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FirstAid:GI > GI:Anatomy > Flashcards

GI:Anatomy Flashcards

1
Q

What are retroperitoneal structures?

A

GI structures that lack a mesentery

Non-GI structures

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2
Q

Injuries to retroperitoneal structures can cause:

A

Blood or gas accumulation in the retroperitoneal space

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3
Q

What are the retroperitoneal structues?

A 
Suprarenal gland (adrenal)
Aorta and IVC
Duodenum (2nd and 3rd)
Pancreas (except tail)
Ureters
Colon (ascending and descending)
Kidneys
Esophagus (lower 2/3)
Rectum (lower 2/3)
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4
Q

What makes up the portal triad?

A

Proper hepatic artery
Common bile duct
Portal vein

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5
Q

What does the falciform ligament connect?

A

Liver

Anterior abdominal wall

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6
Q

What does the hepatoduodenal ligament connect?

A

Liver

Duodenum

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7
Q

What does the gastrohepatic ligament connect?

A

Liver

Lesser curvature of the stomach

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8
Q

What does the gastrocolic ligament connect?

A

Greater curvature of the stomach

Transverse colon

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9
Q

What does the gastrosplenic ligament connect?

A

Greater curvature of the stomach

Spleen

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10
Q

What does the splenorenal ligament connect?

A

Spleen

Posterior abdominal wall

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11
Q

What ligament seperates the greater and lesser sacs on the right? Left?

A

Gastrohepatic

Gastrosplenic

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12
Q

What is the Pringle maneuver?

A

Hepatoduodenal ligament may be compressed between the thumb and index finger placed in omental foramen to control bleeding

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13
Q

What may be cut during surgery to access the lesser sac?

A

Gastrohepatic ligament

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14
Q

What structures are contained in the falciform ligament?

A

Ligamentum teres hepatis (derivative of the fetal umbilical vein)

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15
Q

What structures are contained in the hepatoduodenal ligament?

A

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

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16
Q

What structures are contained in the gastrohepatic ligament?

A

Gastric arteries

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17
Q

What structure is contained in the gastrocolic ligament?

A

Gastroepiploic arteries

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18
Q

What structures are contained in the gastrosplenic ligament?

A

Short gastrics

Left gastroepiploic vessels

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19
Q

What structures are contained in the splenorenal ligament?

A

Splenic artery and vein

Tail of the pancreas

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20
Q

What are the four layers of the gut wall?

A

Mucosa
Submucosa
Muscularis externa
Serosa/adventitia

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21
Q

What layer of the gut includes Meissener’s nerve plexus?

A

Submucosa

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22
Q

What are the three components of the mucosa of the gut?

A 
Epithelium (absorption)
Lamina propria (support)
Muscularis mucosa (motility)
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23
Q

What layer of the gut contains the myenteric/Auerbach’s nerve plexus?

A

Muscularis externa

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24
Q

What is the difference between a serosa and adventitia?

A

Serosa: intraperitoneal
Adventitia: retroperitoneal

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25
Q

What is the difference between how far an ulcer vs erosion can extend into the layers of the gut?

A

Ulcer: submucosa, inner and other muscular layers
Erosion: mucosa only

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26
Q

What is the frequency of basal electric rhythm (slow waves) in the
Stomach
Duodenum
Ileum

A

Stomach: 3 waves/min
Duodenum: 12 waves/min
Ileum: 8-9 waves/min

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27
Q

What is the key histological characteristic of the esophagus?

A

Nonkeritonized stratified squamous epithelium

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28
Q

What is the key histological characteristic of the stomach?

A

Gastric glands

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29
Q

What are the key histological characteristics of the duodenum? (3)

A

Villi and microvilli
Brunner’s glands (submucosa)
Crypts of Lieberkuhn

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30
Q

What are the key histological characteristics of the jejunum? (2)

A

Plicae circularis

Crypts of Liberkuhn

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31
Q

What are the key histological characteristics of the ileum?

A 
Peyer's patches (lamina propria and submucosa)
Plicae circulares (proximal ileum)
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32
Q

What are the key histological characteristics of the colon?

A

Crypts of Lieberkahn but no villi

Numerous goblet cells

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33
Q

Arteries supplying GI structures branch _____

Arteries supplying non-GI structures branch _____

A

Anteriorly

Laterally

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34
Q

What happens in superior mesenteric artery syndrome?

A

Transverse portion of the duodenum (3rd) trapped between the SMA and the aorta, causing intestinal absorption

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35
Q

Arterial supply for the foregut, midgut, hindgut

A

Celiac
SMA
IMA

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36
Q

Parasympathetic innervation of the foregut, midgut, hindgut? Vertebral level?

A

Vagus (T12/L1)
Vagus (L1)
Pelvic (L3)

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37
Q

What structures are supplied by the celiac artery?

A

Stomach to proximal duodenum

Liver, gallbladder, pancreas, spleen (mesoderm)

38
Q

What part of the GI tract does the SMA supply?

A

Distal duodenum to proximal 2/3 of the transverse colon

39
Q

What part of the GI tract does the IMA supply?

A

Distal 1/3 of the transverse colon to the upper portion of the rectum
Splenic flexure is a watershed region

40
Q

What are the branches of the celiac trunK?

A

Common hepatic
Splenic
Left gastric

41
Q

Quality of anastomoses between short gastrics?

Between L and R gastroepiploics, L and R gastrics?

A

Poor

Strong

42
Q

What does the superior epigastric (internal thoracic/mammary) anastomose with?

A

Inferior epigastric (external iliac)

43
Q

What does the superior pancreaticoduodenal (celiac trunk) anastomose with?

A

Inferior pancreaticoduodenal (SMA)

44
Q

What does the middle colic (SMA) anastomose with?

A

Left colic (IMA)

45
Q

What does the superior rectal (IMA) anastomse with?

A

Middle and inferior rectal (internal iliac)

46
Q

Where are the three areas that you can see varices with portal HTN?

A 
Esophageal varices (esophagus)
Caput medusae (umbilicus)
Internal hemorrhoids (rectum)
**gut, butt, and caput
47
Q

What is the portal to systemic anastomosis that causes esophageal varices?

A

Left gastric to esophageal

48
Q

What is the portal to systemic anastomosis that causes caput medusae

A

Below the umbilicus: paraumbilical to superficial and inferior epigastric
Above the umbilicus

49
Q

What treatment for portal HTN relieves pressure by shunting blood from the portal vein to the heptatic vein ?

A

Transjugular intrahepatic portosystemic shunt (TIPS)

50
Q

What forms the pectinate or dentate line?

A

Where the endoderm (hindgut) meets with ectoderm

51
Q

Two pathologies that occur above the pectinate line?

A

Internal hemorrhoids

Adenocarcinoma

52
Q

Two pathologies that occur below the pectinate line?

A

External hemorrhoids

Squamous cell carinoma

53
Q

Arterial supply above the pectinate line

A

Superior rectal artery (branch of the IMA)

54
Q

Venous drainage above the pectinate line

A

Superior rectal vein
Inferior mesenteric vein
Portal system

55
Q

Arterial supply below the pectinate line

A

Inferior rectal artery (branch of the internal pudendal artery

56
Q

Venous drainage below the pectinate line

A

Inferior rectal vein
Internal pudendal vein
Internal iliac vein
IVC

57
Q

Are internal or external hemorrhoids painful? Why?

A

Internal: visceral innervation-> not painful
External: somatic innervation-> painful

58
Q

Lymphatic drainage above vs below the pectinate line

A

Above: deep nodes
Below: superficial inguinal nodes

59
Q

What surface of hepatocytes faces the bile canaliculi? Sinusoids?

A

Apical surface

Basolateral surface

60
Q

What liver zone is affected first by ischemia?

A

Zone 3: pericentral vein (centrilobular)

61
Q

What liver zone is affected first by viral hepatitis?

A

Zone 1: periportal zone

62
Q

What liver zone is the site of alcoholic hepatitis?

A

Zone 3: pericentral vein

63
Q

What liver zone is more sensitive to toxic injury?

A

Zone 3: pericentral vein (centrilobular)

64
Q

Where will gallstones block both the bile and pancreatic ducts?

A

In the common channel at the ampulla or Vater

65
Q

Tumors that arise in the head of the pancreas can cause obstruction of:

A

the common bile duct

66
Q

What is the order of structures in the femoral region from lateral to medial?

A

Nerve
Artery
Vein
Lymphatics

67
Q

What is the fascial tube 3-4 cm below the inguinal ligament?

A

Femoral sheath

68
Q

What is contained in the femoral sheath?

A

Femoral vein, artery, and canal (deep inguinal lymph nodes)

**NOT the femoral nerve

69
Q

What is contained within the femoral triangle?

A

Nerve, artery, vein

70
Q

What structures make up the deep inguinal ring and the superficial inguinal ring?

A

Transversus abdominus muscle

Aponeurosis of the external oblique muscle

71
Q

What is the external spermatic fascia derived from?

A

External oblique

72
Q

What is the cremasteric muscle and fascia derived from

A

Internal oblique

73
Q

What is the internal spermatic fascia derived from?

A

Transversalis fascia

74
Q

What is the site of protrusion of an indirec hernia?

A

Internal inguinal ring

75
Q

What is the site of protrusion of a direct hernia?

A

Abdominal wall (through Hesselbach’s triangle)

76
Q

What happens in a diaphragmatic hernia?

A

Abdominal structures enter the thorax

77
Q

What typically causes diaphragmatic hernias?

A

Occurs in infants due to defective development of pleuroperitoneal membrane

78
Q

What is the most common kind of diaphragmatic hernia?

A

Stomach herniates upward through the esophageal hiatus of the diaphragm

79
Q

What is the most common type of hiatal hernia?

A

Sliding hiatal hernia: GE junction is displaced upward (hourglass stomach)

80
Q

What type of hiatal hernia results in a normal GE junction but protrusion of the fundus into the thorax?

A

Paraesophageal hernia

81
Q

Where do abdominal contents herniate in an indirect inguinal hernia

A

Through the internal inguinal ring
Through the external inguinal ring
Into the scrotum
**follows the path of descent of the testes->covered by all three layers of spermatic fascia

82
Q

What is the relationship between an indirect inguinal hernia and the inferior epigastric artery

A

Enters the internal inguinal ring lateral to the inferior epigastric artery

83
Q

What do direct inguinal hernias protrude through?

A

Inguinal (Hesselbach’s) triangle, directly though the abodominal wall
Goes through the superficial inguinal ring only

84
Q

What is the relationship between direct inguinal hernias and the inferior epigastric artery

A

Goes through the abdominal wall MEDIAL to the inferior epigastric artery

85
Q

What is an indirect inguinal artery covered by? Direct?

A

All three layers of spermatic fascia

External spermatic fascia

86
Q

What type of hernia is medial to the inferior epigastric artery? Lateral?

A

Medial: direct
Lateral: indirect

87
Q

Where do femoral hernias protrude?

A

Below the inguinal ligament thorugh the femoral canal below and lateral to the pubic tubercle

88
Q

Who is more likely to get femoral hernias?

A

Women

89
Q

What complication are femoral hernias are leading cause of?

A

Bowel incarceration

90
Q

What makes up hesselbach’s triangle?

A

Inferior epigastric vessels
Lateral border of the rectus abdominus
Inguinal ligament

FirstAid:GI (5 decks)

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