GA GI Organs Flashcards
(55 cards)
At what spine segment level is the esophagus?
T10-T11
At what spine segment level is the stomach?
T11
At what spine segment level is the pylorus?
L1
What important ligament is attached to the esophagus and what is its function?
The phrenico-esophageal ligament
(Phrenic = diaphragm)
Binds the esophagus to the diaphragm
What two nerves travel with the esophagus as it descends through the diaphragm?
The Anterior and Posterior Vagal trunks
What happens with a Cervical Esphageal Constriction, what structures are involved?
Cervical Esophageal Constriction is a result of the closing of the Upper Esophageal Sphincter (which is controlled by the Cricopharyngeus Muscle
What happens with a Thoracic Esophageal Constriction, what structures are involved?
Thoracic Esophageal Constriction occurs as a result of contact with the Left Main Bronchus and the Aorta
What happens with a Diaphragmatic Esophageal Constriction, what structures are involved?
Diaphragmatic Esophageal Constriction occurs as a result of contact with the diaphragm as the esophagus passes through the Esophageal Hiatus at T10.
Also occurs as a result of complications with the Lower Esophageal Sphincter
Implicated in Hiatal Hernias
What is a Paraesophageal Hiatal Hernia?
Hiatal Hernia is when abdominal structures enter the thorax (commonly occurs on the left side)
Paraesophageal Hiatal Hernias occur when the FUNDUS of the stomach protrudes into the thorax adjacent to the esophagus
Note the Gastroesophageal Junction is normal and there is lesser chance of developing GERD with this particular form of Hiatal Hernia
What is a Sliding Hiatal Hernia?
Hiatal Hernia is when abdominal structures enter the thorax (commonly occurs on the left side)
Sliding Hiatal Hernias occur when the CARDIA of the stomach protrudes into the thorax, causing the stomach to have an Hour Glass shape
This is the most common form of Hiatal Hernia and results in the displacement of the Gastoresophageal Junction superiorly.
What are the 5 parts of the stomach?
Cardia Fundus Body Pyloric Antrum Pyloric Canal
What structure(s) will you find anteriorly to the stomach?
Left Lobe of the Liver
Diaphragm
Anterior Abdominal Wall
What structure(s) will you find infero-laterally to the stomach?
The transverse Colon
What structure(s) will you find posteriorly to the stomach?
Left Kidney
Left Suprarenal Gland
Pancreas
Spleen
Diaphragm
Omental Bursa (lesser sac)
- Stomach serves as the anterior wall of the lesser
sacWhat two ligaments are found attached to the stomach and what is their purpose?
Gastrohepatic Ligament - Connects lesser curvature of the stomach to the Liver
- Gastric vessels follow this ligament (including the Left Gastric A
Gastrocolic Ligament - Connects the greater curvature of the stomach to the transverse colon
- The Gastroepiploic vessels follow this ligament
- Also this ligament is part of the Greater Omentum
What is a Gastric Ulcer?
When the acid of the stomach pierces through the wall of the stomach
70% of stomach ulcers are related to H pylori bacteria
Complications can arise if the ulcer occurs at the lesser curvature of the stomach where leaking acid can cause damage to the Left Gastric A., causing hemorrhage.
What is a Peptic/Duodenal Ulcer?
Acid from the stomach breaches through the wall of the pylorus or the duodenum
90% of Peptic/Duodenal Ulcers are related to H pylori bacteria
65% of cases have the ulcer on the posterior side of the 1st part of the duodenum, which can cause hemorrhage by damaging the Gastroduodenal A.
If anterior wall is breached, the pancreas can be affected
What is the purpose of a vagatomy?
Vagatomy is when the vagus is surgically severed
Parasympathetic innervation from the vagus nerve to the parietal cells of the Body and Fundus of the stomach promote acid secretion.
Thus Vagatomies are used as a treatment for ulcers by blocking parasympathetic promotion of acid secretion.
What are the 3 types of Vagotomies and how are they different?
Truncal Vagotomy: Surgical section of vagal trunk; not preferred as this would sever innervation to other abdominal organs besides the stomach
Selective Gastric Vagotomy: Surgical section of vagus nerve, completely denervating the stomach (without compromising the function of other abdominal organs)
Selective Proximal Vagotomy: Surgical section of nerves specifically innervating parietal cells, without compromising other autonomic functions of the stomach (such as motility)
What is the Hepatoduodenal Ligament and what is its function?
Hepatoduodenal Ligament connects the Duodenum to the Liver (resides in the 1st part of the Duodenum)
It is important because it contains:
Proper Hepatic A.
Hepatic Portal V.
Common Bile Duct
It also marks the entrance to the Lesser Sac
What is the Major Duodenal Papilla, where is it located, and what is its function?
Major Duodenal Papilla is the opening found in the 2nd part of the duodenum where Bile and Pancreatic secretions enter the small intestine
What vessels surround the 3rd part of the Duodenum?
Posteriorly there is the Inferior Vena Cava
Anteriorly there is the Superior Mesenteric A. and the Superior Mesenteric V.
Note: Superior Mesenteric A. can cause a bowel obstruction at the 3rd part of the Duodenum
What structure holds the 4th part of the duodenum in place?
The Suspensory M., aka The Ligament of Treitz
Connects the 4th Part of the Duodenum to the Right Crus of the Diaphragm (where the esophagus passes through)
Ligament of Treitz is clinicallt significant in that it is the barrier that separates upper and lower GI.
What are the 3 segments of the small intestine in order?
Duodenum
Jejunum
Ileum
