Bleeding in the GI tract and the anatomy of the blood vessels of the abdomen Flashcards Preview

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Flashcards in Bleeding in the GI tract and the anatomy of the blood vessels of the abdomen Deck (42):
1

What are the parts of the large intestine in order

caecum
appendix
ascending colon
transverse colon
descending colon
sigmoid colon
rectum
anal canal anus

2

What are the 3 functions of the large intestine

defence
absorption
excretion

3

Where is the colon in relation to the liver and spleen

Inferior to both the liver and the spleen

4

What type of organ is the colon

Intraperitoneal, then retroperitoneal then intraperitoneal

5

Describe the mobility of the intraperitoneal segments of the colon

Quite mobile

6

How many paracolic gutters do we have?

2 (right and left

7

Describe the location of the paracolic gutters

Between the lateral eddge of the ascending and descending colon and the abdominal wall

8

What are the paracolic gutters part of?

The greater sac of the peritoneal cavity

9

What are the paracolic gutters potential sites for

Pus collection

10

How many teniae coli do we have and what are they

3
Longitudinal bands of thickened smooth muscle running from caecum to distal end of sigmoid colon

11

How do we visualise the teniae coli?

Use barium contrast via enema

12

Where do the appendix and the caecum lie?

Right iliac fossa

13

What corresponds to the McBurneys point on the anterior abdominal wall

The appendiceal orifice on the posteromedial wall of the caecum

14

Where is the McBurneys point

A third of the way from the right ASIS to the umbilicus (where pain from appendicitis ends)

15

WHere does the sigmoid colon lie?

In the left iliac fossa

16

What gives rise to the movement of the sigmoid and what is the specific name for this?

Long mesentery - sigmoid mesocolon

17

What is the negative side to the degree of movement of the sigmoid colon?

It can twist around itself and cause a bowel obstruction

18

What is the risk if a bowel obstruction is not treated?

Infarction

19

What does the abdominal aorta branch to supply and what are the names of the branches

The abdominal organs
Right and left common iliac arteries

20

What do the common iliac arteries supply?

The pelvis, perineum and the lower limbs

21

The common iliac arteries bifurcate again to form what?

The external and internal iliac arteries

22

Where does the abdominal aorta lie?

Anterior to the vertebral bodies and to the left of the IVC

23

Name the 3 midline branches of the abdominal aorta

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

24

What are the names of the 6 parts of the SMA arteries from superior to inferior on the right hand side of the body

Inferior pancreatico-duodenal artery
Middle colic artery
Right colic artery
Ileocolic artery
Jejunal and ileal arteries
Appendicular artery

25

What are the names of the 3 parts of the IMA from superior to inferior on the left hand side of the body

Left colic artery
Sigmoid colic artery
superior rectal artery

26

What can help prevent bowel ischaemia

The marginal artery of Drummond

27

Why might a patient present with haematemesis

The stomach has filled with blood due to a peptic ulcer in which the wall of the stomach or the duodenum has been eroded through the mucosa

28

What are varices

Abnormal, dilated veins

29

Why do varices have the potential to rupture

They have such thin walls

30

What causes the formation of oesophageal varices?

A result of pathology affecting the portal venous system

31

How many venous systems does the body have?
Name these

2
Hepatic portal venous system
Systemic venous system

32

What does the hepatic portal venous system do?

Drains venous blood from absorpitve parts of the GI tract and associated organs to the liver for cleaning

33

What does the systemic venous system do?

Drains venous blood from all other organs and tissues into the SVC or IVC

34

What occurs in the liver that requires the hepatic portal system?

First pass metabolism (cleaning)

35

What does the splenic vein do?

Drains the blood form the foregut structures to the hepatic portal vein

36

What does the inferior mesenteric vein do?

Drains the blood from the hindgut structures to the splenic vein

37

What does the superior mesenteric vein do?

Drains the blood from the migut structures to the hepatic portal vein

38

What are the 3 clinically important sites of venous anastomosis between the systemic and the portal venous systems (Portal systemic anastomeses)

Distal end of oesophagus
Skin around umbilicus
Rectum / anal canal

39

What means that blood can flow both ways in the anastomoses ?

The presence of small collateral veins
There are no valves in these veins

40

What would happen to the flow of blood in these collateral veins if the blood pressure within the portal venous system was raised?

Portal Hypertension - blood would be diverted through the collateral veins back to the systemic venous system

41

As a consequence to portal hypertension, what happens to the collateral veins

THey have amuch larger volume of blood through them than they are used to and so dilate, becoming varicose

42

What is a clinical sign of portal hypertension

Dilated collateral veins
Dilated epigastric veins
Dilated submucosal collateral veins
Rectal varices

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