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BDS1 > Small intestine > Flashcards

Small intestine Flashcards

1
Q

What does the word ‘small’ in small intestine refer to?

A

The diameter

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2
Q

what are the 3 components of the small intestine?

A

Duodenum, jejunum, ileum

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3
Q

What does it mean when describing the small intestine as partially retroperitoneal?

A

Some parts are behind the peritoneum with only their anterior surface covered, while others are intraperitoneal (enveloped in peritoneum)

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4
Q

Function of small intestine

A

digestion and absorption

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5
Q

What is the peritoneum?

A

Serous membrane that lines the abdominal cavity and organs made of 2 layers continuous with each other.

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6
Q

What are the two layers of the peritoneum?

A

Parietal peritoneum and visceral peritoneum

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7
Q

What is the parietal peritoneum?

A

The layer of the peritoneum that lines the surface of the abdominal cavity

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8
Q

What is the name of the epithelium making up the peritoneum?

A

Mesothelium - simple squamous epithelium that produces serous secretions.

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9
Q

What is the visceral peritoneum?

A

The layer of the peritoneum enveloping organs e.g. liver, stomach, part of small intestine.

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10
Q

What is the mesentery?

A

A fold/extension of the visceral peritoneum that connects the intraperitoneal organs to the posterior abdominal wall (prevents falling to bottom)

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11
Q

What is the omentum?

A

Fused folds of the visceral peritoneum that connects the stomach and duodenum to other abdominal organs. Made up of lesser and greater omentum.

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12
Q

What is the greater omentum?

A

Apron-like structure that connects the greater curvature of the stomach to the transverse colon. Provides protection and insultation to abdomen.

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13
Q

What is the lesser omentum?

A

Attaches onto the lesser curvature of the stomach. Connects the stomach and duodenum to the liver.

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14
Q

How long is the duodenum?

A

25-30 cm

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15
Q

Name of glands found in the duodenum?

A

Brunner’s glands

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16
Q

Function of Brunner’s glands

A

Brunner’s glands secrete alkaline mucous which protects the duodenum by neutralising the acidity of the chyme from the stomach.

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17
Q

2 secretions which enter at the duodenum

A

Bile and pancreatic juice

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18
Q

Where is bile produced?

A

liver

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19
Q

Function of gall bladder

A

Stores and concentrates bile

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20
Q

4 parts of the duodenum

A

superior, descending, inferior, ascending

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21
Q

Where does the duodenum end?

A

At the duodenojejunal junction / flexure at the end of the ascending duodenum

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22
Q

How does bile travel from the gall bladder to the duodenum?

A

Via the common bile duct which joins with the pancreatic duct at the major duodenal papilla

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23
Q

Which structure controls the release of bile and pancreatic enzymes into the duodenum?

A

Sphincter of Oddi (found in the major duodenal papilla)

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24
Q

Where is the duodenum located?

A

From L1 to L3/4 connecting to the stomach. The duodenum is C shaped which wraps around the head of the pancreas.

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25
Q

Where is the major duodenal papilla?

A

in the descending region of the duodenum

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26
Q

What is an anatomical variation which may be present superior to the major duodenal papilla?

A

Minor duodenal papilla - may be connected to a second pancreatic duct, not necessarily functional

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27
Q

What is the name of the hormone secreted by cells in the duodenum when chyme enters?

A

Cholecystokinin.
chole - bile
cysto - gall bladder sac
kinin - move

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28
Q

Function of cholecystokinin

A

Stimulates gall bladder contraction to release bile, stimulates synthesis and secretion of pancreatic juices, relaxed sphincter of Oddi

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29
Q

Which artery supplies the superior and inferior duodenum and the head of the pancreas?

A

Superior pancreaticoduodenal artery

30
Q

Where does the superior pancreaticoduodenal artery originate from?

A

The abdominal artery branches at the coeliac artery into the hepatic artery, which branches into the gastroduodenal artery, which branches into the superior pancreaticoduodenal artery.

31
Q

Which artery supplies the inferior duodenum and the inferior pancreas?

A

Inferior pancreaticoduodenal artery

32
Q

Where does the inferior pancreaticoduodenal artery originate from?

A

The abdominal artery branches into the superior mesenteric artery which branches into the inferior pancreaticoduodenal artery.

33
Q

Significance of anastomosis of superior and inferior pancreaticoduodenal arteries

A

Blood can still be supplied to the duodenum and pancreas by collateral circulation if there is a blockage in one side. E.g. blood can be supplied via the superior mesenteric artery if there is a blockage at the coeliac trunk.

34
Q

Where may a duodenal ulcer typically occur?

A

in the posterior wall of the superior part, nearest to the stomach.

35
Q

What may cause a duodenal ulcer?

A

Stomach acid not being neutralised due to ineffective synthesis/secretion of alkaline mucous from Brunner’s glands.

36
Q

Which drug may increase susceptibility to duodenal ulcers?

A

Ibuprofen - inhibits alkaline mucous secretion so stomach acid is more likely to aggravate the duodenum.

37
Q

Consequences of a duodenal ulcer

A

May perforate the duodenum allowing the digestive contents to escape which may lead to peritonitis (inflammation of peritoneum)

38
Q

What imaging can be used to identify a duodenal ulcer?

A

endoscopy (or x-ray if perforated)

39
Q

How to identify the presence of a GIT perforation using an x-ray?

A

Dark areas seen under diaphragm caused by gas leaking out of perforation.

40
Q

Where is the jejunum and ileum located?

A

In the infracolic compartment (below transverse colon). Jejunum mostly UL, ileum mostly LR.

41
Q

At which point does the small intestine join to the large intestine?

A

Ileocaecal junction

42
Q

Which structure is the start of the large intestine?

A

Cecum

43
Q

How does the function of the small intestine change?

A

Duodenum - mainly digestive, Jejunum - digestive (brush border enzymes) and absorption, Ileum - mainly absorption.

44
Q

Histological layers of the GIT

A

mucosa - epithelium, lamina propria, muscularis mucosae. Submucosa (vessels, nerves, glands), Muscularis propria (CILO - and oblique inner in stomach), Serosa

45
Q

Which epithelium is found in the small intestine?

A

Simple columnar epithelium

46
Q

Which cells are found within the epithelium of the GIT?

A

mucous/goblet cells, endocrine cells

47
Q

Name of crypts found in the GIT

A

Crypts of Lieberkuhn

48
Q

What is found in crypts of Lieberkuhn?

A

Exocrine glands which secrete antimicrobial and digestive enzymes. Stem cells that differentiate to replace epithelial cells that are destroyed by acid anf abrasion.

49
Q

What is the submucous plexus (Meissner plexus)?

A

Collection of parasympathetic nerves found in the submucosa that control blood flow and secretions

50
Q

What is the myenteric plexus (Auerbach plexus)?

A

Collection of sympathetic and parasympathetic nerves that control peristalsis and motility. Found between the circular and longitudinal layer in the muscularis propria.

51
Q

Name of transverse folds on the intestinal surface?

A

Plicae circulares

52
Q

Name of finger-like processes that line the mucosa

A

Villi

53
Q

What cells line villi?

A

Epithelial cells which are lined by a brush border

54
Q

What forms the brush border on the epithelial cells (which line the villi, which line the Plicae circulares)?

A

Microvilli

55
Q

Function of Plicae circulares and villi

A

Increase SA for absorption and digestion (lumen can expand, brush border enzymes secreted from microvilli)

56
Q

How are the blood vessels and lymphatics supplied to the abdominal viscera?

A

within the visceral peritoneum including the mesentery

57
Q

What vessels are found within a villus?

A

Artery, vein, lacteal (lymph capillary)

58
Q

How does the superior mesenteric artery branch to supply the small intestine?

A

Within the mesentery, the superior mesenteric artery branches into arcades (loops) which branch off into straight lines of arteries called vasa recta.

59
Q

How to distinguish between duodenum and ileum?

A

Vasa recta longer in duodenum than ileum

60
Q

Function of the lacteal in the villi?

A

Helps with fat absorption

61
Q

Where are crypts of Lieberkuhn located?

A

Invaginations of the epithelium into the mucosa between villi

62
Q

What is Peyer’s patch?

A

Cluster of lymphatic tissue found in the lamina propria extending into the submucosa. Found mostly in the ileum.

63
Q

Name of the simple columnar / epithelial cells that line the small intestine

A

enterocytes

64
Q

How do enterocytes contribute to small intestine function?

A

Have microvilli which form a brush border to increase SA. Brush border enzymes aid digestion. Contain carrier proteins which aid absorption as they transport substances from the surface to crypts.

65
Q

How does the muscularis propria aid intestinal motility?

A

Inner circular layer contracts on top of bolus which propels it and breaks down the contents. Outer longitudinal layer shortens and lengthens to propel the bolus.

66
Q

Which structure controls the release of bolus from the small intestine to the large intestine?

A

Ileocecal valve - found in ileocecal junction

67
Q

Example of absorption still occurring in the large intestine

A

Cecum involved in absorption of vitamin B12

68
Q

Examples of intestinal diseases

A

dietary deficiencies, malabsorption, coeliac disease, Crohn’s disease, Cystic fibrosis, Meckel’s diverticulum.

69
Q

How may intestinal diseases affect the oral mucosa?

A

Diseases e.g. malabsorption syndromes, can lead to deficiencies that affect blood e.g. anaemia.

70
Q

What is Meckel’s diverticulum?

A

An outpouching of the small intestine, mostly ileal mucosa. May contain acid producing gastric, pancreatic or colonic type mucosa.

71
Q

What is the rule of 2s relating to Meckel’s diverticulum?

A

Symptoms before 2 years old, affects 2% of population, within 2 feet of the cecum.

BDS1 (24 decks)

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