Anatomy- GI bleeds Flashcards

(56 cards)

1
Q

what is the colon made of from proximal to distal

A

appendix, caecum, ascending colon, transverse colon, descending colon, sigmoid colon

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2
Q

what makes up the large intestine

A

colon, rectum, anal canal and anus

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3
Q

what are the functions of the large intestsine

A

defence- commensal bacteria

absorption- H20 and electrolytes

excretion- of formed stool

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4
Q

how mobile is the colon and why

A

depends on part

transverse and end of descending is intraperitoneal (has own mesentery) so mobile

middle of ascending and descending secondarily retroperitoneal

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5
Q

what are the paracolic

A

on both sides between lateral edge of ascending and descending colon and abdominal wall- part of greater sac of peritoneal

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6
Q

what is the role of the paracolic gutters

A

potential sites for pus collection

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7
Q

what lies more superior to splenic ot hepatic flexure

A

splenic- if not could be splenomegaly

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8
Q

what are haustra

A

coils in colon formed by tonic contraction of the teniae coli

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9
Q

what is the teniae coli

A

3 distinct longitudinal bands of thickened smooth muscle running from the caecum to the distal end of the sigmoid colon- combine at the appendix. where contraction occurs

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10
Q

what are where are the omental appendices

A

small fatty projections- not on small intestine or rectum

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11
Q

what causes the mottling in the rectum on an x ray

A

faeces

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12
Q

what is used as a contrast in a GI xray and how is it administered

A

barium via an enema

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13
Q

what quadrant and the caecum and appendix in

A

right iliac fossa

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14
Q

describe the position of the appendix

A

variable, most often retrocaecal

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15
Q

what can explain the different presentations of a appendicitis

A

the variety in appendix position

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16
Q

where is maximum tenderness (in theory) felt in an appendicitis

A

appendiceal orifice on posterior wall of caecum- 1/3 of the way between right asis to umbilicus

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17
Q

which quadrant is the sigmoid colon in

A

left iliac fossa

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18
Q

what is the sigmoid mesocolon

A

mesentery of the sigmoid colon

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19
Q

what is a sigmoid volvulus

A

when sigmoid mesocolon twists around itself which can result in bowl obstruction and infarction

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20
Q

where is the aorta found

A

Midline, retroperitoneal structure

Lies anterior to vertebral bodies and to left of IVC

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21
Q

what are the three midline branches of the aorta and what do they supply

A

Celiac trunk (foregut organs)
Superior mesenteric artery (midgut organs)
Inferior mesenteric artery (hindgut organs)

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22
Q

what do the lateral branches of the aorta supply

A
Kidneys/adrenal glands
Gonads (Testes/Ovaries)
Body wall (Posterolateral)
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23
Q

where does the aorta bifurcate into the common iliacs

A

at L4 (iliac crest)

24
Q

what does the common iliac bifurcate into

A

internal and external iliacs

25
where does the celiac trunk leave aorta
t12
26
where does the renal artery leave aorta
L1
27
where does the SMA leave aorta
L1
28
where does the gonadal artery leave the aorta
L2
29
where does the IMA leave the aorta
L3
30
what does the appendicular artery run within
the mesoappendix
31
describe the jejunum vasculature
longer vasa rectae | larger and fewer arcades
32
descibe the ileum vasculature
shorter vasa rectae, smaller and many arcades
33
what does rectus mea
straight
34
what is the marginal artery of drummond
made of arterial anastomoses between the branches of the SMA and the IMA which help prevent intestinal ischaemia by providing an alternative route by which blood can travel
35
where does the superior rectal artery come from
IMA
36
where does the hind gut extend to
the proximal half of the anal canal (pectinate line)
37
what supplies the distal half of the anal canal
inferior iliac artery (anastomses of hind gut and body wall vasculature)
38
what are the two main venous systems
hepatic portal (gi to liver for cleaning) systemic(organs and tissues to IVC)
39
where is the IVC and what does it do
retroperitoneal | Drains cleaned blood from the hepatic veins into the right atrium
40
what does the hepatic portal vein
Drains blood from foregut, midgut and hindgut structures to the liver for first pass metabolism
41
what is the role of the splenic vein
Drains blood form foregut structures to hepatic portal vein
42
what is the role of the superior mesenteric vein
Drains blood from midgut structures to hepatic portal vein
43
what is the role of the inferior mesenteric vein
Drains blood from hindgut structures to splenic vein
44
what is the function of the portal- systemic anastamosis
venous anastomosis between the systemic and the portal venous systems. At these sites, the presence of small collateral veins means blood can flow both ways - no vlaves - v little blood in collateral veins - can go either into systemic/ portal system
45
where are the portal systemic anastomoses
- skin around umbilicus - distal end of the oesophagus - rectum/ anal canal
46
describe the portal systemic anastomoses at the skin around the umbilicus
connection between para-umbilical veins and small epigastric veins
47
what system do the epigastric veins drain into
the caval system
48
what is the caval system
systemic blood flow (vena cava)
49
where does the inferior part of the distal end of the oesophagus drain into
the hepatic portal vein
50
where does the superior part of the distal end of the oesophagus drain into
azygous vein
51
where does the rectum and superior mesenteric vein drain into
superior rectal vein to inferior mesenteric vein
52
where does the inferior anal canal drain into
the inferior rectal vein to internal iliac veins
53
where does the middle rectum drain into
middle rectal vein and internal iliac vein
54
what are the clinical presentations of portal hypertension
oesophageal varices, caput medusae, rectal varices
55
what is caput medusae
dilated para-umbilical and dilated epigastric veins
56
give two examples of a cause of haematemesis
peptic ulcer that erodes through the mucosa bleeding from oesophageal varices