Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
62 Cards in this Set
- Front
- Back
Circular muscle fibers in the gastroesophageal junction are under ___ and ___ ocontrol
|
Hormonal
Vagal |
|
The esophageal varices anastomose between ___ and ___ circulations
|
Portal (portal vein)
Caval (azygos vein to SVC) |
|
What can happen if the esophageal varices are under an increase of pressure?
|
They could rupture, leading to massive bleeding and vomitting of blood
|
|
What is barrett's esophagus?
|
Its when the lining of the esophageal is replaced by tissue similar to that of the stomach (intestinal metaplasia)
This is pre-cancerous but a small number of people develop a relatively rare but often deadly type of esophageal cancer (adenocarinoma). Associated with gastroesophageal reflux dis. GERD |
|
What is Achalasia?
|
Loss of ability of the esophagus to propel food from the mouth to the stomach.
Valve mechanism at the lower end of the esophagus fails to relax to allow the food into the stomach. |
|
"Megaesophagus-dilation of esophagus beginning at upper 1/3 eventually involving entire length"
^is a characteristic of what disease? |
Achalasia
|
|
Lack or paucity of ganglion cells in Auerbach's plexus is an example of what disease
|
Achalasia
|
|
T/F: Hepatoduodenal ligament supported the duodenum and stomach
|
False. It supports the duodenum only
|
|
What are rugae?
|
Gastric folds/ridges
|
|
Gastric mucosa?
|
Gastric pits that lead to gastric glands in the lamina propria
|
|
What is a common effect of pyloric stenosis?
|
Projectile vomitting
|
|
What organs do the stomach bed consist of?
|
Stomach bed:
1. pancreas-body/tail 2. left kidney 3. spleen 4. diaphragm 5. left suprarenal gland 6. transverse mesocolon 7. omental bursa (lesser sac) |
|
Acid Peptic disease is more common in which part of the stomach?
|
Pyloric part towards the lesser curvature
|
|
what kind of pain does chronic ulcer mainly present as?
|
epigastric pain
|
|
A gastric perforation can adversely affec which organ?
|
The one directly under neath it, the pancreas.
|
|
Which artery can be damaged by a gastric perforation?
|
Splenic Artery
|
|
First part of the duodenum relationships
|
LV1, gall bladder (could pass gall stone into the duodenum through a fistula).
gastroduodenal artery passes posteriorly (could be affected by a posterior perforation of a duodenal ulcer) |
|
Which part of the duodenum is most commonly affected by an ulcer?
|
First part. Duodenal cap or ampulla
|
|
Anterior duodenal perforation can result in what?
|
Peritonitis
|
|
Second part of duodenum relationships
|
LV1-LV3
Transverse colon, anteriorly, comon bile duct and major pancreatic duct, posteriorly. |
|
Third part of duodenum relationships
|
LV3
Superior mesenteric artery and vein pass anterior |
|
Fourt part of duodenum relationships
|
LV2-LV3
Joints the jejenum, attaches the ligament of treitz at junction. |
|
T/F: The lining of the duodenal cap (ampulla) contains plicae circulares
|
False. The internal feature of the ampulla is smooth lining.
|
|
What are plicae circulares?
|
Circular folds or valves of kerkring
|
|
What is so special about the major duodenal papilla?
|
It demarcates the junction of embryonic foregut and midgut.
It also contains opening of hepatopancreatic ampulla (the structure formed by pancreatic duct and common bile duct) |
|
True or False: Jejunum is longer than the ileum.
|
False. 8 vs 12 feet
|
|
True or Fale: Ileum has a bigger diameter than the jejunum
|
False.
|
|
True or False: Jejunum has larger plicae circulares
|
True
|
|
T/F: The ileum has more vasculature and is darker
|
False
|
|
This part of the small intestine is known to have lesser fat in the mesentery and have "windows"
|
Jejunum
|
|
This part of the small intestin is known to have fewer arterial arcades and longer vasa rectae
|
Jejunum
|
|
This part of the small intestine has more mesenteric fat
|
Ileum
|
|
This part of the small intestine has more arcades
|
Ileum
|
|
This part of the small intestine has shorter vasa rectae
|
Ileum
|
|
This part of the small intestine is where meckel's diverticulum happens
|
Ileum
|
|
This part of the small intestine has peyer's patches
|
Ileum
|
|
The walls of the jejunum have what that contributes to their feathery appearance?
|
1) large and numerous plicae circulares
2) Villi Compared to the smooth surface of the DISTAL ileum |
|
What is meckel's diverticulum?
|
Remnant of vitelline duct (the proximal part of the yolk stalk)
May appear in various stages of regression: short finger-like projection, fibrous cord, remain patent creating an umbilico-intestinal fistula, may contain a sinus or cyst. |
|
Whats the difference between diverticulum vs. diverticulosis?
|
A diverticulum contains all layers of the intestinal wall
|
|
What are the rule of 2's (for meckel's diverticulum)?
|
1) present in ~2-3% of infants
2) ~1-2 inches long 3) appears ~2-3 feet proximal to ileocecal junction 4) mucosal lining is similar to that of the ileum, but may contain islands of 2 types of tissues: (gastric or pancreatic mucosa) 5) 2 clinical manifestations: intestinal obstruction or GI bleed |
|
This manisfestion is characteristic of what:
"intestinal obstruction or GI bleeding; could also mimic appendicitis presenting as periumbilical pain which localizes to right lower quadrant" |
Meckel's Diverticulum
|
|
What are some complications of meckel's diverticulum?
|
Ulcerations
Inflammation Torsion +/- strangulation Intussusception (telescoping) Herniation |
|
What is another name for regional enteritis?
|
Crohn's disease
|
|
What are some of the ways to tell if you have crohn's disease
|
Chronic inflammation that affects terminal ileum and possibly colon
segments that are affected are separated by "normal" segments (skip lesions) Increased cancer risk |
|
What bands meet at the root of the appendix?
|
Taeniae coli
|
|
What is the usefulness of the taeniae coli?
|
It is used to locate the appendix
|
|
How come the Vermiform appendix doesn't have any tenia coli?
|
It has its own complete muscle layers (inner and outer longitudinal)
|
|
Is the vermiform appendix always located in the same position?
|
No
Retrocecal is most common Retro colic Subcecal Pelvic |
|
What are some symptoms of appendicitis?
|
1) Anorexia
2) Nausea 3) Vomitting |
|
What is appendicitis?
|
opening of v. appendix into the cecum is blocked by build-up of thick mucus, hardened stool (fecalith) or enlarged lymphoid tissues
poorly localized diffused pain initially, moves to right inguinal area due to involvement of parietal peritoneum (presents with rebound tenderness) |
|
What is psoas sign?
|
Pain on passive extension of the right thigh.
|
|
What is the anatomic basis for the psoas sign?
|
inflamed retrocecal appendix in contact with fascia over the psoas muscle (overstretched during the extension maneuver)
|
|
What is obturator sign?
|
Pain on passive internal rotation of the flexed thigh.
Examiner moves lower leg laterally while applying resistance to the lateral side of the knee resulting in internal rotation of the femur. |
|
What is the anatomic basis for the obturator sign?
|
Inflamed appendix int he pelvis is in contact with the fascia over the obturator internus muscle. Which is stretched by this maneauver. Remember, obturator internus actually is involved in external rotation, thus, when we internally rotate we are going to stretch it.
|
|
What are some characterisitics of diverticulosis?
|
Outpouchings of intestinal wall in the colon
Pouches do no contain layer of intestinal wall Often asymptomatic but can includ mild cramps, bloating, and constipation Complicaions: bleeding, infections, perforations, or tears or blockages |
|
Hirschsprung's disease is also known as ____
|
Congenital Megacolon
|
|
This disease is characterized as the most common cause of neonatal obstruction of the colon
|
Hirschsprungs (congenital megacolon)
|
|
This disease mostly affects the rectum and sigmoid colon
|
Hirschsprungs (congenital megacolon)
|
|
How is hirschsprun'gs disease presented?
|
As abdominal enerlagement, constipation in neonates, and unable to pass meconium at birth
|
|
What is the disease that has this characteristic:
Portion of colon is dilated due to absence of autonomic ganglia (parasympathetic) in the intestinal wall distal |
hirschsprung's
|
|
Why is there an absence of ganglia for hirschsprungs disease?
|
The cells were arrrested during migration of neural crest cells
|
|
Why is there dilation in the colon for hirschsprungs?
|
Due to failure of peristalisis in the aganglionic segment
|