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GIGU > Ab midgut and hindgut > Flashcards

Ab midgut and hindgut Flashcards

1
Q

Describe the jejunum

A
  • makes up proximal 2/5ths of small intestine
  • intraperitoneal supported by mesentery
  • contains plicae circulares
  • mesenteric fat increases from prox to distal
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2
Q

Which part of the intestine has longer vasa recta?

A

Longer in jejunum shorter in ileum

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3
Q

Describe the ileum

A
  • makes up distal 3/5ths of small intestine
  • intraperitoneal supported by meentery
  • supplied by short vasa recta
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4
Q

Where do the vasa recta branch from?

A

Superior mesenteric artery

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5
Q

Where does the colon begin?

A

Ileocecal junction

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6
Q

Describe the order of the colon

A
  1. cecum
  2. appendix
  3. ascending colon
  4. hepatic flexure
  5. transverse colon
  6. splenic flexure
  7. descending colon
  8. sigmoid colon
  9. rectum
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7
Q

Describe rectum

A

Retroperitoneal and sub peritoneal located in the pelvic cavity and contains 3 transverse rectal folds. Continuous with anal canal

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8
Q

Describe the anal canal

A

Surrounded by 2 sphincters:

  1. internal sphincter made of smooth mm
  2. External sphincter made of skeletal mm

External opening is anus

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9
Q

Where is the pectinate line?

A

located at inferior ends of anal valves

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10
Q

What does the SMA supply?

A
  • pancreas
  • duodenum
  • SI
  • Cecum
  • Ascending and transverse colon
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11
Q

What does the IMA supply?

A
  • Descending and sigmoid colon
  • superior rectum
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12
Q

Where does the SMA arise from and what is its relationship to pancreas?

A

Comes from aorta at L1 posterior to the neck of the pancrease and passes inferiorly and anteriorly to horizontal duodenum

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13
Q

What are the proximal branches of the SMA?

A
  • inferior pancreaticoduodenal arteries which anastamose with gastroduodenal from celiac trunk
  • 20% gives rise to hepatic artery
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14
Q

What are the intestinal branches of the SMA?

A
  • Jejunal and ileal intraperitoneal
  • Ileocolic
  • Right colic
  • Middle colic
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15
Q

What are the intestinal branches off of the IMA?

A
  • Left colic
  • Sigmoidal artery
  • Superior rectal artery

IMA comes off of aorta at L3

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16
Q

What arteries make up the Marginal artery

A
  • Anastomoses between SMA and IMA
17
Q

What is the purpose of the Marginal artery of Drummond?

A

Helps prevent intestinal ischemia by providing alternate route if there is an occlusion

18
Q

Blood Supply to rectum?

A
  • Superior rectal artery from IMA
  • Middle rectal form internal iliac
  • Inferior rectal from internal pudendal
19
Q

Where does the portal venous system anastamose with the systemic system?

A
  • Gastroesophageal plexus
  • Umbilicus
  • Rectal venous plexus
20
Q

What are the sympathetics of the midgut and hindgut?

A
  • Thoracic splanchnics:
    • greater T5-9 to celiac ganalia
    • Lesser T10-11 to SMA ganalia
    • Least T12 to aorticorenal ganglia
  • Lumbar splanchnics L1-5
  • Sacral Splanchnics S1-S5
21
Q

Describe the thoracic splanchnics

A
  • They carry presynaptic axons from the spinal cord to postsynaptic neurons in the aortic collateral ganglia
  • Greater T5-9 to celiac ganglia
  • Lesser T10-11 to SMA ganglion
  • Least T12 to aorticorenal ganglia
22
Q

Where do lumbar splanchnics go>

A

carreis presynaptic axons from spinal cord to SMA LMA and hypogastric ganglia

L1-L5

23
Q

What do sacral splanchnics carry and where do they go?

A
  • S1-S5 carreis presynaptic axons from sacral sympathetic chain to hypogastric ganglia
24
Q

Parasympathetics of the midgut and hindgut?

A
  • Post synaptic neurons in the walls of organs
  • Vagus nerve
  • Pelvic splanchnics S2-S4 carries presynaptic axons from sacral spinal nerves to join hypogastric plexus travel into organs and synapse with post synaptic parasympathetic neurons within organ
25
Q

What does the preaortic plexus consist of?

A
  • Celiac ganglia
  • SMA ganglia
  • Aorticorenal ganglia
  • IMA ganglia
26
Q

Where do Sacral Splanchnic nerves originate from, where do they synapse, how do they travel?

A
  • Originate from the spinal cord and are associated with spinal nerves S1-5. They synapse in the inferior hypogastric plexus ganglia
  • Neurons travel with the internal iliac artery to pelvic viscera and perineum
27
Q

How does the somatic afferent pathway work in regards to pain?

A
  • Pain from irritation of the parietal peritoneum
  • The brain interprets the pain as referred pain, if the liver is inflammed pushing on the diaphragm, the pain is sent through C345 so pain will be felt in the cervical area
  • Acute pain and well localized
  • Sensitive to stretching of the peritoneum, as seen with the rebound tenderness
28
Q

How does the visceral afferent pathway work in regards to pain?

A

It is pain from the organ

  • Pain from the organ is sent through the splanchnic nerves to the spinal cord and it is poorly localized
  • The pain radiates to the same dermatome level
  • Stomach pain carried through the greater splanchnic nerved is interpreted as in the T5-9 dermatome region

GIGU (17 decks)

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