Cards For Week Of Oct 1 Flashcards

0
Q

Where does hind but start and stop?

A

Distal transverse colon to rectum

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1
Q

What are derivates of midgut? (Between what segments)?

A

Duodenum to transverse colon

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3
Q

Cause of sternal defects in development of anterior abdomen?

A

Defect in rostral fold closure

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4
Q

Anterior abdominal wall failure of closure caudally can cause?

A

bladder extrophy

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5
Q

omphalocele result froms failure of closure of?

What other defect can result from same site?

A

Lateral folds of anterior abdominal wall

Gastroschisis- intestine sticks out through abdominal wall, not covered by peritonemum

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6
Q

what is omphalocele?

A

persistence of herniation of abdominal content into umbilical cord, covered by peritoneum

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7
Q

What genetic cause assocaited w/ duodenal atresia?

A

Trisomy 21

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8
Q

what is duodenal atresia?

A

congenital absence or complete closure of a portion of the lumen of the duodenum. It causes increased levels of amniotic fluid during pregnancy (polyhydramnios) and intestinal obstruction in newborn babies. Radiography shows a distended stomach and distended duodenum, which are separated by the pyloric valve, a finding described as the “double-bubble sign.”

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9
Q

In abdomen, vascular accidents (apple peel atresia) can cause atresia in what segments of GI?

A

Jejunal
Ileal
Colonic

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10
Q

Describe midgut development (with wk #)

A

6th wk: midgut herniates through umbilical ring

10th wk: returns to abdominal cavity & rotates around SMA

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11
Q

In development, midgut rotates around what BV?

A

SMA (10th week, as midgut goes back in abdominal cavity)

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12
Q

MC type of esophageal atresia w/ Sx?

A

TEF- tracheoesophageal fistula (EA + fistula)

Sx: Drooling, choking, vomiting w/ 1st feed.
Allows air to enter stomach (seen on CXR)
Cyanosis w/ larygospasm

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13
Q

How to test for Tracheaoesophageal fistula?

A

failure to pass NG tube into stomach

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14
Q

Which condition shows a gasless abdomen on CXR?

A

Pure esophageal atresia or stenosis

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15
Q

Describe H-type, Pure TEF

A

Fistula alone

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16
Q

Sx of congenital pyloric stenosis

A

projectile vomiting @ 2 wks old
palpabile olive mass in epigastric region
more in firstborn males

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17
Q

Pancrease as a whole derived from?

A

foregut

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18
Q

What gives rise from ventral pancreatic bud?

A

Pancreatic head
Main pancreatic duct
Uncinate process

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19
Q

Where does uncinate process come from? (embro origin)

A

ventral bud only

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20
Q

What becomes of the dorsal pancreatic duct?

A

Body
Tail
Isthmus
Accessory Pancreatic duct

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21
Q

What disease caused by ventral pancreatic bud abnormally rotating around duodenum causing narrowing; constrictor?

A

Annular pancreas

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22
Q

What is pancreas divisum

A

ventral and dorsal parts fail to fuse @ week 8

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23
Q

Where does spleen come from?

A

Mesentary of stomach (mesodermal)

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24
Q

What is blood supply of spleen?

A

Celiac artery (foregut)

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25
Q

What are the retroperitoneal strucutre?

A

SAD PUCKER

Suprarenal (adrenal) gland
Aorta & IVC
Duodenum (2nd & 3rd part)
Pancreas (excapt tail)
Ureters 
Colon (asc & desc)
Kidneys
Esophagus (low 2/3) 
Rectum
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26
Q

What is the portal triad made of?

A

Portal vein
Proper hepatic artery
Common bile duct

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27
Q

What is w/n the hepatoduodenal ligament?

A

portal triad

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28
Q

What does the falciform ligament connect? What does it contain?

A

connects liver to anterior abdomen

has ligamentum teres hepatis

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29
Q

What in embryonic origin of ligamentum teres hepatis?

A

Fetal umbilical vein

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30
Q

What is pringle maneuver?

A

Hepatoduodenal lig. compressed between thumb & index finger w/n emental foramen (Foramen of Winslow)

used to control bleeding!

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31
Q

What connects the greater and lesser sac?

A

Foramen of Winslow/ Omental foramen

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32
Q

What ligaments are gastric arteries found?

A

Gastrohepatic ligament

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33
Q

What does gastrohepatic lig. connect?

A

liver to lesser curvature of stomach

34
Q

what seperates greater and lesser sac on right?

A

gastrohepatic ligament

35
Q

What is w/n gastrocolic ligament? what does it connect?

A

gastroepiploic arteries

connects greater curvature of stomach to transverse colon

36
Q

What seperates greaters and lesser sacs on left?

on right?

A

Left: Gastrosplenic ligament

Right: Gastrohepatic ligament

37
Q

what is w/n gastrosplenic ligament?

connects?

A

short gastrics & left gastroepiploic vessels w/n

connects greater curvature & spleen

38
Q

what is w/n splenorenal ligament?

A

Splenic artery & vein

tail of pancreas

39
Q

What connects spleen to posterior abdominal wall?

A

splenorenal ligament

40
Q

What is the lesser omentum?

A

lesser omentum (small omentum; gastrohepatic omentum) is the double layer of peritoneum that extends from the liver to the lesser curvature of the stomach and the start of the duodenum.

41
Q

What is the lesser sac?

A

The lesser sac, also known as the omental bursa, is the cavity in the abdomen that is formed by the lesser and greater omentum.

42
Q

What are the layers of the gut wall?

A
Inside to outside
Mucosa
Submucosa
Muscualris externa
Serosa

“MSMS”

43
Q

What is Basal electric rhythm?

A

determines the frequency of the contractions in the gastrointestinal (GI) tract

Smooth muscle contraction by ENS, or Ca influx (by receptor activation)

44
Q

What are B.E.R. values (normal) for:
Stomach
Duodenum
Ileum

A

Stomach- 3 waves/min

Duodenum- 12 waves/min

Ileum: 8-9 waves/min

45
Q

What layer (s) of GI gut wall erosion occur?

A

only mucosa

46
Q

What layer(s) can ulcers be found?

A

Mucosa, submucosa, and/or to inner or outer muscle layer

47
Q

compare serosa to adventia

A

In the abdomen, whether an organ is covered in adventitia or serosa depends upon whether it is peritoneal or retroperitoneal:

  • intraperitoneal organs are covered in serosa (a layer of mesothelium, the visceral peritoneum)
  • retroperitoneal organs are covered in adventitia (loose connective tissue)
48
Q

What is w/n muscularis externa layers? Fx?

A

Myenteric nerve plexus (aka Auerbach’s)- controls inner circular & outer longitudinal muscle contractions

49
Q

What layer is Meissner’s plexus found? Fx?

A

Submucosa- control of secretory activity

50
Q

What muscle layer w/n Mucosa?

Fx?

A

Muscualris mucosae

Fx- motility

51
Q

describe colon histo

A

crypts
NO villi
many goblet celsl

52
Q

Where is the largest # of goblet cells in small intestine?

A

Ileum

53
Q

Describe histo of ileum

A

Peyer’s patches
Plicae circulares (proximal ileum)
Crypts pf Lieberkuhn
Many goblet celsl

54
Q

histo of Jejunum?

A

Plicae circualres

crypts of Lieberkuhn

55
Q

Describe histo of duodenum?

A

Villi & microvilli
Brunners glands
crypts of Lieberkuhn

56
Q

histo of esophagus

A

nonkeratinized stratified squamous

57
Q

What are crypts of Lieberkühn?

A

gland found in the epithelial lining of the small intestine and colon. The crypts and intestinal villi are covered by epithelium which contains two types of cells, goblet cells (secreting mucus) and enterocytes (absorbing water and electrolytes).

58
Q

What is SMA syndrome?

A

3rd segment of duodenum, transverse, entrapped bwn SMA & ascending aorta

59
Q

At what level does andominal aorta bifurcarte?

A

L4

60
Q

What are the levels of Celiac artery?
SMA?
IMA?

A

Celiac artery @ T12/L1

SMA- L1

IMA- L3

61
Q

PANS innervation of Celiac, SMA, IMA?

A

Vagus supplies Celiac & SMA

Pelvic nerve supplies IMA

62
Q

What does the SMA give blood for?

A

MidgutDistal duodenum to proximal 2/3 of transverse cp;pm

63
Q

What does IMA supply?

A

The hindgut: distal transverse colon to upper portion of rectum

64
Q

What is watershed region?

A

referring to regions of the body that receive dual blood supply from the most distal branches of two large arteries, such as the splenic flexure of the large intestine are particularly susceptible to ischemia.[1] The blood supply from the two vessels does not overlap.

65
Q

What are risks for watershed region in hypotension? in Ischemia?

A

During times of blockage of one of the arteries that supply the watershed area, such as in atherosclerosis, these regions are spared from ischemia by virtue of their dual supply. However, during times of systemic hypoperfusion, such as in disseminated intravascular coagulation or heart failure, these regions are particularly vulnerable to ischemia by virtue of the fact that they are supplied by the most distal branches of their arteries, and thus the least likely to receive sufficient blood.

66
Q

What is blood supply of splenic flexure?

A

SMA & IMA

it is a watershed region

67
Q

How are sigmoid colon and rectum watershed regions?

A

blood supply from inferior mesenteric, pudendal and iliac circulations

68
Q

What is suplied by celiac artery?

A

Foregut!

Stomach to proximal duodenum
Liver
GB
Pancrease
Spleen (mesoderm)
69
Q

What causes jaundice, with elevated in UCB only?

A

-Extravascular hemolysis
-ineffective eryhtropoiesis
- UGT low:
mild low: Gilbert syndrome
severe; absent: Crigler-Najjar

70
Q

What are abnormal levels of unconjugated bilirubin in urine?

A

Trick question!

UCB is non water soluble, so, should NOT be present at all in urine

71
Q

What are the branches of the abdoinal aorta?

A

“Prostitutes Cause Super Super Red Testicles Lubaring Into My Cock” pg. 312

72
Q

What are the branches of Left gastric artery?

A

pg. 313

73
Q

What are branches of Common Hepatic arter?

A

pg/ 313

74
Q

What are branches of Splenic artery?

A

Pancreatic branches
Left gastroepiploic
Short gastric

75
Q

Which splenic artery branch has poor anastomoses?

A

short gastric

76
Q

What are collateral circulation of GI?

Super epigastric –> ?

A

inferior epigastric (external ilaic)

77
Q
What is collateral circulation of ?
superior pancreaticoduodenal (celiac trunk)-->
A

inferior pancreaticoduodenal (SMA)

78
Q
What is collateral circulation of ?
middle colic (SMA)--->
A

left colic (IMA)

79
Q

Collateral circulation of Superior rectal (IMA)?

A

middle & inferior rectal

internal iliac

80
Q

What is “coalminer’s lung” called? Which part of lung is affected?

A

Anthrcosis

Upper lobes

81
Q

When do you see eggshell calcification of the hilar lymph nodes?

A

Silicosis

82
Q

What are the types of restrictive lung diseases?

A

Poor breathing mechanics (extra pulmonary, peripheral hypoventilation, normal A-a gradient)

  • Poor muscular effort like Polio, MG
  • interstitial lung diseases