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Flashcards in GI, Topnotch Deck (236):
1

Vertebral level: Umbilicus

IVD of L3-L4

2

Vertebral level: Subcostal plane

10th rib, L3

3

Iliac tubercle

L5

4

Central regions of the anterior abdomen (3)

1) Epigastric 2) Periumbilical 3) Hypogastric/pelvic

5

Lateral regions of the anterior abdomen

1) Hypochondriac 2) Lumbar 3) Inguinal

6

Dermatomal level: Apex of supraclavicular fossa

C3

7

Dermatomal level: Acromioclavicular joint

C4

8

Dermatomal level: Radial side of antecubital fossa

C5

9

Dermatomal level: Dorsal surface of proximal phalanx of thumb

C6

10

Dermatomal level: Dorsal surface of proximal phalanx of middle finger

C7

11

Dermatomal level: Dorsal surface of proximal phalanx of little finger

C8

12

Dermatomal level: Ulnar side of antecubital fossa

T1

13

Dermatomal level: Apex of axilla

T2

14

Dermatomal level: Nipple/4th ICS MCL

T4

15

Dermatomal level: Midway between nipple and xiphisternum MCL

T5

16

Dermatomal level: Xiphisternum

T6

17

Dermatomal level: 1/4 between xiphisternum and umbilicus MCL

T7

18

Dermatomal level: 1/2 between xiphisternum and umbilicus, MCL

T8

19

Dermatomal level: Umbilicus MCL

T10

20

Dermatomal level: Midpoint of inguinal ligament

T12

21

Dermatomal level: Anteromedial thigh

L2

22

Dermatomal level: Medial femoral condyle

L3

23

Dermatomal level: Medial malleolus

L4

24

Dermatomal level: Dorsum of foot

L5

25

Dermatomal level: Lateral heel

S1

26

Dermatomal level: Popliteal fossa

S2

27

Dermatomal level: Ischial tuberosity

S3

28

Dermatomal level: Perianal area 1 cm lateral to mucocutaneous junction

S4-5

29

Most superficial abdominal muscle

External oblique

30

External oblique: Direction of fibers

Obliquely downward and medially

31

Immediately deep to the external oblique

Internal onlique

32

Internal oblique: Direction of fibers

Obliquely upward and medially

33

Components of conjoint tendon

Aponeurotic fivers of 1) Internal oblique 2) Transversus abdominis

34

Muscle whose aponeurosis splits to form the rectus sheath

Internal oblique

35

Innermost abdominal muscle

Transversus abdominis

36

Muscle on either side of line alba

Rectus abdominis

37

Lateral borders of rectus abdominis

Linea semilunaris

38

Crescentic border on the posterior wall of the abdomen midway between the umbilicus and pubic crest

Arcuate line

39

Characteristic arrangement of fibers above arcuate line

Internal oblique aponeurosis splits to form rectus sheath (present posterior layer)

40

Characteristic arrangement of fibers below arcuate line

Internal oblique aponeurosis is superficial to the rectus sheath (absent posterior layer) and transversalis fascia is directly below the rectus abdominis muscle

41

Contents of rectus sheath (4)

1) Rectus abdominis 2) Pyramidalis 3) Superior and inferior epigastric vessels 4) Lower 5 intercostal and subcostal vessels and nerves

42

Boundaries of foramen of Winslow: Anterior

Hepatoduodenal ligament

43

Boundaries of foramen of Winslow: Posterior

IVC

44

Boundaries of foramen of Winslow: Superior

Caudate lobe of liver

45

Boundaries of foramen of Winslow: Inferior

Superior part of duodenum

46

Extensions of visceral peritoneum (3)

1) Mesentery 2) Ligaments 3) Omentum

47

Layers: Mesentery

2

48

Layers: Ligaments

2

49

Supports hollow viscous to body wall for neurovascular communication

Mesentery

50

Connects viscera to each other or to the body wall

Ligaments

51

Connects the stomach with other viscera

Omentum

52

Layers: Greater omentum

4

53

Abdominal policeman

Greater omentum

54

3 parts of greater omentum

1) Gastrophrenic 2) Gastrosplenic 3) Gastrocolic

55

Layers: Lesser omentum

2

56

Greater omentum connects

Greater curvature and proximal duodenum to transverse colon

57

Lesser omentum connects

Lesser curvature to fissure for ligamentum venosum and porta hepatic of liver

58

Hepatoduodenal ligament: Posterior

Portal vein

59

Hepatoduodenal ligament: Anterior to the right

CBD

60

Hepatoduodenal ligament: Anterior to the left

Hepatic artery

61

Inflammation of this layer of peritoneum causes rebound tenderness and guarding

Parietal peritoneum

62

Brough about by congestion of the venous drainage of the abdomen

Ascites

63

Paracentesis at the midline goes through these layers (7)

1) Skin 2) Superficial fascia 3) Deep fascia 4) Linea alba 5) Transversalis fascia 6) Extraperitoneal fat 7) Parietal peritoneum

64

Paracentesis lateral to the inferior epigastric artery and above the deep circumflex artery goes through these layers (7)

1) Skin 2) External oblique 3) Internal oblique 4) Transversus abdominis 5) Transversalis fascia 6) Extraperitoneal fat 7) Parietal peritoneum

65

Branches of the splenic artery (2)

1) Left gastroepiploic 2) Short gastric

66

Branches of the common hepatic artery (3)

1) Right gastric 2) Right and left hepatic 3) Gastroduodenal

67

Branches of the gastroduodenal artery (2)

1) Right gastroepiploic 2) Superior pancreaticoduodenal

68

Branches of the SMA (5)

1) Inferior pancreaticoduodenal 2) Middle colic 3) Right colic 4) Ileocolic 5) Jejunal-ileal

69

Branches of the IMA (3)

1) Left colic 2) Sigmoid 3) Superior rectal

70

Common site of aortic aneurysm

Just proximal to the bifurcation at L4

71

Occlusion of the celiac artery results in collateral circulation by way of anastomosis between

Pancreaticoduodenal and gastroduodenal arteries

72

Branch of celiac artery eroded: Penetrating ulcer of posterior wall of stomach

Splenic

73

Branch of celiac artery eroded: Lesser curvature of stomach

Left gastric

74

Posterior wall of 1st part of duodenum

Gastroduodenal

75

Erosion of celiac circulation may present as referred pain at

Shoulder

76

Tributaries of IVC (8)

1) Right and left hepatic 2) Right suprarenal 3) Right gonadal 4) Right and left renal 5) Inferior phrenic 6) Lumbar 7) Right and left common iliac 8) Median sacral

77

May be compressed by aneurysm of SMA causing renal and adrenal htn

Left renal vein

78

Tributaries of portal venous circulation

1) Superior mesenteric 2) Inferior mesenteric 3) Splenic 4) Left gastric 5) Paraumbilical

79

Length of esophagus

25 cm

80

Esophagus: Enters the stomach at

Cardia

81

Continuous above with laryngeal part of pharynx at the level of

C6

82

Passes through diaphragm at the level of

T10

83

Structures through diaphragm: T8

IVC and right phrenic via Caval hiatus

84

Structures through diaphragm: T10

Esophagus and vagus via esophageal hiatus

85

Structures through diaphragm: T12

Aorta, thoracic duct, and azygos vein via aortic hiatus

86

Esophageal constrictions

1) Upper/Pharyngoesophageal 2) Middle/Thoracic 3) Inferior/Diaphragmatic

87

Upper esophageal constriction is caused by

Cricopharyngeus muscle

88

Middle esophageal constriction is caused by

Aortic arch and left main bronchus

89

Inferior esophageal constriction is caused by

Esophageal hiatus

90

T/F Esophageal constrictions are common sites of carcinoma

T

91

Relations of the esophagus in the neck: Anterior (2)

1) Trachea 2) Recurrent laryngeal nerves

92

Relations of the esophagus in the neck: Posterior (2)

1) Prevertebral layer of deep cervical fascia 2) Vertebral column

93

Relations of the esophagus in the neck: Lateral

Thyroid gland

94

Relations of the esophagus in the thorax: Anterior (4)

1) Trachea 2) Left recurrent laryngeal nerve 3) Left main bronchus 4) Pericardium

95

Relations of the esophagus in the thorax: Posterior (5)

1) Bodies of thoracic vertebrae 2) Thoracic duct 3) Azygos vein 4) Right posterior intercostal artery 5) Descending thoracic aorta

96

Relations of the esophagus in the thorax: Right (2)

1) Mediastinal pleura 2) Azygos vein

97

Relations of the esophagus in the thorax: Left (4)

1) Left subclavian 2) Aortic arch 3) Thoracic duct 4) Mediastinal pleura

98

Relations of the esophagus in the abdomen: Anterior

Posterior surface of left lobe of liver

99

Relations of the esophagus in the abdomen: Posterior

Left crus of diaphragm

100

Arterial supply to the esophagus: Upper 3rd

Inferior thyroid artery from subclavian

101

Arterial supply to the esophagus: Middle 3rd

Descending thoracic aorta

102

Arterial supply to the esophagus: Lower 3rd

Left gastric artery from celiac trunk

103

Venous drainage of the esophagus: Upper 3rd

Inferior thyroid vein

104

Venous drainage of the esophagus: Middle 3rd

Azygos vein

105

Venous drainage of the esophagus: Lower 3rd

Left gastric vein

106

Lymphatic drainage of esophagus: Upper 3rd

Deep cervical

107

Lymphatic drainage of esophagus: Middle 3rd

Superior and inferior mediastinal

108

Lymphatic drainage of esophagus: Lower 3rd

Celiac

109

Management for oesophageal haemorrhage from varicose by balloon insertion

Sengstaken-Blakemore Balloon Insertion

110

Average distance between external nasal orifices and stomach

44 cm

111

Capacity of stomach

1.5 L

112

Part of esophagus near the GEJ

Cardia

113

Part of esophagus that is dilated superiorly

Fundus

114

Part of esophagus between the fundus and pylorus (major part)

Body

115

Distal part of stomach

Pylorus

116

Sharp indentation of the stomach that approximates the junction of the body and pylorus

Angular incisura/notch

117

Concave border of stomach

Lesser curvature

118

Convex border of stomach

Greater curvature

119

Level of the cardiac orifice of stomach

6th left costal cartilage 2-4 cm from median plane at the level of T10 or T11

120

Level of the fundus of stomach

5th left rib, MCL

121

Level of the greater curvature of stomach

Up to 10th costal cartilage

122

Level of the pyloric antrum of stomach

9th costal cartilage or at L1 approximately 1.25 cm from midline

123

Level of the pyloric canal of stomach

Right side, L2-L4

124

Layer that hypertrophies in hypertrophic pyloric stenosis

Muscularis externa

125

Anterior relations of stomach (3)

1) Diaphragm 2) Left lobe of liver 3) Anterior abdominal wall

126

Posterior relations of stomach (2)

1) Omental bursa 2) Pancreas

127

On which the stomach rests when a person is lying supine

Stomach bed

128

Forms the stomach bed

Structures forming the posterior wall of the omental bursa

129

Structures forming the posterior wall of the omental bursa (6)

1) Left dome of diaphragm 2) Spleen 3) Left kidney and adrenal gland 4) Splenic artery 5) Pancreas 6) Transverse mesocolon and colon

130

Blood supply of stomach: Lesser curvature

Right and left gastric arteries

131

Blood supply of stomach: Greater curvature

Right and left gastroepiploic arteries

132

Blood supply of stomach: Fundus

Short gastric artery

133

Largest branch of the celiac trunk

Splenic artery

134

Largest arterial supply to the stomach and smallest branch of the celiac trunk

Left gastric artery

135

Venous drainage of stomach: Right and left gastric

Portal vein

136

Venous drainage of stomach: Left gastroepiploic and short gastric

Splenic vein to the portal vein

137

Venous drainage of stomach: Right gastroepiploic

Superior mesenteric to portal vein

138

PSY supply to the stomach (2)

1) Anterior vagal trunk from left vagus 2) Posterior vagal trunk from right vagus

139

PSY supply to stomach

T6-T9

140

Most gastric ulcers occur at

Lesser curvature, directly above the incisura

141

Carcinomas of the stomach are mostly found in

Distal 3rd

142

Distance from nasal orifices: Proximal esophageal narrowing

18 cm

143

Distance from nasal orifices: Middle esophageal narrowing

28 cm

144

Distance from nasal orifices: Distal esophageal narrowing

44 cm

145

Length of duodenum

25 cm

146

Duodenojejunal junction is seen at what level

L2

147

Parts of duodenum

1) Superior 2) Descending 3) Horizontal 4) Ascending

148

Length of part of duodenum: Superior

5 cm

149

Length of part of duodenum: Descending

7-10 cm

150

Length of part of duodenum: Horizontal

6-8cm

151

Length of part of duodenum: Ascending

5 cm

152

Level of part of duodenum: Superior

L1

153

Level of part of duodenum: Descending

L1-3

154

Level of part of duodenum: Horizontal

L3

155

Level of part of duodenum: Ascending

L3-2

156

Blood supply of duodenum: Superior part

Superior pancreaticoduodenal

157

Blood supply of duodenum: Inferior part

Inferior pancreaticoduodenal

158

Venous drainage of duodenum: Superior part

Superior pancreaticoduodenal to portal

159

Venous drainage of duodenum: Inferior part

Inferior pancreaticoduodenal to superior mesenteric

160

Duodenal ulcers most often occur at: Anterior vs posterior wall

Anterior

161

Perforation of ulcers most often occur at: Anterior vs posterior wall

Anterior

162

Blood type with increased risk of gastric ulcer

A

163

Blood type with increased risk of duodenal ulcer

O

164

Most commonly eroded artery in gastric ulcer perforation

Left gastric artery

165

Most commonly eroded artery in duodenal ulcer perforation

Gastroduodenal

166

Jejunoileal segment: Jejunal part

Proximal 2/5

167

Jejunoileal segment: Ileal part

Distal 3/5

168

Jejunoileal segment: Length

6-7 m

169

Quadrant: Jejunum

LUQ

170

Quadrant: Ileum

RLQ

171

Jejunum: Color

Deep red

172

Jejunum: Caliber

2-4 cm

173

Jejunum: Wall

Thick & heavy

174

Jejunum: Vascularity

Greater

175

Jejunum: Vasa rect

Long

176

Jejunum: Arcades

Few, large

177

Jejunum: Fat

Less

178

Jejunum: Plicae circularis

Large, tall

179

Jejunum: Lymphoid nodules

Few

180

Ileum: Color

Paler pink

181

Ileum: Caliber

2-3 cm

182

Ileum: Wall

Thin and light

183

Ileum: Vascularity

Less

184

Ileum: Vasa recta

Short

185

Ileum: Arcades

Many

186

Ileum: Fat

More

187

Ileum: Plicae circulares

Low, sparse, absent in distal segment

188

Ileum: Lymphoid nodules

Many

189

Instussuceptus vs intussucipiens: Proximal segment that invaginates

Instussuceptus

190

Instussuceptus vs intussucipiens: Distal segment that receives invaginating segment

Intussucipiens

191

Intussusception: Most common

Ileocecal

192

Intussusception: More common, children vs adult

Children

193

Intussusception: Signs of obstruction

1) Right-sided colicky abdominal pain 2) Abdominal distention 3) Hematochezia

194

Pancreas: Anterior, R to L

1) Transverse mesocolon 2) Lesser sac 3) Stomach

195

Pancreas: Posterior, R to L

1) Bile duct 2) Portal and splenic veins 3) IVC 4) Aorta 5) SMA 6) Left psoas 7) Left suprarenal 8) Left kidney 9) Spleen

196

Pancreas: Parts

1) Head 2) Neck 3) Body 4) Tail 5) Uncinate process

197

Pancreas: Part that overlies superior mesenteric vessels

Neck

198

Pancreas: Part that lies to the left of the SMA and SMV

Body

199

Pancreas: Part that is closely related to the hilum of the spleen and left colic flexure

Tail

200

Pancreas: Uncinate process projects from

Inferior part of the head

201

Pancreas: Uncinate process extends medially to the left, posterior to the

SMA

202

Main vs accessory pancreatic duct: Extends the length of the pancreas

Main

203

Main vs accessory pancreatic duct: Enters the duodenum

Both

204

Main vs accessory pancreatic duct: Joins the bile duct

Main

205

Main pancreatic duct joins the bile duct to form the

Hepatopancreatic ampulla

206

Accessory pancreatic duct lies in the

Head

207

Pancreas: Blood supply (3)

1) Superior pancreaticoduodenal from gastroduodenal 2) Inferior pancreaticoduodenal from SMA 3) Pancreatic arteries from splenic

208

Pancreatectomy: With splenic artery ligation

Warshaw technique

209

Pancreas: Venous drainage

Mainly into splenic vein

210

Most common cause of extrahepatic obstruction of biliary system

Pancreatic CA

211

Pancreas: Cancer of body and neck may cause obstruction of (2)

1) Portal circulation 2) IVC

212

Liver: Structures located posteriorly (8)

1) Diaphragm 2) Right kidney 3) Hepatic flexure of colon 4) Duodenum 5) GB 6) IVC 7) Esophagus 8) Fundus of stomach

213

Liver: Covered by peritoneum except at

Posteriorly, called bare area

214

Ligamentum teres hepatis is located between what structures

1) Left lobe 2) Quadrate lobe

215

Ligamentum venosum is located between

1) Left lobe 2) Caudate lobe

216

Liver: Anatomical lobes

1) Left 2) Right

217

Liver: Right lobe is divided into

Caudate and quadrate lobes

218

Liver: Segments

1) Medial superior I 2) Lateral superior II 3) Lateral inferior III 4) Medial inferior IV 5) Anterior inferior V 6) Posterior inferior VI 7) Posterior superior VII 8) Anterior superior VIII

A image thumb
219

Liver: Apices of cross-sections of portal lobules

Central vein

220

Liver: Centers of cross-sections of portal lobules

Portal triad

221

Portal vein is formed by union of

1) Superior mesenteric vein 2) Splenic vein

222

Liver: % blood supplied by portal vein

70%

223

Liver: Biopsy is usually done at

Right 10th ICS MAL

224

Gallbladder: Lies at which surface of the liver

Inferior

225

Gallbladder: Capacity

30-50 mL

226

Gallbladder: Posterior relations

1) Transverse colon 2) 1st and 2nd parts of duodenum

227

Gallbladder: Cystohepatic triangle

Triangle of Calot

228

Triangle of Calot: Boundaries

1) Superior - Liver 2) Inferior - Cystic duct 3) Medial - Common hepatic duct

A image thumb
229

Triangle of Calot: Content

Cystic artery

230

Cystic artery is USUALLY a branch of

Right hepatic artery

231

Common site of impacted gallstone

Hepatopancreatic ampulla

232

Impacted gallstone at hepatopancreatic ampulla: Referred pain

Epigastric region

233

Stone blocking the cystic duct: Characteristic pain

Biliary colic

234

Describe biliary colic

Begins in the epigastric region but moves to a point where 9th costal cartilage intersects the lateral border of the rectus sheath

235

Dermatomes of referred pain of GIT

T5-L1

236

Valve of Houston is associated with what organ

Rectum