Gastro 1

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Author:
lazzsant
ID:
172981
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Gastro 1
Updated:
2012-09-25 10:00:05
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Gastro
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Gastro 1
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  1. Hepatoduodenal ligament
    Liver to duodenum

    • Contains: Portal triad
    • - hepatic artery
    • - portal vein
    • - common bile duct

    • May be compressed between thumb and index finger placed in omental foramen to control bleeding.
    • Connects greater and lesser sac.
  2. Meissner's (submucosal) plexus
    Regulates local secretions, blood flow, and absorption
  3. Abdominal aorta branches and vertebrae level
    • Celiac trunk T12
    • Superior mesenteric artery L1
    • Left renal artery L1
    • Testicular/ovarian arteries L2
    • Inferior mesenteric artery L3
    • Bifurcation of abdominal aorta L4
  4. Foregut embryonic gut region
    • Celiac artery
    • Vagus parasympathetic innervation
    • T12/L1

    • Stomach to proximal duodenum
    • liver
    • gallbladder
    • pancreas
    • spleen (mesoderm)
  5. Collateral circulation if the abdominal aorta is blocked.
    1. Internal thoracic/mammary(subclavian) -- superior epigastric(internal thoracic) -- inferior epigastric(external iliac)

    2. Superior pancreaticoduodenal(celiac trunk) -- inferior pancreaticoduodenal(SMA)

    3. Middle colic(SMA) -- left colic (IMA)

    4. Superior rectal(IMA) -- middle rectal (internal iliac)
  6. ABove the pectinate line characteristics
    internal hemorrhoids

    adenocarcinoma

    • Arterial: superior rectal artery (IMA)
    • Venous: superior rectal vein -> inferior mesenteric vein -> portal system
  7. Femoral sheath contents
    Femoral vein, artery, and canal(deeo inguinal lymph nodes)

    NOT the femoral nerve
  8. Sliding versus paraesophageal hernia
    Both Diaphragmatic hernias

    Sliding- GE junction is displaced - hourglass stomach

    Paraesophageal- GE junction is normal. Cardia moves into the thorax
  9. Indirect inguinal hernia
    Goes through internal (deep) inguinal ring, external (superficial) inguinal ring, and into the scrotum.

    Covered by all 3 layers of spermatic fascia
  10. Gastrin
    G cells (antrum of stomach)

    • Actions:
    • + gastric H+ secretion
    • + growth of gastric mucosa
    • + gastric motility

    • Regulation:
    • + by stomach distention/ alkalinization, amino acids, peptides, vagal stimulation

    (-) by stomach pH <1.5
  11. Cholecystokinin
    I cells (duodenum, jejunum)

    • ACTIONS:
    • + pancreatic secretion
    • + gallbladder contraction
    • (-) gastric emptying, spinchter of Oddi relaxation

    • Regulation:
    • + by fatty acids, amino acids
  12. Gastric acid
    Parietal cells (stomach)

    • Actions:
    • decreases sotmach pH

    • Regulation:
    • + by Histamine, ACh, gastrin
    • (-) by somatostatin, GIP, prostaglandin, secretin
  13. What uses the Gq pathway in gastric Parietal cells?
    Vagus ACh stimulation of M3 receptor

    G cells Gastrin stimulation of CCkb receptors (enhanced by GRP)
  14. Brunner's gland
    Secrete alkaline mucus to neutralize acid contents entering the duodenum form the stomach.

    * Located in duodenal submucosa (only gland in submucosa)

    Hypertrophy seen in peptic ulcer disease

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