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USMLE - GI Flashcards Part 3

Anatomy and Physiology31 CardsCreated 18 days ago

This deck covers key concepts related to gastrointestinal anatomy and physiology, focusing on vascular supply, innervation, and common clinical conditions relevant to the USMLE exam.

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Level of SMA

L1
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Key Terms

Term
Definition
Level of SMA
L1
Level of Left Renal Artery
L1
Level of IMA
L3
Bifurcation of Abdominal Aorta occurs at what level?
L4
Foregut Artery Parasympathetic Innervation Vertebral Level Structure supplied
Celiac Vagus T12/L1 Stomach to proximal duodenum, Liver, Gallbladder, Pancreas, Spleen (mesoderm)
Midgut Artery Parasympathetic Innervation Vertebral Level Structure supplied
SMA Vagus L1 Distal duodenum to proximal 2/3 of transverse colon
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USMLE - GI Flashcards Part 3
TermDefinition
Level of SMA
L1
Level of Left Renal Artery
L1
Level of IMA
L3
Bifurcation of Abdominal Aorta occurs at what level?
L4
Foregut Artery Parasympathetic Innervation Vertebral Level Structure supplied
Celiac Vagus T12/L1 Stomach to proximal duodenum, Liver, Gallbladder, Pancreas, Spleen (mesoderm)
Midgut Artery Parasympathetic Innervation Vertebral Level Structure supplied
SMA Vagus L1 Distal duodenum to proximal 2/3 of transverse colon
Hindgut Artery Parasympathetic Innervation Vertebral Level Structure supplied
IMA Pelvic L3 Distal 1/3 of transverse colon to upper portion of rectum
Splenic flexure
Bend between transverse and descending colon | Watershed region
Branches of Celiac Trunk
Common Hepatic, Splenic, Left Gastric
Strong anastomoses in stomach blood supply
L and R Gastroepiploics | L and R Gastrics
Poor anastomoses in stomach blood supply
Short Gastrics (if splenic artery is blocked)
Collateral circulation if abdominal aorta is blocked?
Internal Thoracic (mammary) --> Superior epigastric ↔ Inferior epigastric --> External iliac Celiac Trunk --> Superior pancreaticoduodenal ↔ Inferior pancreaticoduodenal -- SMA SMA --> Middle Colic ↔ Left Colic --> IMA IMA --> Superior Rectal ↔ Middle and Inferior Rectal --> Internal Iliac
Portosystemc Anastomoses
L Gastric Vein ↔ Esophageal Vein --> Azygos Paraumbilical Vein ↔ Superficial and Inferior Epigastric (below umbilicus) and Superior Epigastric and Lateral Thoracic (above umbilicus) Superior Rectal ↔ Middle and Inferior Rectal
SMV and IMV drain into
Portal Vein
Varices of Portal HTN
Varices of 'Gut, Butt, and Caput' | Esophageal varices, Internal hemorrhoids, Caput medusae
Surgical treatment of Portal HTN
"TIPS" Transjugular Intrahepatic Portosystemic Shunt between Portal Vein and Hepatic Vein percutaneously
What is the Pectinate (Dentate) Line
Where endoderm (hindgut) meets ectoderm
Above the pectinate line What kind of hemorrhoids? What kind of cancer? Arterial Supply Venous drainage
Internal Hemorrhoids Adenocarcinoma Superior Rectal Artery from IMA Superior Rectal Vein --> IMV --> Portal Vein
Below the pectinate line What kind of hemorrhoids? What kind of cancer? Arterial Supply Venous drainage
External Hemorrhoids Squamous Cell Carcinoma Inferior Rectal Artery from Internal Pudendal Inferior Rectal Vein --> Internal Pudendal Vein --> Internal Iliac --> IVC
Internal Hemorrhoids Innervation? Pain? Lymphatic drainage?
Visceral Innervation, therefore NOT painful | Drained by Deep Nodes
External Hemorrhoids Innervation? Pain? Lymphatic drainage?
Somatic Innervation (inferior rectal branch of pudendal nerve) and therefore Painful Drained by Superficial Inguinal Lymph Nodes
Apical Surface of hepatocytes face
Bile Canaliculi
Basolateral Surface of hepatocytes face
Sinusoids
Zones of Liver | What is each one vulnerable to?
I: periportal --> Affected 1st by viral hepatitis II: intermediate III: pericentral vein (centrilobular) Affected 1st by ischemia, Contains P450 system, most sensitive to toxin injury, site of alcoholic hepatitis
Common Hepatic Duct Formed from Goes to
R and L Hepatic Ducts | Joins Cystic duct to form Common Bile Duct
Common Bile Duct Formed from Goes to
Cystic Duct + Common Hepatic Duct | Joins Main Pancreatic Duct at Ampulla of Vater in Duodenum
Ampulla of Vater
Where the Main Pacreatic Duct joins the Common Bile Duct in the 2nd part of the Duodenum
Sphincter of Oddi
Sphincter around ampulla of vater
Gallstones lodged in ampulla of Vater block
Both bile and pancreatic ducts
Tumors that arise near the head of the pancreas near the duodenum can cause
Obstruction of the common bile duct
Organization of Vessels in Femoral Region
Lateral to Medial to find your "NAVEL" | Nerve, Artery, Vein, Empty space, Lymphatics