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GI > organs of digestion > Flashcards

organs of digestion Flashcards

1
Q

esophagus course

A

enters abdomen at esphogeal diaphragmatic hiatus at TV10

abdominal course only 1” enters stomach at TV11

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2
Q

esophogeal mesenteries and ligaments

A

phrenicoesophogeal ligaments- esophagus to diaphragm, allow for independent movement, prevent herniation of esophagus into thorax
mesoesophagus- mesentery of abdominal esophagus

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3
Q

esphogeal contrictions

A

cervical- due to circopharynegeus m
thoracic- due to arch of aorta and left primary bronchus
diaphragmatic- prevents reflux

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4
Q

abdominal esophageal blood supply and lymphatics

A

left gastric a and v

left gastric nodes -> celiac nodes

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5
Q

hiatal hernias

A

herniation of esophagus and/or stomach through esophogeal hiatus
paraesophageal- fundus of stomach herniates through esophageal hiatus anterior to esophagus, may strangulate
sliding- caused by weakening of phrenicoesophageal ligaments allowing cardia and fundus of stomach to herniate into thorax

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6
Q

regions of stomach

A

cardia
fundus
body
pyloric

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7
Q

cardia

A

portion surrounding cardiac orifice

typically TV11

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8
Q

fundus

A

expanded superior portion of stomach

separated from esophagus by cardiac notch

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9
Q

body

A

btwn fundus and pyloric antrum

angular incisure is sharp angulation of lesser curvature where body in continuous w/pyloric region

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10
Q

pyloric region

A

antrum- funnel shaped outflow
pyloric canal- narrow inferior portion
pylorus- portion containing pyloric sphincter, normally locates to the right of midline at LV1/2

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11
Q

layers of stomach wall

A

serosa
muscular layer
mucosa

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12
Q

muscular layer of stomach

A

outer longitudinal layer
inner circular layer (forms pyloric sphincter)
innermost oblique layer

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13
Q

mucosa layer of stomach

A

arranged in folds called gastric folds (rugae)

most prominent along greater curvature and from gastric canal along lesser curvature

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14
Q

stomach mesenteries

A

lesser and greater omentum

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15
Q

lymph supply of stomach

A

gastric nodes along lesser curvature to celiac nodes

gastroepiploic nodes along greater curvature to celiac nodes

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16
Q

duodenum

A

first part of small intestiines 12”

c-shaped courses around head of pancreas

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17
Q

duodenum divisions

A

first (superior)
second (descending)
third (horizontal)
fourth (ascending)

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18
Q

superior duodenum

A

continuous w/pylorus, anterior to LV1
peritonealized assocaiates w/hepatoduoldena ligament
called duodenal bulb bc of thin wall

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19
Q

desending duodenum

A

descends along right side from LV1-3
retropertitoneal
major duodenal papilla (opening for hepatopancreatic ampulla)
minor duodenal papilla (opening for accessory pancreatic duct

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20
Q

horizontal duodenum

A

runs transversly from right to left at LV3

retroperitoneal

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21
Q

ascending duodenum

A

ascends to left of VC from LV3-2
retropertitoneal, except for very end
duodenojejunal flexure
suspensory ligament of treitx supports this flexture

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22
Q

anatomical relationships of duodenum- superior

A

anterior and superior- gallbladder and liver
posterior- common bile duct, gastroduodenal a,
portal v
inferior- head of pancreas
herniation or ulceration of this can erode the gastroduodenal a

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23
Q

anatomical relationships of duodenum- descending

A

anterior- liver, gallbladder, transverse colon, small intestines
posterior- right kidney, renal vessels, IVC
medial- pancreas, gastroduodenal a, bile and pancreatic ducts

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24
Q

anatomical relationships of duodenum- horizontal

A

anterior- superior mesenteric vessels, root of mesentery
posterior- right psoas major, IVC, aorta, right gonadal vessels
superior- head and uncinate process of pancreas

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25
Q

anatomical relationships of duodenum- ascending

A

anterior- root of mesentery, small intestines

posterior- aorta, left psoas major

26
Q

internal feature so duodenum

A

villi- folds of mucosa which increase surface area for absorption
plica circularis- folds of mucosa and submucosa

27
Q

stomach bed

A 
diaphragm
spleen
left kidney
suprarenal gland
pancreas
transverse colon and transverse mesocolon
28
Q

paraduodenal hernias

A

inconstant folds of peritoneum that surrond the third and fourth parts of the duodenum
sometimes small intestines can herniate into paraduodenal fossa created by these folds
surgical repair needs to be careful not to injure inferior mesenteric vessels

29
Q

lymphatics of duodenum

A

anterior to pancreaticoduodenal nodes -> pyloric -> celiac nodes
posterior drainage to superior mesenteric nodes

30
Q

jejunoileum

A

pertionealized
6-7m long
jejunum 2/5s of this mostly in LUQ
illeum 3/5s mostly RLQ and false pelvis

31
Q

mesentery proper

A

root- where attached to posterior body wall
extends on left from LV2 to right sacroiliac joint
crosses duodenum, aorta, IVC, ureter, psoas major, right gonadal vv

32
Q

ilium compared to jejunum

A

thicker wall due to more mm and wider diameter
more plica circulares
incresed vascularity and deeper red color
less mesenteric fat
few peyers patches

33
Q

paralyticileus

A

obstruction of intestine

can be caused by loss of blood supply

34
Q

lymphatic drainage of jeunoileum

A

juxta-intestinal nodes -> mesenteric nodes -> superior mesenteric nodes

35
Q

large intestine

A

cecum, appendix, ascending colon, transverse colon, descending colon, sigmoid colon, rectum, anal canal

36
Q

external cecum -> rectosigmoidal junction

A 
larger diameter then small intestine
tenja coli- longitiudinal muscle is incomplete and present as 3 thick bands
haustra- sacculations of large intestine caused by tonic contractions of tenja coli
omental appendages (fat)
37
Q

internal cecum -> rectosigmoidal junction

A

plica semilunares

mucosa devoid of villi

38
Q

cecum and appendix

A

peritonealized

RLQ

39
Q

internal cecum

A

ileal orifice surrounded by superior and inferior ileocolic lips
no sphincter around ileal orifice, however contraction of terminal ileum likely prevents reflux

40
Q

appendix

A

blind ending diverticulum contianing lymphoid tissue
usually in a retrocecal position
mesoappendix

41
Q

appendicitis

A

initially referred pain T10 dermatome

once spreads to parietal peritoneum pain localized to McBurney (1/3 from ASIS to umbilicus)

42
Q

lymphatics of cecum and appendixx

A

ileocolic nodes-> superior mesenteric lymph nodes

43
Q

colon

A

ascending, transverse, descending, sigmoid,
right colic flexure (hepatic)
let colic flexure (splenic)- where phrenicocolic lig attaches
R/L paracolic gutters

44
Q

ascending colon

A 
retroperitoneal
anterior- small intestine, greater omentum
posterior- posterior body wall, kidney
medial- small intestine
lateral- transversus abdominis
45
Q

transverse colon

A 
peritonealized
anterior- anterior body wall
posterior- transverse mesocolon
superior- liver, gallbladder, stomach, spleen
inferior- small intestines
46
Q

desceding

A

anterior- small intestine
posterior- posterior body wall
medial- small intestine
lateral- transversus abdominis

47
Q

large intestine lymph

A

paracolic -> R/middle colic nodes -> superior mesenteric nodes
paracolic -> L colic nodes -> inferior mesenteric nodes

48
Q

rectum

A

rectosigmoidal jnx at SV3
terminates at anal canal
6-8”

49
Q

external rectum features

A

sacral flexures- follows curvature of sacrum
teniae coli spread out as a continuous layer of longitudinal m
absence of fatty ormental appendages
anorectal flexure- posteroinferior angulation as rectum passes through pelvic diaphragm

50
Q

internal rectum features

A

transverse rectal folds- 2 left, 1 right, folds of mucosa, submucosa, and m which support fecal mass
ampulla- dilated, termina portion of rectum proper, importatn for maintaining fecal continence

51
Q

rectum lymph

A

pararectal nodes drain along superior rectal a to inferior mesenteric nodes
pararectal nodes drain along middle rectal a to internal rectal nodes
inferior half to sacral and internal iliac nodes

52
Q

internal anal sphincter

A

surrounds 2/3s of anal canal
sympathetic (L1,2) contracts
parasympathetic (S2-4) relaxes

53
Q

external anal sphincter

A

surronds 2/3s of anal canal

voluntary, innervated by inferior rectal n

54
Q

anal columns

A

vertical folds of mucosa containing superior rectal vessels

55
Q

anal sinuses

A

small recesses at base of anal columns

56
Q

anal valves

A

folds of epithelium connecting caudal ends of rectal column

57
Q

pectinate line

A

formed by anal valves
represents a change in:
-venous drainage; superior-> drains to superior and middle rectal vv inferior -> drains to inferior rectal v
-lymphatic; superior -> internal iliac nodes, inferior-> superficial inguinal nodes
-nerve supply; superior- autonomic, inferior -> somatic
- epithelial lining; superior-> typical GI mucous lining, inferior -> stratisfies squamous

58
Q

lymph anus

A

superior to pectinate line- internal iliac nodes

inferior to pectinate line- superficial inguinal nodes

59
Q

internal hemorroids

A

usually painless
bright red bleeding
hypertension, pregnancy, constinpation

60
Q

external hemorroids

A

usually painful

pregnancy, constipation, increased abdominal pressure

GI (14 decks)

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