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Block 4 > Pancreas, Duodenum, Intestines > Flashcards

Pancreas, Duodenum, Intestines Flashcards

1
Q

Name the sequential subdivisions of the small intestine.

A

Duodenum, Jejunum, Ileum

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2
Q

Which portion of the duodenum is intraperitoneal?

A

The first part (superior portion) is contained within the hepatoduodenal ligament. All the rest (2nd, 3rd,4th parts) are RETROPERITONEAL.

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3
Q

What structures does the 1st part of the duodenum touch?

A

Gallbladder and quadrate lobe of the liver.

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4
Q

What artery runs posterior to the 1st part of the duodenum?

A

Gastroduodenal artery

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5
Q

In relation to the vertebral column, where is the second part of the duodenum located?

A

Runs along the right side of L1,L2,L3.

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6
Q

What structures are anterior and posterior to the second part of the duodenum?

A

Anterior: Transverse colon
Posterior: Hilum of Right Kidney and renal vessels

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7
Q

What penetrates the second part of the dudenum and what is this location called?

A

The duodenal papilla- the common bile duct and the main pancreatic duct fuse to form the ampulla of Vader.

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8
Q

The muscular portion surrounding the Ampulla of Vader is called…..

A

The Sphincter of Oddi

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9
Q

The 3rd part of the duodenum moves from the right to left sides of the vertebral column at what level?

A

L3

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10
Q

What vessels are anterior/posterior to the 3rd part of the duodenum?

A

Posterior: IVC, Aorta
Anterior: SMA

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11
Q

What structures form the “Nutcracker” and what structures are caught in it?

A

The SMA and the Abdominal Aorta form the nutcracker.The left renal vein and the 3rd part of the duodenum run between these structures.

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12
Q

The 4th part of the duodenum is on which side of the vertebral column?

A

The left, specifically at L2.

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13
Q

The pancreas is mostly RETROPERITONEAL except for …..

A

the tail- introperitoneal due to the splenorenal ligament.

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14
Q

Where is the head of the pancreas located?

A

Lodged in the duodenum

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15
Q

Which part of the pancreas lies behind the superior mesenteric vessels?

A

The uncinate process

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16
Q

What lies behind the NECK of the pancreas?

A

SMA origin, and junction of the superior mesenteric and splenic veins to form the hepatic portal vein.

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17
Q

What two veins converge to form the Hepatic portal vein?

A

Superior mesenteric and splenic

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18
Q

Name the parts of the large intestine.

A

Cecum, Ascending-Transverse-Descending colon, Sigmoid colon, rectum, anal canal.

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19
Q

Which portions of the large intestine are RETROPERITONEAL?

A

Ascending and Descending portions. Transverse and sigmoid colon are peritonealized.

20
Q

What are the bubble-like structures that line the colon called?

A

Haustra

21
Q

What are the 3 parallel lines that run the length of the colon?

A

Teaniae coli

22
Q

What are the fat blobs projecting from the outer surface of the colon?

A

Epiploic Appendices

23
Q

Name the 3 unpaired visceral branches of the abdominal aorta?

A

Celiac Trunk, SMA, IMA

24
Q

What vessels arise from vertebral level L1?

A

Celiac Truck, SMA

25
Q

What’s the first branch off the SMA and where does it do this?

A

Inferior pancreaticoduodenals - behind the neck of the pancreas, before the uncinate process.

26
Q

The SMA passes anteriorly to what structures before entering the mesentery?

A

Uncinate process of pancreas, Left Renal Vein, and 3rd part of the duodenum.

27
Q

Name the branches of the Superior Mesenteric Artery.

A

Inferior Pancreaticoduodenals
Intestinal Branches (to jejunum and ileum)
Middle Colic Artery (to transverse mesocolon)
Right Colic Artery (ascending colon)
Ilieocolic Artery (distal ileum, cecum, and appendix)

28
Q

What vessels contribute to the Marginal Artery?

A

Right Colic, Left Colic, Middle Colic, Ileocolic, and Sigmoid

29
Q

What is the formal name for the Marginal Artery?

A

Marginal Artery of Drummond

30
Q

At what vertebral level does the IMA arise from the Aorta?

A

L3

31
Q

Name the branches of the Inferior Mesenteric Artery.

A

Left Colic Artery (descending colon)
Sigmoid Arteries (sigmoid colon)
Superior Rectal Artery (rectum)

32
Q

What is the most medial branch of the IMA?

A

Superior Rectal Artery

33
Q

Where does the inferior mesenteric vein terminate?

A

Splenic Vein

34
Q

Where is the origin of the Hepatic Portal Vein?

A

Deep to the neck of the pancreas - formed by the superior mesenteric vein and the splenic vein

35
Q

What is a portacaval anastomosis?

A

alternate routes of blood flow between the portal venous system and the caval venous system, should one have a blockage or hypertension.

36
Q

Name the 4 portacaval anastomoses.

A

Esophageal
Rectal
Paraumbilical (Kaput Medusa)
and Retroperitoneal

Important ones: “Butt, Gut, and Kaput”

37
Q

WTF is the Ligament of Treitz?

A

The suspensory ligament of the duodenojejunal flexure.

38
Q

The jéjunum composes what fraction of the intestines? The ileum?

A

2/5 , so the Ileum is 3/5.

39
Q

What is McBurney’s Point?

A

The location of the ileocecal junction. A straight line drawn between the ASIS and the umbilicus.

40
Q

How can you tell the Jejunum from the Ileum?

A

Jejunum: elaborate circular folds (max absorption), Thick walls, large diameter, fewer arterial cascades, presence of windows.

Ileum: Fewer inner mucosal folds, Thinner wall, smaller diameter, more arterial cascades in the mesentery, more mesenteric fat.

41
Q

The small arteries in the mesentery proper are formally called?

A

Vasa Recta

42
Q

What is the Mnemonic for Retroperitoneal Structures and what do the letters stand for?

A 
Suprarenal Glands
Aorta/IVC
Duodenum (ex. first part)
Pancreas (except tail)
Ureters
Colon (ascending and descending)
Kidneys
Esophagus
Rectum
43
Q

What vessels run in the gastrosplenic ligament?

A

The short gastric veins coming from the splenic artery.

44
Q

What are the Retroperitoneal Vessels in the Abdomen?

A

Celiac Trunk, SMA, IMA, Renal A/V, Aorta, IVC

45
Q

Nutcracker syndrome refers to?

A

Compression of the left renal vein by the

46
Q

What marks the junction of the foregut to the midgut?

A

The duodenal papilla - where the common bile and main pancreatic ducts converge and dump into the second part of the duodenum

47
Q

Blood supply to the GI tract superior to the duodenal papilla is supplied by what artery? How about inferior?

A

Superior to papilla = celiac trunk. Inferior = SMA

Block 4 (7 decks)

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