Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Block 3; Week 2 > Hulka > Flashcards

Hulka Flashcards

1
Q

Which section is the shortest portion of the small bowel? What are the boundaries of this portion of bowel?

A

Dudoenum

Begins @ pylorus of stomach & ends at ligament of Trietz (this is the beginning of the jejunum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 3 branches off of the celiac trunk?

A

left gastric
common hepatic
splenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Is the duodenum intraperitoneal or retroperitoneal?

A

The first 2-3 cm are intraperitoneal…

the rest of the duodenum is retroperitoneal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How many divisions are there to the duodenum?

A

4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where is the ligament of Treitz found?

A

This is a suspensory muscle that marks the division b/w the duodenum & the jejunum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the first portion of the duodenum?

A

This is the 2-3 cm that is intraperitoneal. It begins after the pylorus.
It is also referred to as the duodenal bulb.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What 3 vessels run behind the first part of the duodenum?

A

common bile duct
gastroduodenal artery
IVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the clinical significance of the first portion of the duodenum?

A

This is the site for duodenal ulcer disease.

They can develop here b/c of the increased acidity of the stuff leaving the stomach & going straight here.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 2 things that ulcers in this region can do? Where do they often do it?

A

Perforate: bile & acids into intraperitoneal space
–>usu happens on the anterior portion
Bleed: a ton of blood can leave the gastroduodenal artery b/c close to the aorta
–>usu happens on the posterior portion
–>needs to be ligated to stop the bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the area behind the stomach called?

A

the lesser sac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How long is the second portion of the stomach? What is it commonly referred to as? Is it intraperitoneal or retroperitoneal?

A

Retroperitoneal now!!
8-10 cm
C-loop
**the pancreas kind of snuggles up in there.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What important thing drains here?

A

This is where the pancreatic duct & common bile duct come together as the ampulla of Vater & drain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is another name for the ampulla of Vater?

A

hepatopancreatic ampulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How long is the third portion of the duodenum? What is it also referred to as? What significant thing happens here? Intra or retroperitoneal?

A

5-8 cm in length
Retroperitoneal
Horizontal portion
**proceeds horizontally from right to left
**the SMV & SMA cross anterior to the duodenum @ the third portion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How long is the fourth portion of the duodenum? Intra or retroperitoneal? Where does it begin & end?

A

2-3 cm
Retroperitoneal
Begins to the left of the SMV/SMA
Ends @ ligament of trietz (beginning of the jejunum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the journey of the fourth portion of the duodenum? What is another name for it?

A

Ascending portion
It begins left of the SMV/SMA & has a short journey where it hikes superiorly & to the left. Then it takes a perilous dive after the ligament of trietz at which point it is the jejunum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the blood supply to the duodenum very similar to? What are the 2 main arteries that are responsible?

A

very similar to the pancreas

  1. superior pancreaticoduodenal artery
  2. inferior pancreaticoduodenal artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Starting w/ the abdominal aorta…& ending with the superior pancreaticoduodenal artery…describe the branching pathway.

A 
Abdominal Aorta
Celiac Trunk
Common Hepatic Artery
Gastroduodenal Artery
Superior Pancreaticoduodenal Artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Starting w/ the abdominal aorta…& ending with the inferior pancreaticoduodenal artery…describe the branching pathway.

A

Abdominal Aorta
Superior Mesenteric Artery
Inferior Pancreaticoduodenal Artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe the venous drainage of the duodenum.

A

Most of the drainage of the duodenum goes into the superior mesenteric vein. This drains into the portal vein. It goes into portal circulation–>cycles thru the liver.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe the lymphatic drainage of the duodenum.

A

the lymph first drains into the pancreaticoduodenal lymph nodes. It then drains into the celiac nodes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What’s the deal w/ a malrotation of the small bowel?

A

@ 7-8 weeks the intestine exits the fetus to become properly rotated and goes back in. This is where a 270 degree rotation forms the C loop of the duodenum. This is also when the duodenum tucks underneath the superior mesenteric vessels. When it doesn’t do this properly–>malrotation & problems.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the problems with malrotation?

A

the malrotation can make the mesentery very tight & easily turned about to strangle a blood vessel. This is called a mid gut volvulus. It can kill the bowel & cause short bowel syndrome.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the symptoms of malrotation & when do they usu show up?

A

could show up in a newborn, but not necessarily
bilious vomit (green)
This makes you think–>oh no! mid gut volvulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is a crus of the diaphragm? Plural–crura of the diaphragm?

A

tendinous structures that extend inferiorly into the diaphragm & attach to the vertebral column & create a tether for muscle contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the ligament of treitz really a continuation of?

A

the crus of the right diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the blood supply of the jejunum & ileum?

A

the SMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

The last chunk of the small intestine (jejunum & ileum) begins where & ends where? How long is the portion all together?

A

Begins @ ligament of Trietz
Ends @ ileocecal valve
6-7 meters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which portion of the last chunk of small intestine (jejunum & ileum) is jejunum? What is the point of division?

A

The first 2/5 of this last chunk is jejunum. However, there is no structure that demarcates this.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are important external differences b/w the jejunum & the ileum?

A

The jéjunum is thicker & more muscular than the ileum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Generally…where is the jejunum found in the body? How about the ileum?

A

Jejunum: upper abdomen, more toward the left
Ileum: lower abdomen & pelvis, more toward the right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the internal difference b/w the jejunum & ileum?

A

The jéjunum has more well developed plicae circulares in the mucous membrane. This provides an absorptive surface.
Note: if a portion of the SI is removed…other portion can adapt & develop their plicae.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

The jéjunum & ileum are suspended from what structure?

A

Mesentery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What does the mesentery carry w/i it?

A

blood vessels & lymphatics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

If the mesentery is a skirt…what is at the waist? What is at the hem?

A

Waist: root of the mesentery–>emanates from the superior mesenteric vessels & fans out along the bowel…begins underneath the transverse colon
Hem: bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the border of the bowel called that is closest to the mesentery? The part of the bowel that is furthest from the mesentery?

A

Closest to the mesentery: mesenteric border

Furthest from the mesentery: anti-mesenteric border

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

When you are looking at whether or not you need to remove a section of the bowel…do you look at the mesenteric border or the anti-mesenteric border?

A

The anti-mesenteric border b/c that is furthest from the blood supply & shows the true health of the bowel. Remember: when you remove bowel–>there is still collateral flow that will keep the remaining bowel healthy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Describe the blood supply to the jejunum & the ileum.

A

It begins @ the SMA, which gives off 15-18 branches, called jejunal & ileal intestinal arteries. Then these form loops called arcades (help w/ collateral flow).
Then it forms the straight arteries aka vasa recta.
The vasa recta enter the mesenteric side of the bowel.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Describe the venous drainage of the jejunum & ileum.

A

It mirrors the arterial supply. It even has arcade-like loops. It drains into the SMV & then into the portal vein.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Describe the lymphatic drainage of the small intestine.

A

Lacteals in the intestinal villi drain into the lymphatic plexus (which is a part of the mesentery). This plexus drains into the mesenteric lymph nodes.
Then they drain into the cisterna chyli and into the thoracic duct.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the 3 levels of mesenteric lymph nodes?

A

Those @ 3 locations:
Next to the intestine
Along arterial arcades
Along the SMA

42
Q

What is the embryological roots of Meckel’s diverticulum?

A

It begins embryologically as the omphalomesenteric duct, which connects the distal small bowel to the umbilicus. It drains the intestinal contents.

43
Q

What is Meckel’s diverticulum?

A

A 3-6 cm pouch in the ileum, w/i 2 feet of the ileocecal valve.
Can present as a persistent omphalomesenteric duct (somewhat common) OR w/ a fibrous cord connecting it to the umbilicus (very rare) OR just a little pouch (very common).

44
Q

Does the Meckel’s diverticulum have a blood supply? If so, where?

A

Yes. On the anti-mesenteric border.

45
Q

What are the 3 ways that you might find Meckel’s diverticulum?

A

Just randomly during a cadaver dissection or abdominal surgery…
B/c it caused an obstruction by telescoping during peristalsis (intussusception).
B/c it is bleeding from an ulceration to the gastric mucosa inside. Note: gastric mucosa isn’t always inside.

46
Q

What is the rule of 2s with Meckel’s diverticulum?

A

2% of the population has it.
Only 2% of the people who have it are symptomatic.
The pouch is 2 inches long.
The diverticulum is found w/i the 2 feet proximally of the ileocecal valve.

47
Q

Where does the large intestine begin & end? How long is it? What are its 2 functions?

A 
Begins @ ileocecal valve
Ends @ anus
1.5 meters long (5-6 feet)
Absorbs water
Stores feces
48
Q

What is the order of sections of the LI from beginning to end?

A 
Ileocecal valve
Right colon/Ascending colon
Hepatic Flexure
Transverse Colon
Splenic Flexure
Left Colon/Descending Colon
Sigmoid Colon
Rectum
Anus
49
Q

What are the 3 distinguishing features of the LI?

A

Teniae Coli: 3 longitudinal muscle bands that run the full length of the colon
Haustra Coli: circular muscle that creates little pouch-looking things along the length of the colon…
Appendices Epiploicae: fatty appendages attached to the teniae coli.

50
Q

Do the small intestines have longitudinal & circular muscle or only the LI?

A

Both have longitudinal & circular muscles. It is just much more obvious in the LI.

51
Q

Does the SI have fat hanging off of it in portions?

A

NO. Only the LI as a sort of fat store.

52
Q

Where does the cecum begin? What is it a part of? What is its blood supply?

A

Begins @ the ileocecal valve
A part of the ascending colon
sac-like structure
Blood supply: ileocolic artery (branch of SMA)

53
Q

Where is the appendix found? What is its blood supply? What is its function?

A

found @ base of cecum & confluence of teniae coli.
Blood supply: ileocolic artery (branch of SMA)
Function: unknown, vestigial structure, is full of lymphoid tissue

54
Q

T/F The appendix has its own mesentery.

A

True.

55
Q

How does somebody get appendicitis?

A

When stool or something blocks the appendix & inflammation of the lymphoid tissue occurs.

56
Q

What age group is appendicitis most often present in?

A

Age 10-19.

57
Q

What is the classical presentation of appendicitis?

A

Starts off as periumbilical pain at first.
Nausea & Vomiting present.
Pain becomes localized & moves to the RLQ as it becomes more inflamed & peritoneal irritation occurs–> somatic neurons here.
Fever may occur later if it ruptures.

58
Q

What are the 2 sources of the nerves of the small intestine?

A

Vagus nerve & splanchnic nerves

59
Q

What does the parasympathetic nerve supply promote & what nerve is associated w/ this?

A

Promotes motility

Vagus nerve

60
Q

Where does the sympathetic nerve supply come from?

A

Superior Mesenteric Ganglion

T9 & T10 segments

61
Q

Visceral pain of the bowel is mediated by what? What does this feel like?

A

Mediated by thoracic nerve segments, not the vagus nerve…

More general, nonspecific pain.

62
Q

Irritation of the actual peritoneum can be caused by what? What does this feel like? How is this information carried?

A

Blood, air, acid, infection
localized pain
somatic neurons

63
Q

Where does the ascending/right colon begin? Where does it end? How long is it? Is it intra or retro?

A

It begins @ the cecum
It ends @ the hepatic flexure or right flexure
It is 12-20 cm long.
It is retroperitoneal.

64
Q

What is the blood supply to the ascending colon?

A

The right colic artery, which is a branch of the SMA.

65
Q

Where does the transverse colon begin? Where does it end? How long is it? Intra or retro?

A

Begins @ the hepatic flexure/right flexure
Ends @ the splenic flexure/left flexure
30-50 cm long
Intraperitoneal

66
Q

What is the course of the transverse colon?

A

Intraperitoneal.

From the right side of the abdomen to the left…

67
Q

What is the blood supply to the transverse colon?

A

Middle colic artery (branch off of the SMA)

68
Q

Where does the descending colon/left colon begin & end? How long? Intra or retro?

A

Begins @ the splenic flexure/left flexure
Ends @ sigmoid colon/pelvic brim
15-20 cm long
Retroperitoneal

69
Q

What is the blood supply of the descending colon?

A

Left colic artery (branch off of the IMA)

70
Q

Where does the sigmoid colon begin & end? How long is it? Intra or retro?

A

Begins @ pelvic brim
Ends @ rectum
15-80 cm long
Intraperitoneal (in the LLQ)

71
Q

What is a complication of the sigmoid colon being as long as 80 cm in some people?

A

In elderly patients who already struggle with their bowels…having a super long sigmoid colon can create a sigmoid volvulus where it turns in on itself…this can create terrible constipation.

72
Q

What is the blood supply to the sigmoid colon?

A

2 or 3 sigmoid arteries off of the IMA

73
Q

What are diverticuli?

A

pouches off of the colon in b/w teniae coli

usu occur in the sigmoid colon

74
Q

What are 3 possible results when you have diverticuli?

A

Diverticulitis: infection of your diverticuli
Diverticular Hemorrhage: bleeding of the diverticuli
Perforation of the diverticuli: stuff spills out

75
Q

Where does the rectum begin & end? How long is it? Intra or retro?

A

Begins @ S3 vertebrae (end of sigmoid)
Ends @ anus
12-15 cm
Retroperitoneal in the pelvis

76
Q

Describe the blood supply to the rectum. Note: this is an area with collateral flow.

A

Superior Rectal Artery (branch off of IMA)

Middle & Inferior Rectal Arteries (branches of the internal iliacs)

77
Q

What are 2 things that the rectum doesn’t have that the sigmoid colon does have?

A

Doesn’t have:
teniae coli
diverticuli (b/c of the support of the pelvic floor)

78
Q

What is the function of the rectum?

A

to support & store feces before defecation.

79
Q

What does the rectum have that the sigmoid colon doesn’t have?

A

Does have:
internal transverse rectal folds
**they help break up the feces
**they are continuations of the teniae

80
Q

What is the lymphatic drainage of the cecum & appendix?

A

periappendiceal lymph node
to the
superior mesenteric lymph node

81
Q

What is the lymphatic drainage of the ascending colon?

A

paracolic lymph node
to the
superior mesenteric lymph node

82
Q

What is the lymphatic drainage of the transverse colon?

A

Superior mesenteric lymph node

83
Q

What is the lymphatic drainage of the descending colon?

A

Inferior Mesenteric lymph node

84
Q

What is it important to do during oncologic surgery of the colon?

A

Remove the mesentery which has the blood supply & lymph drainage…
this is the way that cancer spreads.
Blood vessels are often removed up to the IMA

85
Q

What is the lymphatic drainage of the sigmoid colon?

A

Inferior Mesenteric Lymph node

86
Q

What is the lymphatic drainage of the superior portion of the rectum?

A

pararectal lymph nodes
to the
inferior mesenteric lymph nodes

87
Q

What is the lymphatic drainage of the inferior portion of the rectum?

A

internal iliac lymph nodes

88
Q

What are the 2 innervations of the large intestine?

A

The colon is supplied by both the superior mesenteric plexus (the portion supplied by SMA)
& the inferior mesenteric plexus (portion supplied by IMA)

89
Q

What is the innervation of the rectum?

A

the middle rectal plexus (from the inferior hypogastric plexus)

90
Q

Where does the anus begin? How long is it?

A

begins @ the puborectalis muscle

2.5-5 cm or 1-2 inches long

91
Q

What’s the deal with the anal sphincters?

A

Internal anal sphincter involuntary

External anal sphincter voluntary

92
Q

What’s the change of tissue in the anus?

A

there is a transition from intestinal mucosa to anoderm (skin).

93
Q

What is the innervation of the anus?

A

The external anal sphincter is innervated by the inferior rectal nerve.

94
Q

What are distinguishing features of the superior portion of the anus?

A

mucosa similar to the rectum

folds called anal columns that allow for stretching for feces

95
Q

What are distinguishing features of the inferior portion of the anus?

A

the anal columns seen in the superior portion end @ the anal valves…around this section is the pectinate line & the division b/w the superior & inferior

96
Q

What are hemorrhoids?

A

dilations of the veins in the anal region

97
Q

Describe the venous drainage of the anus.

A

The middle & inferior portions of the anus are drained by iliac veins…
The superior portion of the anus is drained by the superior rectal vein

98
Q

What is the arterial supply for the superior portion of the anus?

A

Superior rectal artery

99
Q

What is the arterial supply for the inferior portion of the anus?

A

inferior rectal artery

100
Q

Internal hemorrhoids are dilations of what vein? External hemorrhoids are dilations of what vein?

A

Internal: superior rectal vein
External: inferior rectal vein

101
Q

SMA & SMV cross over which part of the duodenum?

A

the 3rd portion

Block 3; Week 2 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions