Organs Of The GI Tract-1/5/16

Question 1

List the vertebral level of which the following pass through the diaphragm:
A) Esophageal hiatus
B) IVC
C) Aorta

Answer 1

A) T10
B) T8
C) T12
“I 8, 10 Eggs, At Noon (12)”

Question 2

_____ hernia is when the esophageal hiatus in the diaphragm enlarges or weakens and allows the abdominal esophagus and parts of the stomach (cardia and sometimes fundus) to herniate upward into the thorax

Answer 2

Sliding hiatal

Question 3

___ hernia is a defect in the diaphragm next to the hiatus and permits fundus of the stomach to herniate (not usually the esophagus)

Answer 3

Paraesophageal hiatal

Question 4

What region(s) is the stomach?

Answer 4

Left hypochondriac and epigastric region

Question 5

____ is the entrance to the pylorus and ____ is the entrance into the duodenum

Answer 5

Pyloric antrum, Pyloric orifice

Question 6

List the posterior relationships of the stomach

Answer 6

Diaphragm, spleen, left suprarenal gland, upper left kidney, pancreas, left colic flexure, left transverse colon, transverse mesocolon

Question 7

List the anterior relationships of the stomach:

Answer 7

Anterior abdominal wall, left costal margin, left diaphragm, left and quadrate lobes of the liver

Question 8

The duodenum is located at approximately _____ vertebral bodies and is subdivided into these 4 parts:

Answer 8

L1-L4

Superior, descending, horizontal, ascending

Question 9

The first part of the duodenum is surrounded by the ____ ligament

Answer 9

Hepatoduodenal

Question 10

What is the relationship of the portal vein, hepatic a., and bile duct to the superior (1st part) part of the duodenum?

Where is the pancreas relative to the superior part of the duodenum?

Answer 10

Posterior and superior

Head of pancreas is inferior to it

Question 11

What is the relationship of the fundus of the gallbladder, right lobe of liver, and transverse colon relative to the 2nd part (descending) of the duodenum? The right kidney & ureter? The head of the pancreas?

Which ducts enter into the 2nd part of the duodenum?

Answer 11

Anterior, Posterior, Medial

Bile and pancreatic ducts at the Major Duodenal Papilla

Question 12

What is the relationship of the superior mesenteric a. & v. And root of the mesentery relative to the 3rd part (horizontal) of the duodenum? Head of the pancreas? Jejunum?

Answer 12

Cross the anterior surface, superior, anterior & inferior

Question 13

The 4th part of the duodenum is held in place by ____

List the relationships of the root of the mesentery and jejunum relative to the 4th part of the duodenum? Left margin of aorta and medial border of psoas muscle?

Answer 13

Suspensory ligament (or muscle) of the duodenum (of Treitz)

Anterior, posterior

Question 14

The jejunum is roughly ____ feet long, has _____ arcades, ____ vasa recta, and is more vascular. It also has ____ diameter, is thicker and more plicae circularis

Answer 14

8-10
Simple vascular
Long
Greater

Question 15

The ileum is roughly ____ feet long, has _____ vascular arcades, _____ vasa recta, and is less vascular. It also has a ____ diameter with a thinner wall and fewer plicae circularis

Answer 15

10-12
Compound vascular
shorter
Smaller

Question 16

_______ is the most common congenital anomaly of the small intestine and is a remnant of the vitelline duct. It is clinically difficult to distinguish from appendicitis

Answer 16

Meckel’s (ileal) diverticulum–> Rule of 2’s: 2 inches long, 2 feet from the ileocecal junction, occurs in ~2% of population, may have 2 types of epithelia (gastric/pancreatic)

Question 17

_____ is about 15 cm long at the root and attaches the jejunum and ileum to the posterior body wall

Answer 17

THE mesentery

Question 18

Regarding the large intestine, ____ are 3 bands of longitudinal muscle on the outside of the colon, converge at the root of the appendix, and produce haustra (sacculations) that slow the movement of feces

Answer 18

Taenia coli

Question 19

Regarding the large intestine, _____ are tags of fat and is a distinct characteristic of the large intestine

Answer 19

Appendices epiploicae (epiploic appendages)

Question 20

____ has no epiploic appendages and is a blind “pouch” inferior to ileocecal orifice

____ is 2 folds that are not a true sphincter

____ is a cone-like projection of the ileum into the cecum and the opening for the appendix is inferior to this

Answer 20

Cecum

Ileocolic valve

Ileal papilla

Question 21

Regarding appendicitis:

If the appendix itself is inflamed, pain is felt in the ____ region

If the peritoneum adjacent to the appendix is inflamed, pain is felt ____

Answer 21

epigastric

at McBurney’s point, overlying appendix

Question 22

The ascending colon & descending colon are usually _____ retroperitoneal while the transverse and sigmoid colon are _____

Answer 22

Secondarily

Intraperitoneal

Question 23

The ____ is the are of colon where lowest sigmoid artery has poor anastomoses with superior rectal a.

Answer 23

“Critical point” of Sudeck

Question 24

The _____ is the dilated terminal part of the rectum

Answer 24

Rectal ampulla

Question 25

The ____ muscle is part of the levator ani muscle that forms a sling at the anorectal junction. It is voluntary and allows for control of defecation.

Answer 25

Puborectalis

Question 26

The ____ line is a line joining the tops (superior ends) of the rectal columns The ____ line is a line joining the inferior ends of the anal valves

Answer 26

Anorectal | Pectinate (AKA Dentate line)

Question 27

``` What are the characteristics of the following ABOVE the Pectinate line? A) Lymph B) Epithelium C) Embryological cell type D) Artery e) Vein F) Hemorrhoid type G) Nerves ```

Answer 27

``` A) Internal iliac LN B) Simple columnar C) Endoderm D) Superior rectal E) Superior rectal F) Internal (not painful) G) Inferior hypogastric plexus ```

Question 28

``` What are the characteristics of the following BELOW the Pectinate line? A) Lymph B) Epithelium C) Embryological cell type D) Artery E) Vein F) Hemorrhoid type G) Nerves ```

Answer 28

``` A) Superficial inguinal n. B) Stratified squamous C) Ectoderm D) Middle & inferior rectal a. E) Middle & inferior rectal v. F) External (painful) G) Inferior Rectal ```

Question 29

List the Retroperitoneal structures

Answer 29

``` SAD PUCKER Suprarenal (adrenal) glands Aorta & IVC Duodenum (2-4th parts) Pancreas Ureters Colon (descending and ascending) Kidneys Esophagus Rectum ```

Question 30

Identify the location (region) of the spleen

Answer 30

Left hypochondriac region; midaxillary line between stomach and diaphragm

Question 31

Where are the following relative to the spleen: A) Diaphragm B) Stomach, left colic flexure, and tail of pancreas C) Left kidney and phrenicocolic ligament

Answer 31

A) Posterior B) Anterior C) Inferior

Question 32

Is the pancreas intraperitoneal, primarily retroperitoneal, or secondarily retroperitoneal?

Answer 32

Secondarily retroperitoneal

Question 33

``` What are the relationships of the following relative to the pancreas? A) Superior mesenteric a. & v. B) Splenic v. & a. C) Spleen D) IVC and aorta E) Stomach F) Transverse colon ```

Answer 33

``` A) Posterior to the neck B) Superior to or posterior to the body C) Tail against the spleen D) Posterior to the body E) Anterior F) Anterior and inferior ```

Question 34

The main (major) pancreatic duct joins the bile duct and enter the 2nd part of the duodenum together through the ____ The accessory pancreatic duct (if present) enters the duodenum of the more superior ____

Answer 34

Hepatopancreatic ampulla Minor duodenal papilla

Question 35

The ____ is a double layer of peritoneum that connects the liver to the anterior wall and contains the obliterated umbilical vein The ____ includes the area where the IVC is posterior to the liver and the hepatic veins drain into it

Answer 35

Falciform ligament Bare area

Question 36

The ____ is a transverse fissure between caudate and quadrate lobes that transmits the portal triad (proper hepatic a., portal v., bile duct)

Answer 36

Porta hepatis

Question 37

The right and left hepatic ducts merge to form the ___ The cystic duct stems directly from the gall bladder and combines with the ___ duct The bile duct is formed from ____

Answer 37

Common hepatic duct Common hepatic duct Common hepatic duct and cystic duct combination

Question 38

The thoracic esophagus pierces the diaphragm at ___ and the esophageal hiatus is ____ of midline

Answer 38

T10, slightly left