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MD3002 GI/GU/Renal > Jejunum, Ileum and Large Intestines > Flashcards

Jejunum, Ileum and Large Intestines Flashcards

1
Q

Describe the 3 divisions of the gut

A

Foregut:

  • oesophagus to mid-duodenum
  • liver, gall bladder, spleen and 1/2 pancreas

Mid-gut:

  • mid-duodenum to proximal 2/3rds of transverse colon
  • 1/2 pancreas

Hind-gut:
- distal 1/3rd transverse colon to proximal 1/2 anal canal

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2
Q

Describe the anatomical position of the jejunum and the ileum

A
  • jejunum lies in upper left abdomen
  • ileum lies in lower right abdomen partly in pelvis
  • they hang from posterior abdominal wall by mesentery
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3
Q

Describe the features of the jejunum and ileum

A

Jejunum:

  • wide
  • more plica circulares
  • MALT (mucosa associated lymphoid tissue)
  • no Peyer’s patches

Ileum:

  • narrow
  • fewer plica circulares
  • MALT and numerous Peyer’s patches
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4
Q

What are the functions of the large intestine?

A
  • fluid-electrolyte balance
  • absorbs fluid and salts
  • dries out chyme to form faeces
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5
Q

Describe some of the characteristic features of the large intestine

A
  • taenia coli formed by thickening of longitudinal smooth muscle fibres
  • form pouches/sacculations cause haustra which are mobile
  • have epiploic/omental appendices that are tags of fat
  • no Peyer’s patches
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6
Q

Describe the anatomical position of the caecum

A
  • lies below junction of ileum with large intestine in right iliac fossa
  • in right lower quadrant/inguinal region
  • continuous with ascending colon
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7
Q

What is the ileocaecal valve and where is it found?

A
  • it is 2 horizontal folds of mucous membrane that project around the orifice of the ileum
  • found at the junction of the ileum with the caecum
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8
Q

What is teh function of the ileocaecal valve?

A

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

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9
Q

Where is the appendix found?

A

can be found in numerous positions:

  • retrocaecal
  • pelvic
  • subcaecal
  • retroileal
  • pre-ileal
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10
Q

Describe some main features of the appendix

A
  • location where 3 taeniae coli converge

- root of appendix is called McBurney’s point

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11
Q

Where can you find the root of the appendix?

A

a third of the way along the oblique line joining the right ASIS to the umbilicus

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12
Q

Where can you find the ascending colon?

A
  • between caecum and hepatic flexure
  • in right lumbar region
  • secondarily retroperitoneal
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13
Q

Describe the position and relations of the transverse colon and flexures

A
  • between hepatic and splenic flexures
  • suspended by transverse mesocolon
  • intraperitoneal
  • hepatic flexure related to liver
  • splenic flexure related to spleen
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14
Q

Where would you find the left and right paracolic gutters?

A
  • right: between right side of ascending colon and posterior abdo wall
  • left: between left side of descending colon and posterior abdominal wall
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15
Q

Describe the position of the descending colon

A
  • in left lumbar region hidden anteriorly by small intestine

- secondarily retroperitoneal (fixed to body wall)

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16
Q

Describe the position of the sigmoid colon

A
  • continuation of descending colon in front of pelvic inlet
  • intraperitoneal
  • suspended by sigmoid mesocolon
  • continuous with rectum in front of 3rd sacral vertebra
17
Q

Describe the position of the rectum

A
  • retroperitoneal
  • begins in front of 3rd sacral vertebra
  • follows curve of sacrum and coccyx
  • ends in front of tip of coccyx by piercing pelvic diaphragm and becoming continuous with anal canal
18
Q

What are the different branches of the abdominal aorta and what do they supply?

A

Midline branches:

  • celiac trunk (foregut organs)
  • superior mesenteric artery (midgut organs)
  • inferior mesenteric artery (hindgut organs)

Lateral branches:
(supply kidneys/adrenal glands, gonads, body wall)

Bifurcates into common iliacs at L4

19
Q

Superior mesenteric artery supply of the colon

A
  • middle colic artery: transverse colon
  • right colic artery: ascending colon
  • ileocolic artery: caecum
  • appendicular artery
  • a terminal artery that runs close and parallel to appendix
20
Q

Describe the differences in jejunal and ileal arteries

A
  • jejunal arteries have 1 or 2 arcades with long vasa recta in its mesentery
  • ileal arteries have many arcades with short vasa recta in its mesentery
21
Q

Inferior mesenteric artery supply of colon

A
  • branches supply distal 1/3rd of transverse colon, splenic flexure, descending colon and sigmoid colon
  • left colic artery: splenic flexure and descending colon
  • sigmoid artery: sigmoid colon
22
Q

What artery supplies rectum and anal canal?

A

the inferior mesenteric artery that continues the superior rectal artery

23
Q

What is the marginal artery of drummond and what is its benefit?

A
  • anastomoses between branches of SMA and IMA
  • if obstruction of a vessel occurs it can help prevent intestinal ischaemia by providing alternative route for blood to travel
24
Q

Describe the lymphatic drainage of the intestines

A

Peyers patches > mesenteric nodes > superior mesenteric nodes > intestinal trunk > cisterna chyli

fats > lacteals > lymph vessels > cisterna chyli

25
Q

Describe the venous drainage of the intestines

A
  • hepatic portal vein (from foregut, midgut and hindgut to liver)
  • splenic vein (from foregut to hepatic portal vein)
  • superior mesenteric vein (from midgut to hepatic portal vein)
  • inferior mesenteric vein (from hindgut to splenic vein)
26
Q

Describe the nerve supply of the intestines

A
  • runs with the 3 arteries:

Coeliac trunk:

  • receives sympathetics from T5-9
  • receives parasympathetics from vagus

Superior mesenteric:

  • receives sympathetics from T10-11
  • receives parasympathetics from vagus

Inferior mesenteric:

  • receives sympathetics from T12-L3
  • receives parasympathetics from S2-4
27
Q

Describe the referred pain regions of the intestine according to arteries

A
  • celiac trunk refers to epigastric region (T6-9)
  • superior mesenteric refers periumbilical region (T10-11)
  • inferior mesenteric refers to suprapubic area (T12)

MD3002 GI/GU/Renal (64 decks)

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