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A&P II - Exam 2 > GIT > Flashcards

GIT Flashcards

1
Q

on abd CT, what structures are very dark/black

A

air/air filled structures

ex: antrum of stomach, hepatic/splenic flexures of colon

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2
Q

black on abd CT indicates

A

hypodense area

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3
Q

on abd CT, what appears dark grey

A

fat

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4
Q

on an abd CT, what appears mid-grey

A

water

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5
Q

mid-grey on abd CT indicates

A

isodense

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6
Q

on abd CT organs and muscle appear

A

somewhat bright

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7
Q

on abd CT, bones and vessels appear

A

very bright

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8
Q

very bright on CT indicates

A

hyperdense

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9
Q

when you use contrast on abd CT, what changes occur in bv density

A

they become more dense → get lighter

as time goes on → less bright as contrast disseminates into tissues/organs

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10
Q

significance of ligament of treitz (4)

A

transition from foregut to midgut → blood supply from celiac to superior mesenteric

separates upper GI from lower GI bleed

anchors duodenum

superior retention band → allows for embryological rotation

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11
Q

if LOT is displaced, think

A

malrotation/volvulus

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12
Q

ligament of treitz extends from ___

to __

A

diaphragm

duodenojejunal flexure

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13
Q

inguinal ligament spans from the __

to the __

A

ASIS

pubic tubercle

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14
Q

inguinal ligament anchors the __

to the __

A

external oblique

pelvis

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15
Q

protection fxn of inguinal ligament

A

protects structures as they pass from pelvic cavity into thigh and inguinal canal

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16
Q

structures related to inguinal ligament

A

external oblique

iliopsoas

pectineus

NAVEL

lateral cutaneous n

lymphatics

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17
Q

what structures pass thru the inguinal canal in males (2)

A

spermatic cord

genitofemoral n

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18
Q

what structures pass through the inguinal canal in females

A

round ligament of uterus

ilioinguinal n

genitofemoral n

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19
Q

the inguinal canal runs obliquely between the __

A

inguinal rings

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20
Q

what structures pass under the inguinal canal

A

NAVEL

iliopsoas

iliacus

psoas major

femoral branch of genitofemoral n

lateral cutaneous n

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21
Q

hernias associated w. inguinal ligament

A

inguinal hernia

femoral hernia

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22
Q

bulge above inguinal ligament

A

inguinal hernia

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23
Q

weakness in anterior abd wall 2/2 to gubernaculum and descent of the testes around the ligament → protrusion of intestines thru inguinal ligament

A

inguinal hernia

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24
Q

bulge below inguinal ligament

A

femoral hernia

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25
Q

usually caused congenital birth defect in abd wall

A

indirect inguinalhernia

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26
Q

usually caused by weakness in muscles of abd wall that develops over time or dt straining/heavy lifting

A

direct inguinal hernia

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27
Q

protusion medially into inferior epigastric vessels w.in hesselbach’s plexus

A

direct hernia

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28
Q

what is hesselbach’s triangle

A

region of lowe, anterior abd wall or groin

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29
Q

inferior border of hesselbach’s triangle

A

inguinal ligament

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30
Q

lateral border of hesselbach’s triangle

A

rectus sheath/rectus abdominus

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31
Q

superiolateral border of hesselbach’s triangle

A

inferior epigastric vessels

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32
Q

which type of hernia is associated w. hesselbach’s triangle

A

direct

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33
Q

protrusion through small and inflexible femoral ring below the inguinal ligament

A

femoral hernia

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34
Q

type of hernia that usually can not be reduced and compromises blood supply

A

strangulated

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35
Q

type of hernia that can be reduced early on, but can become strangulated

A

incarcerated

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36
Q

types of hernias

A

epigastric

direct inguinal → near opening of inguinal canal

indirect inguinal → at opening of inguinal canal

femoral → femoral canal

umbilical

incisional

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37
Q

what are the important abdominal splanchnic nerves

A

greater, lesser, least splachnic nerves -> T5-T11 and/or 12

lumbar splanchnic nerves -> L1, L2

pelvic splanchnic: L3-L4

sacral splanchnic nerves: L4-S4

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38
Q

lumbar splanchnic nerves

A

L1

L2

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39
Q

pelvic splanchnic nerves

A

S2-S4

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40
Q

thoracic splanchnic nerves

A

T1 - L2

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41
Q

SNS innervation of the abdomen

A

T1-L2

greater splanchnic nerves

lesser splanchnic nerves

least splanchnic nerves

lumbar splanchnic nerves

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42
Q

greater splanchnic nerves

A

T5-T9

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43
Q

the greater splanchnic nerves innervate the

A

foregut

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44
Q

lesser splanchnic nerves

A

T10-T11

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45
Q

least splanchnic nerves

A

T11 and/or T12

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46
Q

greater splanchnic nerves supply sympathetic innervation to the

A

foregut

adrenal medulla

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47
Q

lesser splanchnic nerves supply sympathetic innervation to the

A

midgut

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48
Q

least splanchnic nerves supply sympathetic innervation to the

A

kidneys

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49
Q

the greater. lesser, and least splanchnic nerves run from

A

T5-T12

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50
Q

lumbar splanchnic nerves

A

L1-L2

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51
Q

lumbar splanchnic nerves innervate

A

bladder

ductus deferens

prostate

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52
Q

PSNS innervation of the abdomen

A

sacral splanchnic nerves from the inferior hypogastric plexus -> L4-S4

pelvic splanchnic nerves -> S2-S4

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53
Q

pelvic splanchnic nerves innervate the

A

hindgut

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54
Q

extrinsic innervation of the GIT is __ (2)

intrinsic innervation of the GIT is __

A

SNS, PSNS

enteric NS

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55
Q

what is the prevertebral plexus

A

where the splanchnic nerves combine with fibers from other levels to exit the trunk

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56
Q

the prevertebral plexus contains (3)

A

PSNS visceral afferents from the vagus n

PSNS fibers from the pelvic splanchnic n to inferior hypogastric plexus

SNS visceral afferents from the thoracic and lumbar splanchnic nerves

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57
Q

main vessel of the portal venous system

A

portal vein

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58
Q

portal vein drains blood from the __

to the __

for __

A

GIT, gallbladder, pancreas

liver for detox/filtration

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59
Q

blockage of the portal vein increases abdominal __

and causes __

A

pressure

anastomoses/varices

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60
Q

what are portocaval anastamoses

A

connections btw portal system and superior/inferior vena cava

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61
Q

umbilical vein to anterior abdominal wall anastomoses

A

caput medusa

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62
Q

what veins drain into the portal vein

A

superior mesenteric

inferior mesenteric

splenic

left and right gastric

pancreatic

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63
Q

lower esophagus anastomosis

A

left gastric v

esophageal veins

64
Q

anal canal anastomosis

A

superior, middle, inferior rectal veins

65
Q

umbilicus anastomosis

A

paraumbilical veins

small epigastric veins

66
Q

hepatic and splenic flexure anastomosis

A

omental v

colonic v

67
Q

large/small intestine anastomosis

A

retroperitoneal v

68
Q

what structures are close to the posterior pancreas

A

aorta

SMA

left renal vessels

left kidney

left suprarenal gland

69
Q

structures on medial and lateral sides of pancreas

A

gallbladder

spleen

70
Q

structure on superior/inferior side of pancreas

A

stomach

duodenum

71
Q

the head of the pancreas is on the __ side of the pancreas

and lies with the __ of the duodenum

at the __ vertebral level

A

right

C curve

2nd

72
Q

the tip of the pancreas extends across the abdominal cavity almost to the

73
Q

the collecting ducts of the pancrreas empty digestive juices into the

A

pancreatic duct

74
Q

the pancreatic duct runs from the __

to the __ of the organ

75
Q

the pancreatic duct empties into the __

at the __ of the

alongside the __

A

duodenum/duodenal papilla

lesser curve/ampulla of vater

common bile duct

76
Q

adenocarcinoma of the head of the pancreas leads to obstruction of the __

and a main symptom is

A

CBD

painless jaundice

77
Q

acute pancreatitis leads to formation of __

bc the body is trying to wall off enzymes from leaking into the __

A

pseudocysts

retroperitoneal cavity

78
Q

why are the kidneys spared in pancreatitis

A

they are surrounded by gerotas fascia → protects them from digestive enzymes

79
Q

enteric ns includes

A

myoenteric → Auerbach’s plexus

submucosa → Meissner’s plexus

80
Q

enteric ns is a __ network

of __ (2) neurons

A

self sufficient

sensory and motor

81
Q

what does the enteric ns coordinate (3)

A

peristalsis

secretions

blood flow

82
Q

the enteric ns is independent, but can be modified by __ (2)

83
Q

cramping, burning, gnawing, colicky pain

84
Q

visceral pain is caused by

A

distension of viscous/hollow organ

85
Q

in visceral pain, __ stimuli

trigger __

in __

A

noxious

nociceptors

viscera

86
Q

visceral pain can be accompanied by

A

sweating

nausea

pallor

restlessness

87
Q

visceral pain may or may not correspond w. __

and can NOT be __

A

dermatomes

elicited on pe

88
Q

somatoparietal pain involves noxious stimuli of the __

A

peritoneum

89
Q

somatoparietal pain may be described as

A

intense

localized

90
Q

somatoparietal pain is aggravated by

A

moving

coughing

91
Q

somatoparietal pain impulses travel with __

NOT with __

A

somatosensory spinal nerves

ANS

92
Q

somatosensory pain corresponds w.

A

dermatomes

93
Q

example of somatoparietal pain

A

appendicitis pain localizing at McBurney’s point

94
Q

referred pain involves __

and __ afferents

A

visceral

somatic

95
Q

pain that involves visceral and somatic afferents from different anatomic regions that converge on second order neurons in the spinal cord at the same level

A

referred pain

96
Q

example of referred pain

A

diaphragmatic irritation from a subphrenic abscess is interpreted by brain as coming from shoulder

97
Q

is referred pain localized

A

yes! well localized

98
Q

in appendicitis, __ fibers carry pain sensations that

enter spinal cord with __ fibers

at __ level

and pain is referred to __

A

visceral afferent

sympathetic fibers

T10

T10

99
Q

appendicitis pain begins as ___

and after 6-10 hours localizes to __

and becomes __ pain

A

central periumbilical colicky visceral

RLQ

constant somatoparietal

100
Q

cholecystitis pain begins at __ initially

then __ pain

then spreads to __

A

midline

RUQ

right shoulder

101
Q

diverticulitis pain begins at the __

and then moves to the __

A

lower abd midline

LLQ

102
Q

the foregut extends from the __

to the __

A

esophagus

proxima duodenom (papilla/ampulla of vater)

103
Q

blood supply to the foregut is via the __

and it is drained via the __

A

celiac a and its branches

splenic v

104
Q

branches of the celiac a

A

left gastric

splenic

common hepatic

105
Q

the midgut extends from the __

to the __

A

distal descending duodenum

proximal ⅔ of transverse colon

106
Q

blood supply to the midgut is via __

and it is drained by the __

A

superior mesenteric a

superior mesenteric v

107
Q

the superior mesenteric vein joins the __ vein

to form the __ vein

A

splenic

hepatic portal

108
Q

the hindgut extends from the __

to the __

A

distal ⅔ of transverse colon

rectum

109
Q

blood supply to the hindgut is via the __

and it is drained via the __

A

inferior mesenteric a

inferior mesenteric v

110
Q

the splenic v, inferior mesenteric v, and superior mesenteric v

all join to form the __,

which drains into the __

A

hepatic portal v

IVC

111
Q

in a malrotation and midgut volvulus, the foregut rotates __

and the midgut rotates __

around the axis of the __

A

clockwise

counterclockwise

superior mesenteric a

112
Q

midgut volvulus occurs when normal 270 degree twisting at around __ weeks in fetal development does not occur

113
Q

this initial malrotation causes the __

to wrap around a portion of the __,

which causes obstruction, ischemia, infarct

A

mesentery

small bowel

114
Q

sx of midgut volvulus

A

bilious vomiting

hemodynamic instability

abd distension

115
Q

what do you think when you see, congenital diaphragmatic hernia, congenital heart dz, and omphalocele

A

midgut volvulus

116
Q

what is the small bowel mesenteric root

A

origin of the mesentery of the small intestine

117
Q

where is the normal small bowel mesenteric root

A

central portion of the abdomen

extends from duodenojejunal flexure → extends downward to the right of the ileocecal junction

118
Q

the small bowel mesenteric root connects the small bowels to the

A

posterior abd wall

119
Q

transient relaxation of the LES → reflux of acid and bile into distal esophagus → ineffective esophageal clearance → reflux

120
Q

relaxation of upper esophageal sphincter allows food and acid to enter the

A

pharynx

+/- trachea

121
Q

sx of GERD

A

non cardiac pain

hb/indigestion

nocturnal cough/asthma

early satiety/abd fullness

bloating/belching

esophageal spasms

122
Q

complications of GERD

A

barrett’s esophagus

adenocarcinoma

123
Q

esophageal spasms can mimic

124
Q

most dependent portion of peritoneal cavity when supine

A

hepatorenal fossa (morrison’s pouch)

125
Q

most dependent portion of the peritoneal cavity when upright

A

pelvis pouch of douglas

126
Q

what is the pelvis pouch of douglas

A

furthest point of abdominopelvic cavity in women

127
Q

clinical significance of heaptorenal fossa and douglas pouch

A

these places fill w. fluid or air first if there is swelling/inflammation of abdomen

128
Q

what is free air in the abdomen called

A

pneumoperitoneum

129
Q

what will fluid/inflammation in the hepatorenal fossa/douglas pouch look like on CXR

A

corners may look rounded

130
Q

contents of porta hepatis

A

common bile duct

hepatic a proper

hepatic portal v

131
Q

where does CBD enter duodenum

A

thru sphincter of oddi at ampula of vater on lesser curve of duodenum

132
Q

2 types of abnormal bowel gas patterns

A

functional/adynamic ileus

mechanical obstruction

133
Q

irritation/inflammation → loss of peristalsis → dilated non functioning bowel

A

functional/adynamic ileus

134
Q

functional/adynamic ileus can be __

or __

A

1-2 loops of bowel

generalized

135
Q

in a functional/adynamic ileus, BS are

and there may be signs of __

A

hypoactive/quiet

inflammation/irritation

136
Q

what do you think when you see, dilated loops of bowel

+/- air fluid levels

A

ileus

bowel obstruction

137
Q

what causes a true mechanical obstruction of the bowel (5)

A

adhesions

tumors

hernias

intusussception

IBD

138
Q

BS in mechanical obstruction will sound __

and pain will be __

A

hyperactive

cramping

139
Q

transpyloric plane pe correlation

A

L1 vertebral body

140
Q

subcostal plane pe correlation

A

L3 vertebral body

141
Q

supracristal plane pe correlation

A

L4 vertebral body

142
Q

abdominal viscera pe correlation

A

above the costal margins

143
Q

spleen physical exam correlation

144
Q

the liver crosses the

145
Q

inguinal ligament runs from the __

to the __

A

ASIS

pubic tubercle

146
Q

the inguinal canal and the superficial inguinal ring are __

to the pubic tuercle

A

superolateral

147
Q

the deep inguinal ring is midway between the __

and the __

A

ASIS

pubic tubercle

148
Q

the femoral pulse is just below the

A

deep inguinal ring

just below the midline of the ASIS and pubic symphysis

149
Q

what is the transpyloric plane

A

axial plane midway btw jugular notch and superior border of pubic symphysis

150
Q

the transpyloric plane crosses what structures

A

L1 vertebra

pylorus

pancreatic neck

duodenojejunal neck

fundus of gallbladder

9th costal cartilage

hila of kidneys

origin of portal v

transverse mesocolon

2nd part of duodenum

superior mesenteric a origin

hilum of spleen

termination of spinal cord

151
Q

supracolic structures

A

liver

spleen

gastric fundus

152
Q

infracolic structures

A

small intestine

colon

153
Q

what is the subcostal plane

A

horizontal plane passing thru lower limits of 10th costal cartilage

marks boundary btw hypochondriac and epigastric regions

marks boundary between lateral and umbilical regions

154
Q

where is the bifurcation of the abdominal aorta

A

supracristal plane

L4

155
Q

what is the supracristal plane

A

transverse plane lying at the upper most part of pelvis

between superior iliac crest

A&P II - Exam 2 (3 decks)

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