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MGA > Upper GI > Flashcards

Upper GI Flashcards

1
Q

composition of esophagus muscle wise

A

upper 1/3 is skeletal muscle, lower 2/3 is smooth muscle - inner layer is smooth circular and outer is longitudinal

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2
Q

where is the esophagogastric junction

A

left of T11

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3
Q

junction of stomach and esophagus

A
  1. cardia

2. z line

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4
Q

significance of the z line

A

mucosa changes from stratified squamous to simple columnar epithelium, superior to the line diapgragmatic musculature surrounding esophagus functions as inferior esophageal spincter

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5
Q

blood supply ABDOMINAL esophagus

A
  1. branches of left gastric artery

2. inferior phrenic arteries (off abd aorta)

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6
Q

sympathetic innervation of esophagus

A

greater splanchnic nerves

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7
Q

parasympathetic innervation of esophagus

A

vagus nerve (esophageal plexus)

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8
Q

2 constriction points in esophagus

A
  1. thoracic constriction (bronchoaortic)

2. diaphragmatic constriction

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9
Q

para-esophageal hernia

A

cardia remains in place, z line remains in place, fundus of stomach pops through diaphragm LESS COMMON

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10
Q

sliding esophageal hernia

A

abdominal portion of esophagus, cardia, and maybe some fundus of stomach slide above diapgragm (z line displaced) MORE COMMON

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11
Q

causes of GERD

A
  1. sliding hiatal hernia

2. decreased tone of lower esophageal spincter

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12
Q

causes of peptic ulcers

A
  1. mucosa exposed to gastric acid

2. H pylori

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13
Q

what structures lie posterior to the pyloric spincter/first part of duodenum?

A

portal vein, bile duct, neck of pancreas, gastroduodenal artery with its anterior and posterior superior pancreaticoduodenal arteries

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14
Q

what structures lie posterior to the pylorus of the stomach

A

celiac trunk, aorta

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15
Q

lymphatic drainage of the stomach

A

gastric and pyloric lymph nodes

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16
Q

venous drainage of stomach

A

celiac veins to the portal venous system

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17
Q

blood supply stomach

A

celiac trunk as the left gastric, splenic (gastroomental, short gastric), right gastric, gastroduodenal as the right gastroomental)

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18
Q

psns innervation stomach

A

vagus nerves

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19
Q

sns innervation stomach

A

greater splanchnic nerves

20
Q

what is the gastric canal

A

groove between rugae and lesser curvature

21
Q

3 muscle layers of stomach

A
  1. outer longitudinal layer
  2. middle circular layer
  3. inner oblique fibers
    =muscularis extrema
22
Q

stomach located where

A

left hypochondrium, left epigastric and umbilical regions

23
Q

what ligament contains portal triad

A

hepatoduodenal ligament in the lesser omentum

24
Q

cardia

A

esophagogastric junction

25
Q

fundus

A

above and to left of cardia may have air

26
Q

cardiac notch

A

between cardia and fundus

27
Q

pyloric antrum

A

begins at angular notch

28
Q

pyloric canal

A

narrower portion of pylorus

29
Q

pylorus

A

distal spincteric region

30
Q

what is the celiac ganglia

A

fibrous bundle that receieve fibers from greater splanchnic nerve, and send out postganglionic fibers called celiac plexus

31
Q

length of small intestin

A

6-7 meters

32
Q

characteristics of the 1st part of duodenum

A

LACKS plicae circularis, peritonealized, anterior to bile duct,portal vein, gastroduodenal artery, prone to ulcers bc pancreatic bicarb doesnt dump here to neutralize gastric contents

33
Q

characteristics of 2nd part of duodenum

A

secondarily retroperitoneal, plicae circulares PRESENT, common bile duct and main pancreatic duct open into duodenal papilla (duodenopancreatic ampulla of vater) - END OF FOREGUT

34
Q

characteristic of 3rd part of duodenum

A

CIRCULAR FOLDS PRESENT, secondarily retroperitoneal, posterior to SMA, crosses L3, BEGINNING OF MIDGUT

35
Q

characteristic of 4th part duodenum

A

CIRCULAR FOLDS PRESENT, to left of midline secondarily retroperitoneal, supported by suspensory ligament of duod = ligament of trietz, ends at duodojejunal flexures

36
Q

where is the ligament of trietz

A

smooth muscle that passes from the right crus of diaphragm around the esophagus and attaches to the muscle in duod at duodenojejunal flexure - IS A FIXED POINT IN POST ABD WALL

37
Q

nutcracker position

A

3rd part of duodenum is between the origin of SMA and aorta (neck of pancreas is anterior to aorta and superior to 3rd part)

38
Q

division of foregut, midgut, hindgut

A

FOREGUT: esophagus to duodenal papilla, blood celiac trunk, sympathetics greater splanchnic n, parasympathetics vagus n

MIDGUT: duodenal papilla to 2/3 of transverse colon, blood SMA, sympathetics lesser splanchnics, parasympathetics vagus n

HINDGUT: 1/3 transverse colon to rectum, blood IMA, sympathetics lumbar splanchnics, parasympathetics pelvic splanchnic (S2-S4)

39
Q

lymphatic drainage duod

A

pyloric nodes, SM lyphnodes

40
Q

specific blood to duod

A
  1. superior A&P pancreaticoduodenal from gastroduodenal A
  2. inferior A&P pancreaticoduodenal from SMA
41
Q

where does jejunum begin

A

L2 at duodenojejunal flexure on left side

42
Q

where does ileum end

A

ileocecal junction

43
Q

what is meckel’s diverticulum?

A

leftover of umbilical cord! remnant of proximal part of yolk sac that follows the rule of 2’s: 2 inches long, 2 feet from ileocecal junction, and only occurs in 2% of population

44
Q

position of jejunum and ileum

A

jejunum: ULQ
ileum: LRQ

45
Q

distinguishing characteristics of jejunum

A

jejunum: deeper red/greater vascularity, 2-4 cm, thick and heavy, long vasa recta, few large archades, less fat in mesentery, large circular folds, few peyer’s patches (lymphoid nodules)

46
Q

distinguishing characteristics of ileum

A

paler pink, 2-3 cm, thin and light, short vasa recta, more small archades, more fat in mesentery, low and sparce circular folds, has more peyer’s patches

47
Q

lymphatic drainage of jejunum and ileum

A

superior mesenteric and ileocolic lymph nodes

MGA (27 decks)

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