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

(42 cards)

1
Q

What are the parts of the large intestine in order

A
caecum
appendix
ascending colon
transverse colon
descending colon
sigmoid colon
rectum
anal canal anus
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2
Q

What are the 3 functions of the large intestine

A

defence
absorption
excretion

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3
Q

Where is the colon in relation to the liver and spleen

A

Inferior to both the liver and the spleen

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4
Q

What type of organ is the colon

A

Intraperitoneal, then retroperitoneal then intraperitoneal

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5
Q

Describe the mobility of the intraperitoneal segments of the colon

A

Quite mobile

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6
Q

How many paracolic gutters do we have?

A

2 (right and left

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7
Q

Describe the location of the paracolic gutters

A

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

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8
Q

What are the paracolic gutters part of?

A

The greater sac of the peritoneal cavity

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9
Q

What are the paracolic gutters potential sites for

A

Pus collection

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10
Q

How many teniae coli do we have and what are they

A

3

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

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11
Q

How do we visualise the teniae coli?

A

Use barium contrast via enema

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12
Q

Where do the appendix and the caecum lie?

A

Right iliac fossa

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13
Q

What corresponds to the McBurneys point on the anterior abdominal wall

A

The appendiceal orifice on the posteromedial wall of the caecum

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14
Q

Where is the McBurneys point

A

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

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15
Q

WHere does the sigmoid colon lie?

A

In the left iliac fossa

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16
Q

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

A

Long mesentery - sigmoid mesocolon

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17
Q

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

A

It can twist around itself and cause a bowel obstruction

18
Q

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

19
Q

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

A

The abdominal organs

Right and left common iliac arteries

20
Q

What do the common iliac arteries supply?

A

The pelvis, perineum and the lower limbs

21
Q

The common iliac arteries bifurcate again to form what?

A

The external and internal iliac arteries

22
Q

Where does the abdominal aorta lie?

A

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

23
Q

Name the 3 midline branches of the abdominal aorta

A

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

24
Q

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

A
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