle contains?

A

Femoral vein, artery, nerve

137
Q

What is Femoral sheath and where is located?

A

Fascial tube 3-4 cm below inguinal ligament

138
Q

What does Femoral sheath contains?

A

Vein, artery and canal (deep inguinal lymph nodes) but not femoral nerve

139
Q

What is a Hernia?

A

A protrusion of peritoneum through an opening, ussually a site of weakness

140
Q

What happens during diaphragmatic hernia?

A

Abdominal structures enter the thorax

141
Q

Which is a cause of diaphragmatic hernia in infants?

A

Result of defective development of pleuroperitoneal membrane

142
Q

Most common diaphragmatic hernia

A

Sliding hiatal hernia

143
Q

What happens in diaphragmatic hernia?

A

Stomach herniates upward through the esophageal hiatus of the diaphragm

144
Q

What happens in diaphragmatic hernia?

A

Stomach herniates upward through the esophageal hiatus of the diaphragm

145
Q

What happens in Slidding hiatal hernia?

A

Gastroesophageal junction is displaced ↑

146
Q

How is sliding hiatal hernia seen?

A

“Hourglass stomach”

147
Q

Characteristics of Paraesophageal hernia

A

gastroesophageal junction is normal

Fundus protrudes into thorax

148
Q

What happens in indirect inguinal hernia?

A

Goes through the internal (deep) inguinal ring, external (superficial) inguinal ring and into the scrotum
Enters internal inguinal ring lateral to inferior epigastric artery

149
Q

When does indirect inguinal hernia occurs?

A

Occurs in infants owing to failure of processus vaginalis to close

150
Q

What can a male infant patient form when having a indirect inguinal hernia?

A

Hydrocele

151
Q

In whom is more common tje indirect inguinal hernia?

A

Much more common Male patients

152
Q

Main characteristic of Indirect inguinal hernia

A

Follows the path of descent of the testes

Covered by all 3 layers of spermatic fascia

153
Q

Protrudes through the inguinal triangle

A

Direct inguinal hernia

154
Q

Inguinal triangle

A

Hesselbach

155
Q

Protrudes through Hesselbach triangle

A

Direct inguinal hernia

156
Q

Characteristic of Direct inguinal hernia

A

Bulges directly through abdominal wall medial to inferior epigastric artery

157
Q

Which is the way of direct inguinal hernia?

A

Goes through the external (superficial) inguinal ring only

158
Q

Who covers the direct inguinal hernia?

A

External spermatic fascia

159
Q

In which patients is more common to see direct inguinal hernia?

A

Ussualy in older patients

160
Q

Medial to inferior epigastric artery

A

Direct hernia

161
Q

Lateral to inferior epigastric artery

A

Indirect hernia

162
Q

What happens in Femoral hernia?

A

Protrudes below inguinal ligament through femoral canal below and lateral to pubic tubercle

163
Q

In whom is more common to see Femoral hernia?

A

In females

164
Q

Leading cause of bowel incarceration

A

Femoral hernia

165
Q

Which structures form the Hesselbach triangle?

A

Inferior epigastric vessels
Lateral border of rectus abdominis
Inguinal ligament

GASTROINTESTINAL (5 decks)

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