lecture 7+8 Flashcards
The musculature of the esophagus?
superior 1/3 = skeletal muscle
middle 1/3 = mixed
inferior 1/3 = smooth muscle
when does the esophagus pierce the diaphragm?
T10
what are the four constrictions of the esophagus
- junction of esophagus with pharynx
- when the esophagus crosses the aorta
- where the esophagus is compressed by the left main bronchus
- at the esophageal hiatus
blood supply of the upper stomach and lower esophagus?
left gastric
branch of the celiac trunk
blood supply of the lesser curvature of the stomach
right gastric
arises from the hepatic A.
blood supply of the fundus?
short gastric
branch of the splenic A.
blood supply of the superior greater curvature of the stomach?
left gastroepiploic
arises from the splenic A.
what supplies the lower part of the greater curvature of the stomach?
right gastroepiploic
gastroduodenal branch of the hepatic A.
veins of the stomach
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
perforated peptic ulcer
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
what artery may lead to bleeding in a perforated peptic ulcer
gastroduodenal A. or more specifically the posterior superior prancreaticoduodental A.
posterior and anterior perforation of an ulcer leads to the gastric contents spilling where??
posterior: lesser sac
if turn to the right… may go into hepatorenal recess
anterior: greater sac
four parts of the duodenum and importance
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
arteries of the small intestine
main artery is the superior mesenteric
artery to jejunum are jejunal
artery to ileum are ileal
artery to duodenum are arcades
rebound tenderness?
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
Psoas test
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
small bowl obstruction
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
pyruvate to Oxaloacetate
pyruvate carboxylase in mito
oxaloacetate to PEP
PEP carboxykinase in cytosol
what does pyruvate carboxylase need??
acetyl CoA from beta oxidation as an allosteric activator
shifts pyruvate to gluconeogenesis
also needs the vitamin biotin
The glucose-alanine cycle
the formation of glucose in the liver from alanine that was released from the muscle
How does oxaloacetate get into the mito?
it is reduced to malate and then reoxidized in the lumen of the mito back to oxaloacetate
conversion of glucose 6-phosphate into glucose?
glucose 6 phosphatase which is bound to the membrane of the ER
acts toward the lumen
what regulating enzymes are on during glycolysis
PFK-1 is active
bifunctional enzyme is dephosphorylated
PFK-2 active and fructose 2,6-bisP is present
what regulating enzymes are on during gluconeogenesis
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
