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Medicine: Anatomy > Anatomy: Midgut COPY > Flashcards

Anatomy: Midgut COPY Flashcards

1
Q

location of the small intestine

A

gastrointestinal tract
extends from pylorus to ileocaecal junction to the large intestine at the ileocaecal valve

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2
Q

3 parts of the small intestine

A

duodenum
jejunum
ileum

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3
Q

general overview duodenum

A

most proximal portion
derived from duodenum digitorum= twelve fingers length
runs from pylorus to the duodenojejunal junction

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4
Q

what are the 4 parts of the duodenum

A

D1= superior
D2=descending
D3=inferior
D4=ascending

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5
Q

superior D1

A

first section, spinal level L1
known as the cap
ascends upwards from pylorus of the stomach
connected to liver by the hepatoduodenal ligament
most common site for duodenal ulceration
3cm covered anteriorly and posteriorly by visceral peritoneum and remainder is retroperitoneal

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6
Q

descending D2

A

L1-L3
curves inferiorly around head of the pancreas
lies posteriorly to the transverse colon and anterior to the right kidney
internally marked by the major duodenal papilla

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7
Q

what is the major duodenal papilla

A

opening at which bile and pancreatic secretions enter from the ampulla of Vater (hepatopancreatic ampulla)

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8
Q

Inferior D3

A

L3
travels laterally to the left
crosses over the inferior vena cava and aorta
located inferiorly to the pancreas
posteriorly to the superior mesenteric artery and vein

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9
Q

Ascending

A

L3-L2
after duodenum crosses aorta it ascends and curves anteriorly to join the jejunum at the duodenojejunal flexure

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10
Q

duodenojejunal flexure

A

located here is a muscle called the suspensory muscle of the duodenum
contraction of the muscle widens the angle of the flexure
aids movement of the intestinal contents into the jejunum

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11
Q

duodenal ulcers

A

most likely to occur in the superior portion
common causes are helicobacter pylori infection and chronic NSAID therapy
perforation may be complicated by:
-inflammation of the peritoneum (peritonitis): damages surrounding viscera
-erosion of the gasproduodenal artery: causes haemorrhage and potential hypovolaemia shock

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12
Q

contrasting the jejunum and the ileum to the duodenum

A

they’re intraperitoneal

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13
Q

what attaches the jejunum and ileum to the posterior abdominal wall

A

mesentery

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14
Q

jejunum

A

begins are the duodenojejunal flexure
ileum ends at ileocaecal junction

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15
Q

what occurs at the ileocaecal junction

A

the ileum invaginate into the cecum to form the ileocecal valve
can prevent reflux of material back into the ileum

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16
Q

characteristic features of the jejunum

A

located in the upper left quadrant
thick intestinal wall
longer vasa recta (straight arteries)
less arcades (arterial loops)
red in colour

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17
Q

characteristic features of the ileum

A

located in the lower right quadrant
thin intestinal wall
shorter vasa recta
more arcades
pink colour

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18
Q

arterial supply of the duodenum

A

proximal to the major duodenal papilla: supplied by the gastroduodenal artery
distal to the major duodenal papilla: supplied by the inferior pancreaticoduodenal artery

marks the change form foregut to midgut
veins of duodenum follow major arteries and drain into hepatic portal vein

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19
Q

lymphatic drainage of the duodenum

A

pancreatoduodenal
superior mesenteric nodes

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20
Q

arterial and venous supply of jejunum and ileum

A

from the superior mesenteric artery
venous drainage is from the superior mesenteric vein

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21
Q

lymphatic drainage of the jejunum and ileum

A

superior mesenteric nodes

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22
Q

where is the cecum located

A

most proximal part of the large intestine
located between the ileum and ascending colon

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23
Q

when can the cecum be palpated

A

if enlarged due to faeces, inflammation or malignancy

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24
Q

structure of the cecum

A

continuous with the ascending colon
is intraperitoneal
has a variable mesentery

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25
ileocecal valve function
prevents reflux of large bowel contents into the ileum during peristalsis thought to function passively rather than a defined muscular sphincter
26
cecum arterial supply
ileocolic artery- branch of the superior mesenteric divides into anterior and posterior cecal arteries
27
cecum venous supply
ileocolic vein then empties into the superior mesenteric plexus
28
lymphatic drainage of the cecum
drains into the ileocolic lymph nodes
29
what is the appendix
narrow blind-ended tube attached to the posteromedial end of the cecum large amount of lymphoid tissue no vital functions
30
what is the appendix supported by
the mesoappendix fold of mesentery which suspends the appendix from the terminal ileum position of the free end of the appendix is highly variable and categorised into 7 main locations depending on relationship to the ileum, caecum or pelvis
31
what is the most common position of the appendix
retrocecal
32
positions of the appendix
pre-ileac post-ileac sub-ileal pelvic subecal paracecal retrocecal
33
pre-ileal
anterior to the terminal ileum 1 or 2 o clock
34
post-ileal
posterior to the terminal ileum 1 or 2 o clock
35
sub-ileal
parallel with the terminal ileum 3 o clock
36
pelvic
descending over the pelvic brim 5 o clock
37
subcecal
below the cecum 6 o clock
38
paracecal
alongside the lateral border of the cecum 10 o clock
39
retrocecal
behind the cecum 11 o clock
40
arterial supply to the appendix
from the appendicular artery
41
venous drainage of the appendix
via the corresponding appendicular vein
42
where are the arteries and veins associated with the appendix located
in the mesoappendix
43
innveration of the appendix
ileocolic branch of the superior mesenteric plexus
44
colon general information
distal part of the gastrointestinal tract extends from the cecum to the anal canal receives digested food from the small intestine, absorbs water and electrolytes to form faces
45
4 parts of the large intestine
ascending transverse descending sigmoid
46
ascending colon
retroperitoneal ascends superiorly from the cecum meets right lobe of the liver to form the colic/hepatic flexure
47
transverse colon
extends from the right colic flexure to the spleen turns inferiorly to form the left colic/splenic flexure attached to the diaphragm by the phrenicocolic ligament intraperitoneal and enclosed by transverse mesocolon
48
descending colon
after left colic flexure moves inferiorly towards the pelvis retroperitoneal in most individuals located anteriorly to the left kidney passes over its lateral border turns medially and becomes sigmoid
49
sigmoid
40cm long left lower quadrant left iliac fossa to level of S3 vertebrae attached to posterior pelvic wall by mesentery: sigmoid mesocolon mobile due to length of the mesentery
50
parabolic gutters
two spaces between the ascending/descending colon and the posterolateral abdominal wall
51
anatomical structure of the large intestine
attached to the surface of the large intestine are omental appendices runs longitudinally along surface of the large bowel are 3 strips of muscle teniae coli teniae coli contract to shorten the wall of the bowel, produces sacculations called haustra wider diameter Than the small intestine features cease at the rebtosigmoid junction
52
what are omental appendices
small pouches of peritoneum, filled with fat
53
rectosigmoid junction
where the smooth muscle of the teniae coli broken to form a complete layer within the rectum
54
teniae coli
mesocolic free omental coli
55
structures anterior and posterior to the ascending colon
anterior: small intestine, greater momentum, anterior abdominal wall posterior: iliacus and quadrates lumborum, right kidney, iliohypogastric and ilioinguinal nerves
56
transverse colon structures anterior and posterior
anterior: greater omentum, anterior abdominal wall posterior: duodenum, head of pancreas, jejunum and ileum
57
descending colon structures anterior and posterior
anterior: small intestine, greater omentum, anterior abdominal wall posterior: iliacus and quadratus lumborum, left kidney, iliohypogastric and ilioinguinal nerves
58
sigmoid colon structures anterior and posterior
anterior: urinary bladder, uterus and upper vagina posterior: rectum,sacrum,ileum
59
general rule midgut arterial supply
supplied by the superior mesenteric artery
60
general rule hiindgut arterial supply
by the inferior mesenteric artery
61
ascending colon arterial supply
from ileocolic and right colic arteries ileocolic arises the anterior cecal, posterior cecal and colic branches which also supply
62
transverse colon arterial supply
right colic artery, from superior mesenteric middle colic artery, from superior mesenteric left colic artery, from inferior mesenteric
63
descending colon arterial supply q
left colic artery
64
sigmoid colon arterial supply
sigmoid arteries
65
venous drainage of the ascending colon
ileocolic and right colic veins empty into the superior mesenteric
66
venous drainage of the transverse colon
middle colic vein empties into the superior mesenteric
67
venous drainage of the descending colon
left colic vein drains into the inferior mesenteric
68
venous drainage of the sigmoid colon
drained by the sigmoid veins into the inferior mesenteric
69
where do the superior and inferior mesenteric veins empty into
the hepatic portal vein
70
innervation of the midgut-derived structures
ascending colon and proximal 2/3 of the transverse receive their sympathetic, parasympathetic and sensory supply via nerves from the superior mesenteric plexus
71
innervation of the hangout-dervied structures
distal 1/3 of the transverse colon, descending colon and sigmoid colon receive from the inferior mesenteric plexus parasympathetic: pelvic splanchnic nerves sympathetic: lumbar splanchnic
72
functions of the mesentery in the abdomen
suspends the small and large intestine from the posterior abdominal wall, allows slight movement provides a conduit for blood vessels, nerves and lymphatic vessels postulated to play a pathological role in inflammatory disease such as crohns
73
how is the mesentery formed
double layered fold of peritoneum
74
root of the mesentery
point where the mesentery attaches to the posterior abdominal wall bare area root is long and narrow and has an oblique orientation left side of the L2 vertebra to the right sacroiliac junction
75
6 flexures in the gastrointestinal tract
duodenaljejunal ileocaecal hepatic splenic those between descending and sigmoid colon and between the sigmoid and the rectum
76
mesentery of the small intestine
connects the loops of jejunum and ileum to the posterior abdominal wall and is a mobile structure
77
right mesocolon
flattened against the posterior abdominal wall
78
transverse mesocolon
mobile structure and leis between colic flexures
79
left mesocolon
flattened against the posterior abdominal wall
80
mesosigmoid
has a medial portion which is flattened against the posterior abdominal wall region of mesentery associated with the colon itself is mobile
81
mesorectum
assits in anchoring the rectum through the pelvis
82
arterial supply to the mesentery
superior mesenteric to the organs of the midgut inferior mesenteric to the hingut
83
venous drainage of the mesentery
via the superior mesenertic vein and inferior mesenteric vein
84
innervation of the mesentery
superior mesenteric plexus divides into many secondary plexuses containing parasympathetic and sympathetic innervation to mesentery
85
lymphatics of the mesentery
inferior mesenteric lymph nodes receive lymph from hindgut organs and drain to the superior mesenteric superior mesenteric receive lymph from midgut and inferior mesenteric and drain to pre-aortic
86
superior mesenteric artery
arises from the abdominal aorta supplies arterial blood to the organs of the midgut level L1 vertebrae immediately inferior to the origin of the coeliac trunk
87
anatomical position of the superior mesenteric artery
anterior to the SMA- pyloric part of the stomach, splenic vein and neck of the pancreas posterior to the SMA- left renal vein, uncinate process of the pancreas and inferior part of the duodenum
88
uncinate process
only part of the pancreas that hooks around the back of the SMA
89
major branches of the superior mesenteric artery
inferior pancreaticduodenal artery jejunal and ileac arteries middle and right colic arteries ileocolic artery
90
inferior pancreaticoduodenal artery
first branch of the SMA forms anterior and posterior vessels anastomose with branches of the superior pancreaticdudenal artery supplies inferior region of the head of the pancreas, uncinate process and duodenum
91
jejunal and ileac arteries
pass between layers of the mesentery form anastamotic arcades which form smaller straight arteries: vasa recta arise to supply the organs
92
middle colic artery
supplies the transverse colon
93
right colic artery
supplies the ascending colon

Medicine: Anatomy (20 decks)

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