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Block 3 Week 2 Meg > Hulka: Intestine > Flashcards

Hulka: Intestine Flashcards

1
Q

First portion of the small intestine

A

duodenum

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2
Q

Where does the duodenum begin?

Where does it end?

A

after the pylorus of the stomach

ends at the ligament of Trietz

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3
Q

What is the duodenum considered in relation to the peritoneum?

A

It is retroperitoneal

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4
Q

How many divisions is the duodenum divided into?

A

four divisions

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5
Q

The first portion of the duodenum is referred to as the duodenal (blank). How long is this segment? What is it continuous with? What is its relation to the peritoneum?

A

bulb; 2-3cm; pylorus; intraperitoneal

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6
Q

What three structures lie posterior to this first portion of the duodenum?

A
  1. common bile duct
  2. gastroduodenal artery
  3. inferior vena cava
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7
Q

What can cause ulcers to develop in the duodenal bulb?

A

Increased acid from the stomach entering the bulb

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8
Q

Ulcers of the posterior side of the duodenum can perforate or bleed. What artery is typically the source of the bleeding?

A

gastroduodenal

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9
Q

The second portion of the duodenum is referred to as the (blank)

A

The C loop

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10
Q

How long is the second portion of the duodenum? What is its relation to the peritoneum?

A

8-10cm

retroperitoneal

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11
Q

What two significant things drain into the second portion of the duodenum? Through what structure do they enter?

A

common bile duct and pancreatic duct

enter through the ampulla of Vater

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12
Q

The third portion of the duodenum is referred to as the (blank) portion

A

horizontal

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13
Q

Where does the third portion of the duodenum end?

A

Where the superior mesenteric vessels cross

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14
Q

The third portion of the duodenum is where the duodenum proceeds over the (blank) from right to left

A

spine

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15
Q

Where does the fourth portion of the duodenum begin? Where does it end?

A

Begins to the left of the superior mesenteric vessels

Ends at the ligament of Trietz

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16
Q

How long is the fourth portion of the duodenum in length? What is it referred to as?

A

2-3cm; ascending portion

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17
Q

The fourth portion of the duodenum becomes the (blank)

A

jejunum

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18
Q

2 arteries that supply the duodenum

A

superior pancreaticoduodenal from the gastroduodenal artery

inferior pancreaticoduodenal from the SMA

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19
Q

Where does most of the venous drainage from the duodenum go?

A

into the superior mesenteric vein to enter the portal system (recall, blood from bowels is filtered by the liver before entering the IVC)

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20
Q

What is malrotation of the gut? What is a symptom of this?

A

When the intestine fails to return to the fetus in a rotated position during development; bilious vomiting

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21
Q

Where do the jejunum and ileum begin and end?

A

Begin at the ligament of Trietz and end at the ileocecal valve

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22
Q

How long are the jejunum and ileum together? How much of the total is thought to be jejunum?

A

6-7 meters; first 2/5ths

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23
Q

External differences between the jejunum and ileum

A

jejunum is thicker and more muscular
jejunum is more proximal
ileum is more distal

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24
Q

Internal differences between jejunum and ileum

A

circular folds (plicae) are large and well developed in the jejunum

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25
Q

What do the jejunum and ileum hang from?

A

A mesentery with blood vessels and lymphatics

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26
Q

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

A

Root of mesentery

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27
Q

When you lift up the transverse colon, what do you expose? (PIMP question)

A

ligament of Trietz

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28
Q

What artery supplies the entire jejunum and ileum?

A

Superior mesenteric artery

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29
Q

How many branches does the SMA branch into to supply the jejunum and ileum?

A

15-18 branches

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30
Q

What two arrangements of vessels arise in the mesentery supplying the jejunum and ileum?

A

arterial arcades and straight vessels (vasa recta)

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31
Q

Where do the vasa recta enter the bowel?

A

On the mesenteric border

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32
Q

Where does the entire blood supply to jejunum and ileum drain into? What does this vein join with to become the portal vein?

A

superior mesenteric vein; splenic vein

33
Q

The lymphatics of the jejunum and ileum ultimately drain into this structure and then into the thoracic duct

A

cisterna chyli

34
Q

Where do parasympathetics to the small intestine arise from? What does parasympathetic innervation do to the small bowel?

A

vagus; stimulates motility

35
Q

Where do sympathetics to the small intestine arise from?

A

superior mesenteric ganglion at level T9, T10

36
Q

a 3-6 cm long pouch found in the ileum within 2 feet of the ileocecal valve

A

Meckel’s diverticulum

37
Q

Where does the large intestine begin? Where does it end?

A

Begins at the ileocecal valve at the cecum; ends at the anus

38
Q

How long is the long intestine?

A

1.5 meters

39
Q

Functions of the large intestine

A

absorbs water from feces

stores feces

40
Q

The large intestine has 3 distinguishing features

A

teniae coli
haustra coli
appendices epiploicae

41
Q

Three longitudinal muscle bands that run along the entire colon

A

teniae coli

42
Q

permanent sacculations between teniae involving the circular muscle

A

haustra coli

43
Q

fatty appendages attached to the teniae

A

appendices epiploicae

44
Q

First portion of the ascending colon or right colon

Sac like structure

A

Cecum

45
Q

Where does the cecum begin? What artery supplies it?

A

Begins at the ileocecal valve

Supplied by the ileocolic artery

46
Q

What is the function of the appendix? Where is it found?

A

Unknown; base of the cecum

47
Q

What is the blood supply to the appendix?

A

ileocolic artery

48
Q

Classic presentation of appendicitis

A

periumbilical pain in the lower right quadrant

49
Q

Where does the ascending/right colon begin and end?

A

Begins at the cecum; ends at the hepatic/right flexure

50
Q

How long is the ascending colon? What is its relationship to the peritoneum? What’s its blood supply?

A

12-20cm
retroperitoneal
right colic artery

51
Q

Where does the transverse colon begin and end?

A

hepatic/right flexure to splenic/left flexure

52
Q

How long is the transverse colon? What is its relationship to the peritoneum? What’s its blood supply?

A

30-50cm
intraperitoneal
middle colic artery (off the SMA)

53
Q

Where does the descending/left colon begin and end?

A

Begins at the left/splenic flexure and ends at the brim of the pelvis

54
Q

How long is the descending/left colon? What is its relationship to the peritoneum? What’s its blood supply?

A

15-20cm
retroperitoneal
left colic artery (off the IMA)

55
Q

S shaped loop beginning at the pelvic brim

A

sigmoid colon

56
Q

How long is the sigmoid colon? What is its relationship to the peritoneum? What is its blood supply?

A 
15-80cm
intraperitoneal
sigmoid arteries (off of the IMA)
57
Q

Outpouchings of mucosa between the teniae coli in the colon

A

diverticuli

58
Q

Where do diverticuli most commonly occur? What are the complications?

A

in the sigmoid colon
infection (diverticulitis)
bleeding

59
Q

At what spinal level does the rectum begin? Where does it end?

A

S3; anus

60
Q

How long is the rectum?
What is its relationship to the peritoneum?
What’s its blood supply?

A

12-15cm
retroperitoneal
superior rectal artery and middle and inferior rectal arteries

61
Q

What is a feature that distinguishes the rectum?

A

transverse rectal folds

62
Q

What is a function of the rectum?

A

Supports the feces

Stores feces before defecating

63
Q

Are there diverticuli on the rectum?

A

No

64
Q

The cecum, ascending colon, and transverse colon ultimately drain to this lymph node

A

superior mesenteric lymph node

65
Q

The descending colon, sigmoid colon, and rectum ultimately drain to this lymph node

A

inferior mesenteric lymph node

66
Q

Two plexuses that provide the innervation to the large intestine

A

superior mesenteric

inferior mesnteric

67
Q

What plexus provides innervation to the rectum?

A

middle rectal plexus

68
Q

How long is the anus? What two things surround the anus?

A

2.5-5cm

internal and external sphincters

69
Q

What nerve innervates the external anal sphincter

A

inferior rectal nerve

70
Q

The superior portion of the anus has these internally

A

anal columns

71
Q

The inferior portion of the anus has these internally

A

anal valves

72
Q

The superior and inferior portions of the anus are separated by this

A

pectinate line

73
Q

The superior anus receives its blood supply from the (blank) while the inferior anus

A

superior rectal artery; inferior rectal artery

74
Q

Most common anal pathology

A

hemorrhoids

75
Q

What is the difference between cholelithiasis and choledocholithiasis?

A 
cholelithiasis = gallstones present
docholithiasis = gallstones present in the common bile duct
76
Q

What is cholecystitis?

A

inflammation of the gallbladder

77
Q

What is biliary colic?

A

Gallstone in the neck of the gallbladder

78
Q

Does the rectum have teneae coli or diverticuli?

A

NO

Block 3 Week 2 Meg (8 decks)

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