Abdominal Gastroenterology Flashcards

1
Q

Esophagus

A

Muscular tube running from the Laryngopharynx to the stomach

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2
Q

Esophagus reaches the stomach by passing through the:

A

Esophageal Hiatus of the Thoracic Diaphragm

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3
Q

Phenoesophageal Ligament

A

Anchors the Esophagus to the Esophageal Hiatus of the Thoracic Diaphragm

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4
Q

Esophagus opens into the the ___ of the stomach around the level of the ___ thoracic vertebrae

A
  • Cardia
  • 11th
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5
Q

Thoracic Esophagus

A

Portion of the esophagus above the thoracic diaphragm

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6
Q

Abdominal Esophagus

A
  • Lower portion of the esophagus, inferior to the diaphragm
  • Turns left after passing through the esophageal hiatus and enters the stomach
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7
Q

Esophageal Constrictions

A

Areas where there is narrowing due to the structures the esophagus is passing by

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8
Q

Cervical Constriction (Upper Esophageal Constriction, Pharyngoesophageal Constriction)

A
  • Most superior constrictor of the esophagus
  • Located near the Cricopharyngeus muscle
  • Forms the superior esophageal sphincter which is a physiological sphincter (not an actual sphincter)
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9
Q

Middle Esophageal Constriction (Thoracic Constriction)

A
  • Two-part constriction created as the esophagus
  • Contacts the aorta and left main bronchus
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10
Q

Diaphragmatic Constriction (Lower Esophageal Constriction, Phrenic Constriction)

A
  • Creates the inferior esophageal sphincter (gastroesophageal sphincter)
  • Physiological sphincter, not an actual sphincter
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11
Q

Stomach runs from T___ on the left to L__ on the right

A
  • T10
  • L1
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12
Q

Stomach lies behind the:

A
  • Diaphragm
  • Liver
  • Anterior Abdominal Wall
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13
Q

Stomach lies in front of:

A
  • Posterior Diaphragm
  • Spleen
  • Left Kidney and Suprarenal Gland
  • Pancreas
  • Lesser Sac
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14
Q

Cardia of the Stomach

A
  • Superior part of the stomach containing the opening from the esophagus (cardiac orifice)
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15
Q

Cardiac Orifice

A

Opening for the bolus of food to move from the esophagus into the stomach

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16
Q

Cardiac Notch

A

Depression that separates the esophagus from the fundus of the stomach (lateral to the cardia)

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17
Q

Fundus of the Stomach

A
  • Superior, dome-shaped portion of the stomach sitting in the left dome of the thoracic diaphragm (gastrophrenic ligament)
  • Lateral to the cardia and esophagus
  • Most distal to duodenum
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18
Q

Body of the Stomach

A

Lies between the fundus/cardiac and pyloric parts

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19
Q

Greater Curvature of the Stomach

A

Large, inferior, convex border of the stomach

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20
Q

Structures associated with the Greater Curvature of the Stomach

A
  • Greater Omentum
  • Gastrocolic Ligament
  • Gastrosplenic Ligament
  • Gastroepiploic Vessels
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21
Q

Lesser Curvature of the Stomach

A

Superior, smaller, concave curvature of the stomach

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22
Q

Gastric Folds (Gastric Rugae) of the Stomach

A
  • Longitudinal ridges created by the gastric mucosa inside the stomach
  • Allows for the expansion of the stomach during the consumption of food and drink
  • Helps direct chyme
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23
Q

Pyloric Part of the Stomach

A

Funnel-shaped distal out-flow area of the stomach located right of the midline, close to the liver

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24
Q

Pyloric Antrum

A

Widest portion of the pyloric part of the stomach – like the wide, open part of a funnel that collects everything

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25
Q

Pyloric Canal

A

Narrowing part of the pyloric part of the stomach – like the bottom part of a funnel

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26
Q

Pylorus

A
  • Distal part of the pyloric part of the stomach
  • Allows chyme to move from the stomach into the small intestine (duodenum) via the pyloric sphincter
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27
Q

Pyloric Sphincter

A
  • Created by circular smooth muscle in the pylorus
  • Controls the movement of chyme into the small intestine
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28
Q

3 Parts of the Small Intestine

A

(1) Duodenum
(2) Jejunum
(3) Ileum

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29
Q

Location of Small Intestine

A

Lies between two sphincters/valves – pyloric sphincter and ileocecal valve

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30
Q

Function of Small Intestine

A

Responsible for absorption of nutrients from food (chyme)

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31
Q

Duodenum

A
  • First and shortest part of the small intestine
  • Begins after the pyloric part of the stomach and ends at the duodenojejunal flexure
  • Changes course around the Pancreas
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32
Q

The Duodenum is considered _____ although a small portion is _____

A
  • Retroperitoneal (Secondary Retroperitoneal)
  • Intraperitoneal
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33
Q

4 Parts of the Duodenum

A

(1) Superior
(2) Descending
(3) Inferior
(4) Ascending

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34
Q

Superior Duodenum

A
  • First part of duodenum
  • Connected to the stomach and is one inch in length
  • Intraperiotneal at beginning (ampulla or bulb here) and becomes Retroperitoneal
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35
Q

Structure Associated with the Superior Part of the Duodenum:

A

Hepatoduodenal Ligament (Lesser Omentum)

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36
Q

Structures that are Anterior to the Superior Part of the Duodenum:

A
  • Liver
  • Gallbladder
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37
Q

Structures that are Posterior to the Superior Part of the Duodenum:

A
  • Hepatic Portal Triad
  • Pancreas
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38
Q

Descending Part of the Duodenum

A
  • Second part of duodenum
  • Travels inferiorly around the head of the pancreas
  • Retroperitoneal
  • Connects to the superior and inferior portions of the duodenum
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39
Q

Structure that is Anterior to the Descending Part of the Duodenum:

A

Transverse Colon (Mesocolon)

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40
Q

Structures that are Posterior to the Descending Part of the Duodenum:

A
  • Right Kidney
  • Psoas Major M
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41
Q

Descending Part of the Duodenum marks the transition between:

A

Foregut and Midgut

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42
Q

Hepatopancreatic Ampulla (Ampulla of Vater)

A
  • Area where the bile duct from the biliary system and the main pancreatic duct combine
  • Located medial to the descending part of the duodenum
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43
Q

Major Duodenal Papilla

A
  • Opening of the hepatopancreatic ampulla
  • Allows the bile and pancreatic juices into the descending duodenum
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44
Q

The Major Duodenal Papilla is controlled by the ___ ___ ____ which is made of ___ muscle

A
  • Sphincter of Oddi
  • Smooth Muscle
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45
Q

Minor Duodenal Papilla

A

Opening to the accessory pancreatic duct within the pancreas

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46
Q

Inferior Part of the Duodenum (Horizontal Part, Third Part)

A
  • Runs horizontally along the bottom of the pancreas towards the left; located at L3 vertebral level
  • Connects to the descending portion and the distal ascending portion of the duodenum
  • Part of Midgut
  • Retroperitoneal
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47
Q

Structures that are anterior to the Inferior Part of the Duodenum:

A
  • Superior Mesenteric Artery and Vein
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48
Q

Structures that are posterior to the Inferior Part of the Duodenum:

A
  • IVC
  • Aorta
  • Posas Major M
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49
Q

Structure that is superior to the Inferior Part of the Duodenum:

A

Pancreas

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50
Q

Structure that is inferior to the Inferior Part of the Duodenum:

A

Ileum

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51
Q

Ascending Part of the Duodenum

A
  • Fourth part of the duodenum
  • Runs superiorly in front of the abdominal aorta
  • Turns anteriorly at lower edge of the body of the pancreas then joins with the Jejunum
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52
Q

Dudodenojejunal Flexure

A

Point where the duodenum turns anteriorly and changes from the duodenum into the jejunum

53
Q

Suspensory Ligament of the Duodenum (Ligament of Treitz)

A
  • Ligament that contains peritoneum and muscle fibers that contract to aid in the movement of the intestinal contents along the GI path
  • Runs from the right crus of the diaphragm and the celiac trunk to the duodenojejunal flexure
54
Q

Jejunum

A
  • Second part of small intestine
  • Intraperitoneal
  • Starts at the duodenojejunal flexure and ends at the ileum
55
Q

Jejunum: Distinction- Vascular Supply

A
  • Fewer arterial arcades
  • Longer vasa recta in mesentery
56
Q

Jejunum: Distinction - Internal Structures

A
  • Circular folds (plicae circulares) are larger and closely packed
  • Tends to be less fat within the mesentery
57
Q

Ileum

A
  • Last and longest part of the small intestine
  • Releases its product into the larger intestine
  • Intraperitoneal
  • Neurovascular supply comes from the posterior aspect of the abdominal wall via the mesentery
58
Q

Ileum releases the its products into the ____ via the ___ ___

A
  • Cecum
  • Ileocecal Valve
59
Q

Ileum: Distinction - Vascular Supply

A
  • More arterial arcades
  • Shorter vasa recta within mesentery
60
Q

Ileum: Distinction - Internal Structures

A
  • Circular folds (plicae circulares) are less distinct or absent
61
Q

Large Intestine (Colon)

A
  • Final segment of the GI Tract
  • Water is removed from the chyme to produce feces here
62
Q

7 Segments of the Colon:

A

(1) Cecum
(2) Ascending Colon
(3) Transverse Colon
(4) Descending Colon
(5) Sigmoid Colon
(6) Rectum
(7) Anal Canal

63
Q

Omental Appendices (Epiploic Appendices)

A
  • Small, fat blobs that hang off the large intestione
64
Q

Teniae Coli

A
  • Give the appearance of stripes along the large intestine
  • Made of smooth muscle (external longitudinal layer)
  • Play a part in movement within the large intestine
65
Q

What attaches to the Mesocolic Tenia?

A

Mesocolon

66
Q

What attaches to the Omental Tenia?

A

Omental appendices

67
Q

Haustra

A
  • Sac-like structures along the length of the intestines
  • Help with the movement of chyme through the large intestine
68
Q

Haustra are created by the:

A

Tenia Coli

69
Q

Cecum

A
  • First part of large intestine
  • Pouch lying in the lower right quadrant
  • Begins at the Ileocecal junction and runs into the ascending colon
  • Intraperitoneal
70
Q

Ileocecal Valve

A
  • Structure in the Cecum that controls the passage of chyme from the ileum into the Cecum via the ileocecal orifice
71
Q

Vermiform Appendix

A
  • Pouch like structure (diverticulum) that contains lymphatic tissue
  • Attaches to the posteromedial aspect of the cecum
72
Q

The ___ supports the Vermiform Appendix

A

Mesoappendix

73
Q

Ascending Colon

A
  • Part of large intestine that runs along the right side of the abdominal cavity
  • Secondarily Retroperitoneal (originally suspended in mesentery but lost the mesentery when it adhered to the abdominal wall)
74
Q

What gutter is located between the Ascending Colon and the Abdominal Wall?

A

Paracolic Gutter

75
Q

Right Colic Flexure (Hepatic Flexure)

A
  • The curve the GI Tract takes once the large intestine reaches the right lobe of the liver
  • Located between the Ascending Colon and the Transverse Colon
76
Q

Transverse Colon

A
  • Superior part of the large intestine
  • Intraperitoneal
  • Transitions from midgut (proximal 2/3) to hindgut (distal 1/3)
77
Q

Transverse Mesocolon

A
  • Meso-fold of peritoneum that connects the transverse colon to the posterior wall of the abdomen
  • Provides the pathway for the neurovascular supply to reach the transverse colon
78
Q

Left Colic Flexure (Splenic Flexure)

A
  • The curve the GI Tract takes once the transverse colon reaches the spleen
  • Located higher than the right colic flexure and turns more sharply
79
Q

Phrenicocolic Ligament

A

Runs from the Left Colic Flexure to the Diaphragm

80
Q

The Left Colic Flexure is a transition between ___ and ____ as well as a change in _____ innervation (changes from ____ innervation to ____ ______ innervation)

A
  • Midgut
  • Hindgut
  • Autonomic
  • Vagus
  • Pelvic Splanchnic
81
Q

Descending Colon

A
  • Part of the GI Tract that runs along the left side of the abdominal cavity
  • Secondarily Retroperitoneal
  • Located between the transverse colon (left colic flexure) and the sigmoid colon
82
Q

What gutter is located between the abdominal wall and descending colon?

A

Left Paracolic Gutter

83
Q

Sigmoid Colon

A
  • Part of GI Tract that takes on an S-shaped appearance
  • Intraperitoneal
  • Neurovascular supply runs through the sigmoid mesocolon
  • Sits within the pelvis (iliac fossa); found between the descending colon and rectum
84
Q

Rectosigmoid Junction

A
  • Point where sigmoid colon transitions into the rectum
  • Located around S3
85
Q

Rectum

A
  • Distal part of the GI Tract
  • Continuous with the sigmoid colon
  • Located within the pelvis
  • Follows the curvature of the sacrum and coccyx, and ends with the anal canal
  • Retroperitoneal and subperitoneal
86
Q

Function of the Rectum

A

Storage of feces

87
Q

3 Arterial sources of the Rectum:

A

(1) Superior Rectal A
(2) Middle Rectal A
(3) Inferior Rectal A

88
Q

Transverse Rectal Folds

A
  • Thickened parts of circular muscle within the rectal wall
  • 3 rectal folds: superior, intermediate, inferior
89
Q

Ampulla of the Rectum

A
  • End of the rectum that is dilated and has a pouch-like appearance
  • Stores feces until defecation occurs
90
Q

What two structures support the Ampulla of the Rectum?

A
  • Pelvic Diaphragm (Levator Ani)
  • Anococcygeal Ligament
91
Q

Anorectal Flexure (Anorectal Junction)

A
  • Sharp turn between the rectum and anal canal as it passes through the pelvic wall (levator ani muscles)
  • Helps with continence
  • Marks the transition between the distal rectum and anal canal
92
Q

Anal Canal

A
  • Runs between the rectum and the anus within the pelvic diaphragm
  • About 3-5cm long
  • Begins at the anorectal flexure
93
Q

Internal Anal Sphincter

A

Involuntary layer of muscle surrounding the upper aspect (2/3) of the anal canal (modification of the circular muscle layer)

94
Q

Internal Anal Sphincter remains _____ by the ___ ___ plexus

A
  • Contracted
  • Inferior Hypogastric Plexus (sympathetic innervation)
95
Q

External Anal Sphincter

A

Voluntary, skeletal muscle sphincter surrounding the lower portion of the anal canal

96
Q

External Anal Sphincter is anchored by the ___ ___ and ____ ____

A
  • Perineal Body
  • Anococcygeal Ligament
97
Q

External Anal Sphincter: Innervation

A

Inferior Rectal N – branch of the Pudendal N

98
Q

Anal Column (Columns of Morgagni)

A
  • Folds of the mucus membrane running longitudinally within the anal canal
  • Surround the branches of the superior rectal artery and vein
99
Q

Anal Valve

A
  • Folds within the anal mucosa at the inferior end of the anal columns
  • Pouch-like structures that surround the anal sinus
100
Q

Anal Sinus (Anal Crypt)

A

Spaces that end in glands

101
Q

Anal Glands

A

Produce mucus when compressed that helps with fecal movements

102
Q

Pectinate Line (Dentate Line, Anorectal Line)

A
  • Found at the inferior aspect of the anal valves
  • Demarcates the embryological origins of the anal canal
103
Q

Superior to the Pectinate Line, the anal canal derives from the embryological ____ while the inferior aspect comes from the ____

A
  • Hindgut
  • Proctodeum

*these two parts have different innervation, vascularization, histology and lymphatic drainage

104
Q

Anus (External Anal Orifice)

A

Opening of the GI Tract in the Anal Triangle, posterior to the perineum

105
Q

Liver

A
  • Largest internal gland in the body
  • Secretes bile which helps emulsify fat
  • Located in the upper right quadrant immediately underneath the thoracic diaphragm (top of liver around the Xiphisternal Joint)
106
Q

The GI Tract venous flow goes to the ___ before entering the circulatory system (___ ____ ___) to process the blood and store glycogen.

A
  • Liver
  • Portal Venous System
107
Q

Diaphragmatic Surface of the Liver

A

Superior convex portion of the liver

108
Q

Bare Area of the Liver

A
  • Located on the superoposterior aspect of the liver, to the right of the IVC
  • Part of the liver that is not covered by the peritoneum which allows the liver to directly contact the diaphragm
109
Q

Coronary Ligament of the Liver

A
  • Reflection of the peritoneum from the superior surface of the liver to the diaphragm
110
Q

The ___ and ___ ___ ligaments stem from the Coronary Ligament of the Liver; created by the fusion of the coronary ligaments around the bare area

A

Right and Left Triangular Ligaments

111
Q

Left Triangular Ligament is associated with the ___ of the liver (___ lobe)

A
  • Apex
  • Left
112
Q

Visceral Surface of the Liver

A
  • Inferior portion of the liver
  • Covered by the visceral peritoneum
  • Associated with the lesser omentum and the gallbladder (fossa of the gallbladder)
113
Q

Porta Hepatis

A
  • Fissure on the inferior surface of the liver
  • Houses the Hepatic Portal Vein, Hepatic Artery, lymph, Hepatic Nerve Plexus, and Hepatic Ducts
114
Q

The Portal Triad contains:

A
  • Bile Duct
  • Hepatic Artery
  • Hepatic Portal Vein
115
Q

What structures pass through the Hepatoduodenal Ligament (lesser omentum) to reach the liver?

A
  • Bile Duct
  • Hepatic Artery
  • Hepatic Portal Vein
116
Q

Round Ligament of the Liver (Ligamentum Teres Hepatis) forms from the:

A

Left umbilical vein

117
Q

During development, the left umbilical vein travels from the ___ to the ___ _____

A
  • Umbilicus
  • Portal Vein
118
Q

Round Ligament of the Liver (Ligamentum Teres Hepatis): Location

A

Inferior aspect of the Falciform Ligament

119
Q

Ductus Venosus

A

Shunts blood from the left portal vein to the left hepatic vein, bypassing hepatic circulation
- After birth it degrates

120
Q

Ligamentum Venosum

A
  • Remnant of the embryonic structure Ductus Venosus
  • Runs from the portal vein to the IVC
  • Helps in separating the Left Lobe of the Liver from the Caudate Lobe
121
Q

How many functional segments of the liver are there? What are these segments based on?

A
  • 8
  • Blood supply
122
Q

Falciform Ligament

A
  • Reflection of the peritoneum
  • Connects the liver to the anterior abdominal wall
  • Located superior to the umbilicus
  • Runs from the superior abdominal wall to the anterior and superior aspects of the liver
  • Helps separate the liver into two main lobes
123
Q

Falciform Ligament covers the ___ ___ of the liver and ___-____ veins

A
  • Round Ligament
  • Para-umbilical
124
Q

Near the diaphragm, the Falciform Ligament fuses with the ___ ____ __ and the ___ ___ on the right.

A
  • Left Triangular Ligament
  • Coronary Ligament
125
Q

Which Lobe of the Liver is larger, Right or Left?

A

Right

126
Q

The ____ sits on the inferior surface of the right lobe of the liver, in the ___ ___.

A
  • Gallbladder
  • Gallbladder Fossa
127
Q

Quadrate Lobe of the Liver

A
  • Located on the R side of the anterior liver
  • Located between the gallbladder and the porta hepatis
128
Q

Caudate Lobe of the Liver

A
  • Located on the R side of the posterior liver
  • Surrounded by the Lesser Omentum, IVC and Porta Hepatis
129
Q

Left Lobe of the Liver

A

Smaller lobe to the left of the falciform ligament