Where is volvulus most likely in infants?
Where is volvulus most likely in the elderly?
Infants – midgut volvulus
Elderly – sigmoid volvulus
Where are the four parts of the duodenum in relationship to the vertebrae?
Part one is to the right of L1 and on the same level.
Part two descends from L1 to L3.
Part three is directly anterior to L3.
Part four starts at L3 moves left then superiorly to about L2.
What is the name of the mesentery of the sigmoid colon?
The sigmoid mesocolon.
What and where is the Cantlie line?
An imaginary line on the liver drawn from the fundus of the gallbladder to the diaphragm.
What is a volvulus?
A rotation of a loop of bowel, which can cause constipation, necrosis, and ischemia.
What is Meckel's diverticulum?
A 2 inch long "true" diverticulum resulting from a persistent vitelline/omphalomesenteric duct.
What do we call the ridged outpouchings of colon traveling along the tinea coli?
Which functional segments of the liver are part of the left functional lobe?
Segments II, III, and IV.
What runs through the gastrocolic ligament?
The gastroepiploic vessels
In which quadrant do we find the majority of the ileum?
The right lower quadrant
Where to the superior mesenteric vein and artery pass in front of the duodenum?
The third portion of the duodenum.
Where does the hepatoduodenal ligament reside?
The hepatoduodenal ligament resides in the first portion of the duodenum.
The esophagus enters the cardial orifice of the stomach at the height of what vertebra?
What muscle connects the duodenum to the right crus of the diaphragm?
The suspensory muscle of the duodenum
(a.k.a. ligament of Treitz)
How can you find the level of L3 on a physical exam?
You can find L3 at the inferior costal margin at the mid axillary line.
What section of the stomach is protruding in a paraesophageal hiatal hernia?
The fundus of the stomach
What separates the functional lobes of the liver into right and left?
The Cantlie line.
What is the most common site of volvulus in the elderly?
The sigmoid colon.
What blood vessel is contained within the gastrosplenic ligament?
The short gastric arteries
(Which come off of the splenic artery and supply the fundus of the stomach)
When might Meckel's diverticulum become pathological?
If it becomes populated with ectopic gastric tissue, causing acid production and damaging the small intestine.
Which segment of the left functional liver is a part of the right anatomical lobe of the liver?
Functional segment IV. Also called the "left medial division."
What empties out through the major duodenal papilla?
Where do we see the major duodenal papilla?
The common bile duct and the main pancreatic duct.
In the second portion of the duodenum
What ligament attaches the esophagus to the diaphragm?
The phrenico-esophageal ligament
The portal vein, bile duct, and proper hepatic artery are housed within what structure?
The hepatoduodenal ligament
Where are the cervical, thoracic, and a diaphragmatic constriction point of the esophagus?
Cervical – at the upper sphincter due to the cricopharyngeus muscle.
Thoracic – at the contact of the aorta, and the left main bronchus.
Diaphragmatic – passing through the esophageal hiatus at T10
What is the purpose of a technetium scan?
Detection of gastric tissue in Meckel's diverticulum (among other things, I'm sure).
What is the clinical significance of the ligament of Treitz (suspensory ligament of the duodenum)?
It denotes the change between the upper and lower G.I. Bright red blood in stool comes from a bleed distal to the ligament of Treitz.
Which has a denser, shorter vasa recta and smaller, tighter arcades – the jejunum or the ileum?
The ileum has a denser, shorter vasa recta and smaller, tighter arcades.
What is the name of the large longitudinal band traveling the large intestine?
The tinea coli
What is the relationship of the duodenum to the peritoneum?
The first half of the first part of the duodenum is intraperitoneal, but the rest of the duodenum is retroperitoneal.