Peritoneum & GI Tract

Question 1

parietal peritoneum pain?

Answer 1

• sensitive to pressure, laceration, temp
• pain well localized

Question 2

visceral peritoneum pain?

Answer 2

• sensitive to stretching and chemical irritation
• pain poorly localized and referred to dermatomes

Question 3

mesothelium

Answer 3

serous membrane of the peritoneum

Question 4

peritoneum innervation
parietal?
visceral?

Answer 4

parietal - somatic innervation
visceral - visceral innervation

Question 5

peritoneal cavity

Answer 5

potential space between parietal and visceral layers of the peritoneum

Question 6

pneumoperitoneum

Answer 6

air in the peritoneal cavity

Question 7

CC: where do uterine tubes open into in females? What does this cause?

Answer 7

uterine tubes open into the peritoneal cavity

makes a path for ascending infection

Question 8

gravity dependent recesses of the greater sac

Answer 8

• hepatorenal recess
• recto-uterine pouch (females)
• rectovesical pouch (males)

Question 9

mesentery

Answer 9

extension of peritoneum that connects an organ to body wall, has neurovasculature & lymphatics

Question 10

ligament

Answer 10

extension of peritoneum that connects organs to other organs or the body wall

Question 11

what travels within the hepatoduodenal ligament?

Answer 11

portal triad

Question 12

what makes up the portal triad?

Answer 12

bile duct, portal vein, hepatic artery

Question 13

functions of greater omentum

Answer 13

insulation, cushion, wall off inflammatory processes

Question 14

what covers intraperitoneal organs?

Answer 14

visceral peritoneum

Question 15

what covers extraperitoneal organs?

Answer 15

parietal peritoneum (partly)

Question 16

embryologic origin foregut

Answer 16

esophagus through mid duodenum

Question 17

embryologic origin midgut

Answer 17

mid duodenum through proximal 2/3 of transverse colon

Question 18

embryologic origin hindgut

Answer 18

distal 1/3 transverse colon through anus

Question 19

arterial supply foregut

Answer 19

celiac trunk

Question 20

arterial supply midgut

Answer 20

SMA

Question 21

arterial supply hindgut

Answer 21

IMA

Question 22

what flows into the caval system?

Answer 22

lower rectum & anal canal into IVC

Question 23

parasympathetics foregut & midgut?

Answer 23

vagus nerves (CN X)

Question 24

parasympathetics hindgut?

Answer 24

pelvic splanchnic nerves (S2-S4)

Question 25

fiber types of the parasympathetics of the GI tract?

Answer 25

pre-synaptic fibers synapse with post-synaptic fibers at the target organ

Question 26

what does parasympathetic innervation in the GI tract do?

Answer 26

- stimulates peristalsis - relaxes sphincters - stimulates secretion of digestive juices

Question 27

sympathetic innervation of the foregut & midgut?

Answer 27

thoracic splanchnic nn. (T5-T12)

Question 28

sympathetic innervation of the hindgut?

Answer 28

lumbar splanchnic nn. (L1-L2)

Question 29

what does sympathetic innervation do in the GI tract?

Answer 29

- inhibit peristalsis & constrict sphincters - constrict blood vessels to GI tract

Question 30

where do splanchnic nerves synapse in the GI tract?

Answer 30

pre-aortic ganglia (pre vertebral ganglia) = celiac, superior mesenteric, aorticorenal, & inferior mesenteric ganglia

Question 31

where do post-synaptic fibers of most of the GI tract travel?

Answer 31

peri-arterial plexuses to the end organ

Question 32

cord levels for the visceral afferent pain fibers of most of the GI tract?

Answer 32

T6-L2

Question 33

cord levels for visceral afferent pain fibers for midsigmoid colon through pectinate line of anal canal?

Answer 33

S2-S4

Question 34

where are somatic afferent pain fibers in the GI tract? Cord levels?

Answer 34

anal canal below the pectinate line, S2-S4

Question 35

what does the inferior rectal n supply?

Answer 35

somatic afferent pain fibers below the pectinate line (S2-S4)

Question 36

vertebral level of umbilicus?

Answer 36

T10

Question 37

what is the path for lymph in the GI tract starting with nodes adjacent to an organ?

Answer 37

node adjacent organ --> pre aortic lymph node (celiac, SM, IM), --> intestinal lymphatic trunk --> cisterna chyli --> thoracic duct

Question 38

CC: what causes GERD?

Answer 38

relaxation of the lower esophageal sphincter

Question 39

arterial supply esophagus?

Answer 39

left gastric a

Question 40

venous drainage esophagus?

Answer 40

portal: L gastric V --> hepatic portal v caval: esophageal vv --> azygous v.

Question 41

rugae

Answer 41

longitudinal mucosal folds in stomach

Question 42

what is the most common site of a gastric ulcer of the stomach?

Answer 42

along lesser curve

Question 43

clinical correlation for the stomach?

Answer 43

hypertrophic pyloric stenosis

Question 44

arterial supply stomach?

Answer 44

celiac trunk

Question 45

folds within the small intestine are called/

Answer 45

plica circularis

Question 46

what are the functions of the small intestine?

Answer 46

- nutrient absorption - enterohepatic circulation of bile acids - GI hormone production - immune function

Question 47

what is the only intraperitoneal part of the duodenum?

Answer 47

ampulla (bulb)

Question 48

where is the major duodenal papilla? what drains into it?

Answer 48

2nd part of the duodenum biliary ducts & pancreatic ducts

Question 49

what is the embryologic origin of the duodenum?

Answer 49

foregut & midgut

Question 50

why can gallstones erode into the duodenum?

Answer 50

because the gallbladder is anterior to the duodenal bulb (ampulla)

Question 51

what is the source of hemorrhage with