Flashcards in Stuff I Can't Remember Deck (16):
1
What is an external supravesicular hernia?
Just medial to a direct hernia. At risk of cutting iliohypogastric nerve
2
Where do you anesthetize the scrotum?
Ilioinguinal for anterolateral and
pudendal for inferiorposterior
3
Know the ligaments of:
Liver (4)
Stomach
Spleen
And the arteries and veins that run through some of them.
Liver: (Last 2 part of the lesser omentum
Falciform
Hepatogastric --> Left gastric artery
Hepatoduodenal --> Contains triad (portal vein, hepatic artery, biliary duct)
Coronary ligament --> limits the lesser space's superior recess
Stomach: (all part of the greater omentum)
Gastropyloric
Gastrocolic --> gastroepiploic artery
Hepatogastric
Gastrosplenic -> Short gastric artery; left gastroepiploic artery
Splenorenal ligament --> Splenic artery and vein
4
What organs are in the supracolic compartment?
Infracolic?
What splits the infracolic into righ tand left?
stomach spleen liver
Everything else
Mesentary of small intestine
5
Esophagus and Stomach Histology
Esophagus
Mucosa:
Stratified squamous
Lamina propria has cardiac esophageal glands
Muscularis mucosae present only in lower segment
Submucosa:
Submucosal glands
Submucosal venous plexus drain into portal system
Increase pressure causes esophageal varices
Muscularis externa:
upper=skeletal muscle
middle=skeletal and smooth
Lower=smooth
serosa/adventitia:
Esophagus is only part of digestive system that does not have mesothelium on it’s serosa layer - has adipose instead
Stomach
Mucosa:
Secretory simple columnar epithelium
Lamina propria
Contains Cardiac, gastric, pyloric glands (gastric pits)
Muscularis mucosa facilitates gastric gland secretions
Submucosa:
Dense irregular CT
arteries/veins
NO GLANDS (will help ID the stomach on a slide)
Muscularis externa:
3 layers instead of 2
Circular layer thicker in pyloric region
Serosa:
Loose CT with blood vessels
6
What is Ménétrier’s disease?
Autoimmune gastritis?
Achlorhydia?
Pernicious anemia?
Helicobacter Pylori?
Men disease: TGF-a is low, and causes hypergenesis of mucous cells.
Autoimmune gastritis: Abs eat H/K+ ATPase = no parietal cells to make HCL.
Achlorhydria = Decrease in HCL. Caused by top 2
Pernicious anemia = RBCs made by intrinsic factor made by parietal cells. if gastritis, then no parietal cells = no RBCs = anemia
Helicobacter pylori = Makes a crap ton of ammonia
7
Duodenum parts and important stuff about them, also Vertebral location?
Part 1
Part 2
Part 3
Part 4
Part 1: L1
- hepatoduodenal ligament with hepatic triad.
- Location for duodenal ulcers
Part 2: L1-L3
- Bile enters here via duodenal papilla
Part 3: L3
- Crosses SMA
- Nutcracker Syndrome
Part 4: L3 - L2
- Held by ligametn of duodenum
8
The jejunum and ileum have similar arteries and ligaments attached to them. What are they?
Arteries:
SMA --> Jejunum and ileal arteries --> arterial arcades --> vasa recta
Ligaments:
THE mesentary ligament
Holds: SMA, lymph node, fat, autonomic nerve.
Crosses:
3rd and 4th duodenum
Aorta
IVC
R Ureter
R Psoas Major
R Gonadal vessels
9
Diverticulosis?
Vovlulus of sigmoid colon?
Esophagesal varices?
Pyrosis?
Displaced stomach?
Pylorospasm?
PYloric Stenosis?
Diverticulosis: little pockets
Volvulus: Colon gets twisted
Pyrosis: Heartburn. Hiatal hernias
Displaced stomach by pancreas enlargement
Pylorospasm: stomach muscles can't relax
Pylroic Stenosis: Pylorus is hard, elongated, and narrow. hard to get food through
Carcinoma: Have to cut out everything. Whole spleen, pancreas.
10
2nd duo part
Medial
Anterior
Posterior
Medial : pancreas
Anterior: R lobe Liver, Transverse colon, gall bladder
Posterior: kidney
11
Timeline
Dorsal mesentary
Week 4
12
Timeline
Day 20-26
Spleen formation
Dorsal mesentary
Herniated midgut
Midgut brought back in
First rotatino of midgut
Final rotation of midgut
Stomach
Week 4
Weeek 6
week 10
Day 50 - 90 degrees (week 6
Day 70 - 90 (week 10)
day 73 (week 11)
13
You get a slide. How do you know it's not Large intestine?
There is villi. No villi in L intestine
14
You get a slide. How do you know it's not Large intestine?
There is villi. No villi in L intestine
15
Diarrhea = too much water. What gut wall layer is screwed up.
Mucosa.
16