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GI Midterm > Lectures 4 and 5- Organs of GI tract > Flashcards

Lectures 4 and 5- Organs of GI tract Flashcards

1
Q

The thoracic esophagus pierces the diaphragm at the level of what vertebra?

  • What is this called?
  • Where is it relative to midline?
A

T10

  • Called the esophageal hiatus
  • Slightly left of midline
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2
Q

After the esophageal hiatus, the esophagus turns sharply to the left to enter the stomach at the cardiac orifice
-At about the level of what vertebra?

A

T11

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3
Q

IVC pierces the diaphragm at the level of what vertebra?

A

T8

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4
Q

The aorta pierces the diaphragm at the level of what vertebra?
-pneumonic to remember these?

A

T12
-I ate 10 Eggs At Noon
ate = 8

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5
Q

“Sliding” hiatal hernia

A
  • Esophageal hiatus of diaphragm enlarges or weakens
  • Abdominal esophagus and parts of the stomach (cardia and sometimes fundus) herniate into the thorax
  • Regurgitation of gastric contents
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6
Q

Paraesophageal hiatal hernia

A
  • A defect in the diaphragm next to the esophageal hiatus
  • Permits fundus of stomach to herniate (not usually the esophagus)
  • No regurgitation of gastric contents
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7
Q

Stomach-located in what regions?

A
  • Left upper quadrant

- Hypochondriac and epigastric regions

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8
Q

Stomach

  • Left end is fixed at the level of what vertebra?
  • Right end is fixed at the level of what vertebra?
A
  • Left end (esophageal end) is fixed at T10-T11

- Right end (duodenal end) is fixed at L1-L2

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9
Q

Know the parts of the stomach

A

Slides 9 and 10

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10
Q

Pyloric orifice

A

Entrance to the duodenum

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11
Q

Surfaces of the stomach?

A

Slide 12

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12
Q

Things that are anterior to the stomach?

A
  • Anterior abdominal wall
  • Left costal margin
  • Left diaphragm
  • Left and quadrate lobes of liver
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13
Q

Small intestine-divided into 3 parts:

-Duodenum-general characteristics?

A
  • C-shaped

- 10 in long

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14
Q

Duodenum

-Located approximately at what vertebral bodies?

A

Located approximately at L1-L4 vertebral bodies

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15
Q

Duodenum

  • Where does it start?
  • Where does it end?
A

Starts at the pylorus of the stomach and ends at the duodenal-jejunal junction

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16
Q

Duodenum

-Subdivided into 4 parts?

A

Superior, descending, horizontal, ascending,

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17
Q

Duodenum

-Secondarily retroperitoneal except for?

A

Some of the 1st and 4th parts

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18
Q

Duodenum

  • Covered anteriorly by?
  • Except where?
A

Covered anteriorly by the peritoneum except where the mesocolon of the transverse colon crosses the second part

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19
Q

Duodenum

-The first part is surrounded by what ligament?

A

Hepatoduodenal ligament

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20
Q

Duodenum

-The root of the mesentery begins at the?

A

Duodeno-jejunal flexure

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21
Q

Duodenum

  • Features of the first part (superior)
    • where does it start?
A

Starts at the pyloric sphincter

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22
Q

Duodenum

-Superior part of the duodenum is held in place by?

A

the hepatoduodenal ligament

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23
Q

Duodenum

-Where are the portal vein, hepatic artery, and bile duct located relative to the superior part of the duodenum?

A

the portal vein, hepatic artery, and bile duct are superior and posterior

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24
Q

Duodenal bulb

A

Widened area

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25
Q

Duodenum

-where is the head of the pancreas relative to the first part of the duodenum?

A

The head of the pancreas is inferior to the first part of the duodenum
-The head of the pancreas “sits inside the C” (the shape of the duodenum)

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26
Q

Which 2 parts of the duodenum are completely secondarily retroperitoneal?

A

The 2nd and 3rd (descending and horizontal)

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27
Q

Duodenum-Features of the 2nd part (descending)

-Anterior to the descending part?

A

the fundus of the gall bladder, right lobe of liver, transverse colon are all anterior to the descending duodenum

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28
Q

Duodenum

-Posterior to the descending part?

A

Right kidney and ureter

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29
Q

Where is the head of the pancreas relative to the 2nd part of the duodenum?

A

The head of the pancreas is medial to the descending duodenum

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30
Q

Descending part of the duodenum

-What enters into the major duodenal papilla?

A

The bile and pancreatic ducts

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31
Q

3rd part of the duodenum

-What 3 things cross the anterior surface?

A
  • Superior mesenteric artery
  • Superior mesenteric vein
  • Root of the mesentery
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32
Q

Where is the head of the pancreas relative to the horizontal part of the duodenum?

A

The pancreas is superior to the horizontal part of the duodenum

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33
Q

Where is the jejunum relative to the horizontal part of the duodenum?

A

The jejunum is anterior and inferior to the horizontal part of the duodenum

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34
Q

4th part (ascending) of the duodenum

  • Intraperitoneal (not covered by parietal peritoneum)
    • Where are the root of the mesentery and jejunum relative to the ascending part of the duodenum?
A

the root of the mesentery and jejunum are anterior to the ascending part

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35
Q

Where are the left margin of the aorta and medial border of the psoas muscle relative to the ascending part of the duodenum?

A

The left margin of the aorta and the medial border of the psoas muscle are posterior to the ascending duodenum

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36
Q

The ascending duodenum is held in place by?

-What does it anchor the ascending duodenum to?

A
  • The ascending duodenum is held in place by the suspensory ligament of the duodenum
  • It anchors the ascending part of the duodenum to the right crus of the diaphragm
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37
Q

Jejunum and ileum

A
  • Occupy most of the peritoneal cavity of the abdomen and pelvis
  • Very mobile
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38
Q

Where does the jejunum begin?

Where does the ileum end?

A
  • The jejunum begins at the duodenal-jejunal junction

- The ileum ends at the ileo-cecal valve

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39
Q

Jejunum and ileum

-Held to the posterior wall by?

A

THE mesentery

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40
Q

Which is longer-the jejunum or ileum?

A

Ileum

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41
Q

Jejunum-characteristics?

A
  • Simple vascular arcades
  • Long vasa recta
  • More vascular
  • Greater diameter, thicker
  • More plicae circularis (folds)
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42
Q

Ileum-characteristics?

A
  • Complex vascular arcades
  • Shorter vasa recta
  • Less vascular
  • Smaller diameter, thinner wall
  • Fewer plicae circularis
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43
Q

Ileum-Meckel’s diverticulum-congenital anomaly

-Arises from?

A

Arises from the antimesenteric border of the ileum

44
Q

Ileum-Meckel’s diverticulum-congenital anomaly

-Remnant of?

A

The vitelline duct

45
Q

Ileum-Meckel’s diverticulum-congenital anomaly

-Clinically difficult to distinguish from?

A

Appendicitis

46
Q

The mesentery crosses what structures?

A
  • LV1-2
  • 3rd part of duodenum
  • Aorta
  • IVC
  • Right ureter
  • Right gonadal vessels
  • Right psoas major
47
Q

Where does the mesentery end?

A

Right S.I. joint

48
Q

THE mesentery

-Made up of 2 layers of peritoneum-what runs between the layers?

A

Nerves, lymph nodes, vessels, fat, arteries, and veins

49
Q

Large intestine

-Mobility?

A

Highly mobile

50
Q

Large intestine-functions?

A
  • Fecal formation, transport and evacuation
  • Water absorption
  • Mucus secretion
51
Q

Taenia coli

-What are they?

A

3 bands of longitudinal muscle on the outside of the colon

52
Q

Taenia coli

-Where do they converge?

A

Converge at the root of the appendix

53
Q

Taenia coli

-Produce?

A

Haustrae (sacculations) that slow the movement of feces

54
Q

Epiploic appendages

A
  • Tags of fat

- Characteristic of the large intestine

55
Q

Cecum

-Characteristics?

A
  • NO EPIPLOIC APPENDAGES

- Blind ‘pouch” inferior to iliocecal orifice

56
Q

Cecum

-Iliocolic valve?

A
  • 2 folds

- Not a true sphincter

57
Q

Ileal papilla

-What is it?

A

Cone-like projection of the ileum into the cecum

58
Q

Cecum

-Where is the opening for the appendix relative to the ileal papilla?

A

The opening for the apendix is inferior to the ileal papilla

59
Q

Vermiform appendix

-What part of the cecum is it usually attached to?

A

Usually attached to the posteromedial part of the cecum

60
Q

Vermiform appendix

-Supported by?

A

Supported by a mesoappendix (not a true mesentery)

61
Q

Colon

-4 parts-Ascending colon-where does it end?

A

Right colic flexure

62
Q

Transverse colon-Where does it end?

A

Left colic flexure

63
Q

Rectum

-Located between?

A

Located between sigmoid colon and anal canal

64
Q

Anorectal line

A

A line joining the tops of the anal columns

65
Q

Transverse rectal folds

A

Superior, medial, and inferior

66
Q

Rectal ampulla

A
  • Dilated terminal part of rectum

- The rectum is superior to anorectal junction (line)

67
Q

Puborectalis muscle

-Relaxation of this muscle allows for?

A

Defecation

68
Q

Acronym used to remember the organs that are retroperitoneal?

A

SADPUCKER

69
Q

Anal valves

-Where are they located?

A

Located at the base of the anal columns

70
Q

Anal sinuses

-What are they?

A

Spaces between and at the inferior part of the anal columns

71
Q

Pectinate line

-What is it?

A

A line joining the inferior ends of the anal valves

-Dentate line?

71
Q

Accessory organs of the GI tract

-Spleen-Where is it located-regions?

A
  • Left hypochondriac region
  • Parallels left ribs 9-11
  • Midaxillary line, between stomach and diaphragm
72
Q

Spleen-size?

A

About the size of a hand

Normally not palpable below costal margin

73
Q

Spleen-peritoneal relationships?

-develops from?

A
  • Covered by peritoneum

- Develops in the dorsal mesentery from mesoderm

74
Q

Where is the diaphragm relative to the spleen?

A

The diaphragm is posterior to the spleen

75
Q

Where are the stomach, left colic flexure and tail of the pancreas relative to the spleen?

A

The stomach, left colic flexure, and tail of the pancreas are anterior to the spleen

76
Q

Where are the left kidney and phrenicocolic ligament relative to the spleen?

A

The left kidney and phrenicocolic ligament are inferior to the spleen

77
Q

Spleen

-Diaphragmatic surface?

A

Against diaphragm

Smooth

78
Q

Spleen

Visceral surface?

A
  • Hilum with gastrosplenic and splenorenal ligaments

- There are colic, gastric, and renal impressions on the visceral surface of the spleen

79
Q

Pancreas

-Located at the level of what vertebra?

A

L1-L2

80
Q

Pancreas-head

A

Uncinate process

Located in duodenal curve

81
Q

Pancreas-body

A

Triangular cross section

82
Q

Pancreas-Neck?

A

Constricted part between head and body

83
Q

Pancreas-tail?

A

Some of the tail is located in the splenorenal ligament

Anterior to the hilus of the spleen

84
Q

Pancreas-relationships

-Where are the superior mesenteric artery and vein relative to the neck of the pancreas?

A

The superior mesenteric artery and vein are posterior to the neck of the pancreas

85
Q

Where are the splenic vein and artery relative to the body of the pancreas?

A

The splenic vein and artery run horizontally superior to or posterior to the body of the pancreas

86
Q

Where is the duodenum relative to the head of the pancreas?

A

The duodenum is superior, right, and inferior to the head of the pancreas (duodenum forms a C around the head of the pancreas)

87
Q

Where is the transverse colon relative to the pancreas?

A

The transverse colon is anterior and inferior to the pancreas

88
Q

Development of the pancreas and its duct system

The pancreas develops from a?

A
  • The pancreas develops from a ventral bud in the ventral mesentery AND a larger dorsal bud in the dorsal mesentery
  • Rotation of the stomach and duodenum brings these buds together and the duct systems unite
89
Q

Pancreatic duct system

  • The major pancreatic duct
    • Joins with the?
A

Bile duct

90
Q

After the major pancreatic duct joins with the bile duct?

A

They enter the 2nd part of the duodenum through a common hepatopancreatic ampulla forming the major duodenal papilla

91
Q

Where does the accessory pancreatic duct enter the duodenum?

A

At the more superior minor duodenal papilla

92
Q

Falciform ligament

A

Double layer of peritoneum that connects liver to the anterior wall

93
Q

Liver-surfaces

-Diaphragmatic surface

A
  • Smooth, fits concavity of diaphragm
  • Peritoneum attaches the liver to the anterior body wall
  • The peritoneum splits to enclose the “bare area” of the liver
94
Q

Liver

-The bare area is defined by?

A
  • Anterior, posterior, left, and right coronary ligaments

- Includes the area where the IVC is posterior to the liver and the hepatic veins drain into it

95
Q

The porta hepatis

-What is it?

A

-A transverse fissure between caudate and quadrate lobes that transmits the portal triad (proper hepatic artery, portal vein, and bile duct)

96
Q

Liver

-Ligamentum venosum-what is it?

A
  • Remnant of the ductus venosus

- Used to connect the umbilical vein with the IVC

97
Q

Liver

-Anatomical lobes?

A

Left, right, caudate, quadrate

98
Q

Liver-Functional lobes?

A

Left and right

99
Q

Gall bladder and biliary tract

-Where is it located?

A

In the hepatic fossa (between right and quadrate lobes)

100
Q

Gall bladder and biliary tract

  • Fundus
    • What part is it?
    • Where is it located?
A
  • The lowest and widest part
  • Contacts anterior abdominal wall at the midclavicular line, 9th or 10th costal cartilage
  • Usually located on the transpyloric line
101
Q

Extrahepatic bile passages?

A

Right and left hepatic duct

102
Q

When the right and left hepatic duct combine they form the?

A

Common hepatic duct

103
Q

When the common hepatic duct combines with the cystic duct they form the?

A

Common bile duct

104
Q

Common bile duct

-Where is it located?

A
  • Runs in the edge of the lesser omentum (hepatoduodenal ligament)
  • Goes posterior and inferior to the 1st part of the duodenum, posterior to the head of the pancreas, enters the 2nd part of the duodenum with pancreatic duct

GI Midterm (11 decks)

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