lecture 7+8

Question 1

The musculature of the esophagus?

Answer 1

superior 1/3 = skeletal muscle

middle 1/3 = mixed

inferior 1/3 = smooth muscle

Question 2

when does the esophagus pierce the diaphragm?

Answer 2

T10

Question 3

what are the four constrictions of the esophagus

Answer 3

1. junction of esophagus with pharynx
2. when the esophagus crosses the aorta
3. where the esophagus is compressed by the left main bronchus
4. at the esophageal hiatus

Question 4

blood supply of the upper stomach and lower esophagus?

Answer 4

left gastric

branch of the celiac trunk

Question 5

blood supply of the lesser curvature of the stomach

Answer 5

right gastric

arises from the hepatic A.

Question 6

blood supply of the fundus?

Answer 6

short gastric

branch of the splenic A.

Question 7

blood supply of the superior greater curvature of the stomach?

Answer 7

left gastroepiploic

arises from the splenic A.

Question 8

what supplies the lower part of the greater curvature of the stomach?

Answer 8

right gastroepiploic

gastroduodenal branch of the hepatic A.

Question 9

veins of the stomach

Answer 9

the right and left gastric veins drain directly into the portal vein

the short gastric and left gastroepiploic drain into the splenic vein and then the portal vein

Question 10

perforated peptic ulcer

Answer 10

sudden and severe pain in the abdomen

the abdomen will be rigid
will find abnormal free air in diaphragm
may lead to bleeding

most likely occur in the first part of the duodenum

Question 11

what artery may lead to bleeding in a perforated peptic ulcer

Answer 11

gastroduodenal A. or more specifically the posterior superior prancreaticoduodental A.

Question 12

posterior and anterior perforation of an ulcer leads to the gastric contents spilling where??

Answer 12

posterior: lesser sac
if turn to the right… may go into hepatorenal recess

anterior: greater sac

Question 13

four parts of the duodenum and importance

Answer 13

1st or superior:
located at L1
suspended my mesentery
also known as duodenal bulb

2nd or descending:
contains hepatopancreatic duct, major and minor duodenal papilla, and accessory pancreatic duct

3rd or horizontal:
crosses left and anterior of aorta

4th or ascending:
left side of the aorta
suspended from the posterior wall by ligament of treitz

Question 14

arteries of the small intestine

Answer 14

main artery is the superior mesenteric

artery to jejunum are jejunal

artery to ileum are ileal

artery to duodenum are arcades

Question 15

rebound tenderness?

Answer 15

appendix is innervated by T10

used to confirm appendicitis diagnoses

compress and rapidly release pressure applied to the right lower quadrant

due to peritoneal irritation.. the patient will have a sharp sudden pain

Question 16

Psoas test

Answer 16

extending the thigh of the patient either passively or actively with knees extended

if abdominal pain occurs that is a positive test

can be used to test for appendicitis

Question 17

small bowl obstruction

Answer 17

tend to be located centrally

increase in intraluminal gas, thus will have stacks of coins appearance

clinically: 
nausea and vomiting 
abdominal distention 
increased bowel sounds 
no passage of gas

Question 18

pyruvate to Oxaloacetate

Answer 18

pyruvate carboxylase in mito

Question 19

oxaloacetate to PEP

Answer 19

PEP carboxykinase in cytosol

Question 20

what does pyruvate carboxylase need??

Answer 20

acetyl CoA from beta oxidation as an allosteric activator

shifts pyruvate to gluconeogenesis

also needs the vitamin biotin

Question 21

The glucose-alanine cycle

Answer 21

the formation of glucose in the liver from alanine that was released from the muscle

Question 22

How does oxaloacetate get into the mito?

Answer 22

it is reduced to malate and then reoxidized in the lumen of the mito back to oxaloacetate

Question 23

conversion of glucose 6-phosphate into glucose?

Answer 23

glucose 6 phosphatase which is bound to the membrane of the ER

acts toward the lumen

Question 24

what regulating enzymes are on during glycolysis

Answer 24

PFK-1 is active
bifunctional enzyme is dephosphorylated
PFK-2 active and fructose 2,6-bisP is present

Question 25

what regulating enzymes are on during gluconeogenesis

Answer 25

Fructose 1,6 bis-P is active (converts fructose 1,6 bis-P to fructose 6-P)

bifunctional enzyme is phosphorylated
BPase-2 is active
no fructose 2,6-bisP