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USMLE Step 1: GI > GI Anatomy > Flashcards

GI Anatomy Flashcards

1
Q

Name the 9 retroperitoneal structures.

A

Suprarenal (adrenal) gland, aorta and IVC, duodenum (2nd and 3rd parts), pancreas (except tail), ureters, colon (descending and ascending), kidneys, esophagus (lower 2/3), rectum (lower 2/3) (*Remember SAD PUCKER mnemonic!)

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2
Q

The FALCIFORM ligament connects the _____ to the _____ and contains the _____.

A

Liver; anterior abdominal wall; ligamentum teres hepatis (derivative of fetal umbilical vein)

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3
Q

The HEPATODUODENAL ligament connects the _____ to the _____ and contains the _____.

A

Liver; duodenum; portal triad (hepatic artery, portal vein, common bile duct)

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4
Q

What is the Pringle maneuver and when is it used?

A

Compress the hepatoduodenal ligament between the thumb and index finger placed in omental foramen, to control bleeding

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5
Q

The GASTROHEPATIC ligament connects the _____ to the _____ and contains the _____.

A

Liver; lesser curvature of stomach; gastric arteries

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6
Q

The GASTROCOLIC ligament connects the _____ to the _____ and contains the _____.

A

Greater curvature; transverse colon; gastroepiploic arteries

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7
Q

The GASTROSPLENIC ligament connects the _____ to the _____ and contains the _____.

A

Greater curvature; spleen; short gastrics, left gastroepiploic vessels

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8
Q

The SPLENORENAL ligament connects the _____ to the _____ and contains the _____.

A

Spleen; posterior abdominal wall; splenic artery and vein; tail of pancreas

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9
Q

Which ligament connects the greater and lesser sacs? Separates the greater and lesser sacs on the right? Separates the greater and lesser sacs on the left?

A

Hepatoduodenal; gastrohepatic; gastrosplenic

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10
Q

Name the 4 layers of the gut wall from the inside to outside.

A

Mucosa (includes epithelium, lamina propria, muscularis mucosa), Submucosa (includes submucosal/Meissner’s nerve plexus), Muscularis externa (includes myenteric/Auerbach’s nerve plexus), Serosa(intraperitoneal)/adventitia (retroperitoneal) (*Remember MSMS mnemonic!)

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11
Q

Ulcers extend into the _____ while erosions are in the _____.

A

Submucosa, inner or outer muscular layer; mucosa only

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12
Q

Identify the histology of the esophagus.

A

Nonkeratinized stratified squamous epithelium

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13
Q

Identify the histology of the stomach.

A

Gastric glands

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14
Q

Brunner’s glands and crypts of Lieberkuhn are located in the _____.

A

Duodenum

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15
Q

Plicae circulares and crypts of Lieberkuhn are located in the _____.

A

Jejunum

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16
Q

Peyer’s patches and crypts of Lieberkuhn are located in the _____.

A

Ileum

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17
Q

The largest number of goblet cells in the small intestine are located in the duodenum/jejunum/ileum.

A

Ileum

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18
Q

The colon has crypts and no villi/villi and no crypts/villi and crypts

A

Crypts and no villi

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19
Q

Arteries supplying GI STRUCTURES branch anteriorly/laterally. Arteries supplying NON GI STRUCTURES branch anteriorly/laterally.

A

Anteriorly; laterally

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20
Q

When does SMA syndrome occur?

A

When the transverse portion (third segment) of the duodenum is entrapped between SMA and aorta, causing intestinal obstruction.

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21
Q

FOREGUT is supplied by the _____ artery, is innervated by the _____ nerve, is at the vertebral level _____, and supplies the _____.

A

Celiac; vagus; T12/L1; stomach to proximal duodenum, liver, gallbladder, pancreas, spleen

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22
Q

MIDGUT is supplied by the _____ artery, is innervated by the _____ nerve, is at the vertebral level _____, and supplies the _____.

A

SMA; vagus; L1; distal duodenum to proximal 2/3 of transverse colon

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23
Q

HINDGUT is supplied by the _____ artery, is innervated by the _____ nerve, is at the vertebral level _____, and supplies the _____.

A

IMA; pelvic; L3; distal 1/3 of transverse colon to upper portion of rectum

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24
Q

_____ flexure is a watershed region.

A

Splenic

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25
What are the 3 branches of the celiac trunk that constitute the main blood supply of the stomach?
Common hepatic, splenic, left gastric
26
Of the branches of the celiac trunk, strong anastomoses exist between the left and right _____ and _____.
Gastroepiploics; gastrics
27
What are the 4 arterial anastomoses that would compensate if the branches off the abdominal aorta are blocked?
Superior/inferior epigastric; superior/inferior pancreaticoduodenal; middle/left colic; superior/middle and inferior rectal
28
A patient presents with esophageal varices. What portosystemic anastomosis would be present in this patient?
Left gastric to esophageal
29
A patient presents with caput medusae. What portosystemic anastomosis would be present in this patient?
Paraumbilical to superficial and inferior epigastric below the umbilicus and superior epigastric and lateral thoracic above the umbilicus
30
A patient presents with internal hemorrhoids. What portosystemic anastomosis would be present in this patient?
Superior rectal to middle and inferior rectal
31
Varices which organs are commonly seen with portal hypertension?
Esophagus, umbilicus, rectum (*Remember gut, butt, and caput mnemonic!)
32
How does TIPS treat portal hypertension?
Shunts blood to the systemic circulation
33
Where is the pectinate (dentate) line?
Formed where endoderm (hindgut) meets ectoderm
34
Internal hemorrhoids are located above/below the pectinate line; external hemorrhoids are located above/below the pectinate line.
Above; below
35
Squamous cell carcinoma occurs above/below the pectinate line; adenocarcinoma occurs above/below the pectinate line.
Below; above
36
Arterial supply above the pectinate line is from the superior/inferior rectal artery; below the pectinate line is from the superior/inferior rectal artery
Superior; inferior
37
Describe the venous drainage and lymphatic drainage above the pectinate line.
Superior rectal vein --> inferior mesenteric vein --> portal system; deep nodes
38
Describe the venous drainage and lymphatic drainage below the pectinate line.
Inferior rectal vein --> internal pudendal vein --> internal iliac vein --> IVC; superficial inguinal nodes
39
Which zone of the liver is affected first by viral hepatitis?
Zone I (periportal zone)
40
Which zone of the liver is affected first by ischemia?
Zone III (pericentral vein (centrilobular) zone)
41
Which zone of the liver contains the P-450 system?
Zone III (pericentral vein (centrilobular) zone)
42
Which zone of the liver is most sensitive to toxic injury?
Zone III (pericentral vein (centrilobular) zone)
43
Which zone of the liver is the site of alcoholic hepatitis?
Zone III (pericentral vein (centrilobular) zone)
44
T/F: Gallstones that reach the common channel at ampulla of Vater can block both the bile and pancreatic ducts.
TRUE
45
T/F: Tumors that arise in the head of the pancreas (near the duodenum) cannot cause obstruction of the common bile duct.
FALSE; CAN cause obstruction
46
Name the 5 structures in the femoral region laterally to medially.
Nerve, artery, vein, empty space, lymphatics (*Remember NAVEL mnemonic!)
47
What 3 structures are contained in the femoral triangle?
Femoral vein, artery, nerve
48
What 3 structures are contained in the femoral sheath?
Femoral vein, artery, canal (deep inguinal lymph nodes)
49
Where is the site of protrusion of indirect hernias?
Internal inguinal ring
50
Where is the site of protrusion of direct hernias?
Abdominal wall
51
A diaphragmatic hernia occurs in infants as a result of defective development of _____.
Pleuroperitoneal membrane
52
What is a hiatal hernia?
Stomach herniates upward through the esophageal hiatus of the diaphragm
53
What is the difference between a sliding hiatal hernia and paraesophageal hernia?
GE junction is displaced upward in sliding; GE junction is normal/fundus protrudes into thorax in paraesophageal
54
Follow the path of an indirect inguinal hernia.
Internal (deep) inguinal ring (lateral to inferior epigastric artery), external (superficial) inguinal ring, scrotum,
55
An indirect inguinal hernia occurs in infants due to the failure of the _____ to close.
Processus vaginalis
56
Follow the path of a direct inguinal hernia.
Inguinal (Hesselbach's) triangle, abdominal wall (medial to inferior epigastric artery), external (superficial) inguinal ring
57
T/F: Direct inguinal hernia is covered by all 3 layers of spermatic fascia.
FALSE; covered by external spermatic fascia only. Indirect inguinal hernia is covered by all 3 layers
58
Direct inguinal hernia is usually in women/older men; femoral hernia is more common in women/older men.
Older men; women
59
Which hernia type is the leading cause of bowel incarceration?
Femoral hernia
60
Name the borders of Hesselbach's triangle.
Inferior epigastric vessels, lateral border of rectus abdominis; inguinal ligament

USMLE Step 1: GI (5 decks)

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