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Gross III Exam 2 > Anatomy of Midgut and Hindgut > Flashcards

Anatomy of Midgut and Hindgut Flashcards

1
Q

Where does the jejunum begin?

A

At the duodenojejunal flexure (just after SMA/SMV cross over) on Left side of L2 vertebra

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2
Q

About how long is the jejunum?

A

2-3m long

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3
Q

Is the jejunum intraperitoneal or retroperitoneal?

A

intraperitoneal (suspended by mesentery)

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4
Q

What quadrant do you find the jejunum?

A

LUQ

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5
Q

Where does the ileum end?

A

At ileocecal junction

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6
Q

How long is the ilium?

A

About 3-4m long

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7
Q

Is the ileum intraperitoneal or retroperitoneal?

A

intraperitoneal (suspended by mesentery)

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8
Q

What quadrant do you find the ileum?

A

RLQ

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9
Q

What is the primary function of the jejunum and ileum?

A

absorption of food stuffs

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10
Q

T/F - the transition between the ileum and jejunum can be externaly determined.

A

False - no external demarcation

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11
Q

What are the primary lymph nodes of the jejunum and ileum?

A

mesenteric nodes

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12
Q

What are the secondary lymph nodes of the jejunum and ileum?

A

superior mesenteric nodes

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13
Q

Where do the lymphatics from primary and secondary nodes of jejunum and ileum drain?

A

To cisterna chyli then to thoracic duct

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14
Q

Pertaining to the innervation of jejunum and ileum, what nerve plexus surrounds the SMA?

A

perivascular nerve plexus

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15
Q

How does the jejunum and ileum receive sympathetic innervation?

A

Via greater and lesser splanchnic nn (T8-T10); synapse in celiac and superior mesenteric ganglion

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16
Q

What do sympathetic nn. do to jejunum and ileum?

A

Reduce motility and sectretion, vasoconstriction

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17
Q

How does the jejunum and ileum receive parasympathetic innervation?

A

Via posterior vagal trunk; synapse on myenteric and submucosal plexuses

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18
Q

What do parasympathetic nn. do to jejunum and ileum?

A

Increase motility and secretion, vasodilation occurs secondarily

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19
Q

What is the path of the visceral afferents of jejunum and ileum?

A

Visceral afferents (pain) accompany sympathetics to T8-T10 dermatomes

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20
Q

What is ileal (Meckel’s) diverticulum?

A

A rare(er) congenital anomaly; a finger-like pouch that is a remnant of embryonic omphaloenteric duct connecting midgut to umbilical vesicle

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21
Q

Where is an ileal diverticulum found?

A

Its about about 2 inches, seen on anterior ileum about 2 ft (look it up Canadians!) from ileocecal junction

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22
Q

Is an ileal diverticulum symptomatic?

A

Usually asymptomatic, (2% symptomatic)

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23
Q

An ileal diverticulum usually only contains ileal tissue, but what other type of tissue might it contain?

A

acid-producing gastric tissue or pancreatic tissue

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24
Q

What is the most common symptom seen with ileal diverticulum?

A

rectal bleeding

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25
Q

What might the pain of an ileal diverticulum mimic?

A

when inflammed, the pain of appendicitis

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26
Q

What are the main function of the colon?

A

Completing absorption (mostly water) and compacting/storing feces

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27
Q

What are the regions of the colon?

A

Cecum (with appendix), ascending, transverse, descending and sigmoid colon, rectum, anal canal

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28
Q

What are the external characteristics of the large intestine?

A

Teniae coli, haustra, and epiploic appendages

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29
Q

What are teniae coli?

A

3 bands of longitudinal smooth muscle in outer layer of muscularis externa beginning at appendix and broadening/merging at longitudingal layer around rectum

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30
Q

What happens when teniae coli contract?

A

tonic contraction shortens the walls of colon

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31
Q

What are haustra

A

sacculations in wall of colon between teniae coli

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32
Q

What are epiploic appendages?

A

Small fatty projections on outside of large intestine

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33
Q

What is the function of epiploic appendages?

A

unknown

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34
Q

Where is the cecum located?

A

Beginning of large intestine, RLQ

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35
Q

What is the cecum?

A

A blind puch at inferior portion of ascending colon, inferior to ileocecal junction

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36
Q

Is the cecum palpable?

A

Palpable through anterolateral abdominal wall, only when distended

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37
Q

Is the cecum intraperitoneal or retroperitoneal?

A

intraperitoneal (but no mesentery)

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38
Q

What is the function of the ileocecal valve?

A

To prevent reflux from cecum into ileum

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39
Q

What is the appendix of the cecum?

A

A blind intestinal diverticulum that is retrocecal; contains much GALT

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40
Q

What is the mesoappendix?

A

A short, triangular mesentery of appendix between cecum and proximal appendix

41
Q

What is an inflammation of the appendix producing severe abdominal pain?

A

Appendicitis

42
Q

When does appendicitis occur in young and old people respectively?

A

Due to hyperplasia of lymph tissue occluding lumen; occurs due to fecalith (a stone turd)

43
Q

Normally, pain due to appendicitis is due to swelling/stretching of tissue; what makes that pain more severe?

A

When parietal peritoneum is also irritated.

44
Q

What are the symptoms of a ruptured appendix?

A

Peritonitis, increased pain, and nasea

45
Q

What is a surgical removal of the appendix called?

A

Appendectomy

46
Q

What are the arteries of the cecum and appendix?

A

Ileocolic a. from SMA and the appendicular a. (of ileocolic a.)

47
Q

What vein drains the cecum and appendix?

A

Ileocolic v. draining to SMV

48
Q

What are the primary lymph nodes of the cecum and appendix?

A

Ileocecal nodes

49
Q

What are the secondary lymph nodes of the cecum and appendix?

A

superior mesenteric nodes

50
Q

Where do the lymphatics from primary and secondary nodes of cecum and appendix drain?

A

To cisterna chyli then to thoracic duct

51
Q

What are the sympathetic innervations to the cecum and appendix?

A

Via lesser splanchnic n. (T10); synapse on superior mesenteric ganglion

52
Q

What are the parasympathetic innervations to the cecum and appendix?

A

Via vagal trunks; synapse on myenteric and submucosal plexuses

53
Q

What do the visceral afferent innervations from cecum and appendix accompany?

A

(Pain) - accompany sympathetics to T10 dermatome (at level of umbilicus)

54
Q

Where is the ascending colon positioned?

A

Passing superiorly on right side of the abdominal cavity from cecum to liver

55
Q

Describe the right colic (hepatic) flexure

A

Leftward bend of colon at liver, transition to transverse colon

56
Q

Is the ascending colon intraperitoneal or retroperitoneal?

A

Retroperitoneal on right side of posterior abdominal wall, covered by parietal peritoneum anteriorly

57
Q

What are the main arteries of the ascending colon?

A

Right colic a. and ileocolic a.

58
Q

Where do the right colic and ileocolic aa. branch from?

A

SMA

59
Q

What does the ileocolic a. supply?

A

terminal ileum, cecum, appendix, and inferior ascending colon

60
Q

What does the right colic a. supply?

A

Passes retroperitonealy, gives an ascending and descending branch

61
Q

What does the right colic a. anastomose with?

A

Marginal a.

62
Q

What are the 2 main veins of the ascending colon?

A

Ileocolic and right colic vv.

63
Q

Where do the ileocolic and right colic vv. drain?

A

SMV

64
Q

What are the primary nodes of the ascending colon?

A

paracolic, ileocolic, right colic nodes

65
Q

What are the secondary nodes of the ascending colon?

A

superior mesenteric nodes

66
Q

What are the sympathetic innervations to the ascending colon?

A

Via lesser splanchnic n. (T10); synapse on superior mesenteric ganglion

67
Q

What are the parasympathetic innervations to the ascending colon?

A

Via vagal trunks; synapse on myenteric and submucosal plexuses

68
Q

What do the visceral afferent innervations from ascending colon accompany?

A

Sympathetics; refer to T10 dermatome

69
Q

What is the largest and most moble part of the large intestine?

A

Transverse colon

70
Q

What is the position of the transverse colon?

A

Crosses abdomen from right colic flexure to left colic flexure

71
Q

Which colic flexure is normally located higher and less mobile

A

left colic flexure

72
Q

How is the transverse colon suspended in the abdomen?

A

By transverse mesocolon, hangs to level of umbilibus

73
Q

What is the main branch of the transverse colon and where is it from?

A

Middle colic a. from SMA, shares common branch with right colic a.

74
Q

Where does the middle colic a. run?

A

passes through transverse mesocolon where it devides into right and left branches

75
Q

What other artery does the middle colic a. anastomose with?

A

Marginal a.

76
Q

What is the main vein of the transverse colon and where does it drain?

A

Middle colic v. to SMV

77
Q

What are the primary nodes of the transverse colon?

A

middle colic nodes

78
Q

What are the secondary nodes of the transverse colon?

A

superior mesenteric nodes

79
Q

What are the sympathetic innervations to the transverse colon?

A

Via lesser splanchnic n. (T11) and superior mesenteric plexus

80
Q

What are the parasympathetic innervations to the transverse colon?

A

Via vagal trunks and superior mesenteric plexuses

81
Q

Where does the hindgut begin?

A

Descending colon

82
Q

From where does the descending colon travel?

A

From left colic flexure to left iliac fossa where it transitions to sigmoid colon.

83
Q

Is the descending colon intraperitoneal or retroperitoneal?

A

retroperitoneal

84
Q

Where is the left paracolic gutter present?

A

lateral to the left of descending colon

85
Q

From where does the sigmoid colon travel?

A

S-shaped segmend connection descending colon to rectum

86
Q

Where do the tenia coli stop?

A

About 15 cm from the anus, broaden and merge to form longitudinal layer of rectum

87
Q

Is the sigmoid colon intraperitoneal or retroperitoneal?

A

intraperitoneal with long mesentery, adds to mobility

88
Q

Where does the mesentary dissapear from the sigmoid colon?

A

At transition to rectum (S2)

89
Q

What is the main vascular supply to descending and sigmoid colon and what is it a branch of?

A

IMA, branch of abdominal aorta just superior to its bifurcation

90
Q

What are the branches of the IMA that supply the descending and sigmoid colon?

A

Left colic a. and sigmoidal aa., terminating as superior rectal a.

91
Q

What does the left colic a. supply and what does it anastomose with?

A

supplys descending colon; anastamoses between SMA and IMA via marginal a.

92
Q

What does the sigmoidal aa supply?

A

About 2-4 aa in sigmoid mesocolon, supply sigmoid colon

93
Q

What is the main vein of the descending and sigmoid colons?

A

IMV, drains to splenic vein (most common), SMV, or junction between splenic v. and SMV.

94
Q

What are the primary nodes of the descending and sigmoid colons?

A

paracolic or left colic nodes

95
Q

what are the secondary nodes of the descending and sigmoid colons?

A

Either inferior or superior mesenteric nodes

96
Q

What are the sympathetic innervations to the descending and sigmoid colon?

A

Via least and lumbar splanchnic nn. (T12-L3), synapse in superior mesenteric and inferior mesenteric ganglia respectively

97
Q

What are the parasympathetic innervations to the descending and sigmoid colon?

A

Via pelvic splanchnic n. (S2-4), pass through inferior hypogastric plexus

98
Q

What do the proximal visceral afferents to descending and sigmoid colons accompany?

A

Proximal (orad) accompany sympathetics (pain); those for reflexes follow parasympathetics

99
Q

What do the distal visceral afferents to descending and sigmoid colons accompany?

A

Distal (aborad) accompany parasympathetics (pain and reflexes)

Gross III Exam 2 (11 decks)

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