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pathophys, GI / Heme > GI > Flashcards

GI Flashcards

1
Q

Organs within foregut

A 
Lower esophagus
Stomach
Spleen
Pancreas
Liver
Gallbladder
1st and 2nd part of Duodenum

CELIAC TRUNK

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2
Q

Organs within midgut

A 
3rd-4th part of Duodenum
Jejunum
Ileum
Cecum
Appendix
Ascending Colon
Proximal 2/3 Transverse Colon

SUPERIOR MESENTERIC ARTERY

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3
Q

Organs within hind gut

A 
Distal 1/3 Transverse Colon
Descending Colon
Sigmoid Colon
Rectum
Upper Anal Canal
Urogenital Sinus

INFERIOR MESENTERIC ARTERY

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4
Q

Blood supply to foregut

A

Celiac Trunk

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5
Q

Blood supply to midgut

A

Superior Mesenteric Artery

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6
Q

Blood supply to hind gut

A

Inferior Mesenteric Artery

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7
Q

In what trimester does gut rotation occur?

A

6-8 weeks (1st trimester)

Herniation of the primary intestinal loop within umbilicus undergoes 90 degree counterclockwise rotation around superior mesenteric artery

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8
Q

Where the apex of the primary intestinal loop connects to the yolk sac (within umbilicus). Regresses and disappears during fetal period (second trimester).

A

Vitelline Duct

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9
Q

A “bud” which develops on the caudal limb of primary intestinal loop, around 8-10 weeks development. Acts as a “knot” which prevents caudal limb (which becomes hind gut, ascending colon) from retracting into abdominal cavity with cranial limb

A

Cecum

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10
Q

How much does the gut rotate?

A

90 then 180 degrees (270)

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11
Q

Which part of the intestines are retroperitoneal?

A

Ascending and descending colon - mesenteries fused to posterior abdominal wall

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12
Q

Malrotation of the guy is associated with great risk of this

A

Volvulus - when intestine twists on itself (severe pain, necrosis)

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13
Q

Intestinal hernia, occurs when intestines fail to return into abdominal cavity in 10th-11th week. Herniated loops create large swelling only covered by amnion.

A

Omphalocele

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14
Q

Portion of the vitelline duct that has failed to degenerate

A

Meckel’s Diverticulitum

May appear as:

  • Appendix - like structure of ileum
  • Fibrous cord that attaches to umbilicus
  • Patent
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15
Q

Which two ducts converge to form the common bile duct?

A

Common hepatic duct + Cystic duct

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16
Q

Opening of the pancreatic duct into duodenum

A

Major Duodenal Papilla

Pancreatic duct + Common Bile Duct

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17
Q

Spinal landmarks of:

Celiac Trunk
Superior Mesenteric Artery
Inferior Mesenteric Artery
Iliac bifurcation

A
  • T12 / L1
  • L1 / L2
  • L2 / L3
  • L4
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18
Q

Nerve that stimulates gastric secretion and motility

A

VAGUS

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19
Q

Hormones that stimulate gastric emptying

A

GASTRIN and MOTILIN

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20
Q

Hormones that delay gastric emptying

A

SECRETIN and CHOLECYSTOKININ

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21
Q

Epigastric pain could be coming from

A

Foregut

Lower esophagus
Stomach
Pancreas
Spleen
Liver
Gallbladder
1st and 2nd portion of Duodenum
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22
Q

Umbilical pain could be coming from

A

Midgut

3rd and 4th portion of Duodenum
Jejunum
Ileum 
Cecum
Appendix
Ascending Colon
First 2/3 Transverse Colon
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23
Q

Pubic / Suprapubic pain could be coming from

A

Hindgut

Distal 1/3 of transverse colon
Descending colon
Sigmoid colon
Rectum
Anal canal

Pubic areas (proximal vagina, uterus, cervix, bladder, urethra, prostate)

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24
Q

How is stomach attached to abdominal cavity

A

Dorsally (rotated to be left) and ventrally (rotated to be right) by mesogastrium

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25
Lesser and greater momentum arise from
Peritoneum of stomach (mesogastrium)
26
Created within the ventral fold of mesogastrium and attached via
LIVER attached ventrally via falciform ligament
27
Created within dorsal fold of mesogastrium
SPLEEN
28
Midgut begins at what level of Duodenum
Last 1/3 of duodenum, at Ampulla of Vater / Sphincter of Oddi (major duodenal papilla)
29
Created as two outpouchings of duodenum (dorsal and ventral) that later fuses to have one middle duct
PANCREAS
30
Three initial branches of Celiac Trunk
Left Gastric Splenic Common Hepatic
31
Left Gastric a. >>
Esophageal Branches Anastamoses with Right branch **lesser curve of stomach**
32
Splenic a. >>
``` Short gastric branches (fundus) Gastroepiploic branches (greater curvature stomach and greater omentum) ```
33
Common hepatic a. >>>
Right gastric (to left gastric, lesser curve) Gastroduodenal > right gastroepiploic (anastomose w left) Superior pancreaticoduodenal
34
Which artery is found behind the first part of the duodenum and can be damaged by a perforating ulcer on posterior duodenal wall
Gastroduodenal artery (branch from Common Hepatic)
35
Which artery supplies the greater curvature of the stomach and the greater omentum?
Gastroepiploic (left from Splenic a, right from Common Hepatic a.)
36
At what spinous level would a Celiac Block be done?
L1
37
T-E Fistula and VACTERL Anomalies
ANOMALIES: ``` Vertebral Anorectal Cardiac T-E fistula Esophageal Atresia Rectal Limb and Bone ```
38
Histological changes that occur as a result of chronic acid reflux / chronic inflammation of lower esophageal epithelium
Barretts Esophagus Includes growth of columnar epithelium with goblet cells - normally only found in intestines Pre-malignant
39
Which gastric cells secrete HCL and Intrinsic Factor
Parietal
40
Which gastric cells secrete Pepsin
Chief Cells
41
Which gastric cells secrete Gastrin
Enteroendocrine / G cells
42
4 stimulants of HCL production
1. Cephalic Phase (stims parietal cells) 2. Acetylcholine (PSNS) 3. Histamine (triggered by and increases gastrin) 4. Gastrin
43
Inhibition of HCL
Somatostatin (triggered by products of digestion reaching duodenum)
44
Comes from G cells in the antrum of stomach. Triggered by distention or polypeptides, or vagus.
GASTRIN
45
Comes from enterochromaffin-like cells (ECL cells) in gastric mucosa. Triggered by gastrin. Potentiates effects of gastrin.
HISTAMINE
46
Negative effector of HCL production. Comes from stomach/intestine/pancreas/hypothalamus. Both endocrine and exocrine. Triggered by products of digestion in duodenum.
SOMATOSTATIN
47
Clinical combination of duodenal ulcers and pancreatic gastrin tumor
Zollinger-Ellison Syndrome
48
Normal size of spleen
12x17 cm long 3-4cm thick 150g
49
Superior Duodenum
Brunner's glands (bicarb and mucous, urogastrone) | Hormonal triggers to gallbladder and pancreas
50
Descending Duodenum
Ampulla of Vater / Sphincter of Oddi / MDP empty here | Duct of Santorini (accessory pancreatic duct)
51
Horizontal Duodenum
Digestion | Crosses IVC and aorta
52
Ascending duodenum
Digestion Connects to jejunum, where bowel is no longer retroperitoneal **duodenum ends at Ligament of Treitz**
53
Inhibits stomach's parietal and chief cells
Urogastrone, secreted by Brunner's glands in superior duodenum
54
Retroperitoneal organs
Pancreas Duodenum Kidneys
55
Pancreatic pain
Mid-epigastric | Back (L1-L2)
56
Cholelithiasis - pigment stones
Hemolytic anemias | Parasitic infection
57
Cholelithiasis - cholesterol/mixed stones
Obestity Dietary Oral contraceptives Diabetes mellitus
58
Bloody stools
Hematochezia
59
Black, tarry stools
Melena
60
Most GI symptoms caused by one of these
Stenosis Regurgitation Movement abnormalities Inflamation / trauma of mucosa
61
Esophageal stenosis
Vomitting - undigested foods Stricture / Achalasia
62
Esophageal regurgitation / insufficiency
Pain, Vomitting, Hoarseness, Cough GERD, lower esophageal sphincter
63
Abnormalities of movement
Pain, vomitting, regurge of food Esophageal dysmotility (too slow)
64
Esophageal inflammation
Pain, esophageal bleeding (hematemesis) | Esophagitis, Barretts, GERD
65
Neurologic problem– specifically, degeneration of myenteric plexus– causing defective inhibition of the lower esophageal sphincter muscles.
Achalasia
66
Peripheral neuropathy if enteric nerves Vagal dysfunction (parasymp inhibition) Bezoars.
Gastroparesis
67
Epigastric pain and fullness, nausea, “succussion splash”, vomiting; if prolonged, malnutrition and dehydration
Pyloric Stenosis
68
The sound of a large GI lumen (e.g. stomach) filled with gas and liquid contents.
Succession Splash
69
Projectile, nonbilious vomiting Met alkalosis Blood volume will decrease, causing decreased BP at the afferent arteriole as well as decreased sodium content of filtrate at the distal tubule. Both these things will cause JG cells of the kidneys to release renin. Renin → ATI→ ATII-→ Aldosterone.
Pyloric Stenosis

pathophys, GI / Heme (2 decks)

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