Pancreas, Small Intestine, And Large Intestine Flashcards
Function of the exocrine portion of the pancreas?
Produces a secretion that contains enzymes capable of hydrolyzing proteins, fats and carbs
What abdominal regions is the pancreas located in
Epigastric and LUQ
Location of the head of the pancreas
Location of the tail
Within the concavity of duodenum
Passes in the splenorenal ligament and comes in contact with hilum of spleen
What 4 structures are anteriorly related to the pancreas
Transverse colon, transverse mesocolon, lesser sac and stomach
Location of pancreatic duct
Where does it open into?
Tail of pancreas
Opens into middle of 2nd part of duodenum
What two arteries and veins supply the pancreas
Splenic and superior and inferior pancreaticoduodenal arteries and their corresponding veins (which drain into portal system
~review: splenic artery is branch of celiac trunk, superior pan. Is branch of gastroduodenal artery from common hepatic artery, inferior pan. Is branch of superior mesenteric artery
Which two lymph nodes do the pancreas drain into
Celiac and superior mesenteric lymph nodes
Parasympathetic and sympathetic innervation of pancreas comes from?
Vagus nerve
What happens at the small intestine
Greater part of digestion and absorption
What is the major duodenal papilla?
Rounded elevation where the bile duct and main pancreatic duct pierce the second part of duodenum
What abdominal regions is the duodenum located
Epigastric and umbilical
Relations of 1st part of duodenum:
- Anteriorly
- Posteriorly
- Superiorly
- Inferiorly
- Quadrate lobe of liver and gallbladder
- Part of lesser sac, gastroduodenal artery, bile duct, portal vein, and IVC
- Epiploic foramen (entrance into lesser sac)
- Head of pancreas
Relations of 2nd part of duodenum (vertical):
- Anteriorly
- Posteriorly
- Laterally
- Medially
- Gallbladder, right lobe of liver, transverse colon
- Hilum of right kidney and right ureter
- Ascending colon, right lobe of liver
- Head of pancreas, bile duct
Arterial supply of :
- Upper half of duodenum
- Lower half of duodenum
- Superior pancreaticoduodenal artery
2. Inferior pancreaticoduodenal artery
Veinous drainage of the upper and lower half of duodenum
Upper: superior pancreaticoduodenal vein drains into the portal vein
Lower: inferior pancreaticoduodenal vein joins the superior mesenteric vein
Lymph drainage:
Arteries that run upwards drain upwards through which 3 nodes?
Arteries that run downwards drain downwards through which 2 nodes
Upward: pancreaticoduodenal nodes -> gastroduodenal nodes -> celiac nodes (follows arteries)
Downward: pancreaticoduodenal nodes -> superior mesenteric nodes (follows arteries)
Nerve supply to duodenum?
Vagus nerves from the celiac and superior mesenteric plexuses
Mesentery of the small intestine connects what?
Coils of jejunum and ileum to posterior abdominal wall
Difference in size of jejunum compared to ileum
Jejunum is wider and thicker walled and redder
Location of jejunal mesentery compared to ileal mesentery?
Jejunal is to the left of aorta
Ileal is to the right of aorta
What are peyers patches and where are they located
Aggregations of lymphoid tissue in the lower ileum
Arterial supply of jejunum and ileum
Branches of superior mesenteric artery that anastomose with one another to form a series of arcades
Ileocolic artery also supplies lowest part of ileum
Lymph drainage of jejunum and ileum
Superior mesenteric nodes
Nerve supply of jejunum and ileum
Vagus nerves from the superior mesenteric plexus
6 parts of the large intestine
Cecum, appendix, ascending colon, transverse colon, descending colon, and sigmoid colon
Primary function of large intestine
Absorption of water and electrolytes and storage of undigested material until it can be expelled as feces
Location of the cecum
Right iliac fossa
Where on the cecum is the appendix located
Posteromedial surface
Relations of the cecum:
- Anteriorly
- Posteriorly
- Coils of small intestines, anterior abdominal wall in the right iliac region and sometimes part of the greater omentum
- Psoas and iliacus muscle, femoral nerve, lateral cutaneous nerve of the thigh, appendix
Blood supply of cecum
Anterior and posterior cecal arteries from the ileocolic artery which is a branch of the superior mesenteric artery
Venous drainage
Into superior mesenteric vein
Nerve supply of cecum
Same as ileum and jejunum; vagus nerves from the superior mesenteric plexus
What is gastrin
Hormone produced by the stomach that causes relaxation of the muscle tone
You can find the appendix at McBurneys point. Location?
Joining the right ASIS to the umbilicus
Arterial supply of the appendix
Appendicular artery (branch of posterior cecal artery)
Lymph drainage of appendix
Superior mesenteric nodes
Nerve supply of appendix
Vagus nerve from superior mesenteric plexus
~afferent nerve fibers for visceral pain enter spinal cord at T10
Blood supply of ascending colon
Ileocolic and right colic branches of superior mesenteric artery
Lymph drainage of ascending colon
Superior mesenteric nodes
Blood supply of the transverse colon
Proximal 2/3 by middle colic artery (branch of SUPERIOR mesenteric artery); distal 1/3 by left colic artery (branch of INFERIOR mesenteric artery)
Lymph drainage of transverse colon
Proximal 2/3: colic nodes-> superior mesenteric nodes
Distal 1/3: colic nodes-> inferior mesenteric nodes
Nerve supply of transverse colon
Proximal 2/3: vagus nerve from superior mesenteric plexus
Distal 1/3: pelvic splanchnic nerves through inferior mesenteric plexus
Blood supply of descending colon
Left colic and sigmoid branches of the inferior mesenteric artery
~venous drainage into inferior mesenteric vein
Lymph drainage of descending colon
Colic nodes-> inferior mesenteric nodes
Nerve supply of descending colon
Pelvic splanchnic nerves through inferior mesenteric plexus
Blood supply of sigmoid colon
Sigmoid branches of inferior mesenteric artery
Lymph drainage of sigmoid colon
Nodes along sigmoid arteries->Inferior mesenteric nodes
Nerve supply of sigmoid colon
Nerves from inferior hypogastric plexuses
Blood supply to rectum is from superior, middle and inferior rectal arteries: what are each branches of and what do they supply?
- Superior= direct continuation of inferior mesenteric artery; mucous membrane
- Middle= branch of internal iliac artery; muscular coat
- Inferior= branch of internal pudendal artery in peritoneum
Venous drainage of superior, middle, and inferior rectal arteries
Superior= inferior mesenteric vein Middle= internal iliac vein Inferior= internal pudendal artery
Union of rectal veins forms?
Portal-systemic anastomoses
Lymph drainage of the rectum
Pararectal nodes-> inferior mesenteric nodes
Lower part of rectum: internal iliac nodes
Nerve supply of rectum?
Inferior hypogastric plexuses
Superior mesenteric artery:
- Supplies what 7 organs
- Originates and runs?
- Distal duodenum, jejunum, ileum, cecum, appendix, ascending colon and most of transverse colon
- Abdominal aorta (below celiac trunk); runs down and to the right behind pancreas to in between layers of the mesentery then anastomoses with ileal branch of ileocolic branch
Name 4 branches of the superior mesenteric artery
Inferior pancreaticoduodenal artery, middle colic artery, right colic artery, and ileocolic artery
Where does the inferior pancreaticoduodenal artery run and what does it supply
Runs along the upper border of third part of duodenum and head of pancreas and supplies pancreas and adjoining part of duodenum
Where does the middle colic artery run and what does it supply
Forward in the transverse mesocolon and supplies transverse colon (also divides into right and left branch)
Right colic artery supplies?
Ascending colon; divides into ascending and descending branches
Ileocolic artery gives rise to two branches. What are they and what they anastomose with
Superior branch-anastomoses with right colic artery
Inferior branch- anastomoses with end of superior mesenteric artery
How does the inferior mesenteric artery run and what does it become?
Runs down and to the left and crosses the left common iliac artery. It becomes the superior rectal artery
3 branches of the inferior mesenteric artery
Left colic artery, sigmoid arteries and superior rectal artery
What does the left colic artery supply
Distal 1/3 of transverse colon, left colic flexure and upper part of descending colon
What do the sigmoid arteries supply
(There are ~2-3) supply descending and sigmoid colon
Where does the superior rectal artery run and what does it supply
Continuation of inferior mesenteric artery- runs into the pelvis behind the rectum. Supplies the rectum and upper half of anal canal and anastomoses with the middle rectal and inferior rectal arteries
What is the marginal artery
Anastomoses of colic arteries around the concave margin of the large intestine (begins at ileocecal junction and ends where it anastomoses less freely with the superior rectal artery)
