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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
Q

Lesser and greater momentum arise from

A

Peritoneum of stomach (mesogastrium)

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26
Q

Created within the ventral fold of mesogastrium and attached via

A

LIVER

attached ventrally via falciform ligament

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27
Q

Created within dorsal fold of mesogastrium

A

SPLEEN

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28
Q

Midgut begins at what level of Duodenum

A

Last 1/3 of duodenum, at Ampulla of Vater / Sphincter of Oddi (major duodenal papilla)

29
Q

Created as two outpouchings of duodenum (dorsal and ventral) that later fuses to have one middle duct

A

PANCREAS

30
Q

Three initial branches of Celiac Trunk

A

Left Gastric
Splenic
Common Hepatic

31
Q

Left Gastric a.&raquo_space;

A

Esophageal Branches
Anastamoses with Right branch

lesser curve of stomach

32
Q

Splenic a.&raquo_space;

A 
Short gastric branches (fundus) 
Gastroepiploic branches (greater curvature stomach and greater omentum)
33
Q

Common hepatic a.&raquo_space;>

A

Right gastric (to left gastric, lesser curve)
Gastroduodenal > right gastroepiploic (anastomose w left)
Superior pancreaticoduodenal

34
Q

Which artery is found behind the first part of the duodenum and can be damaged by a perforating ulcer on posterior duodenal wall

A

Gastroduodenal artery (branch from Common Hepatic)

35
Q

Which artery supplies the greater curvature of the stomach and the greater omentum?

A

Gastroepiploic (left from Splenic a, right from Common Hepatic a.)

36
Q

At what spinous level would a Celiac Block be done?

A

L1

37
Q

T-E Fistula and VACTERL Anomalies

A

ANOMALIES:

Vertebral
Anorectal
Cardiac
T-E fistula
Esophageal Atresia 
Rectal
Limb and Bone
38
Q

Histological changes that occur as a result of chronic acid reflux / chronic inflammation of lower esophageal epithelium

A

Barretts Esophagus

Includes growth of columnar epithelium with goblet cells - normally only found in intestines

Pre-malignant

39
Q

Which gastric cells secrete HCL and Intrinsic Factor

A

Parietal

40
Q

Which gastric cells secrete Pepsin

A

Chief Cells

41
Q

Which gastric cells secrete Gastrin

A

Enteroendocrine / G cells

42
Q

4 stimulants of HCL production

A
  1. Cephalic Phase (stims parietal cells)
  2. Acetylcholine (PSNS)
  3. Histamine (triggered by and increases gastrin)
  4. Gastrin
43
Q

Inhibition of HCL

A

Somatostatin (triggered by products of digestion reaching duodenum)

44
Q

Comes from G cells in the antrum of stomach.

Triggered by distention or polypeptides, or vagus.

A

GASTRIN

45
Q

Comes from enterochromaffin-like cells (ECL cells) in gastric mucosa.

Triggered by gastrin. Potentiates effects of gastrin.

A

HISTAMINE

46
Q

Negative effector of HCL production.

Comes from stomach/intestine/pancreas/hypothalamus.
Both endocrine and exocrine.

Triggered by products of digestion in duodenum.

A

SOMATOSTATIN

47
Q

Clinical combination of duodenal ulcers and pancreatic gastrin tumor

A

Zollinger-Ellison Syndrome

48
Q

Normal size of spleen

A

12x17 cm long

3-4cm thick

150g

49
Q

Superior Duodenum

A

Brunner’s glands (bicarb and mucous, urogastrone)

Hormonal triggers to gallbladder and pancreas

50
Q

Descending Duodenum

A

Ampulla of Vater / Sphincter of Oddi / MDP empty here

Duct of Santorini (accessory pancreatic duct)

51
Q

Horizontal Duodenum

A

Digestion

Crosses IVC and aorta

52
Q

Ascending duodenum

A

Digestion
Connects to jejunum, where bowel is no longer retroperitoneal
duodenum ends at Ligament of Treitz

53
Q

Inhibits stomach’s parietal and chief cells

A

Urogastrone, secreted by Brunner’s glands in superior duodenum

54
Q

Retroperitoneal organs

A

Pancreas
Duodenum
Kidneys

55
Q

Pancreatic pain

A

Mid-epigastric

Back (L1-L2)

56
Q

Cholelithiasis - pigment stones

A

Hemolytic anemias

Parasitic infection

57
Q

Cholelithiasis - cholesterol/mixed stones

A

Obestity
Dietary
Oral contraceptives
Diabetes mellitus

58
Q

Bloody stools

A

Hematochezia

59
Q

Black, tarry stools

A

Melena

60
Q

Most GI symptoms caused by one of these

A

Stenosis
Regurgitation
Movement abnormalities
Inflamation / trauma of mucosa

61
Q

Esophageal stenosis

A

Vomitting - undigested foods

Stricture / Achalasia

62
Q

Esophageal regurgitation / insufficiency

A

Pain, Vomitting, Hoarseness, Cough

GERD, lower esophageal sphincter

63
Q

Abnormalities of movement

A

Pain, vomitting, regurge of food

Esophageal dysmotility (too slow)

64
Q

Esophageal inflammation

A

Pain, esophageal bleeding (hematemesis)

Esophagitis, Barretts, GERD

65
Q

Neurologic problem– specifically, degeneration of myenteric plexus– causing defective inhibition of the lower esophageal sphincter muscles.

A

Achalasia

66
Q

Peripheral neuropathy if enteric nerves
Vagal dysfunction (parasymp inhibition)
Bezoars.

A

Gastroparesis

67
Q

Epigastric pain and fullness, nausea, “succussion splash”, vomiting; if prolonged, malnutrition and dehydration

A

Pyloric Stenosis

68
Q

The sound of a large GI lumen (e.g. stomach) filled with gas and liquid contents.

A

Succession Splash

69
Q

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.

A

Pyloric Stenosis

pathophys, GI / Heme (2 decks)

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