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GIT- anatomy

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drnieves's version from 2017-06-11 15:13

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Question Answer
Retroperitoneal structuresSAD PUCKER: Suprarenal (adrenal) glands Aorta and IVC Duodenum (not 1rst) Pancreas Ureters/ bladder Colon (descending/ascending) Kidneys Esophagus (thoracic portion) Rectum (partially)
Falciform ligamentLiver to anterior abdominal wall. Derivative of ventral mesentery.
Falciform ligamentLigamentum teres hepatis (derivative of fetal umbilical vein)
Hepatoduodenal ligamentLiver to duodenum
Hepatoduodenal ligamentPortal triad: proper hepatic a., portal vein, common bile duct
Pringle manouverHepatoduodenal ligament compressed btw thumb and index finger placed in mental foramen. control bleeding.
Hepatoduodenal ligamentBorders mental foramen, that connects the greater and lesser sacs
Gastrohepatic ligamentLiver to lesser curvature of stomach. Has gastric arteries. Sometimes cut to assess lesser sac.
Gastrohepatic ligamentSeparates greater and lesser sacs.
Gastrocolic ligamentGreater curvature and transverse colon. Gastroepiploic arteries.
Gastrocolic ligamentSeparates greater and lesser sacs on R. Part of greater omentum.
Gastrosplenic ligamentGreater curvature and spleen. Short gastric, left gastroepiploics. Separates greater and lesser sacs on Left.
Splenorenal ligamentSpleen to posterior abdominal wall.
Splenorenal ligamentSplenic a., vein, tail of pancreas.
MucusaEpithelium, lamina propia, musculares mucosa
SubmucosaSubmucosal nerve plexus (Meissner), secretes fluid
Muscularis externaMyenteric nerve plexus (Auerbach), motility.
Serosaintraperitoneal
adventitiaretroperitoneal
Stomach waves3/min
Duodenum waves12/min
Ileum8-9/ min
EsophagusNonkeratinized stratifies squamous epithelium
StomachGastric glands
DuodenumVilli + microvilli
DuodenumBrunner glands (HCO3 submucosa) and crypts of Lieberkhun.
JejunumPlicae circulares and crypts of Lieberkhun
IleumPeyer patches (lamina propia, submucosa) Plicae circulares (prox. ileum) crypts of Lieberkhun
IleumLargest number of goblet cells in SI
ColonCrypts of Lieberkhun, but no villi. Abundant goblet cells
Superior mesenteric artery syndromeTransverse portion (3rd) of duodenum is entrapped btw SMA and aorta= obstruction.
Foregut arteryCeliac. T12-L1
Midgut arterySMA L1
Hindgut arteryIMA L3
Parasympathetic innervation of foregut/ midgutVagus
arasympathetic innervation of hindgutPelvic n.
Celiac supplyPharynx, lower oesophagus to prox. duodenum; liver, gallbladder, pancreas, spleen.
SMA supplyDistal duodenum to prox. 2/3 transverse colon
IMA supplyDistal 1/3 transverse colon to upper rectum
Watershed region btw SMA/IMASplenic flexure
Branches of celiac trunkCommon hepatic, splenic, left gastric.
Short gastricsPoor anastamoses if splenic a. is blocked
Strong anastamosesL and R gastroepiploics L and R gastric
Esophageal varicesEsophagus. L gastric and esophageal a.
Caput medusaeUmbilicus. Paraumbilical- small epigastric veins of the anterior abdominal wall.
Anorectal varicesRectum Superior recta- middle and inferior rectal.
TIPS tx (transjugular intrahepatic portosystemic shuntBtw portal vein and hepatic vein. Shunts blood to the systemic circulation, bypassing liver. For portal HTN
Pectinate lineEndoderm (hindgut) meets ectoderm.
Above pectinate lineInternal hemorrhoids/ adenocarcinoma IMA= superior rectal a. Visceral innervation (no pain)
Above pectinate line venous drainagesuperior rectal vein= IMA= portal system
Above pectinate line lymphatic drainageInternal ileac
Below pectinate lineExternal hemorrhoids, anal fissures, squamous cell carcinoma. Internal pudendal a= inferior rectal a. Somatic innervation- painful
Below pectinate line lymphatic drainageSuperficial inguinal nodes
Below pectinate line venous drainageInferior rectal veina= internal pudendal vein- internal ileac veain= common ileac vein= IVC.
Zone 1 of liverPeriportal zone: affected 1st by hepatitis and toxins.
Zone 2 of liverIntermediate zone Yellow fever
Zone 3Pericentral vein (centrilobular zone) Affected first by schema Cytp450 system Most sensitive to metabolic toxins. alcoholic hepatitis.
Apical surface of hepatocytesFaces bile canaliculi
Basal surfaceFaces sinusoids
Painless jaundiceTumors in head of the pancreas Obstruction of common bile duct
CholangitisGallstones that reach ampulla of Vater block common bile duct
PancreatitisGallstones that reach ampulla of Vater block pancreatic duct
Femoral region (lateral to medial)Nerve, artery, vein, lymphatics
Femoral sheathFascial tube 3-4cm below inguinal ligament. Femoral vein, artery, and canal (deep inguinal LN), but not femoral nerve.
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