Gi A & P

Front 1

retroperitoneal structures

Back 1

duodenum (2nd, 3rd, 4th) parts
desc colon
asc colon
kidneys and ureters
pancreas
aorta
ivc
adrenal glands and rectum

Front 2

celiac artery

Back 2

supplies forgut

Front 3

forgut

Back 3

stomach to proximal duodenum, liver, gallbladder, pancr

Front 4

SMA

Back 4

supplies midgut

Front 5

midgut

Back 5

distal duodenum to proximal 2/3 of transverse colon

Front 6

IMA

Back 6

hindgut

Front 7

hindgut

Back 7

distal 1/3 of transverse colon to upper rectum

Front 8

branches of celiac trunk

Back 8

common hepatic, splenic, left gastric

Front 9

common hepatic artery branches

Back 9

r gastric, gastroduodenal, l and r hepatic

Front 10

anastomoses between

Back 10

l and r gastroepiploic
l and r gastrics

Front 11

if abdominal aorta is blocked, anastomoses:

Back 11

internal thoracic/mammary (subclavian) - superior epigastric (internal thoracic) - inf epigastric (external iliac)
sup pancreaticoduodenal (celiac trunk) - inf pancreaticoduodenal (SMA)
middle colic (SMA) - left colic (IMA)
superior rectal (IMA) - middle rectal (internal iliac)

Front 12

esophageal varices

Back 12

L gastric-->azygous

Front 13

external hemorrhoids

Back 13

superior-->inf rectal

Front 14

caput medusae

Back 14

paraumbilical-->inf epigastric

Front 15

falciform ligament

Back 15

connects liver to anterior ab wall; contains ligamentum teres

Front 16

hepatoduodenal ligament

Back 16

connects liver to duodenum; contains portal triad: hepatic artery, portal vein, common bile duct
can be compressed to control bleeding

Front 17

gastrohepatic ligament

Back 17

connects liver to lesser curvature of stomach; contains gastric arteries

Front 18

gastrocolic ligament

Back 18

connects greater curvature and transverse colon; contains gastroepiploic arteries

Front 19

gastrosplenic ligament

Back 19

connects greater curvature and spleen
does not contain any vessels
separates L greater and lesser sacs

Front 20

splenorenal ligament

Back 20

connects spleen to posterior abdominal wall
contains splenic artery and vein

Front 21

layers of gut wall (inner to outer)

Back 21

mucosa, submucosa (meissners), muscularis externa (auerbachs), serosa/adventitia

Front 22

myenteric nerve plexus (Auerbachs)

Back 22

coordinates motility along entire gut wall; contains cell bodies of PS neurons; between inner (circular) and outer (longitudinal) layers of smooth muscle

Front 23

submucosal nerve plexus (Meissners)

Back 23

regulates local secretions, blood flow and absorption; contains cell bodies of PS neurons; located between mucosa and inner layer of smooth muscle in GI tract wall

Front 24

abdominal layers (inner to outer)

Back 24

transversalis fascia, transversus abdominis, internal oblique, external oblique

Front 25

brunner's glands

Back 25

secrete alka mucus to neutralize acid contents entering the duodenum from the stomach
located in duodenal submucosa (the only GI submucosal glands)
hypertrophy seen in PUD

Front 26

Peyer's patches

Back 26

unencapsulated lymphoid tissue found in lamina propria and submucosa of small intestine
stimulate b cels to leave and differentiate into IgA plasma cells in myenteric LN; then transported across epithelium

Front 27

Peyer's patches and adenovirus

Back 27

adenovirus causes hypertrophy of Peyer's patches causing intussuception

Front 28

sinusoids of liver

Back 28

irregular capillaries with fenestrated endothelium
no BM; allow macromolecules of plasma full access to basal surface of hepatocytes through space of disse

Front 29

biliary structures

Back 29

GB-->cystic duct-->common duct-->duodenum
R and L hepatic duct-->common hepatic duct-->common duct
pancreatic duct

Front 30

pectinate line

Back 30

where hindgut meets ectoderm

Front 31

internal hemorrhoids (above pectinate line)

Back 31

receive visceral innervation - not painful but bleed alot
arterial supply from superior rectal artery

Front 32

external hemorrhoids (below pectinate line)

Back 32

receive somatic innervation and are therefore painful
arterial supply from inf rectal artery

Front 33

cancer above pectinate line

Back 33

adenocarc

Front 34

cancer below pectinate line

Back 34

sq cell carc

Front 35

organization of femoral region (L to M)

Back 35

Nerve (artery, vein, empty space, lymphatics)

Front 36

diaphragmatic hernia

Back 36

abdominal structures enter thorax; may occur in infants; most commonly hiatal (cardiac stomach goes up)- predisposes to barretts

Front 37

indirect inguinal hernia

Back 37

through internal (deep) inguinal ring, external (superficial) inguinal ring, into scrotum
lateral to inf epigastric artery
infants because of failure of processus vaginalis to close
covered by all three layers of spermatic fascia

Front 38

direct inguinal hernia

Back 38

protrudes through inguinal (Hesselbachs) triangle; bulges directly through abdominal wall medial to inf epigastric artery
goes through external (supf) inguinal ring only
covered by transversalis fascia

Front 39

femoral hernia

Back 39

protrudes through femoral canal below and lateral to pubic tubercle; more common in women

Front 40

alpha cells of pancreas

Back 40

make glucagon

Front 41

beta cells of pancreas

Back 41

make insulin

Front 42

delta cells of pancreas

Back 42

make somatostatin

Front 43

hesselbach's triagle

Back 43

inferior epigastric artery; lateral border of rectus abdominus; inguinal ligament

Front 44

salivary secretions

Back 44

have alpha-amylase (starch digestion), bicarb, mucins (lubricate food)
secretion is simulated by both sympathetic and PS
low flow- hypotonic
high flow- closer to isotonic

Front 45

parietal cells

Back 45

IF (vit B12 binding protein) and gastric acid (decreases pH)

Front 46

gastric acid stimulated by

Back 46

histamine, Ach, gastrin
Ca salts

Front 47

gastric acid inhibited by

Back 47

stomatostatin, GIP, prostaglandin, secretin
anticholinegics, H2 receptor antag (ranitidine, cimetidine, famotidine)

Front 48

chief cells

Back 48

pepsin for protein digestion
stimulated by vagal stimulation

Front 49

mucosal cells

Back 49

secrete bicarb- from stomach, pancreas and pancreatic duct
neutralizes acid and prevents autodigestion
increased by secretin

Front 50

G cells

Back 50

gastrin (+ gastric things)
+ by: stomach distention, amino acids, peptides, vagal stim, phe and tryp

Front 51

I cells

Back 51

CCK (+ duodenum things, decrease gastric emptying)

Front 52

S cells

Back 52

secretin (+ bicarb, - acid)
allows pancreatic enzymes to function

Front 53

D cells

Back 53

somatostatin (inhibits all)
increased by acid and decreased by vagal stimulation
anti GH
used to tx VIPoma and carcinoid tumors

Front 54

K cells

Back 54

GIP, increase insulin, decrease acid

Front 55

VIP

Back 55

from ganglia; increase secretions; increase relaxation of muscle and sphincters

Front 56

NO

Back 56

increases SM relaxation, including LES
(loss --> achalasia)

Front 57

ACh

Back 57

increases gastric acid secretion and pancreatic zymogen release, decrease somatostatin

Front 58

alpha amylase

Back 58

starch digestion, secreted in active form

Front 59

lipase, phospholipase A, colipase

Back 59

fat digestion

Front 60

proteases (trypsin, chymotrypsin, elastase, carboxypeptides)

Back 60

protein digestion, secreted as proenzymes

Front 61

trypsinogen

Back 61

converted to trypsin by enterokinase - trypsin then activates more proenzymes and more trypsinogen

Front 62

salivary amylase

Back 62

starts digestion, hydrolyzes alpha 1,4 linkages to yield disaccharides

Front 63

pancreatic amylase

Back 63

highest concentration in duodenal lumen, hydrolyses starch to oligosach and disacch

Front 64

oligosaccharide hydrolases

Back 64

at brush border of intestine, rate limiting step in carbohydrate digestion, produce monosacch from oligo and disacch

Front 65

monosacch absorption (glucose, galactose, fructose)

Back 65

absorbed by enterocytes

Front 66

glucose and galactose

Back 66

taken up by SGLT 1 (Na dependent)

Front 67

fructose

Back 67

taken up by facilitated diffusion by GLUT 5

Front 68

GLUT2

Back 68

transports all the sugars to the blood

Front 69

zone 1 (periportal)

Back 69

affected first by viral hep

Front 70

zone II

Back 70

intermediate zone

Front 71

zone III (pericentral vein)

Back 71

contains P450 system, affected first by ischemia, alcoholic hepatitis, and most sensitive to toxic injury

Front 72

Kupffer cell

Back 72

liver macrophage

Front 73

bile

Back 73

composed of bile salts (bile acids conjugated to glycine or taurine making them water sol), phospholipids, cholesterol, bilirubin, water, ions
cholesterol excretion

Front 74

bilirubin

Back 74

actively taken up by hepatocytes
direct br- conjug with glucuronic acid, water sol
indirect br- uncong, water sol

Front 75

pathway of bilirubin excretion

Back 75

liver--> bile-->conversion to urobilinogen in colon-->some secretion as stercobilin in feces
distal ileum- active absorpt of bile salts
urobilingoen goes back to liver-->renal excretion as urobilirubin