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Anatomy Week 10 > Duodenum, Pancreas, and Intestines (lecture) > Flashcards

Duodenum, Pancreas, and Intestines (lecture) Flashcards

1
Q

What part of the duodenum is at risk from an anterior midline stab wound and what major artery would be at risk?

A
  • 3rd part

- SMA would probably be severed as well because it overlies the 3rd part of the duodenum

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2
Q

Which part of the duodenum receives the combined pancreatic and bile ducts?

A

part 2

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3
Q

What structures could be damaged by pressure of the SMA pressing down on them?

A
  • Left Renal v.

- 3rd part of the duodenum

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4
Q

What are some symptoms of Nutcracker syndrome?

A
  • L Renal vein gets entraped by the SMA

- Often this presents with pain in the left testicle

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5
Q

What holds up the gooseneck at the duodenojejunal junction?

A
  • Suspensory ligament
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6
Q

Describe the parameters of the suspensory ligament.

A
  • Starts from RIGHT CRUS of diaphragm at esophageal hiatus (T10)
  • Runs from L to R across aorta to end at dudodenojejunal junction 1 in to the LEFT of midline
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7
Q

T or F: the common bile duct runs posterior to the 1st part of the duodenum.

A

True

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8
Q

Describe the appearance of the 1st part of the duodenum on a radiograph.

A

Smooth

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9
Q

What structure marks the junction of the midgut and foregut?

A

Duodenal Papilla

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10
Q

What is the blood supply to the GI proximal and distal to the duodenal papilla?

A
  • Foregut - celiac trunk

- Midgut - SMA

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11
Q

In which mesentery can the tail of the pancreas be found?

A
  • Lienorenal fold

- This means the tail is the only part of the pancreas that intraperitoneal

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12
Q

What artery and vein lie deep to the neck of the pancreas?

A

SMA and SMV

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13
Q

What pancreatic structure is defined as lying behind the SMA and SMV?

A

Uncinate process

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14
Q

What would be the primary concern with a perforated ulcer in the posterior wall of the stomach?

A

You would worry about the pancreas being exposed to erosive secretions

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15
Q

In an attempt to tie off the cystic duct a surgeon accidentally closes off a nearby duct in the epiploic foramen causing jaundice in the patient. What duct was closed off?

A
  • common bile duct
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16
Q

While trying to tie off the cystic duct the surgeon pierces a vein located posteriorly. What vein was hit?

A
  • IVC
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17
Q

What part of the small intestine is located more superiorly and to the left of the midline?

A

Jejunum

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18
Q

What part of the small intestine is located more inferiorly and to the right of the midline?

A

Ileum

19
Q

Where does the root of the mesentary begin and end?

A
  • Begins at duodenojejunal junction 1 in to the left of the midline at or below the transpyloric plane
  • Ends at McBurney’s pt. which is 1/3 of the way up on the line from the ASIS to the umbilicus
20
Q

Which contains more fat, the mesentery of the jejunum or that of the ileum?

A

Jejunum contains less fat gives it some translucent windows

21
Q

Where would you expect to see a greater amount of arterial arches between the jejunum and ileum?

A

the ileum has many more arches

22
Q

What three external features distinguish the colon from the other parts of the gut tube?

A
  1. Tenia Coli - long bands of longitudinal muscle running the length of the intestine (there are 3 of these)
  2. Haustra - pouches caused by widely spaced circular bands of muscle
  3. Epiploic appendices - small fat pouches found along the colon
23
Q

Where would you expect tenderness if a patient has appendicitis?

A

McBurney’s pt. which is 1/3 of the way up on the line from the ASIS to the umbilicus

24
Q

What happens if you loose blood supply in your colon?

A

You die

25
Q

What are the branches of the SMA?

A
  1. Inferior pancreaticoduodenal aa.
  2. Intestinal aa. (jejunal and ileal aa.)
  3. Middle Colic a.
  4. Right colic a.
  5. Ileocolic a.
26
Q

What are the branches of the IMA?

A
  1. Left Colic a.
  2. Sigmoidal aa.
  3. Superior Rectal a.
27
Q

T or F: both the celiac and SMA arise from the aorta above the transpyloric line

A

True

28
Q

What anatomical landmark approximates the change in parasympathetic innervation in the gut tube?

A

Splenic flexure

  • This marks the line between midgut (vagus n.) and hindgut (S2-S4)
29
Q

What two arteries form the marginal a. and where do they anastomose?

A

SMA and IMA

- they come together about 2/3 of the way down the transverse colon just before the splenic flexure

30
Q

You notice that a patient has a decrease in muscle tone in the colon as it passes anterior to the spleen. What could this be indicative of?

A

pathology in the S2-S4 parasympathetic nn.

31
Q

What courses along the root of the mesentery proper?

A

SMA

32
Q

In relation to surface anatomy, where does the IMA branch out from the aorta?

A

3/4 of an inch above the umbilicus

33
Q

In relation to surface anatomy, where does the aorta bifurcate into the R and L common iliac aa?

A

3/4 of an inch below the umbilicus

34
Q

What two veins come together to make the portal vein and where does this occur?

A
  • Superior mesenteric vein and splenic vein

- occurs in the pyloric plane just posterior to the neck of the pancreas

35
Q

What causes portal hypertension?

A

increased vascular resistance through the liver

36
Q

What are some common indicators of portal hypertension?

A

engorgement of portal-caval anastomoses and ascites

37
Q

T or F: portal venous pressure typically = caval venous pressure

A

True

38
Q

What are some common causes of portal hypertension?

A
  1. Cancer

2. Cirrhosis of the liver

39
Q

Where does caval blood go?

A

RA

40
Q

Where does portal blood go?

A

The liver

41
Q

What are 3 common places where we see portal-caval anastomoses occur?

A
  1. Esophageal
  2. Across the stomach
  3. In Anus
42
Q

Describe how esophageal portal-caval anastomoses occur and their associated risk.

A
  • Esophageal branch of L. gastric VIEN (portal) connects with one of the VIENs (caval) from the upper 2/3 of the esophagus (that run into azygous)
  • These can burst and kill you
43
Q

Explain why a person may have portal-caval anastomoses across their stomach.

A
  • Veins surrounding the obliterated umbilical vein (ligamentum teres) (portal) start to drain into the superior and inferior epigastic veins (caval) causing them to enlarge and become visible in some cases
  • Not that dangerous
44
Q

Explain why a personal may have portal-caval anastomoses in dat ass hole.

A
  • Superior rectal vein (portal) anastomoses with middle and inferior rectal veins (caval)
  • NO pain, NOT dangerous
  • usually recognized when people have bright red stuff in the stool

Anatomy Week 10 (8 decks)

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