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Gastrointestinal - The Basics Flashcards

1
Q

foregut

A

pharynx to duodenum

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2
Q

midgut

A

duodenum to transverse colon

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3
Q

hindgut

A

distal transverse colon to rectum

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4
Q

developmental defects of anterior abdominal wall due to failure of:

A
  • rostral fold closure: sternal defects
  • lateral fold closure: omphalocele, gastroschisis
  • caudal fold closure: bladder exstrophy
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5
Q

duodenal atresia

A

failure to recanalize (trisomy 21)

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6
Q

jejunal, ileal, colonic atresia

A

due to vascular accident (apple peel atresia)

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7
Q

midgut development

A

6th week - midgut herniates through umbilical ring

10th week - returns to abdominal cavity + rotates around SMA

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8
Q

gastroschisis

A

extrusion of abdominal contents through abdominal folds; not covered by peritoneum

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9
Q

omphalocele

A

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

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10
Q

most common transesophageal anomaly

A

esophageal atresia with distral transesophageal fistula

EA + TEF

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11
Q

congenital pyloric stenosis

A

hypertrophy of pylorus causes obstruction
“olive” mass in epigastric region, nonbilious projectile vomiting ~ 2 wks.
firstborn males

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12
Q

annular pancreas

A

ventral pancreatic bud abnormally encircled 2nd part of duodenum; forms a ring of pancreatic tissue that may cause duodenal narrowing

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13
Q

pancreas divisum

A

ventral and dorsal parts fail to fuse at 8 weeks

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14
Q

retroperitoneal structures

A 
SAD PUCKER
Suprarenal/adrenal gland
Aorta and IVC
Duodenum (2nd, 3rd parts)
Pancreas (except tail)
Ureters
Colon (descending and ascending)
Kidneys
Esophagus (lower 2/3)
Rectum (lower 2/3)
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15
Q

falciform ligament connects

A

liver to anterior abdominal wall

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16
Q

falciform ligament contains

A

ligamentum teres hepatis (derivative of fetal umbilical vein)

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17
Q

falciform ligament fun fact

A

derivative of ventral mesentery

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18
Q

hepatoduodenal ligament connects

A

liver to duodenum

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19
Q

hepatoduodenal ligament contains

A

portal triad
hepatic artery
portal vein
common bile duct

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20
Q

hepatoduodenal ligament fun facts

A

Pringle maneuver - control bleeding

connects greater and lesser sacs

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21
Q

gastrohepatic ligament connects

A

liver to lesser curvature of stomach

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22
Q

gastrohepatic ligament contains

A

gastric arteries

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23
Q

gastrohepatic ligament fun facts

A

separates greater and lesser sacs on the right

may be cut during surgery to access lesser sac

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24
Q

gastrocolic ligament connects

A

greater curvature and transverse colon

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25
gastrocolic ligament contains
gastroepiploic arteries
26
gastrocolic ligament fun fact
part of greater omentum
27
gastrosplenic ligament connects
greater curvature and spleen
28
gastrosplenic ligament contains
short gastrics, left gastroepiploic vessels
29
gastrosplenic ligament fun fact
separates greater and lesser sacs on the left
30
splenorenal ligament connects
spleen to posterior abdominal wall
31
splenorenal ligament contains
splenic artery and vein, tail of pancreas
32
Gut wall layers - inside to outside
MSMS Mucosa - epithelium, lamina propria, muscularis mucosa Submucosa - submucosal nerve plexus/Meissner's Muscularis externa - myenteric/Auerbach's Serosa (intraperitoneal)/Adventitia (retroperitoneal)
33
Slow wave frequency Stomach Duodenum Ileum
Stomach - 3 waves/min Duodenum - 12 waves/min Ileum - 8-9 waves/min
34
esophagus histology
nonkeritanized stratified squamous epithelium
35
stomach histology
gastric glands
36
duodenum histology
villi, microvilli increase absorptive surface Brunner's glands (submucosa) crypts of Lieberkuhn
37
jejunum histology
plicae circulares, crypts of Lieberkuhn
38
ileum histology
Peyer's patches (lamina propria, submucosa) plicase circulares (proximal ileum) crypts of Lieberkuhn largest number of goblet cells
39
colon histology
crypts no villi numerous goblet cells
40
Superior mesenteric artery syndrome
transverse portion (3rd segment) of duodenum is entrapped between SMA and aorta, causing intestinal obstruction
41
celiac trunk level
T12
42
SMA level
L1
43
left renal artery level
L1
44
inferior mesenteric artery level
L3
45
bifurcation of abdominal aorta level
L4
46
foregut blood supply
celiac artery
47
foregut parasym innervation
vagus
48
foregut structures supplied
``` stomach to proximal duodenum liver gallbladder pancreas spleen (mesoderm) ```
49
midgut blood supply
SMA
50
midgut parasym innervation
vagus
51
midgut structures supplied
distal duodenum to proximal 2/3 transverse colon
52
hindgut blood supply
IMA
53
hindgut parasym innervation
pelvic
54
hindgut structures supplied
distal 1/3 transverse colon to upper portion of rectum; splenic flexure is a watershed region
55
celiac trunk branches - think main blood supply of stomach
common hepatic splenic left gastric
56
strong anastomoses of celiac trunk
left and right gastroepiploics | left and right gastrics
57
blocked abdominal aorta branches - anastomotic compensation for arteries
superior epigastric + inferior epigastric superior pancreaticoduodenal + inferior pancreaticoduodenal middle colic + left colic superior rectal + middle and inferior rectal
58
portosystemic anastomoses - think portal HTN
esophagus - esophageal varices umbilicus - caput medusa rectum - internal hemorrhoids
59
esophageal varices anastomosis
left gastric (portal) + esophageal (systemic)
60
caput medusa anastomoses
paraumbilical (portal) + superficial & inferior epigastric below umbilicus, superior epigastric & lateral thoracic above umbilicus (systemic)
61
internal hemorrhoids anastomoses
superior rectal (portal) + middle & inferior rectal (systemic)
62
portal HTN Tx
TIPS - transjugular intrahepatic portosystemic shunt | btwn portal & hepatic vv., shunt to systemic
63
internal hemorrhoids
painless, above pectinate line | venous drainage: superior rectral vein to inferior mesenteric vein to portal system
64
external hemorrhoids
painful, below pectinate line | venous drainage: inferior rectal vein to internal pudendal vein to internal iliac vein to IVC
65
The Liver | Zone I: periportal zone
affected 1st by vital hepatitis
66
The Liver | Zone II: intermediate zone
just a thing
67
The Liver | Zone III: pericentral vein/ centrilobular zone
affected 1st by ischemia contains P450 system most sensitive to toxic injury site of EtOH hepatitis
68
The Liver | Blood flow
Zone I to III
69
The Liver | Bile flow
Zone III to I
70
femoral region contents lateral to medial
NAVEL Nerve, Artery, Vein, Empty space, Lymphatics femoral sheath contains all but nerve
71
diaphragmatic hernia
abdominal structures enter the thorax | hiatal hernia most common - stomach herniates upward through esophageal hiatus of diaphragm
72
indirect inguinal hernia
through the internal (deep) inguinal ring, external (superficial) inguinal ring, into scrotum male infants - descent of testes lateral to inferior epigastric artery
73
direct inguinal hernia
protrudes through inguinal (Hesselbach's) triangle medial to inferior epigastric artery through external (superficial) inguinal ring only older men
74
femoral hernia
protrudes below inguinal ligament through femoral canal below and lateral to pubic tubercle more common in women
75
Hesselbach's triangle borders
inferior epigastric vessels laterial border rectus abdominis inguinal ligament

First Aid (6 decks)

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