Nov 18 - Abdomen II: Abdominal Viscera Flashcards
What does the gastrointestinal tract (GI) consist of (for the purposes of this section)?
The esophagus, the stomach, the small intestine and the large intestine (colon). Sometimes the term GI is used to refer to all structures from mouth to anus
What is the esophagus?
Long, muscular tube that carries food from the oral cavity to the stomach (peristalsis). It extends through the posterior mediastinum, and passes through the diaphragm (at T10) to reach the stomach
Where is the stomach?
It is located in the left hypochondriac and epigastric regions
Name the parts of the stomach
The cardia, the fundus, the cardiac notch, the body, the pyloric antrum, the pyloric canal
Describe the cardia
It is the area surrounding the opening of the esophagus
Describe the fundus
It is located beneath the left dome of the diaphragm (above the cardia) and it is usually filled with air
What is the cardiac notch?
The angle between the esophagus and fundus
Describe the body of the stomach
It is located between the fundus and the pyloric antrum
Describe the pyloric antrum
It is the funnel shaped region of the stomach between the body and pyloric canal
Describe the pyloric canal
It’s narrower than the antrum, contains the pyloric sphincter aka pylorus
What happens if the cardiac notch becomes larger?
The closer mechanism becomes much weaker (reflux)
Describe the internal structure of the stomach
It is highly ridged. These mucosal folds are called rugae
What is the pyloric sphincter?
It is a thick band of muscle that controls the passage of stomach contents into the duodenum. It can be compromised during surgery
What is the pH of the stomach?
Between 2 and 3
What is the small intestine?
It is the main site of nutrient absorption. It is approximately 7 metres in length in an adult. The small intestine consists of the duodenum, the jejunum and the ileum
Describe the duodenum
It’s about 25 cm in length and divided into four parts: the superior, descending, horizontal and ascending duodenum
Describe the superior duodenum
It lies anterolateral to the body of the L1 vertebra
Describe the descending duodenum
It descends along the right side of the L1-L3 vertebrae. It is the location of the major duodenal papilla, entrance of the bile duct and the pancreatic duct
Describe the horizontal duodenum
It crosses the L3 vertebrae
Describe the ascending duodenum
It begins at the left of the L3 vertebrae, ascending to the superior border of the L2 vertebrae
Describe the jejunum and ileum
They are suspended from the posterior abdominal wall by the mesentery, very mobile. There is no distinct border between the jejunum and the ileum. Generally the jejunum is found in the left upper quadrant, ileum in the right lower quadrant
Jejunum and ileum differences: colour
Jejunum is deeper red and ileum is pale pink
Jejunum and ileum differences: wall thickness
Jejunum: thick
Ileum: thin
Jejunum and ileum differences: vascularity
Jejunum: more vascular
Ileum: less vascular
Jejunum and ileum differences: vasa recta (blood vessels in mesentery)
Jejunum: long
Ileum: short
Jejunum and ileum differences: arcades (also blood vessels in mesentery)
Jejunum: a few large loops
Ileum: lots of short loops
Jejunum and ileum differences: fat in mesentery
Jejunum: less
Ileum: more
Jejunum and ileum differences: plicae circulares (internal circular folds)
Jejunum: lots of prominent folds, tightly bunched
Ileum: sparse, absent in the distal part of the ileum
Jejunum and ileum differences: Peyer’s patches (lymphoid nodules)
Jejunum: few
Ileum: many
Describe the large intestine
It extends from the ileocecal junction to the anus - 1.5 m long. It consists of the cecum, ascending, transverse, descending and sigmoid colon, rectum and anal canal. It re-absorbs water and electrolytes
Describe the left colic flexure
Aka the splenic flexure. It’s a watershed region; it receives blood supply from the superior and inferior mesenteric arteries
Name three distinguishing features of the large intestine
Teniae coli, the haustra and the epiploic appendages