Large and small intestine

Question 1

What are the parts of the small intestine?

Answer 1

duodenum, ileum, jejunum

Question 2

What is the largest part of small inestine?

Answer 2

Ileum

Question 3

Function of intestine:

Answer 3

Absorption of nutrients

Question 4

What increases absorption?

Answer 4

microvilli

Question 5

What is the name of the epithelium that has microvilli on its surface?

Answer 5

Brush border

Question 6

Name the parts of the duodenum

Answer 6

1) superior
2)descending
3) inferior
4) ascending

Question 7

What is the embryological origin of the superior part of the duodenum?

Answer 7

foregut

Question 8

Which three parts of the duodenum are retroperitoneal and which part is intraperitoneal?

Answer 8

2,3, an4 and 1

Question 9

What is the anatomy of the superior part of duodenum?

Answer 9

gastroduodenal artery and common bile duct lie posterior to duodenal bulb

Question 10

What is the clinical significance of the superior part?

Answer 10

-most common site for duodenal ulcers
-posterior duodenal ulcer may erode the gastroduodenal artery and cause an upper GI bleed; if there’s air
-attached to liver by hepatoduodenal ligament

Question 11

What is the embryolocial origin of the descending part of duodenum?

Answer 11

Proximal to ampulla of vater: foregut
distal to ampulla of vater: midgut

Question 12

What is the anatomy of the descending part?
(S.A.M.M)

Answer 12

-ampulla of vater
-major duodenal papilla: protrusion of the ampulla of vater into the duodenum
-sphincter of oddi
-minor duodenal papilla: opening of the accessory pancreatic duct

Question 13

What are the clinical significance for the descending part?

Answer 13

-the major duodenal papilla is cannulated during ERCP
-ampulla of vater sphincterotomy is performed for impacted distal choledocholithiasis

Question 14

What is the embryological origin of the inferior ascending part of duodenum?

Answer 14

midgut

Question 15

What is the clinical significance of the inferior part?

Answer 15

SMA syndrome- In severe abdominal injuries, this part of the duodenum may be crushed against the L3 vertebra

Question 16

What is the anatomy of the inferior part?

Answer 16

Anterior relation: superior mesenteric vessels
Posterior: aorta

Question 17

What is the embryological origin of the ascending part of duodenum?

Answer 17

midgut

Question 18

What is the anatomy of the ascending part?

Question 19

What is the clinical significance of the ascending part?

Answer 19

Ligament of Treitz landmark of distinction of upper and lower GI tract

Question 20

Where is the common opening for bile and major pancreatice duct?

Answer 20

major duodenal papilla

Question 21

Where is the opening of the accessory pancreatic duct?

Answer 21

minor duodenal papilla

Question 22

If there is a ruptured duodenal ulcer what can be seen on a radiograph and where is the referred pain?

Answer 22

Air and Shoulder

Question 23

If there is a ruptured gastric ulcer on lesser curvature of stomach which artery is affected?

Answer 23

Left gastric artery

Question 24

If there’s a ruptured posterior duodenal wall ulcer, which artery is affected?

Answer 24

gastroduodenal artery

Question 25

What is the venous drainage of the jejunum and ileum?

Answer 25

To superior mesenteric vein which joins with splenic vein to form portal vein

Question 26

Where is the location of jejunum and ileum?

Answer 26

jejunum: left upper quadrant ileum: rigt lower quadrant

Question 27

Describe the walls, lumen circular folds and villi of the jejunum and ileum

Answer 27

Jejunum: walls- thicker, more vascular lumen-wider, often empty circular folds- larger, thick and closely set villi-tall,leaf liike Ileum: walls-thinner, less vascular lumen-narrow, often loaded circular fold-smaller, sparse villi- short finger like

Question 28

Where are peyer patches found?

Answer 28

ileum

Question 29

Fat distribution of jejunum vs ileum

Answer 29

jejunum: less ileum: abundant

Question 30

_____ is the invagination of one part of the intestine into another

Answer 30

Intussusception

Question 31

What is a structure that identifies the large intestine?

Answer 31

Teniae coli

Question 32

Where is McBurney’s point ,ocated

Answer 32

McBurney’spoint: Base of appendix located here

Question 33

Pain that moves from the umbilical region to the right lower quadrant suggests _____

Answer 33

appendicitis

Question 34

What are the parts of large intestine

Answer 34

Ascending colon (retroperitoneal): extent –cecum to hepatic flexure Transverse colon (intraperitoneal) extenthepatic to splenic flexure Descending colon (retroperitoneal) extentsplenic flexure to left iliac fossa. Sigmoid colon (intraperitoneal) extent – iliac fossa(S1) to S3 vertebra. Teania coli terminates at recto sigmoid junction

Question 35

Lymphatic drainage of small intestine:

Answer 35

Coeliac and superior mesenteric lymph nodes

Question 36

Lymphatic drainage of large intestine:

Answer 36

a. Epicolic lymph nodes b. Paracolic lymph nodes c. Intermediate nodes d. Terminal nodes

Question 37

Arterial blood supply to the rectum

Answer 37

Superior rectal artery (branch of IMA) * Middle rectal artery (branch of internal iliac) * Inferior rectal artery (branch of internal pudendal)

Question 38

Venous drainage of rectum

Answer 38

* Superior rectal vein(drains into IMV→Portal system) * Middle rectal & inferior rectal veins (drain into internal iliac vein→systemic circulation)

Question 39

What is the epithelium above the pectinate line?

Answer 39

simple columnar

Question 40

What is the epithelium below the pectinate line?

Answer 40

stratified sqaumous

Question 41

Blood supply to the anus

Answer 41

Superior rectal artery –branch of inferior mesenteric artery (above pectinate line) * Middle rectal artery –branch of internal iliac artery * Inferior rectal artery –branch of internal pudendal artery (internal iliac artery)-supplies the lower part

Question 42

Internal (true) piles/hemorrhoids occurs where?

Answer 42

Occurs above the pectinate line Painless and bleed profusely

Question 43

external (false) piles/hemorrhoids occurs where?

Answer 43

Occurs below pectinate line Very painful with minimal bleeding

Question 44

what are the branches of the superior mesenteric artery? (MRI)

Answer 44

Middle colic, right colic, and Ileocolic arteries

Question 45

what are the branches of the inferior mesenteric artery? (LSS)

Answer 45

Left colic, sigmoid, and superior rectal