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Anatomy 206 > Duodenum > Flashcards

Duodenum Flashcards

1
Q

Site

A
  1. Small intestine proximal part
  2. Lies partly in epigastric and partly in umbilical regions
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2
Q

Length

A

10 inches long

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3
Q

Shape

A

C-shape with concavity to left

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4
Q

Parts

A

4 parts

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5
Q

1st part

A
  1. 2 inches long
  2. Extends horizontally to right from stomach pyloric end 1/2 inch to right of midline at Transpyloric plane (1st lumbar vertebra) level
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6
Q

2nd part

A
  1. 3 inches long
  2. Extends vertically downwards from 1st part right end to end at 3rd lumbar vertebra level
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7
Q

3rd part

A
  1. 4 inches long
  2. Extends horizontally from 2nd part lower end to left at 3rd lumbar vertebra level
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8
Q

4th part

A
  1. 1 inch long
  2. Extends vertically upwards from 3rd part left end to join jejunum at duodenojejunal flexure 1 inch to left of midline at 2nd lumbar vertebra level
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9
Q

Extent

A
  1. Begins at L1 vertebra level
  2. Ends at L2 vertebra level and its lowest part (3rd part) lies at L3 vertebra level
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10
Q

Peritoneal covering and recesses

A
  1. Retroperitoneal structure fixed to posterior abdominal wall except it’s 1st inch which is mobile and completely covered by peritoneum
  2. Peritoneum covers duodenum anterior and along periphery only
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11
Q

4 recesses related to duodenum terminal part

A
  1. Superior duodenal recess
  2. Inferior duodenal recess
  3. Paraduodenal recess
  4. Retroduodenal recess
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12
Q

4 recesses related to duodenum terminal part

A
  1. Superior duodenal recess
  2. Inferior duodenal recess
  3. Paraduodenal recess
  4. Retroduodenal recess
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13
Q

Superior duodenal recess

A
  1. On left side of duodenum 4th part upper end behind superior duodenal fold
  2. It’s opening looks downwards and related to inferior to inferior mesenteric vein which runs in fold edge
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14
Q

Inferior duodenal recess

A
  1. On left side of duodenum 4th part lower end behind inferior duodenal fold
  2. It’s opening looks upwards and not related to vessels
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15
Q

Paraduodenal recess

A
  1. Little to left of duodenum whole 4th part behind Paraduodenal fold
  2. Its opening looks to right with inferior mesenteric vein present in overlying fold
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16
Q

Retroduodenal recess

A
  1. Behind duodenum 3rd and 4th
  2. In front of aorta
  3. Opening is directed downwards and to the left
17
Q

Relations 1st part: 1st inch

A

1st inch duodenal cap
Only mobile part
Anterior:
1. Liver quadrate lobe separated from it by greater sac
Posterior:
1. Pancreas Neck, separated from it by lesser sac
Superior:
1. Lesser omentum right free border attachment (containing common bile duct, hepatic artery, and portal vein)
2. Epiploic foramen behind it
Inferior:
Greater omentum attachment with pancreas head behind it

18
Q

Relations 1st part: 2nd inch

A

Anterior:
1. Liver quadrate lobe separated from it by greater sac
2. Gall bladder neck, at junction between 1st and 2nd parts
Posterior:
1. Gastroduodenal artery
2. Common bile duct to right of artery
3. Portal vein, behind artery and duct
4. IVC posterior to portal vein
Inferior:
1. Pancreas head

19
Q

Relations 2nd part: anterior

A
  1. Upper part:
    Related to inferior surface of liver right lobe separated from it by greater sac
  2. Middle part:
    Crossed by transverse colon
  3. Lower part:
    Related to jejunum coils
20
Q

Relations 2nd part: posterior

A
  1. Right kidney hilum with renal vein, renal artery, and ureter pelvis
  2. Right Psoas major
21
Q

Relations 2nd part: medial

A
  1. Pancreas head
  2. Ampulla of Vater, opens in middle of duodenum 2nd part Posteromedial aspect
  3. Superior and inferior pancreatico-duodenal arteries in groove between duodenum 2nd part and pancreas head
22
Q

Relations 2nd part: lateral

A
  1. Liver right lobe
  2. Ascending colon
  3. Right colic flexure
23
Q

Relations 3rd part: anterior

A
  1. Root of small intestine mesentery (containing superior mesenteric vessels)
  2. Jejunum coils
24
Q

Relations 3rd part: posterior

A
  1. Right Psoas major separated from it by right ureter
  2. IVC separated from it by gonadal artery
  3. Abdominal aorta separated from it by inferior mesenteric artery
25
Q

Relations 3rd part: superior

A

Pancreas head and its uncinate process

26
Q

Relations 3rd part: inferior

A

Jejunum coils

27
Q

Relations 4th part: anterior

A

Jejunum coils

28
Q

Relations 4th part: posterior

A
  1. Left sympathetic chain
  2. Left gonadal artery
29
Q

Relations 4th part: medial

A
  1. Uncinate process of pancreas head
  2. Abdominal aorta
30
Q

Relations 4th part: lateral

A
  1. Jejunum coils
  2. Left kidney hilum
31
Q

Atrial supply: 1st part 1st inch

A
  1. Supplied by supraduodenal artery (branch of gastroduodenal or hepatic artery)
  2. Additional supply from right gastric and gastroepiploic arteries
32
Q

Atrial supply: 1st part 2nd inch and 2nd part upper 1/2 (duodenum foregut part)

A

Supplied by superior pancreatico-duodenal artery (branch of gastroduodenal artery)

33
Q

Atrial supply: Duodenum remaining parts (duodenum midgut part)

A

Supply by inferior pancreatico-duodenal artery (branch of superior mesenteric artery)

34
Q

Venous drainage

A

Accompanies the atrial supply to drain into portal circulation (splenic, superior mesenteric, and portal veins)

35
Q

Lymphatic drainage

A
  1. Hepatic node
  2. Superior mesenteric node
  3. Pyloric node
36
Q

Applied anatomy

A
  1. Duodenum end (duodenojejunal junction) is marked at operation by ligament of Treitz (Suspensory ligament of duodenum)
  2. Fibromuscular band suspends and fixes duodenojejunal flexure
  3. Arises from diaphragm right crus and descends behind pancreas to gain attachment into posterior surface of duodenojejunal flexure 3rd and 4th parts of duodenum
37
Q

Peptic ulcer site

A

Duodenum is the most common site for it

Anatomy 206 (98 decks)

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