GIT-Peritoneal Cavity, Pancreas and Small Intestine Flashcards
Where is pus accumulated in conditions like gallbladder infection and pancreatitis?
Peritoneal space
Where is the lesser sac located? (Posterior, Superior, Inferior )
- 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
What is another name for lesser sac of the pritoneal cavity?
Omental Bursa
What is the main part of the peritoneal cavity?
Greater sac
____ devides the greater sac into ____ compartment and ____ compartment
Transverse mesocolon devides the greater sac into **supracolic compartment ** and infracolic compartment
What does the supracolic compartment consists of?
Stomach, liver and spleen
What does th infracolic compartment consits of?
Small intestine and colon
____ 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 ______
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
What type of jaundice does cancer of the head of the pancrease cause?
Obstructive jaundice
Is pancreas retroperitoneal or interaperitoneal?
Retroperitoneal
Pancreas:
- Lies between the ____ on the ____ and ____ on the ____
- Head, neck, body, ____ and ____
- Root of the transverse mesoclon lies along the anterior margin
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
Which cancer has a better prognosis? Cancer at the tail of pancreas or cancer at the head of pancrea?
Cancer at the tail of pancreas has a better prognosis as head is nearer to the bile duct
Pancreatic Ducts:
Main pancreatic duct open into the ____. Accessory pancreatic duct opens into the ____
Pancreatic Ducts:
Main pancreatic duct open into the ampulla of vater. Accessory pancreatic duct opens into the duodenum
The pancreas produces exocrine secretion that enters the ____ and endocrine secretions that enter the ___
The pancreas produces exocrine secretion that enters the duodenum and endocrine secretions that enter the blood
mainly glucagon and insulin
Head of pancreas:
Attached to the ____ part of the ____, ____ lies posteriorly
Atrtached to the descending part of the duodenum **common bile duct **lies posteriorly
Neck of pancreas:
____ vessels and ____ vein posteriorly
Superior mesenteric vessels and **splenic vein ** posteriorly
Body of pancreas:
- Forms the floor of the ____
- ____ anteriorly
- ____ posteriorly
- Forms the floor of the omental bursa (Lesser sac)
- Stomach anteriorly
- Left kidney posteriorly
Tail of pancreas:
Related to the ____ of the ____
Related to the hilum of the spleen
Uncinate process:
____ vessels lie in front (But the lie behind the neck of the pancreas)
Superior mesentrice vessels
Arterial supply:
Head:
- Branches of the ____ and superior mesentric artries via superior ____ arteries and inferior ____
Neck, Body and Tail:
- Branches of the ____ arteries
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
Where does the pancreas drain to?
Splenic vein and portal vein
Sympathetic innervation of the pancreas:
- ____ pancreatic secretions
Parasympathetic innervation of the pancreas:
- ____ pancreatic secretion
Sympathetic innervation of the pancreas:
- ** Decrease** pancreatic secretions
Parasympathetic innervation of the pancreas:
- Increase pancreatic secretion
What is Pancreatitis associated with?
Alcoholism
What are the four portal-systemic anastomoses?
Oesophagus
Rectum
Umbilicus
Posterior abdominal walls
Haemorrhage is common in oesophagus and rectum
How does cancer of the head of the pancreas give rise to obstructive jaundice?
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.
Where is a major site of digestion and absorption?
Small Intestines
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 ____
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
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 ____
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
Duodenum (IMPT):
1(Superior part): 5cm long, L1 level
2(Descending): 7-10cm long, L1-L3
3(Inferior): 6-8cm, crosses L3
4(Ascending): ____
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
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)
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)
Duodenal ulcers occurs most commonly om which part of the duodenum?
1st part: Superior part
Anteriorly/ posteriorly
Anterior duodenal ulcer eroudes ____ causing ____
Posterior duodenal ulcer erodes either ____ or ____ causing ____
Anterior duodenal ulcer eroudes peritoneum causing peritonitis
Posterior duodenal ulcer erodes either gastroduodenal artery or posterior superior pancreaticoduodenal artery causing hemorrhage
What is the junction between the duodenum and jejunum called?
Duodeno jejunal junction
What is the junction between ileum and caecum called?
Ileocaecal junction
Are jejunem and ileum retroperitoneal?
No, they are entirely intraperitoneal
Jejunem and Ileum:
- Length 20 feet approximately
- Upper 2/5 jejunem rest ileum
- Jejunem loops ____ quadrant
- Ileum loops ____ quadrant
Jejunem and Ileum:
- Length 20 feet approximately
- Upper 2/5 jejunem rest ileum
- Jejunem loops left upper quadrant
- Ileum loops right lower quadrant
Jejunem and Ileum (morphology):
- ____ mesentry with long free edge and a short root
- Mucosa: ___ folds
- ___ frequent in terminal ileum
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
What morphologic features suggests the terminal ileum?
Peyer’s patches
What are the difference between jejunem and ileum?
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
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
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
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 ____
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
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)
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)
Where does the upper digestive system end?
Beginning of the duodenum
