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GI > Anatomy- GI bleeds > Flashcards

Anatomy- GI bleeds Flashcards

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
Q

where does the celiac trunk leave aorta

A

t12

26
Q

where does the renal artery leave aorta

A

L1

27
Q

where does the SMA leave aorta

A

L1

28
Q

where does the gonadal artery leave the aorta

A

L2

29
Q

where does the IMA leave the aorta

A

L3

30
Q

what does the appendicular artery run within

A

the mesoappendix

31
Q

describe the jejunum vasculature

A

longer vasa rectae

larger and fewer arcades

32
Q

descibe the ileum vasculature

A

shorter vasa rectae, smaller and many arcades

33
Q

what does rectus mea

A

straight

34
Q

what is the marginal artery of drummond

A

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
Q

where does the superior rectal artery come from

A

IMA

36
Q

where does the hind gut extend to

A

the proximal half of the anal canal (pectinate line)

37
Q

what supplies the distal half of the anal canal

A

inferior iliac artery (anastomses of hind gut and body wall vasculature)

38
Q

what are the two main venous systems

A

hepatic portal (gi to liver for cleaning)

systemic(organs and tissues to IVC)

39
Q

where is the IVC and what does it do

A

retroperitoneal

Drains cleaned blood from the hepatic veins into the right atrium

40
Q

what does the hepatic portal vein

A

Drains blood from foregut, midgut and hindgut structures to the liver for first pass metabolism

41
Q

what is the role of the splenic vein

A

Drains blood form foregut structures to hepatic portal vein

42
Q

what is the role of the superior mesenteric vein

A

Drains blood from midgut structures to hepatic portal vein

43
Q

what is the role of the inferior mesenteric vein

A

Drains blood from hindgut structures to splenic vein

44
Q

what is the function of the portal- systemic anastamosis

A

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
Q

where are the portal systemic anastomoses

A
  • skin around umbilicus
  • distal end of the oesophagus
  • rectum/ anal canal
46
Q

describe the portal systemic anastomoses at the skin around the umbilicus

A

connection between para-umbilical veins and small epigastric veins

47
Q

what system do the epigastric veins drain into

A

the caval system

48
Q

what is the caval system

A

systemic blood flow (vena cava)

49
Q

where does the inferior part of the distal end of the oesophagus drain into

A

the hepatic portal vein

50
Q

where does the superior part of the distal end of the oesophagus drain into

A

azygous vein

51
Q

where does the rectum and superior mesenteric vein drain into

A

superior rectal vein to inferior mesenteric vein

52
Q

where does the inferior anal canal drain into

A

the inferior rectal vein to internal iliac veins

53
Q

where does the middle rectum drain into

A

middle rectal vein and internal iliac vein

54
Q

what are the clinical presentations of portal hypertension

A

oesophageal varices, caput medusae, rectal varices

55
Q

what is caput medusae

A

dilated para-umbilical and dilated epigastric veins

56
Q

give two examples of a cause of haematemesis

A

peptic ulcer that erodes through the mucosa

bleeding from oesophageal varices

GI (64 decks)

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