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Gross III Exam 2 Pgs 88-94 > Gross III Exam 2 Pages 88-94 > Flashcards

Gross III Exam 2 Pages 88-94 Flashcards

1
Q

what is diverticulosis

A

a disorder where multiple false diverticula develop along the intestine

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2
Q

where is diverticulosis most commonl found

A

in elderly and middle aged persons in the Sigmoid colon

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3
Q

how do colonic diverticula differ from true diverticula

A

Colonic diverticula are formed as prtrusions through the mucous membrane between weak points in the muscle fibers whereas true divertucula involve the whole intestinal wall

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4
Q

What is diverticulitis

A

The infection and rupture of colonic diverticula

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5
Q

what are the main effects of diverticulitis

A

distortion and erosion of the nutrient aa, hemorrhage, severe abdominal pain in the LLQ, and blood in the stool

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6
Q

what is the main sign of diverticulosis

A

pellet like, slimy stool

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7
Q

what is the main artery to the midgut

A

superior mesenteric a,

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8
Q

what are the seven midgut derivative aa.

A

anterior/posterior inferior pancreaticoduodenal a, jejunal/ileal aa, middle colic a, right colic a, ileocolic a

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9
Q

what organ does the middle colic a. supply

A

transverse colon

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10
Q

What anastomoses with the left colic a. from IMA

A

Marginal a.

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11
Q

what does the ileocolic a supply

A

the distal ileum and cecum

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12
Q

what does the appendicular atery supply

A

the appendix

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13
Q

which artery supplies the hindgut

A

Inferior mesenteric a.

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14
Q

what artery supplies the descending colon

A

the Left colic a.

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15
Q

What do the sigmoidal arteries supply

A

the sigmoid colon

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16
Q

What is the superior rectal a.

A

the terminal branch to the superior portion of the rectum

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17
Q

Which abdominal parts of the GI tract does the Hepatic Portal vein receive nutrient rich bood from

A

Esophagus, stomach, small/large intestines, pancreas, gallbladder, spleen

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18
Q

The union of which veins form the HPV

A

The splenic v. unites with the superior mesenteric v. to form the HPV

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19
Q

Where does the blood in the splenic v. originate from

A

There are 2 main sources: bilirubin rich blood from the spleen drains to the splenic vein, and the inferior mesenteirc v. drains to the splenic from the distal large intestine.

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20
Q

What does the superior mesenteric v. drain

A

the superior mesenteric v. drains the small intestine and proximal large intestine

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21
Q

What are the 3 main hepatic portal venous return anastamoses with systemic (caval) venuos return

A
  1. esophageal vv and azygos v
  2. rectal vv via either inferior mesenteric v or IVC
  3. Paraumbilical vv. via superficial epigastric vv.
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22
Q

What causes portal hypertension

A

Obstruction of blood flow through the liver (usually HPV) by cirrhosis

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23
Q

What does portal hypertension lead to

A

The large volume of blood between portal and systemic system causes varicose veins to arise at portal-systemic anastomoses

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24
Q

Where do the varicose veins caused by portal hypertension normally arise

A

dilated vv in lower esophagus become esophageal varices, and dilated and prolapsed rectal vv.

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25
Q

Which veins becomes varicose in severe cases

A

vein in the abdominal wall that anastomoses with the paraumbilical vv become varicose

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26
Q

what is “caput Medusae”

A

“Head of Medusa” is the appearance of snake like varices radiating around the umbilicus in severe cases of portal hypertension

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27
Q

What are the main risks associated with portal hypertension

A

extreme dilation of the vessels puts them at risk for hemorrhage, and bleeding from esophageal varices is often severe, potentially fatal

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28
Q

What is the current treatment for portal hypertension

A

Pressure is reduced by surgically creating a communication between the HPV and IVC posteior to the liver, where the vessels are clostest to each other. This bypasses the liver.

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29
Q

Where are the Kidneys located

A

Retroperitoneal on posterior abdominal wall at T12-L3

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30
Q

Which Kidney is lower than the other and why

A

The right kidney is lower than the left because of the liver.

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31
Q

What is the right kidney associated with

A

The liver, duodenum, and the ascending colon

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32
Q

What is the left kidney associated with

A

The pancreas, stomach, spleen, and descending colon

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33
Q

Which nerves pass posterior to the kidneys

A

Subcostal, iliohypogastic, and ilioinguinal nn.

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34
Q

What are the 3 main functions of the kidneys

A
  1. Remove salts and wastes from the blood while preserving nutrients
  2. Maintain appropraite water balance
  3. secrete substances that regulate blood pressure and erythropoiesis
35
Q

What is the function of the ureter

A

The ureter is the tube that connects the kidney to the urinary bladder for the passage of urine.

36
Q

Where is the suprarenal gland located

A

It is located supermedially to each kidney in the perirenal fat which in turn is inside the renal fascia

37
Q

What is the function of the suprarenal gland

A

The suprarenal gland produces corticosteroids, androgens, epinephrine, and norepinephrine

38
Q

Where is the pararenal fat located

A

The pararenal fat is located outside the renal fascia and is most obvious posterior to the kidney

39
Q

Do the kidneys move

A

While large amounts of fat and connective tissue hold the kidneys relatively in place, normal vertical range of motion for kidneys is 3 cm

40
Q

In a kidney transplant, what happens to the donor’s suprarenal gland

A

The donor suprarenal gland is undamaged because it and the kidney are in separate fascial compartments

41
Q

How is a transplanted kidney connected to the recipient

A

The donor kidney is placed in the recipient iliac fossa. The renal a. and v. are sutured to the iliac a. and v., and the ureter is sutured to the urinary bladder.

42
Q

What is the hilum

A

The hilum is a vertical concave cleft on the medial surface of the kidney

43
Q

What passes through the hilum

A

In anterior to posterior order: Renal v., Renal a., Renal pelvis (ureter)

Small nerves and lymphatics also pass through the hilun

44
Q

What is in the renal sinus

A

A fat filled space, the renal sinus houses the renal pelvis and calyces.

45
Q

What is the renal pelvis

A

The renal pelvis is the flattened, funnel shaped origin of the ureter.

46
Q

What is the function of the renal pelvis

A

The renal pelvis collecys urine directly from the major calyces and indirectly from the minor calyces.

47
Q

Where does the renal a. branch from

A

The renal a. braches from the abdominal aorta at the L1-L2 IVD

48
Q

Which side of the renal a. is longer

A

The right side is longer and it passes posterior to IVC

49
Q

What happens to the renal a at the hilum

A

It divides into 5 segmental aa

50
Q

What forms the renal v.

A

The renal v. is formed by the union of several non-segmented intrarenal vv.

51
Q

Which side of the renal v. is longer

A

The left side is longer and passes anterior to the abdominal aorta and posterior to SMA

52
Q

Which vv. does the left renal v. receive

A

The left renal v. receives the left inferior phrenic v., left suprarenal v., and left gonadal v.

53
Q

Which vv. does the IVC receive?

A

The right inferior phrenic v., the right suprarenal v., and right gonadal v.

54
Q

What are the primary nodes for the kidneys and where do they drain

A

The lumbar nodes are the primary nodes for the kidneys and they drain to the thoracic duct.

55
Q

what is the sympathetic innervation of the kidney

A

sympathetic innervation is supplies by lesser and least splanchnic nn., which synapse in the aorticorenal ganglion. It causes vasoconstriction.

56
Q

What is the parasympathetic innervation of the kidney

A

The parasympathetic innervation of the kidney is supplied by the renal plexus from posterior vagal trunk. causes vasodilation (increased urine output).

57
Q

Pain in the kidneys is referred to which dermatomes

A

sympathetics to T10-T12 core segments and is normally referred as back pain.

58
Q

what is the fascial plane of the ureter

A

retroperitoneal

59
Q

what are the three points of constriction in the ureter

A
  1. junction between renal pelvis and ureter
  2. point where ureter crosses brim of pelvic inlet
  3. point where ureter crosses through the wall of the urinary bladder.
60
Q

which aa. supply the ureter

A

renal a, gonadal a, abdominal aorta

61
Q

Which veins drain the ureter

A

renal v. and gonadal v.

62
Q

what are the lymph nodes for the ureter

A

lumbar or common iliac lymph nodes

63
Q

what is the sympathetic innervation for the abdominal part of the ureter

A

T11-L2 via renal aortic and hypogastric plexuses

64
Q

what is hydronephrosis

A

fluid backup in renal pelvis and calyces

65
Q

What are the symptoms of renal and ureteric calculi

A

ureteric pain is rhythmic, sharp, stabbing, and follows course of ureter

66
Q

what is renal and uteric calculi

A

stones found in calyces, renal pelvis, ureteres, and urinary bladder

67
Q

where is pain referred from renal and ureteric calculi

A

T11-L2 dermatome

68
Q

what is lithotripsy

A

procedure that uses shockwaves to break stones into small pieces for easier passage

69
Q

what is horseshoe kidney

A

inferior poles of the kidney fuse resulting in one, U-shaped kidney

70
Q

what is ectopic pelvic kidney

A

kidney fails to send out a pelvis

71
Q

what are the differences in shape between the suprarenal glands

A

right suprarenal gland is triangular in shape, left suprarenal gland in cresent in shape

72
Q

what does the right suprarenal gland contact in the abdomen

A

thoracic diaphram, IVC, and Liver

73
Q

what does the left suprarenal gland contact in the abdomen

A

thoracic diaphram, spleen, stomach, and pancreas

74
Q

what does the suprarenal cortex secrete

A

corticosteroids and androgens

75
Q

what does the suprarenal medulla secrete

A

epinephrine and norepinephrine

76
Q

what sympathetic response do epinephrine and norepinephrine elicit

A

fight or flight! increased heart rate and blood pressure, dilated bronchioles, and increased blood flow to brain and skeletal muscles.

77
Q

which arteries supply the suprarenal glands

A

superior suprarenal artery - branches from inferior phrenic artery

middle suprarenal aretery - branches from abdominal aorta

inferior suprarenal artery - branches from renal artery

78
Q

what veins drain the suprarenal glands

A

right suprarenal vein - drains directly to IVC

left suprarenal vein - drains directly to left renal vein

79
Q

Where do the lymphatics for the suprarenal glands drain

A

lumbar nodes and thoracic duct

80
Q

what is the sympathetic innervation for the suprarenal glands

A

lesser and least splanchnic nn. and celiac plexus

81
Q

what part of the suprarenal gland do the sympathetic nerves supply

A

neurons synapse directly on suprarenal medullary cells. cortex has no nerve supply

82
Q

What is parasympathetic innervation for the suprarenal glands

A

posterior vagal trunk and celiac plexus

83
Q
A

Gross III Exam 2 Pgs 88-94 (1 decks)

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