Keim CIS Flashcards
left lower quadrant pain that started infra scapular region and radiated to groin? potential diagnosis?
Kidney stone
Pyelonephritis
urine dipstick positive for blood?
kidney stone, kidney infection.
innervation of the ureters?
what nerve plexus would be involved?
visceral or somatic pain?
T11 to L1 –> L2 maybe.
Aorticorenal ganglion –> renal plexus superior
superior hypogastric plexus –> especially as the ureter goes down to the aorta.
aortic plexus too.
visceral pain
What is the blood supply to the ureters?
ureteric branches of the renal artery
branches from the abdominal aorta
gonadal A.
just blood supply kind of
4 anastomotic connections for portal hypertension
paraumbilical v and epigastric veins
left gastric v and esophageal v
superior and inferior rectal veins
colic veins with retroperitoneal veins
why are internal hemorrhoids not painful?
above the pectinate line, where do visceral afferents travel with?
visceral and the lining is not of the skin! so visceral afferents pick up ischemia, obstruction, stretch.. those kinds of things.
parasympathetics
below the pelvic pain line is where in the GI?
half way through the sigmoid colon.
Caval to Caval anastomoses connection?
if we occlude the IVC and blood can no longer go up.. we need another route to get up to the heart.
lumbars can ascend and go into the azygos system and then through the IVC
common iliac can go to inferior epigastric veins to superior epigastric veins, to the internal thoracic and back into the IVC
If we block the SMA, what could be problematic?
ileum, jejunum, transverse colon, right colon, cecum, appendix,
marginal could probably save most of the transverse but you would be screwed with the splenic flexure.
Celiac trunk, retroperitoneal or intraperitoneal?
common hepatic?
proper hepatic
retro
retro
intraperitoneal + runs through hepatoduodenal ligament.
