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lower duodenum; Ileum; Jejunum; Cecum and appendix; Ascending Colon; Prox 2/3 transverse colon
Distal 1/3 transverse colon; descending colon; sigmoid colon; Rectum; upper part of anal canal
between week5-6 and 10-11 gut gets adult configuration w/ midgut rotation totalling 270 degrees counterclockwise
25cm muscular tube going through diaphragm at t10 and terminating at cardiac orifice at T11
gastroesophageal reflux disorder: incompetent esophageal valve allows acid to rise into esophagus causing lining to change or get eroded
esophageal veins dilation from hypertension. now they're prone to hemorage and can cause death in persons with portal hypertension
25-60y/o. Men=women. Loss of myenteric neurons (auerbach's plexus) in lower esophagus. Lower esophageal sphincter (LES) paralyzed in constricted state and esophagus is dilated
obstructive jaundice due to pancreatic carcinoma
results from retention of bile that stain tissues like sclera (whites) of eyes. Cancer of head of pancreas compresses bile duct or hepatopancreatic ampulla (of vater)
obstructive Jaundice due to pancreatic carcinoma symptoms
severe back pain, large gallstone can cause obstructive jaundice and so one must consider this as possibility of differential
bare area of liver
in contact with diaphragm. site where original relationship w/ septum transversum is retained. liver suspended from diaphragm by coronary ligament
female 2x liklier. severe epigastric or right upper quadrant pain. can be referred to R shoulder (irritation of diaphragm). Large ones cause obstructive jaundice
cholesteral gallstones. 20%men over 75, 35%women over 75 AND women in reproductive years 3x liklier than men
brown pigment gallstones associated w/ bacterial cholangitis due to increased concentration fo unconjugated bilirubin in bile
sympathetic innervation from T6-9 with pain afferents running with them. Other afferents run with parasympathetics (vagus)
superior mesenteric vein and artery vs uncinate process of pancreas
head of pancreas right next to superior mesenteric vein, then more left is the artery
7m long starting w/ duodenum. jejunum is upper 2/5 of remainder, located in L upper quadrant. Ileum is lower 3/5 in R lower quadrant
Large Intestine parts (7)
Cecum; Ascending Colon; Transverse Colon; Descending Colon; Sigmoid Colon; Rectum; Anal Canal
symp innervation from spinal segments t8-t12, pain running with them. other afferents run w/ parasympathetics (vagus)
midgut to hindgut transition line
line on the left transverse colon between center of body and decending colon
SMA and IMA anastomoses clinical
left colic flexure vulnerable to ischemia. atherosclerosis could occlude openings of either one. marginal artery allows blood distribution of these arteries when one or the other is occluded
"Congenital aganglionic megacolon" Failure of neural crest cels to migrate into distal colon (males 4:1) and 1:5000 births
formed when splenic and superior mesenteric vein join post. to neck of pancreas at level of L2. Gets blood from GI tract and spleen. Blood from kidneys do not drain into portal vein
portal venous drainage w/ somatic venous drainage 4 sites: 1)esophageal veins 2)paraumbilical veins 3) veins of anal canals 4) retroperitoneal veins
lymphatics follow arteries. upper portion of rectum drains along route of inferior mesenterec a. middle and lower portions drain back toward internal iliac arteries. below pectinate line, drainage is to superficial inguinal nodes
symp from t12-L2, pain runs with these. Other afferents run w/ parasympathetics (pelvic splanchnics)
fore/midgut get parasympathetic from vagus through left 1/3 transverse colon. symp supply to fore/midgut from thoracic splanchnics
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