Term
| What constitutes the digestive system? |
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Definition
| Oral cavity, pharynx, esophagus, stomach, small intestines, large intestines, accessory digestive organs (salivary glands, liver, gallbladder, pancreas) |
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Term
| What does the esophagus connect? |
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Definition
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Term
| What is the distribution of skeletal and smooth muscle in the esophagus? |
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Definition
| Upper 1/3 = skeletal, Middle 1/3 = mixed, Lower 1/3 = smooth |
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Term
| What is the function of the upper esophageal sphincter? |
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Definition
| Prevents entrance of air during respiration, secondary line of defence against gastric reflux |
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Term
| What is the function of the lower esophageal sphincter? |
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Definition
| Gaurds against gastroesophageal reflux |
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Term
| What are the three constrictions of the esophagus? |
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Definition
| Cervical, thoracic, and diaphragmatic constrictions |
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Term
| Cervical and diaphragmatic constrictions are caused by upper and lower esophageal sphincters, but what causes the thoracic constriction in the esophagus? |
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Definition
| Arch of the aorta and left main bronchus |
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Term
| Why must clinicians be familiar with the esophageal constrictions |
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Definition
| Swallowed foreign objects often lodge at the constrictions, caustic fluids cause strictures at them due to delayed passage |
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Term
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Definition
| Esophageal motility disorder: absence of esophageal peristalsis and failure of lower esophageal sphincter to relax, may result from absence of autonomic ganglion cells within esophageal wall |
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Term
| What are symptoms of achalasia? |
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Definition
| Dsyphagia, possible regurgitation, chest pain, bird-beak appearance on a radiograph following barium swallowing |
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Term
| Why is prevention of gastric reflux important? |
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Definition
| Esophageal stratified squamous epithelium is vulnerable to damage |
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Term
| What might cause metaplastic change of stratified squamous epithelium into columnar epitherlium? |
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Definition
| Chronic gastric reflux causing Barrett's esophagus |
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Term
| What might arise from columnar epithelium due to Barrett's esophagus? |
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Definition
| Prone to ulceration and stricture development, may cause obstruction, may develop into adenocarcinoma |
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Term
| What are the four parts of the stomach? |
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Definition
| Cardia, fundus, body, pyloric part (pyloric antrum and canal) |
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Term
| Where are the cardia and fundus sections of the stomach located? |
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Definition
| Cardia = gastroesophageal junction, Fundus = dilated superolateral part below the left dome of the diaphragm, contains an air bubble in radiographs |
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Term
| What remains tonically contracted except to allow the passage of chyme into the small intestines and separates the pylorus from the duodenum? |
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Definition
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Term
| What indicates the junction of the body and pyloric part of the stomach? |
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Definition
| Angular incisure which is a notch to the right of the lesser curvature |
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Term
| What kind of stomach ulcer is most common? |
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Definition
| Peptic ulcer from mucosal erosion |
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Term
| Most ulcers are associated with what? |
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Definition
| Bacterial infection of Helicobacter pylori (H. pylori) |
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Term
| What factors can influence development of an ulcer? |
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Definition
| Chronic anxiety and chronic use of nonsteroidal anti-inflammatory drugs (NSAIDS) |
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Term
| What are complications of gastric ulcers? |
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Definition
| Bleeding, perforation, obstruction, may be life threatening |
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Term
| What accounts for 25% of ulcer deaths? |
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Definition
| bleeding, may be first indication of ulcer |
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Term
| What accounts for 2/3 of ulcer deaths? |
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Definition
| Perforation, rare first indication of ulcer |
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Term
| What complication is most often seen in chronic ulcers, often associated with pyloric channel ulcers, and may occur with duodenal ulcers? |
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Definition
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Term
| What is the most common cancer in the stomach? |
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Definition
| Adenocarcinoma, <30% survival rate |
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Term
| The small instestine is broken up into what parts? |
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Definition
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Term
| What are the circular folds of mucosa-submucosa in the small intestines called? |
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Definition
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Term
| What are the 4 parts of the duodenum in order? |
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Definition
| Superior, descending, inferior/horizontal, ascending |
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Term
| What parts of the duodenum have a distinct radiographic appearance using contrast medium? |
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Definition
| Superior part, duodenal cap/ampulla within the first 2cm |
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Term
| What is the clinical importance of the duodenal cap/ampulla in the superior part of the duodenum? |
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Definition
| Frequent location of peptic ulcers |
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Term
| What recieves the common bile duct and the main pancreatic duct? |
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Definition
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Term
| What forms the hepatopancreatic ampulla? |
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Definition
| Joining of the bile duct and main pancreatic duct |
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Term
| Where does the hepatopancreatic ampulla drain into? |
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Definition
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Term
| Where is the superior mesenteric artery and vein located along the small intestines? |
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Definition
| Crosses anterior to the inferior/horizontal part of the duodenum |
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Term
| What causes superior mesenteric artery syndrome? |
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Definition
| Compression and obstruction of the artery as it crosses anterior to the inferior/horizontal part of the duodenum following sudden weight loss |
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Term
| Why is the duodenojejunal junction an important clincial landmark? |
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Definition
| It is the junction between upper and lower GI bleeding |
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Term
| Where is the suspensory muscle of the duodenum (ligament of Treitz) and why is it clinically important? |
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Definition
| Suspends the duodenojejunal junction from the diaphragm, is a surgical landmark |
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Term
| What gives the jejunum a feathery appearance? |
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Definition
| Large mucosal-submucosal folds known as plicae circulares |
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Term
| Where is the ileal (Mechel's) diverticulum? |
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Definition
| Attached near the opening of the ileum at the ileocecal junction, is an embryonic vitelline duct |
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Term
| What may be contained in the ileal (Meckel's) diverticulum |
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Definition
| Ectopic gastric or pancreatic tissue, may cause hemorrhage, bowel obstruction, or perforation |
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Term
| What features distinguish the large intsetines from the small intestines? |
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Definition
| Omental appendices, taniae coli, haustra or sacculations |
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Term
| What are omental appendices? |
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Definition
| Small fatty projections found in the large intestines |
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Term
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Definition
| Three bands of longitudinal smooth muscle found in the large intestines |
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Term
| What are the partitions of the large intestines? |
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Definition
| Cecum and appendix, colon (ascending, transverse, descending, sigmoid), rectum, anal canal |
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Term
| What is the function of the cecum? |
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Definition
| Receives the contents of the ileum through the ileocecal junction, location of the appendix |
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Term
| What are the types of intestinal obstruction that can occur at the ileocecal junction and the cecum? |
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Definition
| Intussusception, Volvulus, Gallstone ileus |
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Term
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Definition
| The telescopig of a proximal segment of the intestine into a more distal segment |
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Term
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Definition
| Twisting of the intestine on itself |
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Term
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Definition
| Gallstone blockage of the ileocecal junction |
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Term
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Definition
| An intestinal diverticulum that contains lymphoid tissue, variable location in the cecum |
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Term
| What might cause appendicitis? |
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Definition
| Occlusion of the lumen or infection, may become gangrenous or perforate, causing peritonitis |
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Term
| Where does the ascending colon meet the transverse colon? |
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Definition
| Right colic (hepatic) flexure |
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Term
| Where does the transverse colon meet the descending colon? |
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Definition
| At the left colic (splenic) flexure |
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Term
| At what verterbal level does the sigmoid colon join the rectum? |
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Definition
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Term
| What are the accessory organs of the digestive system? |
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Definition
| Salivary glands, liver and gallbladder, pancreas |
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Term
| What is the largest gland within the body? |
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Definition
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Term
| What are the two surfaces of the liver? |
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Definition
| Diaphragmatic surface related to the inferior surface of the diaphragm, Visceral surface related to other abdominal organs |
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Term
| What divides the liver into two anatomical right and left lobes? |
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Definition
| A sagittal fissure formed by the fissure for the ligamentum teres hepatis and the fissure for the ligamentum venosum |
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Term
| Which anatomical lobes of the liver also includes the quadrate and caudate lobes? |
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Definition
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Term
| What forms the portal triad? |
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Definition
| Each liver lobe has its own branch of the hepatic artery, portal vein, and bile duct, branches join in the portal triad to form proper hepatic artery, hepatic portal vein, and the common bile duct |
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Term
| Where does the portal triad enter the liver? |
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Definition
| Visceral surface at the porta hepatis |
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Term
| What is the arrangement of the contents of the portal triad? |
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Definition
| Bild duct = right side, Proper hepatic artery = left side, Portal vein = posterior to other structures |
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Term
| What are some causes of cirrhosis, fibrous connective tissue replacement of hepatocytes (liver cells) |
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Definition
| Chronic alcoholism, hepatitis B & C |
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Term
| What are the three partitions of the gallbladder? |
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Definition
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Term
| Describe the fundus of the bladder and where it is located |
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Definition
| Blund end projecting from inferior border of the liver at the tip of the right 9th costal cartilage |
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Term
| What is the function of the neck of the gallbladder? |
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Definition
| Narrow tapering end, usually makes an S-turn to become continuous with the cystic duct |
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Term
| What is another name for gallstones? |
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Definition
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Term
| What ducts carry bile and from where? |
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Definition
| Common hepatic duct from the liver, Cystic duct from the gallbladder, Common bile duct from union of the former two, joins pancreatic duct at the hepatopancreatic ampulla |
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Term
| What is the vertebral location of the pancreas? |
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Definition
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Term
| What are the 4 parts of the pancreas? |
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Definition
| Head (lies within the C-shaped concavity of the duodenum), neck, body, tail (near the spleen) |
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Term
| Where does the main pancreatic duct originate from? |
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Definition
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Term
| What pancreatic duct drains part of the head of the pancreas? |
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Definition
| Accessory pancreatic duct |
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Term
| Why does cancer of the head of the pancreas cause jaundice? |
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Definition
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Term
| Though it is initially painless, pancreatic cancer may eventually cause mild or severe pain where? |
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Definition
| Radiating to the mid or lower back |
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Term
| What is the fourth leading cause of cancer death in the US? |
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Definition
| Pancreatic cancer, typically does not present until metastasis |
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Term
| What is contained in the peritoneum? |
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Definition
| Organs of the digestive system and urinary tract |
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Term
| In what cases is the paritoneal cavity closed or open? |
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Definition
| Closed in males, connected to the genital organs in females, uterine tubes open into the peritoneal cavity, a potential pathway for spread of infection |
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Term
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Definition
| Excess peritoneal fluid accumulation, may be drained as treatment |
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Term
| What might cause ascites? |
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Definition
| Cirrhosis of the liver, heart failure, ovarian cancer, etc. |
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Term
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Definition
| Bacterial infection of the peritoneum |
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Term
| What might cause peritonitis? |
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Definition
| Perforation of a peptic ulcer, penetrating wound, etc. |
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Term
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Definition
| Normally flows superiorly toward diaphragm, rapidly absorbed |
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Term
| During bacterial peritonitis, how is the patient often positioned? |
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Definition
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Term
| Why are patients with bacterial peritonitis usually seated? |
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Definition
| Encourages infection fluid to flow downward where absorption is slower |
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Term
| When might peritoneal adhesions occur? |
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Definition
| Peritonitis due to trauma or infection causing chronic pain and bowel or uterine tube obstruction |
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Term
| What does it mean when an abdominal cavity organ is intraperitoneal? |
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Definition
| Invaginating the peritoneal sac from behind and suspended from the body wall by a double layer of peritoneum (mesentary) |
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Term
| What does it mean when an organ of the abdominal cavity is retroperitoneal? |
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Definition
| Located posterior to the peritoneum |
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Term
| What is characteristic of intraperitoneal organs? |
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Definition
| Covered in visceral peritoneum, suspended by mesentery |
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Term
| What is the name for peritoneum lining the body wall? |
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Definition
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Term
| How are intraperitoneal organs supplied blood and innervation? |
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Definition
| Blood vessels and nerves reach through the mesentery |
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Term
| Where are retroperitoneal organs located? |
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Definition
| Posterior to the parietal peritoneum between the posterior abdominal wall, only partially covered by parietal peritoneum |
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Term
| What are the intraperitoneal organs? |
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Definition
| Abdominal esophagus, stomach, small intestines (only proximal duodenal cap), large intestines, liver, gallbladder, tail of pancreas, spleen |
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Term
| What are the retroperitoneal organs? |
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Definition
| Duodenum (except duodenal cap), ascending colon, descending colon, pancreas (except tail), kidneys and ureters, abdominal aorta, inferior vena cava |
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Term
| What are the peritoneal formations consisting of double layers of peritoneum? |
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Definition
| Mesentaries, Omenta, Peritoneal ligaments |
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Term
| What does the omenta connect? |
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Definition
| Peritoneal double layer formation, connects the stomach and proximal duodenum to other organs |
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Term
| What do the peritoneal ligaments connect? |
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Definition
| Abdominal organs to each other or to the abdominal wall |
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Term
| Where is the greater omentum suspended from? |
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Definition
| Greater curvature of the stomach |
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Term
| What does the lesser omentum connect? |
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Definition
| Lesser curvature of the stomach and the proximal duodenum to the liver |
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Term
| What is the function of the greater omentum? |
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Definition
| Mobile, moves to wall off infections within the peritoneal cavity to keep them localized, helps prevent peritonitis |
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Term
| Where does the lesser sac (omental bursa) lie? |
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Definition
| Posterior to the stomach and lesser omentum |
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Term
| How do the greater sac and omental bursa communicate? |
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Definition
| Omental (epiploic) foramen |
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Term
| What are the boundaries of the omental foramen? |
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Definition
| Anteriorly by hepatoduodenal ligament, posteriorly by inferior vena cava, superiorly by caudate lobe of liver, inferiorly by superior part of duodenum |
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Term
| How is an internal hernia into the omental foramen treated? |
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Definition
| None of the boundaries of the foramen can be incised, so the swollen intestines are decompressed with a needle to free it |
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Term
| What divides the greater sac? |
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Definition
| Transverse colon and transverse mesocolon |
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Term
| What are the subdivisions of the greater sac? |
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Definition
| Supracolic compartment, Infracolic compartment |
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Term
| What is contained within the supracolic compartment? |
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Definition
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Term
| What is contained within the infracolic compartment? |
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Definition
| Small intestines, ascending/descending colon, subdivided by mesentary of the small intestines into right and left spaces |
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Term
| How does the abdominal cavity communicate with the pelvic cavity? |
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Definition
| Right parcolic gutter lateral to the ascending colon and left parcolic gutter lateral to the descending colon, both are a pathway for spread of infection or cancer |
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Term
| What is the lowest part of the abdominal portion of the peritoneal cavity in the supine position? |
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Definition
| Hepatorenal recess (Morison's pouch) |
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Term
| Where is the hepatorenal recess (Morison's pouch) located? |
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Definition
| Between the right lobe of the liver and the right kidney |
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Term
| How does infected fluid enter the hepatorenal recess? |
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Definition
| From the omental bursa or subphrenic recess |
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Term
| What produces the pouched segmentation known as haustra characteristic of the large intestines? |
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Definition
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