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5/24 GI Flashcards

(67 cards)

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1
Q

midgut development

A

6th week midgut herniates through umbilical ring

10th- returns to abdominal vacity and roates around SMA 270 degrees clockwise

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2
Q

duodenal atresia

A

failure to recanalize–> dilate stomach and prox duodenum

down’s- double bubble

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3
Q

jejunal and ileal atresia

A

disrupt mesenteric vessels–> ischemic necrosis–> segmental resorption

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4
Q

retroperitoneal structures

A

Suprarenal (adrenal) glands
Aorta, IVC
Dudenum (2nd-4th)

Pancreas (except tail)
Ureters
Colon (ascending and descending)
Kidneys
Esophagus (thoracic)
Rectum
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5
Q

falciform ligament

A

liver to anterior abdominal wall

ligamentum teres

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6
Q

hepatoduodenal ligament

A

liver to duodenum

contains portal triad

pringle manuever- control bleeding

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7
Q

gastrohepatic ligament

A

liver to lesser curve of stomach

carries gastric arteries

separates greater and lesser sacs on the right

cut during surgery to access lesser sac

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8
Q

Gastrocolic ligament

A

greater curvature and transverse colon

carries gastroepiploic arteries

part of greater omentum

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9
Q

gastrosplenic ligament

A

greater curvature and spleen

carries short gastrics, left gastroepiploic vessels

separates greater and lesser sacs on the left

part of greater omentum

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10
Q

splenorenal ligament

A

spleen to posterior abdominal wall

carries splenic artery and vein, tail of pancreas

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11
Q

ulcers vs erosions

A

erosions- only mucosa

ulcers- all the way through submucosa and muscularis layer

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12
Q

abdominal aorta branches in order

A 
T12- celiac trunk, middle suprarenal
L1- SMA, 
L1-L2- renal, gonadal
L3-IMA
L4- bifurcation into iliacs
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13
Q

what does celiac trunk supply?

A

foregut!

pharynx, lower esophagus to proximal duodenum

mesoderm- liver, gallbladder, pancreas, spleen

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14
Q

what does SMA supply

A

midgut! distal duodenum to proximal 2/3 of transverse colon

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15
Q

what does IMA supply

A

hindgut! distal 1/3 of transverse colon to upper rectum

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16
Q

3 main branches of celiac trunk

A

common hepatic
splenic
left gastric

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17
Q

which arteries anastomose in esophageal varices?

A

left gastric– azygos

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18
Q

which arteries anastomose in caput medusae?

A

paraumbilical– small epigastric veins of anterior abdominal wall

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19
Q

which arteries anastomose in anorectal varices

A

superior rectal— middle and inferior rectal

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20
Q

what is the treatment for portal hypertension

A

TIPS- transjugular portosystemic shunt- shunts blood to systemic circulation bypassing the liver

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21
Q

pectinate line

A

where hindgut of endoderm meets ectoderm

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22
Q

arteries, veins, lymphatics of above pectinate line in rectum

A

superior rectal artery

superior rectal vein –> IMV –> portal

lymph- internal iliac nodes

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23
Q

arteries, veins, lymphatics of below pectinate line in rectum

A

inferior rectal artery (pudendal branch)

inferior rectal vein –> internal iliac vein –> common iliac vein –> IVC

lymph- superior inguinal nodes

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24
Q

hepatic space of disse

A

store vitamin A

produce ECM

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25
zone 1 of liver most affected by
viral hepatitis | ingested toxins
26
zone 2 of liver most affected by
yellow fever
27
zone 3 most affected by
(centrilobular) - ischemia - cyt p450--> metabolic toxins - alcoholic hepatitis
28
3 layers of spermatic cord
ICE Internal spermatic fascia (transversalis fascia) Cremasteric muscle and fascia (internal oblique) External spermatic fascia (external oblique)
29
diaphragmatic hernia
causes: trauma; congential defect in pleuroperitoneal membrane mostly on left side (no liver protection) - -sliding hiatal hernia (GEJ displaced) - -paraesophageal hernia (fundus protrudes)
30
which layer of spermatic cord is direct hernia covered by
external spermatic fascia (whereas indirect hernia has all 3 layers)
31
what are the 3 sides of hesselbach triangle
inferior epigastric arteries lateral border of rectus abdominis inguinal ligament (where direct hernias are)
32
where is CCK made
I cells of duodenum and jejunum
33
where is secretin made and function
S cells of duodenum increases pancreatic bicarb and bile secretion decreases gastric acid
34
glucose-dep insulinotropic peptide source and function
K cells (duodenum, jejunum) decreases gastric acid secretion increases insulin release (why oral glucose leads to more insulin release than IV)
35
motilin souce and function
small intestine produce migrating motor complexes during fasting state
36
vasoactive intestinal peptide source and function
parasympathetic ganglia in sphincters, gall bladder, and small intestine (vagal stim.) increases intestinal water and electrolyte secretion relaxes intestinal smooth muscle and sphincters
37
VIPoma
islet pancreatic tumor- secretes VIP watery diarrhea hypokalemia achlorhydria
38
pancreatic secretions types
alpha amylase lipases proteases trypsinogen
39
what is high in low flow in pancreatic secretions and what is high in high flow
low flow --> high Cl high flow --> high HCO3
40
apthous ulcer
painful superficial ulcer due to stress gray base surrounded by erythema
41
behcet syndrome
recurrent apthous ulcers, genital ulcers, uveitis due to immune complex vasculitis of small vessels
42
sialadenitis
inflammation of salivary gland stone obstruction --> staph aureus
43
pleomorphic adenoma
benign mixed tumor (most in parotid) chondromyxoid stroma (cartilage) and epithelium (glands) recurs if not excised completely (irregular border)
44
warthin tumor
papillary cystadenoma lymphomastum- benign, cystic with germinal centers parotid gland mostly
45
mucoepidermoid carcinoma
malignant salivary tumor (parotid) mucinous and squamous facial nerve - pain or paralysis
46
lymph node spread in upper 1/3 of esophagus
cervical nodes
47
lymph node spread in middle 1/3 of esophagus
mediastinal | tracheobronchial
48
lymph node spread in lower 1/3 of esophagus
celiac and gastric nodes
49
complications of ulcer
---hemorrhage: if gastric--> lesser curvature--> left gastric artery if duodenal--> posterior--> gastroduodenal artery ---obstruction ---perforation: anterior duodenum free air under diaphragm- referred pain to shoulder
50
vit E deficiency symptoms
ataxia impaired prioception and vibratory sense hemolytic anemia look out for some form of malabsorption in anecdote
51
Abetapoproteinemia
MTP mutation --> defect in apoliprotein B (absent chylmicrons, VLDL) --> lipids cant be absorbed --> accumulate in intestinal epithelium --> enterocytes with clear/foamy cytoplasm --> malabsorption of fat-sol vitamins, neuro problems, acanthocytes
52
acute hep A on histo
hepatocyte ballooning degeneration and apoptosis with mononuclear cell infiltrate
53
how do people with crohn's get gallstones
ileum inflamm--> cant absorb bile acids --> higher cholesterol: bile acids --> gallstones
54
riboflavin deficiency
(seen in alcoholics) precursor for FAD, FMN --> TCA (succinate dehydrogenase ) and ETC symptoms: angular stomatitis, chelitis, glossitis, eye changes, anemia, seborrheic dermatitis
55
surgical landmark for appendectomy
taenia coli- to its origin at cecal base
56
how do you test for malabsorptive disorders
fat malabsorption most sensitive (since fats earliest affected usually) Sudan III stain
57
diagnosis and treatment of hirschsprung disease
diagnose: rectal suction biopsy- see no ganglion cells in submucosa treatment: resection
58
angiodysplasia
tortuous dilatation of blood vessels--> hematochezia in cecum, right colon elderly
59
ileus
intestinal hypomotility without obstruction associations: surgery, opiates, hypokalemia, sepsis
60
meconium ileus
in CF: meconium plug obstructs intestine --> blocks stool from passing
61
cancers associated with lynch syndrome
colorectal ovarian endometrial skin
62
lab finding in HCC
increased AFP
63
mallory bodies
seen in alcoholic hepatitis esoinophilic inclusions of damaged keratin filaments
64
somatostatin functions
decrease gastric acid and pepsinogen decrease pancreatic and small intestine fluid secretion decrease gall bladder contraction decrease insulin and glucagon release
65
diseases that are p-ANCA besides vasculitis
ulcerative colitis | primary sclerosing cholangitis
66
c dif toxins
inactivate Rho regulatory proteins in actin cytoskeleton structure maintenance --> disrupt tight junctions --> fluid secretion
67
how does lactose intolerance lead to acidic stool
fermenting undigested lactose by gut bacteria --> short chain fatty acids --> acidify stool --> hydrogen produced

Wrongs (36 decks)

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