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GIGU > GI Organs > Flashcards

GI Organs Flashcards

1
Q

Esophagus path/landmarks

A

Passes through esophageal hiatus at T10
Enters stomach at the cardiac orifice at T11
Cardiac notch separates esophagus from fundus of stomach
Inferior esophageal sphincter- physiological, not anatomical

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2
Q

Esophageal constrictions

A

Superior- level of cricoid cartilage/juncture with pharynx
Middle- crossed by aorta and left main bronchi
Inferior- diaphragmatic sphincter

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3
Q

Para-esophageal hiatal hernia

A

Cardia of stomach in normal position

Peritoneum and fundus of stomach protrude superiorly and small pouch becomes anterior to esophagus

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4
Q

Sliding hiatal hernia

A

Esophagus, cardia of stomach and fundus of stomach protrude through esophageal hiatus - small portion of these structures become superior to diaphragm

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5
Q

Greater curvature of stomach

A

Inferior border- greater omentum attaches here

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6
Q

Lesser curvature of stomach

A

Superior border- lesser omentum attaches here

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7
Q

Stomach anterior relations

A

Abdominal wall
Left costal margin
Diaphragm
Left lobe of liver

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8
Q

Stomach superior relations

A

Left dome of diaphragm

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9
Q

Stomach posterior relations

A 
Lesser sac
Pancreas
Transverse mesocolon
Transverse colon
Left kidney/suprarenal gland
Spleen/splenic artery
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10
Q

Truncal vagotomy

A

Denervates nerve supply to all of stomach plus most of GI tract and liver

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11
Q

Proximal gastric vagotomy

A

Denervates branches of vagus nerve going only to the stomach

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12
Q

Selective proximal vagotomy

A

Denervates specific area of stomach in which parietal cells are located (fundus and cardia)

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13
Q

Duodenum parts 1-4

A

Begins at pylorus and ends at duodenojejunal junction (L2)
1st part- intraperitoneal, 1” long, travels superior and to the right, associated with hepatoduodenal ligament
2nd part- retroperitoneal, 3-4”
3rd part- retroperitoneal, 4”
4th part- retroperitoneal, 1”, joins with jejunum

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14
Q

Anterior relations to 2nd part of duodenum

A

Gallbladder (fundus)
Right lobe of liver
Transverse colon
Coiled small intestine

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15
Q

Posterior relations to 2nd part of duodenum

A

Hilum of right kidney

Right ureter

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16
Q

Lateral relations to 2nd part of duodenum

A

Right colic flexure
Ascending colon
Right lobe of liver

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17
Q

Medial relations to 2nd part of duodenum

A

Head of pancreas

Bile and pancreatic ducts

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18
Q

Anterior relations to 3rd part of duodenum

A

Root of mesentery of small intestine
Superior mesenteric vessels within mesentery
Coils of jejunum

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19
Q

Posterior relations to 3rd part of duodenum

A

Right ureter
Right psoas major
Inferior vena cava
Aorta

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20
Q

Superior relations to 3rd part of duodenum

A

Head of the pancreas

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21
Q

Inferior relations to 3rd part of duodenum

A

Coils of jejunum

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22
Q

Posterior relations to 4th part of duodenum

A 
Left crus of diaphragm
Left psoas major
Left sympathetic trunk
Left renal vessels
Left gonadal vessels
Left supra renal vein
Inferior mesenteric vein
23
Q

Right side relations to 4th part of duodenum

A

Uncinate process of pancreas

24
Q

Left side relations to 4th part of duodenum

A

Left kidney and ureter

25
Superior relations to 4th part of duodenum
Body of pancreas
26
Jejunum location, definition, blood supply
Left upper quadrant, intraperitoneal, supported by mesentery Proximal 2/5s of small intestine Mesenteric fat increases from proximal to distal Has circular folds (plicae circulares) Supplied by arterial arcades with long vasa recta
27
Ileum location, definition, blood supply
Right lower quadrant, intraperitoneal, supported by mesentery Distal 3/5s of small intestine Supplied by arterial arcades with short vasa recta
28
The mesentery description
Attaches jejunum and ileum to posterior body wall Contains superior mesenteric a/v, lymph nodes, fat and autonomic nerves Crosses 3rd/4th parts of duodenum, aorta, IVC, right ureter, right psoas major and right gonadal A/V Conveys nutrition and innervates the gut
29
Colon description, features
Cecum, appendix, ascending colon, transverse colon, descending colon, sigmoid colon 5' long Begins at ileocecal junction Has 3 tenia coli (longitudinal bands of smooth muscle), haustra and appendices epiploicae (store fat)
30
Cecum
``` Blind pouch (intraperitoneal) continuous with ileum and ascending colon Contains ileal papilla (cone-like projection of ileum) Ileocecal valve regulates passage of ileal contents into cecum ```
31
Appendix
Attached to posterior-medial part of cecum and supported by mesoappendix Position is variable Contains several lymphoid nodules
32
Ileal (Meckels) diverticulum
Congenital anomaly located 50cm from ileocecal junction in adults May be free, or attached to umbilicus May become inflamed and mimic pain produced by acute appendicitis
33
Ascending colon
8-10" in length Continuous with cecum and transverse colon at right colic flexure Retroperitoneal organ, adjacent to right paracolic gutter
34
Transverse colon
Intraperitoneal with length 10-14" Suspended by transverse mesocolon Continuous with descending colon at right colic flexure
35
Descending colon
Retroperitoneal- left paracolic gutter is lateral to descending colon Continuous with sigmoid colon
36
Sigmoid colon
12" Continuous with rectum at level of S3 Suspended by sigmoid mesocolon
37
Volvulus of sigmoid colon
Involves rotation and twisting of the mobile loop of the sigmoid colon and mesocolon Results in obstruction of the lumen of the descending colon and any part of sigmoid colon proximal to twist Obstipation and ischemia of the looped portion may result Acute surgical emergency
38
Rectum
Both retroperitoneal and subperitoneal Located in pelvic cavity Contains 3 transverse rectal folds Continuous with anal canal
39
Anal canal
Internal sphincter- smooth muscle External sphincter- skeletal muscle Contains anal columns, anal valves and anal sinuses Pectinate line- located at inferior ends of anal valves
40
Spleen
Left upper quadrant or left hypochondriac region Between stomach and diaphragm Intraperitoneal organ Attached to gastrosplenic and splenorenal ligaments
41
Anterior/posterior/inferior spleen relationships
Has a diaphragmatic surface facing diaphragm Anterior- fundus of stomach Posterior- left suprarenal gland and kidney Inferior- tail of pancreas and left colic flexure
42
Pancreas head/neck/tail/uncinate process
Head- lies in curvature of duodenum Neck-indistinct, joins head to body, overlies superior mesenteric artery Tail- located within the splenorenal ligament, its tip is adjacent to hilum of spleen Uncinate process- adjacent to head; superior to third part of duodenum
43
Pancreatic ducts
Main duct- begins in tail and courses to head. Usually joined by accessory duct in head. Contains the sphincter of the main pancreatic duct, which prevents bile entering the pancreas. Joins common bile duct Accessory duct- may have separate opening in the duodenum at the minor duodenal papilla
44
Hepatopancreatic ampulla
Formed by union of common bile duct and main pancreatic duct | Associated with sphincter of Oddi and major duodenal papilla
45
Anterior pancreas relationships
Lesser sac (omental bursa) and stomach
46
Posterior pancreas relationships
``` Aorta IVC Splenic V Common bile duct Right crus of diaphragm Left kidney and vessels Left suprarenal gland Superior mesenteric a/v ```
47
Right/left/inferior pancreas relationships
Right- duodenum 2nd part Left- spleen Inferior- duodenum 3rd part
48
Liver location
Right lobe in upper right quadrant or epigastric and right hypochondriac regions Left lobe located in upper left quadrant
49
What determines functional lobes of the liver
Based on the division of the portal triad and the blood supply
50
Coronary ligaments of liver
Reflection of visceral peritoneum from liver to the respiratory diaphragm; surrounds bare area of liver
51
Hepatoduodenal ligament
Passes from porta hepatis to duodenum first part; contains proper hepatic a., hepatic portal v., common bile ducts, lymphatic vessels and hepatic nerves
52
Alcoholic cirrhosis of liver
Characterized by hepatomegaly and "hobnail" appearance of liver surface, resulting from fatty changes and fibrosis
53
Gall stones "cholelithiasis"
Made of cholesterol crystals Can be lodged in cystic duct, hepatic duct or hepatopancreatic ampulla Blockage of hepatopancreatic ampulla blocks both common bile ducts and main pancreatic duct, results in bile backing up into pancreas causing pancreatitis

GIGU (21 decks)

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