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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
Q

has presence of ectopic tissue (gastric or pancreatic) due to incomplete obliteration of vitelline duct

A

Meckel’s Diverticulum

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26
Q

if gastric tissue surrounds this and gets inside can erode wall due to low pH and perforate

A

Meckel’s Diverticulum

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27
Q

painless rectal bleeding
abdominal pain
intestinal obstruction
perforation

A

Meckel’s Diverticulum

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28
Q

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

A

Meckel’s Diverticulum

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29
Q

congenital disorder characterized by failure of neural crest cell migration

A

Hirschsprung Disease

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30
Q

abscence of ganglion cells in the myenteric and submucosal plexuses in distal colon

A

Hirschsprung disease

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31
Q

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

A

Hirschsprung disease

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32
Q

megacolon

A

Hirschsprung disease

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33
Q

RET mutation; lack of ICCs

A

Hirschsprung disease

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34
Q

clinical features of this include delayed passage of meconium w/in first 48 hours

A

Hirschsprung disease

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35
Q

progressive abdominal distension
bilious vomiting
failure to thrive
enterocolitis

A

Hirschsprung disease

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36
Q
A

megacolon

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37
Q

older individuals
chronic constipation
parkinson’s
surgeries

A

Volvulus

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38
Q

loop of intestine twists around itself leading to mechanical obstruction

A

Volvulus

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39
Q

twisting–poor blood supply—edema—blockage—perforation

A

volvulus progression

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40
Q

abdominal pain
abdominal distension
N/V
constipation
shock

A

Volvulus

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41
Q

high fiber diet makes this worse

A

volvulus

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42
Q

“whirlpool sign” on US

A

volvulus

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43
Q

“coffee bean shape”

A

sigmoid volvulus

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44
Q

mostly in kids
prior viral infections
congenital anomalies

A

Intussusception

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45
Q

condition in which part of the intestine telescopes into itself

A

Intussusception

46
Q
A

Intussusception

47
Q

occurs when a segment of the intestine telescopes into an adjacent segment, leading to obstruction and potential ischemia

A

intussusception

48
Q

typically involves the ileum telescoping into the colon at ileocecal junction

A

intussusception

49
Q

intermittent abdominal pain
vomiting
“currant jelly” stools
palpable abdominal mass

A

intussusception

50
Q

currant jelly stools
sausage shaped palpable mass in RUQ or epigastrium

A

intussusception

51
Q
A

currant jelly stools

52
Q

target configuration on US

A

intussusception

53
Q

lies at level of L1-L3; has segments

A

duodenum

54
Q

D1
D2
D3
D4

A

D1: superior
D2: descending
D3: horizontal
D4: ascending

55
Q

superior part of duodenum at what vertebral level

A

L1

56
Q

horizontal part of duodenum at what vertebral layer

A

L3

57
Q

main arteries supplying top part of duodenum

A

gastroduodenal
anterior superior + posterior superior pancreaticoduodenal

58
Q

main arteries supplying bottom part of duodenum

A

posterior inferior + anterior inferior pancreaticoduodenal arteries

59
Q

layers of duodenum

A

mucosa
submucosa
muscularis externa
adventitia

60
Q

this layer of duodenal mucosa consists of enterocytes, goblet cells, and crypts

A

epithelial

61
Q

this layer of duodenum has brunner glands

A

submucosa

62
Q
A

duodenum

63
Q

small intestine has ___% enterocytes and ____% goblet cells

A

80% enterocytes
20% goblet cells

64
Q

tumors that grow out of lymphoid tissue

A

GALT

65
Q

these glands help change acidic stomach pH to more neutral pH

A

brunner glands

66
Q

feathery

A

duodenum

67
Q
A

ileum

68
Q
A

connivent valves

69
Q

part of small intestine located on L side

A

jejunum

70
Q

part of small intestine located in lower abdomen

A

ileum

71
Q

connivent valves of duodenum and jejunum aid in what

A

peristaltic movements

72
Q
A

blue: ascending colon
white: transverse colon
green: descending colon
orange: cecum
yellow: rectum

73
Q

vasa recta longer in _____ than in the ileum

A

jejunum

74
Q

this artery runs along the whole colon

A

marginal a.

75
Q

branches of SMA

A

iliocolic
right colic
middle colic
marginal

76
Q

branches of IMA

A

left colic
sigmoidal
superior rectal
marginal

77
Q

branches of iliocolic artery off SMA

A

illeal branch
colic branch
appendicular branch

78
Q

branches of L colic artery off of IMA

A

ascending branch
descending branch

79
Q

arteries that supply rectum

A

superior rectal
middle rectal
inferior rectal

80
Q

this pain starts around umbilicus (dull) and travels to RLQ as sharp pain

A

appendicitis

81
Q

when there is sharp pain in the abdomen, not referred pain, why?

A

irritation of peritoneum

82
Q

rebound tenderness means what

A

peritoneum is involved

83
Q

periumbilical visceral pain runs through what nerve to CNS

A

lesser splanchnic n. (T10-T11)

84
Q

when peritoneum is inflamed, somatic pain runs through what to CNS

A

least splanchnic n
lumbar sacral
(T11-L1)

85
Q

contains valves of Kerckring
mucosa
submucosa
muscularis externa
serosa

A

Jejunum

86
Q

no glands seen in this submucosa

A

jejunum

87
Q

this layer of jejunum contains immune cells

A

lamina propria

88
Q

this layer of jejunum mucosa contains enterocytes w/ goblet cells

A

epithelial

89
Q
A

jejunum

90
Q

filled with army of lymphoid tissue (GALT); many tumors from this tissue that lines the GI tract arise at the ______

A

Ileum

91
Q

this layer of Ileum contains Peyer’s Patches (a lot of lymphocytes–bc ileum is close to colon that has a lot of bacteria)

A

lamina propria

92
Q
A

Peyer’s Patches (of Ileum)

93
Q
A

Ileum

94
Q

not as much villi here (absorption happens mainly in small intestine)

A

Colon

95
Q

culprit of diveriticuli formations

A

colon

96
Q

huge amount of goblet cells

A

colon

97
Q
A

colon

98
Q
A

colon (w/ diverticuli)

99
Q

___% enterocytes in colon
___% goblet cells in colon

A

20% enterocytes in colon
80% goblet cells in colon

100
Q
A

rectum part of recto-anal junction

101
Q
A

anus part of recto-anal junction

102
Q

anal transition zone

A

pectinate line

103
Q

external sphincter composed of what muscle

A

skeletal

104
Q
A

apocrine and sebaceous glands of recto-anal junction

105
Q

68 yr old pt w/ post prandial pain
hx of A-fib
hasn’t taken warfarin in a few days

A

acute mesenteric ischemia

106
Q

if you lose SMA on CT, means a clot (necrosis)

A

acute mesenteric ischemia

107
Q

what part of GI tract would be removed in acute mesenteric ischemia where SMA was occluded

A

all part of proximal small bowel

108
Q

risk factors include:
A-Fib
advanced age
atherosclerosis

A

acute mesenteric ischemia

109
Q

embolic occlusion
thrombotic occlusion
non-occlusive mesenteric ischemia
mesenteric venous thrombosis

A

pathophys of acute mesenteric ischemia

110
Q

severe abdominal pain
N/V
diarrhea or bloody stools

A

acute mesenteric ischemia

DIG: Biweekly 3 (12 decks)

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