Lecture 24. Stomach and small intestine Flashcards
Surface projection of stomach
Only the cardiac and the pyloric end of the stomach have a relatively constant position: T10, ~2-3 cm on the left and L1, ~2-3 cm on the right, respectively.
Identify
Identify
Identify
Anterior surface of stomach is partially covered by (1)___, contacts (2)___ and according to the Labbé’s triangle,directly (3)___
- the liver
- the diaphragm
- the abdominal wall.
Identify this triangle
Gastric triangle (of Labbé)
Gastric triangle (of Labbé) is bounded by ___ (5)
- the inferior margin of the liver
- the left costal arch
- a horizontal line running along the transverse colon
- the greater curvature
- the 9th costal cartilages
The greater curvature of the stomach is in contact with ___ and ___
the spleen and the transverse mesocolon.
The rest of the posterior surface is isolated from ___ (3) by the omental bursa (lesser sac).
the pancreas, left kidney and left suprarenal gland
Stomach: peritoneal relations
→ Identify
: if an organ has at least one peritoneal duplication connecting it to the body wall or to other organs, it must be ___
intraperitoneal
Stomach belongs to the forgut and is supplied by ____.
the dominant artery of that: the celiac trunk
Along the lesser and greater curvatures (1)____ are found and from them the lymph is mainly drained toward (2)___ accumulating around (3)___
- the primary lymph nodes
- the (secondary) paraaortic lymph nodes
- the celiac trunk.
Duodenum extends from (1)___ to (2)____ as a horseshoe-shaped tube.
- the pylorus
- the duodenojejunal flexure
Jejunum is mostly in ___ quadrant of the abdomen
the left upper
. Ileum is mostly in ___ quadrant, has smaller diameter and thinner wall
the right lower
- ____ extends from the pylorus to the duodenojejunal flexure as a horseshoe-shaped tube.
- ____ is mostly in the left upper quadrant of the abdomen and is larger in diameter and has a thicker wall than the ileum.
- ____ is mostly in the right lower quadrant, has smaller diameter and thinner wall.
- Duodenum
- Jejunum
- Ileum
Identify
Identify 4 parts of duodenum
The horseshoe-shaped duodenum can be divided into four parts, which enclose ___
the head of pacreas.
Name the planes and line
L1 – transpyloric plane
pylorus, superior horizontal part of duodenum, gall bladder, body and tail of pancreas
L3 – subcostal plane
inferior horizontal part of duodenum
medioinguinal line
on its medial side: descending part of duodenum
Duodenum: surface projection
→ Identify
Duodenum: adjacent organs
→ Superior horizontal part contacts __ and _
the right lobe of the liver and the gall-bladder.
Duodenum: adjacent organs
The second part descends anterior to (1)___ and is crossed anteriorly by (2)___
- the hilum of the right kidney
- the transverse colon.
Duodenum: adjacent organs
Inferior horizontal part lies anterior to ___ and ___ (vessels)
the IVC and the abdominal aorta.
Duodenum: adjacent organs
(1)___ cross the inferior horizontal and the ascending part, respectively.
Superior mesenteric vessels
Duodenum: peritoneal relations
Only the superior horizontal part of duodenum is (1)___: its peritoneal duplication is the (2)____ which encloses the common bile duct, the portal vein and the proper hepatic (and gastroduodenal) artery.
The rest of theduodenum is retroperitoneal.
- intra-peritoneal
- hepatoduodenal ligament
Duodenum: peritoneal relations
Only the superior horizontal part of duodenum is intra-peritoneal: its peritoneal duplication is the hepatoduodenal ligament which encloses ____
The rest of theduodenum is ___
- the common bile duct, the portal vein and the proper hepatic (and gastroduodenal) artery.
- retroperitoneal.
Duodenum: blood supply
Superior and inferior pacreaticoduodenal arteries form (1)___and ___
→ This anastomosis makes connection between (2)___ and ___
Superior and inferior pacreaticoduodenal arteries
Duodenum: blood supply
Superior and inferior pacreaticoduodenal arteries form (1)___
→ This anastomosis makes connection between (2)___ and ___
- the lesser arch of Riolan.
- the celiac trunk (main vessel of the foregut) and the superior mesenteric artery (dominant artery of the midgut.)
the lesser arch of Riolan is formed by ___
Superior and inferior pacreaticoduodenal arteries
Identify this structure. its role?
The suspensory muscle of duodenum (or the ligament of Treitz) that connects the duodenum to the left crus of the diaphragm
What is Root of mesentery?
line of attachment of the mesentery.
(Extends from the duodenojejunal flexure tothe iliocecal junction.)
Root of mesentery
→ Extends from (1)____ to (2)___
- the duodenojejunal flexure
- the iliocecal junction.
Root of mesentery crosses: (6 structures)
- inferior part of duodenum
- abdominal aorta
- inferior vena cava
- right gonadal artery and veins
- right ureter
- Psoas major
Jejunum, ileum: blood supply??
Branches of the superior mesenteric artery:
- jejunal arteries
- iliac arteries
- ileocolic artery
Identify jejunum and ileum
Identify
Veinous drainage: portal system
Everything absorbed from the GI tract gets into (1)___ system.
(2)____ and ___ merge behind the head of pancreas to form theportal vein.
Inferior mesenteric vein usually opens into (3)____
Before entering the liver, portal vein picks up (4)____ as the last tributary.
- the portal veinous
- Superior mesenteric vein and splenic vein
- the splenic vein.
- the coronary vein of the stomach
