GA1 - intestines Flashcards
most of the small intestine is ___peritoneal
intra
duodenum is ____peritoneal
retro
small intestine has 3 parts
duodenum, jejunum, ileum
duodenum is _-shaped about ___in long
C
10
duodenum has 4 parts
superior
descending
inferior
ascending
superior duodenum is _in long running ___ and ____ on the right side of __ vertebrae
2
upwards
backwards
L1
descending duodenum is _in long running ____ ____ along the right side of ___-___ vertebrae
3
vertically downward
L1-L3
inferior duodenum is _in long running _____ in front of ___ vertebrae
3
horizontally
L3
ascending duodenum is _in long running ___ and to the ___ and ends at ____ flexure
2
upwards
duodenojejunal
___ ___/____ ____ increase the absorption area of the duodenum
circular folds/plica circularis
major duodenal papilla is where the __ ___ ___ and ___ ___ __ come together to drain into the duodenum
main pancreatic duct and common bile duct
minor duodenal papilla is where the ___ ___ ___ drains into the duodenum
accessory pancreatic duct
blood supply to the duodenum - 2 arteries
superior and inferior pancreatico-duodenal
superior pancreatico-duodenal artery is a branch of the
gastroduodenal
inferior pancreatico-duodenal artery is a branch of the
superior mesenteric a
superior and inferior pancreatico-duodenal arteries will ___
anastomose
lymph flow of the duodenum
pancreatoduodenal nodes –> celiac nodes –> superior mesenteric nodes –> cystern chyli
jejunum and ilium measures __ft long
20
jejunum and ileum is ____ mobile attached to the posterior abdominal wall by the ____ of the small intestine
freely
mesentery
jejunum and ileum are __peritoneal
iintraperitoneal
jejunum is coiled in the ____ ___ part of the peritoneal cavity
left upper
ileum is in the ___ ___ part of the peritoneal cavity
lower right
jejunum has a ___ lumen, ___ wall, and ___ than the ileum
wider
thicker
redder
the jejunum is more ___ than the ileum
vascular
jejunum has ___ and ___ cirucular folds; ileum has ___ and ___ circular folds
taller
more
shorter
fewer
jejunum - mesentery is attached to posterior wall ___ and to the ___ of aorta
above
left
ileum - mesentery is attached ___ and to the ___ of aorta
below
right
jejunum - vessels form ___ arcades with __ long branches; ileum - vessels form ___ arcades with ___ numerous terminal branches
few
few
numerous
short
jejunal end of mesentery has ____ deposited in the root area and very ___ amount near intestine
fat
little
ileal end has __ deposited ___ the mesentary
fat
throughout
the root area of jejunum that is attached to the posterior wall is thicker because of the ____ deposited there
fat
___ ___ are present in the mucous membrane of the lower ileum along the ___-____ border
peyers patches
anti-mesenteric
the branches from the superior mesenteric arteries come together to form
arcades
the branches that come off of the arcades are the terminal branches called ___ ____
vasa recta
peyers patches are aggregates of ____ nodules
lymphoid
the branches off the superior mesenteric have 2 different names
intestinal branches
jejunal/ileal
blood supply to the small intestine
superior mesenteric
venous drainage of the small intestine =
portal system = superor mesenteric v –> portal v.
lymph drainage flow
mesenteric nodes –> superior mesenteric nodes –> intestinal lymph trunk –> cisterna chyli
mesenteric lymph noes within the ____
mesentary
duodenum is innervated by the ____ plexus
celiac
ilium and jujenum is innervated by the ___ ___ plexus
superior mesenteric
superior mesenteric ganglia surrounds the ___ ___ artery
superior mesenteric
superior mesenteric plexus has ___ parasympathetic, ____ symp
preganglionic
postganglionic
pre ganglionic sympathetic from ___ ___ a
lesser splanchnic
large intestine extends from the ____ to the ___ about __ft long
ileum
anus
5
large intestine divided into 7 parts
cecum appendix ascending colon transverse colon descending colon sigmoid colon rectum anal canal
3 gross characteristic features of the large intestine
tenia colia
haustrations
epiploical appendages
tenia colia
longitudinal muscles
grouped into 3
form into band like structures
haustrations
segments of large intestines
haustrum - single
haustra - plural
epiploical appendages
fat deposits/protrusions
surrounded by visceral peritoneum
cecum - lies below level of ___ jxn
ileocecal
if you draw a line straight across from the bottom of the ileum where it comes into contact with the colon you will get the border for the ____
cecum
___-___ pouch located in the right iliac fossa
blind-ended
___ attaches to the cecum on its posteromedial side
appendix
blood supply to the cecum (2)
anterior and posterior cecal branches of the ileocolic artery
ileocolic artery is a branch of the ___ __ a
superior mesenteric
lymph drainage flow
mesenteric nodes –> superior mesenteric nodes
___ is a narrow muscular tube, 3-5 in long containing a large amount of lymphoid tissue
appendiz
appendix contains a lot of ____ tissue
lymphoid
appendix lies in the ___ __ fossa and in relation to the anterior abdominal wall, its base is situated beneath the ____ point
McBurney’s
2 arteries that supply the appendix
appendicular artery
branch of the posterior cecal artery
lymph drainage of the appendix
mesenteric nodes
superior mesenteric nodes
appendix innervated by the ___ ___ plexus
superior mesenteric
appendix innervated by afferent fibers for pain enter ___ segment
T10
appendix has referred pain to the ____
umbilicus
4 signs of appendicitis
pt tenderness at McBurneys point
rebound tenderness
Rouvsing sign
iliopsoas sign
rebound tenderness
when you press, the pain goes away, and when you let go, suddenly the patient comes right back
Rovsing sign
press on L side and let go they complain of pain on the right
iliopsoas sign
appendix right over iliacus
lift R leg and press down
patient will feel pain
ascending colon is about _in, extending upward from the ____ to the inferior surface of the __ lobe of the liver
5
cecum
right
ascending colon ends at the __ ___ flexure
right colic
ascending colon is ___peritoneal
retro
blood supply to the ascending by two arteries that are branches of the __ ___ artery
ileocolic
right colic
superior mesenteric
ascedning colon is innervated by the __ ___ plexus
superior mesenteric
transverse colon is about __in long extednign across the abdomen occupying the __ region
15
umbilical
transverse colon hangs ____ suspended by the ____ ___ and ___ ___ from the anterior surface of ___
downward
transverse mesocolon
greater omentum
pancreas
blood supply to the R 2/3 of the transverse colon
middle colic
blood supply to the L 1/3 of the transverse colon
left colic
middle colic is a branch of the __ __
superior mesenteric
left colic a is a branch of the ___ ___
inferior mesenteric
nerve supply to the transverse colon is the ___ and ___ ___ plexus
superior and inferior plexus
descending colon is about __in long extending from the ___ ___ ___ to the ___ ___
left colic flexure
pelvic brim
descending colon is ____peritoneal
retro
blood supply to the descending colon ____ ___ and ___ arteries
left colic
sigmoidal
left colic and sigmoidal are branches of ___ ___
inferior mesenteric
nerve supply to the descending aorta
inferior mesenteric plexus
inferior mesenteric plexus is derived from ____ ___ ganglia
inferior mesenteric
sigmoid colon is __-__in long extending from the __ ___ to the front of ___
10-15
S3
sigmoid colon is attached to posterior abdominal wall by __ ___
sigmoid mesocolon
sigmoid colon is ___peritoneal
intra
blood supply to the sigmoid colon by ___ __ of the __ __ artery
sigmoid branches
inferior mesenteric
upper sigmoid colon is innervated by ___ ___
inferior mesenteric
lower sigmoid colon is innervated by ___ ___
hypogastric plexus
rectum is about __in long and begins infront of __ and ends __in in front of tip of ___
5
S3
coccyx
rectum has an outer ___ muscle surrounding entire circumference of rectum
longitudinal
blood supply to the rectum is by 3 arteries
superior, middle, inferior rectal arteries
lymph drainage of the upper half of the rectum
pararectal lymph nodes to inferior mesenteric nodes
lymph drainage of the lower half of the rectum
internal iliac lymph nodes
nerve supply to the rectum is the ___ ___
hypogastric plexuses
rectum is normally ___
empty
peristaltic rush of the rectum =
defecation
the urge to use the bathroom occurs when the rectum is ____
full
anal canal is about ___in long passing downward and backwards from the ___ ___ to the ___
1.5
rectal ampulla
anus
anal canal has an _____ smooth muscle internal sphincter and ___ external sphincter
involuntary
voluntary
blood supply to the anal canal 2 arteries
superior and inferior rectal arteries
upper half of the anal canal lymph drainage
internal iliac nodes
lower half of anal canal lymph drainage
superficial inguinal nodes
nerve supply to the upper half of the anal canal
hypogastric plexuses
nerve supply to the lower half of the anal canal
inferior rectal nerve and perineal branch of S4 nrve
anorectal angle
by the puborectalis muscle
dilation of the anal canal
rectal ampulla
___ ___: longitudinal ridges at the anorectal junction
anal columns
interconnected anal columns =
prevents liquid from oozing out
below dentate line epithelium
stratified squamous keratinized by the outside, non-keratinized toward the dentate line
above dentate line epithelium
simple columnar
superior mesenteric artery gives off 3 arteries
middle colic, right colic, ileocolic
inferior mesenteric artery gives off 3 arteries
left colic, sigmoidal, superior rectal
internal iliac gives off 2 arteries
middle and inferior rectal artery
superior rectal artery supplies upper 1/2 of ___
rectum
middle and inferior rectal artery supplies lower 1/2 of ____
rectum
9 structures derived from the foregut
esophagus trachea, bronchi, lungs stomach upper 2/3 of duodenum liver, pancreas, gallbladder
blood supply to the foregut
celiac trunk
sympathetic nerve supply to foregut
greater splanchnic; celiac ganglia
parasympathetic nerve supply to foregut
Vagus
7 structures from midgut
lower 1/3 of duodenum jujenum ilium cecum, appendix, ascending colon R 2/3 of transverse colon
blood supply to midgut
superior mesenteric artery
sympathetic nerve supply to the midgut
lesser splanchnic; least splanchnic; superior mesenteric ganglia
parasympathetic nerve supply to the midgut
Vagus
blood supply to the rectum is by 3 arteries
superior, middle, inferior rectal arteries
lymph drainage of the upper half of the rectum
pararectal lymph nodes to inferior mesenteric nodes
lymph drainage of the lower half of the rectum
internal iliac lymph nodes
nerve supply to the rectum is the ___ ___
hypogastric plexuses
rectum is normally ___
empty
peristaltic rush of the rectum =
defecation
the urge to use the bathroom occurs when the rectum is ____
full
anal canal is about ___in long passing downward and backwards from the ___ ___ to the ___
1.5
rectal ampulla
anus
anal canal has an _____ smooth muscle internal sphincter and ___ external sphincter
involuntary
voluntary
blood supply to the anal canal 2 arteries
superior and inferior rectal arteries
upper half of the anal canal lymph drainage
internal iliac nodes
lower half of anal canal lymph drainage
superficial inguinal nodes
nerve supply to the upper half of the anal canal
hypogastric plexuses
nerve supply to the lower half of the anal canal
inferior rectal nerve and perineal branch of S4 nrve
anorectal angle
by the puborectalis muscle
dilation of the anal canal
rectal ampulla
___ ___: longitudinal ridges at the anorectal junction
anal columns
interconnected anal columns =
prevents liquid from oozing out
below dentate line epithelium
stratified squamous keratinized by the outside, non-keratinized toward the dentate line
above dentate line epithelium
simple columnar
superior mesenteric artery gives off 3 arteries
middle colic, right colic, ileocolic
inferior mesenteric artery gives off 3 arteries
left colic, sigmoidal, superior rectal
internal iliac gives off 2 arteries
middle and inferior rectal artery
superior rectal artery supplies upper 1/2 of ___
rectum
middle and inferior rectal artery supplies lower 1/2 of ____
rectum
9 structures derived from the foregut
esophagus trachea, bronchi, lungs stomach upper 2/3 of duodenum liver, pancreas, gallbladder
blood supply to the foregut
celiac trunk
sympathetic nerve supply to foregut
greater splanchnic; celiac ganglia
parasympathetic nerve supply to foregut
Vagus
7 structures from midgut
lower 1/3 of duodenum jujenum ilium cecum, appendix, ascending colon R 2/3 of transverse colon
blood supply to midgut
superior mesenteric artery
sympathetic nerve supply to the midgut
lesser splanchnic; least splanchnic; superior mesenteric ganglia
parasympathetic nerve supply to the midgut
Vagus
5 structures from hindgut
L 1/3 transverse colon descending colon sigmoid colon rectum upper 1/2 anal canal
sympathetic innervation to L 1/3 transverse colon, descending colon, and sigmoid colon through ___ ___ and ___ ___
lumbar splanchnic
inferior mesenteric
blood supply to the hindgut, except for lower 1/2 of rectum
inferior mesenteric artery
middle and inferior rectal a
sympathetic innervation for the hindgut
lumbar splanchnic
inferior mesenteric ganglia
sacral splanchnic nerves
inferior hypogastric plexus
lumbar splanchnic (L1,L2) synapse at
inferior mesenteric ganglia
parasympathetic nerve supply to hindgut
pelvic splanchnic (S2, S3, S4)