Term
| What are the four areas where the esophageal lumen is prone to constriction? |
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Definition
| 1. Junction of esophagus and pharynx, 2. Arch of aorta, 3. left main bronchus, 4. Esophageal hiatus of diaphragm. |
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Term
| Which vertebrae does the esophagus enter the diaphragm? |
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Definition
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Term
| What keeps the food you eat inside your stomach, and out of the esophagus? |
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Definition
| As stomach expands, the angle created between it and the esophagus constricts the esophagus. Also, the diaphragm muscle fibers help constrict it as well. |
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Term
| What is the arterial and venous supply of the cervical region of the esophagus? |
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Definition
| The inferior thyroid arteries, and the inferior thyroid veins. |
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Term
| What is the arterial and venous supply of the thoracic region of the esophagus? |
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Definition
| Branches off the right bronchial artery, branches off the posterior intercostal arteries, and branches of the descending aorta. Venous supply is simpler and its the azygos, hemiazygos system. |
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Term
| What is the arterial and venous supply of the abdominal segment of the esophagus? |
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Definition
| Left gastric artery, and short gastric and left inferior phrenic arteries. Venous return drained by short gastric veins, which feed into the portal vein.*** The esophagus starts off posterior and on the right side of body, then moves anteriorly and to the left side as it gets to stomach. That might help remembering L vs R. |
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Term
| What's a tracheo-esophageal fistula? |
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Definition
| connection between the esophagus and the trachea. During feeding, food will enter trachea, resulting in coughing. |
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Term
| What's a non-congenital example of a disruption between the esophagus and trachea? |
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Definition
| If the posterior, muscular end of the trachea is ruptured during intubation, the tube will hit the esophagus. Posterior side of trachea is more likely to rupture than anterior side because it's muscular. |
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Term
| Describe an esophageal filling defect, |
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Definition
| When the esophagus is obstructed, so it doesn't completely fill. May be a sign of cancer. |
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Term
| The lesser omentum is composed of which two ligaments? |
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Definition
| Hepatoduodenal ligament and hepatogastric ligament |
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Term
| Which arteries run along the lesser curvature and the greater curvature of the stomach? |
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Definition
| The lesser curvature has the gastric arteries running alongside it, while the greater curvature has the gastro-omental arteries running next to it. |
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Term
| Describe the arterial supply to the stomach, and where each artery originates from. |
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Definition
| Left and right gastric arteries. The right gastric artery usually comes from right hepatic artery (variable). Left gastric artery comes from celiac trunk. Right and Left gastro-omental arteries -> right one comes from gastroduodenal artery, left one comes from splenic artery. Short gastric arteries as well, which arise from the splenic artery too. |
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Term
| What vertebral level is the duodenum located? |
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Definition
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Term
| Describe each of the 4 parts of the duodenum, and what's happening at each level. |
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Definition
| Superior (first part): mostly horizontal, receives stomach juices. Descending part (2): curves around the head of pancreas, receives bile and pancreatic ducts. Horizontal part (3): cross anteriorly to IVC and aorta, posteriorly to SMA and SMV. Ascending part (4): joins jejunum, and this area is supported by the LIGAMENT of TREITZ, which attaches this area to right crus of the diaphragm. |
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Term
| Which arteries supply the blood to the duodenum? |
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Definition
| Branches of the gastroduodenal artery and superior mesenteric artery (supples most of small and large intestines). |
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Term
| What are some of the characteristic features of the jejunum? |
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Definition
| Thicker wall than ileum, and it has well defined plicae circularis. It also has longer vasa recta, and short arcades. Fat from the mesentary does NOT reach the intestinal wall. |
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Term
| What are some of the characteristic features of the ileum? |
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Definition
| Short vasa recta, longer arcades. Also has peyer's patches (lymphatics). Fat from mesentary reaches the intestinal wall. |
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Term
| What part of the small intestine can be used to reconstruct a bladder? |
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Definition
| Ileum. ureters attach to a portion of ileum, which is then brought closer to surface. Catheter can remove the piss. |
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Term
| What are the retroperitoneal portions of the large intestine? |
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Definition
| Ascending colon, descending colon, and rectum. Transverse colon, cecum, and sigmoid colon are interperitoneal. |
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Term
| What are omental appendices? |
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Definition
| Fat pads located on the colon. |
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Term
| How many bands of taeniae coli run along the length of the colon? |
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Definition
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Term
| What's the blood supply to large intestines? |
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Definition
| SMA and IMA. More specifically, ileocolic and right colic arteries, and middle colic arteries are branches of SMA. Left colic, and sigmoid arteries are branches of IMA. |
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Term
| Where does venous return from the stomach, small and large intestines go? |
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Definition
| Portal vein, and into the liver. |
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Term
| What does the inferior mesenteric vein drain, and what larger vein does it hook up with? |
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Definition
| It drains the descending colon, sigmoid colon, and rectum. It meets up with the splenic vein. |
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Term
| What does the superior mesenteric vein drain? |
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Definition
| Small intestines, cecum, ascending colon, transverse colon. It then joins with the splenic vein to turn into portal vein. |
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Term
| Between which two layers is the submucosal plexus located? |
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Definition
| Submucosa and the circular muscle layer |
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Term
| Between which two layers is the myenteric plexus located? |
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Definition
| Circular muscle layer and longitudinal muscle layer. |
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Term
| What's the sympathetic innervation to the foregut, and midgut? |
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Definition
| Foregut and midgut have the same innervations: Greater (T5-9), lesser (T10-T11, Least splanchnic nerves (T12). |
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Term
| What's the sympathetic innervation to the hindgut? |
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Definition
| The hindgut is supplied by the Lumbar Splanchnic nerves (L1-L2) |
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Term
| In sympathetic innervation, where do the pre-ganglionic fibers synapse? |
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Definition
| Pre-vertebral ganglion. NOT the sympathetic trunk. |
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Term
| What are the parasympathetic innervations to the foregut and midgut? |
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Definition
| They're the same: vagal stimulation from C10 |
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Term
| What are the parasympathetic innervations to the hindgut? |
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Definition
| Pelvic splanchnic nerves (S2-4) |
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Term
| In PNS innervation, where do the preganglionic fibers synapse? |
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Definition
| Directly at the organ of interest |
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Term
| Visceral sensation of the GI organs is conveyed to the brain via the somatic afferents to that organ. What does this mean? |
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Definition
| Since each of the spinal nerves that innervates each area of the abdomen consists of multiple spinal nerves, any pain in these region will be felt in multiple dermatomes (one spinal nerve per dermatome). If pain is carried away via a visceral afferent instead of a somatic afferent, then it'll be localized pain. |
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Term
| Where is the appendix located? |
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Definition
| Inferior to the ileocecal junction. |
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Term
| What's Meckel's diverticulum? |
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Definition
| It's basically a congenital, small pouch in the small intestine that's a remnant of the vitelline duct. Found in 2% of the population, 2 times more common in males, 2 inches long, 2 feet from ileocecal junction, 2 possible ectopic tissues, and it's most commonly diagnosed within the first two years of life. TWO |
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