Pancreas, Duodenum, Intestines

Question 1

Name the sequential subdivisions of the small intestine.

Answer 1

Duodenum, Jejunum, Ileum

Question 2

Which portion of the duodenum is intraperitoneal?

Answer 2

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

Question 3

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

Answer 3

Gallbladder and quadrate lobe of the liver.

Question 4

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

Answer 4

Gastroduodenal artery

Question 5

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

Answer 5

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

Question 6

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

Answer 6

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

Question 7

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

Answer 7

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

Question 8

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

Answer 8

The Sphincter of Oddi

Question 9

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

Answer 9

L3

Question 10

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

Answer 10

Posterior: IVC, Aorta
Anterior: SMA

Question 11

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

Answer 11

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

Question 12

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

Answer 12

The left, specifically at L2.

Question 13

The pancreas is mostly RETROPERITONEAL except for …..

Answer 13

the tail- introperitoneal due to the splenorenal ligament.

Question 14

Where is the head of the pancreas located?

Answer 14

Lodged in the duodenum

Question 15

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

Answer 15

The uncinate process

Question 16

What lies behind the NECK of the pancreas?

Answer 16

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

Question 17

What two veins converge to form the Hepatic portal vein?

Answer 17

Superior mesenteric and splenic

Question 18

Name the parts of the large intestine.

Answer 18

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

Question 19

Which portions of the large intestine are RETROPERITONEAL?

Answer 19

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

Question 20

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

Answer 20

Haustra

Question 21

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

Answer 21

Teaniae coli

Question 22

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

Answer 22

Epiploic Appendices

Question 23

Name the 3 unpaired visceral branches of the abdominal aorta?

Answer 23

Celiac Trunk, SMA, IMA

Question 24

What vessels arise from vertebral level L1?

Answer 24

Celiac Truck, SMA

Question 25

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

Answer 25

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

Question 26

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

Answer 26

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

Question 27

Name the branches of the Superior Mesenteric Artery.

Answer 27

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)

Question 28

What vessels contribute to the Marginal Artery?

Answer 28

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

Question 29

What is the formal name for the Marginal Artery?

Answer 29

Marginal Artery of Drummond

Question 30

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

Answer 30

L3

Question 31

Name the branches of the Inferior Mesenteric Artery.

Answer 31

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

Question 32

What is the most medial branch of the IMA?

Answer 32

Superior Rectal Artery

Question 33

Where does the inferior mesenteric vein terminate?

Answer 33

Splenic Vein

Question 34

Where is the origin of the Hepatic Portal Vein?

Answer 34

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

Question 35

What is a portacaval anastomosis?

Answer 35

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

Question 36

Name the 4 portacaval anastomoses.

Answer 36

Esophageal Rectal Paraumbilical (Kaput Medusa) and Retroperitoneal Important ones: "Butt, Gut, and Kaput"

Question 37

WTF is the Ligament of Treitz?

Answer 37

The suspensory ligament of the duodenojejunal flexure.

Question 38

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

Answer 38

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

Question 39

What is McBurney's Point?

Answer 39

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

Question 40

How can you tell the Jejunum from the Ileum?

Answer 40

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.

Question 41

The small arteries in the mesentery proper are formally called?

Answer 41

Vasa Recta

Question 42

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

Answer 42

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

Question 43

What vessels run in the gastrosplenic ligament?

Answer 43

The short gastric veins coming from the splenic artery.

Question 44

What are the Retroperitoneal Vessels in the Abdomen?

Answer 44

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

Question 45

Nutcracker syndrome refers to?

Answer 45

Compression of the left renal vein by the

Question 46

What marks the junction of the foregut to the midgut?

Answer 46

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

Question 47

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

Answer 47

Superior to papilla = celiac trunk. Inferior = SMA