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A_First Aid Random Memorizing > GI > Flashcards

GI Flashcards

1
Q

foregut becomes

A

esophagus to 2nd part of duodenum

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2
Q

midgut becomes…

A

upper duodenum to proximal 2/3rds transverse colon

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3
Q

hindgut becomes..

A

distal 1/3rd transverse colon to anal canal above pectinate

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4
Q

when does midgut start rotating and until when

A

midgut physiologic herniation through UMBILICAL RING at week6 and 270 deree counterclockwise rotation around SMA by week 10

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5
Q

rostral fold closure failure leads to

A

sternal defects (ectopia cordis)

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6
Q

lateral food closure failure leads to

A

gastroschisis and omphalocele

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7
Q

caudal fold closure failure leads to

A

bladder extrophy

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8
Q

most common tracheoesophageal anomaly

A

esophageal atresia with distal TEF

air enters stomach, vomits with FIRST feeding

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9
Q

double bubble sign associated with down syndrome

A

duodenal atresia

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10
Q

what does jejunal and ileal atresia lead to

A

disruption of mesenteric vessels, ischemic necrosis, and segmental resorption (bowel discontinuinity and “apple ppel”

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11
Q

pancreas comes from foregut, midgut, or hindgut?

A

foregut

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12
Q

origin of pancreatic head

A

both ventral and dorsal pancreatic bud

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13
Q

origin of uncinate process, and main pancreatic duct

A

ventral pancreatic duct

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14
Q

origin of pancreatic boy, tail, isthmus, accessory pancreatic duct

A

dorsa lpancreatic duct

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15
Q

ring of pancreatic tissue that causes narrowing of duodenum

A

annular pancreas (encircles 2nd part of duodenum)

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16
Q

ventral and dorsal pancreatic tail fails to fuse at 8 weeks

A

pancreas divisum

mostly asymptomatic, but can cause chronic abdominal pain or pancreatitis

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17
Q

where does spleen arise and what blood supplies

A

spleen arises from mesentery of stomach (mesodermal) but is supplied by foregut (celiac trunk -> splenic artery)

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18
Q

what makes a GI structure retroperitoneal?

A

lacks mesentery

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19
Q

what are the retroperitoneal structures

A 
SAD PUCKER
suprarenal/adrenal glands
aorta/ivc
dudoenum (part 2-4)
pancreas (everything but tail)
ureters
colon (ascending and descending parts)
kidneys
esophagus (thoracic)
rectum
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20
Q

what part of duodenum has opening to CBD and pancreatic duct

A

2nd part

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21
Q

blood supply to foregut

A

celiac trunk

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22
Q

p and s supply of foregut

A

parasym - vagus nerve

symp - throacic splanchnic

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23
Q

p and s supply of midgut

A

para - vagus

symp - thoracic splanchnic

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24
Q

blood supply midgut

A

SMA

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25
Q

blood supply hindgut

A

IMA

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26
Q

p and s of hindgut

A

para - pelvic splanchnic

sym - lumbar splanchnic

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27
Q

besides esophagus and duodenum what else comes from foregut

A

pharynx, liver gallbladder, pancreas, spleen (tehcnically mesoderm) but gets blood supply from celiac

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28
Q

what is contained in falciform ligament (comes from ventral mesentery)

A

ligamentum teres hepatis (fetal umbilical vein derivative)

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29
Q

what is contained in hepatoduodenal ligament

A

portal triad (proper hepatic, common bile duct, portal vein)

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30
Q

what is the pringle manuever

A

squeezing the hepatoduodenal ligament to control bleeding in omental foramen

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31
Q

which ligament contains gastric arteries

A

gastro hepatic ligament

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32
Q

what houses the gastro epiploic arteries

A

gastrocolic ligament

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33
Q

what is contained within splenorenal ligament

A

splenic artery and vein, tail of pancreas

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34
Q

layers of gut wall from inside to outside

A 
MSMS
mucosa
submucosa
muscularis
serosa
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35
Q

which layer of gut wall contains messner nerve plexus and secretes fluid

A

submucosa

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36
Q

which layer contains myenteric nerve plexus (auerbach) and is responsbile for motility

A

muscularis

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37
Q

gastric erosion vs gastric ulcer

A

erosion only affects mucosa

ulcer can invade into submucosa, inner or outer muscular layer

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38
Q

difference in functio between auerbach and meissner’s plexus

A

meissner plexus (submucosal) only has parasympathetic tone (secretory) whereas auerbach has both

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39
Q

what type of cells reside in esophagus

A

nonkeratinized stratified squamous

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40
Q

histology of stomach

A

gastric glands

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41
Q

what are brunner glands and where are they located

A

hco3 secreting cells of submucosa located in duodenum

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42
Q

location and function of crypts of liberkuhn

A

contain stem cells that repalce enterocytes/goblet cells and Paneth cells that secrete defensins, lysozyme and TNF) located in duodenum and jejunum

43
Q

where are peyer patches located

A

ileum, jejunum lacks these

44
Q

which has more plicae circularis jejunum or ileum

A

jejunum

45
Q

nutcracker syndrome

A

sandwiching of L renal vein between SMA and aorta…varicocele

46
Q

intermittent intestinal obstruction (primarily postprandial) when transverse protaon of duodenum is compressed between SMA and aorta

A

superior mesenteric artery syndrome

low body weight and weight/malnutrition

47
Q

complication of posterior duodenal ulcer

A

penetrate gastroduodenal artery and cause hemorrhage

48
Q

complication of anterior duodenal ulcers

A

peprforate into anterior abdominal cavity and cause pneumoperitoneum

49
Q

three branches of celiac artery that supplies stomach

A

common hepatic, left gastric, splenic

50
Q

what portion of stomach does splenic artery supply

A

fundus and half of body via short gastric and left gastroepiploic

51
Q

what portion of stomahc does left gastri supply

A

cardia and part of lesser curvature

52
Q

how does common hepatic artery supply stomach

A

branches into right gastric to supply bottom part of lesser curvature and branches into gastroduodenal which branches into right gastroepiploic to supply bottom part of fundus *that isn’t suppled by left gastroepiploic

53
Q

which stomach arteries have strong anastomoses

A

left and right gastroepiploics

left and right gastrics

54
Q

portal and systemic anast at esophagus

A

left gastric and azygosvein

55
Q

portal systemic anast at umbilicus

A

paraumbilical to small epigastric veins of atnerior abdominal wall

56
Q

portal systemtic anast at rectum

A

superior rectal to middle and inferior rectal

57
Q

portal hypertension sign at umbilicus

A

caput madusae

58
Q

significance of pectinate line

A

formed where endoderm (hindgut) meets ectoderm

59
Q

borders of femoral triangle

A

inguinal ligament (superiorly), adductor longus, sartorius laterally

60
Q

cellular component in charge of vascular remodeling and invading basement membraines (tumors)

A

metalloproteinases

61
Q

what defends against local vs systemic candidiasis

A

local - t lymphocytes

systemic - neutrophils

62
Q

main cause of cluadication

A

atherosclerosis of larger named arteries which cause fixed stenotic lesions caused by atheromas (lipid filled intimal plaques that bulge into lumen)

63
Q

recurrent apthous ulcers, genital ulcers, uveitis

A

behcet syndrome often seen after viral infection

64
Q

vesicles in oral mucosa that rupture and result in shallow painful red ulcers

A

hsv1

usually occurs in childhood

65
Q

where does HSV1 remean latent

A

can remain dormant in ganglia of trigeminal nerve and can cuase reactivation later in life (cold sores)

66
Q

major risk factor for sqamous cell carc

A

tobacco and alcohol

67
Q

most common location in oral mucosa

A

floor of mouth

68
Q

precursor lesions to squamous dysplasia in oral mucosa

A

leukoplakia and erythroplakia (cannot be scraped away)…more toward ERYTHROPLAKIA FOR CANCER

69
Q

rough shaggy patch in LATERAL TONGUE

A

hairy luekoplakia

associated with EBV CAN BE scraped off

70
Q

inflamed parotid glands bilaterally

A

mumps

can also develop orchitis

71
Q

what lab value is elevated in mumps

A

serum amylase (can also indicate pancreatic involvement) as well as salivary amylase

72
Q

feared complications of mumps

A

orchitis, pancreatitis, aseptic meningitis

73
Q

inflammation fo salivary gland due to obstructing stone

A

sialadentiisi

74
Q

most common organism in siladenitis

A

staph aureus

75
Q

mcc tumor of salivary gland

A

pleomorphic adenoma (benign) stromal and epithelial tissue mix…is mobile painless and circumscribed at angle of jaw

76
Q

rate of recurrence on pleomorphic adenoma

A

high rate of reccurence

because surgical resection isn’t complete often time

77
Q

sign of malignant transformation of parotid mass

A

turns painless into painful (indicates malignant invasion of facial nerve)

78
Q

benign cystic tumor with abundant lymphocytes and germinal centers

A

warthrin tumor

79
Q

2nd most common tumor of salivary gland

A

warthrin tumor

cystic tumor with lymphoid tissue

80
Q

malignant tumor composed of mucinous and squamous cells

A

mucoepidermoid carcinoma, can involve facial nerve

81
Q

hx of gallstones, presents with SBO and air in gallbladder and biliary tree

A

gallstone ileus due to cholecystenteric fistula with stone now lodged in ILEUM (narrowest part of small intestine)

82
Q

if pringle manuver is performed and bleeding doens’t stop…where is source of bleeding

A

hepatic vein or IVC

83
Q

vomiting on first feed, polyhydramnios, abdominal distention, aspiration

A

TE fistula

84
Q

beefy red tongue, esophageal web, ida

A

plummer vinson

85
Q

dysphagia, obstruction, halitosis

A

zenker diverticulum (outpouching of pharyngeal mucosa through acquired muscular wall defect…usually affects upper esophageal sphincter at junction of esophague and pharynx)

86
Q

longitudinal linear laceration of mucosa at GE junction

A

mallory weiss syndrome

seen in frequent vomiting/alcoholics

87
Q

painful hematemesis

A

mallory weiss syndrome

88
Q

rupture of (mediatinal air into esophagus, subcutaneous emphysema and crepitus)

A

boerhaave

89
Q

painless hematemsis in portal hypertension

A

bleeding varices (most common cause of death)

90
Q

achalasia results from damge to what nerves

A

ganglion cells in myenteric plexus

causes disordered esophageal motility and inability to relax

91
Q

infection that cuases achalasia

A

chagas

92
Q

achalasia gives increased risk for what cancer

A

esophageal squamous cell carcinoma

93
Q

transformation of cells in GERD

A

go from nonkeratinizing squamous epithelium to nonciliated columnar cells with goblet cells

94
Q

bowel sounds in lower lung field

A

paraesophageal hernia
not assocaited with GERD
but risk of lung hypoplasia

95
Q

hourglass stomach

A

sliding hiatal hernia, assocaited with GERD

96
Q

malignant proliferation fo glands in esophagus

A

adenocarcinoma (from Barrett’s esophagus) MCC esophageal carcinoma in west

97
Q

what portion of esophagus is adeno and squamous

A

adeno- lower 1/3rd

squamous - upper 2/3rds

98
Q

risk factors for squamous cell carcinoma

A

anything that causes IRRITATION

alcohol, tobacco, hot tea, achalasia, esophageal webs, esophageal injury

99
Q

what hair chemical product can cause esophageal irritation

A

lye

100
Q

progressive dysphagia, weight loss, pain , hematemesis

A

esophageal cancer

101
Q

which lymph nodes supply upper, middle, and lower thirds of esophagus

A

upper - cervical
middle - mediastinal/tracheobronchial nodes
lower - celiac/gastic nodes

102
Q

what runs over 3rd part of duodenum

A

SMA

103
Q

hx chronic pancreatitis presents with gastric varices without esophageal varices…which vessel involve

A

splenic vein

spleniv vein thrombosis can be seen in chronic pancreatitis

A_First Aid Random Memorizing (17 decks)

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