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MD3002 - GI Anatomy > Jejunum, Ileum and Large Intestines > Flashcards

Jejunum, Ileum and Large Intestines Flashcards

1
Q

What is the longest part of the GI tract?

A

jejunum and ileum

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2
Q

Describe the jejunum and ileum?

A

convoluted tube that runs from the duodenojejunal junction to the ileocecal valve

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3
Q

What best describes the change from jejunum to ileum?

A

gradual - no clear boundary

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4
Q

Where does the jejunum lie?

A

upper left abdomen

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5
Q

Where does the ileum lie?

A

lower right abdomen and partly in the pelvis

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6
Q

What is the ratio of jejunum to ileum?

A

40% jejunum - 60% ileum

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7
Q

What do the jejunum and ileum had from and what are they suspended by?

A

posterior abdominal wall by the mesentery

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8
Q

What structures does the small intestine cross?

A
  • base crosses 3rd part of the duodenum
  • aorta
  • inferior vena cava
  • right gonadal vessels
  • right ureter
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9
Q

What is contained within the mesentery?

A
  • branches of the superior mesenteric artery, forming anastomatic arcades
  • branches of the superior mesenteric vein
  • lymph vessels
  • nerves
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10
Q

Describe the jejunum?

A
  • wide
  • more plica circulares
  • no peyer’s patches
  • MALT (mucous associated lymphoid tissue)
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11
Q

Describe the ileum

A
  • narrow
  • fewer plic circulares
  • numerous Peyer’s patches (aggregations of lymphoid tissue along the antimesenteric border)
  • MALT
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12
Q

What does the ilecocecal valve consist of?

A

2 horizontal folds of mucous membrane that project around the orifice of the ileum

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13
Q

Where is the ileocecal valve situated?

A

at the junction of the small intestine and the large intestine (caecum)

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14
Q

What is the function of the ileocecal valve?

A

limit the refluc of colonic contents into the ileum and possibly control the flow of ileal contents into the caecum

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15
Q

What are jejunal and ileal arteries branches of?

A

superior mesenteric artery

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16
Q

Where does the superior mesenteric artery arise from?

A

aorta at the lower border of L1

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17
Q

What does the superior mesenteric artery supply?

A

Supplies the midgut (from ampulla of Vater in duodenum to 2/3 along the transverse colon)

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18
Q

What does the superior mesenteric artery form within the mesentery?

A

series of vascular anastomotic arcades

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19
Q

What has one pr two arcades with long vasa recta in the mesentery?

A

jejunum

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20
Q

What has many arcades with short vasa recta in its mesentery?

A

ileum

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21
Q

Where do jejunal and ileal veins drain into? And what does this eventually form?

A

superior mesenteric vein

portal vein

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22
Q

Draw a diagram indicating the lymphatic drainage of the small intestine

A
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23
Q

How is the mucous memrbane of the small intestine adapted to increase asbsoprtive SA?

A

raised in multiple villi (finger-like projections)

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24
Q

What is the function of the lacteal at the centre of each villus?

A

absoption of digested fats and lipids (chyle)

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25
Q

Where does chyle pass from and to?

A
  • pass from lacteals into mesenteric lymph channels
  • don’t pass through lymph nodes
  • coverge on cisterna chyli
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26
Q

Where does cisterna chyli lie and where does it pass through?

A
  • lies in upper abdomen
  • pass through diaphragm as the thoracic duct
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27
Q

Draw a diagram showing the nerve supply of the small intestine

A
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28
Q

Where is pained referred from the small intestine

A

periumbilical (T10)

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29
Q

What are the functions of the large intestine?

A
  • fluid-electrolyte balance - absorbs fluids and salts
  • Dries out the chyme to form faeces
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30
Q

Where does the LI run between?

A

caecum to the rectum and anal canal

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31
Q

How long is the LI?

A

approximately 1.5m long

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32
Q

What are the components of the LI?

A

Caecum, ascending colon, hepatic (right colic) flexure, transverse colon, splenic (left colic) flexure, descending colon, sigmoid colon

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33
Q

What parts of the LI are retroperitoneal?

A

ascending & descending colon

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34
Q

What parts of the LI are on the mesentery? (intraperitoneal)

A

transverse & sigmoid colon

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35
Q

How does the diameter of the LI compare with the SI?

A

larger unless contracted by a wave of peristalsis

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36
Q

What do longitudnal smooth muscle fibres thicken to form?

A

3x taenia coli

37
Q

What length are taenia coli?

A

shorter than the LI

38
Q

What are the sacculations/pouches of the LI known as?

A

haustra

mobile

39
Q

What is the name for the tags of fat in the LI?

A

Possesses epiploic/omental appendices (appendices epiploicae)

40
Q

What does the LI lack that is present in the SI?

A

Peyer’s patches

41
Q

What is the widest and first part of the LE?

A

caecum

42
Q

Where is the caecum located?

A

Lies below the junction of the ileum with the large intestine in the right iliac fossa

43
Q

What is the caecum continous with?

A

Continuous with the ascending colon

44
Q

What is the caecum covered by?

A

Covered by peritoneum but not on a mesentery

45
Q

How does the ileum enter the caecum?

A

enters the caecum obliquely and partly invaginates into it, forming ileocaecal orifice

46
Q

What is the veriform appendix?

A

A blind intestinal diverticulum, from the posteromedial aspect of the caecum

47
Q

What cinverge of the root of the veriform appendix? And what is the name of this point?

A

The 3 taeniae coli converge at the root of the vermiform appendix

Root of vermiform appendix is at McBurney’s point

48
Q

Describe the submucosa of the veriform appendix

A

packed full of lymphoid tissue

49
Q

Where is the veriform appendix suspended?

A

suspended on a short but highly variable mesoappendix that transmits the appendicular vessels

50
Q

What are the differnet anatomical positions the veriform appendix can be found in?

A

retrocaecal (65%); pelvic (30%); subcaecal; retroileal; pre- ileal

51
Q

Where does the base of the appendix most often lie deep to?

A

a point that is one third of the way along the oblique line joining the right anterior superior iliac spine to the umbilicus (McBurney point).

52
Q

Where is the ascending colon located?

A

in the right lumbar region

53
Q

What is the ascending colon between?

A

caecum and hepatic flexure

54
Q

Describe the attachment of the ascending colon

A

secondarily retroperitoneal

55
Q

Where is the right parabolic gutter formed?

A

between ascending colon and posterior abdominal wall

56
Q

Where does the transverse colon extend between?

A

hepatic and splenic flexures

57
Q

What is the transverse colon suspended by?

A

transverse mesocolon

58
Q

Describe the attachment of the transverse colon

A

intraperitoneal

59
Q

What is the hepatic (right colic) flexture related to?

A

liver

60
Q

What is the splenic (left colic) flexture related to?

A

spleen

61
Q

What is the transverse mesocolon?

A

mesentery of the ytransverse colon

62
Q

What does the root of the transverse mesoclon cross?inferior edge of the pancreas in the left lumbar region

A
63
Q

Where is the descending colon located?

A

left lumbar regiom, hidden anteriroly by the small intestine

64
Q

What forms the left paracolic gutter?

A

descending colon and posterior abdominal wall

65
Q

What is the sigmoid colon a continuation of?

A

Continuation of the descending colon in front of the pelvic inlet

66
Q

What is the sigmoid colon suspended by?

A

sigmoid mesocolon

67
Q

What is the sigmoid colon continous with?

A

Continuous with the rectum in front of the 3rd sacral vertebra

68
Q

Where is the rectum located within the peritoneum?

A

Retroperitoneal

69
Q

Where does the rectum begin?

A

in front of 3rd sacral vertebra

70
Q

What does rhe rectum follow the curve of?

A

sacrum and coccyx

71
Q

Where does the rectum end?

A

Ends in front of the tip of the coccyx by piercing the pelvic diaphragm & becoming continuous with the anal canal

72
Q

What does the rectum lack?

A

Lacks taenia, haustra or appendices epiploica

73
Q

What is the function of the rectum?

A

Stores faeces

74
Q

How long is the anal canal

A

approx. 4cm

75
Q

What is the anal canal

A

canal from pelvic diaphragm to the anus

conduit to the outside world

76
Q

Where does the superior mesenteric artery originate

A

lower border of L1 vertebra

77
Q

What do branches of the superior mesenteric artery supply?

A

part of the large intestine, from vermiform appendix to proximal 2/3 of the transverse colon

78
Q

What are the 3 main branches of the superior mesenteric artery that form anastomoses in the LI

A

− Ileocolic artery: Caecum; appendicular artery

− Right colic artery: Ascending colon

− Middle colic artery: Transverse colon

79
Q

Describe the appendicular artery

A

a terminal artery that runs close and parallel to the appendi

80
Q

Where does the inferior mesenteric artery arise from?

A

arises from aorta at L3

81
Q

What do the branches of the inferior mesenteric artery supply?

A

supply distal 1/3 of the transverse colon, the splenic flexure, descending colon & sigmoid colon

82
Q

What are the branches of the inferior mesenteric artery and what do they supply?

A

− Left colic artery: Splenic flexure, descending colon

− Sigmoid artery: Sigmoid colon

83
Q

What does the inferior mesenteric artery end as?

A

ends as the superior rectal artery supplying the rectum & anal canal

84
Q

What nerves run with the coeliac trunk to the foregut?

A

− Sym from T5-9 (greater splanchnic)

− PSym from vagus

85
Q

What nerves run with the superior mesenteric artery to the midgut?

A

− Sym from T10-11 (lesser splanchnic)

− PSym from vagus

86
Q

What nerves run with the inferior mesenteric artery to the hindgut?

A

− Sym. from T12-L3 (least splanchnic and lumbar splanchnic nerves)

− Psym. from S2-4

87
Q

Where does pain from areas supplied by the coeliac trunk refer to?

A

epigastric region (T7-9)

88
Q

where does Pain from areas supplied by Superior
mesenteric artery refer to?

A

Periumbilical region (T10-11)

− Appendicitis pain in the first 6-8h

89
Q

Where does pain from areas supplied by the inferior mesenteric artery refer to?

A

suprapubic region (T12)

MD3002 - GI Anatomy (11 decks)

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