Lab Guide 55-56

Question 1

What are the segments of the duodenum?

Answer 1

first (superior)
second (descending)
third (horizontal)
fourth (ascending)

Question 2

What vertebra level is the first segment of the duodenum at?

Answer 2

L1 (in the transpyloric plane)

Question 3

Does the superior segment of the duodenum pass slightly upward or downward from the pylorus?

Answer 3

upward

Question 4

Which part of the duodenum is intraparitoneal?

Answer 4

only the 1st, the 2nd-4th are retroparitoneal

Question 5

What provides the visceral paritoneum for the first segment of the duodenum

Answer 5

the hepatoduodenal ligament

Question 6

What runs posterior to the first part of the duodenum?

Answer 6

the gastroduodenal artery and common bile duct

Question 7

Is the head of the pancreas inferior or superior to the superior segment of the duodenum?

Answer 7

inferior

Question 8

The second part of the duodenum spans which vertebrae?

Answer 8

L1-L3

Question 9

What is anterior to the second part of the duodenum?

Answer 9

the transverse colon crosses it anteriorly

Question 10

What is posterior to the second part of the duodenum?

Answer 10

hilum of the right kidney and renal vessels

Question 11

What enters the second part of the duodenum? Specifically at what part?

Answer 11

Near its midpoint (and adjacent to the pancreas), the fused common bile duct and main pancreatic duct enter the duodenum at the greater duodenal papilla

Question 12

The 3rd part of the duodenum crosses over the midline (to the left) where?

Answer 12

at L3 level

Question 13

What is anterior to the third part of the duodenum?

Answer 13

root of mesentery and superior mesenteric vessels

Question 14

What is posterior to the third part of the duodenum?

Answer 14

IVC and aorta

Question 15

The angle between the superior mesenteric artery and the abdominal aorta is called?

Answer 15

the ‘nutcracker’

Question 16

To the left of the midline, what does the 4th part of the duodenum ascend to?

Answer 16

the duodenojejunal flexure

Question 17

What vertebra level is the duodenojejunal flexure at?

Answer 17

L2

Question 18

Is the aorta to the right or left to the 4th part of the duodenum?

Answer 18

right

Question 19

Is the pancreas retroparitoneal?

Answer 19

Yes, except for its tail

Question 20

Horizontally, what two organs does the pancreas span between?

Answer 20

duodenum to the right and spleen to the left

Question 21

Does the mesenteric artery run anterior or posterior to the pancreas?

Answer 21

Posterior, it then becomes anterior to the 3rd part of the duodenum as it passes though the small gap that spans the inferior margin of the pancreas and the superior margin of the duodenum

Question 22

The hook like portion of the head of the pancreas that projects posterior to the superior mesenteric vessels what?

Answer 22

the uncinate process

Question 23

What portion of the pancreas lies anterior to the superior mesenteric artery?

Answer 23

the neck

Question 24

the anterior and posterior inferior pancreaticoduodenal arteries branch from which artery?

Answer 24

the superior mesenteric artery

Question 25

How does the tail of the pancreas reach the spleen?

Answer 25

by entering the lienorenal ligament at a slightly superior angle as it runs horizontally

Question 26

The duodenojejunal flexure is suspended by what?

Answer 26

the ligament of Treitz

Question 27

Where does the superior mesenteric artery branch from the abdominal aorta?

Answer 27

the inferior aspect of the first lumbar vertebra (in the transpyloric plane) immediately inferior to the celiac trunk

Question 28

Does the SMA run deep or superficial to the pancreas? Which part?

Answer 28

deep to the neck (where it gives off the inferior pancreaticoduodenal arteries)

Question 29

What three things does the SMA pass anterior to as it enter the mesentery proper?

Answer 29

left renal vein, uncinate process of pancreas, and 3rd part of duodenum

Question 30

Does the SMA descend anterior or posterior to the abdominal aorta? To the left or to the right?

Answer 30

anterior and slightly to the right. As it descends it gives off 10-12 intestinal branches from its left side that supply the jejunum and ileum

Question 31

What do intestinal branches of the SMA go on to form?

Answer 31

They form anastomosing networks of vascular arcades which then give off straight arteries that run to the small intestine

Question 32

Is the middle colic artery a branch of the SMA or IMA?

Answer 32

SMA. Along with the right colic and ileocolic arteries (and the intestinal arteries)

Question 33

Where does the the middle colic artery go once branching from the SMA?

Answer 33

it runs superior and to the right (at varying degrees) and branches into right and left branches that form portions of the marginal artery near the transverse colon

Question 34

Where does the the right colic artery go once branching from the SMA?

Answer 34

It passes right to the midpoint of the ascending colon where it forms ascending an descending branches (that form a portion of the marginal artery)

Question 35

the marginal artery (of Drummond) is composed of contributions from which arteries?

Answer 35

the right, left, and middle colic arteries, the ileocolic artery, and the sigmoid arteries

Question 36

What is the most inferior unpaired branch of the abdominal aorta?

Answer 36

The IMA

Question 37

Where does the IMA branch from the aorta?

Answer 37

at L3 level, 3-4 cm superior to the aortic bifurcation

Question 38

Where does the inferior mesenteric vein run?

Answer 38

ascends left of the IMA and passes left of the duodenojejunal junction and deep to the body of the pancreas, where it terminates in the splenic vein

Question 39

Where is the hepatic portal vein located?

Answer 39

deep to the neck of the pancreas near the junction of the SMA and splenic veins