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DIG: Biweekly 3 > Lopez: Small Intestine, Colon, Anus > Flashcards

Lopez: Small Intestine, Colon, Anus Flashcards

1
Q

foregut supplied by what artery

A

celiac trunk

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2
Q

foregut consists of what structures

A

(liver, gallbladder, stomach, spleen, pancreas, proximal duodenum, esophagus)

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3
Q

midgut consists of what structures

A

(distal duodenum, jejunum, ileum, cecum, appendix, ascending colon, and proximal 2/3 of transverse colon)

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4
Q

midgut supplied by what artery

A

superior mesenteric artery

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5
Q

hindgut consists of what structures

A

distal 1/3rd of transverse colon, descending colon, sigmoid colon, rectum, and upper part of anal canal

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6
Q

hindgut supplied by what artery

A

inferior mesenteric artery

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7
Q

lymphatic drainage of fore, mid, and hindgut

A

foregut: celiac nodes
midgut: superior mesenteric nodes
hindgut: inferior mesenteric nodes

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8
Q

4 steps of midgut embryology

A

herniation of midgut loop
rotation of midgut loop
retraction of intestinal loops
fixation of intestines

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9
Q

herniation of midgut loop happens through ____ duct

A

omphaloenteric duct

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10
Q

____ limb grows rapidly and forms small intestinal loops

A

cranial limb

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11
Q

_____ limb develops the cecum and appendix

A

caudal limb

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12
Q

while in umbilical cord, how much does the midgut loop rotate

A

90 degrees

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13
Q

how much does the large intestine turn (retraction of intestinal loops)

A

180 degrees

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14
Q

around 10-12 weeks, this rotation is crucial for normal position of organs in abdominal cavity

A

270 degree rotation (fixation of intestines)

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15
Q

the ____ and ____ colon become fixated in retroperitoneum

A

ascending and descending

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16
Q

congenital anomaly that occurs due to an abnormal rotation and fixation of intestines during fetal development

A

midgut malrotation

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17
Q

small intestine being on the right side; doesn’t rotate fully

A

incomplete rotation

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18
Q

abnormal fibrous bands leading to obstruction

A

Ladd’s bands

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19
Q

abnormal positioning and fixation of midgut leaves it prone to ____

A

volvulus

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20
Q

persistence of the herniation of abdominal contents into proximal part of umbilical cord (herniation of intestines into cord)

A

congenital omphalocele

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21
Q

congenital abdominal wall defect characterized by the protrusion of abdominal contents through a defect in abdominal wall

A

Gastroschisis

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22
Q

defect in lateral body folding (mainly on R side) and leads to abdominal contents failing to return to abdominal cavity

A

Gastroschisis

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23
Q

congenital anomaly resulting from incomplete obliteration of the omphalomesenteric duct (vitelline duct)

A

Meckel’s Diverticulum

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24
Q

anomaly that leaves a connection from ileum to umbilicus

A

Meckel’s Diverticulum

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25
has presence of ectopic tissue (gastric or pancreatic) due to incomplete obliteration of vitelline duct
Meckel's Diverticulum
26
if gastric tissue surrounds this and gets inside can erode wall due to low pH and perforate
Meckel's Diverticulum
27
painless rectal bleeding abdominal pain intestinal obstruction perforation
Meckel's Diverticulum
28
2 year-old male with history of constipation presented with one episode of painless hematochezia that occurred 1 hour prior to arrival. He had a benign abdominal exam. POCUS revealed a focal fluid collection in the RLQ with a bowel wall appearance containing a hyperechoic focus
Meckel's Diverticulum
29
congenital disorder characterized by failure of neural crest cell migration
Hirschsprung Disease
30
abscence of ganglion cells in the myenteric and submucosal plexuses in distal colon
Hirschsprung disease
31
This aganglionosis results in a lack of peristalsis in the affected segment and of the bowel is unable to relax and remains in a contracted state
Hirschsprung disease
32
megacolon
Hirschsprung disease
33
RET mutation; lack of ICCs
Hirschsprung disease
34
clinical features of this include delayed passage of meconium w/in first 48 hours
Hirschsprung disease
35
progressive abdominal distension bilious vomiting failure to thrive enterocolitis
Hirschsprung disease
36
megacolon
37
older individuals chronic constipation parkinson's surgeries
Volvulus
38
loop of intestine twists around itself leading to mechanical obstruction
Volvulus
39
twisting--poor blood supply---edema---blockage---perforation
volvulus progression
40
abdominal pain abdominal distension N/V constipation shock
Volvulus
41
high fiber diet makes this worse
volvulus
42
"whirlpool sign" on US
volvulus
43
"coffee bean shape"
sigmoid volvulus
44
mostly in kids prior viral infections congenital anomalies
Intussusception
45
condition in which part of the intestine telescopes into itself
Intussusception
46
Intussusception
47
occurs when a segment of the intestine telescopes into an adjacent segment, leading to obstruction and potential ischemia
intussusception
48
typically involves the ileum telescoping into the colon at ileocecal junction
intussusception
49
intermittent abdominal pain vomiting "currant jelly" stools palpable abdominal mass
intussusception
50
currant jelly stools sausage shaped palpable mass in RUQ or epigastrium
intussusception
51
currant jelly stools
52
target configuration on US
intussusception
53
lies at level of L1-L3; has segments
duodenum
54
D1 D2 D3 D4
D1: superior D2: descending D3: horizontal D4: ascending
55
superior part of duodenum at what vertebral level
L1
56
horizontal part of duodenum at what vertebral layer
L3
57
main arteries supplying top part of duodenum
gastroduodenal anterior superior + posterior superior pancreaticoduodenal
58
main arteries supplying bottom part of duodenum
posterior inferior + anterior inferior pancreaticoduodenal arteries
59
layers of duodenum
mucosa submucosa muscularis externa adventitia
60
this layer of duodenal mucosa consists of enterocytes, goblet cells, and crypts
epithelial
61
this layer of duodenum has brunner glands
submucosa
62
duodenum
63
small intestine has ___% enterocytes and ____% goblet cells
80% enterocytes 20% goblet cells
64
tumors that grow out of lymphoid tissue
GALT
65
these glands help change acidic stomach pH to more neutral pH
brunner glands
66
feathery
duodenum
67
ileum
68
connivent valves
69
part of small intestine located on L side
jejunum
70
part of small intestine located in lower abdomen
ileum
71
connivent valves of duodenum and jejunum aid in what
peristaltic movements
72
blue: ascending colon white: transverse colon green: descending colon orange: cecum yellow: rectum
73
vasa recta longer in _____ than in the ileum
jejunum
74
this artery runs along the whole colon
marginal a.
75
branches of SMA
iliocolic right colic middle colic marginal
76
branches of IMA
left colic sigmoidal superior rectal marginal
77
branches of iliocolic artery off SMA
illeal branch colic branch appendicular branch
78
branches of L colic artery off of IMA
ascending branch descending branch
79
arteries that supply rectum
superior rectal middle rectal inferior rectal
80
this pain starts around umbilicus (dull) and travels to RLQ as sharp pain
appendicitis
81
when there is sharp pain in the abdomen, not referred pain, why?
irritation of peritoneum
82
rebound tenderness means what
peritoneum is involved
83
periumbilical visceral pain runs through what nerve to CNS
lesser splanchnic n. (T10-T11)
84
when peritoneum is inflamed, somatic pain runs through what to CNS
least splanchnic n lumbar sacral (T11-L1)
85
contains valves of Kerckring mucosa submucosa muscularis externa serosa
Jejunum
86
no glands seen in this submucosa
jejunum
87
this layer of jejunum contains immune cells
lamina propria
88
this layer of jejunum mucosa contains enterocytes w/ goblet cells
epithelial
89
jejunum
90
filled with army of lymphoid tissue (GALT); many tumors from this tissue that lines the GI tract arise at the ______
Ileum
91
this layer of Ileum contains Peyer's Patches (a lot of lymphocytes--bc ileum is close to colon that has a lot of bacteria)
lamina propria
92
Peyer's Patches (of Ileum)
93
Ileum
94
not as much villi here (absorption happens mainly in small intestine)
Colon
95
culprit of diveriticuli formations
colon
96
huge amount of goblet cells
colon
97
colon
98
colon (w/ diverticuli)
99
___% enterocytes in colon ___% goblet cells in colon
20% enterocytes in colon 80% goblet cells in colon
100
rectum part of recto-anal junction
101
anus part of recto-anal junction
102
anal transition zone
pectinate line
103
external sphincter composed of what muscle
skeletal
104
apocrine and sebaceous glands of recto-anal junction
105
68 yr old pt w/ post prandial pain hx of A-fib hasn't taken warfarin in a few days
acute mesenteric ischemia
106
if you lose SMA on CT, means a clot (necrosis)
acute mesenteric ischemia
107
what part of GI tract would be removed in acute mesenteric ischemia where SMA was occluded
all part of proximal small bowel
108
risk factors include: A-Fib advanced age atherosclerosis
acute mesenteric ischemia
109
embolic occlusion thrombotic occlusion non-occlusive mesenteric ischemia mesenteric venous thrombosis
pathophys of acute mesenteric ischemia
110
severe abdominal pain N/V diarrhea or bloody stools
acute mesenteric ischemia

DIG: Biweekly 3 (12 decks)

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