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Gastrointestinal System Step 1 > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Retroperitoneal structures

A

GI structures that lack a mesentery and non GI structures:

Suprarenal glands
Aorta and IVC
Duodenum (2nd to 4th parts)
Pancreas(exc tail)
Ureters
Colon(descending and ascending)
Kidneys
Esophagus(thoracic portion)
Rectum (partially)
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2
Q

Falciform ligament function

A

Connects liver to anterior abdominal wall

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3
Q

Falciform ligament – structures contained

A

ligamentum teres hepatis (derivative of fetal umbilical vein)

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4
Q

Falciform ligament origin

A

Derivative of ventral mesentery

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5
Q

Hepatoduodenal ligament function

A

Connects liver to duodenum

it is part of lesser omentum

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6
Q

Hepatoduodenal ligament– structures contained

A

Portal triad:

  1. proper hepatic artery
  2. portal vein
  3. common bile duct
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7
Q

What is the Pringle maneuver?

A

Ligament may be compressed between thumb and index finger to control bleeding.
Used to stop bleeding from the liver

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8
Q

Gastrohepatic ligament function

A

Connects liver to lesser curvature of the stomach

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9
Q

Gastrohepatic ligament- Structures contained

A

Gastric arteries

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10
Q

Gastrocolic ligament- Function

A

Connects greater curvature and transverse colon

it is part of greater omentum

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11
Q

Gastrocolic ligament- contains

A

gastroepiploic arteries

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12
Q

Gastrosplenic ligament Function

A

Connects greater curvature and spleen

part of greater omentum

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13
Q

Gastrosplenic ligament — Structures contained

A

Short gastrics

Lest gastrepiploic vessels

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14
Q

Splenorenal ligament Function

A

Connects spleen to posterior abdominal wall

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15
Q

Splenorenal ligament - structures contained

A

Splenic artery and vein

tail of pancreas

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16
Q

Where is Meissner’s nerve plexus located?

A

Submucosa

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17
Q

Which part of the gut wall secrete fluid?

A

Submucosa

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18
Q

Serosa vs adventitia

A

Serosa when intraperitoneal

Adventitia when retroperitoneal

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19
Q

Pacemaker of the GI tract

A

Cajal cells

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20
Q

Frequencies of basic electrical rhythm (slow waves) of the GI tract

A

Stomach: 3/min
Duodenum: 12/min
Ileum: 8-9/min

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21
Q

Epithelium of the esophagus

A

Nonkeratinized stratified squamous epithelium

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22
Q

Function of Brunner Glands of the duodenum

A

HCO3- secreting cells of the mucosa

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23
Q

Where are crypts of Lieberkuhn located?

A

Duodenum
Jejunum
Ileum
Colon

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24
Q

What do crypts of Lieberkuhn contain?

A

stem cells

paneth cells that secrete lysozyme, defensins and TNF

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25
Q

Gross anatomy of jejunum

A

Contains plicae circulares (folds)

They are also present in distal duodenum and proximal ileum

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26
Q

What are Peyer patches? Where are they located?

A

Lymphoid aggragates in lamina propria and submucosa of ileum

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27
Q

Where is the largest number of Goblet cells in the small intestine?

A

ileum

28
Q

Level of Celiac artery

A

T12

29
Q

Level of SMA

A

L1

30
Q

Level of IMA

A

L3

31
Q

Level of bifurcation of the aorta

A

L4

32
Q

SMA syndrome

A

Intermittent intestinal obstruction symptoms when transverse (THIRD portion) of duodenum is compresed
Associated with low mesenteric fat

33
Q

Foregut artery supply

A

Celiac

34
Q

PNS innervation of the gut

A

Foregut and Midgut–> Vagus

Hindgut–> Pelvic

35
Q

Difference between anterior and posterior duodenal ulcer

A

Posterior ulcer penetrate gastroduodenal artery causing hemorrhage

Anterior perforate into abdominal cavity–> potentially lead to pneumoperitoneum

36
Q

Portosystemic anastomoses

A
  1. left gastric vein—>esophageal vein–> azygos
  2. paraumbilical—> small epigastric veins of anterior abdominal wall (CAPUT MEDUSAE)
  3. Superior rectal—> middle and inferior rectal
  4. TIPS
37
Q

Where is pectinate line formed?

A

Where endoderm (hindgut) meets extoderm.

38
Q

Above pectinate line– arterial supply and venous drainage, lymph drainage, innervation

A

superior rectal artery (branch of IMA)

superior rectal vein–> inferior mesenteric vein–> splenic vein–> portal vein

Lymph to internal iliac lymph nodes

Receive splachnic innervation–> not painful

39
Q

Below pectinate line– arterial supply and venous drainage, lymph drainage, innervation

A

inferior rectal artery (branch of internal pudendal artery)

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

Lymph to superficial inguinal nodes

Receive somatic innervation (inferior rectal branch of pudendal nerve)–> painful if thrombosed

40
Q

Anal fissure- what is it and location

A

tear in the anal mucosa below pectinate line

located posteriorly and is poorely perfused

41
Q

Anal fissure symptoms

A

Pain while pooping, blood on toilet paper

42
Q

Femoral triangle contents

A

Contains femoral nerve, artery, vein (venous near penis)

43
Q

Zones of hepatic parenchyma

A

Zone 1: periportal
Zone 2: intermediate
Zone 3: pericentral vein/ centrilobular

44
Q

Zone 1 of liver parenchyma

A

Periportal zone
Affected first by viral hepatitis
Ingested toxins

Makes sense because the portal vein connects the intestine to the liver

45
Q

Zone 2 of hepatic parenchyma

A

Affected by yellow fever

46
Q

Zone 3 of hepatic parenchyma

A

Affected first by ischemia
Contains cytochrome P450
Most sensitive to metabolic toins
Site of alcoholic hepatitis

47
Q

Role of hepatic stellate cells

A

Store Vit A when inactive

produce extracellular matrix when activated

48
Q

What are Kuppfer cells? Where are they located?

A

specialized macrophages

Form the lining of sinusoids

49
Q

Surfaces of hepatocytes

A

Apical faces bile canaliculi

Basolateral faces sinusoids

50
Q

Blood flow vs bile flow in the liver

A

Blood goes from portal triad to central vein

Bile goes the other way around

51
Q

What does the femoral sheath contain?

A

It is a fascial tube 3-4 cm below inguinal ligament
Contains
femoral vein, artery and canal (deep inguinal lymph nodes) BUT NOT FEMORAL NERVE

52
Q

Boundaries of femoral triangle

A

Superior: Inguinal ligament
Medial: adductor longus muscle
Lateral: sartorius muscle

53
Q

Sliding vs paraesophageal hiatal hernia

A

Sliding: most common
Stomach herniates through the esophageal foramen and gastroesophageal junction is displaced upward–> hourglass stomach

Paraesophageal–> gastroesophageal junction is normal
Fundus protrudes through stomach

54
Q

Indirect inguinal hernia– what is the pathway herniated stuff goes through?

A

INternal inguinal ring—>
extrenal inguinal ring—>
IN scrotum

It it the pathway of the descent of the testes

55
Q

Relation of indirect inguinal hernia to inferior epigastric vessels

A

It is lateral to them

56
Q

Indirect inguinal hernia – patient population where it is common

A

INfants due to failure of processus vaginalis to close (can form hydrocele)

57
Q

indirect inguinal hernia- what surrounds it?

A

covered by all layers of spermatic fascia

58
Q

Direct Inguinal Henia– site of protrusion

A

Hesselbach triangle

Goes through external inguinal ring only

59
Q

Relation of direct inguinal hernia to inferior epigastric vessels

A

Medially

but lateral to rectus abdominis

60
Q

direct inguinal hernia- what surrounds it?

A

external spermatic fascia

61
Q

indirect inguinal hernia- patient population that it affects?

A

older men due to acquired weakness in the transversalis facsia

62
Q

Femoral hernia— site of protrusion

A

Below inguinal ligament through femoral canal and lateral to pubic tubercle.

63
Q

Femoral hernia– presentation

A

More ikely to present with incarceration or strangulation

than inguinal hernias

64
Q

Femoral hernia–Patient population it affects more

A

Women (but inguinal are more common overall)

65
Q

Hesselbach triangle

A

inferior epigastric veins
inguinal ligmanent
lateral border of rectus abdominis

Gastrointestinal System Step 1 (5 decks)

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