6th (265-327 - end of GI) A Flashcards
What vertebral level is the inferior mesenteric artery found at?
L3
Name 3 characteristic features of the large intestine that allow it to be distinguished from other abdominal organs.
- Haustrations.
- Tenia coli.
- Appendices epiploicae.
What are appendices epiploicae?
Small pouches of peritoneum filled with fat. They mark where blood vessels enter the bowel to supply the mucosa.
What are tenia coli?
3 strips of longitudinally running muscle on the outer surface of the large intestine.
What are haustrations?
Sacculations produced from where the tenia coli contract to shorten the wall of the bowel.
Where does the hind gut begin and end?
Distal 1/3 of the transverse colon to the anal canal.
What is the importance of the marginal artery of Drummond?
If there is an occlusion to the IMA, blood can still be supplied to the large intestine via the SMA through this artery.
Give 4 locations where the distal end of the appendix may lie.
- In the pouch of Douglas.
- Behind the caecum.
- Behind the umbilicus.
- Below the liver.
What structure(s) lie anterior to the liver?
The rib cage and the anterior abdominal wall.
What structure(s) lie posterior to the liver?
Oesophagus, stomach, gall bladder, first part of duodenum. (All are foregut derived organs).
What aspects of the liver does the visceral surface refer to?
The posterior inferior aspects. It is moulded by the shape of surrounding organs and so is irregular.
What is the function of the coronary and triangular ligaments?
They attach the superior surface of the diaphragm to the liver.
What structures bind the Caudate lobe and where is it located?
The IVC and a fossa produced by the ligamentum venosum. It is located on the upper aspect of the right lobe on the visceral surface.
What structures bind the Quadrate lobe and where is it located?
The gall bladder and a fossa produced by the ligamentum teres. It is located on the lower aspect of the right lobe on the visceral surface.
What is the storage capacity of the gall bladder?
30-50ml
What is the orifice called where bile empties into the duodenum?
Major duodenal papilla
What artery supplies blood to the gall bladder?
Cystic artery
What is the arrangement anterior to posterior of the ducts, artery and portal vein at the porta hepatis?
Anterior: common bile duct, hepatic artery, hepatic portal vein (DAV)
Where is the bare area of the liver?
Under the tendinous part of the right hemi-diaphragm. This area has no peritoneal covering.
What is the surface marking for the gall bladder?
The tip of the 9th costal cartilage. Where the lateral rectus sheath joins the costal margin.
Where do the hepatic veins drain?
Into the IVC
What are the 3 major branches of the Coeliac trunk?
The left gastric, the splenic and the common hepatic.
What branches does the splenic artery give off?
- The short gastric arteries.
- The pancreatic arteries.
- The left gastroepiploic artery.
- 5 branches just before it reaches the Spleen.
Name the 2 branches of the common hepatic artery.
- Proper hepatic artery.
2. Gastroduodenal artery.
Name the 2 branches of the Gastroduodenal artery.
- Right gastroepiploic artery (supplies greater curvature of the stomach).
- Superior pancreaticoduodenal artery (supplies head of pancreas).
What is a branch of the right hepatic artery?
The cystic artery (supplies the gall bladder).
Where in the duodenum are ulcers most likely? And which artery would they affect?
Most likely in the superior duodenum (1st part). If the ulcers erode through the posterior wall they may effect the gastroduodenal artery and cause haemorrhage.
What does the descending portion of the Duodenum lie posteriorly and anteriorly to?
Posteriorly to transverse colon. Anteriorly to the right kidney.
What does the tail of the pancreas lie in close proximity to?
The hilum of the spleen.
What is the inferior pancraticoduodenal artery a branch of?
Superior mesenteric artery
What is the blood supply to the rest of the pancreas?
Pancreatic branches of the splenic artery.
What is the venous drainage of the pancreas?
The head drains into the SMV (drains into hepatic portal vein). the pancreatic veins drain the rest of the pancreas (these drain into the splenic vein).
What ligaments of the greater omentum connect the spleen to the stomach and kidney?
Gastrosplenic and Splenorenal.
How far away is the major duodenal papilla from the pylorus of the stomach?
5cm
How far away is the major duodenal papilla from the pylorus of the stomach?
It marks the junction between the foregut and the midgut.
