GI Flashcards
retroperitoneal structures?
SAD PUCKER suprarenal = adrenal aorta/IVC duodenum (2-4) pancreas (except tail) ureters colon (ascending/descending) kidneys esophagus rectum
connects liver to ant abd wall, contains ligamentum teres?
falciform ligament
** ventral mesentery derivative
connects liver to duod, contains portal triad?
hepatoduodenal ligament
part of lesser omentum
- Pringle maneuver: squeeze it to stop blood loss
- borders omental foramen
connects liver to lesser curvature of stomach, contains gastric arteries?
gastrohepatic ligament
part of lesser omentum
- separates greater and lesser sacs on R
- may be cut to access lesser sac
connects greater curvature of stomach and transverse, contains gastroepiploic arteries?
gastrocolic ligament
part of greater omentum
connects greater curvature of stomach and spleen, contains short gastric and L gastroepiploic aa?
gastrosplenic ligament
part of greater omentum
** separates greater and lesser sacs on L
connects spleen to post abdominal wall, contains splenic a/v, pancreatic tail?
splenorenal ligament
portal triad?
proper hepatic a
portal v
common bile duct
layers of gut wall?
inside --> outside: mucosa submucosa muscularis externa serosa/adventitia
epithelium, lamina propria, muscularis mucosa?
mucosa of gut
Meissner plexus, fluid secretion?
submucosa of gut
Auerbach (myenteric) plexus, motility?
muscularis externa of gut
what are the basal rhythms of the gut?
stomach: 3 waves/min
duodenum: 12 waves/min
ileum: 8-9 waves/min
where do you see crypts of Lieberkuhn?
SI and colon
where do you see plicae circulares?
jejunum and ileum
where do you see Brunner glands?
duodenum - secrete HCO3
where do you see peyer patches?
ileum
which part of SI has largest # of goblet cells?
ileum
does the colon have villi?
nope
level of celiac trunk?
T12/L1
level of SMA?
L1
level of IMA?
L3
level of aortic bifurcation?
L4
level of renal aa?
L1
what is SMA syndrome?
3rd part of duodenum trapped bw SMA and aorta –> obstruction
aa/nn of foregut?
a: celiac –> liver, GB, panc, spleen, gut to prox duod
n: vagus
aa/nn of midgut?
a: SMA –> prox 2/3 transverse colon
n: vagus
aa/nn of hindgut?
a: IMA –> upper rectum
n: pelvic
where is the watershed bw SMA and IMA?
splenic flexure of colon
branches of celiac a?
L gastric –> esophagus, lesser curvature
splenic –> spleen, panc, fundus, L greater curvature
hepatic –> liver, duodenum, head of panc, lesser curvature, R greater curvature
anastomoses in celiac a supply?
L and R gastroepiploics
L and R gastrics
weak anastomoses for short gastrics
esophageal portosystemic anastomosis?
L gastric v (portal) and esophageal v (systemic)
umbilical portosystemic anastomosis?
paraumbilical vv (portal) and small epigastric vv (systemic)
rectal portosystemic anastomosis?
superior rectal v (portal) and middle/inferior rectal v (systemic)
what cancers do you get above vs below the pectinate line?
above: adenocarcinoma
below: squamous cell
arterial/venous supply of rectum above vs below pectinate line?
above: sup rectal a (IMA); sup rectal vein –> IMV –> portal
below: inf rectal a (int pudendal); inf rectal v –> int pudendal –> iliac –> IVC
lymphatic drainage of rectum above vs below pectinate line?
above: internal iliac
below: superficial inguinal
zone of liver affected 1st by viral hep, ingested toxins?
zone 1: periportal
zone of liver affected by yellow fever?
zone 2: intermediate
zone of liver affected 1st by ischemia, metabolic toxins, alcoholic hepatitis?
zone 3: pericentral/centrilobular
** site of CYP450
what is a Kupffer cell?
specialized macrophage of liver
apical vs basolateral surface of hepatocytes?
apical –> bile canaliculi
basolateral –> sinusoids
double duct sign?
stone in ampulla of vater –> CBD and panc duct dilation
what is in the femoral sheath?
femoral vein, artery, deep inguinal LNs
** DOES NOT have femoral n
layers of inguinal canal?
internal –> external:
- parietal peritoneum
- extraperitoneal tissue
- transversalis fascia
- transversus abdominis
- internal oblique
- external oblique aponeurosis/ing ligament
layers of spermatic cord?
external spermatic fascia (from ext oblique)
cremasteric mm/fascia (from int oblique)
internal spermatic fascia (from transversalis fascia)
** transversus abdominus skipped
goes thru deep inguinal ring, enters internal ring lateral to inf epigastric a?
indirect hernia
- covered by all 3 layers of spermatic fascia
- infants: failure of processus vaginalis closure
- more common in males
goes thru abdominal wall, enters internal righ medial to inferior epigastric a?
direct hermia
- covered by external spermatic fascia only
- goes through Hesselbach’s triangle
- older men
goes through femoral canal below inguinal ligament?
femoral hernia
- leading cause of bowel incarceration
- more common in females
hesselbach’s triangle borders?
rectus abdominis (medial border) inf epigastric vessels (lateral) inguinal ligament (inferior)
