Week 3 Flashcards
learning objs for Tbl 2
Interpret a Forest plot
Discuss the relationship between GERD and ulcers and the following risk factors: H.pylori infection, coffee consumption, age, gender, bmi, pepsinogen I/II ratio, smoking, and alcohol
Describe the benefits of a cross-over study design
Draw the mechanism of dumping syndrome
Evaluate therapeutic options including pasireotide in the treatment of dumping syndrome
Malrotation
midgut herniates at 4th week and returns approx 10th week
rotates around the axis of SMA 270 degrees counterclockwise
see birds beak
complete nonrotation of the gut
ligament of treitz on the right side of abdomen does not cross midline
for malrotation what do you do before and after surgery
resuscitate first decompress the stomach with NG tube or they would have a cardiac collapse because they don’t have enough intravascular volume
place a foley
after the main procedure (i guess during the surgery tho) you take out the appendix because future appendectomy would present in the LUQ and would be confusing…..
ion status of pyloric stenosis
hypokalemic, hypochloremic metabolic alkalosis from vom
give normal saline until they start making urine, THEN replace the potassium one they have the “extracellular space” for it
intussusception
inversion of the small bowel into the large (usually)
think of the water snake toys
colicky abdominal pain “bring up their legs for a couple minutes, cry, and then they are fine. repeat every couple minutes. Bilious emesis, previous URI (causes lymphoid aggregates in the terminal ileum to increase), currant jelly stool (mucosal ischemia - order is lymphatic obstruction, venous congestion, arterial congestion, ischemia and necrosis)
where does the pelvic diaphrgm insert
“hangs” from a thickened layer of fascia on the obturator internus
muscles that make up the pelvic diaphram
levator ani (anterior) (contains the muscle from back to front iliococcygeus, pubococcygeus, puborectalis)
coccygeus is further back than those (AKA ischiococcygeus)
(piriformis is posterior to the coccygeus
What muscle connects the back of the pubic bone with the coccyx?
pubococcygeus
what structures go out of the greater siatic foramen in back into the lesser siatic foramen
pudendal nerve, artery, vein
hey curve around the ischial spine
what does the obturator nerve innervate
the adductors of the legs
what goes from the coccyx to the ischial spine
coccygeus
the pelvic abdomen originates from this muscle
Tendinous arch of obturator internus
what go in between piriformis and coccygeus
sciatic nerve
inferior gluteal N,A,V
pudendal (but it comes back in through the greater sciatic foramen)
what muscle extends anteriorly from the pubic bone to the ischial spine
obturator internus
what muscle goes from the posterior portion of the tendinous arch of the obturator internus to the coccygeus
iliococcygeus
what forms the “puborectal sling”
puborectalis
what are peptides cotransported with in order to get into the enterocyte
H+
Pept1 cotransporter
during the cephalic and gastric phases, vagal stimulation causes release of pancreatic enzyme including this peptide that isn’t in first aid so its not in my other flashcards
Monitor peptide
this and CCK-RP cause release of CCK from I cells into the blood
what part of the brain is important in monitoring energy expenditure vs energy intake
hypothalamus
neuropeptide-y
increases ghrelin
agouti related peptide
increases ghrelin
GIP
stimulus
target
effect
gastric inhibitory peptide
glucose, fatty acids, amino acids in small intestine
targets beta cells of pancreas
stimulates insulin release, inhibits gastric emptying and acid secretion
kupffer cells
macrophages of the liver
what cells secrete cytokines inducing collagen production by stellate cells, which causes portal hypertension and hepatic encephalopathy
kupffer cells
bacteria convert bile into
urobilinogen - goes to urine and is converted to urobilin (makes urine yellow)
what compound make poop brown
stercobilin
made from urobilinogen
what makes a gall stone
unconjugated bilirubin most of the time
