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GI Anatomy > Midgut Anatomy > Flashcards

Midgut Anatomy Flashcards

1
Q

What are the two organs of the midgut?

A
  1. small intestine: (Distal 1/2 of the duodenum, jejunum, ileum)
  2. Two thirds of the large intestine: (Cecum, appendix, ascending colon, transverse colon
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2
Q

Is the transverse colon anterior or posterior?

A

Anterior; it can be seen from an anterior view of the stomach without the greater omentum removed.

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3
Q

When you open the abdominal wall, what cavity are you peering into?

A

peritoneal cavity

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4
Q

When you open the abdominal wall, what sac are you peering into? Greater or lesser?

A

Greater sac

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5
Q

In order to view the last portion of the duodenum, what portions of the small intestine need to be removed?

A

Jejunum and ileum

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6
Q

Which trunk of the aorta serves the midgut?

A

Superior mesenteric artery

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7
Q

What plexus innervates the organs of the midgut?

A

superior mesenteric plexus (pre-aortic plexus)

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8
Q

What are the most anterior structures of the midgut?

A
  1. transverse colon
  2. jejunum
  3. ileum
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9
Q

The ascending colon is (anterior/posterior).

A

posterior; however sometimes the ileum and jejunum are found behind the ascending colon

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10
Q

The duodenum is (anterior/posterior) to the jejunum and ileum.

A

posterior

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11
Q

What organ of the midgut is just anterior to the aorta and the inferior vena cava?

A

Duodenum

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12
Q

What other organ is snuggled in the curvature of the duodenum?

A

pancreas

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13
Q

On an axial CT or MRI image through an approximate L3, list the location of the midgut organs from most posterior to most anterior.

A

Anterior: Transverse colon, ileum, jejunum, ascending colon, duodenum

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14
Q

What is the name of the ligament that secures the duodenum to the esophagus?

A

suspensory ligament

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15
Q

When the suspensory ligament is covered by peritoneum, what structure does it form?

A

the Ligament of Treitz

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16
Q

The majority of the duodenum is retroperitorneal/peritoneal?

A

Retroperitoneal; only parts 2 and 3 have peritoneum draping over the organ. It is not surrounded.

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17
Q

Which mesentery attaches the ileum and jejunum to the posterior abdominal wall?

A

The Mesentery

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18
Q

Are the jejunum and ileum peritoneal or retroperitoneal?

A

Both are peritoneal; they are completely covered by peritoneum and attached to the posterior abdominal wall by The Mesentery.

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19
Q

Which is slightly larger in caliber (diameter), the jejunum or the ileum?

A

The jejunum has a slightly larger caliber.

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20
Q

Which is longer the jejunum or ileum?

A

the ileum (14ft long), the jejunum is only 9ft long.

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21
Q

Which has more folds, the jejunum or ileum?

A

Jejunum

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22
Q

List differences between the jejunum and ileum.

A

Ileum:

  • Longer (12 ft)
  • smaller caliber
  • less folds
  • shorter vasa recta
  • less metabolic activity
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23
Q

Which has longer straight vasa recta, the jejunum or the ileum?

A

Jejunum

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24
Q

Which portion of the small intestine has higher metabolic activity?

A

Jejunum, thus it has more folds to increase absorptive surface and a more direct artery supply.

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25
Q

What valve connects the ileum to the cecum?

A

ileocecal valve in the ileocecal junction, formed by the ileocecal sphincter.

26
Q

Is the cecum peritoneal or retroperitoneal?

A

The cecum is completely covered by peritoneum and is thus peritoneal.

27
Q

Where is the appendix?

A

It hangs from the cecum.

28
Q

What is the lymphoid structure that hangs from the cecum?

A

appendix

29
Q

Is the appendix retroperitoneal or peritoneal?

A

peritoneal; it is completely surrounded and is supplied by the mesoappendix.

30
Q

Why do patients with appendicitis usually experience pain in dermatome T10?

A

referred pain

31
Q

Can the appendix be found in multiple places?

A

Yes, the appendix can be found in multiple positions with respect to the cecum. The most common are retrocecal and pelvic.

32
Q

What is the name of the junction between the ascending colon and the transverse colon?

A

The hepatic flexure or right colic flexure

33
Q

What is the function of haustrum (pl: haustra)?

A

sacculation

34
Q

What are epiploic appendages?

A

small sacs filled with fat; they are for fat storage

35
Q

What type of muscle is tenia coli, where would you find them in the body?

A

smooth muscle thickenings, found on the surface of the colon as longitudinal ribbons

36
Q

How is the transverse colon attached to the posterior abdominal wall?

A

by its mesentery, the transverse mesocolon

37
Q

Is the ascending colon peritoneal or retroperitoneal?

A

retroperitoneal

38
Q

Is the transverse colon peritoneal or retroperitoneal?

A

peritoneal

39
Q

Retroperitoneal or peritoneal?

  • Cecum
  • Ascending colon
A

Cecum: peritoneal; the peritoneum covering the ileum completely covers the cecum
Ascending colon: retroperitoneal; the peritoneum is draped on the top, but does not cover this structure.

40
Q

What 3 additional features distinguish the colon from the small intestine?

A
  1. tenia coli
  2. epiploic appendages
  3. haustrum
41
Q

The aorta has 3 major unpaired trunks. Name them.

A
  1. Celiac trunk
  2. Superior Mesenteric Artery
  3. Inferior Mesenteric Artery
42
Q

List the major branches of the superior mesenteric artery.

A
  1. intestinal branches (12-18)
  2. middle colic artery
  3. ileocecal artery
  4. Right colic artery
43
Q

What portion of the large intestine does the middle colic artery serve?

A

Transverse colon

44
Q

What portion of the small intestine do the intestinal branches serve?

A

the jejunum and ileum

45
Q

What portion of the large intestine does the ileocecal artery serve?

A

ileocolic region

46
Q

What 3 structures or regions are served by the right colic artery?

A
  1. ascending colon
  2. hepatic flexure
  3. transverse colon
47
Q

The beginning of the superior mesenteric artery is posterior to what organ?

A

pancreas

48
Q

To gain access to the superior mesenteric artery during surgery what structures would you have to cut through using an anterior abdominal approach?

A
  1. skin
  2. Abdominal wall muscles
  3. parietal peritoneum
  4. Stomach
  5. pancreas
    6 finally the SMA
49
Q

What two blood vessels “sandwich” the duodenum?

A
  1. superior mesenteric artery

2. aorta

50
Q

If you had to use an anterior approach to access the superior mesenteric artery, list the organs you would pierce.

A

SAPSPS

  1. skin
  2. abdominal wall muscles
  3. Parietal peritoneum-peritoneal cavity-visceral peritoneum
  4. stomach
  5. pancreas
  6. SMA
51
Q

The portal vein is formed by the combination of which two veins?

A
  1. splenic vein

2. superior mesenteric vein

52
Q

Which is a tributary to the IVC, (portal vein/hepatic vein/superior mesenteric artery)

A

the hepatic vein is a tributary to the IVC. Blood from the gut enters the portal vein & travels through the liver to the hepatic veins which are tributaries to the IVC.

53
Q

What organ is found immediately anterior to the SMA at the point where it branches from the aorta?

A

pancreas

54
Q

The SMA projects slightly anteriorly, from its root on the aorta. When we see it emerging anteriorly, it is between which two organs?

A

pancreas and the duodenum

55
Q

What is the name of the smaller ganglia flanking the superior mesenteric ganglion?

A

aorticorenal ganglia

56
Q

What type of fibers might you find in the superior mesenteric artery?

A
  1. motor fibers carrying movement orders from the CNS to the organ
    1a. para/pre from vagus
    1b. symp/pre from thoracic & lumbar splanchnic
    1c. symp/post
  2. sensory fibers carrying sensor stimuli from the organ to the CNS
57
Q

List the verterbral levels in which you would find cell bodies of thoracic splanchic nerves.

A

T5-T12

58
Q

Describe the sympathetic preganglionic fibers that form the (1) greater thoracic splanchnic nerve (2) lesser thoracic splanchnic nerve & (3) least thoracic splanchnic nerve.

A
  1. Greater thoracic splanchnic nerve is formed by T5-T9
  2. Lesser thoracic splanchnic nerve is formed by T10-T11
  3. Least thoracic splanchnic nerve is formed by T12
59
Q

How and where do vagal fibers enter into the abdomen?

A

The right and left vagal trunks enter the abdomen with the esophagus at vertebral level T10.

60
Q

Where are all of the cell bodies of preganglionic sympathetic neurons located? (in terms of sympathetic innervation)

A

T5-L2

61
Q

Describe the location of the intermesenteric plexus.

A

In between the two mesenteric arteries; also in between the two mesenteric plexuses.

62
Q

What fibers might you find in the intermesenteric plexus?

A
  1. mostly sympathetic pre and post ganglionic fibers

2. some mini tiny ganglia where symp/pre fibers synapse instead of synapsing in the IMA or SMA

GI Anatomy (6 decks)

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