Aly and Rahn Ultimate Review Part II (Gross II Exam III)

What adheres to areas of inflammation to restrict the spread of infection, the ABDOMINAL POLICEMAN?

greater omentum

Which omentum extends from the porta hepatis to the lesser curvature of the stomach?

lesser

Which part of the SI is most commonly involved in inguinal hernia?

ileum

The hepatogastric ligament is between the liver and the ____________ of the stomach?

lesser curvature

Which ligament attaches the LEFT colic flexure to the diaphragm?

phrenicocolic ligament (FIB)

Where is the only place the omental bursa (lesser sac) is open?

at omental foramen to greater sac

Which sac extends from the diaphragm to the pelvic floor and across the entire breadth of the abdominal cavity?

greater sac

Which depression is lateral to the ascending colon?

right paracolic gutter

Which depression is lateral to the descending colon?

left paracolic gutter

Why are the right and left paracolic gutters important?

channel and compartmentalize peritoneal fluid and infectious proceses

What is the superior boundary of the omental bursa?

liver

What is the inferior boundary of the omental bursa?

first part of duodenum

What is the anterior boundary of the omental bursa?

free edge of lesser omentum

What is the posterior boundary of the omental bursa?

peritoneum covering IVC

What structures pass through porta hepatis and in which direction do they go?

bile duct to right, hepatic artery proper to left, and portal vein behind

Which gut ends with the second part of the duodenum, at the entrance of the bile duct?

foregut

Which gut begins at the entrance of the bile duct into the second part of the duodenum, and ends at the RIGHT 2/3 of the transverse colon?

midgut

Which gut beings with the LEFT 1/3 of the transverse colon and ends in the upper part of the anal canal?

hindgut

Which gut is supplied by the celiac trunk?

foregut

Which gut is supplied by the superior mesenteric artery?

midgut

Which gut is supplied by the inferior mesenteric artery?

hindgut

Which guts both receive sympathetic innervation from the greater and lesser splanchnic nerves?

foregut and midgut

Which gut receives sympathetic innervation from lumbar splanchnic nerves?

hindgut

Which guts both receive parasympathetic innervation from the vagus nerve?

foregut and midgut

Which gut receives parasympathetic innervation from the pelvic splanchnic nerves?

hindgut

What is responsible for peristalsis?

muscularis externa

What covers retroperitoneal organs?

adventitia

What powers the muscularis externa?

myenteric plexus

What is the capacity of the stomach?

2 to 3 liters

Where does the stomach lie?

left hypochondrium, epigastric, and umbilical region

Which orifice is between the esophagus and stomach?

cardial orifice

Which orifice is between the stomach and duodenum?

pyloric orifice

Wideset part of the stomach?

pyloric antrum

Narrowest part of the stomach?

pyloric canal

What are the longitudinal folds of mucous membrane, located within the cavity of the stomach?

gastric folds (rugae)

What condition increases the size of the pyloric sphincter and can be brought on by treatment with erythromycin?

congenital hypertrophic pyloric stenosis

Subluxation of which area may cause pylorospasm and gastric ulcers?

T5-T9

In which layer of the stomach do gastric ulcers occur?

mucosa

Which cells secrete gastric acid?

parietal cells (vagus nerve)

What is the smallest branch of the celiac trunk, running along the lesser curvature of the stomaach?

left gastric artery

Which artery is the largest of the celiac trunk, running posterior to the stomach and along the superior border of the pancreas?

splenic artery

The bile duct is to the _________ of the hepatic artery proper, the portal vein is _______________ it

right; behind

How long is the SI?

7 meters

What does the SI mostly absorb?

nutrients

What does the LI mostly absorb?

water

Which glands of the duodenum work to neutralize gastric acid?

brunner glands

How long is the duodenum?

25 cm

Which part of the duodenum is the longest?

inferior/horizontal/third

Where does the superior (first) part of the duodenum begin?

duodenal cap (ampulla)

Which portion of the duodenum contains the junction between foregut and midgut?

descending (second)

Which part of the duodenum terminates at the duodenojejunal flexure?

ascending (fourth)

The duodenum is entirely retroperitoneal except for what part?

duodenal cap

What passes ANTERIOR to the third part of the duodenum?

superior mesenteric vessels

Which parts of the duodenum are served by the inferior pancreaticoduodenal artery?

third and fourth

Where are duodenal ulcers most common?

duodenal cap

How does fluid of peritonitis from a duodenal ulcer travel?

subhepatic recess, right paracolic gutter, right iliac fossa

Which organs may also be damaged with a peritoneal duodenal ulcer?

liver, pancreas, and gallbladder

Which artery is at risk for erosion from a pancreatic duodenal ulcer?

gastroduodenal

Which segment of the SI mainly does nutrient uptake?

jejunum

Which part of the SI takes in fat soluble vitamins and bile salts?

ileum

What are the circular folds found within the SI that increase surface area?

plicae circulares (FIB)

What are the aggregations of lymphoid tissue found within the walls of the SI, important for immune response?

peyer's patches (FIB)

What are the straight terminal branches of arteries that travel through the mesentery to supply the SI?

vasa recta

The remnant of which embryonic duct can cause ileal (Meckel's) diverticulum?

vitelline duct (FIB)

What is the fingerlike outpouching of the distal ileum, mimicking appendicitis?

ileal diverticulum

What is the inflammatory bowel disease, most commonly impacting the distal ileum, with a COBBLESTONE appearance on xray?

crohn's

How long is the LI?

1.5 m

Which vitamin is produced in the LI?

K

What prevents the backflow of feces into the ileum?

ileal fold

What is the most common position of the appendix?

retrocecal

What is the most common intra-abdominal inflammatory condition, with pain being felt in the umbilicus and right lower quadrant?

appendicitis

What are the three narrow longitudinal bands of muscle seen in the cecum and ascending colon?

taeniae coli (FIB)

What are the sacculations/outpouchings of the colon?

haustra

What is the herniation of the mucosa of the colon WITHOUT INFLAMMATION, showing up as numerous outpouchings of the colon, caused by a LOW FIBER DIET?

diverticulosis

Where does diverticulosis most commonly occur?

sigmoid colon

What is it called when diverticuli become inflamed?

diverticulitis

What is the severe ulceration and inflammation of the rectum and lower colon?

ulcerative colitis

What deformity is characteristic on xray for ulcerative colitis?

tear drop bowel

What is aka as spastic colon?

irritable bowel syndrome

Stress and anxiety cause which GI disorder?

IBS

Which artery supplies the pancreas and distal part of the duodenum?

inferior pancreaticoduodenal artery

Which artery supplies the ascending colon?

right colic

Which artery supplies the transverse colon?

middle colic

Which artery supplies the ascending colon, cecum, and appendix?

ileocolic artery

What is the complete occlusion of the intestinal artery by a lipid plaque?

bowel infarction

What is the most fatal type of bowel infarction?

transmural

Which artery supplies the descending colon?

left colic

Into what do the branches of the superior and inferior mesenteric arteries empty?

marginal artery

What drains the GI, spleen, pancreas and gallbladder?

portal venous system

Which nutrient doesn't go through the portal venous system?

fat

How does fat get to the liver?

lacteals, hepatic artery proper (second pass processing)

How does blood flow via the portal venous plexus?

1. from abdominal organs

2. tributaries of portal vein

3. portal vein to R and L branches

4. liver sinusoids

5. IVC

What are the only two structures with caval drainage?

kidney and suprarenal gland

What is the most common organ, outside of the intestines, for metastasis for colon cancer?

liver

Which tributary of the portal vein is the only one to not accompany the artery with the same name?

paraumbilical vein

Which condition is characterized by destruction of hepatic cells replaced with fibrous tissue and fat?

cirrhosis

What is the abnormal elevation of pressure within the portal system, often due to cirrhosis?

portal hypertension

What is the obstructive sign in the distal esophagus between the esophageal and left gastric veins?

esophageal varices

What is the obstructive sign around the umbilicus between the superficial veins of the ab wall and paraumbilical veins?

caput medusae

What is the obstructive sign at the rectum and anal canal between the middle, inferior, and superior rectal veins?

hemorrhoid