GI: 334 - 336 Flashcards Preview

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Flashcards in GI: 334 - 336 Deck (43):
1

What defines the foregut?

Pharynx to duodenum

2

What defines the midgut?

Duodenum to proximal 2/3 of transverse colon

3

What defines the hindgut?

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

4

What 3 things that lead to developmental defects of the anterior abdominal wall and what are their associated defects?

1. Failure of rostral fold close - sternal defects
2. Failure of lateral folds to close - omphalocele, gastroschisis
3. Failure of caudal folds to close - bladder exstrophy

5

What is duodenal atresia due to?

Failure to recanalize

6

What is duodenal atresia associated with?

Trisomy 21

7

What causes jejunal, ileal, colonic atresia?

Vascular accident

8

Explain the two important steps in midgut development.

1. Week 6: Midgut herniates through umbilical ring
2. Week 10: Returns to abdominal cavity and rotates around SMA

9

What is gastroschisis?

Extrusion of abdominal contents through abdominal folds, not covered by peritoneum

10

What is omphalocele?

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

11

How does TE fistula typically present?

Drooling, choking, and vomiting with first feeding

12

What would you see on CXR with a TE fistula?

Air in the stomach

13

What is a clinical test for TE fistula?

Failure to pass nasogastric tube into stomach

14

What causes cyanosis in TE fistula?

Laryngospasms which work to avoid reflux-related aspiration

15

What causes congenital pyloric stenosis?

Hypertrophy (of the pylorus)

16

How does congenital pyloric stenosis present?

Palpable "olive" mass in epigastric region and nonbilious projectile vomiting at 2-6 weeks

17

What is the treatment for congenital pyloric stenosis?

Surgical incision

18

How common is congenital pyloric stenosis?

1/600 live births

19

Congenital pyloric stenosis is more common in what subset of patients?

Firstborn males

20

What are the different embryological precursors to the pancreas?

Pancreas comes from the foregut

Ventral pancreatic buds - form pancreatic head, main pancreatic duct, uncinate process

Dorsal bud - forms body, tail, isthmus, accessory pancreatic duct

21

What are two developmental defects that can occur with the pancreas?

1. Annular pancreas
2. Pancreas divisum

22

What happens in an annular pancreas?

Ventral pancreatic bud abnormally encircles 2nd part of the duodenum, forms a ring of pancreatic tissue that may cause duodenal narrowing

23

What happens in pancreas divisum?

Ventral and dorsal parts fail to fuse at 8 weeks

24

What does the spleen vs. its blood supply arise from embryologically?

Spleen - mesentery of the stomach (mesodermal)
Blood supply - from the foregut (celiac artery)

25

What can injury to retroperitoneal structures lead to?

Blood or gas accumulation in retroperitoneal spaces

26

What are the retroperitoneal structures?

Mnemonic: 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)

27

What are 6 important GI ligaments?

1. Falciform
2. Hepatoduodenal
3. Gastrohepatic
4. Gastrocolic
5. Gastrosplenic
6. Splenorenal

28

What does the falciform ligament connect?

Liver to the anterior abdominal wall

29

What is contained within the falciform ligament?

Ligamentum teres hepatis (derivative of fetal umbilical vein)

30

What does the hepatoduodenal ligament connect?

Liver to duodenum

31

What does the hepatoduodenal ligament contain?

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

32

What does the gastrohepatic ligament connect?

Liver to less curvature of the stomach

33

What does the gastrohepatic ligament contain?

Gastric arteries

34

What does the gastrocolic ligament connect?

Greater curvature of stomach and transverse colon

35

What does the gastrocolic ligament contain?

Gastroepiploic arteries

36

What does the gastrosplenic ligament connect?

Greater curvature of stomach and spleen

37

What does the gastrosplenic ligament contain?

Short gastrics, left gastroepiploic vessels

38

What does the splenorenal ligament connect?

Spleen to posterior abdominal wall

39

What does the splenorenal ligament contain?

Splenic artery and vein, tail of pancreas

40

Which ligament separates the greater and lesser sacs on the right and why is this important?

Gastrohepatic - may be cut during surgery to access the lesser sac

41

What is the Pringle maneuver?

Ligament may be compressed between thumb and index finger placed in omental foramen to control bleeding

42

What separates the greater and lesser sacs on the left?

Gastrosplenic

43

Which ligament is part of the greater omentum?

Gastrocolic ligament