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First Aid 2014 > GI: 340 - 342 > Flashcards

GI: 340 - 342 Flashcards

1
Q

What are the three sites for anastomoses between the portal circulation and the systemic circulation?

A
  1. Esophagus
  2. Umbilicus
  3. Rectum
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2
Q

What are the two vessels that anastomose at the esophagus (for portal-systemic)?

A

Left gastric (portal) and esophageal (systemic)

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3
Q

What are the two vessels that anastomose at the umbilicus (for portal-systemic)?

A

Paraumbilical (portal) and small epigastric veins of the anterior abdominal wall (systemic)

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4
Q

What are the two vessels that anastomose at the rectum (for portal-systemic)?

A

Superior rectal (portal) and middle/inferior rectal (systemic)

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5
Q

What are the clinical signs for portal hypertension?

A

Mnemonic: Gut, butt, and caput (medusae in the umbilicus)

  1. Esophageal varices
  2. Caput medusae
  3. Anorectal varices (NOT internal hemorrhoids)
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6
Q

How can we treat portal hypertension?

A

Transjugular intrahepatic portosystemic shunt (TIPS) between the portal vein and hepatic vein percutaneously relieves portal hypertension by shunting blood to the systemic circulation

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7
Q

What is the pectinate line?

A

Formed where the endoderm (hindgut) meets the ectoderm

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8
Q

What is another name for the pectinate line?

A

Dentate

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9
Q

Where do internal vs. external hemorrhoids occur?

A

Internal hemorrhoids - above the pectinate line

External hemorrhoids - below the pectinate line

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10
Q

Contrast the more likely cancers above vs. below the pectinate line.

A

Above - adenocarcinoma

Below - squamous cell carcinoma

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11
Q

What is the arterial supply above the pectinate line?

A

Superior rectal artery (branch of the IMA)

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12
Q

What is the venous drainage above the pectinate line?

A

Superior rectal vein –> inferior mesenteric vein –> portal system

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13
Q

What is the lymphatic drainage above the pectinate line?

A

Deep nodes

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14
Q

Are internal or external hemorrhoids more painful? Why?

A

Internal hemorrhoids - visceral innervation, NOT painful

External hemorrhoids - somatic innervation (inferior rectal branch of pudendal), painful

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15
Q

Do anal fissures occur above or below the pectinate line?

A

Below

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16
Q

What is the arterial supply below the pectinate line?

A

Inferior rectal artery (branch of internal pudendal artery)

17
Q

What is the venous drainage below the pectinate line?

A

Inferior rectal vein –> internal pudendal vein –> internal iliac vein –> IVC

18
Q

What is the lymphatic drainage below the pectinate line?

A

Superficial inguinal nodes

19
Q

What is an anal fissure?

A

Tear in the anal mucosa below the pectinate line

20
Q

Are anal fissures painful or painless?

A

Painful on defecation, bloody

21
Q

Why do anal fissures tend to be posterior?

A

Area is poorly perfused

22
Q

What are the three zones of the liver?

A

Zone I: periportal zone
Zone II: intermediate zone
Zone III: pericentral vein (centrilobular) zone

23
Q

Does the apical or basolateral side of hepatocytes face the bile canaliculi?

A

Apical

24
Q

What does the basolateral side of hepatocytes face?

A

Sinusoids

25
Q

Which zone of the liver is affected 1st by viral hepatitis?

A

Zone I

26
Q

Which zone of the liver is affected 1st by ischemia?

A

Zone III

27
Q

Which zone of the liver is associated with ingested toxins (e.g. cocaine)?

A

Zone I

28
Q

What important system does zone III of the liver contain?

A

Cytochrome P450

29
Q

What is zone III of the liver particularly sensitive to?

A

Metabolic toxins

30
Q

Where is the site of alcoholic hepatitis?

A

Zone III

31
Q

What comes together to form the common bile duct?

A

Common hepatic duct (composed of a right and left hepatic duct) and the cystic duct

32
Q

Where does the cystic duct originate?

A

Gall bladder

33
Q

What is the name of the opening where the common bile duct and the pancreatic duct meet?

A

Ampulla of Vater

34
Q

Tumors arising where in the pancreas can cause obstruction of the common bile duct?

A

Head of the pancreas (near the duodenum)

35
Q

What sphincter muscle is located at the base of the biliary tree and controls the bile/pancreatic enzymes that reach the duodenum?

A

Sphincter of Oddi

36
Q

How is the femoral region organized (lateral to medial)?

A 
Mnemonic: NAVEL
Nerve
Artery
Vein
Empty space
Lymphatics
37
Q

What is contained within the femoral triangle?

A

Femoral vein, artery, nerve

38
Q

What is the femoral sheath?

A

Fasical tube 3-4 cm below the inguinal ligament that contains the femoral vein, artery, and canal (deep inguinal lymph nodes)

39
Q

What structure is notably NOT contained in the femoral sheath?

A

Femoral nerve

First Aid 2014 (24 decks)

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