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805 - Exam 3 > Anatomy - Midgut and Hindgut > Flashcards

Anatomy - Midgut and Hindgut Flashcards

1
Q

what parts of the pancreas are retroperitoneal vs intraperitoneal

A

everything is retroperitoneal except for the tail

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2
Q

what does the pancreas produce

A

exocrine secretions (digestive)
endocrine secretions (hormones)

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3
Q

what is lateral to the head of the pancreas

A

2nd portion of the duodenum

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4
Q

what is posterior to the head of the pancreas

A

IVC
Common bile duct
right renal artery & vein

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5
Q

what is inferior to the uncinate process of the pancreas

A

3rd portion of the duodenum

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6
Q

what is anterior to the uncinate process of the pancreas

A

SMA
SMV

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7
Q

what is anterior to the neck of the pancreas

A

pylorus of stomach

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8
Q

what is posterior to the neck of the pancreas

A

SMA
SMV
formation of hepatic portal vein

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9
Q

what is superior/posterosuperior to the body of the pancreas

A

splenic artery and vein

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10
Q

what is anterior to the body of the pancreas

A

omental bursa

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11
Q

what is posterior to the body of the pancreas

A

aorta
origin of SMA
left adrenal gland
left kidney and renal vessels

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12
Q

what is lateral to the tail of the pancreas

A

hilum of spleen

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13
Q

what is anterior to the tail of the pancreas

A

left colic flexure

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14
Q

what is posterior to the tail of the pancreas

A

left kidney

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15
Q

what is the shortest, widest, and most fixed part of the SI

A

duodenum

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16
Q

where does the duodenum begin and extend to

A

the pylorus and extends to the duodenojejunal junction

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17
Q

the duodenum is the major site of

A

chemical digestion

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18
Q

what does the duodenum mark the transition of

A

the foregut to midgut

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19
Q

the duodenum receives blood supply and innervation from both

A

foregut and midgut structures

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20
Q

what is another name for the suspensory muscle of the duodenum

A

ligament of treitz

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21
Q

what is the ligament of treitz

A

Slip of skeletal muscle from diaphragm and fibromuscular band of smooth muscle from duodenum

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22
Q

Contraction of muscle widens angle of ?

A

duodenojejunal flexure

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23
Q

Contraction of muscle widens angle of duodenojejunal flexure and facilitates movement of

A

intestinal contents

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24
Q

Portions and Levels of the duodenum

A

1st portion (superior) - L1
2nd portion (descending) - L2-3
3rd portion (horizontal) - L3
4th portion (ascending) - L3 to L2

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25
Q

what is anterior to the 1st portion of the duodenum

A

body of gallbladder
peritoneum

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26
Q

what is posterior to the 1st portion of the duodenum

A

bile duct
gastroduodenal artery
hepatic portal vein
IVC

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27
Q

what is superior to the 1st portion of the duodenum

A

neck of gallbladder

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28
Q

what is anterior to the 2nd portion of the duodenum

A

transverse colon
transverse mesocolon

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29
Q

what is posterior to the 2nd portion of the duodenum

A

right kidney hilum
renal vessels
right ureter

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30
Q

what is medial to the 2nd portion of the duodenum

A

head of pancreas
pancreatic duct
bile duct

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31
Q

what is anterior to the 3rd portion of the duodenum

A

SMA
SMV

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32
Q

what is posterior to the 3rd portion of the duodenum

A

IVC
abdominal aorta
right ureter

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33
Q

what is superior to the 3rd portion of the duodenum

A

head and uncinate process of pancreas

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34
Q

what is anterior to the 4th portion of the duodenum

A

beginning of root of mesentery proper

jejunum

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35
Q

what is posterior to the 4th portion of the duodenum

A

left edge of abdominal aorta

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36
Q

what is superior to the 4th portion of the duodenum

A

body of pancreas

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37
Q

where is a duodenal ulcer most often to occur

A

posterior wall of the superior part of duodenum

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38
Q

what parts of the pancreas/duodenum are supplied by branches of the gastroduodenal artery?

A

superior portion of head
1st and superior portion of 2nd part of duodenum

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39
Q

what parts of the pancreas are supplied by the splenic artery

A

neck
body
tail

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40
Q

what parts of the pancreas are supplied by branches of the SMA?

A

inferior portion of head and uncinate process

inferior portion of 2nd part of the duodenum, 3rd part, 4th part

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41
Q

the hepatic portal vein collects blood from

A

superior portion of head of pancreas

1st and superior portion of 2nd part of duodenum

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42
Q

the splenic vein collects blood from which parts of the pancreas

A

neck
body
tail

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43
Q

superior mesenteric vein collects blood from

A

inferior portion of head and uncinate process

inferior portion of 2nd part of the duodenum, 3rd part, 4th part

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44
Q

lymphatic nodes of the pancreas and duodenum

A

celiac nodes
pyloric nodes
pancreatico-splenico nodes

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45
Q

innveration of pancreas and duodenum proximal to entrance of common bile duct

A

duodenum (1st part and superior portion of 2nd part)

pancreas: neck, body, tail, and superior portion of head

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46
Q

parasympathetic innervation of pancreas and duodenum proximal to entrance of common bile duct

A

vagus nerve to peri-arterial plexus to viscera

47
Q

sympathetic innervation of pancreas and duodenum proximal to entrance of common bile duct

A

Greater thoracic splanchnic N (T5-T9)
Synapse at celiac ganglion
Peri-arterial plexus to viscera

48
Q

Sensory REFLEX innervation of pancreas and duodenum proximal to entrance of common bile duct

A

travels back with parasympathetics

49
Q

Sensory PAIN innervation of pancreas and duodenum proximal to entrance of common bile duct

A

travels back with sympathetics

50
Q

innveration of pancreas and duodenum DISTAL to entrance of common bile duct

A

inferior portion of 2nd part of duodenum then all of 3rd and 4th part

51
Q

parasympathetic innervation of pancreas and duodenum distal to entrance of common bile duct

A

vagus nerve to peri-arterial plexus to viscera

52
Q

sympathetic innervation of pancreas and duodenum distal to entrance of common bile duct

A

Lesser thoracic splanchnic N
Synapse at superior mesenteric ganglion
Peri-arterial plexus to viscera

53
Q

Sensory REFLEX innervation of pancreas and duodenum proximal to entrance of common bile duct

A

travels back with parasympathetics

54
Q

Sensory PAIN innervation of pancreas and duodenum proximal to entrance of common bile duct

A

travels back with sympathetics

55
Q

jejunum and ileum handle the majority of

A

nutrient absorption

56
Q

the jejunum and ileum are continuous with the duodenum at the

A

duodenojejunal junction

57
Q

the jejunum and ileum are continuous with the cecum (large intestine) at the

A

ileocecal junction

58
Q

the jejunum and ileum are anchored to the posterior wall by the

A

mesentery proper

59
Q

the root of mesentery spans

A

obliquely, inferiorly, and to the right

60
Q

what runs between layers of mesentery

A

SMA
intestinal arcades
vasa recta

61
Q

The jejunum primarily occupies upper quadrants, especially the

A

left epigastric region

62
Q

The jejunum is related primarily to the

A

left colic flexure
transverse colon

63
Q

The ileum primarily occupies the lower quadrants, especially the

A

right hypogastric region

64
Q

the ileum is related to the

A

cecum
inferior ascending colon
inferior descending colon

65
Q

arterial supply of the jejunum and ileum

A

SMA –> intestinal arteries (15-18 total), arcades, vasa recta

66
Q

what does the large intestine do

A

absorb water, storage, compaction of wastes

67
Q

large intestine is divided into

A

cecum
appendix (vermiform)
colon
rectum
anal canal

68
Q

what is the first part of the large intestine

A

cecum

69
Q

what does the cecum receive

A

the ileum (small intestine)

70
Q

where does the cecum lie

A

in the iliac fossa in the right lower quadrant

71
Q

where are appendicitis visceral sensory pain fibers

A

T10 level

72
Q

colon is further divided into

A

ascending
transverse
descending
sigmoid

73
Q

longitudinal muscles are reduced to 3 bands of

A

taenia coli muscle (not on appendix or rectum)

74
Q

tone in the large intestine creates pouches called

A

haustra

75
Q

incomplete rings in the large intestine

A

plicae semilunares

76
Q

where does the rectum begin and end

A

begins: rectosigmoidal junction at S3
ends: anorectal junction

77
Q

at the level of the rectum, Tania coli muscles spread out and form a

A

continuous layer of longitudinal muscle

78
Q

the terminal portion of the rectum is dilated and supported by

A

pelvic diaphragm

79
Q

the perineal flexure angle at resting bonus helps to maintain

A

fecal continence

80
Q

during defectation, the puborectalis and anorectal canal do what

A

puborectalis RELAXES
anorectal canal STRAIGHTENS

81
Q

where does the anal canal being and end

A

perineal flexure/anorectal junction and ends at the anus

82
Q

where are anal columns located

A

in the superior portion of anal canal

83
Q

anal columns secrete

A

mucus that aids in defectation

84
Q

Blood supply and drainage, lymphatics, innervation of the anal canal ABOVE the pectinate line

A

Superior rectal arteries (from IMA)
Superior rectal veins (drains into IMV)
Internal iliac lymph nodes
Autonomic innervation

85
Q

Blood supply and drainage, lymphatics, innervation of the anal canal BELOW the pectinate line

A

Inferior rectal arteries (from internal pudendal A)
Inferior rectal veins
Superficial inguinal nodes
Somatic innervation (pudendal n)

86
Q

internal and external anal sphincter must do what for defecation to occur

A

relax

87
Q

internal anal sphincter
- voluntary or involuntary?
- what does it surround

A

involuntary (smooth muscle)

surrounds upper 2/3 anal canal

88
Q

sympathetic innervation of internal anal sphincter

A

lumbar SN (L1-L2)
stimulates contraction
tonically contracted most of the time to prevent leakage

89
Q

parasympathetic innervation of internal anal sphincter

A

Pelvic SNs (S2-S4)
inhibits contraction

90
Q

external anal sphincter
- voluntary or involuntary?
- what does it surround

A

voluntary (skeletal muscle)

surrounds lower 2/3 of anal canal

91
Q

Somatic innervation of external anal sphincter

A

pudendal nerve

92
Q

the defecation reflex is initiated when

A

the rectum is distended (sensory fibers relay)

93
Q

when the rectum is distended, what happens to the internal anal sphincter

A

it relaxes it

94
Q

if defecation is appropriate, what will happen

A

Relaxation of external anal sphincter
Relaxation of the puborectalis M
Contraction of abdominal wall muscles

95
Q

Large Intestine SMA supply

A

Ileocolic A
- appendicular A
- marginal A
- vasa recta
Right colic A
- marginal A
- vasa recta
Middle colic A
- marginal A
- vasa recta

96
Q

Large Intestine - SMV drainage

A

Veins course retrograde to arteries
Venous return enters SMV
SMV flows into hepatic portal vein

97
Q

Midgut lymphatics pathway starting with the superior mesenteric LNs

A

lymph around intestinal wall/arterial arcades/proximal portions of the SMA –> Superior mesenteric LNs –> cisterna chyli –> thoracic duct

98
Q

sympathetic innervation of the midgut does what?

A

Reduces motility and glandular secretion

vasoconstricts GI blood supply

99
Q

Sympathetic Innervation of the Midgut

A

Preganglionic sympathetic cell bodies in IML of T10-T11

Preganglionic sympathetic fibers travel through ventral root to white ramus to sympathetic trunk

Pass through paravertebral ganglion
(NO synapsing)

Leave sympathetic trunk as preganglionic sympathetic fibers via lesser thoracic splanchnic nerve

Synapse on the postganglionic sympathetic cell bodies within the superior mesenteric ganglion (a prevertebral ganglion)

Postganglionic sympathetic fibers wrap around the major arteries as a peri-arterial plexus to travel to viscera

100
Q

parasympathetic innervation of the midgut does what?

A

Stimulates and restores smooth muscle contractions for peristalsis and glandular secretions, vasodilates GI supply

101
Q

parasympathetic Innervation of the Midgut

A

Preganglionic parasympathetic cell bodies located in brainstem

Preganglionic parasympathetic fibers carried on the vagus N (CN X)

Pass through neck and thorax to abdomen, passing through diaphragm with the esophagus

Join the peri-arterial plexuses that wrap around the major arteries traveling to midgut viscera

Synapse on postganglionic parasympathetic cell bodies (intramural ganglia) on midgut viscera

102
Q

visceral sensory pain sympathetics for midgut

A

Travels back on nerves that carried sympathetics to midgut =

Lesser thoracic splanchnic NN (T10-T11)

103
Q

Large Intestine - IMA supply

A

Left colic A
- marginal A
- vasa recta
Sigmoid AA
- marginal A
- vasa recta
Superior rectal A

104
Q

sympathetic innervation of the hindgut does what

A

Reduces motility and glandular secretion, vasoconstricts GI blood supply

105
Q

sympathetic innervation pathway of the hindgut

A

Preganglionic sympathetic cell bodies in IML of LI-L2

Preganglionic sympathetic fibers travel through ventral root to white ramus to sympathetic trunk

Pass through paravertebral ganglion
(NO synapsing)

Leave sympathetic trunk as preganglionic sympathetic fibers via lumbar splanchnic nerves

Synapse on the postganglionic sympathetic cell bodies within the inferior mesenteric ganglion (a prevertebral ganglion)

Postganglionic sympathetic fibers wrap around the major arteries traveling to hindgut viscera as a peri-arterial plexus

106
Q

parasympathetic innervation of the hindgut does what

A

Stimulates and restores smooth muscle contractions for peristalsis and glandular secretions, vasodilates GI supply

107
Q

parasympathetic innervation pathway of the hindgut

A

Preganglionic parasympathetic cell bodies located in sacral portion of spinal cord

Preganglionic parasympathetic fibers carried on pelvic splanchnic NN (S2-S4)

Pass through inferior hypogastric plexus in pelvis (no synapsing)

Emerge as ascending parasympathetic fibers that travel to hindgut viscera

Synapse on postganglionic parasympathetic cell bodies (intramural ganglia) on viscera

108
Q

Hindgut parasympathetic innervation

A

Pelvic SNs (S2-S4)
Inferior hypogastric plexus
Ascending parasympathetic fibers

109
Q

Innervation of Hindgut - pelvic pain line corresponds to

A

the inferior limit of the peritoneum and mid-sigmoid colon

110
Q

Innervation of Hindgut - Superior to Pelvic Pain Line

A

pain fibers travel back on the sympathetic pathway for that structure
- lumbar SNs (L1-L2)

111
Q

Innervation of Hindgut - Inferior to Pelvic Pain Line

A

pain fibers travel back on the parasympathetic pathway for that structure
- pelvic SNs (S2-S4)

112
Q

Depending on the portion of the GI tract involved, nociceptive (pain) fibers travel on different pathways

Innervation and Pathway for the proximal sigmoid colon (more superior portion)?

A

Autonomic innervation

Pain fibers follow the sympathetic pathway (superior to the pelvic pain line)

Lumbar splanchnics (L1-L2)

113
Q

Depending on the portion of the GI tract involved, nociceptive (pain) fibers travel on different pathways

Innervation and Pathway for the distal sigmoid colon (more inferior portion), rectum, and superior anal canal?

A

Autonomic innervation

Pain fibers follow the parasympathetic pathway (inferior to the pelvic pain line)

Pelvic splanchnics (S2-S4)

114
Q

Depending on the portion of the GI tract involved, nociceptive (pain) fibers travel on different pathways

Innervation and Pathway for the inferior anal canal (inferior to pectinate line)

A

Somatic innervation

Pudendal nerve (S2-S4)

805 - Exam 3 (4 decks)

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