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Block 4 Anatomy > Pancreas, Duodenum, Intestines > Flashcards

Pancreas, Duodenum, Intestines Flashcards

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1
Q

After the first part of the duodenum passes slightly upward from the pylorus of the stomach, What side of the vertebrae and at what level vertebrae is the superior duodenum at?

A

on the right side of the ventral column at the level of the 1st lumbar vertebra

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2
Q

What peritoneum is the superior duodenum located in?

A

Mostly perionealized within the Hepatoduodenal Ligament

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3
Q

What is the relationship of the superior duodenum to the gallbladder and the quadrate lobe of the liver ?

A

Superior to the gallbladder and the quadrate lobe of the liver

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4
Q

What structures run posterior to the superior duodenum ?

A

common bile duct and gastroduodenal artery

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5
Q

The first part of the duodenum lies in what plane?

A

Transpyloric

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6
Q

What is the relationship of the head of the pancreas to the superior duodenum ?

A

The head of the pancreas is Inferior to the first part of the duodenum

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7
Q

The second part of the Duodenum turns inferiority along the right side of the _____, ______, ______ lumbar vertebra and runs _____peritoneal

A

1st, 2nd and 3rd Lumbar vertebra

runs RETROperitoneal

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8
Q

what major structure passes immediately anterior to the second (descending) duodenum?

A

transverse colon

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9
Q

What is the relationship of the hilum of the right kidney renal vessels to the second (descending) duodenum?

A

Posterior

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10
Q

What is the relationship of the head of the pancreas to the second (descending) duodenum?

A

to the Left

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11
Q

What two structures penetrate the second (descending) duodenum to open at the greater duodenal papilla?

A

common bile duct and pancreatic duct at the major and accessory pancreatic duct opens into the minor papillae respectively

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12
Q

Where do the common bile duct and pancreatic duct run before entering the duodenum?

A

At the midpoint of the 2nd part of duodenum adjacent to the pancreas fused together

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13
Q

What is the general path that the 3rd (horizontal) part of the duodenum takes?

A

Passes to the left ACROSS the midline at the 3rd lumbar vertebra and is RETROperitoneal.

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14
Q

What is the relationship of the Inferior Vena Cava and the aorta to the 3rd (horizontal) part of the duodenum?

A

Posterior to the 3rd part of the duodenum

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15
Q

What is the relationship of the root of the mesentery and the superior mesenteric vessels to the 3rd (horizontal) part of the duodenum?

A

Anterior to the 3rd part of the duodenum

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16
Q

What is the relationship of the 4th (ascending) part of the duodenum to the vertebral column and at what column level?

A

the 4th (ascending) part of the duodenum lies to the LEFT of the mid-line along the left of the 2nd lumbar vertebra

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17
Q

What is the relationship of the aorta to the 4th (ascending) part of the duodenum?

A

the aorta is to the RIGHT of the 4th (ascending) part of the duodenum

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18
Q

Between what two structures does the suspensory ligament of the duodenum run between and what is its function?

A

The celiac trunk and the duodenal flexure

Acts to suspend the duodenal flexure from the diaphragm

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19
Q

What is the muscular sphincter surrounding the major duodenal papilla

A

Sphincter of Oddi

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20
Q

What is the segment where the path of the bile duct and the main pancreatic duct are shared?

A

Ampulla of Vater

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21
Q

The jejunum and ileum are connected to the posterior abdominal wall via the _______ _______ and are therefore ____peritoneal

A

Mesentery proper

INTRAperitoneal

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22
Q

Does the Jejunum or the Ileum have elaborate circular mucosal folds?

A

Jejunum

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23
Q

Which, the Jejunum or the Ileum has thicker walls?

A

Jejunum

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24
Q

Which, the Jejunum or the Ileum has a larger diameter lumen?

A

Jejunum

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25
Q

Which, Jejunum or the Ileum has more prominent/complex arterial arcades?

A

Ileum

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26
Q

Which, Jejunum or the Ileum, has longer straight arteries (vasa recta)?

A

Jejunum

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27
Q

Which, Jejunum or the Ileum, has more mesenteric fat (i.e. absence of windows)?

A

Ileum

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28
Q

Except for the tail, the pancreas is _____peritoneal

A

RETROperitoneal

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29
Q

What two organs is the pancreas situated between left and right?

A

Descending Duodenum on the right

Spleen on the left

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30
Q

The Pancreas makes of the posterior wall of what Space?

A

Omentum Bursa

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31
Q

The hook-like portion of the head of the pancreas that projects posterior to the superior mesenteric vessels is the _____ process

A

Uncinate

32
Q

What dictated the location of the neck of the pancreas

A

The Neck is the constricted portion that overlies the origin of the superior mesenteric artery
AND
the junction of the superior mesenteric and splenic veins to form the hepatic portal vein

33
Q

What vessels are posterior to the neck of the pancreas and are the first branches from the superior mesenteric artery ?

A

Anterior and posterior inferior pancreaticoduodenal arteries

34
Q

The body of the pancreas crosses to the left and anteriorly to which three structures before reaching the spleen

A

Aorta, left Suprarenal gland, and Left Kidney

35
Q

What structures cross anterior to the body of the pancreas?

A

The transverse colon and the transverse mesocolon

36
Q

The tail of the pancreas turns superiorly and enters the ________ ligament to reach the spleen

A

Lienorenal Ligament

37
Q

the peritoneum of the cecum, the transverse mesocolon, and the sigmoid mesocolon ALL act to attach their viscera where?

A

to the posterior body wall

38
Q

The superior Mesenteric artery arises at the level of the inferior aspect of the ____ lumbar vertebra in the transplyoric plane immediately inferior to the celiac trunk

A

1st

39
Q

The initial course of the superior mesenteric artery is deep to the ____ of the pancreas, where arteries that supply the _______ and ________ are formed

A

Neck of the pancreas

pancreas and duodenum
inferior pancreaticoduodenal arteries

40
Q

From deep to the pancreas, what structures does the superior Mesenteric Artery cross in order to reach the mesentery proper?

A

The artery crosses ANTERIOR to the uncinate process of the pancreas, the left renal vein, and the third part of the duodenum to enter the mesentery proper

41
Q

the Superior Mesenteric Vein ascend deep to the neck of the pancreas to join the splenic vein to form what structure?

A

Hepatic Portal Vein

42
Q

Intestinal branches of the Superior Mesenteric Artery form arches and loops with adjacent arteries for form several generations of ________ ________

A

Arterial Arcades

43
Q

Which,Jejunum or the Ileum, has more numerous arcades and the mesentery contains more fat?

A

Ileum

44
Q

The middle colic artery branches from the superior mesenteric artery at the ________ border of the pancreas

A

Inferior

45
Q

The middle colic artery enters the ________ mesocolon, forming right and left branches to the proximal 2/3 of the _______ ______

A

Transverse mesocolon

Transverse colon

46
Q

The Right colic artery passes posterior to the peritoneum in the fascia on the right posterior body wall the reach the midpoint of the ______ _____

A

Ascending colon

47
Q

The Iliocolic Artery branches from the ______ side of the superior mesenteric artery and courses inferiorly to the lower-right quadrant to reach the _________ junction

A

Ileocecal Junction

48
Q

The Ileocolic artery provides branches to the distal _______, _______. and ________ and forms an ascending branch that anastomoses with ______ _____ artery along the ascending colon

A

distal Ileum, cecum, and appendix

right colic artery

49
Q

The Marginal Artery that forms the arterial channel along the margin of the large intestine if formed from branches of which arteries?

A 
It is formed by branches from: 
              right colic
              ileocolic
              middle colic
              sigmoid arteries 
         &   left colic arteries
50
Q

The marginal artery forms an important collateral blood supply between which two arteries

A

Superior and Inferior Mesenteric Arteries

51
Q

The duodenum begins one inch to the ______ of the midline in the transpyloric plane and it ends one inch to the ______ of the midline, also in or very close to the transpyloric plane.

A

begins RIGHT

Ends LEFT

52
Q

Nutcracker Syndrome is the compression of what structure between the Superior mesenteric Artery and the Abdominal Aorta

A

Left Renal Vein

53
Q

Entrapment of the 3rd part of the duodenum is called ?

A

superior mesenteric artery syndrome

54
Q

The Ampulla of Vater is where the segments of what two structures fuse together to enter the Major duodenal papilla?

A

Common bile and pancreatic duct

55
Q

The duodenal papilla is also at the junction between __________ and ___________

A

foregut and midgut

56
Q

Blood supply proximal to the duodenal papilla is from the ?

A

Celia Trunk

57
Q

Distal to the major duodenal papilla, the blood supply is from the ?

A

superior mesenteric artery

58
Q

A perforated gastric ulcer in the posterior wall of the stomach would release erosive gastric secretions into what space and affect what organ?

A

Omentum Bursa and Pancreas

59
Q

While the loops of the both Ileum and Jejunum may crosee both sides of the mid-lines, the root of the mesentary of the jejunum is on the ____ side of the midline and that of the ileum is to the ____ of the midline.

A

Jejunum roots on the Left side

Ileum roots on the right side

60
Q

There is more absorptive surface in the ______, so its walls are thicker

A

jejunum

61
Q

Two, the tenia coli and haustra are due to uneven distribution of _____ ______ in the wall of the colon.

A

smooth muscle

62
Q

The transverse colon is in or very close to the _______ plane.

A

transpyloric

63
Q

The ileocecal junction is roughly at McBurney’s point. Describe how this location is found

A

This point is one-third of the distance from the ASIS to the umbilicus.

You will learn that a patient’s reaction to pressure on McBurney’s point is part of the examination for suspected appendicitis.

64
Q

The Inferior Mesentery Artery arises ____peritonial from the aorta at the level of the ______ lumbar vertebrae, 3-4 cm above the aortic bifurcation into illiac arteries

A

RETROperitoneal

3rd Lumbar vertebrae

65
Q

Which branch of the Inferior Mesentery Artery is the superior branch and passes posterior to the peritoneum to reach the descending colon?

A

Left Colic Artery

66
Q

The ascending branches of the left colic artery contribute to which artery?

A

Marginal Artery

67
Q

Descending branches of the left colic artery anastomose with with what artery

A

Sigmoid artery

68
Q

Which branch of the Inferior Mesentery Artery is most medial and can be found deep the peritoneal before it enters the pelvis>

A

Superior Rectal artery

69
Q

The inferior mesenteric vein ascends to the _____ of the artery deep to the peritoneum.

A

Left of the artery

70
Q

The inferior mesenteric vein crosses left to which junction before coursing deep the pancreas and terminating into the ______ vein

A

to the left of the Duodenojeunal junction

into the Splenic vein

71
Q

The origin of the Hepatic portal vein is formed deep to the neck of the pancreas bythe junction of which to veins

A

Superior Mesenteric
&
Splenic Veins

72
Q

With respect to surface anatomy, the origin of the IMA and the third part of the duodenum lie 2 cm (3/4”) above the ________ plane.

A

transumbilical plane

**NOTE
The bifurcation of the abdominal aorta into R & L common iliac arteries lies the same
distance, 2 cm, below the transumbilical plane.

73
Q

There is no single vein that corresponds to the celiac trunk. List the veins corresponding to the celiac trunk

A

the L & R gastric veins,
the L & R gastroepiploic veins
and
the splenic vein are direct tributaries to the portal vein.

74
Q

Blood drainage into veins system that is NOT the hepatic portal system (Everything but 1/3 of esophagus, GI tract and company) is referred to as what? Why?

A

Caval System because they drain directly into the IVC or SVC

75
Q

When two different venous systems lie in close proximity to each other they tend to form anastomoses– this is referred to sa

A

Portal- Caval Anastomoses

76
Q

When do Portal Caval Anastomoses become of clinical significance?

A

Normally there is NO blood flow through these anastomoes in a healthy individual. However,with portal hypertension blood flows through these anastomoses and these veins becomes distended into varicose veins which, if rupture in certain areas such as the esophagus could be life threatening

77
Q

What are the 3 major Portal Anastomoses discussed?

A

(1) esophageal varices,
(2) internal hemorrhoids and
(3) kaput medusa (around belly button)

Block 4 Anatomy (4 decks)

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