GI Tract Flashcards
Describe esophageus
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
What are the parts of the Stomach and remarkable features
Cardia to fundus to body to antrum to pylorus
Rugae expand and mix food
Describe the relationships of the stomach
A: L liver, T cage, Abd wall, L Dia
P: Omental Bursa, Pancreas
InLat: T colon
Describe neurovasculature and lymph of the stomach
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 celaicWhat are the major branches of the celiac trunk
Left gastric, Splenic, and Common Hepatic
What are the branches of the Left gastric and what they supply
Esophageal branches, L gastric supplies lesser curvature of Sto
What are the branches and destinations of Splenic
Dorsal Pancreas, Short Gastric (Fundus), Left Gastroepiploic (Greater curvature of Sto)
What are the major branches from Common Hepatic
Hepatic proper branches into Right gastric (lesser curve of sto), gastroduodenal, RL Hepatic, and Cystic (gall)
What are the branches of the gastroduodenal artery
Right gastroepiploic (great curve sto) and Sup pancreaticoduodenal
What are the divisions of the small intestine
Duod - jej - ileum. SI is from pylorus to ileocecal jx
What is the neurovasculature of the Duodenum
A: C - sup panduod, SMA - Inf Panduod
N: Splanchnic and Vagus
L: Panduod to celiac
What are the portions of the Duodenum
- Superior - Shartest, Ant to L1, mesentery
- Descending - Largest, L1 to L3, no mes, retroperitoneal, C around panc, Hepatoduod lig support, Bile and main panc duct enter
- Inferior - towards left at L3. Post = Aorta and IVC Ant = SMA
- Ascending - L3 to L2, Lig of Trietz (susp lig of duod)
Describe Jejunum and Ileum
Within peritoneum. Art= SMA
J = Deep red and thicker, less fat and fewer loops, greater vasc and larger vasa recta
Describe the lymph system of J and I
juxtaintestinal to mesenteric to sup lymph to cis chyli
Describe the affect of nerves on I and J
SNS (Spl) decrease Peri, sec, and dig
PSNS (vagus) increases above
Describe the large intestine
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)
What are the differences between large and small intestines
- Omental or Epiploic appendages
- Haustra
- Tenea Coli (sm musc) - mesocolic, omental, and free
- Caliber (diameter)
Describe the Cecum and Appendix
Cecm in RLQ covered by peritoneum. Ileum enters obliquely on post medial side. Appendix enters below ileocecal jx
Describe the neurovasculature and lymph of cecum and appendix
A: SMA - ileocolic - appendix
V: similar
L: ileocolic nodes
N spl and vagus
What are the tests for appendicitis
- Psoas sign - left lateral recumbent = pain = flex hip
2. Obturator - supine doc flex hip, knee = pt medially rotate hip and extend knee
Describe the sigmoid colon
Long mesentery and location of the confluence of tenea coli.
What is the neurovas of sigmoid colon
A: IMA sigmoid
V: similar
L: sm - large - inf mesenteric - sup mesenteric - celiac
N: spl and vagus
Describe the rectum and anal canal
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)
Describe the Arterial supply for Rectum
Sup rectal - IMA up 1/3
Mid Rectal - Int Iliac mid 1/3 and paired
Infrarectal - Inf pudendal and paired
