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49 Cards in this Set
- Front
- Back
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retroperitoneal structures
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duodenum (not cap)
ascending colon descending colon kidney/ureter/adrenal pancrease (not tail) DAD Killed People |
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GI blood supply and innervation and vertebral level
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foregut=celiac=vagus=T12/L1=stomach to proximal dodenum, liver, gb, pancreas
midgut=sma=vagus=L1=distal duodenum->2/3 of tranverse colon hindgut=ima=pelvic splanchnics=L3=distal 1/3 of tranverse colon to upper rectum |
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esophageal varices
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left gastric to esophageal anastamoses
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caput medusae
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paraumbilical to superficial and inferior epigastric anastamoses
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hemorrhods
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superior rectal to middle and inferior rectal anastamoses
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retroperitoneal structures
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duodenum (not cap)
ascending colon descending colon kidney/ureter/adrenal pancrease (not tail) DAD Killed People |
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GI blood supply and innervation and vertebral level
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foregut=celiac=vagus=T12/L1=stomach to proximal dodenum, liver, gb, pancreas
midgut=sma=vagus=L1=distal duodenum->2/3 of tranverse colon hindgut=ima=pelvic splanchnics=L3=distal 1/3 of tranverse colon to upper rectum |
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esophageal varices
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left gastric to esophageal anastamoses
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caput medusae
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paraumbilical to superficial and inferior epigastric anastamoses
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hemorrhoids
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superior rectal to middle and inferior rectal anastamoses
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Portocaval shunt
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shunt placed between splenic and left renal vein to relieve portal HTN
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Acinus vs Lobule
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acinus = around portal tract
lobule = around central vein |
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Zones of Liver
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zone1=periportal, around portal tract, 1st affected by viral hep and involved in bile secretion
zone3=centrilobular, around central vein, contains P450, 1st affected by ischemia, toxic injury, alcoholic hepatitis |
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Venous drainage of Rectum
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above pectinate line: superior rectal->IMA->portal
below pectinate line: inferior rectal->internal pudendal->internal iliac>IVC (systemic) |
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Femoral Triangle: Borders and Contents
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superior=inguinal lig
lateral=sartorius m. medial=adductor longus m. contents=NAVEL (from lateral->med) all in femoral sheath except NERVE |
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Components of spermatic cord and origin
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internal spermatic fascia = transversalis
cremasteric muscle/fascia = internal oblique aponeurosis external spermatic fascia = external oblique aponeurosis |
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Brunner's Glands
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only GI submucosal glands, found in duodenum
secrete alkaline mucus to neutralize acidic contents of stomach they are hypertrophied in peptic ulcer disease |
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GIP
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secreted by K cells of duodenum/jejunum
stimulated by aa, fa, esp oral glucose causes insulin release and decreases gastric H+ production |
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Secretin , CCK
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secretin by S cells, CCK by I cells
secretin stimulates pancreatic ducts to release HCO3 and inhibits gastric H+ secretion CCK causes gb contractions/relax of oddi and directly pancreatic acinar secretion of pancreatic enzymes and potentiate secretin-dept HCO3 release and inhibit gastric emptying |
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Enterokinase
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activated tyrpsinogen
found in duodenal mucosa |
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what activated pepsinogen?
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H+ in stomach
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Absorption of carbs
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as mono's
fructose via glut5, facilitated diffusion glucose,galactose via sglt1, Na-dept all into blood via glut2 |
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VATER syndrome
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vertebral abnormalities
anal atresia TE fistula renal disease/absent radius |
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Celiac Sprue
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autoantibodies to wheat/gluten. usually involves prox small bowel (duodenum/jejunum)
associ with dermatitis herpetiforms (autoimmune vesicular skin rash on extensor surface) |
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types of gastric polyps
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hyperplastic=hamartomas, not neoplastic
adenomatous=neoplastic |
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erosion vs ulcer
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erosion not lower than submucosa
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Type A vs B chronic gastritis
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A=fundus,body=autoimmune, autoantibodies to patietal cells, pernicious anemia, achylohydria
B=antrum=caused by H. pylori, with increased risk of malt, adenocarcinoma, ulcers a=autoimmune b=bacteria |
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menetrier's disease
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mucus cell hyperplasia
giant rugal folds protein loss, parietal cell atrophy precancerous |
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acanthosis nigrans
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associated with linitus plastica cancer
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gastric vs duodenal ulcers
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gastric=pain Greater with meals, so wt loss 70% Hpylori, NSAIDs also. nl of dec bao/mao. can become malignant
duodenal=pain Decreases with meal, so wt gain. 100% H.pylori. no malignant potential. hypertrophy of brunner's glands |
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Primary sclerosis cholangitis
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assoc with UC
beading pattern on ercp onion skin bile duct fibrosis |
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necrotizing enterocolitis
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life threatening cause of abdominal distress presenting in early life (1st week)
multifactorial causes, including intestinal ischemia, microbes, poor GI immune system |
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Meconium Ileus
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presents in 1st days of life as failure to poop.
may be due to CF bc viscous poop gets stuck |
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Angiodysplasia
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tortous dilation of vessels-> bleeding
found often in cecum and ascending colon in elderly. related to straining |
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duodenal atresia
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failure of recanalization of small bowel
bilious vomiting and proximal stomach distention "double bubble" |
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colon cancer marker
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cea
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Peutz Jegher Syndrome
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autodominant benign polyposis syndrome, predominanty in small intesting but also in colon
increased risk of crc and other malignancies |
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Nutmeg liver
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centrilobular (zone3) hemorrhagic necrosis
due to lhf (hypoperfusion) or rhf (back up) remember zone 3 is most prone to ischemia |
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peliosus hepatis
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sinusoidal dilation of blood vessels in liver assoc with anabolic steroids of bartonella henselae
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crigler-najjar
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absent udp glcuronyl transferase
presents early in life die early of kerinecterus elevated unconjugated bilirubin |
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Dubin Johnson
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conjugated hyperbilirubinemia due to defective liver excretion
liver is grossly black but its a benign condition |
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Rotor syndrome
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like dubin johnson but milder and liver doesnt turn black
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primary biliary cirrhosis
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autoimmune disorder assoc with scleroderma or crest
elevated serum mitochondrial antibodies, ALP, and IgM |
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Macro vs Micronodular Cirrhosis
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macro = wilsons, aat def, hep B
micro=hhc, hep C, alcohol |
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Macro vs Micovesicular steatosis
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macro= alcohol, dm, obesity, corticosteroids
micro=pregnancy, reyes, tetracycline, valproic acid, nuceolside analogs |
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Treatment of cholecystitis pain?
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meperidine, opiod agonist which is least likely to cause spasm bc of antimuscarinic properties
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Signs of Acute Pancreatitis
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grey turner sign
cullen sign pain radiating to back hypocalcemia (enzymatic fat necrosis with Ca binding it up) Hyperglycemia (islet destruction) |
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ALP
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alkaline phosphatase
found in bile duct, elevated with infection, inflammation, or invasion by tumor, etc |
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Markers of Pancreatic Cancer
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CA-19-9 (gold standard)
CEA |
