5 DSA Organs of The GI Tract Flashcards by Brett Niles

At what level does the esophagus enter the diaphragm

T10

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At what level does the esophagus enter the stomach

T11 at the cardiac orifice

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The upper esophageal sphincter is the

Cricopharyngeus m

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What are the constrictions of the esophagus

Cervical constriction (upper esophageal sphincter)

Thoracic (broncho-aortic constriction)

Diaphragmatic constriction

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What is a hiatal hernia

When portions of the stomach push through the diaphragm

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What are the 2 types of hiatal hernias

Para-esophageal and sliding

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Which hiatal hernia is characterized by regurgitation

Sliding, and this type is more common

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During a para-esophageal hiatal hernia, what do we find piercing the diaphram

Peritoneum and fundus

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During a sliding hiatal hernia, what do we find piercing the diaphragm

Esophagus, cardia, fundus

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Which hiatal hernia is exacerbated upon bending over or laying down

Sliding

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what are the portions of the stomach from esophagus to duodenum

cardia –> fundus –> body –> pyloric antrum –> pyloric canal –> pylorus –> duodenum

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what is touching the anterior portions of the stomach

left lobe of liver (along lesser curvature)
diaphragm (along greater curvature)
anterior wall (along lower greater curvature)

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what touches the posterior surface of the stomach

diaphragm, spleen, left adrenal gland, left kidney, pancreas, transverse colon, transverse mesocolon, lesser sac

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what are the parts of the small intestine

duodenum, jejunum, ileum

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what are the parts of duodenum

1st (superior)
2nd (descending)
3rd (horizontal or inferior)
4th (ascending)

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what parts of the duodenum are retroperitoneal? what are the other parts?

2-4 are retroperitoneal, 1 is intraperitoneal

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when you get posterior duodenal ulcers, what artery can be affected

gastroduodenal A is posterior to the first part of the duodenum

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where does the bile duct and the mean pancreatic duct meet

hepatopancreatic ampulla

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where does the bile duct and the pancreatic duct enter the duodena?

at the duodenal papilla towards the end of the 2nd portion of the duodenum

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where is the 4th part of the duodenum anchored to? by what?

right crus of the diaphragm; the suspensory ligament of the duodenum (of Treitz)

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tumors in what portion of the pancreas can block the bile duct

the head

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what portion of the bile duct does not everyone have

accessory pancreatic duct

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what is nutcracker syndrome

a syndrome where the left renal vein can be compressed between the SMA and aorta. this can lead to renal venous hypertension and hematuria

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what portion of the SI is characterized with thick and heavy walls

jejunum

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what portion of the SI has less circular folds

ileum

what portion of the SI has more lymph nodes

ileum

what level is the R colic flexure

what is the most common anomaly of the SI

meckels diverticulum

what is meckel's diverticulum

it is a remnant of the vitelline duct

what does meckel's diverticulum look like

appendicitis

what levels does the mesentery occupy

L2-5

what are the muscles which form haustrae (pockets) in the LI

taenia coli

what is the L colic flexure also called

splenic flexure

what are the regions of the colon

``` cecum (beginning) appendix ascending colon right colic (hepatic) flexure transverse colon left colic (splenic) flexure descending colon sigmoid colon rectum anal canal ```

what are epicloicae or omental appendices

tags of fat that are characteristic of the LI

what portion of the LI has no eplicloic appendages

cecum

what is the opening of the ileum to the cecum

illeal papilla

what peritoneal classification are the LI poritons

Ascending - 2° retroperitoneal transverse - intraperitoneal descending - 2° retroperitoneal sigmoid - intraperitoneal

where is diverticulosis most commonly found

sigmoid colon

what is volvulus of sigmoid colon

twisting of the colon causing constipation, possible fecal compaction, possible ischemia, and possible necrosis

what peritoneum status is the rectum

retro- and sub-peritoneal

is the spleen retro or intraperitoneal

intra

where is the spleen

parallels L ribs 9-11

what ligaments are on the spleen

gastrosplenic and splenorenal

where is the pancreas located

L1-2

what portions of the pancreas are retroperitoneal

head, neck, body, but NOT the tail

if there is an accessory pancreatic duct where does it enter

superior to the duodenal papilla

what ligament splits the liver in 2

falciform

what are the anatomic lobes of the liver

left, right, caudate (superior), quadrate (inferior)

what re the functional lobes of the liver

``` Segment I - caudate lobe Segment II - left posterior lateral (L) Segment III - left anterior lateral (L) Segment IV - left medial segment (L) Segment V - right anterior medial (R) Segment VI - right anterior lateral (R) Segment VII - right posterior lateral (R) Segment VIII - right posterior medial (R) ```

what line divides the functional left and right liver

cantlie

what determines the functional liver lobes

branching of the portal vein and the hepatic A

what portion of the liver has a left functional lobe and right anatomical lobe

part 4

the round ligament of the liver is a remnant of what

L umbilical V

what ligaments form the lesser omentum

hepatoduodenal and hepatogastric ligaments

what surface transmits the portal triad

porta hepatis (fissure between quadrate and caudate lobes)

what is the portal triad made of

proper hepatic A portal V bile duct

what is the ligamentum teres

oblirerated umbilical v

what is the ligamentum venosum

obliterated ductus venosus which used to connect the umbilical vein to the IVC

what two things meeting form the common bile duct

cytstic duct + common hepatic duct (L + R hepatic ducts)

what are the portions the gallbladder

fundus (most inferior) body neck (where the cystic duct forms)

what are gallstones called

cholelithiasis (made of cholesterol)

where can gallstones become lodged

cystic duct (main), hepatic duct, hepatopancreatic ampulla

what sign is positive for a blockage of the cystic duct

murphys sign

where would pain be felt for a cystic duct blockage

right ribs, also referred to back and epigastric

what can a block of the hepatopancreatic ampulla cause

block the bile and pancreatic ducts, bile can backup into pancreas and cause pancreatitis, jaundice

where are adhesions between the gallbladder likely to form

transverse colon, duodenum, diaphragm

when a stone enters the superior duodenum, where is it likely to cause issues

ileocecal junction

What is annular pancreas

Pancreas wraps around the 2nd portion of the duodenum - can cause bilous vomiting if below the papilla - low birth weight