Study sets, textbooks, questions
Upgrade to remove ads
DM Lecture 9: GI System III
Terms in this set (46)
Be able to recognize parts of the Large Intestine
What are the three main key features of the large intestine (can be seen with naked eye)???
1. Taenia coli
-Longitudinal muscle (forms 3 bands)
3. Epiploic/fatty appendages
Large bowel obstruction tends to be located in the ....? It causes increased intra-luminal ...... ? It is also characterized by the presence of ...?
- To understand bowel obstruction think of the GI tract as a tube. Obstruction at any point along the tube would cause the part of the tube proximal to the point of the obstruction to be dilated and the part located distally to be flattened.
Symptoms of Large bowel obstruction include .... and .... , ..... distention? On physical examination there is increased ......? It doesn't allow passage of .... via the Rectum?
-due to increased peristaltic motion to try to overcome the obstruction
What is the first part of the Large intestine?
What empties into it? and via what valve?
What is the last part of the large intestine?
Ileum (of small intestine)
-Controls the flow of material from the ileum to the cecum
-Start of the rectum
The Rectum is the continuation of the GI tract into the ...?
It begins at the .... junction and terminates in the .... junction?
The Rectum has no ....?
-At the level of S3
The Superior 2/3 of the Rectum is ..... and forms the posterior surface of the .... and .... pouches?
The inferior 1/3 of the Rectum is ....?
-Pouch of douglas in females!!!
The Internal structure of the Rectum is made up of 3 .....?- 2 on the .... and 1 on the ...?
-2 on the left: superior and inferior rectal folds
-1 on the right: middle rectal fold
The .... is the most distal part of the Rectum? It stores .... until defecation?
The Puborectalis muscle forms a sling around the ... junction?
Puborectalis is important in fecal continence
The Internal Anal sphincter is made up of .... muscle?
The External Anal sphincter is made up of ... muscle?
-We can't control it
-We can control it
The Anal canal above the Pectinate line is ..... in origin and is innervated by ...?
The Anal canal below the Pectinate line is ..... in origin and is innervated by ...?
Sympathetic innervation causes the Internal anal sphincter (smooth muscle) to ....?
Parasympathetic innervation causes it to ....?
The External Anal sphincter (skeletal muscle) is innervated by ..... nerves which are branches of .... nerve?
The Levator Ani are innervated by nerves of the ... plexus?
what kind of muscle are they composed of?
Venous drainage above the Pectinate line goes to the ..... plexus?
..... hemorrhoids are formed above the pectinate line?- are these painful or painless?
Internal Rectal Venous
Venous drainage below the Pectinate line goes to the ..... plexus?
..... hemorrhoids are formed below the pectinate line?- are these painful or painless?
External Rectal Venous
The Rectum and Anal canal are supplied by the Superior, middle and inferior ..... arteries?
Where do they each come from (what arteries)?
Superior rectal -> branch of inferior mesenteric
Middle rectal -> branch of internal iliac
Inferior rectal -> branch of internal pudendal
-Internal pudendal is a branch of internal iliac
What 3 arteries form a rich Anastomosis around the Rectum?
1- Inferior Mesenteric
2- Internal Iliac
3- Internal Pudendal
In the Venous drainage of the Rectum- Above the Pectinate line the ....... plexus drains into the ..... vein ?
Superior Rectal (inferior mesenteric --> portal vein)
•The internal rectal plexus drains in both directions at the level of the pectinate line
In the Venous drainage of the Rectum- Below the Pectinate line the ....... plexus drains into the ..... vein ?
Inferior Rectal (caval system ie IVC)
-Inferior rectal drains into internal iliac which drains into common iliac and finally drains into inferior vena cava
Internal hemorrhoids are dilations of the ...... plexus?
External hemorrhoids are dilations of the ...... plexus?
-Prolapses of the rectal mucosa containing dilated veins of the internal rectal plexus
Any disorder that impedes venous return and Increases intra-abdominal pressure can lead to the occurrence of ...?
The Porto-Caval anastomosis serves as a .... route for drugs?
ie Rectal suppositories
In a condition like Portal Hypertension the portocaval anastomoses between the Superior middle and Inferior rectal veins become .....? This can lead to the occurrence of ....?
What is Hematochezia?
-Leads to backflow/pressure buildup along the portal vein
- specifically: Hematochezia: the passage of fresh blood per anus, usually in or with stools.
Above the Pectinate line Lymph drains to the .... nodes?
Below the Pectinate line Lymph drains to the ..... ....... nodes?
Superficial Inguinal aka Horizontal inguinal
..... is a condition characterized by the outpouching of Colonic mucosa and Submucosa that herniate through the muscular layer? It generally occurs in the .... colon? It may erode into colonic vessels causing ...?
•May be asymptomatic . If erosion into the colonic vessels take place painless rectal bleeding occurs.
In the Lab Diverticulosis can be confirmed by ..... due to bleeding or by a positive ..... test during bleeding? What does radiography show?
Radiology: diverticular seen on barium enema and colonoscopy.
Obstruction of the Diverticulum can lead to the occurrence of an .....? Rupturing of the Diverticulum may lead to ...... and/or .... formation?
Diverticulosis is characterized by .......-.... quadrant pain? .... tenderness and distention as well as occcurrence of a ... ?
What are some terms to remember?
Terms to remember:
Be able to ID parts of the Colon
Be able to ID parts of the Colon-2
1- ascending colon
2- transverse colon
4- sigmoid colon
Sigmoid Volvulus is the .... of the ..... colon around its ......... causing ......?
Obstruction of the colon
Clinical features of Sigmoid Volvulus includes .... and .... , ...... pain and a history of ...?
Nausea and Vomiting
Complications of Sigmoid Volvulus include Colonic .... , Colonic ..... as well as ....?
Radiologically Sigmoid Volvulus is characterized by a ..... obstruction?- this is presented as a ..... sign? Is there any gas seen in the rectum?
May have symptoms of both ...... and ...... depending on the severity of the obstruction
Large and small bowel obstruction
What is the Arterial Blood supply to cecal region? Ascending colon? Transverse colon? Descending colon? Sigmoid colon? Upper Rectum?
Which ones are tributaries from superior mesenteric and which ones are tributaries from inferior mesenteric?
Describe the concept of the water shed area!!!
Right colic artery
Middle colic artery
Left colic artery
marginal arteries provide anastamoses throughout
Area predisposed to ischemia first -> the area of the left colic flexure (splenic flexure) because its the most distal to the main source of blood supply
-Ischemia can result to this are first if any of the blood supply is obstructed
Venous drainage of the Ascending and Transverse colon occur via the .... vein?
Drainage of the Descending and Sigmoid colon occur via the .... vein, then into the ........ vein?
Both of these veins eventually drain into the ...?
Superior Mesenteric Vein
Inferior Mesenteric Vein -> then drains into the Splenic vein
Hepatic Portal Vein
Be able to ID the Veins of the following image
Lymphatic drainage from the Stomach and Duodenum go into .... group nodes?
The ..... collects lymph from the whole viscera ?- this then drains into the ...?
•Sacculation at the lower end (beginning of thoracic duct.
The Thoracic duct drains lymph of the ..... and ..... quadrants of the body and ALL the ....? drains to the ......
Left subclavian region
right lymphatic duct--> drains right head and neck, right side of body and right arm, everything else goes to thoracic duct
-To right subclavian region
Distant metastasis from Abdominal organs can cause the enlargement of the ..... node aka ....?
Left Supraclavicular -> where thoracic duct drains
image shows small bowel obstruction- stacked coin appearance
Sets found in the same folder
DM Lecture 10: Regulation of Glycolysis/…
DM Lecture 17: Digestive Glands
DM Lecture 25: Inherited disorders of Am…
DM Lecture 36: Minerals and Nutritional…
Other sets by this creator
NB DLA 49: Examination of a Comatose Pat…
NB Lecture 64: Consciousness
NB Lecture 65: Eating Disorders
NB DLA 48: Sleep Deprivation