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Flashcards in GI, Topnotch Deck (236)
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1
Q

Vertebral level: Umbilicus

A

IVD of L3-L4

2
Q

Vertebral level: Subcostal plane

A

10th rib, L3

3
Q

Iliac tubercle

A

L5

4
Q

Central regions of the anterior abdomen (3)

A

1) Epigastric 2) Periumbilical 3) Hypogastric/pelvic

5
Q

Lateral regions of the anterior abdomen

A

1) Hypochondriac 2) Lumbar 3) Inguinal

6
Q

Dermatomal level: Apex of supraclavicular fossa

A

C3

7
Q

Dermatomal level: Acromioclavicular joint

A

C4

8
Q

Dermatomal level: Radial side of antecubital fossa

A

C5

9
Q

Dermatomal level: Dorsal surface of proximal phalanx of thumb

A

C6

10
Q

Dermatomal level: Dorsal surface of proximal phalanx of middle finger

A

C7

11
Q

Dermatomal level: Dorsal surface of proximal phalanx of little finger

A

C8

12
Q

Dermatomal level: Ulnar side of antecubital fossa

A

T1

13
Q

Dermatomal level: Apex of axilla

A

T2

14
Q

Dermatomal level: Nipple/4th ICS MCL

A

T4

15
Q

Dermatomal level: Midway between nipple and xiphisternum MCL

A

T5

16
Q

Dermatomal level: Xiphisternum

A

T6

17
Q

Dermatomal level: 1/4 between xiphisternum and umbilicus MCL

A

T7

18
Q

Dermatomal level: 1/2 between xiphisternum and umbilicus, MCL

A

T8

19
Q

Dermatomal level: Umbilicus MCL

A

T10

20
Q

Dermatomal level: Midpoint of inguinal ligament

A

T12

21
Q

Dermatomal level: Anteromedial thigh

A

L2

22
Q

Dermatomal level: Medial femoral condyle

A

L3

23
Q

Dermatomal level: Medial malleolus

A

L4

24
Q

Dermatomal level: Dorsum of foot

A

L5

25
Q

Dermatomal level: Lateral heel

A

S1

26
Q

Dermatomal level: Popliteal fossa

A

S2

27
Q

Dermatomal level: Ischial tuberosity

A

S3

28
Q

Dermatomal level: Perianal area 1 cm lateral to mucocutaneous junction

A

S4-5

29
Q

Most superficial abdominal muscle

A

External oblique

30
Q

External oblique: Direction of fibers

A

Obliquely downward and medially

31
Q

Immediately deep to the external oblique

A

Internal onlique

32
Q

Internal oblique: Direction of fibers

A

Obliquely upward and medially

33
Q

Components of conjoint tendon

A

Aponeurotic fivers of 1) Internal oblique 2) Transversus abdominis

34
Q

Muscle whose aponeurosis splits to form the rectus sheath

A

Internal oblique

35
Q

Innermost abdominal muscle

A

Transversus abdominis

36
Q

Muscle on either side of line alba

A

Rectus abdominis

37
Q

Lateral borders of rectus abdominis

A

Linea semilunaris

38
Q

Crescentic border on the posterior wall of the abdomen midway between the umbilicus and pubic crest

A

Arcuate line

39
Q

Characteristic arrangement of fibers above arcuate line

A

Internal oblique aponeurosis splits to form rectus sheath (present posterior layer)

40
Q

Characteristic arrangement of fibers below arcuate line

A

Internal oblique aponeurosis is superficial to the rectus sheath (absent posterior layer) and transversalis fascia is directly below the rectus abdominis muscle

41
Q

Contents of rectus sheath (4)

A

1) Rectus abdominis 2) Pyramidalis 3) Superior and inferior epigastric vessels 4) Lower 5 intercostal and subcostal vessels and nerves

42
Q

Boundaries of foramen of Winslow: Anterior

A

Hepatoduodenal ligament

43
Q

Boundaries of foramen of Winslow: Posterior

A

IVC

44
Q

Boundaries of foramen of Winslow: Superior

A

Caudate lobe of liver

45
Q

Boundaries of foramen of Winslow: Inferior

A

Superior part of duodenum

46
Q

Extensions of visceral peritoneum (3)

A

1) Mesentery 2) Ligaments 3) Omentum

47
Q

Layers: Mesentery

A

2

48
Q

Layers: Ligaments

A

2

49
Q

Supports hollow viscous to body wall for neurovascular communication

A

Mesentery

50
Q

Connects viscera to each other or to the body wall

A

Ligaments

51
Q

Connects the stomach with other viscera

A

Omentum

52
Q

Layers: Greater omentum

A

4

53
Q

Abdominal policeman

A

Greater omentum

54
Q

3 parts of greater omentum

A

1) Gastrophrenic 2) Gastrosplenic 3) Gastrocolic

55
Q

Layers: Lesser omentum

A

2

56
Q

Greater omentum connects

A

Greater curvature and proximal duodenum to transverse colon

57
Q

Lesser omentum connects

A

Lesser curvature to fissure for ligamentum venosum and porta hepatic of liver

58
Q

Hepatoduodenal ligament: Posterior

A

Portal vein

59
Q

Hepatoduodenal ligament: Anterior to the right

A

CBD

60
Q

Hepatoduodenal ligament: Anterior to the left

A

Hepatic artery

61
Q

Inflammation of this layer of peritoneum causes rebound tenderness and guarding

A

Parietal peritoneum

62
Q

Brough about by congestion of the venous drainage of the abdomen

A

Ascites

63
Q

Paracentesis at the midline goes through these layers (7)

A

1) Skin 2) Superficial fascia 3) Deep fascia 4) Linea alba 5) Transversalis fascia 6) Extraperitoneal fat 7) Parietal peritoneum

64
Q

Paracentesis lateral to the inferior epigastric artery and above the deep circumflex artery goes through these layers (7)

A

1) Skin 2) External oblique 3) Internal oblique 4) Transversus abdominis 5) Transversalis fascia 6) Extraperitoneal fat 7) Parietal peritoneum

65
Q

Branches of the splenic artery (2)

A

1) Left gastroepiploic 2) Short gastric

66
Q

Branches of the common hepatic artery (3)

A

1) Right gastric 2) Right and left hepatic 3) Gastroduodenal

67
Q

Branches of the gastroduodenal artery (2)

A

1) Right gastroepiploic 2) Superior pancreaticoduodenal

68
Q

Branches of the SMA (5)

A

1) Inferior pancreaticoduodenal 2) Middle colic 3) Right colic 4) Ileocolic 5) Jejunal-ileal

69
Q

Branches of the IMA (3)

A

1) Left colic 2) Sigmoid 3) Superior rectal

70
Q

Common site of aortic aneurysm

A

Just proximal to the bifurcation at L4

71
Q

Occlusion of the celiac artery results in collateral circulation by way of anastomosis between

A

Pancreaticoduodenal and gastroduodenal arteries

72
Q

Branch of celiac artery eroded: Penetrating ulcer of posterior wall of stomach

A

Splenic

73
Q

Branch of celiac artery eroded: Lesser curvature of stomach

A

Left gastric

74
Q

Posterior wall of 1st part of duodenum

A

Gastroduodenal

75
Q

Erosion of celiac circulation may present as referred pain at

A

Shoulder

76
Q

Tributaries of IVC (8)

A

1) Right and left hepatic 2) Right suprarenal 3) Right gonadal 4) Right and left renal 5) Inferior phrenic 6) Lumbar 7) Right and left common iliac 8) Median sacral

77
Q

May be compressed by aneurysm of SMA causing renal and adrenal htn

A

Left renal vein

78
Q

Tributaries of portal venous circulation

A

1) Superior mesenteric 2) Inferior mesenteric 3) Splenic 4) Left gastric 5) Paraumbilical

79
Q

Length of esophagus

A

25 cm

80
Q

Esophagus: Enters the stomach at

A

Cardia

81
Q

Continuous above with laryngeal part of pharynx at the level of

A

C6

82
Q

Passes through diaphragm at the level of

A

T10

83
Q

Structures through diaphragm: T8

A

IVC and right phrenic via Caval hiatus

84
Q

Structures through diaphragm: T10

A

Esophagus and vagus via esophageal hiatus

85
Q

Structures through diaphragm: T12

A

Aorta, thoracic duct, and azygos vein via aortic hiatus

86
Q

Esophageal constrictions

A

1) Upper/Pharyngoesophageal 2) Middle/Thoracic 3) Inferior/Diaphragmatic

87
Q

Upper esophageal constriction is caused by

A

Cricopharyngeus muscle

88
Q

Middle esophageal constriction is caused by

A

Aortic arch and left main bronchus

89
Q

Inferior esophageal constriction is caused by

A

Esophageal hiatus

90
Q

T/F Esophageal constrictions are common sites of carcinoma

A

T

91
Q

Relations of the esophagus in the neck: Anterior (2)

A

1) Trachea 2) Recurrent laryngeal nerves

92
Q

Relations of the esophagus in the neck: Posterior (2)

A

1) Prevertebral layer of deep cervical fascia 2) Vertebral column

93
Q

Relations of the esophagus in the neck: Lateral

A

Thyroid gland

94
Q

Relations of the esophagus in the thorax: Anterior (4)

A

1) Trachea 2) Left recurrent laryngeal nerve 3) Left main bronchus 4) Pericardium

95
Q

Relations of the esophagus in the thorax: Posterior (5)

A

1) Bodies of thoracic vertebrae 2) Thoracic duct 3) Azygos vein 4) Right posterior intercostal artery 5) Descending thoracic aorta

96
Q

Relations of the esophagus in the thorax: Right (2)

A

1) Mediastinal pleura 2) Azygos vein

97
Q

Relations of the esophagus in the thorax: Left (4)

A

1) Left subclavian 2) Aortic arch 3) Thoracic duct 4) Mediastinal pleura

98
Q

Relations of the esophagus in the abdomen: Anterior

A

Posterior surface of left lobe of liver

99
Q

Relations of the esophagus in the abdomen: Posterior

A

Left crus of diaphragm

100
Q

Arterial supply to the esophagus: Upper 3rd

A

Inferior thyroid artery from subclavian

101
Q

Arterial supply to the esophagus: Middle 3rd

A

Descending thoracic aorta

102
Q

Arterial supply to the esophagus: Lower 3rd

A

Left gastric artery from celiac trunk

103
Q

Venous drainage of the esophagus: Upper 3rd

A

Inferior thyroid vein

104
Q

Venous drainage of the esophagus: Middle 3rd

A

Azygos vein

105
Q

Venous drainage of the esophagus: Lower 3rd

A

Left gastric vein

106
Q

Lymphatic drainage of esophagus: Upper 3rd

A

Deep cervical

107
Q

Lymphatic drainage of esophagus: Middle 3rd

A

Superior and inferior mediastinal

108
Q

Lymphatic drainage of esophagus: Lower 3rd

A

Celiac

109
Q

Management for oesophageal haemorrhage from varicose by balloon insertion

A

Sengstaken-Blakemore Balloon Insertion

110
Q

Average distance between external nasal orifices and stomach

A

44 cm

111
Q

Capacity of stomach

A

1.5 L

112
Q

Part of esophagus near the GEJ

A

Cardia

113
Q

Part of esophagus that is dilated superiorly

A

Fundus

114
Q

Part of esophagus between the fundus and pylorus (major part)

A

Body

115
Q

Distal part of stomach

A

Pylorus

116
Q

Sharp indentation of the stomach that approximates the junction of the body and pylorus

A

Angular incisura/notch

117
Q

Concave border of stomach

A

Lesser curvature

118
Q

Convex border of stomach

A

Greater curvature

119
Q

Level of the cardiac orifice of stomach

A

6th left costal cartilage 2-4 cm from median plane at the level of T10 or T11

120
Q

Level of the fundus of stomach

A

5th left rib, MCL

121
Q

Level of the greater curvature of stomach

A

Up to 10th costal cartilage

122
Q

Level of the pyloric antrum of stomach

A

9th costal cartilage or at L1 approximately 1.25 cm from midline

123
Q

Level of the pyloric canal of stomach

A

Right side, L2-L4

124
Q

Layer that hypertrophies in hypertrophic pyloric stenosis

A

Muscularis externa

125
Q

Anterior relations of stomach (3)

A

1) Diaphragm 2) Left lobe of liver 3) Anterior abdominal wall

126
Q

Posterior relations of stomach (2)

A

1) Omental bursa 2) Pancreas

127
Q

On which the stomach rests when a person is lying supine

A

Stomach bed

128
Q

Forms the stomach bed

A

Structures forming the posterior wall of the omental bursa

129
Q

Structures forming the posterior wall of the omental bursa (6)

A

1) Left dome of diaphragm 2) Spleen 3) Left kidney and adrenal gland 4) Splenic artery 5) Pancreas 6) Transverse mesocolon and colon

130
Q

Blood supply of stomach: Lesser curvature

A

Right and left gastric arteries

131
Q

Blood supply of stomach: Greater curvature

A

Right and left gastroepiploic arteries

132
Q

Blood supply of stomach: Fundus

A

Short gastric artery

133
Q

Largest branch of the celiac trunk

A

Splenic artery

134
Q

Largest arterial supply to the stomach and smallest branch of the celiac trunk

A

Left gastric artery

135
Q

Venous drainage of stomach: Right and left gastric

A

Portal vein

136
Q

Venous drainage of stomach: Left gastroepiploic and short gastric

A

Splenic vein to the portal vein

137
Q

Venous drainage of stomach: Right gastroepiploic

A

Superior mesenteric to portal vein

138
Q

PSY supply to the stomach (2)

A

1) Anterior vagal trunk from left vagus 2) Posterior vagal trunk from right vagus

139
Q

PSY supply to stomach

A

T6-T9

140
Q

Most gastric ulcers occur at

A

Lesser curvature, directly above the incisura

141
Q

Carcinomas of the stomach are mostly found in

A

Distal 3rd

142
Q

Distance from nasal orifices: Proximal esophageal narrowing

A

18 cm

143
Q

Distance from nasal orifices: Middle esophageal narrowing

A

28 cm

144
Q

Distance from nasal orifices: Distal esophageal narrowing

A

44 cm

145
Q

Length of duodenum

A

25 cm

146
Q

Duodenojejunal junction is seen at what level

A

L2

147
Q

Parts of duodenum

A

1) Superior 2) Descending 3) Horizontal 4) Ascending

148
Q

Length of part of duodenum: Superior

A

5 cm

149
Q

Length of part of duodenum: Descending

A

7-10 cm

150
Q

Length of part of duodenum: Horizontal

A

6-8cm

151
Q

Length of part of duodenum: Ascending

A

5 cm

152
Q

Level of part of duodenum: Superior

A

L1

153
Q

Level of part of duodenum: Descending

A

L1-3

154
Q

Level of part of duodenum: Horizontal

A

L3

155
Q

Level of part of duodenum: Ascending

A

L3-2

156
Q

Blood supply of duodenum: Superior part

A

Superior pancreaticoduodenal

157
Q

Blood supply of duodenum: Inferior part

A

Inferior pancreaticoduodenal

158
Q

Venous drainage of duodenum: Superior part

A

Superior pancreaticoduodenal to portal

159
Q

Venous drainage of duodenum: Inferior part

A

Inferior pancreaticoduodenal to superior mesenteric

160
Q

Duodenal ulcers most often occur at: Anterior vs posterior wall

A

Anterior

161
Q

Perforation of ulcers most often occur at: Anterior vs posterior wall

A

Anterior

162
Q

Blood type with increased risk of gastric ulcer

A

A

163
Q

Blood type with increased risk of duodenal ulcer

A

O

164
Q

Most commonly eroded artery in gastric ulcer perforation

A

Left gastric artery

165
Q

Most commonly eroded artery in duodenal ulcer perforation

A

Gastroduodenal

166
Q

Jejunoileal segment: Jejunal part

A

Proximal 2/5

167
Q

Jejunoileal segment: Ileal part

A

Distal 3/5

168
Q

Jejunoileal segment: Length

A

6-7 m

169
Q

Quadrant: Jejunum

A

LUQ

170
Q

Quadrant: Ileum

A

RLQ

171
Q

Jejunum: Color

A

Deep red

172
Q

Jejunum: Caliber

A

2-4 cm

173
Q

Jejunum: Wall

A

Thick & heavy

174
Q

Jejunum: Vascularity

A

Greater

175
Q

Jejunum: Vasa rect

A

Long

176
Q

Jejunum: Arcades

A

Few, large

177
Q

Jejunum: Fat

A

Less

178
Q

Jejunum: Plicae circularis

A

Large, tall

179
Q

Jejunum: Lymphoid nodules

A

Few

180
Q

Ileum: Color

A

Paler pink

181
Q

Ileum: Caliber

A

2-3 cm

182
Q

Ileum: Wall

A

Thin and light

183
Q

Ileum: Vascularity

A

Less

184
Q

Ileum: Vasa recta

A

Short

185
Q

Ileum: Arcades

A

Many

186
Q

Ileum: Fat

A

More

187
Q

Ileum: Plicae circulares

A

Low, sparse, absent in distal segment

188
Q

Ileum: Lymphoid nodules

A

Many

189
Q

Instussuceptus vs intussucipiens: Proximal segment that invaginates

A

Instussuceptus

190
Q

Instussuceptus vs intussucipiens: Distal segment that receives invaginating segment

A

Intussucipiens

191
Q

Intussusception: Most common

A

Ileocecal

192
Q

Intussusception: More common, children vs adult

A

Children

193
Q

Intussusception: Signs of obstruction

A

1) Right-sided colicky abdominal pain 2) Abdominal distention 3) Hematochezia

194
Q

Pancreas: Anterior, R to L

A

1) Transverse mesocolon 2) Lesser sac 3) Stomach

195
Q

Pancreas: Posterior, R to L

A

1) Bile duct 2) Portal and splenic veins 3) IVC 4) Aorta 5) SMA 6) Left psoas 7) Left suprarenal 8) Left kidney 9) Spleen

196
Q

Pancreas: Parts

A

1) Head 2) Neck 3) Body 4) Tail 5) Uncinate process

197
Q

Pancreas: Part that overlies superior mesenteric vessels

A

Neck

198
Q

Pancreas: Part that lies to the left of the SMA and SMV

A

Body

199
Q

Pancreas: Part that is closely related to the hilum of the spleen and left colic flexure

A

Tail

200
Q

Pancreas: Uncinate process projects from

A

Inferior part of the head

201
Q

Pancreas: Uncinate process extends medially to the left, posterior to the

A

SMA

202
Q

Main vs accessory pancreatic duct: Extends the length of the pancreas

A

Main

203
Q

Main vs accessory pancreatic duct: Enters the duodenum

A

Both

204
Q

Main vs accessory pancreatic duct: Joins the bile duct

A

Main

205
Q

Main pancreatic duct joins the bile duct to form the

A

Hepatopancreatic ampulla

206
Q

Accessory pancreatic duct lies in the

A

Head

207
Q

Pancreas: Blood supply (3)

A

1) Superior pancreaticoduodenal from gastroduodenal 2) Inferior pancreaticoduodenal from SMA 3) Pancreatic arteries from splenic

208
Q

Pancreatectomy: With splenic artery ligation

A

Warshaw technique

209
Q

Pancreas: Venous drainage

A

Mainly into splenic vein

210
Q

Most common cause of extrahepatic obstruction of biliary system

A

Pancreatic CA

211
Q

Pancreas: Cancer of body and neck may cause obstruction of (2)

A

1) Portal circulation 2) IVC

212
Q

Liver: Structures located posteriorly (8)

A

1) Diaphragm 2) Right kidney 3) Hepatic flexure of colon 4) Duodenum 5) GB 6) IVC 7) Esophagus 8) Fundus of stomach

213
Q

Liver: Covered by peritoneum except at

A

Posteriorly, called bare area

214
Q

Ligamentum teres hepatis is located between what structures

A

1) Left lobe 2) Quadrate lobe

215
Q

Ligamentum venosum is located between

A

1) Left lobe 2) Caudate lobe

216
Q

Liver: Anatomical lobes

A

1) Left 2) Right

217
Q

Liver: Right lobe is divided into

A

Caudate and quadrate lobes

218
Q

Liver: Segments

A

1) Medial superior I 2) Lateral superior II 3) Lateral inferior III 4) Medial inferior IV 5) Anterior inferior V 6) Posterior inferior VI 7) Posterior superior VII 8) Anterior superior VIII

219
Q

Liver: Apices of cross-sections of portal lobules

A

Central vein

220
Q

Liver: Centers of cross-sections of portal lobules

A

Portal triad

221
Q

Portal vein is formed by union of

A

1) Superior mesenteric vein 2) Splenic vein

222
Q

Liver: % blood supplied by portal vein

A

70%

223
Q

Liver: Biopsy is usually done at

A

Right 10th ICS MAL

224
Q

Gallbladder: Lies at which surface of the liver

A

Inferior

225
Q

Gallbladder: Capacity

A

30-50 mL

226
Q

Gallbladder: Posterior relations

A

1) Transverse colon 2) 1st and 2nd parts of duodenum

227
Q

Gallbladder: Cystohepatic triangle

A

Triangle of Calot

228
Q

Triangle of Calot: Boundaries

A

1) Superior - Liver 2) Inferior - Cystic duct 3) Medial - Common hepatic duct

229
Q

Triangle of Calot: Content

A

Cystic artery

230
Q

Cystic artery is USUALLY a branch of

A

Right hepatic artery

231
Q

Common site of impacted gallstone

A

Hepatopancreatic ampulla

232
Q

Impacted gallstone at hepatopancreatic ampulla: Referred pain

A

Epigastric region

233
Q

Stone blocking the cystic duct: Characteristic pain

A

Biliary colic

234
Q

Describe biliary colic

A

Begins in the epigastric region but moves to a point where 9th costal cartilage intersects the lateral border of the rectus sheath

235
Q

Dermatomes of referred pain of GIT

A

T5-L1

236
Q

Valve of Houston is associated with what organ

A

Rectum