GIT-Peritoneal cavity, pancreas and small intestine Flashcards

1
Q

Where is pus accumulated in conditions like gallbladder infection and pancreatitis?

A

Peritoneal space

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2
Q

Where is the lesser sac located? (Posterior, Superior, Inferior )

A
  • Lies posterior to the stomach and the lesser omentum
  • Superiorly bounded by the diaphragm
  • Inferiorly bounded by the layers of greater omentum
  • Communicates with the greater sac through the omental foramen
  • Its left margin is formed by the spleen

lesser sac is a cavity while lesser omentum is a connective tissue structure

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3
Q

What is another name for lesser sac of the pritoneal cavity?

A

Omental Bursa

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4
Q

What is the main part of the peritoneal cavity?

A

Greater sac

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5
Q

____ devides the greater sac into ____ compartment and ____ compartment

A

Transverse mesocolon devides the greater sac into **supracolic compartment ** and infracolic compartment

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6
Q

What does the supracolic compartment consists of?

A

Stomach, liver and spleen

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7
Q

What does th infracolic compartment consits of?

A

Small intestine and colon

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8
Q

____ lie on the lateral sides of the ascending and descending colons
Right ____ communicates with right subhepatic space
Left ____ communicates is seperated from the diaphragm by the ______

A

Paracolic gutters lie on the lateral sides of the ascending and descending colons
Right paracolic gutter communicates with right subhepatic space
**Left paracolic gutter ** is seperated from the diaphragm by the **phrenicocolic ligament **

Right: It communicates with the hepatorenal recess and the pelvic cavity. It provides a route for the spread of infection between the pelvic and the upper abdominal pain

Left: It is a fold of perotoneum that passes from the colic flexure to the diaphragm

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9
Q

What type of jaundice does cancer of the head of the pancrease cause?

A

Obstructive jaundice

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10
Q

Is pancreas retroperitoneal or interaperitoneal?

A

Retroperitoneal

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11
Q

Pancreas:
- Lies between the ____ on the ____ and ____ on the ____
- Head, neck, body, ____ and ____
- Root of the transverse mesoclon lies along the anterior margin

A

Pancreas:
- Lies between the duodenum on the right and spleen on the ** left**
- Head, neck, body, neck and uncinate process
- Root of the transverse mesoclon lies along the anterior margin

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12
Q

Which cancer has a better prognosis? Cancer at the tail of pancreas or cancer at the head of pancrea?

A

Cancer at the tail of pancreas has a better prognosis as head is nearer to the bile duct

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13
Q

Pancreatic Ducts:
Main pancreatic duct open into the ____. Accessory pancreatic duct opens into the ____

A

Pancreatic Ducts:
Main pancreatic duct open into the ampulla of vater. Accessory pancreatic duct opens into the duodenum

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14
Q

The pancreas produces exocrine secretion that enters the ____ and endocrine secretions that enter the ___

A

The pancreas produces exocrine secretion that enters the duodenum and endocrine secretions that enter the blood

mainly glucagon and insulin

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15
Q

Head of pancreas:
Attached to the ____ part of the ____, ____ lies posteriorly

A

Atrtached to the descending part of the duodenum **common bile duct **lies posteriorly

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16
Q

Neck of pancreas:
____ vessels and ____ vein posteriorly

A

Superior mesenteric vessels and **splenic vein ** posteriorly

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17
Q

Body of pancreas:
- Forms the floor of the ____
- ____ anteriorly
- ____ posteriorly

A
  • Forms the floor of the omental bursa (Lesser sac)
  • Stomach anteriorly
  • Left kidney posteriorly
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18
Q

Tail of pancreas:
Related to the ____ of the ____

A

Related to the hilum of the spleen

19
Q

Uncinate process:
____ vessels lie in front (But the lie behind the neck of the pancreas)

A

Superior mesentrice vessels

20
Q

Arterial supply:
Head:
- Branches of the ____ and superior mesentric artries via superior ____ arteries and inferior ____

Neck, Body and Tail:

  • Branches of the ____ arteries
A

Arterial supply:
Head:
- Branches of the gastroduodenal and superior mesentric artries via superior **pancreatico duodenal ** arteries and inferior pancreatico duodenal arteries

Neck, Body and Tail:

  • Branches of the** splenic** arteries
21
Q

Where does the pancreas drain to? (venous)

A

Splenic vein and portal vein

22
Q

Sympathetic innervation of the pancreas:
- ____ pancreatic secretions

Parasympathetic innervation of the pancreas:
- ____ pancreatic secretion

A

Sympathetic innervation of the pancreas:
- ** Decrease** pancreatic secretions

Parasympathetic innervation of the pancreas:
- Increase pancreatic secretion

23
Q

What is Pancreatitis associated with?

A

Alcoholism

24
Q

What are the four portal-systemic anastomoses?

A

Oesophagus
Rectum
Umbilicus
Posterior abdominal walls

Haemorrhage is common in oesophagus and rectum

25
Q

How does cancer of the head of the pancreas give rise to obstructive jaundice?

A

Common bile duct lies behind the head of pancreas. Hence, a cancerous mass in the head of pancreas can compress the bile duct (obstruction) giving rise to obstructive jaundice.

26
Q

Where is a major site of digestion and absorption?

A

Small Intestines

27
Q

Small Intestine:
- Extends from the ____ of the somach to the ____
- Major part of the digestion and absorption tkes place in the small intestine
- Divided into duodenum, ____ and ____

A

Small Intestine:
- Extends from the ** pylorus **of the somach to the ileocecal junction
- Major part of the digestion and absorption tkes place in the small intestine
- Divided into duodenum, jejunum and ileum

28
Q

Duodenum (IMPT):
- 10 inches long, divided into superior, descending, inferior and ascending part
- ____ part of the duodenum = duodenal cap
- ____ part of the duodenum contains entrance for ____ (Major Duodenal Papilla)
- Most of the duodenum is ____

A

Duodenum:
- 10 inches long, divided into superior, descending, inferior and ascending part
- ** First** part of the duodenum = duodenal cap
- **Second **part of the duodenum contains entrance for common bile duct (Major Duodenal Papilla)
- Most of the duodenum is retroperitoneal

29
Q

Duodenum (IMPT):
1(Superior part): 5cm long, L1 level
2(Descending): 7-10cm long, L1-L3
3(Inferior): 6-8cm, crosses L3
4(Ascending): ____

A

Duodenum (IMPT):
1(Superior part): 5cm long, L1 level
2(Descending): 7-10cm long, L1-L3
3(Inferior): 6-8cm, crosses L3
4(Ascending): 5cm, to L2

30
Q

Duodenum (IMPT):
* Supplied by the branches of ____ trunk and ____ artery
* Superior pancreatico duodenal artery (indirectly from celiac): Supplies the part above the entry of ____
* Inferior pancreatico duodenal artery (a direct branch of superior mesentric artery): Supplies the part ____ to the ____ of bile duct
* Both ____ and ____ anastomose
* ____ veins drain into the ____ vein
* Innervated by the ____ nerves from the ____ and ____ plexus and parasympathetic (vagus)

A

Duodenum (IMPT):
* Supplied by the branches of **celiac ** trunk and superior mesentric artery
* Superior pancreatico duodenal artery (indirectly from celiac): Supplies the part above the entry of bile duct
* Inferior pancreatico duodenal artery (a direct branch of superior mesentric artery): Supplies the part distal to the entry of bile duct
* Both **superior ** and inferior pancreatico duodenal arteies anastomose
* Duodenal veins drain into the portal vein
* Innervated by the sympathetic nerves from the celiac and superior mesentric plexus and parasympathetic (vagus)

31
Q

Duodenal ulcers occurs most commonly om which part of the duodenum?

A

1st part: Superior part

Anteriorly/ posteriorly

32
Q

Anterior duodenal ulcer eroudes ____ causing ____

Posterior duodenal ulcer erodes either ____ or ____ causing ____

A

Anterior duodenal ulcer eroudes peritoneum causing peritonitis

Posterior duodenal ulcer erodes either gastroduodenal artery or posterior superior pancreaticoduodenal artery causing hemorrhage

33
Q

What is the junction between the duodenum and jejunum called?

A

Duodeno jejunal junction

34
Q

What is the junction between ileum and caecum called?

A

Ileocaecal junction

35
Q

Are jejunem and ileum retroperitoneal?

A

No, they are entirely intraperitoneal

36
Q

Jejunem and Ileum:
- Length 20 feet approximately
- Upper 2/5 jejunem rest ileum
- Jejunem loops ____ quadrant
- Ileum loops ____ quadrant

A

Jejunem and Ileum:
- Length 20 feet approximately
- Upper 2/5 jejunem rest ileum
- Jejunem loops left upper quadrant
- Ileum loops right lower quadrant

37
Q

Jejunem and Ileum (morphology):
- ____ mesentry with long free edge and a short root
- Mucosa: ___ folds
- ___ frequent in terminal ileum

A

Jejunem and Ileum (morphology):
- Fan shaped mesentry with long free edge and a short root
- Mucosa: Circular folds plicae circulares
- Peyer’s patches (lymphoid tissue) frequent in terminal ileum

38
Q

What morphologic features suggests the terminal ileum?

A

Peyer’s patches

39
Q

What are the difference between jejunem and ileum?

A

Jejunem:
- Proximal two-fifths
- Wide-bored and thick walled. Closely arranged plicae. inside
- Less prominent arterial arcades
- Longer vasa recta

Ileum:
- Distal three-fifths
- Smaller in diameter and thinner walls
- Prominent arterial arcades
- shorter vasa recta

40
Q

Jejunum and Ileum:
-Arterial supply from the ____ artery
- ____ drains the venous blood from the jejunem and ileum into the ____ vein
- ____ vein joins with ____ vein to form the ____ vein

A

Jejunum and Ileum:
-Arterial supply from the superior mesentric artery (SMA)
- SMV drains the venous blood from the jejunem and ileum into the portal vein
- SMV vein joins with splenic vein to form the portal vein

41
Q

Nerve supply to small intestine:
- The small intestine is supplied by autonomic (sympathetic and parasympathetic) and sensory fibers in the ____ and ____
- Sympathetic fibers (____): reduce bowel motility, reduce intestinal secretions, causes vasoconstriction
- Parasympathetic nerve fibres (Vagus): Increase bowel motility, stimulate intestinal secretions, causes vasodilation
- The sensory fibers are sensitive to ____ and ____

A

Nerve supply to small intestine:

  • The small intestine is supplied by autonomic (sympathetic and parasympathetic) and sensory fibers in the celiac and superior mesenteric plexus
  • Sympathetic fibers (greater splanchnic): reduce bowel motility, reduce intestinal secretions, causes vasoconstriction
  • Parasympathetic nerve fibres (Vagus): Increase bowel motility, stimulate intestinal secretions, causes vasodilation
  • The sensory fibers are sensitive to distension and nociceptive pain
42
Q

Lympatics vessels of jejunem and ileum:
- Lympatic vessels from the walls of jejunem and ileum drain into ____ (found btwn the layers of mesentry)
- ____ lympatic vessels from the ____ nodes drain into the superior mesentric nodes (found around the origin of SMA)

A

Lympatics vessels of jejunem and ileum:
- Lympatic vessels from the walls of jejunem and ileum drain into mesentric lymph nodes (found btwn the layers of mesentry)
- Efferent lympatic vessels from the mesentric nodes drain into the superior mesentric nodes (found around the origin of SMA)

43
Q

Where does the upper digestive system end?

A

Beginning of the duodenum