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Flashcards in GI Deck (32)
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1

Histology of esophagus

Nonkeratinized stratified squamous epithelium.

2

Histology of stomach

Gastric glands.

3

Histology of duodenum

Villi and microvilli

4

Histology of jejunum

Plicae circulares and crypts of Lieberkühn.

5

Histology of ileum

Peyer patches (lamina propria, submucosa), plicae circulares (proximal ileum), and crypts of Lieberkühn.

Largest number of goblet cells in the small intestine.

6

Histology of colon

Colon has crypts of Lieberkühn but no villi; numerous goblet cells.

7

What is zone I of the liver?

Zone I: periportal zone:
-Affected 1st by viral hepatitis
-Ingested toxins (e.g., cocaine)

8

What is zone II of liver?

Zone II: intermediate zone.

9

What is zone III of liver? what is is significant about this area?

Zone III: pericentral vein (centrilobular) zone:
- Affected 1st by ischemia
- Contains cytochrome P-450 system
- Most sensitive to metabolic toxins
- Site of alcoholic hepatitis

10

What are the borders of Hesselbach triangle?

- Inferior epigastric vessels
- Lateral border of rectus abdominis
- Inguinal ligament

11

What are the functions of bile?

- Digestion and absorption of lipids and fat-soluble vitamins
- Cholesterol excretion (body’s only means of eliminating cholesterol)
- Antimicrobial activity (via membrane disruption)

12

elevated ALP

Obstructive hepatobiliary disease, HCC, bone disease

13

elevated Aminotransferases (AST and ALT)

Viral hepatitis (ALT > AST)
Alcoholic hepatitis (AST > ALT)

14

elevated amylase

Acute pancreatitis, mumps

15

Low ceruloplasmin

Wilson disease

16

elevated γ-glutamyl transpeptidase (GGT)

elevated in various liver and biliary diseases (just as ALP can), but not in bone disease; associated with alcohol use

17

elevated lipase

Acute pancreatitis (most specific)

18

Name the retroperitoneal structures

SAD PUCKER:
Suprarenal (adrenal) glands
Aorta and IVC
Duodenum (2nd through 4th parts)
Pancreas (except tail)
Ureters
Colon (descending and ascending)
Kidneys
Esophagus (lower 2/3)
Rectum (partially)

19

Name the connection & structures contained of the falciform ligament. What is it a derivative of?

connects liver to anterior abdominal wall

Contains ligamentum teres hepatis (derivative of fetal umbilical vein)

Derivative of ventral mesentery

20

Name the connection & structures contained of the hepatoduodenal ligament. What does it border?

Liver to duodenum

Portal triad: proper hepatic artery, portal vein, common bile duct

Borders mental foramen which connects greater & lesser sacs

21

Describe the pringle maneuver in relationship to hepatoduodenal ligament

ligament may be compressed bw thumb & index finger placed in mental foramen to control bleeding

22

Name the connection & structures contained of the gastrohepatic ligament. What does it separate? what is significant during surgery?

liver to lesser curvature of stomach

gastric arteries

separates greater & lesser sacs on right

may be cut during surgery to access lesser sac

23

Name the connection & structures contained of the gastrocolic ligament. What is this ligament a part of?

greater curvature & transverse colon

Gastroepiploic arteries

part of greater momentum

24

Name the connection & structures contained of the gastrosplenic ligament. What does it separate?

greater curvature & spleen

short gastrics, left gastroepiploic vessels

separates greater & lesser sacs on left

25

Name the connection & structures contained of the splenorenal ligament.

spleen to posterior abdominal wall

splenic artery & vein; tail of pancreas

26

Name the artery, PANS innervation, vertebral level & structures supplied by the embryonic foregut region

Artery: celiac
PANS: Vagus
Vertebral level: T12/L1
Structures supplied: Pharynx to proximal duodenum; liver, gallbladder, pancreas, spleen (mesoderm)

27

Name the artery, PANS innervation, vertebral level & structures supplied by the embryonic midgut region

Artery: SMA
PANS: Vagus
Vertebral level: L1
Structures supplied: Distal duodenum to proximal 2/3 of transverse colon

28

Name the artery, PANS innervation, vertebral level & structures supplied by the embryonic hindgut region

Artery: IMA
PANS: Pelvic
Vertebral level: L3
Structures supplied: Distal 1/3 of transverse colon to upper portion of rectum; splenic flexure is a watershed region

29

If branches off of the abdominal aorta are blocked, which arterial anastomoses compensate? (from origin)

Superior epigastric (internal thoracic/mammary) ↔ inferior epigastric (external iliac)

Superior pancreaticoduodenal (celiac trunk) ↔ inferior pancreaticoduodenal (SMA)

Middle colic (SMA) ↔ left colic (IMA)

Superior rectal (IMA) ↔ middle & inferior rectal (internal iliac)

30

Describe the transjugular intrahepatic portosystemic shunt (TIPS) Tx

shunt b/w portal vein & hepatic vein percutaneously relieves portal hypertension by shunting blood to the systemic circulation