Anthony Shared "Step 1 FA Gastrointestinal" - 166 Picmonics
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Step 1 FA Gastrointestinal
Foregut Structures, Blood Supply and Innervation
- Structures
- Esophagus
- Lower Respiratory Tract
- Stomach
- Proximal Duodenum
- Liver
- Gallbladder
- Pancreas
- Spleen
- Vascular Supply
- Celiac Artery
- Innervation
- Vagus Nerve
2 mins
Midgut Structures, Blood Supply and Innervation
- Structures
- Distal Duodenum
- Jejunum
- Ileum
- Appendix
- Ascending Colon
- Proximal 2/3 of Transverse Colon
- Vascular Supply
- Superior Mesenteric Artery
- Innervation
- Vagus Nerve
- Lesser Splanchnic Nerve
2 mins
Hindgut Structures, Blood Supply and Innervation
- Structures
- Distal 1/3 of Transverse Colon
- Descending Colon
- Sigmoid Colon
- Rectum
- Pectinate (Dentate) Line
- Urogenital Sinus
- Vascular Supply
- Inferior Mesenteric Artery
- Innervation
- Lumbar Splanchnic Nerves
- Pelvic Splanchnic Nerves
2 mins
Omphalocele Vs Gastrochitis
- Omphalocele
- Failure of Midgut returning to abdominal cavity
- Assiociated with malformations
- Gastroschisis
- Protrusion
2 mins
Congenital GI Abnormalities
- Defects of anterior abdominal wall closure
- Rostral fold closure: sternal defects (ectopia cordis)
- Lateral fold: Omphalocele, gastroschisis
- Caudal fold closure: Bladder extrophy
- Duodenal Atresia
- Failure to recanalize
- Jejunal, Ileal, colonic atresia
- Vascular accident (apple peel atresia)
- Embryology
- Midgut herniates through umbilical ring ~6 weeks
- 10th week returns to abdominal cavity
- Midgut rotates counterclockwise while outside body
- Pancreatic Buds Fuse around 8 Weeks
- Ventral bud
- Uncinate process
- Dorsal Bud
- Accessory pancreatic duct
- Both contribute to head
- Pancreas rotates around 2nd part of duodenum
- Both contribute to main pancreatic duct
- Failure to fuse= pancreatic divisium
- Midgut malrotation--> Duodenal obstruction
- Ladd's bands
Tracheoesophageal Fistula (TEF)
- Cause
- Esophageal Atresia
- Ends in Blind Pouch
- Assessment
- Coughing
- Choking
- Cyanosis
- Drooling
- Considerations
- NPO
- Surgical Emergency
- Aspiration Pneumonia
2 mins
Hypertrophic Pyloric Stenosis (HPS) Assessment
- Mechanism
- Hypertrophied Pylorus
- Risk Factor
- Macrolide Use
- Assessment
- 3-6 Weeks of Age
- Projectile Vomiting After Feeding
- No Pain or Discomfort
- Weight Loss
- Dehydration
- Hungry Baby
- Olive Mass
2 mins
Hypertrophic Pyloric Stenosis (HPS) Interventions
- Treatment
- Pyloromyotomy
- Preoperative Care
- Stabilize Fluid and Electrolyte Balance
- Nasogastric Tube
- Monitor Feeding
- Postoperative Care
- Start Formula or Breastfeeding Within 24 Hours
- Feedings Every 4-6 hours
- Full Feeding Within 2 days
2 mins
Pancreas
- Characteristics
- Acinar Cells Release Digestive Enzymes
- Ductal Epithelial Cells Release Bicarbonate
- Islets of Langerhans
- Beta Cells Release Insulin
- Alpha Cells Release Glucagon
- Delta Cells Release Somatostatin
- Somatostatin Inhibits Alpha and Beta Cells
3 mins
Annular pancreas and pancreatic divisum
- Pancreatic divisum
- pancreas with divide
- failure for ventral and dorsal buds to fuse
- at 8 weeks
- can cause chronic abdominal pain
- can cause chronic pancreatitis
- mostly asymptomatic
- Annular pancreas
- antler pan
- ventral bud forms ring around second part of duodenum
- nausea/vomiting
- obstruction
- bilious vomiting
Retroperitoneal organs (SADPUCKER)
- SADPUCKER
- S: Suprarenal glands
- A: Aorta + IVC
- D: Duodenum (except 1st part)
- P: Pancreas (head and body)
- U: Ureters + Bladder
- C: Colon (ascending and descending)
- K: Kidneys
- E: Esophagus
- R: Rectum
- Secondarily Retroperitoneal
- ACDC Party Down
- AC: Ascending Colon
- DC: Descending colon
- P: Pancreas
- D: Duodenum
GI Ligaments
- Falciform Ligament
- Contains ligamentum teres
- Ligamentum teres is derivative of fetal umbilical vein
- Gastrohepatic ligament
- Contains gastric vessels
- Gastrohepatic ligament cut during surgery to access lesser sac
- Hepatoduodenal Ligament
- Contains portal triad
- Gastrosplenic Ligament
- Contains short gastric arteries
- Contains left gastroepiploic vessels
- Splenorenal Ligament
- Contains splenic vessels
- Contains tail of pancreas
- Gastrocolic ligament
- Contains epiploic arteries
- Median Umbilical Ligament
- Derivative of Allantois-->Urachus
- Medial Umbilical ligaments
- Derived from umbilical arteries
Oral Cavity
- Characteristics
- Mouth
- Mechanical Digestion
- Salivary Amylase Begins Carbohydrate Breakdown
- Lingual Lipase Begins Lipid Breakdown
- Esophagus
- Bolus
- Peristalsis
1 min
Small Intestine Absorption
- Characteristics
- Carbohydrates Undergo Active Transport
- Amino Acids Undergo Active Transport
- Small Lipids Undergo Passive Diffusion
- Epithelial Cells
- Intestinal Capillaries
- Hepatic Portal Transports Nutrients
- Liver
- Large Lipids Transported as Chylomicrons
- Lacteals Transport Chylomicrons
2 mins
Small Intestine Digestion
- Brush border enzymes
- Pancreatic Enzymes are secreted via a Duct
- Pancreas secretes bicarbonate
- Brush Border activates Pancreatic Trypsin
- Trypsin activates Chymotrypsin
- Trypsin and Chymotrypsin digest Proteins
- Gallbladder Releases Bile
- Pancreatic Lipase breaks down Lipids
- Goblet cells secrete mucus
- Pancreatic Amylase breaks down Carbohydrates
- Pancreatic Nucleases breakdown DNA/RNA
- Digestion occurs in the Duodenum
2 mins
Stomach Digestion
- Characteristics
- Chief Cells Secrete Pepsinogen
- Pepsinogen Turned to Pepsin By H+
- Protein Breakdown Begins
- Mucous Cells Secrete Mucus and Bicarbonate
- G Cells Secrete Gastrin
- Gastrin Stimulates Parietal Cell HCl Release
- Parietal Cells Secrete Intrinsic Factor
2 mins
Mesenteric Ischemia
- Signs and Symptoms
- Severe Abdominal Pain
- Bloody Diarrhea
- Metabolic Acidosis
- Diagnosis
- Increased WBC
- Increased Lactate (Lactic Acid)
- X-ray
- Air Within Bowel Wall
- CT Angiography
- Bowel Wall Edema
- Treatment
- Antibiotics
- Emergent Surgical Intervention
2 mins
Pectinate (dentate) line
- Internal hemorrhoids
- Adenocarcinoma
- Superior rectal artery
- Superior rectal vein
- Painless hemorrhoid
- Internal iliac lymph node
- Squamous cell carcinoma
- Painful hemorrhoid
- Inferior rectal artery
- Inferior rectal vein
- External hemorrhoid
- Anal fissure
- Superficial inguinal lymph drainage
Types of Hernias
- Hiatal
- Gastroesophageal Reflux Disease (GERD)
- Inguinal
- Men
- Femoral
- Women
- Incisional
- Umbilical
- Consideration
- Strangulation
1 min
Hernia Interventions
- Reduce Intra Abdominal Pressure
- Avoid Straining and Lifting
- Open Mouth Sneezing
- Excision
- Herniorrhaphy
- Hernioplasty
- Consideration
- Scrotal Support
1 min
