Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

3A week 4 - HPB, malabsoprtion and EDs > Upper and lower GI bleeding > Flashcards

Upper and lower GI bleeding Flashcards

(66 cards)

Start Studying
1
Q

what types of muscle is the oesophagus comprised of (3)

A
  1. striated, voluntary muscle in the upper 1/3
  2. smooth, involuntary muscle in the lower 1/3
  3. mixture of both in the middle third
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

at what vertebral level is the cervicle oesophagus at

A

C6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the 2 sphincters that are at either end of the oesphagus

A
  1. upper oesophageal sphincter
  2. lower oesophageal sphincter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the arterial and venous supply of the cervical oesphagus

A

inferior thyroid artery/vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is there arterial and venous supply of the thoracic oesophagus

A

arterial - oesophageal branches of the thoracic artery
venous - azygous system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is there arterial and venous supply of the abdominal oesophagus

A

arterial - left gastric artery
venous - portal system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what ligament does the lesser curvature give rise to

A

hepatogastric ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the arterial supply of the fundusand upper body of the stomach

A

the short and posterior gastric branches of the splenic artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the arterial supply of the pylorus of the stomach

A

the gastroduodenal artery (branch of the common hepatic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the cardia of the stomach

A

the opening of the oesophagus into the stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what areas does the small bowel develop from (2)

A
  1. the distal foregut
  2. midgut
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the 3 main structures of the small bowel

A
  1. distal duodenum
  2. jejenum
  3. ileum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the main artery that supplied the small bowel

A

superior mesenteric artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what do pancreatic secretions and bile do in the duodenum

A

break down chyme into sugars, amino acids and fatty acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what does the jejenum primarily absorb (2)

A
  1. water
  2. micronutrients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what does the terminal ileum absorb (2)

A
  1. vit B12
  2. bile acids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the ampulla of vater

A

the spot where the pancreatic and bile ducts release their secretions into the intestines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the etymology of jejenum

A

from the latin jejenus meaning ‘fasting’as it was often found empty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is different about he proximal 40% of the jejenum

A

the lumen is wider and thicker than the rest with more prominent mucosal folds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the names of the mucosal folds in the jejenum

A

valvulae conniventes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

is there a clear demarcation between thee ileum and jejenum

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what does the ileum have more of compared to the jejenum (2)

A
  1. lymph nodes
  2. peyer’s patches
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are peyers patches

A

clusters of subepithelial, lymphoid follicles found in the intestine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the average length of the ileum

A

2m

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
what is the main venous drainage of the small bowel
portal vein
25
where doe the colon extend from and to
extends from the cecum to the anal canal
26
what is absorbed in the colon (2)
water and electrolytes
27
what are the 4 parts of the colon
1. ascending 2. transverse 3. descending 4. sigmoid
28
what artery supplies the hind gut
inferior mesenteric artery
29
which artery supply the ascending colon
ileocolic - branch of the sma
30
what arteries supply the transverse colon
the SMA (right and middle colic arteries) and IMA (left colic artery) - it is both mid and hind gut
31
what artery supplies the descending colon
left colic artery (branch of the IMA)
32
what does the superior mesenteric vein drain (4)
1. small intestine 2. cecum 3. asending colon 4. transverse colon
33
what does the inferior mesenteric vein drain (3)
1. descending colon 2. sigmoid 3. rectum
34
which 3 veins join together to make the portal vein
SMV, IMV, splenic
35
what anatomical marker is sued to differentiate between an upper and lower GI bleed
the ligament of treitz - supports and anchors the duodenum, without it intestinal twisting can occur
36
causes of an upper GI bleed (6)
1. peptic ulcer 2. oesophagus varices 3. oesophagitis 4. mallory weiss tear 5. AV malformation 6. upper GI cancers
37
causes of a lower GI bleed (5)
1. diverticulosis 2. haemorrhoids 3. colorectal cancer 4. mesenteric ischaemia 5. AV malformations
38
what is haematemesis
vomiting fresh or altered blood
39
what is haematochezia
bright red rectal bleeding
40
what is occult bleeding
blood in the feces that is not visibly apparent
41
where is the disease site if haematemesis is seen
proximal to the ligament of treitz (upper GI)
42
where is the disease site if melaena is seen
upper GI - jejenal usually; can be ileal and right colon also
43
where is the disease site if bright red rectal bleeding is seen
usually ileo-colonic; rarely - rapid upper tract bleeding
44
what pumps are responsible for gastric acid secretion
1. Acid secretion occurs through gastric proton pumps located in parietal cells; 2. These are hydrogen-potassium ATPase pumps (H+ into gastric lumen and K+ out), At rest, these pumps are located intracellularly;
45
what can stimulate parietal cells and what does this stimulation cause to happen
Simulation of parietal cells by a combination of Ach (vagus nerve) gastrin (antral G cells) and histamine (enterochromaffin like cells) translocate the proton pumps to the apical secretory canalicular (luminal) membrane;
46
what happens in the cephalic phase of a meal
During the cephalic phase of meal stimulated acid secretion; vagal activity stimulates ECL cells, G cells and parietal cells
47
what happens in the gastric phase of the meal
During the gastric phase, gastric distention of the stomach augments vagal output and short peptides, amino acids and calcium, as well as alkaline pH stimulate gastrin release by G cells. Gastrin release is inhibited by a gastric pH <3
48
what are the normal mucosal defense mechanisms against gastric acid (4)
1. the secretion of bicarbonate mucus and phospholipid by gastroduodenal epithelial surface mucous cells; 2. the epithelial barriers, 3. mucosal blood flow 4. epithelial cell renewal Many of these defense mechanisms are prostaglandin dependent
49
what are the 2 most common causes of peptic ulcer disease
1. H.pylori 2. NSAIDs
50
less common causes of peptic ulcer disease
1. hypersecretory states 2. viral infection (CMV, HSV1) 3. drugs - cocaine 4. ischaemia 5. radiation 6. infiltrative disorders e.g. sarcoidosis
51
how does H.pylori survive in stomach acid (4)
1. urease activity (convert urea to ammonia) 2. motility 3. microaerophilic properties 4. proteases (digest protective mucus)
52
how does H.pylroi damage gastric mucosa
1. production of ammonia 2. proteases 3. lipases 4. mucinates
53
6 physiological changes with hypovolaemia
1. tachycardia 2. peripheral shut down 3. hypotension 4. postural drop may be evident (BP) 5. confusion 6. oliguria nb. BP may be well preserved in young and fit
54
what is the Glasgow blatchford score
stratifies upper GI bleeding patients who are 'low-risk' and candidates for outpatient management
55
what is portal hypertensive bleeding
a spectrum of conditions encompassing oesophageal, gastric and ectopic varies, and portal hypertensive gastropathy
56
what value is portal venous pressure normally
5-10mmHg
57
how do oesophageal varices arise
the gradients between portal venous pressure and ICV pressure is >10mmHg (normally 3-7mmHg) due to a rise in portal venous pressure -> blood flowing through the hepatic portal system is redirected from the liver into areas with lower venous pressures -> collateral circulation develops in the lower esophagus, abdominal wall, stomach, and rectum -> The small blood vessels in these areas become distended, becoming more thin-walled, and appear as varicosities
58
variceal haemorrhage mgx (7)
1. resusitation and supportive care; 2. blood transfusion 3. terlipressin or somatostatin analogue - give at presentation if suspected bleed 4. prophylactic abx - intravenous ceftriaxone given immediately 5. endoscopic variceal band ligation 6. balloon tamponade (emergency holding measure) or Danis stent 7. transjugular intrahepatic portosystemic shunt (TIPSS)
59
what does splanchnic circulation refer to
blood flow tot he abdominal GI organs, including stomach, liver, spleen, pancreas, small intestimes, large intestines - comprises of the coeliac artery, SMA and IMA
60
why must abx be given for variceal haemorrhages
bacteraemia and subsequent sepsis is very common
61
secondary prevention of variceal haemorrhages
1. treat liver disease 2. variceal obliteration 3. drugs - BBs (carvediol) 4. determine cause of portal hypertension
62
complications of balloon tamponade for variceal haemorrhages (2)
1. aspiration 2. mucosal necrosis
63
what is transjugular intrahepatic portosystemic shunt (TIPSS)
a mgx for variceal hamorrhages that shunts blood from the portal vein to the hepatic vein - definative treatment for bleeding gastric varices
64
transjugular intrahepatic portosystemic shunt complications (6)
1. procedural/technical fault 2. infection 3. stent occlusion 4. rebleeding 5. portal systemic shunting 6. encephalopathy
65

3A week 4 - HPB, malabsoprtion and EDs (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions