Spom Exam 3 - Gi Tract, Peritoneum, Blood Supply, & Innervation - Powerpoint Cards

Front 1

A 2 year old boy presents with a distended abdomen and cries a lot while holding his ‘belly.’ His parents say he often wont defecate for days at a time and is smaller than most of the other boys his age. The family physician referred him for an abdominal x-ray. Radiographs showed marked dilation of the bowel superior to the pelvic brim, with no gas found in the rectum. Rectal biopsy was ordered.

Back 1

Hirschsprung disease

Front 2

What are some signs and symptoms of Hirschsprung disease?

Description of Hirschsprung disease?

Back 2

-Gas in abdomen, but certain regions may be devoid of gas.
-Marked dilation of the bowel, with no gas in rectum.
-Newborns that cannot have a bowel movement within first days of life
-No peristalsis

Hirschsprung’s disease results when neural crest tubes fail to migrate properly during development of the intestines. In a majority of the cases Auerbach’s and Meissner’s plexuses are missing in the rectum and sigmoid colon. In less than 10% of cases, the plexus is missing throughout the large intestine. The smooth muscle in the large intestine is not stimulated to contract. A new born would have delayed passage of meconium, constipation and abdominal distention. This can be corrected by surgically stretching the working portion of the large intestine.

Front 3

This disease occurs when neural crest tubes fail to migrate properly during development of the intestines.

Furthermore, parasympathetic ganglia fail to form in submucosal and myenteric neural plexuses in the wall of colon and rectum

Back 3

Hirschsprung’s disease

Front 4

What is the former patent
umbilical artery?

Back 4

Umbilical ligament

Front 5

Places in the gut where the peritoneum fixes the colon up against the body wall

Back 5

Right and left colic flexures

Front 6

Base of ascending colon

Back 6

Cecum

Front 7

___________ is continuous over Abdominal Contents

Back 7

Peritoneum is continuous over Abdominal Contents

Front 8

Name the 3 vocabulary associated with the peritoneum

Back 8

Intraperitoneal
Retroperitoneal
Secondarily retroperitoneal

Front 9

Describes structures that are completely covered by peritoneum.

_________ is/are an example of (a) structure(s) covered by peritoneum

Back 9

Intraperitoneal

(stomach, liver and spleen)

Front 10

Describes structures that are covered anteriorly by peritoneum THROUGHOUT development

_________ is/are an example of (a) structure(s) covered by peritoneum

Back 10

Retroperitoneal

(kidney)

Front 11

Describes structures that are covered anteriorly by peritoneum LATER in development. These start as intraperitoneal and later become retroperitoneal

_________ is/are an example of (a) structure(s) covered by peritoneum

Back 11

Secondarily Retroperitoneal

(duodenum, pancreas, ascending colon, and descending colon)

Front 12

Describes structures that are inferior to peritoneum

_________ is/are an example of (a) structure(s) covered by peritoneum

Back 12

*Subperitoneal

(bladder)

Front 13

What structure hangs off the cecum?

Back 13

the Appendix

Front 14

Food from the ascending colon passes what structure?

Back 14

the right colic flexure

Front 15

What structure does the midgut begin with?

Back 15

Jejunum

Front 16

The ascending colon is part of which gut?

Back 16

Midgut

Front 17

The first 1/2 of the transverse colon is part of which gut?

Back 17

Midgut

Front 18

What is the endpoint of the midgut?

Back 18

The first 1/2 of the transverse colon

Front 19

The last 1/2 of the transverse colon is part of which gut?

Back 19

Hindgut

Front 20

The descending colon is part of which gut?

Back 20

Hindgut

Front 21

The sigmoid colon is part of which gut?

Back 21

Hindgut

Front 22

What structure is the termination of the hindgut?

Back 22

the Rectum

Front 23

What ligament connects the liver to the lesser curvature of the stomach?

Back 23

Hepatogastric ligament

Front 24

What ligament connects the liver to the duodenum?

Back 24

Hepatoduodenal ligament

Front 25

The stomach contains folds called ________ (which contribute to the expansive properties of the stomach)?

Back 25

Rugae

Front 26

The ________ part of the stomach contains a sphincter that opens up into the duodenum of the small intestine

Back 26

Pyloric

Front 27

What are the branches of the celiac trunk?

Back 27

Common hepatic artery
Left gastric artery
Splenic artery

Front 28

The ___________ branches off the proper hepatic artery or less frequently from the common hepatic artery?

Back 28

Right gastric artery

Front 29

Back 29

Front 30

What allow bile and pancreatic enzymes to enter the gut tract?

Back 30

Duodenal papilla

Front 31

What artery comes off of the abdominal  aorta, about one inch inferior to where the celiac trunk comes off?

This artery supplies the mesentery and the gut that is associated with the small intestine

Back 31

superior mesenteric artery

Front 32

2nd part of duodenum is also called _________.
3rd part of duodenum is also called _________.
4th part of duodenum is also called _________.

Back 32

2nd part of duodenum is also called Descending duodenum.
3rd part of duodenum is also called Horizontal duodenum.
4th part of duodenum is also called Ascending duodenum.

Front 33

The superior mesenteric artery gives off long branches toward the jejunum, called the _____________

Back 33

jejunal arteries

Front 34

What are also vessels that branch to the gut from the superior mesenteric artery?

Back 34

Arteriae rectae

Front 35

Jejunum vs distal ileum:

What has more folds and appears more rugose?

Back 35

The jejunum has more folds and appears more rugose than the distal ileum

Front 36

Jejunum vs distal ileum:

The arterial distribution in which is more networked?

Back 36

The arterial distribution in the distal ileum is more networked than the supply in the distal ileum

Front 37

What are “pockets” that are hanging off of the gut called?

Back 37

Omental appendices

Front 38

What are strands that run the length of the colon?

Back 38

Taenia coli

Front 39

What appear as bulbous folds along the exterior of the colon?

Back 39

Haustra

Front 40

*The inferior mesenteric artery comes off of the aorta at approximately which spinal cord level?

Back 40

L3

Front 41

[“Fright” is a total ANS response – involving which branch of the nervous system?]

Back 41

both sympathetic & parasympathetic

Front 42

What branch of nervous system causes pupillary dilation?

Back 42

Sympathetic

Front 43

What branch of nervous system causes bronchial dilation?

Back 43

Sympathetic

Front 44

What branch of nervous system causes vasoconstriction in the skin?

Back 44

Sympathetic

Front 45

What branch of nervous system causes sweating?

Back 45

Sympathetic

Front 46

What branch of nervous system causes an active bowel?

Back 46

Parasympathetic

Front 47

What branch of nervous system causes relaxation of rectal and urinary sphincters?

Back 47

Parasympathetic

Front 48

*?*
Sympathetic innervation to the gut is from the splanchnic nerves
The splanchnics come from the T5-T12 region
The greater splanchnic nerve comes from T5-T9
This nerve synapses at the celiac ganglia
The celiac ganglia sit on the celiac trunk, which is just past the hiatus which the aorta enters the abdomen
The lesser splanchnic nerve comes from T10-T11
This synapses on the superior mesenteric ganglion, which is right on top of the superior mesenteric artery
The least splanchnic nerve comes from T12
This synapses on the inferior mesenteric ganglion, which is on top of the inferior mesenteric artery

Back 48

Sympathetic innervation to the gut is from the splanchnic nerves
The splanchnics come from the T5-T12 region
The greater splanchnic nerve comes from T5-T9
This nerve synapses at the celiac ganglia
The celiac ganglia sit on the celiac trunk, which is just past the hiatus which the aorta enters the abdomen
The lesser splanchnic nerve comes from T10-T11
This synapses on the superior mesenteric ganglion, which is right on top of the superior mesenteric artery
The least splanchnic nerve comes from T12
This synapses on the inferior mesenteric ganglion, which is on top of the inferior mesenteric artery

Front 49

The majority of parasympathetic innervation to the gut is via which cranial nerve?

Back 49

the Vagus nerve, CN10

Front 50

What is the name for the nerves that supply parasympathetic innervation to the hindgut, in the same region where the blood supply is from the inferior mesenteric artery?

Back 50

Pelvic splanchnic nerves

Front 51

Pain from visceral sensation travels mostly with what branch of nervous system back to T1-L2 spinal cord segments from the body wall and internal organs?

Back 51

Sympathetics

Front 52

Sympathetic Motor vs Visceral sensation:

The ___________ is the “on ramp” to the sympathetic Chain!
Travel via Splanchnic Nerves to the Gut

Back 52

white ramus

Front 53

Sympathetic Motor vs Visceral sensation:

In which must TWO NEURONS SYNAPSE IN A pre-vertebral GANGLION BEFORE GOING TO TARGET?

Back 53

Sympathetic Motor

Front 54

Sympathetic Motor vs Visceral sensation:

In which is there no gray ramus?

Back 54

Sympathetic motor

Front 55

White ramus communicans are found at which vertebral levels?

"White not quite"

Back 55

T1-L2

Front 56

Sympathetic Motor vs Visceral sensation:

In which is there no synapse in prevertebral ganglia, just passing through?

Back 56

Visceral sensation

Front 57

Referred Visceral Pain

Brain “thinks” pain from a visceral structure is coming from an area of skin innervated by the same segmental level at which the ___________ synapses (in the ______ horn)

Results from “cross talk” of ____________ on the same segmental level of the spinal cord. Signals transfer that trick the brain

Back 57

visceral afferent
&
dorsal.

somatic & visceral afferents