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Block 3 Week 2 Dani > Hulka Anatomy Small and Large Intestine > Flashcards

Hulka Anatomy Small and Large Intestine Flashcards

1
Q

What is the first portion of small intestine and where does it end?

A

duodenum

ends at ligament of trietz

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2
Q

What is the shortest portion of the small bowel?

A

duodenum

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3
Q

The duodenum except for the first 2-3 cm, is a completely (blank) structure

A

retroperitoneal

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4
Q 
What is this:
In continuity with the pylorus
Is the intraperitoneal portion
Approximately 2-3 cm in length
Also referred to as the duodenal bulb
The common bile duct, gastroduodenal artery and inferior vena cava run posterior to this portion of the duodenum
A

First portion of duodenal

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5
Q

(blank) can develop in the duodenal bulb due to increased acidity entering the bulb from the stomach

A

ulcers

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6
Q

If ulcers are on anterior wall of duodenum it will perforate (blank) and result in acute abdominal pain.

A

intraperitoneal

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7
Q

If ulcers are on posterior wall of duodenum it will perforate into the (blank) and have it bleed extensivly.

A

gastroduodenal artery

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8
Q

What is this:
Where the duodenum becomes retroperitoneal
Approximately 8-10 cm in length
Also referred to as the “C loop”
Where the pancreatic and common bile duct drain into the duodenum through the ampulla of Vater (hepatopancreatic ampulla)

A

second portion of duodenal

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9
Q

What portion of the duodenum is the C loop?

A

2nd portion

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10
Q

What is this:
ends where the superior mesenteric vessels cross
Approximately 5-8 cm in length
Also referred to as the horizontal portion
Where the duodenum proceeds horizontally over the spine from right to left

A

3rd portion of duodenum

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11
Q

What is this:
Begins to left of superior mesenteric vessels
Ends at the ligament of Trietz
Approximately 2-3 cm in length
Also referred to as the ascending portion
Duodenum proceeds superiorly to the left side of abdomen and acute turn where it becomes the jejunum

A

fourth portion of duodenum

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12
Q

What is the blood supply to the pancreas?

A

Superior pancreaticoduodenal artery from the gastroduodenal artery
Inferior pancreaticoduodenal artery from the superior mesenteric artery

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13
Q

What is the venous drainage of the duodenum?

A

Into superior mesentaric vein (entering portal system)

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14
Q

What is the lymphatic drainage of duodenum?

A

Drain primarily into pancreaticoduodenal lymph nodes

These ultimately drain into the celiac lymph nodes

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15
Q

What is this:
The intestine exits the fetus at 7-8 weeks development and then returns in a rotated position…or sometimes not.
Present with bilious vomiting to septic secondary to mid gut volvulus

A

malrotation

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16
Q

What is this
Second and third portions of the small intestine
Begins at the ligament of Trietz
Ends at the ileocecal valve
No obvious demarcation between these 2 things.
Both total approximately 6-7 meters
First 2/5ths thought to be (blank)

A

jejunum and ileum

jejunum

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17
Q

(blank) is usually thicker and more muscular than ileum

A

Jejunum

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18
Q

(blank) is the more proximal portion so resides in the upper abdomen

A

Jejunum

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19
Q

(blank) is more distal so resides in the pelvis and lower abdomen

A

Ileum

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20
Q

(blank) in the mucous membrane are large and well developed in the jejunum and Provides a more absorptive surface

A

Circular folds (plicae circulares)

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21
Q

Jejunum and ileum are suspended by a (blank)

A

mesentery

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22
Q

(blank) carries blood vessels and lymphatics.

A

mesentary

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23
Q

(blank) Emanates from superior mesenteric vessels and fans out with the bowel along the edge of the mesentery

A

root of the mesentary

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24
Q

Entire blood supply to jejunum and ileum comes from the (blank)

A

superior mesenteric artery

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25
Q

SMA provides (blank) branches to jejunum and ileum

A

15-18

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26
Q

Arteries unite to form (blank)

A

arterial arcades

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27
Q

From arterial arcades,what arise?

A

vasa recta or “straight vessels” arise

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28
Q

(blank) enter bowel on the mesenteric border

A

Vasa recta

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29
Q

Does the SI have collateral circulation?

A

yes via the vasa recta, arterial arcades

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30
Q

Entire blood supply to jejunum and ileum drains into the (blan) vein.
Veins and venules follow arterial supply

A

superior mesenteric vein

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31
Q

(blank) are lymphatics in the intestinal villi

A

Lacteals

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32
Q

Lacteals drain into a lymph vessel plexus in the (blank).

A

mesentery

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33
Q

Lacteals drain into a lymph vessel plexus in the mesentery

Plexus drains into (blank)

A

mesenteric lymph nodes

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34
Q

What are the three levels of mesenteric lymph nodes?

The lymphatics will ultimately drain into the (blank)

A

Next to intestine
Along arterial arcades
Along SMA
cisterna chyli and into the thoracic duct

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35
Q

What are the nerves of the small intestine?

A

Vagus and splachnic nerves

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36
Q

(blank) is a 3-6 cm long pouch found in the ileum within 50 cm of the ileocecal valve - persistent base of duct
May have fibrous cord connecting to umbilicus

A

Meckel’s diverticulum

37
Q

Embryologically, (blank) drains intestinal contents from distal small bowel through umbilicus in the womb

A

omphalomesenteric duct

38
Q

In the small intestine, parasympathetics arising from (blank) stimulates (blank)

A

vagus nerve

motility

39
Q

In the small intestine, sympathetics from superior mesenteric ganglion mediate pain from T(blank)

A

T9-T10

40
Q

Does the vagus sense pain?

A

no

41
Q

Where is meckels diverticulum?

A

in the ileum

42
Q

What can present with bleeding or obstruction in the ileum?

A

meckels diverticulum

43
Q

What is this:
Begins at the ileocecal valve, at the cecum
Ends at the anus
Approximately 1.5 meters long

A

Large intestine

44
Q

What Absorb water from feces and

Stores feces?

A

large intestine

45
Q

What is this:

Three longitudinal muscle bands that run along the entire colon

A

teniae coli

46
Q

What is this:

Permanent sacculations between teniae involving the circular muscle

A

Haustra Coli

47
Q

What are the distinguishing features of Large intestine?

A

Teniae coli
haustra coli
Appendices epiploicae

48
Q

(blank) are fatty appendages that are attached to the teniae

A

appendices epiploicae

49
Q

What is this:
Begins at ileocecal valve
Is first portion of ascending or right colon
Sac like structure

A

cecum

50
Q

What is the blood supply to the cecum?

A

ileocolic artery (branch of SMA)

51
Q

What is this:
Vestigial portion of GI tract
Function unknown - has lymphoid tissue
Begins at confluence of teniae coli, at base of cecum

A

vermiform appendix

52
Q

What is the blood supply to the appendix?

A

ileocolic artery-branch of SMA

53
Q

What is the most important question to ask patients?

A

how did things change

54
Q

What is this:
Approximately 250,000 cases annually in US
Highest incidence in age group 10-19
Classic presentation:
Periumbilical pain moving to right lower quadrant
Nausea +/- vomiting
Fever is later finding

A

appendicitis

55
Q 
What is this:
Begins at cecum
Ends at the hepatic or right flexure
Approximately 12-20 cm long
Lies retroperitoneally, along right side of abdomen
A

ascending or right colon

56
Q

Where is the appendix in relation to peritoneum?

A

it can be intraperiotoneal or retroperitoneal

57
Q

What is the blood supply to the AC of the large intestine?

A

Right colic artery-branch of SMA

58
Q 
What is this:
Begins at hepatic or right flexure
Ends at the splenic or left flexure
Approximately 30-50 cm long
Lies intraperitoneally, draped across abdomen from right to left side of abdomen
A

transverse colon

59
Q

What is the blood supply to the transverse colon?

A

middle colic artery-branch of SMA

60
Q

What is this:
Begins splenic or left flexure
Ends at the brim of pelvis - becomes sigmoid colon
Approximately 15-20 cm long
Lies retroperitoneally, along left side of abdomen

A

descending or left colon

61
Q

What is the blood supply to the left colon?

A

Left colic artery - branch of IMA

62
Q 
What is this
Begins pelvic brim - “S” shaped loop
Ends at S3- becomes rectum
Approximately 15-80 cm long
Lies intraperitoneally, in the left lower quadrant
A

sigmoid colon

63
Q

WHat is the blood supply to the sigmoid colon?

A

sigmoid arteries (2 or 3)-branches of IMA

64
Q

(blank) are Outpouchings of mucosa between teniae coli in colon

A

diverticuli

65
Q

diverticuli can occur anywhere in the colon, most commonly in the (blank)

A

sigmoid colon

66
Q

What are these complications of:

Complications include infection (diverticulitis) or bleeding (diverticular hemorrhage)

A

diverticuli

67
Q 
What is this:
Begins at S3
Ends at the anus
Approximately 12-15 cm long
Lies retroperitoneally, in the pelvis
A

Rectum

68
Q

What is the blood supply to the rectum?

A

Superior rectal artery-branch of IMA

Middle and inferior rectal arteries-branches of internal iliacs

69
Q

Are there haustra or diverticuli or tinea coli in the rectum?

A

no

70
Q

What are the internal folds of the rectum?

What do they do?

A

transverse rectal folds

aids in supporting feces

71
Q

(blank) functions to store feces before defecating

A

Rectum

72
Q

Since the rectum goes through the pelvic floor, there are no (blank)

A

diverticuli

73
Q 
What is thsi:
Terminal portion of GI tract
Approximately 2.5-5 cm in length
Begins at the puborectalis muscle
Surrounded by internal and external sphincters
Internal anal sphincter - involuntary
External anal sphincter - voluntary
A

anus

74
Q

What is the innervation to the anus?

A

External anal sphincter - inferior rectal nerve

75
Q

What is the blood supply to the anus?

A

Superior rectal artery supplies the superior part of canal

Inferior rectal arteries supply inferior part of canal

76
Q

What are some anal pathologies?

A

perirectal/perianal abscesses

Hemorrhoids (internal from superior rectal vein and external from inferior rectal vein)

77
Q

What is the lymphatic drainage of the cecum/appendix?

A

Periappendiceal LN –>superior mesenteric LN

78
Q

What is the lymphatic drainage of the ascending colon?

A

Paracolic LN –>superior mesenteric LN

79
Q

What is the lymphatic drainage of the transverse colon?

A

Superior mesenteric LN

80
Q

What is the lymphatic drainage of the descending colon?

A

inferior mesenteric LN

81
Q

What is the lymphatic drainage of the sigmoid colon?

A

inferior mesenteric LN

82
Q

What is the lymphatic drainage of the rectum?

A

-Superior portion
Pararectal LN –>Inferior mesenteric LN
-Inferior portion
Internal iliac LN

83
Q

What is the innervation of the colon?

A

Colon: superior and inferior mesenteric plexus

84
Q

What is the innervation of the rectum?

A

Middle rectal plexus –>from inferior hypogastric plexus

85
Q

What is this:
Mucosa similar to rectum
Has folds called anal columns

A

Superior portion of anus

86
Q

What is this:

Anal columns end in anal valves

A

inferior portion of anus

87
Q

Superior and inferior portions of anus is separated by (blank)

A

pectinate line

88
Q

What portions of the small and large intestine are retroperitoneal?

A

duodenum
ascending/right colon
descending/left colon
rectum

Block 3 Week 2 Dani (9 decks)

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