GIT Flashcards
on abd CT, what structures are very dark/black
air/air filled structures
ex: antrum of stomach, hepatic/splenic flexures of colon
black on abd CT indicates
hypodense area
on abd CT, what appears dark grey
fat
on an abd CT, what appears mid-grey
water
mid-grey on abd CT indicates
isodense
on abd CT organs and muscle appear
somewhat bright
on abd CT, bones and vessels appear
very bright
very bright on CT indicates
hyperdense
when you use contrast on abd CT, what changes occur in bv density
they become more dense → get lighter
as time goes on → less bright as contrast disseminates into tissues/organs
significance of ligament of treitz (4)
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
if LOT is displaced, think
malrotation/volvulus
ligament of treitz extends from ___
to __
diaphragm
duodenojejunal flexure
inguinal ligament spans from the __
to the __
ASIS
pubic tubercle
inguinal ligament anchors the __
to the __
external oblique
pelvis
protection fxn of inguinal ligament
protects structures as they pass from pelvic cavity into thigh and inguinal canal
structures related to inguinal ligament
external oblique
iliopsoas
pectineus
NAVEL
lateral cutaneous n
lymphatics
what structures pass thru the inguinal canal in males (2)
spermatic cord
genitofemoral n
what structures pass through the inguinal canal in females
round ligament of uterus
ilioinguinal n
genitofemoral n
the inguinal canal runs obliquely between the __
inguinal rings
what structures pass under the inguinal canal
NAVEL
iliopsoas
iliacus
psoas major
femoral branch of genitofemoral n
lateral cutaneous n
hernias associated w. inguinal ligament
inguinal hernia
femoral hernia
bulge above inguinal ligament
inguinal hernia
weakness in anterior abd wall 2/2 to gubernaculum and descent of the testes around the ligament → protrusion of intestines thru inguinal ligament
inguinal hernia
bulge below inguinal ligament
femoral hernia
usually caused congenital birth defect in abd wall
indirect inguinalhernia
usually caused by weakness in muscles of abd wall that develops over time or dt straining/heavy lifting
direct inguinal hernia
protusion medially into inferior epigastric vessels w.in hesselbach’s plexus
direct hernia
what is hesselbach’s triangle
region of lowe, anterior abd wall or groin
inferior border of hesselbach’s triangle
inguinal ligament
lateral border of hesselbach’s triangle
rectus sheath/rectus abdominus
superiolateral border of hesselbach’s triangle
inferior epigastric vessels
which type of hernia is associated w. hesselbach’s triangle
direct
protrusion through small and inflexible femoral ring below the inguinal ligament
femoral hernia
type of hernia that usually can not be reduced and compromises blood supply
strangulated
type of hernia that can be reduced early on, but can become strangulated
incarcerated
types of hernias
epigastric
direct inguinal → near opening of inguinal canal
indirect inguinal → at opening of inguinal canal
femoral → femoral canal
umbilical
incisional
what are the important abdominal splanchnic nerves
greater, lesser, least splachnic nerves -> T5-T11 and/or 12
lumbar splanchnic nerves -> L1, L2
pelvic splanchnic: L3-L4
sacral splanchnic nerves: L4-S4
lumbar splanchnic nerves
L1
L2
pelvic splanchnic nerves
S2-S4
thoracic splanchnic nerves
T1 - L2
SNS innervation of the abdomen
T1-L2
greater splanchnic nerves
lesser splanchnic nerves
least splanchnic nerves
lumbar splanchnic nerves
greater splanchnic nerves
T5-T9
the greater splanchnic nerves innervate the
foregut
lesser splanchnic nerves
T10-T11
least splanchnic nerves
T11 and/or T12
greater splanchnic nerves supply sympathetic innervation to the
foregut
adrenal medulla
lesser splanchnic nerves supply sympathetic innervation to the
midgut
least splanchnic nerves supply sympathetic innervation to the
kidneys
the greater. lesser, and least splanchnic nerves run from
T5-T12
lumbar splanchnic nerves
L1-L2
lumbar splanchnic nerves innervate
bladder
ductus deferens
prostate
PSNS innervation of the abdomen
sacral splanchnic nerves from the inferior hypogastric plexus -> L4-S4
pelvic splanchnic nerves -> S2-S4
pelvic splanchnic nerves innervate the
hindgut
extrinsic innervation of the GIT is __ (2)
intrinsic innervation of the GIT is __
SNS, PSNS
enteric NS
what is the prevertebral plexus
where the splanchnic nerves combine with fibers from other levels to exit the trunk
the prevertebral plexus contains (3)
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
main vessel of the portal venous system
portal vein
portal vein drains blood from the __
to the __
for __
GIT, gallbladder, pancreas
liver for detox/filtration
blockage of the portal vein increases abdominal __
and causes __
pressure
anastomoses/varices
what are portocaval anastamoses
connections btw portal system and superior/inferior vena cava
umbilical vein to anterior abdominal wall anastomoses
caput medusa
what veins drain into the portal vein
superior mesenteric
inferior mesenteric
splenic
left and right gastric
pancreatic