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Step 1 > GI- physiology and anatomy > Flashcards

GI- physiology and anatomy Flashcards

1
Q

What is the foregut?

A

pharynx to duodenum

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2
Q

What is the midgut?

A

duodenum to proxima 2/3 of transverse colon

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3
Q

What is the hidngut?

A

distal 1/3 of transverse colon to anal canal above pectinate line

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4
Q

When does the midgut herniate through the umbilical ring?

A

6th week

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5
Q

What does the midgut return to the abdominal cavity and rotate around the SMA?

A

10th week

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6
Q

Compare gastroschisis to omphalocele. What fold is defective in both?

A

Lateral fold
Gastroschisis- not covered by peritoneum (defect in abd wall)
omphalocle- covered by peritoneum (persistent herniation)

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7
Q

What chromosomal abnormality is duodenal atresia associated with?

A

Trisomy 21

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8
Q

What congenital abnormality presents as an olive mass and nonbilious projectile vomiting at 2-6 weeks?

A

congenital pyloric stenosis

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9
Q

What is the uncinate process formed from?

A

ventral pancreatic bud only

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10
Q

What is an annular pancreas

A

ventral pancreatic bud encircles 2nd part of duodenum- duodenal narrowing

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11
Q

what is a pancreas divisum

A

ventral and dorsal parts fail to fuse

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12
Q

What parts of the colon and rectum are intraperitoneal and retroperitoneal?

A

ascending, descending, upper rectum- secondarily retropertioneal
transverse colon, sigmoid colon- intraperitoneal
lower rectum, anal canal- primary retropartineum

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13
Q

What ligament is the portal triad contained in?

A

hepatoduodenal

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14
Q

What vessels are contained in the gastrohepatic ligament?

A

gastric arteries

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15
Q

What vessels are contained in the gastrocolic ligament?

A

gastroepiploic arteries

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16
Q

What vessels are contained in the gastrosplenic ligament?

A

short gastrics, left gastroepiploic

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17
Q

What vessels are contained in the splenorenal ligament?

A

splenic artery and vein, tail of pancrease

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18
Q

What directions do the inner and outer muscle layers of the digestive tract face?

A

Inner- circular

outer- longitudinal

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19
Q

Where is the myenteric/auerbach plexus located? What does it do?

A

in muscularis externa, controls muscle contractions

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20
Q

Where is the Meissner plexus located? What does it do?

A

submucosa, controls secretory activity

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21
Q

Where are brunner glands located?

A

duodenum

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22
Q

What are the levels of the celiac trunk, SMA, IMA, Renal arteries

A

Celiac: T12
SMA/renal: L1
IMA: L3

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23
Q

What is the parasympathetic innervation of the foregut, midgut, and hindgut?

A

foregut, midgut- vagus

hindgut- pelvic

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24
Q

What area of the colon is particularly susceptible to ischemia?

A

splenic flexure (jxn midgut + hindgut)

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25
Q

What are the 3 branches of the celiac trunk?

A

common hepatic, splenic, left gastric

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26
Q

What arteries supply the greater vs lesser curvature of the stomach?

A

lesser curvature- gastric

greater curvature- gastroepiploic

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27
Q

What is the embryologic and circulatory significance of the pectinate line?

A

above pectinate- endoderm, portal venous

below- ectoderm, systemic circ

28
Q

How does an external vs internal hemorrhage differ?

A

internal- not painful, drain deep nodes

external- painful, drain superficial inguinal

29
Q

Describe blood flow and bile flow of the liver

A

Glood flows from portal ven to central vein

bile flows towards portal triad

30
Q

What area of the liver is most likely to be damaged by viral hepatitis?

A

Periportal zone (zone I)

31
Q

What area of the liver is most likely to be damaged by ingested toxins?

A

Periportal zone (zone I)

32
Q

What area of the liver is most likely to be damaged by ischemia?

A

centrilobular zone (zone III)

33
Q

What area of the liver is most likely to be damaged by alcohol hepatitis?

A

centrilobular zone (zone III)

34
Q

What area of the liver contains the cytochrome P450 system?

A

centrilobular zone (zone III)

35
Q

Describe the locations of the medial and median umbilical ligaments

A

Medial lig- located just lateral to the rectus abdominus

median lig- located just medial to the rectus abdominus

36
Q

Where would the inferior epigastric artery be in relation to a direct and indirect hernia?

A

Medial to- direct hernia

lateral to- indirect hernia

37
Q

Which inguinal ring(s) does an indirect hernia pass through?

A

deep and superficail rings

38
Q

What is the underlying defect for an indirect hernia?

A

failure of processus vaginalis to close

39
Q

Which inguinal ring(s) does a direct hernia pass through?

A

superficial ring only

40
Q

What hernia is most common in women? Where is it located?

A

femoral hernia

below femoral canal and lateral to pubic tubercle

41
Q

What cells produce cholecystokinin?

A

I cells (duodenum, jejunum)

42
Q

What stimulates CCK?

A

fatty acids, amino acids

43
Q

What cells produce gastrin?

A

G cells (antrum of stomach)

44
Q

What stimulates gastrin?

A

stomach distention, alkalinization, vagal stim, amino acids

45
Q

What does motilin do?

A

produces migrating motor complexes, increased in fasting state

46
Q

What cells produce GIP

A

K cells (duodenum, jejunum)

47
Q

What are the symptoms of a VIPoma

A

watery diahrrhea, hypokalemia, achlorhydria

48
Q

What cells produce VIP?

A

parasympathetic ganglia in sphincters, gallbladder, SI

49
Q

What cells produce secretin?

A

S cells (duodenum)

50
Q

What stimulates secretin?

A

acid, fatty acids in lumen of duodenum

51
Q

What cells secrete somatostatin?

A

D cells (pancreatic islets, GI mucosa)

52
Q

What stimulates somatostatin?

A

incr acid, decr vagal stim

53
Q

What intestinal hormones affect insulin and glucagon secretion?

A

GIP- increases insulin

somatostatin- decreases insulin and glucagon

54
Q

What intestinal hormones affect gastric acid secretion?

A

Gastrin (+ histamine, vagal stim)- incr H+ secr

GIP, Secretin, somastostatin- decr acid secr

55
Q

What GI hormones affect pancreatic secretion?

A

CCK- incr secr
secretin- incr HCO3 secr
somatostatin- decreases

56
Q

What two amino acids are potent stimulators of gastrin?

A

phenylalanine, tryptophan

57
Q

What do parietal cells produce (2)

A

intrinsic factor, gastric acid

58
Q

What cells produce pepsin?

A

chief cells of stomach

59
Q

How does is gastrin stimulation of acid secretion mediated?

A

act directly on ECL cells which produce histamine

60
Q

How do pancreatic secretions compare with high and low flow?

A

low flow- high Cl

high flow- high HCO3

61
Q

What is the purpose of the D-xylose absorption test?

A

distinguishes GI mucosal damage from other types of malabsorption

62
Q

How are glucose, galactose, and fructose absorbed? transported to blood?

A

glucose, galactose- taken up by SGLT1
froctuse- by GLUT-5
all taken to blood- GLUT-2

63
Q

Where are iron, folate and B12 absorbed?

A

Iron- duodenum
floate- jejunum and ileum
Bqw- terminal ileum

64
Q

What enzyme catalyzes the rate-limiting step of bile synthesis?

A

cholesterol 7a-hydroxylase

65
Q

Compare direct to indirect bilirubin?

A

direct- conjugated with glucoronic acid, water sol

indirect- unconjugated, water insol

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