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75 Cards in this Set

  • Front
  • Back
retroperitoneal structures
duodenum (2nd, 3rd, 4th) parts
desc colon
asc colon
kidneys and ureters
adrenal glands and rectum
celiac artery
supplies forgut
stomach to proximal duodenum, liver, gallbladder, pancr
supplies midgut
distal duodenum to proximal 2/3 of transverse colon
distal 1/3 of transverse colon to upper rectum
branches of celiac trunk
common hepatic, splenic, left gastric
common hepatic artery branches
r gastric, gastroduodenal, l and r hepatic
anastomoses between
l and r gastroepiploic
l and r gastrics
if abdominal aorta is blocked, anastomoses:
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)
esophageal varices
L gastric-->azygous
external hemorrhoids
superior-->inf rectal
caput medusae
paraumbilical-->inf epigastric
falciform ligament
connects liver to anterior ab wall; contains ligamentum teres
hepatoduodenal ligament
connects liver to duodenum; contains portal triad: hepatic artery, portal vein, common bile duct
can be compressed to control bleeding
gastrohepatic ligament
connects liver to lesser curvature of stomach; contains gastric arteries
gastrocolic ligament
connects greater curvature and transverse colon; contains gastroepiploic arteries
gastrosplenic ligament
connects greater curvature and spleen
does not contain any vessels
separates L greater and lesser sacs
splenorenal ligament
connects spleen to posterior abdominal wall
contains splenic artery and vein
layers of gut wall (inner to outer)
mucosa, submucosa (meissners), muscularis externa (auerbachs), serosa/adventitia
myenteric nerve plexus (Auerbachs)
coordinates motility along entire gut wall; contains cell bodies of PS neurons; between inner (circular) and outer (longitudinal) layers of smooth muscle
submucosal nerve plexus (Meissners)
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
abdominal layers (inner to outer)
transversalis fascia, transversus abdominis, internal oblique, external oblique
brunner's glands
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
Peyer's patches
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
Peyer's patches and adenovirus
adenovirus causes hypertrophy of Peyer's patches causing intussuception
sinusoids of liver
irregular capillaries with fenestrated endothelium
no BM; allow macromolecules of plasma full access to basal surface of hepatocytes through space of disse
biliary structures
GB-->cystic duct-->common duct-->duodenum
R and L hepatic duct-->common hepatic duct-->common duct
pancreatic duct
pectinate line
where hindgut meets ectoderm
internal hemorrhoids (above pectinate line)
receive visceral innervation - not painful but bleed alot
arterial supply from superior rectal artery
external hemorrhoids (below pectinate line)
receive somatic innervation and are therefore painful
arterial supply from inf rectal artery
cancer above pectinate line
cancer below pectinate line
sq cell carc
organization of femoral region (L to M)
Nerve (artery, vein, empty space, lymphatics)
diaphragmatic hernia
abdominal structures enter thorax; may occur in infants; most commonly hiatal (cardiac stomach goes up)- predisposes to barretts
indirect inguinal hernia
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
direct inguinal hernia
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
femoral hernia
protrudes through femoral canal below and lateral to pubic tubercle; more common in women
alpha cells of pancreas
make glucagon
beta cells of pancreas
make insulin
delta cells of pancreas
make somatostatin
hesselbach's triagle
inferior epigastric artery; lateral border of rectus abdominus; inguinal ligament
salivary secretions
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
parietal cells
IF (vit B12 binding protein) and gastric acid (decreases pH)
gastric acid stimulated by
histamine, Ach, gastrin
Ca salts
gastric acid inhibited by
stomatostatin, GIP, prostaglandin, secretin
anticholinegics, H2 receptor antag (ranitidine, cimetidine, famotidine)
chief cells
pepsin for protein digestion
stimulated by vagal stimulation
mucosal cells
secrete bicarb- from stomach, pancreas and pancreatic duct
neutralizes acid and prevents autodigestion
increased by secretin
G cells
gastrin (+ gastric things)
+ by: stomach distention, amino acids, peptides, vagal stim, phe and tryp
I cells
CCK (+ duodenum things, decrease gastric emptying)
S cells
secretin (+ bicarb, - acid)
allows pancreatic enzymes to function
D cells
somatostatin (inhibits all)
increased by acid and decreased by vagal stimulation
anti GH
used to tx VIPoma and carcinoid tumors
K cells
GIP, increase insulin, decrease acid
from ganglia; increase secretions; increase relaxation of muscle and sphincters
increases SM relaxation, including LES
(loss --> achalasia)
increases gastric acid secretion and pancreatic zymogen release, decrease somatostatin
alpha amylase
starch digestion, secreted in active form
lipase, phospholipase A, colipase
fat digestion
proteases (trypsin, chymotrypsin, elastase, carboxypeptides)
protein digestion, secreted as proenzymes
converted to trypsin by enterokinase - trypsin then activates more proenzymes and more trypsinogen
salivary amylase
starts digestion, hydrolyzes alpha 1,4 linkages to yield disaccharides
pancreatic amylase
highest concentration in duodenal lumen, hydrolyses starch to oligosach and disacch
oligosaccharide hydrolases
at brush border of intestine, rate limiting step in carbohydrate digestion, produce monosacch from oligo and disacch
monosacch absorption (glucose, galactose, fructose)
absorbed by enterocytes
glucose and galactose
taken up by SGLT 1 (Na dependent)
taken up by facilitated diffusion by GLUT 5
transports all the sugars to the blood
zone 1 (periportal)
affected first by viral hep
zone II
intermediate zone
zone III (pericentral vein)
contains P450 system, affected first by ischemia, alcoholic hepatitis, and most sensitive to toxic injury
Kupffer cell
liver macrophage
composed of bile salts (bile acids conjugated to glycine or taurine making them water sol), phospholipids, cholesterol, bilirubin, water, ions
cholesterol excretion
actively taken up by hepatocytes
direct br- conjug with glucuronic acid, water sol
indirect br- uncong, water sol
pathway of bilirubin excretion
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