L21- Hindgut Flashcards

1
Q

What is the major artery supplying the hindgut?

A

inferior mesenteric artery

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2
Q

What viscera are included in the hindgut?

A
  • distal transverse colon
  • descending colon
  • sigmoid colon
  • rectum
  • proximal anus
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3
Q

What is the mesentery off of the sigmoid called?

A

The sigmoid mesocolon

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4
Q

What is the junction between the rectum and sigmoid called? What is no longer visible at this point on the colon?

A
  • The rectosigmoid junction
  • tenia coli no longer visible
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5
Q

What are fistulae?

A

Patent connections when developmentally connected structures fail to disconnect

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6
Q

Where does the inferior mesenteric artery arise?

A

From the abdominal aorta at the L3 level

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7
Q

What are the main branches of the inferior mesenteric artery

A
  • left colic artery
  • sigmoid artery (2-4)
  • superior rectal artery
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8
Q

What is the major vein of the hindgut?

A

The inferior mesenteric vein (parallels the arteries, as do the left colic, sigmoid and superior rectal)

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9
Q

What are the three major tributaries to the hepatic portal system?

A
  • splenic vein
  • superior mesenteric vein
  • inferior mesenteric vein
  • also contributions from the right and left gastric veins
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10
Q

The superior rectal vein and Inferior Mesenteric Vein are part of what system?

A

The portal system

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11
Q

The middle and inferior vein to the internal iliac are part of what system?

A

The caval system

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12
Q

What are the hidden retroperitoneal varices?

A

Retroperitoneal portions of the GI may drain via lumbar veins directly to the IVC -can also drain through the portal system

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13
Q

What is the pathway for the lymphatics of the hindgut?

A

Inferior mesenteric and lumbar lymph nodes –> chyle cistern –> thoracic duct

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14
Q

Sympathetic preganglionic fibers originate from where?

A

T1-L2

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15
Q

Sympathetics to the body wall synapse where?

A

In the paravertebral ganglion and exit via rami

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16
Q

What do the sympathetics of the abdomen cause? Where do these nerves originate?

A
  • Inhibit peristalsis, reduce blood flow via vasoconstriction
  • originate from lateral horn of T5-L2
17
Q

Where do the sympathetics to the abdominal viscera synapse?

A

Exit the paravertebral ganglia via abdominopelvic splanchnic nerves -synapse on prevertebral ganglia -travel to target organs on blood vessels

18
Q

What is the splanchnic nerve to the foregut called?

A

Greater splanchnic nerve (T5-T9)

19
Q

What is the splanchnic nerve to the midgut called?

A

Lesser splanchnic nerve (T10-T11)

20
Q

What is the splanchnic nerve to the kidneys called?

A

Least splanchnic nerve (T12)

21
Q

What are the splanchnic nerve to the hindgut and pelvis called?

A

Lumbar splanchnic nerves (T12-L2)

22
Q

What are the prevertebral ganglia of the foregut, superior mesenteric, inferior mesenteric called?

A
  • Foregut: Celiac (greater splanchnic nerves)
  • Midgut: Superior mesenteric (lesser/least splanchnic nerves)
  • Hindgut: Inferior mesenteric (lumbar splanchic nerves)
23
Q

Where do parasympathetic fibers synapse?

A

In the ganglia in walls of target organs (body walls have no parasympathetics)

Preganglionic fibers: cranial nerves or S2-S4

24
Q

What are the functions of parasympathetics in the abdomen?

A

Stimulate peristalsis of abdominal organs

25
Q

What nerve provides the parasympathetics of the foregut and midgut?

A

Vagus (CN X)

26
Q

What nerve provides the parasympathetics of the hindgut?

A

Pelvic splanchnic nerves from S2-4

27
Q

Which vagus nerve can you find anteriorly? Which is posterior to the esophagus?

A
  • Anterior- Left vagus
  • Posterior- Right vagus (travel with esophagus to abdomen)
28
Q

What pathway does the sensation of pain follow in the foregut/midgut?

A

The sympathetic pathway backward (thoracic, lumbar or sacral splanchnic nerves)

29
Q

What pathway does the sensation of pain follow in the hindgut?

A

The parasympathetic pathway backward (pelvic splanchnic nerves)

30
Q

What does the non-pain sensation follow in the foregut and midgut?

A

The parasympathetic backward (vagus)

31
Q

What pathway does the non-pain sensation follow in the hindgut?

A

The parasympathetic pathway backward (pelvic splanchnic nerves)

32
Q

What is referred pain?

A

Visceral pain interpreted as somatic as they both enter the posterior horn -(when parietal peritoneum/pleura get inflamed the pain becomes sharp and localized as this has a somatic sensation innervation)