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BDS1 BAMS human systems > small intestine > Flashcards

small intestine Flashcards

1
Q

what is the other name for the small intestine?

A

small bowel

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2
Q

what are the three parts of the small intestine?

A
  • duodenum
  • jejunum
  • ileum
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3
Q

describe the small instestine

A
  • part of GIT
  • around 6metres long
  • primary site for absorption
  • starts at pylorus and extends to the ileocaceal junction
  • partially retroperitoneal
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4
Q

what is the peritoneum?

A
  • Continuous membrane lining the abdominal cavity and covers abdominal viscera
  • Supports those organs and provides a route for blood vessels
  • 2 layers that are continuous with each other – made up of simple squamous epithelial cells called MESOTHELIUM

PARIETAL peritoneum is sensitive to pressure, pain, temp.

VISCERAL peritoneum covers majority of abdominal viscera. Pain from this is referred to dermatomes (areas of skin supplied by a single spinal nerve)

INTRAPERITONEAL ORGANS – enveloped by visceral peritoneum

RETROPERITONEAL ORGANS – eg duodenum, pancreas, rectum

MESENTERY – Double layer of visceral peritoneum – connects structure to posterior abdominal wall. Mesentery contains blood vessels, nerves and lymphatics

OMENTUM – Sheets of visceral peritoneum extending from the stomach and proximal duodenum to other abdominal organs.

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5
Q

describe the duodenum

A
  • Receives chyme from the stomach
  • Short length
  • Contains Brunner’s glands (found above where pancreatic and biliary secretions enter the duodenum):
    - alkaline and mucous secretion to protect the duodenum from acidity of chyme, provide optimal condition for intestinal enzymes to be active and for lubrication
  • Receives common bile duct (Sphincter of Oddi)
    - Bile- produced and stored in the gall bladder and then passes into the Sphincter of Oddi. This muscular valve controls the flow of bile and the pancreatic juice, or enzymes as they pass into the duodenum.
    - Pancreatic “juice”
  • Ends at duodenojejunal junction
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5
Q

describe the duodenum

A
  • Receives chyme from the stomach
  • Short length
  • Contains Brunner’s glands (found above where pancreatic and biliary secretions enter the duodenum):
    - alkaline and mucous secretion to protect the duodenum from acidity of chyme, provide optimal condition for intestinal enzymes to be active and for lubrication
  • Receives common bile duct (Sphincter of Oddi)
    - Bile- produced and stored in the gall bladder and then passes into the Sphincter of Oddi. This muscular valve controls the flow of bile and the pancreatic juice, or enzymes as they pass into the duodenum.
    - Pancreatic “juice”
  • Ends at duodenojejunal junction
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6
Q

describe the location of the duodenum

A

Sits between the first lumbar vertebra i.e. L1 and the third/fourth lumbar vertebra i.e. L3/4

It is described as C shaped as it comes from the pyloric sphincter through to the duodenojejunal flexure

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7
Q

what is the Sphincter of Oddi?

A

Muscular valve controlling pancreatic and biliary secretions

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8
Q

what parts of the duodenum is the sphincter of oddi found?

A

2nd and 4th

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9
Q

what is surrounded by the sphincter of oddi?

A

major duodenal pipilla - rounded projection at the opening of the common bile duct and pancreatic duct

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10
Q

what is the minor dueodenal pipilla?

A

the opening of the accessory pancreatic duct and is typically present in 10% of people- 2cm proximal to major

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11
Q

what is CCK?

A
  • cholecytokinin
  • a peptide hormone and helps digest fat and protein
  • secreted by cells of the duodenum and highest secretion when there is fatty acids in the chyme entering the duodenum
  • inhibits gastric emptying but increases the release of pancreatic enzymes, as well as increases the production of bile, contraction of the gall bladder and relaxes the Sphincter of Oddi resulting in better fat digestion
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12
Q

what are the four parts of the duodenum?

A
  • superior
  • descending
  • inferior
  • ascending
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13
Q

describe the superior part of the duodenum

A
  • also known as the cap
  • ascends upwards from the pylorus
  • this area that is most common to have a duodenal ulcer
  • sits at the level of L1
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14
Q

describe the descending part of the duodenum

A
  • passes downwards around the head of the pancreas
  • lying behind the transverse colon and in front of the right kidney
  • at this site where the major duodenal papilla lies
  • sits at the level of L1-L3
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15
Q

describe the inferior part of the duodenum

A
  • passes to the left over the inferior vena cava and aorta
  • lies behind the superior mesenteric artery (supplying the midgut)
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16
Q

describe the ascending part of the duodenum

A
  • crosses the aorta and curves up to join the jejunum at the duodenojejunal flexure)
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17
Q

what is the second part of the duodenum (prior to the major duodenal papilla) supplied by?

A

gastroduodenal artery

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18
Q

what supplies the duodenum distal to the major duodenal papilla?

A

superior mesenteric artery and its branch, the inferior pancreaticoduodenal artery

19
Q

where is the venous drainage of the duodenum to?

A

the portal system either through the splenic or superior mesenteric vein to the portal vein

20
Q

describe a duodenal ulcer

A
  • mostly in the posterior wall of the superior part- red, inflamed
  • possibility of perforation (hole)
  • peritonsis- fever, nausea and vomiting
  • pain worse at night
  • caused by infection and non-steroidal inflammatory drugs eg ibruprofen
  • can lead to air under diaphragm
  • could rupture
21
Q

what is the diagnosis and treatment for a peptic ulcer?

A
  • CT scan can help
  • treatment is surgery
22
Q

what quadrant is the jejunum in?

A

more upper left

23
Q

what quadrant is the ileum in?

A

more lower right

24
Q

what is the infracolic compartment?

A

contains the coils of small bowel which is separated from paracolic gutter on either side by ascending and descending colon

25
Q

what is the duodenojejunal flexure?

A

sharp angle in the small intestine between the duodenum and the jejunum

26
Q

what are the main functions of the parts of the small intestine?

A

Duodenum
- mainly digestion
- pancreatic enzymes and bile
Jejunum
- digestion (brush border enzymes)
- absorption
Ileum
- mainly absorption

27
Q

what is the structure of the jejunum and ileum?

A

Lumen
Mucosa
- epithelium
- lamina propria
- muscularis mucosae
Submucosa
Muscularis externa
- innermost oblique (stomach only)
- inner circular
- outer longitudinal
Adventitia (serosa)

28
Q

describe the mucosa

A
  • enterocytes – tall columnar epithelium and have an absorptive function
  • goblet cells – exocrine glands which secrete mucin and Crypts of Lieberkuhn (where hormones are secreted and new stem cells found)
29
Q

describe the mucosa

A
  • enterocytes – tall columnar epithelium and have an absorptive function
  • goblet cells – exocrine glands which secrete mucin and Crypts of Lieberkuhn (where hormones are secreted and new stem cells found)
30
Q

describe the submucous plexus

A

(Meissner’s plexus)- these nerves come from the parasympathetic nervous system.

31
Q

describe the myenertic plexus

A

motor innervation to both layers of muscle and has both parasympathetic and sympathetic innervation

32
Q

describe the myenertic plexus

A

(Auerbach plexus)- motor innervation to both layers of muscle and has both parasympathetic and sympathetic innervation

33
Q

what features on the intestinal surface area?

A

plicae circulares
villi

34
Q

what are pilicae circulares?

A

Permanent circular folds of mucous membranes which are most numerous in the latter part of the duodenum through the upper part of the jejunum. These increase the surface area in the small intestine by 2-3x

35
Q

what is the function of villi?

A

increase surface area by approimmately 10x – 30x and microvilli x600

36
Q

what is serosa?

A

The outer lining of organs and body cavities of the abdomen and chest, including the stomach. Also called serous membrane.
2 layers of mesothelium.

37
Q

describe the jejunum

A

Thick intestinal wall
Longer vasa recta (straight arteries)
Less arcades (arterial loops)

38
Q

describe the ileum

A

Thin intestinal wall
Shorter vasa recta
More arcades

39
Q

what are peyer’s patches?

A

groupings of lymphoid follicles in the mucus membrane that lines your small intestine
involved with thickening of the intestinal epithelium and part of immune response

40
Q

what are peyer’s patches?

A

groupings of lymphoid follicles in the mucus membrane that lines your small intestine
involved with thickening of the intestinal epithelium and part of immune response

41
Q

what are enterocytes and their functions?

A

a cell of the small intestine
Microvilli (“brush border”)
Digestion – brush border enzymes
Absorption – carrier proteins

42
Q

describe intestinal mobility

A

segmentation
- differing role for musculature in movement of chyme:
- circular- local contraction and breakdown
- longitudinal- moves further along as well as breakdown

43
Q

what occurs at the ileo-caecal junction/

A

Vitamin B12 and bile acid absorption occurs here.

44
Q

describe intestinal diseases

A
  • Dietary deficeinces
  • Malabsorption syndromes can lead to deficeinces that affect blood e.g. anaemia
  • Can therefore affect oral mucosa
  • Coeliac disease
  • Crohn’s disease
  • Cystic fibrosis
45
Q

what is Meckel’s diverticulum?

A

Rule of 2’s:
- Usually presents before age of 2yrs old
- 2% of population
- Within 2 feet from ileocaecal valve
- 2 inches long
- 2 types of mucosa- mostly ilial mucosa
- May contain acid producing gastric, pancreatic or colonic type mucosa

BDS1 BAMS human systems (47 decks)

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