Duodenum, Pancreas, and Intestines (lecture) Flashcards
What part of the duodenum is at risk from an anterior midline stab wound and what major artery would be at risk?
- 3rd part
- SMA would probably be severed as well because it overlies the 3rd part of the duodenum
Which part of the duodenum receives the combined pancreatic and bile ducts?
part 2
What structures could be damaged by pressure of the SMA pressing down on them?
- Left Renal v.
- 3rd part of the duodenum
What are some symptoms of Nutcracker syndrome?
- L Renal vein gets entraped by the SMA
- Often this presents with pain in the left testicle
What holds up the gooseneck at the duodenojejunal junction?
- Suspensory ligament
Describe the parameters of the suspensory ligament.
- 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
T or F: the common bile duct runs posterior to the 1st part of the duodenum.
True
Describe the appearance of the 1st part of the duodenum on a radiograph.
Smooth
What structure marks the junction of the midgut and foregut?
Duodenal Papilla
What is the blood supply to the GI proximal and distal to the duodenal papilla?
- Foregut - celiac trunk
- Midgut - SMA
In which mesentery can the tail of the pancreas be found?
- Lienorenal fold
- This means the tail is the only part of the pancreas that intraperitoneal
What artery and vein lie deep to the neck of the pancreas?
SMA and SMV
What pancreatic structure is defined as lying behind the SMA and SMV?
Uncinate process
What would be the primary concern with a perforated ulcer in the posterior wall of the stomach?
You would worry about the pancreas being exposed to erosive secretions
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?
- common bile duct
While trying to tie off the cystic duct the surgeon pierces a vein located posteriorly. What vein was hit?
- IVC
What part of the small intestine is located more superiorly and to the left of the midline?
Jejunum
What part of the small intestine is located more inferiorly and to the right of the midline?
Ileum
Where does the root of the mesentary begin and end?
- 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
Which contains more fat, the mesentery of the jejunum or that of the ileum?
Jejunum contains less fat gives it some translucent windows
Where would you expect to see a greater amount of arterial arches between the jejunum and ileum?
the ileum has many more arches
What three external features distinguish the colon from the other parts of the gut tube?
- Tenia Coli - long bands of longitudinal muscle running the length of the intestine (there are 3 of these)
- Haustra - pouches caused by widely spaced circular bands of muscle
- Epiploic appendices - small fat pouches found along the colon
Where would you expect tenderness if a patient has appendicitis?
McBurney’s pt. which is 1/3 of the way up on the line from the ASIS to the umbilicus
What happens if you loose blood supply in your colon?
You die
