Gastro - FA Anat/Phys p352 - 369 Flashcards by Sahaja Parsa

extrusion of abdominal contents through abdominal folds but not covered by peritoneum is called?

Gastroschisis

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Foregut encompasses what structures?

esophagus to first 1/2 of duodenum

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With gastroschisis, what marker is increased?

alpha FP

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Midgut encompasses what structures?

2nd 1/2 of duodenum to proximal 2/3 of transverse colon

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Hindgut encompasses what structures?

distal 1/3 of transverse colon to anal canal above pectinate line

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persistence of herniation of abdominal contents into umbilical cord, sealed by peritoneum is called?

Omphalocele

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omphalocele and gastroschisis are both due to what type of defective closure of the anterior abdominal wall?

Lateral fold closure

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Pectus excavatum or ectopia cordis due to what type of defective closure of the anterior abdominal wall?

rostral fold closure

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Intestinal obstruction in newborn babies who have Down syndrome is due to failure to?

Duodenal atresia due to failure to recanalize. double bubble sign.

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Ectopia vesicae is due to

bladder exstrophy is due to Caudal fold closure failure

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Bonus q: polyhydramnios is seen with which congenital intestinal abnormalities? (DM mother)

-Anenecephaly - facial cleft - Duodenal atresia - Esophageal atresia - Tracheoesophageal fistula - Diaphragmatic hernias

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Exstrophy of the bladder is associated with what other congenital anomaly?

Epispadias

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After delivery of a cyanotic baby, doctor fails to pass nasogastric tube into stomach.

Clinical test for Tracheo-Esoph fistula

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At — midgut herniates through umbilical ring.

6th week

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Cyanosis in TEF is 2° — to avoid reflux-related aspiration.

laryngospasm

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At — midgut returns to abdominal cavity + rotates around —-.

10th week SMA

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Newborn drools or chokes with first feeding. On Xray, you see air in the stomach. Dx?

Trach-esoph fistula

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Apple peel bowel on xray due to a disruption of what vessels?

mesenteric vessel disruption –> ischemic necrosis –> jejunal and ileal atresia.

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Which Tracheoesophageal anomalies shows gasless abdomen on CXR?

In pure Esoph Atresia

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3 Pathologies due to malrotation of midgut,

intestinal atresia or stenosis, - volvulus

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—- abnormally encircles 2nd part of duodenum; Annular pancreas

ventral pancreatic bud

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Pancreas divisum—ventral and dorsal parts fail to fuse at—–.

8 weeks

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Spleen—arises in mesentery of stomach hence is —- but is supplied by —-.

mesodermal foregut, celiac artery.

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what structures contribute to the pancreatic head?

Both the ventral and dorsal buds

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Circumferential ectopic pancreatic tissue can cause what?

Stenosis of second part of duodenum

The dorsal pancreatic bud becomes which structures?

body, tail isthmus accessory pancreatic duct

Hepatoduodenal ligament encompasses what structures?

Portal triad: Proper hepatic artery Common bile duct Portal vein

---- ligament separates greater and lesser sacs on the right and --- ligament separates greater and lesser sacs on the Left.

Gastrohepatic GastrospLenic

Describe the Pringle maneuver?

Hepatoduodenal ligament compressed between thumb and index finger at the lesser border of omental foramen to control bleeding.

If after doing Pringle maneuver, bleeding continues, what could be the source of the bleed?

inferior vena cava or the hepatic vein

Which ligament may be cut during surgery to access lesser sac?

Gastrohepatic

Layer that contains Meissner nerve plexus and secretes fluid?

Submucosa

layer that contains Auerbach and is for motility?

Muscularis externa (Myenteric nerve plexus)

which GI structure has the fastest frequency of basal electric rhythm?

Duodenum—12 waves/min

T or F? Brunner glands are only found in duodenum.

T (hypertrophy)

which GI structure has the slowest frequency of basal electric rhythm?

Stomach—3 waves/min

Erosions are in which layer/s?

mucosa only

The only 2 digestive organs not containing crypts of Lieberkühn?

stomach and esophagus

Brunner glands location and function?

HCO3 secreting cells of submucosa of duodenum

Which structure has the largest number of goblet cells in the small intestine?

Ileum

T or F? Peyer patches are found in the same structure as where vit B12 is absorbed.

which structure has crypts of Lieberkühn but no villi?

Colon

Describe the Superior mesenteric artery syndrome?

occurs when the transverse portion (third part) of the duodenum is entrapped between SMA and aorta, causing intestinal obstruction.

“Bifourcation” of abdominal aorta happens at what level?

Arteries supplying GI structures branch ----. Arteries supplying non-GI structures branch ---- .

anteriorly laterally

Level of transverse portion (third part) of the duodenum?

L1 (Superior mesenteric artery syndrome)

Level Inferior mesenteric artery?

Which nerve is affected in chagas dx?

parasympathetic branches of the vagus nerve

splenic flexure is a watershed region between --- and ----.

SMA and IMA

upper portion of rectum is supplied by which artery?

IMA

Due to failure of proper descent of hindgut?

Anal atresia/imperforate anus

which organ has most susceptibility to infarction?

CNS (damage w/ 5 min) Heart (20-30m) Kidney/Spleen Liver and renal unlikely bc dual blood supply

Which structures in the intestine contain stem cells?

crypts of Lieberkühn

list the branches of the celiac trunk

Left gastric artery, splenic artery & common hepatic artery

ulcer at the lesser curvature of the stomach will affect what artery?

L gastric a

Epigastric pain that improves with meals and posterior ulcer, what artery could be damaged?

Gastroduodenal artery

what anastomoses are seen in esophageal varices

left gastric & Azygous

anastomoses between paraumbilical vein to small epigastric vein of the anterior abdominal wall is seen in what clinical sign

caput medusae

what two pathology is seen above the pectinate line?

Adenocarcinoma & internal hemorrhoids

why are internal hemorrhoids not painful

they receive visceral innervation and are therefore not painful

what is the lymphatic drainage above the pectinate line

internal iliac l.n.

what lymphatic drains the testes and ovaries

Para-aortic

what pathology is seen below the pectinate line

ext hemorrhoids, squamous cell cancer, anal fissures

lymphatic drainage below the pectinate line

superficial inguinal nodes

what zone of the liver is first affected by viral hepatitis

periportal zone (zone 1)

yellow fever targets what zone in the liver?

Zone 2

what liver zone do you see the pericentral vein?

Zone 3

what zone is the most sensitive to metabolic toxins

Zone 3

what zone is the site for alcohol hepatitis

Zone 3

Gall stones that block the common bile duct and pancreatic duct at the ampulla of Vater causes what two pathologies?

Cholangitis and pancreatitis

what type of pathology is associated with the head of the pancreas that cause painless jaundice

Ductal adenocarcinoma (obstruct common bile duct)

which structure is not found in the femoral sheath

femoral n

Cremastic muscle and fascia comes from what inguinal canal structure?

Int oblique

Transversals Fascia becomes what part of spermatic cord?

internal spermatic fascia

External Oblique becomes

ext spermatic fascia

defect of pleuroperitoneal membrane refers to what disease?

diaphragmatic hernia

why does Diaphragmatic Hernia commonly occur on the left side?

due to the protection of the right Hemidiaphragm by the liver

Hour Glass stomach refers to?

sliding hiatal hernia

what is a complication of sliding hiatal hernia

GERD

what kind of cancer is associated with Barret Esophagus?

Adenocarcinoma

Fundus protruding into the thorax is seen in what pathology?

Paraesophageal Hernia

Occurs in infants due to failure of the processus Vaginialis

indirect hernia

what other pathology is associated with failure of process vaginalis

hydrocele

what type of hernia is more common in females

femoral hernia

what zone is affected by hemochromatosis

zone 1

Which regulatory substances decrease gastric acid secretion?

somatostatin, secretin, GIP

Which regulatory substance is produced by K cells?

GIP - glucose dep insulinotropic peptide

What is motilin's mech of action?

produces migrating motor complexes

Fatty acids increase the release of which GI substances?

CCK, Secretin, GIP

Amino acids increase the release of which GI substances

gastrin, CCK, GIP

What hormone secreting tumor causes watery diarrhea, hypokalemia, achlorhydria?

VIP-oma

Loss of NO secretion is related to which GI issue?

Inc LES tone of achalasia

Where is VIP released from?

PNS ggl of sphincters, GB, and SI

Which hormone inc/dec GB contraction?

CCK/Somatostatin

Brunner glands of duod produce what?

HCO3-

Enterochromaffin cells release what that cause inc in gastric acid secretion?

Histamine

What stimulates enterochromaffin cells?

Gastrin

What distinguishes GI mucosal damage from other forms of malabsorption?

D-xylusose absorption test

What transporter is responsible for glucose and galactose uptake?

SGLT1

How is fructose uptake done?

facilitated diffusion

Where is Fe absorbed?

Absorbed as Fe2+ in duodenum

Folate is absorbed in ?

M cells are located where? function?

in peyers patches; are antigen presenting cells

Which IG is secreted from Peyer's patches?

IgA

rate limiting step of bile acid synthesis?

cholesterol 7 alpha hydroxylase

Which GI hormone is increased by chronic PPI use?

Gastrin

Octreotide is an analogue of what GI hormone, and is used to treat which pathologies?

Somatostatin, and used to treat acromegaly, carcinoid syndrome, and variceal bleeding

Which hormone is increased in Prader Willi syndrome?

Ghrelin (Inc appetite)

Gastro - FA Anat/Phys p352 - 369 Flashcards

(108 cards)