Anatomy exam II GI
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| The gastroespohageal or cadiac sphincter function is to _____ | prevent reflux of gastric contents into the esophagus
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| The gastoesophageal sphincter's circular muscle fibers are under _____ and ____ control | hormonal and vagal
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| ______ form a submucosal venous plexus at the distal end of the esophagus | esophageal veins
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| Esophageal veins drain into tributaries of the ____ system and of the portal vein | azygos
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| If the ______ is ruptured, could result in massive bleeding and vomitting of blood (hematemesis) | esophageal varices
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| With _____, the esophageal lining epithelium is replaced by tissue similar to that found in the stomach. This process is called ____ | Barrett's esophagus; intestinal metaplasia
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| The ability of the esophagus to propel food from the mouth to the stomach is lost and the valve mechanism (sphincter) at the lower end of the esophagus fails to relax to allow the food into the stomach. This is called ____ | achalasia
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| In most cases, achalasia is found mostly in people ages ____ to ____ | 20-40
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| Patients with achalasia complain of _____, which becomes worse during emotional stress or rapid eating | dysphagia
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| People with achalasia can develop _____, dilatation of esophagus beginning at upper 1/3, eventually involving entire length | megaesophagus
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| What are the 4 parts of the stomach? | 1. cardia 2. fundus (at cardiac notch) 3. body 4. pyloic part
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| What are the 2 curves of the stomach? | greater and lesser curvature
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| What 3 ligaments are in the greater omentum? | 1. gastrocolic 2. gastrospenic 3. gastrophrenic
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| What 2 ligaments are in the lesser omentum? | 1. hepatogastric 2. hepatoduodenal
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| The _____ ligament supports the duodenum but not the stomach | hepatoduodenal
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| What are the 5 internal features of the stomach? | 1. cardiac orfice 2. rugae 3. gastric muscosa 4. gastric canal 5. pyloric orfice
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| What is the rugae? | gastric folds/ridges
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| ______ lead to gastric glands in the lamina propria | gastric pits
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| What are the 3 muscular layers of the stomach? | 1. outer longitudinal 2. middle circular 3. inner oblique
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| The middle circular muscle of the stomach, in the plyoris it is normally thickened to form the ______ | pyloric sphincter
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| _____ is a marked thickening of the pyloric sphincter, severe narrowing of the pyloric canal, and obstruction to passage of food | pyloric stenosis
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| With pyloric stenosis, the stomach is marked disteneded, and infant has _____ | projectile vomiting
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| Congenital hypertrophic pyloric stenosis is more commonly found in ___ then ___ | females then men
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| The pancreas, L kidney, spleen, diaphragm, L suprarenal gland, transverse mesocolon and the omental bursa make up the ____ | stomach bed
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| ____ weakens the protective mucous coating of the stomach and duodenum, which allows acid to get through to the mucosa. Both the acid and the bacteria irritate the mucosa causing an ____ | H. pylori; ulcer
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| H. pylori is able to survive in ____ because it secretes enzymes that neutralize the acid. Its spiral shape helps it burrow through the mucosa | stomach acid
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| ____ can range in size from multiple erosions that may heal in acute stages or enlarge into single chronic ____ | gastric ulcer; ulcers
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| Gastric ulcers are more common in the body near the ____ towards the lesser curvature | pyloric part
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| _____ is the posterior perforation of an ulcer in the body of the stomach can secondarily in inlve the structures of the stomach bed especially the ____ | perforated gastric ulcer; pancreas
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| _____ is a posterior perforation of an ulcer in the body of the stomach can also involve the ____ resulting in massive intra-abdominal bleeding | perforated gastric ulcer; splenic artery
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| The duodenum contains how many parts? | 4
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| The 1st part of the duodenum contains ___, ____ and ____ | liver; gallbladder and gastroduodenal artery
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| ______ most commonly affects proximal half of first part of the duodenum (duodenal cap or ampulla) | duodenal ulcer
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| A duodenum ulcer can perforate posteriorly and erode into the ____ resulting in hemorrhage | gastroduodenal artery
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| Anterior perforation of the duodenal ulcer can result in ____ | peritonitis
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| The 2nd part of the duodenum contains ____, ____ and ____ | transerve colon, common bile duct and major parcreatic duct
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| The 3rd part of the duodenum contains the ___ and ___ | superior mesenteric artery and vein
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| The 4th part of the duodenum joins the jejunum; attachemnt of ____ at junction with jejunum | ligament of Treitz
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| _____ is also known as the suspensory muscle of the duodenum | ligament of Treitz
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| The ligament of Treitz fibromuscular band connects ____ to the right crus of the diaphragm | duodenojejunal flexure
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| The ligament of Treitz is belived to stabilize the duodenal flexure and regulate ____ | passage of food
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| The ____ contains opening of hepatopancreatic ampulla | major duodenal papilla
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| The major duodenal papilla demacates junciton of embryonic _____ and ____ | foregut and midgut
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| How long is the jejunum? | 8ft
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| How long is the ilium? | 12ft
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| The jejunum contains ____ (4) | larger plicae circulares, "windows", fewer arterieal arcades and vasa rectae
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| The ilium contains ____ (2) | Meckel's diverticulum and Peyer's patches
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| During a barium swallow test, the Upper GI series show the normal ____ of jejunum due to the presence of large and numerous plicae circulares and villi in the walls of the jejunum in contrast to the smooth surface of the distal ileum | “feathery’ appearance
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| _____ are remnants of vitelline duct, the proximal part of the yolk stalk which normally regresses between the fifth and eight week of life | Meckel's diverticulum
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| Meckel's diverticulum is present in _____ of infants | ~2-3%
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| Meckel's diverticulum appears ____ proximal to ileocecal junction | ~2-3ft
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| What are the 2 clinical manifestations of Meckel's diverticulum? | interinal obstruction or GI bleed
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| With Meckel's diverticulum, the mucosal lining is similar to that of the ileum, but may contain islands of 2 types of tissues: ____ and ____ | gastric and pancreatic muscosa
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| Meckel's diverticulum manifestations: intestinal obstruction or GI bleeding; could also mimic ____ presenting as periumbilical pain which localizes to ____ quadrant | appendicitis; right lower
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| Ulcerations, inflammation, torsion ± strangulation, intussusception (“telescoping”) and herniation are complications with ____ | Meckel's diverticulum
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| Regional enteritis is also named ____ | Crohn's disease
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| ______ is chronic inflammation often affecting terminal ileum but can also involve the colon | regional enteritis
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| The longitudinal bands of the large intenstine are ____ | taeniae coli
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| The sacculations due to shorter teniae as compared with length of the colon are called ____ | haustra coli
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| What are the fat tags of the large intestine? | omental appendages
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| The ____ are the 3 longitudinal bands represent the outer longitudinal muscle layer of the large intestines | taeniae coli
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| What are the 8 parts of the large intestine? | 1. cecum 2. vermiform appendix 3. ascending colon 4. transverse colon 5. descending colon 6. sigmoid colon 7. rectum 8 anal canal
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| The vermiform appendix contains no ____. Located retrocecal ____% and pelvic ____% | tenis coli; 64% and 32%
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| _____ marks the point of tenderness in acute appendicitis; marks the base of the appendix | McBurney's point
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| _____ is the where the opening of v. appendix into the cecum is blocked by build-up of thick mucus, hardened stool (fecalith) or enlarged lymphoid tissues | appendicitis
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| What are 3 symptoms of early appendicitis? | anorexia, nasuea and vomitting
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| _____ is pain on passive extension of the right thigh. Patient lies on left side. Examiner extends patient's right thigh while applying counter resistance to the right hip | psoas sign
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| _____ is pain on passive internal rotation of the flexed thigh. Examiner moves lower leg laterally while applying resistance to the lateral side of the knee resulting in internal rotation of the femur | obturator sign
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| ____ are outpouchings (sacs) of intestinal wall in the colon | diverticulosis
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| What is Hirschsprung’s disease aslo named as? | congenital megacolon
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| _____ presents as abdominal enlargement and constipation in neonate; unable to pass meconium at birth | Hirschsprung's disease
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| For Hirschsprung's disease, a portion of colon is dilated (megacolon) due to absence of ____ in the intestinal wall distal to the dilated segment | autonomic ganglia (parasympathetic)
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