GI Organs Flashcards
Level of:
Esophagus
Stomach
Pylorus
Esophagus - T10-11
Stomach - T11
Pylorus - L1
Esophagus is attached to the diagphragm via:
Phrenico-esophageal ligament
Where does the esophagus enter the cardial orifice of the stomach?
T11
Where does the esophagus pass thru the right crus of the diaphragm at?
T10
4 Esophageal constrictions:
Cricopharyngeal muscle
Aorta
Left main bronchus
Esophageal hiatus (T10)
Paraesophageal hiatal hernia (3)
Normal GEJ
Fundus protrudes into thorax
Less chance of GERD
Sliding hiatal hernia (4)
GEJ displaced superiorly
Cardia protrudes
“Hourglass” stomach
Most common
Anatomy of the stomach (8)
Esophagus Cardia Fundus Body Pyloric antrum Pyloric canal Pylorus Duodenum
What is anterior to the stomach? (3)
Diaphragm
Left lobe of liver
Anterior abdominal wall
What lies inferolateral to the stomach? (1)
Transverse colon
What is posterior to the stomach? (6)
Diaphragm Spleen Kidney Adrenal gland Pancreas Omental bursa
The gastrohepatic l. connects:
Lesser curvature of the stomach to the liver.
Gastric vessels.
The gastrocolic l. connects:
Greater curvature to transverse colon.
Gastroepiplotic vessels.
Part of greater omentum.
Gastric ulcers (2)
Stomach
70% related to H. pylori
Duodenal ulcers (3)
Pylorus or duodenum
90% related to H. pylori
65% occur in posterior wall of 1st part of duodenum
Complications of duodenal ulcers (4)
Hemorrhage from gastroduodenal a.
Adhesions w/ Gb, liver.
Perforation into peritoneal space.
Affected pancrease.
Ulcer in the lesser curvature can cause:
Hemorrhage from left gastric a.
Vagotomy
Surgical TTM for GERD.
Locations of 4 parts of duodenum
1st: L1
2nd: L2-L3 on right
3rd: anterior to L3
4th: superior to about L2
Ligament of Treitz
Suspends Duodenojejunal flexure
Most of the jejunum exists in which quadrant?
LUQ
Most of the ileum exists in which quadrant?
RLQ
How are the jejunum and ileum attached to the posterior wall?
A mesentery that begins at L2 and ends at L5 (ileocecal junction).
Vascularity of jejunum vs. ileum:
Jejunum: greater, long vasa recta, few large arcade loops.
Ileum: less, short vasa recta, many short arcade loops.
Which has more fat and LNs: jejunum or ileum?
Ileum
Meckel diverticulum
Most common anomaly of GI tract.
Persistent vitelline duct.
Can contain ectopic gastric or pancreatic tissue.
Most common cause of intussusception.
What is the “Rule of 2s” of Meckel Diverticulum?
2x more likely in males. 2 in. long. 2 ft. from ileocecal valve. 2% of population. Common in first 2 yrs of life. 2 types of epithelia may be present.
Intussusception
A part of the proximal bowel slides into a distal segment.
Common at ileocecal jxn.
Mostly in kids.
Idiopathic, Meckel (kids) and tumor (adults)
Ileocecal jxn is at which plane?
L5 - transtubercular plane
Lower edge of ascending colon is at which plane?
S2 - interspinous plane
Which parts of the colon are retroperitoneal?
Descending and ascending colon
Sigmoid colon occurs from:
Iliac fossa to S3
Sigmoid colon has a:
Long mesentery
Volvulus
Rotation of a loop of bowel (usually sigmoid colon).
Can cause constipation, ischemia, necrosis.
“Coffee bean” sign on XR.
Liver location
Top is at xiphisternal plane and follows subcostal line.
Will move inferiorly on inspiration.
Falciform l. separates:
Separates R and L lobes of the liver and connect liver to anterior wall.
2 accessory lobes of the liver
Quadrate lobe (left hemi-liver) Caudate lobe (functionally separate)
Round ligament of the liver is a remnant of:
Umbilical vein
Ligamentum venosum is a remnant of:
Ductus venosus
Hepatoduodenal l. contains (3):
Proper hepatic a.
Bile duct
Portal v.
Connects liver to duodenum.
Cantlie line
Imagined from fundus of Gb to diaphragm in the right lobe.
Divisions of the liver (4)
RL: Right lateral Right medial Left medial LL: Left lateral
Gallbladder is located between which segments of the liver?
IV and V.
Cystic duct
Connects common bile duct to the Gb.
Common bile duct empties into:
Ampulla of Vater in 2nd part of duodenum w/ pancreatic duct.
Cholelithiasis
50% asymptomatic
Can be caused by gallstones.
Female, 40, fertile.
Murphy’s sign for cholelithiasis
Palpate RUQ and have pt. inhale.
Sudden halt to inspiration due to pain is a + sign.
Choledocolithiasis is due to:
Obstruction of common bile duct.
Gallstone ileus is due to:
Obstruction of the ileocecal jxn by a gallstone.
Location of spleen
LUQ
Spleen’s relationship to other organs (stomach, diaphragm/ribs, L kidney)
Stomach is anterior.
Diaphragm and ribs 9-11 are posterior.
Left kidney is medial
Splenic ligaments (2)
Splenorenal l. (splenic a.)
Gastrosplenic l. (short gastric as.)
