Term
Intraperitoneal organs
almost completely covered with visceral peritoneum
Stomach
1st part of duodenum
Jejunum/Ilium
Appendix
Cecum
Transverse colon
Sigmoid colon
Liver/Gallbladder
Spleen |
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Definition
|
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Term
Retroperitoneal organs
partially covered on just one surface by parietal peritoneum
2nd, 3rd, and 4th parts of duodenum
Ascending colon
Descending colon
Rectum
Kidneys/Adrenals
Pancreas
Ureters
Major blood vessels (IVC, aorta) |
|
Definition
|
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Term
|
Definition
Greater sac
Lesser sac
Paracolic gutters
Hepatorenal recess (Morrison’s pouch) |
|
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Term
| The greater sac is separated from the lesser sac by the ________ and _______ _________. |
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Definition
| greater and lesser omentum |
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Term
| The greater sac is divided into the _________ compartment and the ___________ compartment which are further divided into the ________ space and ____ and _____ __________ compartments. |
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Definition
supracolic
infracolic
subphrenic
right and left infracolic |
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Term
| The lesser sac can be accessed through the ________ _________, otherwise known as the ________ _________ or the _________ of _________. |
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Definition
epiploic foramen
omental foramen
foramen of Winslow |
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Term
| Borders of the lesser sac: |
|
Definition
anterior- hepatoduodenal ligament
posterior- IVC and right crus of diaphragm
superior- liver
inferior- first part of the duodenum |
|
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Term
| The right and left paracolic gutters are the communication between the _________ and __________ compartments. |
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Definition
|
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Term
| The hepatorenal recess is the space between the right ______ and the ______ lobe of the ______. |
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Definition
right kidney
right lobe of the liver |
|
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Term
The esophagus extends from ___ to ___
and has ______ and _______ portions.
The esophagus passes through the esophageal hiatus formed by the ______ diaphragmatic ____ and ends at the _____________ junction. |
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Definition
CV6- TV10
thoracic and abdominal
right diaphragmatic crus
esophagogastric |
|
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Term
| The _______ __________ sphincter is found at the end of the esophagus, and is otherwise known as the _______ sphincter or the ________ sphincter. |
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Definition
lower esophageal
cardiac
gastroesophageal |
|
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Term
| The gastroesophageal sphincter has _________ muscle fibers under hormonal and ______ control. |
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Definition
|
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Term
| 2 muscle layers of the esophagus |
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Definition
inner circular
outer longitudinal |
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Term
Esophageal muscle fiber: proximal (superior) 1/3 is _______ and _________.
distal (inferior) 1/3 is ________.
middle 1/3 is __________ showing gradual changes. |
|
Definition
voluntary and striated
smooth
combination |
|
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Term
| The gastroesophageal sphincter is a __________ not __________ sphincter. |
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Definition
| physiological not anatomical |
|
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Term
| The inferior esophageal sphincter is formed by ___________ musculature at the ______. It prevents _______ of gastric contents into the esophagus. |
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Definition
diaphragmatic
hiatus
reflux |
|
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Term
| The abdominal part of the esophageal artery supply comes from the ____ ______ artery and the ____ _________ _________ artery. |
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Definition
left gastric
left inferior phrenic |
|
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Term
| The left _______ artery is a branch of the _______ ______. |
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Definition
|
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Term
Proximal esophageal venous drainage is _________, the esophageal veins drain into the _________ vein.
Distal esophageal venous drainage is _________, esophageal veins drain into the ______ ________ vein. |
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Definition
systemic
azygous
portal
left gastric |
|
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Term
| 3 areas of esophageal constriction: |
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Definition
Aortic arch
Left main bronchus
Diaphragm |
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Term
A _______ ________ uses barium as contrast material to visualize _____ of the esophagus to the __________.
Constriction of lumen as shown by ____ of contrast suggests tumor-formation or pressure from adjacent structures. |
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Definition
barium swallow
lumen
duodenum
lack |
|
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Term
| Areas of esophageal constriction are common sites of ______ _____ __________. |
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Definition
| foreign body constriction |
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Term
| ___________ esophagus is due to chronic ____ ________ resulting in metaplasia of the mucosa |
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Definition
|
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Term
| Hiatal hernias can be ________ or ____________. Most common is ________. ____________ is most likely to result in stricture and discomfort. |
|
Definition
sliding
paraesophageal
sliding
paraesophageal |
|
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Term
|
Definition
Cardia
Fundus - from cardiac notch
Body
Pyloric region - antrum and canal
Pylorus
Pyloric sphincter |
|
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Term
________ curvature - attachment for greater _______
Lesser _________ - attachement for ______ omentum |
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Definition
greater
omentum
curvature
lesser |
|
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Term
| internal features of stomach: |
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Definition
Cardiac orifice
Rugae - gastric folds/ridges
Gastric mucosa - seen histologically
Gastric canal
Pyloric orifice |
|
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Term
_______ ulcers range in size and can develop from multiple erosions. They may heal in acute stages or enlarge into ______ _______ ulcers.
More common in the body near the _______ part towards the ______ curvature |
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Definition
Gastric
single chronic
pyloric
lesser |
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Term
| Chronic ulcers mainly present as __________ pain that radiates to the back. |
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Definition
|
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Term
| An ulcer may perforate into the _______ sac (omental bursa) and can erode the _______ artery which is often fatal. |
|
Definition
|
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Term
|
Definition
| ulcers caused by the acid production of gastric tissue |
|
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Term
Gastric ulcers are characterized by burning __________ pain usually _________ by eating. __% are associated with H. pylori. Numerous risk factors include H. pylori, _____ abuse, Zollinger-ellison syndrome, gastrin producing tumor, and ______.
Perforation can result in damage of the surrounding organs including the _______ and arteries (splenic, etc.) |
|
Definition
epigastric
exacerbated
70%
NSAID abuse
stress
pancreas |
|
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Term
| ________ ulcers are characterized by burning epigastric pain usually _________ by eating. __% are associated with H. pylori. Have the same risk factors as ______ ulcers. Most commonly on the ________ wall of the abdomen. Perforation may result in damage of the surrounding structures (gastroduodenal artery etc.) Perforations in the _____ may result in pneumoperitoneum. |
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Definition
duodenal
relieved
90%
gastric
posterior
bowel |
|
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Term
| The _________ is the first part of the small intestine, approximately _____ long, C-shaped, and has _________ folds. |
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Definition
|
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Term
| _____ part of the duodenum: superior, overlapped by _____ and gallbladder, at ____ level |
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Definition
|
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Term
| _____ part of the duodenum- ________, LV1-LV3, ______ _____ duct & major _________ duct; major duodenal papilla; ________ colon |
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Definition
second
descending
common bile
pancreatic
transverse |
|
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Term
| ____ part of the duodenum- ________, LV3, crossed over by _________ _________ artery and vein. |
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Definition
third
horizontal
superior mesenteric |
|
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Term
| ______ partof the duodenum - ________, ____ of LV3 and goes up to _______ border of LV2, ________ of _______(suspensory muscle of the duodenum), ________ starts here. |
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Definition
fourth
left
superior
ligament of Treitz
jejunum |
|
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Term
| The suspensory muscle of the duodenum, the _______ of ______ marks the flexure and is the marker for the division between the duodenum and jejunum. |
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Definition
ligament of Trietz
duodenaljejunal |
|
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Term
| The _____ ____ ____ and the ____ ________ _____ come together into the hepatopancreatic ampulla (of Vater) as the major ________ papilla. |
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Definition
common bile duct
main pancreatic duct
duodenal |
|
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Term
| The muscle around the major _________ papilla that closes the ampulla is the _______________ ________ (of Oddi). |
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Definition
duodenal
hepatopancreatic sphincter |
|
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Term
Pyloric stenosis signs and symptoms:
Nonbilious vomiting that begins 2-3 weeks after birth
Failure to thrive
Palpable olive-like mass in RUQ
Stricture of the pylorus on barium swallow |
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Definition
|
|
Term
Duodenal atresia signs and symptoms:
Bilious vomiting beginning immediately after birth
Failure to thrive
“double-bubble” sign on x-ray |
|
Definition
|
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Term
| ________ - _____ part of the small intestine, most of the ________ lies in the ___, attached to posterior abdominal wall via mesentery and is approx. __ _____ long. |
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Definition
jejunum
2nd
jejunum
LUQ
8 feet |
|
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Term
| The _______ is large in ________ and has great ____________. |
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Definition
jejunum
diameter
vascularity |
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Term
| The jejunum is deep ____ in color, has a _____ wall and the ____ ________ is long. |
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Definition
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Term
| The _______ in the jejunum are few and long. There is less ___ in the mesentery and fewer ______ _________. |
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Definition
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Term
| The components of the small intestine that are large, tall, and closely packed giving it a feathery appearance. |
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Definition
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Term
| _____ - ___ part of the small intestine, approx. ____ _____ long, lies mostly in the ___, attached to posterior abdominal wall via mesentary. |
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Definition
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Term
The _____ of the small intestine is ____ ____ in color and has a _____ vasa recta. The arcades have many short _____
with ____ fat in mesentary. |
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Definition
ilium
pale pink
short
loops
more |
|
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Term
| The ____ _______ are low and sparse in the ______, and absent in the ______ part. |
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Definition
plica circulares
ilium
distal |
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Term
| Peyer's patches are found in the ______ of the _____ _________. |
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Definition
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Term
| __________ ____________ is a remnant of the ompalomesenteric (vitelline) duct |
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Definition
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Term
| _____ diverticulum is an out-pouching of the lumen that is comprised of ____ of the layers of the gut wall. |
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Definition
|
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Term
| Rule of 2’s – 2 inches long, 2 feet from the ileocecal valve, present in 2% of the population, symptomatic in 2% of the afflicted, 2 possible ectopic tissues (gastric and pancreatic) |
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Definition
|
|
Term
| Meckel's diverticulum manisfests as ______ ________ or ___ ________. May mimic the symptoms of ___________ with periumbilical pain which localizes to ___. |
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Definition
intestinal obstruction or GI bleeding
appendicitis
RLQ |
|
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Term
| Complications of Merkel's diverticulum include: |
|
Definition
Ulcerations
Inflammation
torsion ± strangulation
Intussusception (telescoping)
herniation |
|
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Term
| The parts fo the large intestine include: |
|
Definition
Appendix
Cecum
Ascending colon
Right (hepatic) flexure
Transverse colon
Left (splenic) flexure
Descending colon
Sigmoid colon
Rectum
Anal canal |
|
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Term
| The ______ is the most likely portion of the colon to rupture due to the law of ________: wall tension ________ as radius __________. |
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Definition
cecum
Laplace
increases
increases |
|
|
Term
| Distinguishing features of the large intestine: |
|
Definition
teniae coli
haustra
Omental (epiploic) appendices
caliber |
|
|
Term
| The teniae are ________ than the colon, causing the formation of ________. The teniae run from the base of the ________ to the rectosigmoid junction. |
|
Definition
|
|
Term
|
Definition
| three thickened bands of muscle |
|
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Term
|
Definition
| sacculations of the colon between the teniae |
|
|
Term
| Omental (epiploic) appendices |
|
Definition
| fatty projections of the omentum |
|
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Term
|
Definition
| much larger internal diameter |
|
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Term
| The _________ is completely peritonealized and has no ______ _______. |
|
Definition
|
|
Term
| 4 different locations for the appendix: |
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Definition
| retrocecal, retrocolic, subcolic, pelvic |
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Term
__________ _________ = Point of tenderness on anterior abdominal wall during _________ . Typically 1/3 the distance from the _____ to the ________.
Usually where the base of the appendix and _____ converge. |
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Definition
McBurney's point
appendicitis
ASIS
umbilicus
cecum |
|
|
Term
| ____________ generally starts as periumbilical pain that migrates to the ____ followed by ________. ______ tenderness and ________ tenderness are present. |
|
Definition
appendicitis
RLQ
vomiting
point
rebound |
|
|
Term
| ___________ _____ – pain on passive internal rotation of the flexed thigh. Associated with ___________. |
|
Definition
obturator's sign
appendicitis |
|
|
Term
| _____ ______ – Pain on passive extension at the hip |
|
Definition
|
|
Term
| The rectum is the point of the GI tract where the _____ spread out and fatty omental __________ are discontinued. |
|
Definition
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|
Term
The rectal ______ of ________ have 3 lateral flexures that create 3 ________ folds. Their function is to ________ the weight of feces and to _________ the urge to deficate.
Decreases urge to deficate |
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Definition
valves of Houston
transverse
support
decrease |
|
|
Term
| Where the rectum joins the anal canal |
|
Definition
|
|
Term
| The anorectal junction is located at the __________ part of the anal _______. |
|
Definition
|
|
Term
| The anal columns are located along the __________ ________. |
|
Definition
|
|
Term
| The anal valves are located at the ________ end of the anal _________. |
|
Definition
|
|
Term
| The anal _______ secrete _____ that aids in the evacuation of feces. |
|
Definition
|
|
Term
| The _________ ______ is the inferior part of the anal valves which forms the junction of the superior part of the anal canal with the inferior part. |
|
Definition
|
|
Term
| The superior part of the anal canal differs from inferior part in: (4) |
|
Definition
| blood supply, innervation, lymphatic and venous drainage |
|
|
Term
| _______ _____ _____ - between external and internal anal sphincters, below this point lymph drains to superficial ______ _______. Epithelium changes from _____________ to ____________. |
|
Definition
Hilton's white line
inguinal nodes
non-keratinzed
keratinized |
|
|
Term
|
Definition
|
|
Term
| The rectum is innervated by both ___________ and _____________ nerves. |
|
Definition
sympathetic
parasympathetic |
|
|
Term
| sympathetic rectal innervation |
|
Definition
| sympathetic trunk and superior hypogastric plexus |
|
|
Term
| parasympathetic rectal innervation |
|
Definition
| pelvic splanchnic nerves (S2,3,4) |
|
|
Term
| anal canal venous drainage, divided by the pectinate line |
|
Definition
Superior to pectinate line - portal system
Inferior to pectinate line - caval system |
|
|
Term
| Anal canal innervation: superior to pectinate line - ________ from inferior __________ ______ (sympathetic and parasympathetic fibers), sensitive only to stretching |
|
Definition
visceral
hypogastric plexus |
|
|
Term
| Anal canal innervation- inferior to pectinate line - ________ from inferior _____ ______ (branches of the pudendal), sensitive to pain, touch, temp. |
|
Definition
|
|
Term
| ____________ cancer is one of the ___ most common cancers. It is most commonly seen as an _____________ and occurs in the _______ and up into the __________ junction. |
|
Definition
colorectal
3
adenocarcinoma
rectum
rectosigmoid |
|
|
Term
Colorectal cancer is often ____________.
Tumors may be palpable on ______ ______ exam and there is generally a positive _____ ______ _____ test.
Patient may present with _______.
Most commonly metastasizes to the _____. |
|
Definition
asymptomatic
digital rectal exam
fecal occult blood test
anemia
liver |
|
|
Term
| A _________ typically occurs in the sigmoid colon and involves the bowel turning around itself causing bowel obstruction. |
|
Definition
|
|
Term
| ________ ______________ affects 10% of Americans who are 40 or older and 50% who are 60 or older. |
|
Definition
|
|
Term
| Colonic _____________ is characterized by outpouchings (sacs) of intestinal wall in the colon that do not contain a full layer of intestinal wall. |
|
Definition
|
|
Term
Colonic diverticulosis is often __________ but can include mild _____, bloating, and constipation.
Complications can include bleeding, _________, perforations, tears, or _________. |
|
Definition
asymptomatic
cramps
infections
blockages |
|
|
Term
| Colonic diverticulosis is most common in the _______ colon or the ______ colon and when inflamed is called ______________. |
|
Definition
sigmoid
distal
diverticulitis |
|
|
Term
In __________ ________ a portion of the colon is dilated (megacolon) due to absence of _________ _________ (parasympathetic) in the intestinal wall _______ to the dilated segment. Absence of ganglia is due to arrest in ________ of ______ ______ cells.
Dilation is due to failure of ____________ in the aganglionic segment. |
|
Definition
Hirschprung's disease
autonomic ganglia
distal
migration
neural crest
peristalsis |
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|
