Small and large intestines Flashcards
What is the suspensory ligament of Treitz?
Fold of peritoneum containing muscle fibers and CT that surrounds the duodeno-jejunal flexure
What is the arterial supply of the proximal duodenum?
Superior pancreaticoduodenal branch of gastroduodenal A
What is the arterial supply of the distal duodenum?
Inferior pancreaticoduodenal branch of superior mesenteric A
What is the venous drainage of the duodenum?
Superior mesenteric V and splenic veins to hepatic portal vein
What is the drainage of the anterior lymphatics of the duodenum?
Into pancreaticoduodenal and pyloric nodes
What is the drainage of the posterior lymphatics of the duodenum?
Into superior mesenteric nodes
What is the arterial supply of the jejunum and ileum?
Jejunal and ileal branches of the superior mesenteric arteries forming arcades that form vasa recta
What is the venous drainage of the jejunum and ileum?
To superior mesenteric vein to splenic vein to portal vein
What are clinical signs of Meckel’s diverticulum?
Melena
RLQ pain
Vomiting
Intussusception
Volvulus
Obstruction near terminal ileum
What are the early and late signs of intussusception?
Early - N/V, and abd cramps
Late - rectal bleeding
What is the location of McBurney’s point on the abdomen?
Junction of medial 2/3 and lateral 1/3 of right spino-umbilical line
What is the branching leading to the appendicular artery?
Abd aorta to superior mesenteric to ileocolic to appendicular A
What are the clinical signs of appendicitis?
Pain in the umbilical or epigastric region that later localizes to right lumbar region
Nausea/vomiting
Anorexia
Fever
Tenderness to palpation
Percussion in right lumbar region
Where would you find numerous Peyer’s patches?
Ileum
What are the branches of the superior mesenteric artery?
Inferior pancreaticoduodenal
Jejunal and ileal
Ileocolic
Right colic
Middle colic
What are the branches of the inferior mesenteric artery?
Left colic
Sigmoid
Superior rectal
What forms the marginal artery of Drummond?
Branches of SMA and IMA forming collateral ring along wall of colon
What is the lymphatic drainage of the small intesting?
Celiac and superior mesenteric nodes
What is the lymphatic drainage of the large intestine?
Epicolic nodes
Paracolic nodes
Intermediate nodes
Terminal nodes
What structures are palpable in a digital rectal exam of a male pt?
Prostate
Seminal vesicles
Vas deferens
What structures are palpable in a digital rectal exam of a female pt?
Perineal body
Cervix
What is the arterial supply to the rectum?
Superior rectal branch of IMA
Middle rectal branch of internal iliac
Inferior rectal branch of internal pudendal
What is the venous drainage of the rectum?
Superior rectal to IMV to splenic to portal
Middle and inferior rectal to internal iliac to systemic circulation
What are characteristics of the upper anal canal?
Anal columns
Anal sinuses
What structures are present of the pectinate line?
Anal valves
From what does the lower anal canal develop from?
Ectoderm
What are the characteristics of an internal hemorrhoid?
Above pectinate line
Painless
Profuse bleeding
What are the characteristic of an external hemorrhoid?
Below pectinate line
Very painful
Minimal bleeding
What is the nerve supply that relaxes the internal anal sphincter?
Parasympathetic
What is the nerve supply that maintains the tone of the internal anal sphincter?
Sympathetic
What is the innervation of the external anal sphincter?
Somatic
Inferior rectal branch of pudendal nerve
How is surface area increased in the small intestine?
Circular folds
Villi
Microvilli
Where would you see crypts of Lieberkuhn?
Simple tubular intestinal glands that extend from the muscularis mucosa and open into the lumen at base of villi in SI and in the colon
What is a histological marker of the ileum?
Peyer’s patches
What is the histological marker of the jejunum?
Submucosa without glands or lymph nodules
What is the histological marker of the duodenum?
Brunner’s glands in submucosa
What is the function of Brunner’s glands?
Mucous secreting
Where will you see an increase in goblet cells in the SI?
Ileum
What are histological features of the large intestines?
No villi
More goblet cells
Teniae coli
