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STEP 1 Review > GI > Flashcards

GI Flashcards

1
Q

Foregut

A

Pharynx to duodenum

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2
Q

Midgut

A

Duodenum to proximal 2/3 of transverse colon

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3
Q

Hindgut

A

Distal 1/3 of transverse colon to anal canal above pectinate line

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4
Q

Omphalocele

A

Persistence of herniation of abdominal contents into umbilical cord, sealed by peritoneum.

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5
Q

Gastroschisis

A

Extrusion of abdominal contents through nonfused lateral abdominal walls

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6
Q

Rostral fold failure

caudal fold failure

A

Rostral – sternal defects

Caudal fold failure – bladder extrophy

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7
Q

Midgut development 6 weeks-10

A

Midgut herniates through ring and by the 10th returns to abdominal cavity and rotates around SMA

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8
Q

Duodenal atresia

A

Associated with trisomy 21, duodenum isn’t canalized causes double bubble sign and bilous vomiting.

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9
Q

Apple peel atresia

A

In jejunum, ileum, colon, due to vascular accident.

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10
Q

Esophageal atresia with TE fistula

A

Most common, vomiting, drooling, choking with first feeding. TEF allows air to enter stomach.

Cyanosis is due to laryngospasm to prevent reflux related aspiration.

Diagnose with failure to pass NG tube.

Also polyhydramnios due to lack of swallowing

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11
Q

Congenital pyloric stenosis

A

Doesn’t appear right away. Usually happens in firstborn males. Few weeks later there is projectile vomiting with palpable epigastric olive mass. Nonbilous.

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12
Q

Behcet syndrome

A

Recurrent apthous ulcers, uviitis, and genital ulcers. Due to small vessel immune complex vasculitis

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13
Q

Pancreas derived from…

A

Foregut. Ventral pancreatic buds rotate and contribute to pancreatic head and main pancreatic duct. Uncinate process is formed by the ventral bud alone.

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14
Q

Annular pancreas

A

Failure of ventral bud fusion that encircles the second part of the duodenum. Can cause duodenal narrowing.

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15
Q

Pancreas divisum

A

Ventral and dorsal parts fail to fuse

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16
Q

Spleen

A

Derived from mesoderm, but is supplied by foregut – celiac artery

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17
Q

Retroperitoneal structures

A 
SAD PUCKER
Suprarenals (adrenals)
Aorta and IVC
Duodenum 2-4
Pancreas (but not tail)
Ureters
Colon (ascending and descending)
Kidneys
Esophagus (lower 2/3)
Rectum (partially)
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18
Q

Falciform ligament

A

Connects liver to anterior abdominal wall – contains the ligamentum teres hepatus (derivative of fetal umbilical vein)

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19
Q

Hepatoduodenal

A

Connects liver to duodenum. Contains the portal triad(portal vein, hepatic artery, common bile duct). Borders omental foramen

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20
Q

Pringle maneuver

A

Press on hepatoduodenal ligament to stop bleeding.

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21
Q

Gastrohepatic

A

Connects liver to lesser curvature of stomach and contains gastric arteries. Separates the greater and lesser sacs and may be cut during surgery to access the lesser sac

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22
Q

Gastrocolic

A

Connects greater curvature of stomach to transverse colon. Contains the gastroepiploic arteries. Part of the greater omentum.

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23
Q

Gastrosplenic

A

Connects greater curvature and spleen. Contains the short gastric arteries and the left gastroepiploic vessels. Separates the greater and lesser sacs on the left.

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24
Q

Splenorenal

A

Connects spleen to posterior abdominal wall. Contains the splenic artery and vein, and the tail of the pancreas

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25
Q

Layers of the digestive tract

A

Mucosa - contains epithelium, lamina propria, and muscularis propria
Submucosa- includes the submucosal nerve plexus (meissners)
Muscularis propria - Includes myenteric plexus between inner circumferential and outer longitudinal muscle

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26
Q

Frequencies of contractions in digestive tract

A

Stomach is slow, duodenum is fast, ileum/cecum is medium (8-9 waves)

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27
Q

What are brunner’s glands

A

Mucus secreting cells in the submucosa of duodenum.

28
Q

Where are the crypts of leiberkuhn?

A

In the duodenum all the way to the colon.

29
Q

Which part of the digestive tract has the highest number of goblet cells

A

Ileum

30
Q

Which artery supplies the foregut, what level?

A

Celiac artery supplies the pharynx to proximal duodenum, liver, gallbladder, pancreas, and spleen (even though it’s mesoderm).

At T12

31
Q

Which artery supplies the midgut

A

SMA at L1

32
Q

Which artery supplies the hindgut?

A

IMA at L3.

33
Q

Where is the bifurcation of the abdominal aorta?

A

L4.

34
Q

SMA syndrome

A

When the duodenum (3rd segment) is trapped between SMA and aorta and causes intestinal obstruction.

35
Q

Branches of celiac trunk

Where are the strong anastamoses?

A

Common hepatic, left gastric, splenic.
Strong anastamoses between left and right gastroepiploic (left from splenic, right from common hepatic). And left and right gastric (right gastric from common hepatic).

36
Q

Short gastric arteries

A

Arise from splenic artery, have poor anastomoses if splenic is blocked

37
Q

Superior epigastric (internal thoracic) anastomoses with…

A

Inferior epigastric (external iliac)

38
Q

Superior pancreaticoduodenal artery (celiac trunk) anastomoses with?

A

Inferior pancreaticoduodenal (from SMA)

39
Q

Middle colic (SMA) anastomoses with?

A

Left colic (IMA)

40
Q

Superior rectal (IMA) anastomoses with?

A

middle and inferior rectal (internal iliac)

41
Q

Esophageal varices from?

A

Left gastric ->esophageal

42
Q

Umbilical varices from?

A

Paraumbilical veins ->small epigastric veins (systemic)

43
Q

Rectal varices from?

A

Superior rectal -> inferior rectal

44
Q

Pectinate line

A

Where endoderm meets ectoderm

45
Q

Internal hemorrhoids drainage and innervation

A

Systemic innervation so not painful, drain to deep nodes

46
Q

External hemorrhoids

A

Receive somatic innervation form pudendal nerve, and are therefore painful. Lymphatic drainage to superficial inguinal nodes.

47
Q

Zone I of liver affected by?

A

Viral hepatitis and ingested toxins

48
Q

Zone III of liver affected by

A

Ischemia, metabolic toxins, site of alcoholic hepatitis.

49
Q

What is not in the femoral sheath?

A

The femoral nerve.

FemorAL sheath contains VAL.

50
Q

Spermatic cord layers

A 
Contains internal spermatic fascia (from transversalis)
Cremasteric muscle (internal oblique), external spermatic fascia (from external oblique fascia)
51
Q

Hesselbach’s triangle

A

Inferior epigastrics, rectus sheath, inguinal ligament.

52
Q

Femoral hernia

A

usually in females, through femoral ring.

53
Q

Cholecystokinin

A

From I cells in the duodenum and jejunum. Contract gall bladder to release bile, cause pancreatic secretion, decrease gastric emptying, relax sphincter of oddi. Activated by amino acids and proteins. Acts on muscarinic pathways

54
Q

Gastrin

A

Released from G cells of the antrum. Causes firing of ECL cells to release histamine, causes H+ release from parietal cells. Activated by GRP from vagus. Causes growth of gastric mucosa. Activated by phenylalanine and tryptophan. Decreased by stomach acids.

55
Q

Potent stimulators of gastrin

A

Phenylalanine and tryptophan!

56
Q

Glucose dependent insulinotropic peptide

A

Released from K cells in duodenum and jejunum. Decreases gastric secretion but causes release of insulin from pancreas. Secreted in response to amino acids, fatty acids, glucose. This is why we can release insulin so quickly in response to meals

57
Q

Motilin

A

Released from small intestine, produces migrating motor complexes. Erythromycin in a motilin agonist and causes peristalsis.

58
Q

Secretin

A

Released from S cells in duodenum to increase pancreating HCO3 secretion. Released in response to acid, fatty acids. HCO3 neutralizes acids in lumen allowing pancreatic enzymes to function

59
Q

Somatostatin

A

Released by D cells in the islets and mucosa. Stops everything.

60
Q

NO implication in achalasia?

A

Loss of NO may cause loss of inhibitory tone at LES in achalasia.

61
Q

VIP

A

Vasoactive intestinal peptide increases intestinal water and electrolyte secretion. Increased by distension and vagal stimulation. Decreased by adrenergic input

62
Q

Pepsin

A

Made in chief cells, activated by acid from pepsinogen to digest proteins

63
Q

Enterokinase/enteropeptidase

A

Activates trypsinogen to trypsin to activate pancreatic enzymes.

64
Q

Glucose and galactose taken up by

A

SGLT1

65
Q

Fructose taken up by

A

GLUT5

66
Q

Which receptor is Gs in parietal cell?

A

Histamine

67
Q

CCKB receptor works through?

A

IP3 system

STEP 1 Review (21 decks)

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