Atlas of Human Anatomy by Netter

FACTS & HINTS

High-Yield Facts

Clinical Points
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Hiatus hernia

Herniation of part of the stomach through the esophageal hiatus of the diaphragm

May cause pain and discomfort and predispose to reflux of gastric contents

Sliding hernias involve the cardia of the stomach sliding superiorly

Rolling hernias (less common) involve part of the fundus extending through the hiatus

Congenital hypertrophic pyloric stenosis

Thickening of smooth muscle of the pylorus

Causes severe stenosis of the pyloric canal

Gastric emptying is greatly reduced and typically leads to the presentation of projectile vomiting following a feeding

More common in males, and usually presents 3 to 8 weeks after birth

Diagnosis made by palpating a pyloric mass in the right upper quadrant (RUQ) during a test feeding

Intestinal volvulus

Rotation of a loop of bowel upon its mesentery

May cause acute bowel obstruction

Can compromise the vascular supply leading to ischaemia, infarction, and eventually necrosis

Most commonly occurs in the mobile small bowel, but may also affect the sigmoid colon, owing to the length of its mesentery

Prompt surgical decompression may be required, although passage of a flatus tube is usually sufficient in cases of sigmoid volvulus

Mnemonics

Memory Aids

Stomach Parts: "The CAR is FUN 'til the BODY PILES

This relates to the four parts of the stomach:

CAR Cardiac

FUN Fundus

BODY Body

PILES* Pylorus

*The pylorus is where the food piles waiting for the sphincter to open

Memory Aids

Bowel segments: Dow Jones Industrial Averages Closing Stock Report

Dow Duodenum

Jones Jejunum

Industrial Ileum

Averages Appendix (attached to cecum)

Closing Colon

Stock Sigmoid

Report Rectum

Memory Aids

Sphincters of the gastrointestinal tract: APE OIL

A Anal

P Pyloric

E Esophageal (lower)

O Oddi

I L Ileocecal