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Anatomy EXAM 2 > 11-6 Abdomen II > Flashcards

11-6 Abdomen II Flashcards

1
Q

Small Intestine is the ____ part of the GIT and extends from _____ ____ to _____ ____. It consist of three parts. What are they?

B: Which part is a C-shaped tube surrounding the Pancreas head? Where do these 2 organs lie?

A

Small Intestine is the LONGEST part of the GIT & extends from STOMACH PYLORUS to iLEOCECAL JUNCTION.
º3 parts= Duodenum –>Jejunum—>iLeum

B: DUODENUM is C-shaped Tube surrounding Pancreas Head.
ºDuodenum & Pancreas lie @ Junction between FOREGUT & MIDGUT (Celiac trunk + [SUP Mesenteric a.]/SMA)

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2
Q

A: The DUODENUM is the __part, C-shpaed tube of the ___ _____ that is described as ________. Is this structure retroperitoneal?

B: Briefly describe the 4 parts of the DUODENUM
º1st SUPERIOR prt [3] (AKA ___ ___/___)

º2nd DESCENDING prt

º3rd inferior prt

C: What is the MAJOR duodenal papilla? minor duodenal papilla?

D: Which organ does the DUODENUM surround?

A

A: DUDODENUM is the 1st part, C-shaped tube of the SMALL INTESTINE = shortest / widest / most FIXD part of small intestine .
º2nd / 3rd parts = Retroperitoneal!&raquo_space;1st part is connected to liver by [hepatoduodenal ligament of lesser omentum]

B:
1st SUP (AKA duodenal bulb/cap)=
ºanterolateral to L1 & NOT RETROPERITONEAL like other parts
ºattached to Greatr/lesser stomach omenta
ºcommon place for duodenal ulcers
****************
2nd DESCENDING=
º lies R of L2/L3 & receives Major/minor duodenal papilla
****************
3rd inf=
ºANT to L3 –> crosses IVC& [Abd aorta] but is ANTERIORLY CROSSED itself by [SUP Mesenteric a.]/[SUP Mesenteric vein]
****************
4th ASCENDING=
ºASCENDS L of L3 –>L2 and ends @ [duodenojejunal flexure] and it’s tethered to Liver by [suspensory ligament of Treitz]
———————————————————————————
C: –MAJOR Duodenal Papilla= OPENING of [MAIN PANCREATIC DUCT OF WIRSUNG] & BILE DUCT

-minor duodenal papilla= opening of [accessory pancreatic duct of santorini]

D: DUODENUM surrounds PANCREAS HEAD

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3
Q

A: Describe the Pancreas
B: Where is it located? Is it Retroperitoneal?
C: It has ___ PARTS and 2 ducts

D: Describe the PARTS

E: Describe the ducts
º[Main Pancreatic Duct of Wirsung]

º[accessory pancreatic duct of santorini]

A

B: Lies across POST abd wall from duodenum—>spleen. MOST is RETROPERITONEAL

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4
Q

A: BOTH begin at ____ _____ & ends at the _____ ____ . They are completely covered in ____, which makes them _____ organs. And they are suspended by mesentery from the ____ ___ _____.

B: Describe the mesentery [2]

C: What are the perfused by?

A

A: BOTH begin at [duodenojejunal flexure] & end at [iLeocecal junction]. BOTH completely covered in PERITONEUM = “INTRAperitoneal Organs” . Are suspended by Mesentery from POST ABD WALL

B: Mesentery= fan-shaped with 2 borders
1. Root/Attached brder= 6 inches long, crosses [3 inf part duodenum ], IVC, (R ureter), (R psoas major)

  1. FREE brder= 6 METERS long, encloses loops of

C: perfused by [SUP mesenteric a.]

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5
Q 
< JeJunum >
A: Color
B: Wall
C: Vascularity / Vasa recta / Arcades 
D: Mesentery Fat

E: [Peyer patch Lymphoid nodules]

F: [Plicae Circular folds]

A 
< JeJunum >
A: Deep Red
B: THICK & HEAVY
C: Greater / Long VR / few lrge loops
D: less mesentery fat

E: few

F: Large, tall & closely packed

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6
Q 
>iLeum<
A: Color
B: Wall
C: Vascularity / Vasa recta / Arcades 
D: Mesentery Fat

E: [Peyer patch Lymphoid nodules]

F: [Plicae Circular folds]

A 
>iLeum<
a: pale pink
b: thin & light
C: less / short vr / MANY LRGE LOOPS
D: MORE mesentery fat

E: More

F: scattered & absent in distal part

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7
Q

A: Large Intestine extends from the ____ to __ __ and includes several components. Name these components in order [10]

B: Is this organ retroperitoneal (__)?

C: What perfuses the Large Intestine?

A 
A: Large Intestine extends from CECUM to ANAL CANAL. Includes (in order)
1st i. CECUM //// 1st ii.w/Appendix
2nd. ASCENDING colon
3rd. [R Hepatic colic flexure]
4th. Transverse colon
5th. [L Splenic colic flexture] 
6th. DesCending colon
7th. Sigmoid Colon 
8th. Rectosigmoid jnction
9th. Rectum
10th. [ANAL CANAL]
---------------------------------------------------------------------------------
B: MOST Lrge Intestine = Retroperitoneal(fixed) except 3 parts of appendix, Transverse colon &amp; sigmoid colon[mobile]

C: Perfused by SMA & IMA

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8
Q

Large Intestine Features
A: [Omental Appendices Epiploicae]

B: Taeniae Coli (Omental vs. Free vs. Mesocolic)

C: Haustra Sacculations

A

Large Intestine Features
A: [OAE]= small pouches of fat tht are absent in CAR[Cecum/Appendix/Rectum]
———————————————————————————
B: Taeniae Coli= outer thick longitudinal muscle–>forms 3 bands shorter than other layers. Starts at appendix base & ends at Sigmoid Colon
———————————————————————————
C: Haustra Sacculations=found inbetween [Taeniae Coli] and bulges outward—>form 3 rows of pouches

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9
Q

List the Peritoneal fold coverings for these ____ ____ parts

  1. Cecum
  2. Appendix
  3. Ascending colon
  4. Transverse colon
  5. DeScending colon
  6. Sigmoid Colon
  7. Rectum
A

Peritoneal fold coverings for LARGE INTESTING parts
1. Cecum = RETROPERITONEAL

  1. Appendix = Mesoappendix
  2. Ascending colon = RETROPERITONEAL
  3. Transverse colon= Transverse mesocolon
  4. DeScending colon = RETROPERITONEAL
  5. Sigmoid Colon[mobile]= Sigmoid Mesocolon
  6. Rectum= RETROPERITONEAL
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10
Q
  1. The Cecum is a ____ sac in the ___ ___ ____ that medially receives what 2 structures?

2.Describe:
A: iLeocecal valve(IC)

B: APPENDIX [3]

A
  1. Cecum is a BLIND sac in R iLiac Fossa that medially receives APPENDIX & iLEUM
  2. A: iLeocecal valve(IC)= 2 lip valve 2 cm above Appendix opening tht Guards iLeal opening into cecum

B: APPENDIX=
ºtube rich in lymphoid tissue, suspended by [Mesoappendix Peritoneal fold covering]

ºBase serves as meeting point for 3 types of [Taeniae coli]= IMP LNDMRK IN SURGERY

ºhas variable positioning but Retrocecal is most common

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11
Q

A1: Acute Appendicitis [2]
A2: How does Acute Appendicitis Pain get to brain?

B: McBurney’s Point

C: Meckel’s Diverticulum Inflammation [6]

A

A1: Acute Appendicitis = ºacute appendix inflammation 2º to viral/bacterial infection.
ºMay result in clot thrombosis of appendicular a.[daughter of iLeocolic artery]—>leads to APPENDIX PERFORATION!

B: McBurney’s Point
ºMAX point of tenderness in Acute Appendicitis
ºlocated at Meeting Point 2/3 distance from Umbilicus & 1/3 distance from [R ASIS]
———————————————————————————
C: Meckel’s Diverticulum Inflammation (AKA Syndrome of 2’s)
ºInflammation of Meckel’s Diverticulum tht presents Same as Acute Appendicitis
º2 feet from IC valve /2 inches long
º2 % of population / 2% symptomatic
º2 types of ectopic tissue (gastric vs. pancreatic)
º2 years of age at clinical presentation
º2 x more common in Boys
———————————————————————————
«< ASIS= ANT SUP iliac spine&raquo_space;>

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12
Q

What is GIT [PARAsympathetic Autonomic] innervation for….
A: Foregut/Midgut

B: Hindgut

C: All of these fibers are _____[pre/POST ganglionic] and will relay in the ________

A

PARAsympathetic Autonomic innervation:
A: Foregut/Midgut = Vagus n.

B: Hindgut= [Pelvic splanchnic n. ] -sacral outflow S2, S3, S4

C: All of these fibers are preganglionic and relay in terminal ganglia of their target organs

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13
Q

What is GIT [Sympathetic Autonomic] innervation for….
A1: Foregut/Midgut
A2: What is the nerve route of passage for this section?
———————————————————————————
B1: Hindgut
B2: What is the nerve route of passage for this section?

A

Sympathetic Autonomic innervation:

A: FOREGUT/MIDGUT = 3 Thoracic splanchnic nerves

GREatr (T5-T9)—>Celiac sympathetic ganglia
Lesser (T10-T11)—>[SUP mesenteric] sympathetic ganglia
least (T12) —>[prevertebral aorticorenal] sympathetic ganglia

A2: ºAll arise from thoracic prt of sympathetic trunk
—>convey presynaptic sympathetic fibers to distinct prevertebral sympathetic ganglia]

B1: HINDGUT= 4 Lumbar Splanchnic nerves
B2: All arise from Lumbar prt of sympathetic trunk—>convey presynaptic sympathetic fibers to associated [prevertebral ganglia] of those plexuses

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14
Q

1- Which Artery perfuses the Midgut and where does it come from?

2-Describe its Route of Passage from Parent A. to Midgut [4]

3-Describe the 5 artery daughter groups from this artery and what they feed

4- Which daughter artery has special “connections”?

5- Which daughter artery branches to the Right? (vs. all the others which branch to L)

A

MIDGUT
1-[SUP mesenteric Artery/SMA]=2nd unpaired branch from ABD AORTA at level L1

3-
A: inf pancreaticoduodenal—>1/2 duodenum & pancreas
B: Mid colic–>R 2/3 Transverse colon

C: R colic—->Ascending colon

D: ileocolic [ANT cecal/POST cecal/Appendicular/iLeaL]
—–>Cecum & Appendix

4-[ iLeocolic a. > iLeal branch] anastomoses with end of SMA
———————————————————————————
5- ALL SMA branches go to R except….
[JejunaL & iLeaL] daughter arteries = GO TO LEFT

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15
Q

1- Which Artery perfuses the HINDgut and where does it come from?

2-Describe its Route of Passage from Parent A. to HINDgut [4]

3-Describe the 3 artery daughter groups from this artery and what they feed

4- Which daughter artery is a DIRECT CONTINUATION of the HINDgut Parent Artery?

5- Marginal artery of Drummond

A

1-[inf mesenteric artery]= 3rd unpaired branch from ABD AORTA at level L3

3-
a: L colic—> L 1/3 Transverse colon & higher end Descending colon

b: sigmoid a. 2&3 —>Sigmoid colon & lower end Descending colon

4-[SUP rectal ] daughter a. is DIRECT CONTINUATION of [inf mesenteric artery] Parent
———————————————————————————
5-Marginal a. of Drummond= arterial arcade along colon that interconnects
L colic, [middle colic & R colic (from SMA) ]

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16
Q
  • *Portal Vein**
    1. Purpose
  1. Route of Passage & final Location [4]
  2. This Vein is special because it begins as a ___ and ends as an ____ in the [porta hepatis] by dividing into ___ branches. Describe it’s supply to the Liver
A
  • *Portal Vein**
    1. Transmits blood collected from intestinal capillary bed, pancreas, spleen & Gallbladder —–>[Liver sinusoids/2nd capillary bed] ////

  1. Starts POSTERIORLY at Pancreas Neck as [SMV+splenic vein] union
    —>ascends as Vein in free border of lesser omentum
    —>enters POSTERIOR [porta hepatis] AS ARTERY
    —>terminates inbetween [intestinal capillary bed] & [Liver sinusoid/2nd capillary bed] POSTERIORLY
    ———————————————————————————
  2. ºPortal Vein beings as VEIN and ..ends as ARTERY in [porta hepatis] by dividing into 2 branches.
    ºGives liver 75% of its blood & 50% of its needed O2
17
Q

A: The Portal Vein has 5 Daughter venous Tributaries. What are they and what granddaughter veins feed into them? (Or what do they drain into)

B: Which vein receives the HINDgut veins?

A
  • *Portal Vein** daughter venous Tributaries
    1. [SUP mesenteric vein/SMV]—>receives veins similar to SMA branches + R gastroomental vein
  1. Splenic Vein–>receives veins similar to splenic a. + [inf mesenteric vein]/IMV (which receives HINDgut veins)
  2. R & L gastric veins
  3. Cystic vein–> drains into R branch
  4. Paraumbilical veins—> drains into L branch

B: IMV receives HINDgut veins

18
Q

A: [systemic caval system] consist of the ____ + ____. The_____ system has multiple anastomosis with the [systemic caval system]. What is the purpose of this?

B: Name the 3 Important sites of ___-___ Systemic Anastomoses

A

A: [systemic caval system] consist of . The PORTAL system has multiple anastomosis with [systemic caval system]. = ALLOWS REROUTING OF VENOUS RETURN TO HEART

B: 3 IMP sites of PORTAL-CAVAL Systemic Anastomoses
1. L gastric vein & esophageal vein of Azygos system

  1. [SUP rectal vein] & middle/inf rectal veins
  2. Paraumbilical veins & SEVR[superficial epigastric vein Radicles]
19
Q

A: Liver Cirrhosis

B: What are 3 clinical manifestations of this dz

A

A: progressive liver fibrosis, which disrupts portal blood flow—>leads to portal HTN

B: portal HTN will cause:
1. Lower Esophageal varices——>Hematemesis

  1. [Hemorrhoid Rectal varices]—>rectal bleeding
  2. Caput medusae —->varicose veins radiating from [Medusa’s head @ umbilicus]
20
Q

The Jejunum and Ileum receive Sympathetic innervation from Which nerve and at which vertebrae level?

A

Jejunum & ILeum receive Sympathetic innervation from [Greater Splanchnic n. T5-T9] (via Celiac ganglion)

Anatomy EXAM 2 (16 decks)

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