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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
What do the jejunum and ileum hang from?
A mesentery with blood vessels and lymphatics
26
Emanates from superior mesenteric vessels and fans out with the bowel along the edge of the mesentery
Root of mesentery
27
When you lift up the transverse colon, what do you expose? (PIMP question)
ligament of Trietz
28
What artery supplies the entire jejunum and ileum?
Superior mesenteric artery
29
How many branches does the SMA branch into to supply the jejunum and ileum?
15-18 branches
30
What two arrangements of vessels arise in the mesentery supplying the jejunum and ileum?
arterial arcades and straight vessels (vasa recta)
31
Where do the vasa recta enter the bowel?
On the mesenteric border
32
Where does the entire blood supply to jejunum and ileum drain into? What does this vein join with to become the portal vein?
superior mesenteric vein; splenic vein
33
The lymphatics of the jejunum and ileum ultimately drain into this structure and then into the thoracic duct
cisterna chyli
34
Where do parasympathetics to the small intestine arise from? What does parasympathetic innervation do to the small bowel?
vagus; stimulates motility
35
Where do sympathetics to the small intestine arise from?
superior mesenteric ganglion at level T9, T10
36
a 3-6 cm long pouch found in the ileum within 2 feet of the ileocecal valve
Meckel's diverticulum
37
Where does the large intestine begin? Where does it end?
Begins at the ileocecal valve at the cecum; ends at the anus
38
How long is the long intestine?
1.5 meters
39
Functions of the large intestine
absorbs water from feces | stores feces
40
The large intestine has 3 distinguishing features
teniae coli haustra coli appendices epiploicae
41
Three longitudinal muscle bands that run along the entire colon
teniae coli
42
permanent sacculations between teniae involving the circular muscle
haustra coli
43
fatty appendages attached to the teniae
appendices epiploicae
44
First portion of the ascending colon or right colon | Sac like structure
Cecum
45
Where does the cecum begin? What artery supplies it?
Begins at the ileocecal valve | Supplied by the ileocolic artery
46
What is the function of the appendix? Where is it found?
Unknown; base of the cecum
47
What is the blood supply to the appendix?
ileocolic artery
48
Classic presentation of appendicitis
periumbilical pain in the lower right quadrant
49
Where does the ascending/right colon begin and end?
Begins at the cecum; ends at the hepatic/right flexure
50
How long is the ascending colon? What is its relationship to the peritoneum? What's its blood supply?
12-20cm retroperitoneal right colic artery
51
Where does the transverse colon begin and end?
hepatic/right flexure to splenic/left flexure
52
How long is the transverse colon? What is its relationship to the peritoneum? What's its blood supply?
30-50cm intraperitoneal middle colic artery (off the SMA)
53
Where does the descending/left colon begin and end?
Begins at the left/splenic flexure and ends at the brim of the pelvis
54
How long is the descending/left colon? What is its relationship to the peritoneum? What's its blood supply?
15-20cm retroperitoneal left colic artery (off the IMA)
55
S shaped loop beginning at the pelvic brim
sigmoid colon
56
How long is the sigmoid colon? What is its relationship to the peritoneum? What is its blood supply?
``` 15-80cm intraperitoneal sigmoid arteries (off of the IMA) ```
57
Outpouchings of mucosa between the teniae coli in the colon
diverticuli
58
Where do diverticuli most commonly occur? What are the complications?
in the sigmoid colon infection (diverticulitis) bleeding
59
At what spinal level does the rectum begin? Where does it end?
S3; anus
60
How long is the rectum? What is its relationship to the peritoneum? What's its blood supply?
12-15cm retroperitoneal superior rectal artery and middle and inferior rectal arteries
61
What is a feature that distinguishes the rectum?
transverse rectal folds
62
What is a function of the rectum?
Supports the feces | Stores feces before defecating
63
Are there diverticuli on the rectum?
No
64
The cecum, ascending colon, and transverse colon ultimately drain to this lymph node
superior mesenteric lymph node
65
The descending colon, sigmoid colon, and rectum ultimately drain to this lymph node
inferior mesenteric lymph node
66
Two plexuses that provide the innervation to the large intestine
superior mesenteric | inferior mesnteric
67
What plexus provides innervation to the rectum?
middle rectal plexus
68
How long is the anus? What two things surround the anus?
2.5-5cm | internal and external sphincters
69
What nerve innervates the external anal sphincter
inferior rectal nerve
70
The superior portion of the anus has these internally
anal columns
71
The inferior portion of the anus has these internally
anal valves
72
The superior and inferior portions of the anus are separated by this
pectinate line
73
The superior anus receives its blood supply from the (blank) while the inferior anus
superior rectal artery; inferior rectal artery
74
Most common anal pathology
hemorrhoids
75
What is the difference between cholelithiasis and choledocholithiasis?
``` cholelithiasis = gallstones present docholithiasis = gallstones present in the common bile duct ```
76
What is cholecystitis?
inflammation of the gallbladder
77
What is biliary colic?
Gallstone in the neck of the gallbladder
78
Does the rectum have teneae coli or diverticuli?
NO

Block 3 Week 2 Meg (8 decks)

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