GI Organs

Question 1

Level of:
Esophagus
Stomach
Pylorus

Answer 1

Esophagus - T10-11
Stomach - T11
Pylorus - L1

Question 2

Esophagus is attached to the diagphragm via:

Answer 2

Phrenico-esophageal ligament

Question 3

Where does the esophagus enter the cardial orifice of the stomach?

Answer 3

T11

Question 4

Where does the esophagus pass thru the right crus of the diaphragm at?

Answer 4

T10

Question 5

4 Esophageal constrictions:

Answer 5

Cricopharyngeal muscle
Aorta
Left main bronchus
Esophageal hiatus (T10)

Question 6

Paraesophageal hiatal hernia (3)

Answer 6

Normal GEJ
Fundus protrudes into thorax
Less chance of GERD

Question 7

Sliding hiatal hernia (4)

Answer 7

GEJ displaced superiorly
Cardia protrudes
“Hourglass” stomach
Most common

Question 8

Anatomy of the stomach (8)

Answer 8

Esophagus
Cardia
Fundus
Body
Pyloric antrum
Pyloric canal
Pylorus
Duodenum

Question 9

What is anterior to the stomach? (3)

Answer 9

Diaphragm
Left lobe of liver
Anterior abdominal wall

Question 10

What lies inferolateral to the stomach? (1)

Answer 10

Transverse colon

Question 11

What is posterior to the stomach? (6)

Answer 11

Diaphragm
Spleen
Kidney
Adrenal gland
Pancreas
Omental bursa

Question 12

The gastrohepatic l. connects:

Answer 12

Lesser curvature of the stomach to the liver.

Gastric vessels.

Question 13

The gastrocolic l. connects:

Answer 13

Greater curvature to transverse colon.
Gastroepiplotic vessels.
Part of greater omentum.

Question 14

Gastric ulcers (2)

Answer 14

Stomach

70% related to H. pylori

Question 15

Duodenal ulcers (3)

Answer 15

Pylorus or duodenum
90% related to H. pylori
65% occur in posterior wall of 1st part of duodenum

Question 16

Complications of duodenal ulcers (4)

Answer 16

Hemorrhage from gastroduodenal a.
Adhesions w/ Gb, liver.
Perforation into peritoneal space.
Affected pancrease.

Question 17

Ulcer in the lesser curvature can cause:

Answer 17

Hemorrhage from left gastric a.

Question 18

Vagotomy

Answer 18

Surgical TTM for GERD.

Question 19

Locations of 4 parts of duodenum

Answer 19

1st: L1
2nd: L2-L3 on right
3rd: anterior to L3
4th: superior to about L2

Question 20

Ligament of Treitz

Answer 20

Suspends Duodenojejunal flexure

Question 21

Most of the jejunum exists in which quadrant?

Answer 21

LUQ

Question 22

Most of the ileum exists in which quadrant?

Answer 22

RLQ

Question 23

How are the jejunum and ileum attached to the posterior wall?

Answer 23

A mesentery that begins at L2 and ends at L5 (ileocecal junction).

Question 24

Vascularity of jejunum vs. ileum:

Answer 24

Jejunum: greater, long vasa recta, few large arcade loops.
Ileum: less, short vasa recta, many short arcade loops.

Question 25

Which has more fat and LNs: jejunum or ileum?

Answer 25

Ileum

Question 26

Meckel diverticulum

Answer 26

Most common anomaly of GI tract. Persistent vitelline duct. Can contain ectopic gastric or pancreatic tissue. Most common cause of intussusception.

Question 27

What is the "Rule of 2s" of Meckel Diverticulum?

Answer 27

``` 2x more likely in males. 2 in. long. 2 ft. from ileocecal valve. 2% of population. Common in first 2 yrs of life. 2 types of epithelia may be present. ```

Question 28

Intussusception

Answer 28

A part of the proximal bowel slides into a distal segment. Common at ileocecal jxn. Mostly in kids. Idiopathic, Meckel (kids) and tumor (adults)

Question 29

Ileocecal jxn is at which plane?

Answer 29

L5 - transtubercular plane

Question 30

Lower edge of ascending colon is at which plane?

Answer 30

S2 - interspinous plane

Question 31

Which parts of the colon are retroperitoneal?

Answer 31

Descending and ascending colon

Question 32

Sigmoid colon occurs from:

Answer 32

Iliac fossa to S3

Question 33

Sigmoid colon has a:

Answer 33

Long mesentery

Question 34

Volvulus

Answer 34

Rotation of a loop of bowel (usually sigmoid colon). Can cause constipation, ischemia, necrosis. "Coffee bean" sign on XR.

Question 35

Liver location

Answer 35

Top is at xiphisternal plane and follows subcostal line. | Will move inferiorly on inspiration.

Question 36

Falciform l. separates:

Answer 36

Separates R and L lobes of the liver and connect liver to anterior wall.

Question 37

2 accessory lobes of the liver

Answer 37

``` Quadrate lobe (left hemi-liver) Caudate lobe (functionally separate) ```

Question 38

Round ligament of the liver is a remnant of:

Answer 38

Umbilical vein

Question 39

Ligamentum venosum is a remnant of:

Answer 39

Ductus venosus

Question 40

Hepatoduodenal l. contains (3):

Answer 40

Proper hepatic a. Bile duct Portal v. Connects liver to duodenum.

Question 41

Cantlie line

Answer 41

Imagined from fundus of Gb to diaphragm in the right lobe.

Question 42

Divisions of the liver (4)

Answer 42

``` RL: Right lateral Right medial Left medial LL: Left lateral ```

Question 43

Gallbladder is located between which segments of the liver?

Answer 43

IV and V.

Question 44

Cystic duct

Answer 44

Connects common bile duct to the Gb.

Question 45

Common bile duct empties into:

Answer 45

Ampulla of Vater in 2nd part of duodenum w/ pancreatic duct.

Question 46

Cholelithiasis

Answer 46

50% asymptomatic Can be caused by gallstones. Female, 40, fertile.

Question 47

Murphy's sign for cholelithiasis

Answer 47

Palpate RUQ and have pt. inhale. | Sudden halt to inspiration due to pain is a + sign.

Question 48

Choledocolithiasis is due to:

Answer 48

Obstruction of common bile duct.

Question 49

Gallstone ileus is due to:

Answer 49

Obstruction of the ileocecal jxn by a gallstone.

Question 50

Location of spleen

Answer 50

LUQ

Question 51

Spleen's relationship to other organs (stomach, diaphragm/ribs, L kidney)

Answer 51

Stomach is anterior. Diaphragm and ribs 9-11 are posterior. Left kidney is medial

Question 52

Splenic ligaments (2)

Answer 52

Splenorenal l. (splenic a.) | Gastrosplenic l. (short gastric as.)