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USMLE Step 1: GI > GI Anatomy > Flashcards

GI Anatomy Flashcards

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USMLE® Step 1 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
Q

What are the 3 branches of the celiac trunk that constitute the main blood supply of the stomach?

A

Common hepatic, splenic, left gastric

26
Q

Of the branches of the celiac trunk, strong anastomoses exist between the left and right _____ and _____.

A

Gastroepiploics; gastrics

27
Q

What are the 4 arterial anastomoses that would compensate if the branches off the abdominal aorta are blocked?

A

Superior/inferior epigastric; superior/inferior pancreaticoduodenal; middle/left colic; superior/middle and inferior rectal

28
Q

A patient presents with esophageal varices. What portosystemic anastomosis would be present in this patient?

A

Left gastric to esophageal

29
Q

A patient presents with caput medusae. What portosystemic anastomosis would be present in this patient?

A

Paraumbilical to superficial and inferior epigastric below the umbilicus and superior epigastric and lateral thoracic above the umbilicus

30
Q

A patient presents with internal hemorrhoids. What portosystemic anastomosis would be present in this patient?

A

Superior rectal to middle and inferior rectal

31
Q

Varices which organs are commonly seen with portal hypertension?

A

Esophagus, umbilicus, rectum (*Remember gut, butt, and caput mnemonic!)

32
Q

How does TIPS treat portal hypertension?

A

Shunts blood to the systemic circulation

33
Q

Where is the pectinate (dentate) line?

A

Formed where endoderm (hindgut) meets ectoderm

34
Q

Internal hemorrhoids are located above/below the pectinate line; external hemorrhoids are located above/below the pectinate line.

A

Above; below

35
Q

Squamous cell carcinoma occurs above/below the pectinate line; adenocarcinoma occurs above/below the pectinate line.

A

Below; above

36
Q

Arterial supply above the pectinate line is from the superior/inferior rectal artery; below the pectinate line is from the superior/inferior rectal artery

A

Superior; inferior

37
Q

Describe the venous drainage and lymphatic drainage above the pectinate line.

A

Superior rectal vein –> inferior mesenteric vein –> portal system; deep nodes

38
Q

Describe the venous drainage and lymphatic drainage below the pectinate line.

A

Inferior rectal vein –> internal pudendal vein –> internal iliac vein –> IVC; superficial inguinal nodes

39
Q

Which zone of the liver is affected first by viral hepatitis?

A

Zone I (periportal zone)

40
Q

Which zone of the liver is affected first by ischemia?

A

Zone III (pericentral vein (centrilobular) zone)

41
Q

Which zone of the liver contains the P-450 system?

A

Zone III (pericentral vein (centrilobular) zone)

42
Q

Which zone of the liver is most sensitive to toxic injury?

A

Zone III (pericentral vein (centrilobular) zone)

43
Q

Which zone of the liver is the site of alcoholic hepatitis?

A

Zone III (pericentral vein (centrilobular) zone)

44
Q

T/F: Gallstones that reach the common channel at ampulla of Vater can block both the bile and pancreatic ducts.

A

TRUE

45
Q

T/F: Tumors that arise in the head of the pancreas (near the duodenum) cannot cause obstruction of the common bile duct.

A

FALSE; CAN cause obstruction

46
Q

Name the 5 structures in the femoral region laterally to medially.

A

Nerve, artery, vein, empty space, lymphatics (*Remember NAVEL mnemonic!)

47
Q

What 3 structures are contained in the femoral triangle?

A

Femoral vein, artery, nerve

48
Q

What 3 structures are contained in the femoral sheath?

A

Femoral vein, artery, canal (deep inguinal lymph nodes)

49
Q

Where is the site of protrusion of indirect hernias?

A

Internal inguinal ring

50
Q

Where is the site of protrusion of direct hernias?

A

Abdominal wall

51
Q

A diaphragmatic hernia occurs in infants as a result of defective development of _____.

A

Pleuroperitoneal membrane

52
Q

What is a hiatal hernia?

A

Stomach herniates upward through the esophageal hiatus of the diaphragm

53
Q

What is the difference between a sliding hiatal hernia and paraesophageal hernia?

A

GE junction is displaced upward in sliding; GE junction is normal/fundus protrudes into thorax in paraesophageal

54
Q

Follow the path of an indirect inguinal hernia.

A

Internal (deep) inguinal ring (lateral to inferior epigastric artery), external (superficial) inguinal ring, scrotum,

55
Q

An indirect inguinal hernia occurs in infants due to the failure of the _____ to close.

A

Processus vaginalis

56
Q

Follow the path of a direct inguinal hernia.

A

Inguinal (Hesselbach’s) triangle, abdominal wall (medial to inferior epigastric artery), external (superficial) inguinal ring

57
Q

T/F: Direct inguinal hernia is covered by all 3 layers of spermatic fascia.

A

FALSE; covered by external spermatic fascia only. Indirect inguinal hernia is covered by all 3 layers

58
Q

Direct inguinal hernia is usually in women/older men; femoral hernia is more common in women/older men.

A

Older men; women

59
Q

Which hernia type is the leading cause of bowel incarceration?

A

Femoral hernia

60
Q

Name the borders of Hesselbach’s triangle.

A

Inferior epigastric vessels, lateral border of rectus abdominis; inguinal ligament

USMLE Step 1: GI (5 decks)

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