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Gastrointestinal > Small and Large Intestine > Flashcards

Small and Large Intestine Flashcards

1
Q

What is the shape of the duodenum

A

C-shaped around the head of the pancreas

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2
Q

What is the duodenum continuous with

A

Pylorus of the stomach

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3
Q

Is the duodenum retro or intra peritoneal

A

Retroperitoneal

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4
Q

What is the major duodenal papilla and where is it found

A

Approx. 1/2 way along the internal wall of the duodenum

Opening for the bile duct and main pancreatic duct into the duodenum

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5
Q

What does the first half of the duodenum develop from

A

Embryological foregut

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6
Q

What supplies the first half of the duodenum

A

Branches from the coeliac trunk

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7
Q

What does the second half of the duodenum develop from

A

Embryological mid gut

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8
Q

What supplies the second half of the duodenum

A

Superior mesenteric artery

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9
Q

Which comes first the jejunum or ileum

A

Jejunum

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10
Q

What is continuous with the duodenum

A

Jejunum

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11
Q

Is the jejunum retro or intra peritoneal

A

Intraperitoneal

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12
Q

Is the ileum retro or intra peritoneal

A

Intraperitoneal

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13
Q

What is both the jejunum and ileum suspended from

A

Posterior abdominal wall by the mesentery of the small intestine

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14
Q

What are the jejunum and ileum derived from

A

Embryological midgut

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15
Q

Where does the jejunum lie

A

Left upper region

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16
Q

Where does the ileum lie

A

Right lower region

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17
Q

What features does the small intestine have for nutrient absorption

A

Vast surface area
Small intestine long
Mucosa folded (plicae circulares)
Mucosal folds bear villi
Microvilli

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18
Q

What is Meckel’s diverticulum

A

Blind ended diverticulum approx. 1m from its termination

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19
Q

What is the Meckel’s diverticulum a remnant of

A

Connection that was present between the midgut loop to the yolk sac

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20
Q

What is terminal ileum continuous with

A

Caecum

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21
Q

What is the junction called between the terminal ileum and caecum and where is it found

A

Ileocecal junction
R. iliac fossa

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22
Q

Define appendix

A

Small diverticulum that arises from the caecum

Contains lymphoid tissue

Connected to caecum by a small mesentery

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23
Q

What is the small mesentery called which connects the caecum to the appendix

A

Mesoappendix

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24
Q

What does the urge to defecate arise from

A

Contraction of rectal muscles

Relaxation of internal anal sphincter

Initial contraction of external anal sphincter

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25
Q

What is the nerve supply of the external anal sphincter

A

Pudendal nerve S2,3,4 - allows concious control

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26
Q

Describe defecation

A

Rectum is distended the rectosphinteric reflex is initiated and relaxes the internal sphincter

Then
- relaxation of the external sphincter
- contraction of abdominal wall muscles
- relaxation of pelvic wall muscles

Peristaltic waves facilitate movement of faeces through anal canal

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27
Q

What happens if defecation is not desired

A

Voluntary contraction of the external sphincter - usually enough to override the reflexes of anal distension initiates

28
Q

Describe the Valsalva Manoeuvre

A

Defecation can be assisted by taking a deep breath and attempting to expel air against the glottis

29
Q

What is the blood supply to the jejunum and ileum

A

Superior mesenteric artery

Embedded within the mesentery

30
Q

What is more pronounced in the jejunum

A

Plicae

31
Q

What is the internal ileum characterised by

A

Peyer’s patches - large submucosal lymph nodules

32
Q

What is the role of the large intestine

A

Reabsorbs water from faecal material to form semi-solid faeces

33
Q

What is the large intestine formed of

A

Caecum

Appendix

Ascending colon

Transverse colon

Descending colon

Sigmoid colon

Rectum

Anal canal

34
Q

What is the outer longitudinal muscle layer of the large intestine organised like

A

Three bands - taeniae coli

Inner circular muscle layer forms budges - haustra

35
Q

What is taeniae coli

A

Three bands of the outer longitudinal muscle layer of the large intestine

36
Q

What are haustra

A

Bulges formed by the inner muscular layer of the large intestine

37
Q

What are epiploic appendages

A

Fatty tags which mark the point at which blood vessels penetrate the intestinal wall

38
Q

Describe the caecum

What are its features? What does it have?

A

Peritoneum - but no mesentery

Appendix

39
Q

Describe the appendix

A

Contains lymphoid tissue

Varies in length and position of tip is variable

Connected to caecum by a small mesentery - mesoappendix

40
Q

Describe the ascending colon

A

Runs vertically on right side of posterior abdominal wall - right paracolic gutter

Retroperitoneal (secondary)

41
Q

What is the bend in the ascending colon called

A

Hepatic flexure (right colic flexure)

42
Q

Describe the transverse colon

A

Intraperitoneal - suspended to posterior abdominal wall by transverse mesocolon

1st 2/3 = midgut
2nd 1/3 = hindgut

43
Q

What is the bend in the transverse colon

A

Splenic flexure

Tethered to diaphragm by phrenicocolic ligament

44
Q

Describe the descending colon

A

Runs left side of posterior abdominal wall in left paracolic gutter

Retroperitoneal (secondary)

45
Q

Describe sigmoid colon

A

Sinuous shape

As it approaches midline makes a 90 degrees turn inferiorly = rectosigmoid junction

Intraperitoneal - sigmoid mesocolon

46
Q

At what level does the coeliac trunk leave the aorta

A

T12

47
Q

What does the coeliac trunk supply

A

Foregut

  • oesophagus
  • stomach
  • first half of the duodenum
  • liver
  • gallbladder
  • bile ducts
  • pancreas
  • spleen
48
Q

What does the superior mesenteric supply

A

Midgut

  • Second half of duodenum
  • small intestine
  • large intestine up to 2/3 away transverse colon
  • branches which supply pancreas
49
Q

At what level does the superior mesenteric artery leave the aorta

A

L1

50
Q

What does the inferior mesenteric artery supply

A

Hindgut

  • distal third of transverse colon
  • descending and sigmoid colon
  • rectum
  • upper part of anal canal
51
Q

At what level does the inferior mesenteric artery supply

A

L3

52
Q

What arteries are embedded in the mesentery of the small intestine

A

Jejunal and ileal branches

Anastomose with each other to form loops of arteries - arcades which run the vasa recta - supply the intestinal wall

53
Q

What are the branches of the superior mesenteric artery

A

Jejunal branches

Ileal branches

Ileocolic artery

Right colic artery

Middle colic artery

54
Q

What does the ileocolic artery supply

A

Caecum

Appendix

Ascending colon

55
Q

What does the right colic artery supply

A

Ascending colon

56
Q

What does the middle colic artery supply

A

Transverse colon

57
Q

What are the branches of the inferior mesenteric artery

A

Left colic artery

Sigmoid branches

Superior rectal artery (terminal branch)

58
Q

What does the left colic artery supply

A

Transverse colon

Descending colon

59
Q

What forms the marginal artery

A

Middle colic artery (SMA) and left colic artery (IMA) anastomose along the distal 1/3 of transverse colon and splenic flexure

60
Q

What is the lower rectum supplied by

A

Internal iliac arteries

61
Q

What is the parasympathetic nervous supply to the foregut and midgut

A

Parasympathetic fibres - Vagus nerve

62
Q

What is the parasympathetic nervous supply to the hindgut

A

Pelvis splanchnic nerves

S2-4

63
Q

What is the sympathetic innervation of the foregut

A

Greater splanchnic nerves T5-9

64
Q

What is the sympathetic innervation of the midgut

A

Lesser splanchnic nerves T10-11

65
Q

What is the sympathetic innervation of the hindgut

A

Least splanchnic nerves T12

66
Q

What is the visceral innervation of the gut

A

Comes off the same as the sympathetic nerves

Gastrointestinal (12 decks)

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