Paxk Flashcards
What is the course of the second part of the duodenum?
The second part of the duodenum courses vertically downward, slightly curved, at the levels of L2 and L3.
What structures does the second part of the duodenum overlie?
The second part of the duodenum overlies the hilum of the right kidney, including its vessels and ureter.
What crosses the second part of the duodenum anteriorly?
The second part of the duodenum is crossed anteriorly, about its middle, by the attachment of the transverse mesocolon.
What anterior structures are related to the second part of the duodenum?
Anteriorly, the second part of the duodenum is related to the fundus of the gallbladder and the right lobe of the liver.
What lies medial to the second part of the duodenum?
Medial to the second part of the duodenum is the head of the pancreas.
What does the posteromedial wall of the second part of the duodenum receive?
It recives from the ampulla of vater at the major duodnal papilla
Where does the accessory pancreatic duct open if present?
At the minor duodenal papilla, located a short distance above the major duodenal papilla
How does the third part of the duodenum course?
The third part of the duodenum courses approximately horizontally to the left, crossing the midline.
What are the posterior relations of the third part of the duodenum from right to left?
The posterior relations include the right psoas muscle, right ureter, inferior vena cava, and aorta.
What crosses the third part of the duodenum anteriorly?
At about its left third, the root of the mesentery containing the superior mesenteric vessels crosses the third part of the duodenum.
What is superiorly related to the third part of the duodenum?
The inferior border of the head of the pancreas is in contact with the third part of the duodenum.
How long is the fourth part of the duodenum?
The fourth part of the duodenum is 1 inch long.
How does the fourth part of the duodenum course?
It turns obliquely upward on the left psoas muscle and ends about 2.5 cm (1 inch) to the left of the midline, bending sharply forward to form the duodenojejunal flexure.
What is the posterior relation of the fourth part of the duodenum?
The fourth part of the duodenum is related to the left margin of the aorta posteriorly.
What is to the right of the fourth part of the duodenum?
The lumbar vertebral column is to the right of the fourth part of the duodenum.
What is anteriorly and to the left of the fourth part of the duodenum?
The coils of the jejunum are anteriorly and to the left of the fourth part of the duodenum.
What fixes the duodenojejunal flexure in its position?
The duodenojejunal flexure is fixed by a peritoneal fold (ligament of Treitz), which is attached to the right crus of the diaphragm.
How long are the jejunum and ileum together?
The jejunum and ileum together measure about 20 feet (6 m) long.
What proportion of the small intestine is the jejunum?
The jejunum makes up the upper two-fifths (2/5) of the small intestine.
What is the root of the mesentery?
The root of the mesentery is the line of attachment of the mesentery to the posterior abdominal wall.
How does the root of the mesentery run in the abdominal cavity?
It runs obliquely downward from the left to the right at an angle of about 45°.
Where does the root of the mesentery begin and end?
It begins at the duodenojejunal junction (L2 level) and terminates at the right sacroiliac joint.
How do you differentiate between the jejnum and illeum?
Generally, the jejunum tends to stay in peritoneal cavity superiorly and to the left, the ileum inferiorly and to the right.
- The jejunum is wider bored, thicker walled, and redder than the ileum. The jejunal wall is thicker because the permanent foldings of the mucus membrane (plica circulares) are larger, more numerous, and closely set in the jejunum.
How many arcades do the jejunum mesenteric vessels typically form?
The jejunum mesenteric vessels typically form only one or two arcades (loops).
Describe the branches passing from the jejunum mesenteric vessels to the intestinal wall.
The jejunum mesenteric vessels have long and infrequent branches passing to the intestinal wall.
How many arcades supply the ileum and what are the charactersitics of the branches?
The ileum receives numerous short terminal vessels that arise from a series of 3 or 4 or even more arcades.
What are peyers patches and where are they present?
Aggregations of lymphoid tissue (Peyer’s patches) are present in the mucous membrane of the lower ileum along the antimesenteric border
What is the defention of the meckels diverticulum?
Out pouching part of the terminal illeum within two (2) feet from the ileocecal junction on the antimesenteric border.
What are the types of meckels divertculum?
fibrous cord
Cyst
Sinus
Fistula
What is divertculosis?
Diverticulosis “diverticular disease“: outpocketings of the mucosa and submucosa through weaknesses of muscle layer
A divertculum that is not related to the vitellointestinal duct.
What are the branches of the hepatic artery proper?
The branches of the hepatic artery proper are: 1. Right hepatic artery 2. Left hepatic artery 3. Right gastric artery
What are the branches of the gastroduodenal artery?
The branches of the gastroduodenal artery are: 1. Right gastroepiploic artery 2. Anterior superior pancreaticoduodenal artery 3. Posterior superior pancreaticoduodenal artery
What are the branches of the superior mesenteric artery?
The branches of the superior mesenteric artery are:
1. Inferior pancreaticoduodenal artery
2. 12-15 jejunal and ileal arteries
