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Bloc E - GI & Metabolism > Jan31 M3-Anatomy Lecture 3 > Flashcards

Jan31 M3-Anatomy Lecture 3 Flashcards

1
Q

4 parts of stomach

A

cardia, fundus (bulging), body, pylorus

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2
Q

2 sphincters in stomach

A

LES in beginning

pyloric sphincter

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3
Q

two parts of LES and real functional part and why

A

external and internal sphincter. internal sphincter is real. (in wall of tube itself), constant tone

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4
Q

external sphincter of LES composition and function

A

diaphragm forms right crus and left crus but right crus surrounds whole LES. when breathe in, it tightens.

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5
Q

LES innvervation

A

autonomic (not voluntary)

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6
Q

hiatus hernia def

A

protrusion of upper part of stomach in thorax through tear or weakness in diaphragm

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7
Q

what might be weak in the diaphragm, causing a hiatus hernia

A

external sphincter of LES

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8
Q

2 types of hiatal hernias and %

A

sliding (95%) and paraesophageal (5%)

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9
Q

sliding hiatal hernia def

A

stomach + esophagus move up and down together. stomach starts above diaphragm (gastroesophageal junction above it)

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10
Q

paraesophageal hiatal hernia def

A

part of stomach is squeezed up above the diaphragm (but junction didn’t move)

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11
Q

pyloric spasm or stenosis cause and consequence

A

congenital hypertrophy of pyrolic sphincter.

bloated stomach in baby and vomits

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12
Q

vomit of pyrolic spasm or stenosis vs other disease

A

doesn’t have bile bc bolus doesn’t get beyond pylorus

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13
Q

4 parts of duodenum and intra or retroperitoneal

A

D1 exits stomach (intra then retro)
D2 vertical retro
D3 horizontal to the left (retro)
D4 vertical loop up and jejunum when down (retro then intra)

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14
Q

what’s on top of DI

A

gastroduodenal (or hepatoduodenal) ligament (contains bile duct, veins, etc.)

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15
Q

3 flexures in duodenum + location

A

superior duodenal flexure (D1 to D2)
inferior duodenal flexure (D2 to D3)
duodenojejunal flexure (between D4, vertical going up, and jejunum)

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16
Q

what happens in D2

A

bile duct and pancreatic duct open (there’s an ampula)

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17
Q

how right crus of diaphragm surrounds esophagus (and LES)

A

starts on right, goes up top on right, surrounds it to the left and back down from the left to the right

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18
Q

special landmark at D4

A

duodenojunal ligament or ligament of Treitz or suspensory muscle of the duodenum

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19
Q

ligament of Treitz function and composition

A

band of CT and muscle joining right crus of diaphragm

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20
Q

what’s between ileum and cecum and function

A

ileocecal valve. prevents reflux from cecum to ileum

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21
Q

how to differentiate jejunum and ileum from outside

A

ileum: more fat in mesentery, Peyer’s patches (aggregations of lymphoid tissue) more arterial arcades, shorter straight arteries (vasa recta). ileum has more levels of arcades

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22
Q

Meckel’s diverticulum % of pop and what it is

A

(in ileum). 2-3%. congenital prob where obliteration of vitelline duct (connecting fetus to yolk sac of umbilical cord) is incomplete (incomplete closure)

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23
Q

jejunum vs ileum on inside

A

jejunum has plicae circulares

ileum is smooth

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24
Q

Peyer’s patches def and where to see them

A

accum of unencapsulated lymphoid nodules, on inside of ileum

25
Q

intussusception def

A

part of intestine invaginated into another section of intestine (intestine folds on the side)

26
Q

ileocecal valve real composition

A

not a valve but rather a thickening of the ileum wall

27
Q

appendix location

A

hangs on cecum

28
Q

cecum intra or retroperit

A

intraperitoneal

29
Q

method for identifying appendix: name + description

A

McBurney’s point. go from umbilicus to ASIS and then even further by 1 third of the umbilicus to ASIS distance

30
Q

clinical relevance of appendix pain in McBurney’s point

A

inflammation no longer limited to bowel lumen (which has poor pain localization) and is irritating the lining of the peritoneum (where perit touches appendix). greater likelihood of rupture

31
Q

2 reasons for variations of appendix position

A

can be in diff places bc of gut rotation

+ situs inversus, will be on the left

32
Q

5 parts of large intestine

A

ascending, transverse, descending colon
sigmoid colon
rectum

33
Q

flexures in large intestine

A 
hepatic flexure (ascending to transverse)
splenic flexure (transverse to descending)
34
Q

why bulges in colon + name of the bulges

A

(called haustra). three stripes of longitudinal SM along colon called taenia coli (shorter than colon so bulge it outwards)

35
Q

haustra importance in bowel fct + singular

A

peristaltic mvmt importance. one haustra filled then stretched and squeezes
singular is one haustrum

36
Q

name of peristaltic mvmt caused by haustra + frequency

A

haustral contractions. once in 25 minutes

37
Q

epiploic (omental) appendices def

A

small pouches of peritoneum filled with fat. along colon and upper rectum (mostly in transverse and sigmoid)

38
Q

diverticulosis def and location

A

pocket of membrane sticking out bc of pressure, bulging outwards. (mucosa and submucosa outpocketing bc of weak SM)

39
Q

diverticulosis causes and frequent location

A

weakness of wall with age, or congenital or etc.

often sigmoid colon bc place of high P

40
Q

problem of diverticulosis

A

if ruptures, can get severe abd pain quickly, progressing, septick shock

41
Q

volvulus def

A

loop of bowel completely twisted on itself at its mesenteric attachement. looks like kidney bean

42
Q

2 reasons for symptoms in volvulus

A
  • bowel obstruction = abd distension, vomiting, lack of defecation
  • ischemia to the affected portion
43
Q

3 main branches of aorta feeding intestinal system and liver + what they feed

A
  • celiac trunk: liver + up to middle of duodenum
  • sup. mesenteric a.: after middle duod until two thirds of transverse colon
  • inf mesenteric a: last third of transverse colon + the rest
44
Q

3 branches coming off celiac trunk and what they feed

A
  • common hepatic a. to the right
  • splenic a. to the left (to the spleen)
  • left gastric a. (to lesser curvature of stomach)
45
Q

lienorenal ligament location and why exists

A

pouch on back side of spleen bc of spleen and splenic artery connection

46
Q

3 branches of splenic artery and what they feed

A
  • short gastric arteries to fundus
  • splenic arteries to the spleen
  • left gastropepiploic a. to the stomach (and becomes RGE)
47
Q

2 branchings of common hepatic a.

A

proper hepatic a. and gastroduodenal a.

48
Q

proper hepatic a. branchings

A
  1. left hepatic a.
  2. right hepatic a.
  3. cystic a. (to the bile duct)
49
Q

gastrooduodenal artery branchings (2) and what they feed

A
  • RGE a. (anastomoses with LGE a.). greater curvature of stomach
  • superior pancreaticoduodenal a. (feeds top of duodenum and head of pancreas)
50
Q

blood supply to the rest of the pancreas (other than the head)

A

no specific supply. gets blood from arteries all around

51
Q

superior mesenteric a. branchings on its left side

A

jejunal arteries and ileal arteries

52
Q

superior mesenteric a. branchings on its right side and what they feed

A
  • ileocolic artery (to terminal ileum, cecum, appendix, lower ascending)
  • right and middle colic arteries (to upper ascending and transverse)
53
Q

branchings of the inferior mesenteric a. and what they feed

A

left colic artery artery becomes sigmoid arteries on left and superior rectal artery on the right: last part of transverse, descending, sigmoid and upper rectum

54
Q

marginal artery def

A

artery formed by anastomoses all along the margin of the colon

55
Q

why inferior mesenteric a. hard to see

A

autonomic nerves covering aorta

56
Q

what forms the portal vein

A

splenic vein, SMV and IMV

57
Q

why everything joins in portal vein and can’t drain in IVC

A

need to send the nutrients to the liver for it to process them

58
Q

SMV vs IMV general regions they drain from

A

SMV drains from second half of duodenum to first half of transverse
IMV drains from 2nd half of transverse to upper rectum

59
Q

IMV joins where exactly

A

in splenic vein or SMV (there are variations)

Bloc E - GI & Metabolism (58 decks)

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