Alimentary 2-5 Flashcards
List whether the following are retroperitoneal or suspended organs:
a) ascending colon
b) transverse colon
c) descending colon
d) sigmoid colon
a) retro
b) suspended
c) retro
d) suspended
True or False: the small intestines begin at the pyloric sphincter of stomach and ends at the caecum
False: ends at ileocaecal valve
True or false: the duodenum is approximately 25cm, the jejunum is remaining 3/5ths and the ileum is the remaining 2/5ths
False: jejunum is 2/5ths and ileum is 3/5ths
True or false: the first part of the duodenum is suspended by the greater and lesser omentum
True: the rest of the duodenum is retroperitoneal
What are the permanent circular folds of the duodenum called?
plicae
True or false: the plicae of the duodenum are permanent circular folds that are more pronounced in the proximal duodenum
true
which is these is FALSE regarding the first part of the duodenum:
a) attached to the posterior body wall
b) posterior is the portal vein and bile duct
c) anterior is the gall bladder and quadrate lobe of the liver
d) also known as duodenum cap
a) attached to greater and lesser omentum
which of these is FALSE regarding the second part of the duodenum:
a) posterior is the hilum of the right kidney
b) the bile and main pancreatic duct empty into major duodenal papilla
c) the head of the pancreas is distal
d) the lesser duodenal papilla for the accessory bile duct may be above the major duodenal bile duct
c) head of the pancreas is medial
True or false: The third part of the duodenum is in front of the right psoas
true
True or false: the third part of the duodenum is in front of the superior mesenteric vessels, unicate process, and head of pancreas
false: its behind all those structures
True or false: the fourth part of the duodenum is posterolateral to the left kidney
true
the duodenal junction is between the duodenum and ____ and lies at L_, just medial to the left ____
jejunum, L2, kidney
true or false: both the jejunum and ileum are suspended organs with internal transverse folds
true
The duodenum has three flexures called:
a) Between 1st and 2nd part:
b) Between 2nd and 3rd part:
c) Between 4th and jejunum:
a) superior duodenal flexure
b) inferior duodenal flexure
c) duodenojejunal flexure
true or false: the line between the foregut and midgut lies in the 3rd region of the duodenum
false: 2nd region
an accessory pancreatic duct goes into the lesser duodenal papilla. this occurs if ___ and ____ ____do not fuse
dorsal, ventral, duct
The jejunum is found in the lower __ and umbilical region
left
The ileum is found in the lower ___ and abdominal/pubic region
right
the root of the jejunal and ileal mesentery runs from the ___ left to ____ right and is ___-shaped.
upper, lower, fan
true or false: the internal transverse folds of the jejunum and ileum are not obliterated by distention
true
true or false: the internal transverse folds are more striking from the jejunum to ileum
false: less striking
true or false: transition between jejunum to ileum is gradual
true
true or false: vasa recta are side-to-side anastomoses that join up arcades
false: switch them around
true or false: the vasa recta arise from the inferior mesenteric artery
false: arise from superior mesenteric artery
which of these is FALSE regarding the jejunum:
a) long straight vasa recta with few arcades
b) less fatty mesentery
c) less Peyer’s patch’s
d) less vascular and thinner walls
e) larger folds and longer villi
d) more vascular & thicker walls
which of these is FALSE regarding the ileum:
a) shorter vasa recta with more arcades
b) fattier mesentery
c) presence of Peyer’s patch’s
d) less vascular and thinner walls
e) decreasing folds and longer villi
e) decreasing folds and SHORTER villi
True or false: the main role of the large intestines is digestion and absorption of nutrients
false: absorption of water and ions
True or false: the large intestine begins at the ileocaecal junction to the rectum
false: goes to the anus
true or false: the caecum and appendix is suspended
true
True or false: Haustra are bulges of the small intestinal wall with constrictions interspersed with expanded areas of colon
false: large intestinal wall
true or false: taenia coli are longitudinal external muscular bands as three thickenings that cause haustra
true
True or false: taenia coli are not found in the appendix or rectum junction
true
true or false: epipolic appendices arise form the free wall of the colon throughout the large intestine
false: not found in the caecum, appendix.
true or false: the epipolic appendices are found numerously in the transverse and sigmoid colon
true
true or false: haustra, taenia coli, and epiploic appendices are not found in the appendix or rectum
true
name four defining features of the large intestines
- haustra
- taenia coli
- epipolic appendices
- lack of villi
the caecum is found in the right ___ ____ of the pelvis
iliac fossa
true or false: the caecum is a suspended organ but has no mesentery, instead it is suspended from the ascending colon
true
the caecum is surrounded by peritoneum except when it connects with the ____ and ____ _____
ileum, ascending colon
true or false: the horizontal ileocaecal junction is posterolateral and consists of two valves
false: it is posteromedial
the muscular extensions of the two ileocaecal valves are called:
frenulae
the appendix is found in the ______ recess
retrocaecal
the appendix is suspended by a ________ attached to the ____ mesentery
mesoappendix, ileal
the appendix opens into the caecum below the ileocaecal valve, known as _____ Point
McBurney’s
the right colic flexure, also known as the hepatic flexure is:
a) posterior to the inferior right lobe of liver
b) anterior to the right kidney
c) posterior to fundus of gall bladder
d) all of the above
d
true or false: the transverse colon is firmly attached to the posterior surface of the great omentum
true
the surface landmark for the transverse colon is:
umbilicus level
the left colic flexure, also known as the splenic flexure, is:
a) anterior to the left kidney
b) below the spleen
c) attached to the diaphragm via the phrenicolic ligament
d) all of the above
d
which of these is FALSE regarding the phrenicolic ligament:
a) continuous with splenocolic ligament
b) is attached to the splenic (left colic) flexure
c) passes medially under the spleen
d) provides support for spleen
c: passes laterally under spleen
the descending colon goes from the ____ to the ___
splenic flexure, pelvic inlet
true or false: the descending colon extends down lateral abdominal wall and turns laterally into left iliac fossa to cross gonadal vessels and external iliac vessels
false: extends down lateral abdominal wall and turns MEDIALLY into left iliac fossa to cross gonadal vessels and external iliac vessels
the sigmoid colon goes from the ____ brim to the middle of the ____ at S_
pelvic, sacrum, S3
the sigmoid colon overlies the left _____ and external ____ vessels
uterer, iliac
the sigmoid mesocolon forms an inverted V known as the _______ recess
intersigmoidal
the rectum begins at the mid _____ at S_ and goes to the tip of the ____ where it becomes the anus
sacrum, S3, coccyx
true or false: the rectum is a suspended organ
false: retroperitoneal
true or false: the sigmoid colon is medial and superior to the rectum
false: lateral and superior
the rectum curves in how many planes, list them:
- anteriorly/posteriorly following sacral flexure
laterally: right, left, right
true or false: the rectum has permanent horizontal folds and temporary longitudinal folds.
true
there are ____ permanent horizontal folds which correspond to the lateral curves
three
the temporary longitudinal folds of the rectum are found in the:
rectal ampulla below the middle fold
the rectal ampulla is at the level of what pouch?
uterine pouch
true or false: the peritoneum is loosely attached in the sigmoid colon and tightly attached in the rectum
false: opposite way around
true or false: in the middle third of the rectum, the anterior portion of the peritoneum forms a rectovesticular or rectouterine pouc
true
true or false: in the lower third of the rectum, the peritoneum covers the anterior and lateral surfaces only
false: this is true for the upper 1/3. the lower 1/3 has no peritoneum and the rectum is embedded int he pelvic fascia
with reference to the rectum, the pelvic diaphragm is located (multiple true):
a) medially
b) laterally
c) posteriorly
d) anteriorly
B and C
the rectouterine pouch is also known as:
the pouch of douglas
the anal canal is _cm long
4
the anal canal runs posteroinferiorly through the _____ to the anus opening
pelvic diaphragm
the longitudinal elevations of the anal canal are called ____ and the indentations in between are called ______
columns, sinuses
the puborectalis is part of the levator ani and defines what junction?
rectoanal junction
which of these is NOT a way to define the rectoanal junction?
a) anal valves
b) top of sinuses
c) puborectalis
d) top of columns
a
the anal valves are _____ folds. the line of valves is known as the _____ _______ line.
transverse, pectinate mucocutaneous
true or false: before and after the pectinate mucocutaneous line, there are different blood and nerve supplies
true
true or false: the white line is the junction when the mucosal epithelium undergoes transition from non-keratizined stratified squamous epithelium in the rectum to simple columnar and skin in the anus
false. simple columnar>non-keratinized stratified squamous>skin
true or false: the transitional zone is between the pectinate line and the white line
true
the internal sphincters of the anal canal are part of the anal wall and stop at the ____ line
white
true or false: the external sphincters of the anal canal are outside the external muscle and movement is reflex only
false: movement is partially reflex and voluntary
which of the following is posterior of the anal canal?
a) perineal body and vagina/bulb of penis
b) anococcygeal ligament
c) ischiorectal fossa
d) puborectalis
b
which of the following is anterior of the anal canal?
a) perineal body and vagina/bulb of penis
b) anococcygeal ligament
c) ischiorectal fossa
d) puborectalis
a
which of the following is lateral of the anal canal?
a) perineal body and vagina/bulb of penis
b) anococcygeal ligament
c) ischiorectal fossa
d) puborectalis
c
the anococcygeal ligament goes from the ____ to the _____
coccyx, anal margin
what is the name of the reflex that propels ingested food from the small intestines to the large intestines?
gastrocolic reflex
which of these is FALSE regarding continence?
a) sphincters of anal canal are activated
b) muscles of rectum and sigmoid colon relaxed
c) puborectalis pulls upper part of anal canal forward
d) under parasympathetic control
d: under sympathetic control
which of these is FALSE regarding defecation?
a) sphincters of anal canal are relaxed
b) faeces from splenic flexure down is voided
c) puborectalis is activated
d) muscles of the descending and sigmoid colon are contracted
e) increased abdominal pressure
c: puborectalis is relaxed
true or false: the pancreas is a suspended organ
false
where is the pancreas found?
behind the lesser sac in the stomach bed
true or false: the dorsal pancreas rotates anteriorly and fuses with the ventral pancreas
false: the ventral pancreas rotates posteriorly to fuse with the dorsal pancreas
the main pancreatic duct arises from the dorsal or ventral bud
ventral
the accessory pancreatic duct arises from the dorsal or ventral bud
dorsal
the ventral duct drains:
inferior head & unicate process
the head of the pancreas is medial to the ________
2nd part of duodenum
the superior mesenteric vessels pass __ to the head and ____ to the unicate process
medial, anterior
the IVC and aorta are _________ to the pancreas
posterior
true or false: the transverse mesocolon is attached to the anterior body of pancreas
true
in the head of the pancreas, the anterio____ surface faces the lesser sac and the anterior______ surface faces the greater sac
superior, inferior
the tail of the pancreas accompanies splenic vessels into the _______ ligament
splenorenal
true or false: the splenic vessels run along the posterior boarder of the pancreas
false: superior
the main pancreatic duct drains into the ____ duodenal papilla
major
if the bile duct and main pancreatic duct join before or after entering the major duodenal papilla, it is known as the:
hepatopancreatic ampulla
The spleen develops in mesenchyme of the ____ mesentery:
dorsal
the spleen is a _________ organ
suspended
notching occurs on what border of the spleen?
superior
list the two functions of the spleen:
- recycling of RBCs (75% volume of spleen)
2. production of lymphocytes (white pulp)
list the two ligaments the spleen is suspended by:
- gastrosplenic (spleen = stomach)
2. splenorenal (spleen = pancreas)
the long axis of the spleen is parallel to what rib?
10
list the four borders of the spleen and their appearance:
- anterior: sharp
- superior: notched
- posterior: rounded
- inferior: n/a
name the four impressions of the spleen
- gastric: from stomach, broad concave above hilus
- renal: kidney, below hilus
- colic: transverse colon/left colic flexure
- pancreatic: small, usually not visible
true or false: the hilar surface of the spleen is flattened
true
true or false: the liver is a retroperitoneal organ
false (suspended)
which of these is NOT a function of the liver:
a) recycling of RBCs
b) creation of bile to digest fats (exocrine)
c) metabolism of carbohydrates and proteins
d) detoxification
e) haemopoiesis
f) storage and release of glucose (endocrine)
a (function of spleen)
the liver extends from the _th rib to the ___________
5th, costal margin
the gall bladder protrudes from the liver at the level of the _th costal cartilage and the linea ______
9th, semilunaris
true or false: the visceral surface of the liver is anterior
false (posterior, anterior is diaphragmatic)
the _____ ligament from the _____ mesentery runs between the left and right hepatic lobes anteriorly and attaches to the _______ wall.
falciform, ventral, abdominal
true or false: the caudate lobe is more superior than the quadrate lobe
true
the hilum of the liver is called the:
porta hepatis
the two ligaments above and below the porta hepatis are (respectively):
ligamentum venosum, ligamentum teres
the coronary ligament attaches the liver to the ____ from the ___ area
diaphragm, bare
the coronary ligament is made up of the left and right _____ ligament
triangular
list the parts of the left and right functional lobe:
left lobe: left anatomical lobe, quadrate, caudate
right lobe: right anatomical lobe
the portal vein is ___ rich and the hepatic proper arteries are _____ rich
nutrient, oxygen
in the liver: the portal and hepatic veins & arteries drain into portal ____ which drain into sinusoids of ______. the lobules drain into ____ veins and then the hepatic veins which then break into three ___ veins and multiple ___ veins into the IVC
triads, lobules, central, upper, smaller
true or false: the superior portion of the liver attaches to the right dome of the diaphragm and central tendon
true
the ligamentum teres runs anteriorly to form the ______
round ligament/bottom part of falciform ligament
true or false: the lesser omentum surrounds the porta hepatis and then inferiorly into the fissure of the ligamentum venosum
false: superiorly
the ligament between the umbilicus and left portal vein:
ligamentum teres
the ligament between the left branch of the portal vein and IVC:
ligamnetum venosum
true or false: the lesser omentum is attached to the ligamentum teres
false: it is attached to the ligamentum venosum
the gall bladder can be found in the fossa of the ____ surface in the ____ hepatic lobe
posterior, right
list the three parts of the gall bladder:
- fundus: below margin of the liver
- body
- neck: closest to cystic duct
the cystic artery comes off the ____ branch of the _____ artery
right, hepatic proper
gall bladder ducts: the left and right _____ duct merge just below the ____ to form the main _____ duct. the main ______ duct then joins the _____ duct to form the bile duct. the bile duct passes through the free edge of the _____ omentum, behind the first part of the ______, and then onto the posterior surface of the ____ of the pancreas to come into close proximity with the main _____ duct. if they fuse before entering the greater ____ papilla, they are known as the ___________ ampulla.
hepatic, hilum, hepatic, hepatic, cystic, lesser, duodenum, head, pancreatic, duodenal, hepatopancreatic
true or false: the superior mesenteric nodes drain to foregut and are preaortic
false: drain the midgut
true or false: the inferior mesenteric nodes are part of the preaortic group
true
preganglionic fibres come from _____ and _____ splanchnic nerves
thoracic, lumbar
true or false: splanchnic nerve are mostly parasympathetic, except in the pelvic ones are sympathetic
false: opposite way around
in the foregut,
sympathetic supplied by:
parasympathetic supplied by:
coeliac ganglion from preganglionic thoracic splanchnic nerves
vagus nerve
in the midgut,
sympathetic supplied by:
parasympathetic supplied by:
superior mesenteric ganglion from the thoracic splanchnic nerves
vagus nerve
in the hindgut,
sympathetic supplied by:
parasympathetic supplied by:
inferior mesenteric ganglion from the lumbar splanchnic sympathetic fibres
pelvic splanchnics from sacral parasympathetic outflow
sympathetic stimulation of the gut increases/decreases motility + vasoconstriction
decreases
parasympathetic stimulation of the gut increases/decreases motility + secretion
increases
name the three branches of the coeliac trunk and main regions of supply:
- common hepatic artery: liver, stomach, pancreas
- left gastric: lesser curvature of stomach
- splenic: spleen and greater curvature of stomach
the splenic artery splits into:
- left gastroepiploic which supplies the greater curvature
- short gastric arteries: greater curvature + fundus
- three splenic arteries to spleen
the common hepatic artery splits into the hepatic artery proper (to the liver), the gastroduodenal and the right gastric artery. explain what happens to the last two mentioned
- gastroduodenal splits into
- left gastroepiploic lower greater curvature of stomach
- superior anterior + posterior pancreaticoduodenal to head + uncinate process of pancreas - right gastric artery supplies the lesser curvature
list the six branches of the SMA:
- inferior anterior + posterior pancreaticoduodenal
- jejunal
- ileal
- ileocolic
- right colic
- middle colic
list the three branches of the IMA:
- left colic
- sigmoid
- superior rectal
true or false: the marginal artery allows anastomoses of the SMA and IMA
true
the marginal artery is approximately _cm parallel to the gut loop
1
the portal vein is formed in what order?
splenic vein –> inferior mesenteric vein –> superior mesenteric vein –> portal vein
the inferior and middle rectal arteries come from the:
internal iliac artery
the ____ venous plexus drains mostly to the _____ ______ artery and can form __________
internal, inferior mesenteric, haemorrhoids
the ______ venous plexus drains to what three veins:
inferior mesenteric vein, pudenal vein, internal iliac vein
lymph in the lower anal canal drains to the:
superficial inguinal nodes
the rectum is autonomic except for the lower anal canal which is somatic supplied by _____ nerve from S2-4
pudenal
the pancreas is supplied by the ______ artery
splenic
the head and uncinate process of the pancreas is additionally supplied by the:
superior and inferior anterior and posterior pancreaticoduodenal artery anastomoses
lymph in the liver is drained via the space of ____
disse