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Step 1- System embryology, A and P > GI > Flashcards

GI Flashcards

1
Q

gastrochisis

A

extrusion of abdominal contents through abdominal fold - NOT COVERED BY PERITONEUM

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2
Q

omphalocele

A

percistence of hernation into umbilical cord - covered by peritoneum

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3
Q

most common traceoesophageal anomaly

A

esophageal etresia with distal trachalesophageal fistula (EA with TEF)

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4
Q

EA with TEF sx

A

droolingm chocking and vomiting with firstfeedinh

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5
Q

olive in epigastric region and nonbilious projectile vomiting at 2 weeks of age

A

congenitil pylor stenosis

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6
Q

falicform ligament connects

A

liver to anterior abdominal wall (old umbilical vein)

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7
Q

contained in hepatoduodenal ligament

A

hepatic artery, portal vein, common bile duct

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8
Q

pringle manuver

A

compressing hepatodual ligament between finger and thumb to in omantal foramen to control bleeding

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9
Q

inside to outside gut wall

A

mucosa to submucosa to muscularis to serosa

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10
Q

meissniers plexus in what layer

A

submucosa

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11
Q

myentric/auerbach’s plexis in

A

muscularis

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12
Q

submucosal plexus controls

A

secretion

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13
Q

crypts if leiberkuhn are in

A

jejunum, ilieum

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14
Q

most SI goblet cells

A

ilieum

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15
Q

blood /nerve supply to foregut

A

celiac /vagus

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16
Q

blood /nerve supply to midgut

A

SMA/vagus

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17
Q

blood /nerve supply to hindgut

A

IMA/pevlic

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18
Q

celiac branches off aorta at what level

A

t12/L1

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19
Q

SMA branches off aorta at what level

A

L1

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20
Q

IMA branches off aorta at what level

A

L3

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21
Q

foregut structures

A

stomach, prox duodenum, liver, gallbladder, pancreas, spleen

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22
Q

midgut structures

A

distal duodenum to proximal 2/3 transverse colon

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23
Q

hindgut structures

A

distal 1/2 transverse colon to upper rectum

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24
Q

branches of celiac trunk

A

common hepatic, splenic, left gastric

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25
Q

main blood supply of stomach

A

celiac trunk

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26
Q

strong anamoses in celiac trunk are between

A

left and gastroepiploics and left to righ gastrics

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27
Q

main arterial anamostes in Abominal aorta

A 
superior pigastric (interior thoracic) to infierior epigastric (SMA)
superior pancraticoduodenanl (celiac trunk) to inferior pancreatcduodenal (SMA)
middle colic (SMA) to left colic (IMA)
superior rectal (IMA) to middle and inferior rectal (internal iliac)
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28
Q

surgical tx for portal hypertension

A

transjugular intrahepatic portostystemic shunt (TIPS) between portal vein and heptic vein -shunts blood to systemic circulation

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29
Q

sites of portal anamostes

A

esophageal, umbilicus, rectum (sites of varaies in portal hypertension)

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30
Q

painful hemmoroid site

A

external

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31
Q

above pectinate line drains to

A

portal system/deep lymphatic nodes

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32
Q

below pecinate line drains to

A

IVC system/superficsial inginal nodes

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33
Q

first zone of liver affected by ischemia

A

zone III (pericentral vein/certiclobular) zone

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34
Q

first zone of liver affected by viral hepatitis

A

zone 1 (periportal) zone

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35
Q

apical surface of hepatocytes face

A

bile caniculi

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36
Q

basolateral surface of hepatocytes face

A

sinusoids

37
Q

can block both bile and pancreatic ducts

A

gallstones that reach the common channel at the ampule of vater

38
Q

tumors arising in head of pancreas can block

A

common bile duct

39
Q

lateral to medial femoral structures

A

NAVL

40
Q

femoral triangle contains

A

VAN

41
Q

femoral sheath comtains

A

VAL

42
Q

site of of femoral hernia

A

femoral ring

43
Q

structures in superficsial ingunal ring (in to out_

A 
internal spermatic fascia
cremasteric muscle and fascia
external spermatic fascia
spermatic cord
linea alba
44
Q

most common hernia

A

hiatal

45
Q

GE junction displaced into thorax

A

sliding hiatal hernia

46
Q

fundus of stomach displaced into thoraz

A

paraesopgaheal hernia

47
Q

hernia into the scrotum through deep/external inguinal ring and into scrotum

A

indirect inguinal hernia

48
Q

hernia through inginal triangle through external inguinal ring only

A

direct inguinal hernia (common in old men)

49
Q

most common hernia in women

A

femoral

50
Q

leading cause of bowel incarceration

A

femoral

51
Q

hernia medial to inferior epigastric artery

A

direct

52
Q

hernia lateral to inferior epigastric artery

A

indirect

53
Q

source/action of gastrin

A

G cells in antrum of stomach/increases gastic acid secretion, growth of gastric mucosa and gastric motility

54
Q

source/action of cholecystokinin

A

I cells in duodenum/jejunum/ inreases pancreatic secretion and gallbladder contraction, delays gastric emptying

55
Q

source/action of secretin

A

S cells in duodenum/ increases pancereatic bicarb/bile secretion. decreases gastric acid secretion

56
Q

source/action of somastatin

A

decreases gastric acid, pepsinogen secretion,decrease pancreatic and SI fluid secretion, gallbladder contraction and insulin and glucagon relaase

57
Q

releases/reduces gastrin

A

stomach distention, alkalization, amino acids, peptides, vagal stimulation/extra low stomach pH

58
Q

releases colecystokinin

A

fatty acids and amino acids in stomach

59
Q

releases secretin

A

acid, fatty acids in lumen of duodemum

60
Q

releases/reduces somatostatin

A

acid/vagal stimulation

61
Q

releases gastric insulinotropic peptide

A

fattyacids, amino acids, oral glucose

62
Q

source/action of gastric insulinotropic peptide

A

PS ganglia in sphincters, gallbladder and SI/ releases intestinal water and electrolyte secretion, relaxes smooth muscle and sphincters

63
Q

increased in zollinger-ellison

A

Gastin

64
Q

amino acids that stimulate gastrin

A

phenylanaline and tryptophan

65
Q

sx of VIPoma (non-a/non-b islet cell pancreatic tumor)

A

watery diarrha, hypokalemia, and achlorhydria

66
Q

can increase lower esophageal sphincter

A

nitric oxide

67
Q

stimulates intestinal peristalis

A

motillin (can use erythromycin)

68
Q

saliva becomes more _____ with higher flow

A

isotonic (from hypotonic)

69
Q

parietel cells secrete

A

intrinsic factor and gastric acid

70
Q

chief cells secrete

A

pepsin

71
Q

gastrin MOA

A

effects histamine release from ECL cells

72
Q

peptic ulcer disease wil increase

A

brunner gland hypertrophy (secretes alkaline mucus in duodenal submucosa)

73
Q

digests starches

A

a amylase

74
Q

digests fats

A

lipases

75
Q

secreted as zymogens by pancreas

A

proteases, trypsinogen

76
Q

pancreatic enzyme that feeds back to increase it’s own release

A

trypsinogen

77
Q

digests carbd

A

amylase, oligosaccharide hydrolases

78
Q

rate limitiing step of carb digestion

A

oligosaccharide hydrolases

79
Q

sugars absorbed by enterocyes

A

monosaccarides (fructose, galactose, glucose)

80
Q

fructose taken up by

A

GLUT-5

81
Q

glucose and galactose taken up by

A

SGLT1

82
Q

iron absorped in

A

duodenum

83
Q

folate absorbed by

A

jejunum

84
Q

B12 absorbed by

A

terminal ilieum (requires IF)

85
Q

catylazes rate limiting step of bile production

A

cholesterol 7a hydroxylase

86
Q

functions of bile

A

digestion/absorption of lipids and fat-soluable vitamins
cholesterol excretion
antimicrobial activity

87
Q

excretes bilirubun

A

bile (bile, bile! Billurubin)

88
Q

water soluable bilirubun

A

direct

89
Q

liver does what to bilirubun

A

makes it direct (conjugates it)

Step 1- System embryology, A and P (10 decks)

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