Gastrointestinal First Aid

Question 1

What artery does the midgut rotate around and during which week?

Answer 1

Superior mesenteric artery during 10th week.

Improper rotation can lead to severe pathologies.

Question 2

What is annular pancrease?

Answer 2

The ventral pancrease abnormally encircles the 2nd part of the duodenum forming a ring of pancreatic tissu and duodenal narrowing.

Question 3

The mnemonic SAD PUCKER is used to describe…

Answer 3

Retroperitoneal structures
Suprarenal (adrenal) glands
Aorta and IVC
Duodenum
Pancrease (except tail)
Ureters
Colon (descending and ascending)
Kidneys
Esophagus (thoracic portion)
Rectum

Question 4

What is the falciform ligament?

Answer 4

Attaches liver to anteror abdominal wall. Contains the ligamentum teres hepatis from the fetal umbilical vein.

Is a derivative of ventral mesentary.

Question 5

What does the falciform ligament contain and what is it a remnant of?

Answer 5

Contains the ligamentum teres hepatis.

Originated from the fetal umbilical vein.

Question 6

What structures can be found in the hepatoduodenal ligament?

Answer 6

Connects the liver to the duodenum containing the hepatic triad (Hepatic artery, portal vein, common bile duct)

Question 7

What does the gastrohepatic ligament connect and what is found inside of it?

Answer 7

Gastrohepatic ligament connects the liver to the lesser curvature of the stomach. Contains the gastric arteries and is part of the greater omentm.

Question 8

What is contained in the gastrocolic ligament?

Answer 8

connects the stomach to the transverse colon.
Containing the gastroepiploic arteries.

Part of the greater omentum.

Question 9

Describe the intestinal layers from the lumin to the outside,.

Answer 9

Mucosa
Submucosa
Muscularis externa (myenteric and mysners nerve plexus)
Serosa (when intra peritoneal) and adventitia when retroperitoneal (ascending and descending)

Question 10

Where are brunners glands found and what do they do?

Answer 10

These are found in the duodenum in the crypts of leiberchun. They secrete HCO3-

Question 11

Where are the peyers patches found?

Answer 11

These are found in the ileum

The ileum also has the largest ammount of mucous production in the intestines.

Question 12

Which spinal level can the celiac trunk be found?

Answer 12

T12

Question 13

Which spinal level can the inferior mesenteric artery be found?

Answer 13

L3

Question 14

What spinal level does the descending aorta bifurcate into the two iliac arteries?

Answer 14

L4

Question 15

What is superior mesenteric artery syndrome?

Answer 15

When the duodenum gets trapped between the descending aorta and the superior mesenteric artery causing intestinal obstruction.

Question 16

What is the major arter supply to the foregut? (stoma to the duodenum)

Answer 16

The celiac trunk.

Nerve supply is mostly the Vagus nerve.

Question 17

What artery supplies the midgut?

Answer 17

The superior mesenteric artery supplying the distal duodenum to the proximal 2/3 of the transverse colon.

Question 18

What artery supplies the hindgut?

Answer 18

The infereior mesenteric artery supplying the distal 1/3 of the transverse colon to upper portion of the rectum.

Question 19

What are the three branches of the celiac trunk?

Answer 19

The common hepatic
Splenic
Left Gastric

Question 20

Which vein can lead to esophageal varices in portal hypertension?

Answer 20

The left gastric gives off the esophageal vein.

Question 21

What is caput medusa?

Answer 21

Blood backflow in the parumbellical veins due to portal hypertension.

Question 22

Describe Zone 1 of the liver cells

Answer 22

Periportal zone, infected frist by viral hepatitis and ingested toxins.

Question 23

Describe Zone 2 of the liver cells

Answer 23

This is the intermediate zone and the zone of yellow fever infection.

Question 24

Describe zone 3 of the liver cells

Answer 24

Pericentral vein/ centrilobular zone
Affected first by ischemia!!!!
cytochrome P450 zon is here
Most sensitive to metabolic toxins and the site of hepatic alcoholic hepatitis.

Question 25

What composes the common hepatic duct and what composes the common bile duct?

Answer 25

Common hepatic is composed of the left and right hepatic ducts.

The common bile duct is composed of the cystic duct and the common hepatic duct (left and right hepatic ducts)

Question 26

What structure does not run in the femoral sheath?

Answer 26

the femoral nerve!

It spans out immediately after exiting the pelvis!

Question 27

What is a hiatal hernia?

Answer 27

the stomach herniates through the esophageal hiatus

Question 28

Where do indirect internal inguinal hernias happen?

Answer 28

These start internally and push through the inguinal ring into the scrotum.
LATERAL TO THE INFERIOR EPIGASTRIC ARTERY.

Question 29

Where do direct hernias protrude?

Answer 29

These bad boys push through hesselbecks triagnle medially through the abdominal wall medially to the inferior epigastric aa.

Will go through the external/superficial inguinal ring only.

Question 30

Where does a femoral hernia protrude?

Answer 30

These protrude below the inguinal ligament through the femoral canal below and lateral to the pubic tubercle.

It is most common in females.

Question 31

what makes up hesselbecks triangle?

Answer 31

The rectus abdominus muscle
The inguinal ligament
Iliac artery and vein