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57 Cards in this Set
- Front
- Back
A 2 year old boy presents with a distended abdomen and cries a lot while holding his ‘belly.’ His parents say he often wont defecate for days at a time and is smaller than most of the other boys his age. The family physician referred him for an abdominal x-ray. Radiographs showed marked dilation of the bowel superior to the pelvic brim, with no gas found in the rectum. Rectal biopsy was ordered.
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Hirschsprung disease
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What are some signs and symptoms of Hirschsprung disease?
Description of Hirschsprung disease? |
-Gas in abdomen, but certain regions may be devoid of gas.
-Marked dilation of the bowel, with no gas in rectum. -Newborns that cannot have a bowel movement within first days of life -No peristalsis Hirschsprung’s disease results when neural crest tubes fail to migrate properly during development of the intestines. In a majority of the cases Auerbach’s and Meissner’s plexuses are missing in the rectum and sigmoid colon. In less than 10% of cases, the plexus is missing throughout the large intestine. The smooth muscle in the large intestine is not stimulated to contract. A new born would have delayed passage of meconium, constipation and abdominal distention. This can be corrected by surgically stretching the working portion of the large intestine. |
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This disease occurs when neural crest tubes fail to migrate properly during development of the intestines.
Furthermore, parasympathetic ganglia fail to form in submucosal and myenteric neural plexuses in the wall of colon and rectum |
Hirschsprung’s disease
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What is the former patent
umbilical artery? |
Umbilical ligament
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Places in the gut where the peritoneum fixes the colon up against the body wall
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Right and left colic flexures
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Base of ascending colon
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Cecum
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___________ is continuous over Abdominal Contents
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Peritoneum is continuous over Abdominal Contents
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Name the 3 vocabulary associated with the peritoneum
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Intraperitoneal
Retroperitoneal Secondarily retroperitoneal |
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Describes structures that are completely covered by peritoneum.
_________ is/are an example of (a) structure(s) covered by peritoneum |
Intraperitoneal
(stomach, liver and spleen) |
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Describes structures that are covered anteriorly by peritoneum THROUGHOUT development
_________ is/are an example of (a) structure(s) covered by peritoneum |
Retroperitoneal
(kidney) |
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Describes structures that are covered anteriorly by peritoneum LATER in development. These start as intraperitoneal and later become retroperitoneal
_________ is/are an example of (a) structure(s) covered by peritoneum |
Secondarily Retroperitoneal
(duodenum, pancreas, ascending colon, and descending colon) |
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Describes structures that are inferior to peritoneum
_________ is/are an example of (a) structure(s) covered by peritoneum |
*Subperitoneal
(bladder) |
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What structure hangs off the cecum?
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the Appendix
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Food from the ascending colon passes what structure?
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the right colic flexure
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What structure does the midgut begin with?
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Jejunum
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The ascending colon is part of which gut?
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Midgut
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The first 1/2 of the transverse colon is part of which gut?
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Midgut
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What is the endpoint of the midgut?
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The first 1/2 of the transverse colon
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The last 1/2 of the transverse colon is part of which gut?
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Hindgut
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The descending colon is part of which gut?
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Hindgut
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The sigmoid colon is part of which gut?
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Hindgut
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What structure is the termination of the hindgut?
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the Rectum
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What ligament connects the liver to the lesser curvature of the stomach?
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Hepatogastric ligament
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What ligament connects the liver to the duodenum?
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Hepatoduodenal ligament
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The stomach contains folds called ________ (which contribute to the expansive properties of the stomach)?
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Rugae
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The ________ part of the stomach contains a sphincter that opens up into the duodenum of the small intestine
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Pyloric
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What are the branches of the celiac trunk?
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Common hepatic artery
Left gastric artery Splenic artery |
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The ___________ branches off the proper hepatic artery or less frequently from the common hepatic artery?
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Right gastric artery
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What allow bile and pancreatic enzymes to enter the gut tract?
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Duodenal papilla
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What artery comes off of the abdominal aorta, about one inch inferior to where the celiac trunk comes off?
This artery supplies the mesentery and the gut that is associated with the small intestine |
superior mesenteric artery
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2nd part of duodenum is also called _________.
3rd part of duodenum is also called _________. 4th part of duodenum is also called _________. |
2nd part of duodenum is also called Descending duodenum.
3rd part of duodenum is also called Horizontal duodenum. 4th part of duodenum is also called Ascending duodenum. |
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The superior mesenteric artery gives off long branches toward the jejunum, called the _____________
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jejunal arteries
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What are also vessels that branch to the gut from the superior mesenteric artery?
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Arteriae rectae
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Jejunum vs distal ileum:
What has more folds and appears more rugose? |
The jejunum has more folds and appears more rugose than the distal ileum
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Jejunum vs distal ileum:
The arterial distribution in which is more networked? |
The arterial distribution in the distal ileum is more networked than the supply in the distal ileum
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What are “pockets” that are hanging off of the gut called?
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Omental appendices
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What are strands that run the length of the colon?
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Taenia coli
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What appear as bulbous folds along the exterior of the colon?
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Haustra
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*The inferior mesenteric artery comes off of the aorta at approximately which spinal cord level?
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L3
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[“Fright” is a total ANS response – involving which branch of the nervous system?]
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both sympathetic & parasympathetic
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What branch of nervous system causes pupillary dilation?
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Sympathetic
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What branch of nervous system causes bronchial dilation?
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Sympathetic
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What branch of nervous system causes vasoconstriction in the skin?
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Sympathetic
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What branch of nervous system causes sweating?
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Sympathetic
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What branch of nervous system causes an active bowel?
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Parasympathetic
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What branch of nervous system causes relaxation of rectal and urinary sphincters?
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Parasympathetic
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*?*
Sympathetic innervation to the gut is from the splanchnic nerves The splanchnics come from the T5-T12 region The greater splanchnic nerve comes from T5-T9 This nerve synapses at the celiac ganglia The celiac ganglia sit on the celiac trunk, which is just past the hiatus which the aorta enters the abdomen The lesser splanchnic nerve comes from T10-T11 This synapses on the superior mesenteric ganglion, which is right on top of the superior mesenteric artery The least splanchnic nerve comes from T12 This synapses on the inferior mesenteric ganglion, which is on top of the inferior mesenteric artery |
Sympathetic innervation to the gut is from the splanchnic nerves
The splanchnics come from the T5-T12 region The greater splanchnic nerve comes from T5-T9 This nerve synapses at the celiac ganglia The celiac ganglia sit on the celiac trunk, which is just past the hiatus which the aorta enters the abdomen The lesser splanchnic nerve comes from T10-T11 This synapses on the superior mesenteric ganglion, which is right on top of the superior mesenteric artery The least splanchnic nerve comes from T12 This synapses on the inferior mesenteric ganglion, which is on top of the inferior mesenteric artery |
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The majority of parasympathetic innervation to the gut is via which cranial nerve?
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the Vagus nerve, CN10
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What is the name for the nerves that supply parasympathetic innervation to the hindgut, in the same region where the blood supply is from the inferior mesenteric artery?
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Pelvic splanchnic nerves
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Pain from visceral sensation travels mostly with what branch of nervous system back to T1-L2 spinal cord segments from the body wall and internal organs?
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Sympathetics
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Sympathetic Motor vs Visceral sensation:
The ___________ is the “on ramp” to the sympathetic Chain! Travel via Splanchnic Nerves to the Gut |
white ramus
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Sympathetic Motor vs Visceral sensation:
In which must TWO NEURONS SYNAPSE IN A pre-vertebral GANGLION BEFORE GOING TO TARGET? |
Sympathetic Motor
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Sympathetic Motor vs Visceral sensation:
In which is there no gray ramus? |
Sympathetic motor
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White ramus communicans are found at which vertebral levels?
"White not quite" |
T1-L2
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Sympathetic Motor vs Visceral sensation:
In which is there no synapse in prevertebral ganglia, just passing through? |
Visceral sensation
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Referred Visceral Pain
Brain “thinks” pain from a visceral structure is coming from an area of skin innervated by the same segmental level at which the ___________ synapses (in the ______ horn) Results from “cross talk” of ____________ on the same segmental level of the spinal cord. Signals transfer that trick the brain |
visceral afferent
& dorsal. somatic & visceral afferents |