MSTNRY Flashcards
True about the anatomy of the mesentery EXCEPT
a. contoguous structure suspending and fixing bowel to abdominal wall
b. Endodermal in origin
c. a.k.a dorsal mesentery
d. previous theories of development include sliding and regression models
B. Mesodermal in origin
Lateral reflection of posterior parietal peritoneum of abdomen over the mesentery of the ascending and descending colon known as the _____
white line of Toldt
Defects in proper rotation and fixation of the bowel results in the spectrum of congenital disorders known as _______
intestinal malrotation
Defects that form in anatomical positions may act as routes for intestinal herniation. Common sites of herniation include the ________ or ________
paraduodenal or mesocolic areas
Areas where mesenteric attachment is incomplete may predispose patients to
volvulus
Part of colon most susceptible to volvulus
sigmoid
Posterior peritoneal fixation of colon occurs in the
a. 2nd and 3rd fetal month
b. 3rd and 4th fetal month
c. 4th and 5th fetal month
d. 5th and 6th fetal month
B
The mesentery of these parts of the colon do not fuse to posterior parietal peritoneum thus causing these parts to be mobile
Transverse and sigmoid
Has bactericidal properties, absorptive capacity and ability to form adhesion.
a. mesentery
b. omentum
c. both
d. neither
C
True about mesenteric circulation
a. splanchnic vascular bed receives 30-50% of cardiac output
b. splanchnic vascular bed contains 1/3 of total volume (1,500mL)
c. tolazolin causes vasoconstriction
d. digitalis causes vasodilation
B.
a. 20-30%
c. vasodilate
d. vasoconstrict
The following can cause mesenteric vascular disease EXCEPT
a. thrombosis
b. aneurysm
c. tumors
d. NOTA
D
Acute mesenteric vessel occlusion
a. emboli/thrombosis
b. obliterative arterial disease
c. both
d. neither
A
Three main mesenteric arteries that provide arterial perfusion to the GI system
Celiac artery
SMA
IMA
Celiac artery provides arterial circulation to the ff EXCEPT
a. foregut
b. distal esophagus to duodenum
c. hepatobiliary system
d. spleen
e. NOTA
E
The SMA supplies
a. duodenum to ileum
b. jejunum to mid-colon
c. ileum to sigmoid
d. NOTA
B. midgut
THE IMA supplies
a. cecum to colon
b. mid-colon to sigmoid
c. mid-colon to rectum
d. rectum-anus
C
arise from the ventral surface of the infradiaphragmatic suprarenal abdominal aorta
a. celiac
b. SMA
c. IMA
A and B
C arise from left lateral portion of infra renal aorta
splanchnic vasodilateors include
VNG
VIP, nitric oxide, glucagon,
Vasopressin
a. increase mesenteric blood flow
b. decrease mesenteric blood flow
B
Clinical manifestation of mesenteric ischemia is predominantly
postprandial abdominal pain; most frequently mid abdomen
True of acute occlusion
a. IMA and CA involvement are usually asymptomatic
b. SMA involvement if untreated can lead to infarction and eventually death
c. IMA involvement will cause symptoms if SMA or Internal Iliac artery is compromised
d. 15-20% significant mesenteric VA arises from primary venous thrombosis
AOTA
What is the most commonly involved vessel in acute mesenteric ischemia?
SMA
True about mesenteric artery occlusive disease EXCEPT
a. In acute embolic ischemia, the emboli typically originate from a cardiac source and frequently occur in patients with atrial fibrillation or following MI
b. Non-occlusisive mesenteric ischemia is characterized by a flow state in otherwise normal mesenteric arteries and most frequently occurs in critically ill patients on vasopressors
c. chronic mesenteric ischemia is a functional consequence of a long-standing atherosclerotic process that typically involves at least three main mesenteric vessels
d. NOTA
C. two out of the three
Chronic mesenteric ischemic symptoms can occur due to extrinsic compression of the celiac artery by the diaphragm. This is called ______ or _____
median arcuate ligament syndrome or
celiac artery compression syndrome
What percentatge of mesenteric vascular disease arise from primary arterial occlusion
50%
What is the initial effect of proximal SMA occlusion?
intense spasm to its distal branches, thus exacerbating ischemic insult
