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GI ANAT > Abdominal Cavity 2 > Flashcards

Abdominal Cavity 2 Flashcards

1
Q

What is included as part of the MIDGUT?

A

3rd and 4th parts of duodenum, rest of small intestine, cecum, appendix, ascending colon, and proximal 2/3rd of the transverse colon.

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2
Q

What supplies blood to the midgut?

A

SUPERIOR MESENTERIC ARTERY and its branches

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3
Q

What supplies the sympathetics to the midgut?

A

LESSER and LEAST SPLACHNIC NERVE (T10-T12)

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4
Q

What supplies the PARASYMPATHETICS to the midgut?

A

POSTER VAGAL TRUNK
CN 10

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5
Q

What makes up the small intestine? (The divisions)

A

DUODENUM, JEJUNUM, AND ILEUM

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6
Q

What structures (structural modifications) amplify the absorptive surface area of the small intestine?

A

CIRCULAR FOLDS (PLICAE CIRCULARES)
VILLI
MICROVILLI

villi and microvilli attach to the circular folds

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7
Q

What is in the lamina propria of the villi of the small intestine? (HINT: WIDE LYMPHATIC CAPILLARY)

What brings fat (fat droplets) to this structure?

A

LACTEAL

CHYLOMICRONS –> LACTEALS –> LYMPHATIC SYSTEM

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8
Q

What level is the horizontal (3rd) portion of the duodenum located at?

A

L3

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9
Q

What level is the ascending (4th) portion of the duodenum located at?

What is the junction called where the ascending portion of the duodenum joins the jejunum?

A

L3-L2

DUODENOJEJUNAL JUNCTION

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10
Q

What is another name for duodenal glands ?

What do they secrete and why?

A

BRUNNER’S GLANDS

They secrete alkaline (bicarb reach mucous) to help neutralize acidity of the chyme.

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11
Q

What is the SUSPENSORY LIGAMENT (ligament of Treitz) ?

What structures does it suspend?

Is it a true ligament (like double layer of peritoneum) ?

A

An extension of SKELETAL MUSCLE originated from the RIGHT CRUS OF DIAPHRAGM.
- Wraps around the esophagus.

SUSPENSORY LIGAMENTS suspends the ascending (4th) portion of duodenum and jejunum.

Not a true ligament. Made of SKELETAL MUSCLE.

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12
Q

What percentage of the small intestine does the JEJUNUM make up?

A

40%

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13
Q

Where quadrant does most of the jejunum lie?
Is the jejunum intra or retroperitoneal?

A

LEFT UPPER QUADRANT
INTRAPERITONEAL

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14
Q

What type of folds are in the jejunum (lumen of jejunum)?

A

CIRCULAR FOLDS (PLICAE CIRCULARES)

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15
Q

What percentage of the small intestine does the ILEUM make up?

A

60%

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16
Q

Where does the ileum end?

A

ILEOCECAL JUNCTION

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17
Q

Where does most of the ILEUM lie?
Is the ileum intra or retroperitoneal?

A

RIGHT LOWER QUADRANT
INTRAPERITONEAL

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18
Q

What type of folds does the ileum contain? (inside ileum lumen)

A

CIRCULAR FOLDS (PLICAE CIRCULARES)

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19
Q

What aggregated lymphoid nodules are primarily in the ileum?

A

PEYERS PATCHES

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20
Q

Which structure has a bigger lumen? (Jejunum or Ileum)
What is the typical color of both the jejunum and Ileum?

A

Jejunum (catches food first)

Jejunum = deeper red
Ileum = Pink

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21
Q

What supplies blood and is on the jejunum and ileum?

A

ARTERIAL ARCADES –> VASA RECTA

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22
Q

What is the function of the large intestine?

A

Absorb water and electrolytes

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23
Q

What makes up the LARGE INTESTINE?

A

Transverse colon, Descending colon (right side of body), Sigmoid colon, Ascending colon (left side of body), Vermiform Appendix, Cecum, Rectum, Anal Canal

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24
Q

What are the 3 features of LARGE INTESTINE?

A

Teniae Colon - 3 longitudinal strips of muscularis externa

Haustra (sacs) - outpockets because teniae colon are too small and they make the large intestine kind of shrink up a bit

Epiploic Appendages - fat-filled pouches of visceral peritoneum (they hang from the colon)

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25
Q

What is constipation?

Common treatment of constipation?

What causes severe constipation?

A

When the bowel movements are having a hard time passing through large intestine (colon).
Laxatives

Colon Cancer –> Can cause hemorrhoids (swollen veins in lower rectum)

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26
Q

Inflammation of what 2 structures is known as INFLAMMATORY BOWEL DISEASE? (IBD)

What can IBD cause?

A

Inflammation of the SMALL INTESTINE and LARGE INTESTINE

IBD can cause diarrhea, rectal bleeding, anemia.

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27
Q

What are the most common types of INFLAMMATORY BOWEL DISEASE?

A

CHRON’S DISEASE and ULCERATIVE COLITIS

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28
Q

What structures does CHRON’S DISEASE affect?

A

Small and large intestine
(Also esophagus, stomach, anus)

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29
Q

What structures does ULCERATIVE COLITIS affect?

A

Colon and Rectum

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30
Q

Between Chron’s disease and Ulcerative Colitis, which one can you perform surgery on?

A

Surgery can be performed for ULCERATIVE COLOTIS (most of large intestine has to be removed)

Can’t do surgery for Chron’s disease because it involves too many other organs.

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31
Q

Development of cancer in either the colon or rectum is called what?

A

Colorectal cancer

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32
Q

What disease is associated with out-pocketings of mucosa (like little popcorn) that develops in the sigmoid colon?

A

Diverticulosis

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33
Q

When the diverticula become infected what is this called?

What is the main problem with this disease?

A

Diverticulitis

Diverticula can rupture and spill fecal matter into the peritoneal cavity –> Can cause peritonitis

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34
Q

What is the first part of the large intestine?
What is it continuous with?

A

CECUM
Continuous with the ascending colon (left side of body)
Also attached with the appendix

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35
Q

What quadrant is the cecum located on?
Is the cecum considered intraperitoneal or retroperitoneal?

A

RIGHT LOWER QUADRANT
INTRAPERITONEAL

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36
Q

What valve connects the ileum to the cecum?

A

ILEOCECAL VALVE

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37
Q

What is another name for appendix?

A

VERMIFORM APPENDIX

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38
Q

What quadrant is the appendix located on?

A

RIGHT LOWER QUADRANT

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39
Q

What are the 2 orientations that the appendix could be in?

A

RETROCECAL ORIENTATION (65%)
PELVIC ORIENTATION (35%)

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40
Q

What is the mesentery on the appendix?
Is the appendix intra or retroperitoneal?

A

Mesoappendix
Intraperitoneal

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41
Q

Pain in what quadrant has a high correlation to having appendicitis?
What even is appendicitis?

A

SUDDEN PAIN in RIGHT LOWER QUADRANT

Appendicitis - Inflammation of appendix

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42
Q

What is the common cause of appendicitis in the youngins?

A

Hyperplasia of lymphatic follicles (they get bigger) in the appendix –> occlusion of lumen of appendix

43
Q

What is the common cause of appendicitis in older ppl?

A

Obstruction of lumen of appendix by way of fecalith (stony/hard fecal matter)

44
Q

What happens when you DON’T get full rotation of the appendix during gut development?

A

Appendix is now located in the RIGHT UPPER QUADRANT

45
Q

REMOVING APPENDIX is called?
Where is it performed laproscopically?

A

APPENDECTOMY

MCBURNEY’S POINT on abdominal wall

46
Q

When the appendix is trapped within the hernial sac of an inguinal hernia, what is it called?

A

Appendicular (Amyand’s) Hernia (RARE)

appendectomy to the rescue

47
Q

What is the 2nd part of the colon?
Is it intra or retroperitoneal?

A

ASCENDING PORTION OF COLON
RETROPERITONEAL

48
Q

What spot marks the transition from ascending colon to transverse colon?

A

RIGHT HEPATIC FLEXURE

49
Q

What is the 3rd part of the large intestine? (Largest part part too)
Is it intra or retroperitoneal? (Remember.. does it have a mesentery?)

A

Transverse colon
INTRAPERITONEAL

50
Q

What vertebral level does the transverse colon cross the abdomen at?

A

L1

51
Q

What spot marks the transition from transverse colon to descending colon?

A

LEFT SPLENIC FLEXURE

Extends from the right HEPATIC flexure to the left SPLENIC flexure.

52
Q

What structures are part of the HINDGUT?

A

DISTAL 1/3RD of the transverse colon, descending colon, sigmoid colon, rectum, and anal canal

53
Q

What supplied blood to the HINDGUT?

A

INFERIOR MESENTERIC ARTERY

54
Q

What innervates and delivers SYMPATHETICS to the HINDGUT?

A

LUMBAR SPLANCHNIC NERVES (L1-L4)

55
Q

What innervates and delivers PARASYMPATHETICS to the HINDGUT?

A

PELVIC SPLANCHNIC NERVES

56
Q

What is the fourth part of the LARGE INTESTINE?
Is it intra or retroperitoneal?

A

DESCENDING COLON
RETROPERITONEAL

57
Q

What ligament is seen by the LEFT SPLENIC FLEXURE?

What happens if you yank on it?

A

SPLENOCOLIC LIGAMENT (RESIDENTS LIGAMENT)
This is a true ligament –> DOUBLE LAYER OF PERITONEUM

You can crack the spleen if you yank on the SPLENOCOLIC LIGAMENT (RESIDENT’S LIGAMENT)

58
Q

What is the fifth part of the LARGE INTESTINE?
Is it intra or retroperitoneal?

A

SIGMOID COLON
INTRAPERITONEAL

59
Q

When the sigmoid colon and the rectum meet, what is the junction called?
What vertebral level is this junction at?

A

RECTOSIGMOID JUNCTION
S3

60
Q

What is the most common site for diverticulosis (outpocketings of the colon mucosa)?

A

SIGMOID COLON

61
Q

What is the 6th part of the LARGE INTESTINE?

A

RECTUM

62
Q

Where does the rectum start and go to?

A

starts at RECTOSIGMOID JUNCTION (S3) and goes to the ANAL CANAL

63
Q

What 3 valves does the RECTUM have?
What are there purpose?

A

RECTAL VALVES (3)

Prevent feces form being passed along with gas (flatus)

64
Q

What is the 7th and last part of the LARGE INTESTINE?

A

ANAL CANAL

65
Q

What are the longitudinal folds of mucosa that are in the SUPERIOR HALF of anal canal?

A

ANAL COLUMNS (contain the ends of the superior recal artery and vein

66
Q

When the ANAL COLUMNS join together (inferiorly), what are they called?

A

ANAL VALVES

Right above the anal valves, there are pockets called anal sinuses which release mucus when they are compressed by feces.

67
Q

What are the 2 sphincters in the anal canal?

A

EXTERNAL ANAL SPHINCTER
INTERNAL ANAL SPHINCTER

68
Q

What type of muscle makes up the EXTERNAL ANAL SPHINCTER?
What innervates it?

A

SKELETAL MUSCLE
SOMATIC INFERIOR RECTAL NERVES

69
Q

What type of muscle makes up the INTERNAL ANAL SPHINCTER?
What innervates it?

A

SMOOTH MUSCLE
AUTONOMICS

70
Q

Once again, what supplies blood to the FOREGUT, MIDGUT, AND HINDGUT?

A

CELIAC TRUNK and its branches –> FOREGUT (a little from superior mesenteric artery)
SUPERIOR MESENTERIC ARTERY and its branches –> MIDGUT
INFERIOR MESENTERIC ARTERY and its branches –> HINDGUT

71
Q

Where does the venous blood go for the foregut, midgut and hindgut?

A

Mainly through PORTAL DRAINAGE (to liver)

72
Q

In terms of innervation to foregut, midgut and hindgut, where do the sympathetics and parasympathetics originate from?

A

ENTERIC NERVOUS SYSTEM and AORTIC PLEXUS

73
Q

The superior mesenteric artery gives off how many JEJUNAL and ILEAL branches?

A

15-18 JEJUNAL and ILEAL branches (toward left side of abdomen)

74
Q

What are the other branches of the SUPERIOR MESENTERIC ARTERY?

A

ILEOCOLIC ARTERY
RIGHT COLIC ARTERY
COMMON INFERIOR PANCREATICO-DUODENAL ARTERY
MIDDLE COLIC ARTERY

75
Q

What are the two branches of common inferior pancreatico-duodenal artery?
What structure do these arteries plus their branches supply blood to?

A

ANTERIOR INFERIOR PANCREATICO-DUODENAL ARTERY
POSTERIOR INFERIOR PANCREATICO-DUODENAL ARTERY

3rd and 4th portion (horizontal and ascending) duodenum

76
Q

When the Common inferior pancreaticoduodenal (ANTERIOR AND POSTERIOR) meet the GASTRODUODENALS (ANTERIOR AND POSTERIOR superior arteries), what do they form?

A

ANASTOMISIS

77
Q

What are the branches of the ILEOCOLIC ARTERY?
What do they supply blood to? (4 and 1)

A

ILEAL ARTERY
COLIC ARTERY
ANTERIOR CECAL ARTERY
POSTERIOR CECAL ARTERY
(all 4 ILEOCOLIC Branches + ILEAL BRANCHES) supply blood to the ILEUM AND CECUM)

APPENDICULAR ARTERY –> appendix

78
Q

What does the ILEOCOLIC ARTERY form an anastomosis with?
What artery helps it form this anastomosis?

A

ileocolic artery + inferior mesenteric artery

Marginal artery helps form this anastomosis

79
Q

What supplies blood to the ASCENDING COLON

A

RIGHT COLIC ARTERY

80
Q

What supplies blood to the JEJUNUM?

A

Jejunal Arteries (15-18)

81
Q

What are the branches of the INFERIOR MESENTERIC ARTERY? (Branches come off to the left side)

A

SUPERIOR RECTAL ARTERIES
SIGMOID ARTERIES
LEFT COLIC ARTERIES

82
Q

What artery forms an anastomosis between the inferior and superior mesenteric artery?

A

MARGINAL ARTERY

83
Q

What supplies blood to the transverse colon?

A

MIDDLE COLIC ARTERY (but this comes off of SUPERIOR MESENTERIC ARTERY)

But distal (1/3rd) of transverse colon is part of hindgut

84
Q

What supplies blood to the descending colon?

A

LEFT COLIC ARTERY

85
Q

What supplies blood to the SIGMOID COLON?

A

Sigmoid artery (3-4 branches)

86
Q

What supplies blood to the RECTUM/ANAL CANAL?

A

SUPERIOR RECTAL ARTERY
MIDDLE RECTAL ARTERY
INFERIOR RECTAL ARTERY

87
Q

What does the portal vein do?

A

Drains high-nutrient blood from the large and small intestine to LIVER

88
Q

What veins form the portal vein? (What drains into it)

A

SUPERIOR MESENTERIC VEIN
SPLENIC VEINS

89
Q

What vertebral level is the PORTAL VEIN found at? (lvl that it forms at)

A

L1

90
Q

What drains the blood from the liver to the Inferior Vena Cava?

A

3 HEPATIC VEINS

91
Q

What are the 2 MAJOR VENOUS DRAINAGE SYSTEMS?

A

PORTAL VENOUS CIRCULATION
CAVAL (SYSTEMIC) VENOUS CIRCULATION

92
Q

Where are the 4 areas of anastomisis between PORTAL and CAVAL drainage?

A
  1. between L GASTRIC vein (portal) and esophageal vein (caval)
  2. between PARAUMBILICAL vein (portal) and EPIGASTRIC vein (caval)
  3. between COLIC (portal) and retroperitoneal veins (caval)
  4. between superior rectal (portal) and middle and inferior rectal (caval) veins
93
Q

Where does lymph from the DUODENUM drain into ?

A

CELIAC LYMPH NODES

94
Q

What is the lymph pathway for lymph from JEJUNAL AND ILEUM?

A

All lymph are originate in LACTEALS (lymphatic vesicles in jejunum and ileum) –> juxta-intestional lymph nodes –> intermediate mesenteric lymph nodes–> Central superior lymph nodes –> superior mesenteric lymph nodes

95
Q

Where does lymph from the MIDGUT drain into EVENTUALLY?

A

SUPERIOR MESENTERIC LYMPH NODES

96
Q

Where does lymph from the HINDGUT (distal 1/3rd of transverse colon, descending colon, sigmoid colon) drain into EVENTUALLY?

A

INFERIOR MESENTERIC LYMPH NODES

97
Q

Where does lymph eventually collect to ?

What does this structure eventually become? (Hint: Another duct)

A

Lymph is then drained into cisterna chyli

Cisterna chyli becomes the thoracic duct.

98
Q

Where does the thoracic duct drain?

A

Junction of LEFT INTERNAL JUGULAR VEIN and LEFT SUBCLAVIAN VEIN

99
Q

What deliver the sympathetics to midgut?
What deliver the sympathetics to hindgut?

A

Lesser and Least splanhnic nerves (T10-T12) –> midgut
Lumbar Splanchnic nerves (L1-L4) –> hindgut

100
Q

What deliver the parasympathetics to midgut?
What delivers the parasympathetics to hindgut?

A

Anterior Vagal trunk (CN 10)
Pelvic Splanchnic nerves (S2-S4)

101
Q

What are the 4 ganglia of the aortic plexus?
Remember.. the aortic plexus is made up of autonomic and visceral sensory fibers

A

CELIAC GANGLIA
SUPERIOR MESENTERIC GANGLIA
AORTICORENAL GANGLIA
INFERIOR MESENTERIC GANGLIA

102
Q

What are the 2 nerve plexus of the ENTERIC NERVOUSE SYSTEM?

A

Submucosal (Meissner’s) plexus
Myenteric (Auerbach’s) plexus

103
Q
A

GI ANAT (7 decks)

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