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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
What is constipation? Common treatment of constipation? What causes severe constipation?
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)
26
Inflammation of what 2 structures is known as INFLAMMATORY BOWEL DISEASE? (IBD) What can IBD cause?
Inflammation of the SMALL INTESTINE and LARGE INTESTINE IBD can cause diarrhea, rectal bleeding, anemia.
27
What are the most common types of INFLAMMATORY BOWEL DISEASE?
CHRON'S DISEASE and ULCERATIVE COLITIS
28
What structures does CHRON'S DISEASE affect?
Small and large intestine (Also esophagus, stomach, anus)
29
What structures does ULCERATIVE COLITIS affect?
Colon and Rectum
30
Between Chron's disease and Ulcerative Colitis, which one can you perform surgery on?
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.
31
Development of cancer in either the colon or rectum is called what?
Colorectal cancer
32
What disease is associated with out-pocketings of mucosa (like little popcorn) that develops in the sigmoid colon?
Diverticulosis
33
When the diverticula become infected what is this called? What is the main problem with this disease?
Diverticulitis Diverticula can rupture and spill fecal matter into the peritoneal cavity --> Can cause peritonitis
34
What is the first part of the large intestine? What is it continuous with?
CECUM Continuous with the ascending colon (left side of body) Also attached with the appendix
35
What quadrant is the cecum located on? Is the cecum considered intraperitoneal or retroperitoneal?
RIGHT LOWER QUADRANT INTRAPERITONEAL
36
What valve connects the ileum to the cecum?
ILEOCECAL VALVE
37
What is another name for appendix?
VERMIFORM APPENDIX
38
What quadrant is the appendix located on?
RIGHT LOWER QUADRANT
39
What are the 2 orientations that the appendix could be in?
RETROCECAL ORIENTATION (65%) PELVIC ORIENTATION (35%)
40
What is the mesentery on the appendix? Is the appendix intra or retroperitoneal?
Mesoappendix Intraperitoneal
41
Pain in what quadrant has a high correlation to having appendicitis? What even is appendicitis?
SUDDEN PAIN in RIGHT LOWER QUADRANT Appendicitis - Inflammation of appendix
42
What is the common cause of appendicitis in the youngins?
Hyperplasia of lymphatic follicles (they get bigger) in the appendix --> occlusion of lumen of appendix
43
What is the common cause of appendicitis in older ppl?
Obstruction of lumen of appendix by way of fecalith (stony/hard fecal matter)
44
What happens when you DON'T get full rotation of the appendix during gut development?
Appendix is now located in the RIGHT UPPER QUADRANT
45
REMOVING APPENDIX is called? Where is it performed laproscopically?
APPENDECTOMY MCBURNEY'S POINT on abdominal wall
46
When the appendix is trapped within the hernial sac of an inguinal hernia, what is it called?
Appendicular (Amyand's) Hernia (RARE) appendectomy to the rescue
47
What is the 2nd part of the colon? Is it intra or retroperitoneal?
ASCENDING PORTION OF COLON RETROPERITONEAL
48
What spot marks the transition from ascending colon to transverse colon?
RIGHT HEPATIC FLEXURE
49
What is the 3rd part of the large intestine? (Largest part part too) Is it intra or retroperitoneal? (Remember.. does it have a mesentery?)
Transverse colon INTRAPERITONEAL
50
What vertebral level does the transverse colon cross the abdomen at?
L1
51
What spot marks the transition from transverse colon to descending colon?
LEFT SPLENIC FLEXURE Extends from the right HEPATIC flexure to the left SPLENIC flexure.
52
What structures are part of the HINDGUT?
DISTAL 1/3RD of the transverse colon, descending colon, sigmoid colon, rectum, and anal canal
53
What supplied blood to the HINDGUT?
INFERIOR MESENTERIC ARTERY
54
What innervates and delivers SYMPATHETICS to the HINDGUT?
LUMBAR SPLANCHNIC NERVES (L1-L4)
55
What innervates and delivers PARASYMPATHETICS to the HINDGUT?
PELVIC SPLANCHNIC NERVES
56
What is the fourth part of the LARGE INTESTINE? Is it intra or retroperitoneal?
DESCENDING COLON RETROPERITONEAL
57
What ligament is seen by the LEFT SPLENIC FLEXURE? What happens if you yank on it?
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
What is the fifth part of the LARGE INTESTINE? Is it intra or retroperitoneal?
SIGMOID COLON INTRAPERITONEAL
59
When the sigmoid colon and the rectum meet, what is the junction called? What vertebral level is this junction at?
RECTOSIGMOID JUNCTION S3
60
What is the most common site for diverticulosis (outpocketings of the colon mucosa)?
SIGMOID COLON
61
What is the 6th part of the LARGE INTESTINE?
RECTUM
62
Where does the rectum start and go to?
starts at RECTOSIGMOID JUNCTION (S3) and goes to the ANAL CANAL
63
What 3 valves does the RECTUM have? What are there purpose?
RECTAL VALVES (3) Prevent feces form being passed along with gas (flatus)
64
What is the 7th and last part of the LARGE INTESTINE?
ANAL CANAL
65
What are the longitudinal folds of mucosa that are in the SUPERIOR HALF of anal canal?
ANAL COLUMNS (contain the ends of the superior recal artery and vein
66
When the ANAL COLUMNS join together (inferiorly), what are they called?
ANAL VALVES Right above the anal valves, there are pockets called anal sinuses which release mucus when they are compressed by feces.
67
What are the 2 sphincters in the anal canal?
EXTERNAL ANAL SPHINCTER INTERNAL ANAL SPHINCTER
68
What type of muscle makes up the EXTERNAL ANAL SPHINCTER? What innervates it?
SKELETAL MUSCLE SOMATIC INFERIOR RECTAL NERVES
69
What type of muscle makes up the INTERNAL ANAL SPHINCTER? What innervates it?
SMOOTH MUSCLE AUTONOMICS
70
Once again, what supplies blood to the FOREGUT, MIDGUT, AND HINDGUT?
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
Where does the venous blood go for the foregut, midgut and hindgut?
Mainly through PORTAL DRAINAGE (to liver)
72
In terms of innervation to foregut, midgut and hindgut, where do the sympathetics and parasympathetics originate from?
ENTERIC NERVOUS SYSTEM and AORTIC PLEXUS
73
The superior mesenteric artery gives off how many JEJUNAL and ILEAL branches?
15-18 JEJUNAL and ILEAL branches (toward left side of abdomen)
74
What are the other branches of the SUPERIOR MESENTERIC ARTERY?
ILEOCOLIC ARTERY RIGHT COLIC ARTERY COMMON INFERIOR PANCREATICO-DUODENAL ARTERY MIDDLE COLIC ARTERY
75
What are the two branches of common inferior pancreatico-duodenal artery? What structure do these arteries plus their branches supply blood to?
ANTERIOR INFERIOR PANCREATICO-DUODENAL ARTERY POSTERIOR INFERIOR PANCREATICO-DUODENAL ARTERY 3rd and 4th portion (horizontal and ascending) duodenum
76
When the Common inferior pancreaticoduodenal (ANTERIOR AND POSTERIOR) meet the GASTRODUODENALS (ANTERIOR AND POSTERIOR superior arteries), what do they form?
ANASTOMISIS
77
What are the branches of the ILEOCOLIC ARTERY? What do they supply blood to? (4 and 1)
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
What does the ILEOCOLIC ARTERY form an anastomosis with? What artery helps it form this anastomosis?
ileocolic artery + inferior mesenteric artery Marginal artery helps form this anastomosis
79
What supplies blood to the ASCENDING COLON
RIGHT COLIC ARTERY
80
What supplies blood to the JEJUNUM?
Jejunal Arteries (15-18)
81
What are the branches of the INFERIOR MESENTERIC ARTERY? (Branches come off to the left side)
SUPERIOR RECTAL ARTERIES SIGMOID ARTERIES LEFT COLIC ARTERIES
82
What artery forms an anastomosis between the inferior and superior mesenteric artery?
MARGINAL ARTERY
83
What supplies blood to the transverse colon?
MIDDLE COLIC ARTERY (but this comes off of SUPERIOR MESENTERIC ARTERY) But distal (1/3rd) of transverse colon is part of hindgut
84
What supplies blood to the descending colon?
LEFT COLIC ARTERY
85
What supplies blood to the SIGMOID COLON?
Sigmoid artery (3-4 branches)
86
What supplies blood to the RECTUM/ANAL CANAL?
SUPERIOR RECTAL ARTERY MIDDLE RECTAL ARTERY INFERIOR RECTAL ARTERY
87
What does the portal vein do?
Drains high-nutrient blood from the large and small intestine to LIVER
88
What veins form the portal vein? (What drains into it)
SUPERIOR MESENTERIC VEIN SPLENIC VEINS
89
What vertebral level is the PORTAL VEIN found at? (lvl that it forms at)
L1
90
What drains the blood from the liver to the Inferior Vena Cava?
3 HEPATIC VEINS
91
What are the 2 MAJOR VENOUS DRAINAGE SYSTEMS?
PORTAL VENOUS CIRCULATION CAVAL (SYSTEMIC) VENOUS CIRCULATION
92
Where are the 4 areas of anastomisis between PORTAL and CAVAL drainage?
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
Where does lymph from the DUODENUM drain into ?
CELIAC LYMPH NODES
94
What is the lymph pathway for lymph from JEJUNAL AND ILEUM?
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
Where does lymph from the MIDGUT drain into EVENTUALLY?
SUPERIOR MESENTERIC LYMPH NODES
96
Where does lymph from the HINDGUT (distal 1/3rd of transverse colon, descending colon, sigmoid colon) drain into EVENTUALLY?
INFERIOR MESENTERIC LYMPH NODES
97
Where does lymph eventually collect to ? What does this structure eventually become? (Hint: Another duct)
Lymph is then drained into cisterna chyli Cisterna chyli becomes the thoracic duct.
98
Where does the thoracic duct drain?
Junction of LEFT INTERNAL JUGULAR VEIN and LEFT SUBCLAVIAN VEIN
99
What deliver the sympathetics to midgut? What deliver the sympathetics to hindgut?
Lesser and Least splanhnic nerves (T10-T12) --> midgut Lumbar Splanchnic nerves (L1-L4) --> hindgut
100
What deliver the parasympathetics to midgut? What delivers the parasympathetics to hindgut?
Anterior Vagal trunk (CN 10) Pelvic Splanchnic nerves (S2-S4)
101
What are the 4 ganglia of the aortic plexus? Remember.. the aortic plexus is made up of autonomic and visceral sensory fibers
CELIAC GANGLIA SUPERIOR MESENTERIC GANGLIA AORTICORENAL GANGLIA INFERIOR MESENTERIC GANGLIA
102
What are the 2 nerve plexus of the ENTERIC NERVOUSE SYSTEM?
Submucosal (Meissner's) plexus Myenteric (Auerbach's) plexus
103

GI ANAT (7 decks)

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