GI Tract Flashcards

1
Q

Describe esophageus

A

Starts at C6 and enters abd at T10, Eso with stomach at T11. Arteries are from the celiac trunk and include L gastric and L Inf phrenic. Veins are L gastric (P) and eso azygos (S). Nerve supply is by Splanchnic and Vagus

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2
Q

What are the parts of the Stomach and remarkable features

A

Cardia to fundus to body to antrum to pylorus

Rugae expand and mix food

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3
Q

Describe the relationships of the stomach

A

A: L liver, T cage, Abd wall, L Dia
P: Omental Bursa, Pancreas
InLat: T colon

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4
Q

Describe neurovasculature and lymph of the stomach

A
A: Celiac Trunk
V: Hep portal, Sup Panduod, Splenic
N: Splanchnic and Vagus
L: Sup 2/3 RL gastric nodes
    Inf 1/3 R pyloric L Panduod
    Secondary SupInf to celaic
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5
Q

What are the major branches of the celiac trunk

A

Left gastric, Splenic, and Common Hepatic

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6
Q

What are the branches of the Left gastric and what they supply

A

Esophageal branches, L gastric supplies lesser curvature of Sto

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7
Q

What are the branches and destinations of Splenic

A

Dorsal Pancreas, Short Gastric (Fundus), Left Gastroepiploic (Greater curvature of Sto)

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8
Q

What are the major branches from Common Hepatic

A

Hepatic proper branches into Right gastric (lesser curve of sto), gastroduodenal, RL Hepatic, and Cystic (gall)

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9
Q

What are the branches of the gastroduodenal artery

A

Right gastroepiploic (great curve sto) and Sup pancreaticoduodenal

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10
Q

What are the divisions of the small intestine

A

Duod - jej - ileum. SI is from pylorus to ileocecal jx

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11
Q

What is the neurovasculature of the Duodenum

A

A: C - sup panduod, SMA - Inf Panduod
N: Splanchnic and Vagus
L: Panduod to celiac

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12
Q

What are the portions of the Duodenum

A
  1. Superior - Shartest, Ant to L1, mesentery
  2. Descending - Largest, L1 to L3, no mes, retroperitoneal, C around panc, Hepatoduod lig support, Bile and main panc duct enter
  3. Inferior - towards left at L3. Post = Aorta and IVC Ant = SMA
  4. Ascending - L3 to L2, Lig of Trietz (susp lig of duod)
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13
Q

Describe Jejunum and Ileum

A

Within peritoneum. Art= SMA

J = Deep red and thicker, less fat and fewer loops, greater vasc and larger vasa recta

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14
Q

Describe the lymph system of J and I

A

juxtaintestinal to mesenteric to sup lymph to cis chyli

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15
Q

Describe the affect of nerves on I and J

A

SNS (Spl) decrease Peri, sec, and dig

PSNS (vagus) increases above

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16
Q

Describe the large intestine

A

Function to absorb water.
Cecum to appendix to A, T, D, sig colons to rectum to anal canal
2 flextures Hepatic (R colic) and Splenic (L colic)

17
Q

What are the differences between large and small intestines

A
  1. Omental or Epiploic appendages
  2. Haustra
  3. Tenea Coli (sm musc) - mesocolic, omental, and free
  4. Caliber (diameter)
18
Q

Describe the Cecum and Appendix

A

Cecm in RLQ covered by peritoneum. Ileum enters obliquely on post medial side. Appendix enters below ileocecal jx

19
Q

Describe the neurovasculature and lymph of cecum and appendix

A

A: SMA - ileocolic - appendix
V: similar
L: ileocolic nodes
N spl and vagus

20
Q

What are the tests for appendicitis

A
  1. Psoas sign - left lateral recumbent = pain = flex hip

2. Obturator - supine doc flex hip, knee = pt medially rotate hip and extend knee

21
Q

Describe the sigmoid colon

A

Long mesentery and location of the confluence of tenea coli.

22
Q

What is the neurovas of sigmoid colon

A

A: IMA sigmoid
V: similar
L: sm - large - inf mesenteric - sup mesenteric - celiac
N: spl and vagus

23
Q

Describe the rectum and anal canal

A

Rectum is from sigmoid to ampulla at S3
3 flectures (Sup, inter, Inf - S shape)
Puborectalis is continence
Peritoneum covers superior portions (S ant and lat, M ant, Inf none)

24
Q

Describe the Arterial supply for Rectum

A

Sup rectal - IMA up 1/3
Mid Rectal - Int Iliac mid 1/3 and paired
Infrarectal - Inf pudendal and paired

25
Q

What are the portal caval variances

A
  1. Eso plexus variance
  2. Rectal plexus variance
  3. Paraumbilical variance
  4. Rectoperitoneal variance
26
Q

Describe Eso plexus varaince

A

Eso vein to Azygos SVC. Clin = portal hypertension and cirrhosis leading to hematemesis

27
Q

Describe Rectal plexus variances

A

Sup rectal (P) to Mid and Inf rectal (S) leading to hemorrhoids

28
Q

Describe paraumbilical variance

A

Caput medusa, Sup and Inf epigastric (S) to round ligament (umbilical vein reinstated P) leads to wormlike abdomen

29
Q

What are the branches of SMA and what they supply

A

Inf panduod (distal duod and head panc), Mid colic (proximal T colon), right colic (A colon), Ileocecal (cecum and appendicular branch to appendix)

30
Q

What are the branches of IMA and what they supply

A

Left colic (D colon and branches to marginal artery which anas with mid colic), sigmoid and superior rectal

31
Q

Describe the Hepatic Portal Vein

A

Confluence of SMV and Splenic (with IMV)

32
Q

What is GERD

A

mucosal dmg of eso via stomach acid

33
Q

What are the hiatal hernias

A
  1. Sliding - gastroeso jx up through dia with stomach

2. Rolling - sto to beside eso without involve of gastroeso jx

34
Q

Describe Congenital Hypertrophic Pyloric Stenosis

A

Hypertrophy of pylorus leading to gastric obstruction and projectile vomiting

35
Q

What is Merkels’s Diverticulum

A

GI outpouch Rule of 2’s

36
Q

What is Intussusception

A

loop within loop of SI leading to nausea, cramp, red stool, sausage mass in SI

37
Q

What are the types of IBD

A
  1. Crohn’s - regional, interaction of environment with genetics
  2. Ulcerative colitis - mucus of colon, large area
38
Q

What is volvulus

A

Twist in intestine loop