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First Aid 2014 > GI > Flashcards

GI Flashcards

1
Q

What is the mnemonic to remember the retroperitoneal structures?

A

SADPUCKER

S= Suprarenal glands
A= Aorta and IVC 
D= Duodenum (2nd=4th parts) 
P= Pancreas (except tail) 
U= Ureters 
C= Colon (ascending and descending) 
K= Kidneys
E= Esophagus (lower 2/3) 
R= Rectum
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2
Q

What does the falciform ligament connect?

A

Liver and anterior abdominal wall

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3
Q

What does the falciform ligament contain?

A

Ligamentum teres hepatis

*Derivative of the fetal umbilical vein

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4
Q

What does the Hepatoduodenal ligament connect?

A

Liver to duodenum

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5
Q

What does the Hepatoduodenal ligament contain?

A

Portal triad

  • Proper hepatic a.
  • Portal vein
  • Common bile duct
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6
Q

What does the Gastrohepatic ligament connect?

A

Liver and lesser curvature of the stomach

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7
Q

What does the Gastrohepatic ligament contain?

A

Gastric arteries

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8
Q

What does the Gastrocolic ligament connect?

A

Greater curvature and transverse colon

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9
Q

What does the Gastrocolic ligament contain?

A

Gastroepiploic arteries

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10
Q

What does the Gastrosplenic ligament connect?

A

Greater curvature and spleen

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11
Q

What does the Gastrosplenic ligament contain?

A

1) Short gastrics

2) Left gastroepilopic artery and vein

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12
Q

What does the Splenorenal ligament connect?

A

Spleen to posterior abdominal wall

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13
Q

What does the Splenorenal ligament contain?

A

1) Splenic artery and vein

2) Tail of the pancreas

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14
Q

Where does the celiac trunk branch from the abdominal aorta?

A

T12

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15
Q

Where does the SMA branch from the abdominal aorta?

A

L1

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16
Q

Where does the IMA branch from the abdominal aorta?

A

L3

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17
Q

Where does the abdominal aorta bifurcate?

A

L4–think Bi-FOUR-cate

*Into the right and left common iliac arteries

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18
Q

What is SMA Syndrome?

A
  • This is when the SMA traps the 3RD PART OF THE DUODENUM like a nutcracker
  • Causes SBO
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19
Q

What is the mnemonic to remember the branches of the abdominal aorta?

A

Prostitutes Cause Sagging Swollen Red Testicles [in men] Living In Sin

P= Phrenic (inferior) 
C= Celiac Trunk 
S= SMA 
S= Suprarenal 
R= Renal 
T= Testicular 
L= Lumbars 
I= IMA 
S= Sacral (medial sacral)
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20
Q

What are the three main branches of the celiac trunk?

A

1) Common hepatic a.
2) Splenic a.
3) Left gastric a.

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21
Q

What are the two major arterial anastasmoses of the stomach?

A

1) Left and right gastric a. supplying the lesser curvature

2) Right and left gastroepiploic a. supplying the greater curvature

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22
Q

If the superior epigastric a. or internal thoracic/mammary a. is blocked, what artery will provide anastamotic circulation? Where does this artery branch from?

A

Inferior epigastric, a branch of the external iliac a.

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23
Q

If the superiorpancreaticoduodenal a. (Celiac trunk) is blocked, what artery will provide anastamotic circulation? Where does this artery branch from?

A

Inferior pancreaticoduodenal a. (SMA)

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24
Q

If the middle colic a. (SMA)is blocked, what artery will provide anastamotic circulation? Where does this artery branch from?

A

Left colic a. (IMA)

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25
If the superior rectal a. (IMA) is blocked, what artery will provide anastamotic circulation? Where does this artery branch from?
Middle and inferior rectal a., branches of the internal iliac a.
26
What are portosystemic anastamoses?
Communications between the portal venous system and the systemic venous system
27
List the clinically important portosystemic anastamoses.
1) Esophageal veins (systemic) drain into the left gastric vein (portal) 2) Small epigastric veins of the anterior abdominal wall (systemic) drain into the para-umbilical veins (portal) 3) Middle and inferior rectal vein (systemic) drains into the superior rectal vein (portal)
28
What are the clinical manifestations of portal HTN?
1) Esophageal varices 2) Caput medusae 3) Anorectal varices
29
What surgical procedure can relieve portal HTN?
TIPS- Tranjugular intrahepatic portosystemic shunt
30
What veins are connected by the TIPS procedure?
Portal vein and hepatic vein
31
What forms the pectinate line?
This is where endoderm meets ectoderm in the rectum
32
What type of hemorrhoids are seen above the pectinate line? Below? Are they painful?
``` Above= internal (painless b/c of visceral innervation) Below= external (painful b/c of somatic innervation) ```
33
What type of cancer is common seen above the pectinate line? Below?
``` Above= Adenocarcinoma Below= Squamous Cell Carcinoma ```
34
Describe the arterial supply above and below the pectinate line
``` Above= Superior rectal a. (IMA) Below= Inferior rectal a. (internal pudendal a.) ```
35
Describe the venous drainage above the pectinate line.
Superior rectal vein-->IMA-->portal system
36
Describe the venous drainage below the pectinate line.
Inferior rectal vein-->internal pudendal vein-->internal iliac vein-->IVC
37
Where do anal fissures most commonly occur? What are symptoms of anal fissures?
Anal fissures occur below the Pectinate line: - Pain while Pooping - blood on toilet Paper - located Posterior b/c Poorly Perfused *Remember the P's of anal fissures
38
What structure is obstructed by tumors in the head of the pancreas? Why does this lead to jaundice?
Tumors in the head of the pancreas obstruct the COMMON BILE DUCT - Conjugated bilirubin will lead out with bile - Jaundice results
39
What is the mnemonic to remember the organization of the inguinal canal?
NAVEL (from LATERAL to MEDIAL) - Nerve - Artery - Vein - empty - Lymphatics
40
What are the borders of the femoral triangle?
``` Superior= inguinal ligament Lateral= Sartorious m. Medial= Adductor longus m. ```
41
What structure of the inguinal canal is NOT located in the femoral sheath?
Femoral nerve (lateral and OUTSIDE of the femoral sheath)
42
What ring do indirect hernia protrude through?
Internal inguinal or "deep" ring
43
What do direct inguinal hernias protrude through?
Abdominal wall
44
What forms the external spermatic fascia of the spermatic cord?
External oblique
45
What forms the cremasteric muscle and fascia of the spermatic cord?
Internal oblique
46
What forms the internal spermatic fascia of the spermatic cord?
Transversalis fascia
47
What is the most common form of a diaphragmatic hernia?
Hiatal hernia
48
In infants with a congenital diaphragmatic hernia, what is the most common cause?
Defective development of the left pleuroperitoneal membrane
49
What is the pathognomonic radiographic sign of a sliding hiatal hernia?
"Hourglass stomach"
50
What type of hernia is more common in women?
FEMoral hernias (FEMales)
51
What is the leading cause of bowel incarceration?
Femoral hernias
52
Externally, how can you tell the difference between the Jejunum and ileum?
Jejunum has: 1) Less mesenteric fat 2) Fewer vascular arcades
53
What is the source of CCK?
I-cells in the duodenum and jejunum
54
What is the function of CCK?
CCK generally increases pancreatic secretion. More specifically, 1) Increased pancreatic secretion 2) Increased gallbladder contraction 3) Decreased gastric emptying 4) Relaxation of the sphincter of Oddi
55
What is the source of Gastrin?
G-cells in the antrum of the stomach
56
What are the positive regulators of Gastrin?
- Stomach distention - Stomach alkalinization - Amino acids - Peptides - Vagal stimulation
57
What are the negative regulators of Gastrin?
Stomach pH less than 1.5
58
What are the functions of Gastrin?
1) Increased gastric H+ secretion 2) Growth of gastric mucosa 3) Increased gastric motility
59
What is the source of Glucose-dependent insulinotropic peptide or GIP?
K-cells in the duodenum and jejunum
60
What are the positive regulators of GIP?
- Fatty acids - Amino acids - Oral glucose
61
What is the function of GIP?
1) Decrease gastric acid secretion | 2) Increased insulin release
62
Why is oral glucose used more rapidly than IV glucose?
Oral glucose activates GIP that produces insulin; IV does NOT
63
What is the source of Motilin?
Small intestine
64
What regulating Motilin?
Motilin secretion is increased in the fasting state
65
What is the function of Motilin?
Production of migrating motor complexes (MMCs)
66
What antibiotic is a Motilin receptor agonist?
Erythromycin
67
What is the source of Secretin?
S-cells in the duodenum
68
What causes the secretion of Secretin?
Fatty acids in the lumen of the duodenum
69
What is the function of Secretin?
1) Increased pancreatic bicarbonate secretion 2) Decreased gastric acid secretion 3) Increased bile secretion *Generally aids in the digestion of fats*
70
What is the source of Somatostatin?
D-cells in the pancreas
71
What increases Somatostatin secretion?
Acid
72
What decreases Somatostatin secretion?
Vagal stimulation
73
What are the functions of Somatostatin?
Generally, somatostain is an inhibitory hormone that decreases: 1) Gastric acid and pepsinogen secretion 2) Pancreatic fluid secretion 3) Gallbladder contraction 4) Insulin and glucoagon release
74
What is the function of NO in the GI system?
Smooth muscle relaxation
75
What disease is loss of NO secretion associated with?
Achalasia
76
What is the source of Vasoactive Intesintal Polypeptide (VIP)?
PNS ganglia in the: - Sphincters - Gallbladder - Small intestine
77
What increases VIP release?
Distention and vagal stimulation
78
What decreases VIP release?
Adrenergic input
79
What are the functions of VIP?
1) Increased intestinal water and electrolyte secretion | 2) Relaxation of smooth muscle and sphincters
80
What is a VIPoma?
Pancreatic islet cell tumor that secretes VIP
81
What is the mnemonic to remember the symptoms caused by a VIPoma?
WDHA Syndrome ``` WD= Watery Diarrhea H= Hypokalemia A= Achlorhydria ```

First Aid 2014 (8 decks)

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