Antomy Gi 2

Front 1

WHAT ARE Mallory-Weiss tears?

Back 1

Longitudinal tears in the distal esophagus and gastroesophageal junction due to severe retching or vomiting. are usually due to acute alcohol intoxication; a hiatal hernia is a predisposing factor; these tears are responsible for ≈ 10% of cases of upper GI bleeding, which often presents as hematemesis

Front 2

Nerve controlling pyloric sphincter?

Back 2

vagus nerve under parasympthatic control

Front 3

what is a hiatal hernia?

Back 3

The stomach may protrude superiorly through an enlarged esophageal hiatus of the diaphragm into the mediastinum

Front 4

Two main types of hital hernias?

Back 4

Paraesophageal hiatal hernia, which usually does not result in regurgitation of gastric contents; this type is less common
Sliding hiatal hernia, which does result in regurgitation and may lead to Barrett’s esophagus; more common

Front 5

Pancreas referred pain goes where?

Back 5

back

Front 6

gastric ulcer complications?

Back 6

Pancreas, causing pancreatitis and referred pain to the back
Splenic artery, resulting in potentially fatal hemorrhage

Front 7

backup treatment for stomach ulcers?

Back 7

cut the vagus nerve, but no more pyloric spinchter, so need drainage of stomach.

Front 8

Three complications from duodenal ulcers?

Back 8

posterior: hemmoraging from gastrodueodenal branch
anterior wall would peritonitis
inferior: pancreatitis

Front 9

Second part of duodenum receives what?

Back 9

hepato-pancreatic ampulla. which is bile duct + pancreatic duct.

Front 10

Narrowest part of bile passages?

Back 10

hepato-pancreatic ampulla. backs up into pancreatic duct. common place for tumors.

Front 11

Where is duodenaljoujenal junctional?

Back 11

liagement of trietz at diapraghm.

Front 12

what is junction of upper and lower GI bleeding?

Back 12

liagement of trietz. about is vomitting blood + black stool, below in stool.

Front 13

what is paraduodenal hernia? complications?

Back 13

internal hernia, where small intentine transtion from retraparatenial to intraperitoneal. must case for inferior mesenteric artery.

Front 14

most common congenital anomaly of the small intestine

Back 14

An ileal (Meckel’s) diverticulum; remnant of the embryonic vitelline duct (yolk stalk

Front 15

most common cause of lower GI bleeding (hematochezia) in children

Back 15

ileal (Meckel’s) diverticulum; May contain ectopic gastric or pancreatic tissue and cause painless hemorrhage, intestinal obstruction, inflammation (diverticulitis) and perforation, and/or pain (mimicking appendicitis)

Front 16

appendix position?

Back 16

Varies in position except for its site of attachment (base) but is usually retrocecal (64%); it can always be found by following the teniae coli, which converge at its base

Front 17

signs of appendicitis?

Back 17

The typical patient initially complains of vague central periumbilical pain that later becomes sharp, localized right lower quadrant pain at a point 1/3 of the distance on a line connecting the right ASIS and umbilicus (McBurney’s point, )

Front 18

psoas (iliopsoas) sign

Back 18

Is pain on flexion of the right thigh against resistance
Results from movement against an inflamed appendix in contact with the fascia over the iliopsoas muscle

Front 19

obturator sign

Back 19

Is pain on passive rotation of the flexed right thigh
Often results from an inflamed pelvic appendix (i.e., hanging down into the pelvis), which is in contact with the fascia over the obturator internus muscle; the muscle is stretched by passive medial rotation of the thigh

Front 20

issue with mobile ascending colon?

Back 20

predisposes to twisting of the cecum or ascending colon on itself (volvulus), causing obstruction and compromising the blood supply (strangulation)

Front 21

90% of cases of volvulus involving the colon occur where?

Back 21

sigmoid colon (if long)

Front 22

Hirschsprung’s disease

Back 22

most common cause of neonatal obstruction of the colon
Mostly affects the rectum and sigmoid colon
Presents as abdominal enlargement and constipation in the neonate
Has absent ganglia due to an arrest in migration of embryonic neural crest cells

Front 23

what cuases cirrhosis of the liver?

Back 23

The liver’s attempts at detoxification may be overwhelmed in chronic alcoholism,
viral inflammation (e.g., hepatitis B or C), obstruction of bile drainage, and other etiologies

Front 24

where does venous blood in the abdominal GI tract go?

Back 24

hepatic portal vein to liver

Front 25

portal hypertension issues? 3

Back 25

Esophageal varices within the distal esophagus
Caput medusae, subcutaneous veins radiating outward from the umbilicus
Hemorrhoids at the anorectal junction

Front 26

Esophageal varices

Back 26

may be the source of upper GI bleeding with sometimes fatal hemorrhage in portal hypertension, such as occurs secondary to cirrhosis of the liver

Front 27

caput medusae

Back 27

the subcutaneous veins radiating from around the umbilicus dilate secondary to blood flow within the paraumbilical veins accompanying the ligamentum teres hepatis

Front 28

cystohepatic (hepatocystic) triangle

Back 28

Common hepatic duct
Cystic duct
Visceral surface of the liver

Front 29

the cystic artery is prematurely cut or the right hepatic artery is accidentally cut during gallbladder removal (cholecystectomy, what to do?

Back 29

surgeon can pass an index finger through the omental foramen and pinch the hepatoduodenal ligament between thumb and index finger (Pringle maneuver) to control bleeding

Front 30

jaundice

Back 30

Gallstones (cholelithiasis) develop in approximately 10% of the population over the age of 40, more commonly in obese women; if a gallstone passes into the bile duct and obstructs flow, bile is absorbed into the blood, producing yellowing of the skin, sclera, and mucous membranes (jaundice, icterus)

Front 31

common sites for gallstones getting stuck?

Back 31

become impacted are the hepatopancreatic ampulla and an abnormal sacculation, Hartman’s pouch, at the neck of the gallbladder or its junction with the cystic duct

Front 32

what drains into the major duodenal papilla
?

Back 32

Main pancreatic duct, which joins the bile duct at the hepatopancreatic ampulla to drain into the descending part of the duodenum

Front 33

causes of acute pancreatitis?

Back 33

Typically presents with abdominal pain—epigastric pain radiating to the back, nausea, vomiting, and fever
Most commonly is caused by alcoholism or by gallstones obstructing bile flow; it may follow surgical manipulation of the pancreas

Front 34

most common result from long term alcohol abuse?

Back 34

chronic pancreatis, permanent and progressive damage to the pancreas (fibrosis, calcification, ductal stricture), typically resulting in diminished exocrine and endocrine function

Front 35

Pancreatitis

Back 35

results in development of a pancreatic pseudocyst ( ), which is an encapsulated (fibrous-walled) collection of pancreatic enzyme-rich fluid located within or adjacent to the pancreas; the most common location is in the omental bursa (lesser sac); possible complications of pancreatic pseudocysts include compression or perforation of adjacent structures (e.g., the duodenum), hemorrhage, infection, and peritonitis