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GI > Small intestine > Flashcards

Small intestine Flashcards

1
Q

Compare the mobility of the small intestine with the large intestine

A

Small intestine is mobile except the duodenum

Large intestine is mobile except the ascending and descending colon

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2
Q

Compare the lumen diameter of the small intestine with the large intestine

A

Lumen of the large intestine is much larger

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3
Q

Compare the longitudinal muscle of the small intestine with the large intestine

A

The small intestine has continuous longitudinal muscle

The large intestine has 3 bands of longitudinal muscle called teniae coli

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4
Q

Compare the presence of fatty tags in the small intestine with the large intestine

A

Small intestine has none

Large intestine has fatty tags called epiploic appendices

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5
Q

Compare the wall of the small intestine with the large intestine

A

Small intestine wall is smooth

Large intestine wall is sacculated forming haustra

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6
Q

Compare the mucous membrane of the small intestine with the large intestine

A

Small intestine has permanent folds in its mucous membrane called plicae circulares
Large intestine doesn’t have plicae circulares

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7
Q

Compare the lymphoid tissue in the small intestine with the large intestine

A

Small intestine has peyer’s patches

Large intestine has no lymphoid tissue

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8
Q

Where does the small intestine run from and to

A

From the pylorus so the stomach to the ileoceacal junction

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9
Q

Parts of the small intestine

A

Duodenum
Jejunum
Ileum

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10
Q

How long is the duodenum

A

Breadth of 12 fingers (25cm)

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11
Q

Where does the duodenum run from and to

A

From the pylorus of the stomach to the duodenojejunal flexure

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12
Q

Shape of the duodenum

A

C shape that wraps around the head of pancreas

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13
Q

Describe the duodenojejunal flexure

A

Acute angle

2-3cm to the left of the midline at the level of the L2 vertebra

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14
Q

What are the parts of the duodenum

A

Superior
Descending
Inferior
Ascending

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15
Q

Where is the duodenal cap/ampulla

A

First 2cm of the superior duodenum

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16
Q

Mobility of the duodenum

A

Immobile except the ampulla which has a mesentery

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17
Q

Length of the superior duodenum

A

5cm

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18
Q

Where is the superior duodenum in relation to the vertebra

A

Anterolateral to L1

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19
Q

What is the most common site for duodenal ulcers and why

A

Ampulla as its immediately distal to the pylorus of the stomach

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20
Q

What is attached superiorly and inferiorly to the superior duodenum

A

Superiorly - attached to the liver by the hepatoduodenal ligament
Inferiorly - attached to the greater omentum

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21
Q

Length of the descending duodenum

A

7-10cm

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22
Q

Where is the descending duodenum in relation to the vertebrae

A

Right of L1-3

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23
Q

What lies anterior and posterior to the descending duodenum

A

Anterior - transverse colon

Posterior - right kidney

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24
Q

What internal feature of the descending duodenum distinguishes it from the other parts

A

Major duodenal papilla

25
Q

What does the major duodenal papilla allow entry of

A

Bile and pancreatic secretions

26
Q

Where does the transverse mesocolon form

A

Middle third of the descending duodenum

27
Q

Length of the inferior duodenum

A

6-8cm

28
Q

Where is the inferior duodenum in relation to the vertebrae

A

Crosses the L3 vertebra (right to left)

29
Q

What lies posterior to the inferior duodenum

A

Aorta
IVC
L3 vertebra

30
Q

What lies anterior to the inferior duodenum

A

SMA
SMV
Root of mesentery of the small intestine

31
Q

Length of the ascending duodenum

A

5cm

32
Q

Where is the ascending duodenum in relation to the vertebrae

A

From left of L3 vertebra to the superior margin of L2 vertebra

33
Q

Course of the ascending duodenum

A

Ascends along the left side of the aorta to reach the inferior border of the body of pancreas
It then curves to join the Jejunum at the duodenojejunal flexure

34
Q

What supports the duodenojejunal flexure

A

Suspensory muscle of the duodenum (ligament of Treitz)

35
Q

What does contraction of the suspensory muscle of the duodenum do

A

Widens the angle of the duodenojejunal flexure which increases movement of the intestinal contents into the Jejunum

36
Q

What’s a duodenal ulcer

A

Erosion of the duodenal mucosa

37
Q

Common causes of duodenal ulcers

A

Infections by helicobacter pylori

Chronic NSAID use

38
Q

Complications of duodenal ulcers

A

Can perforate duodenal wall, leading to:
Peritonitis
Erosion of gastroduodenal artery causing severe haemorrhage

39
Q

Length of the Jejunum and ileum

A

6-7m overall
Jejunum makes up 2/5
Ileum makes up 3/5

40
Q

What does the mesentery of the small intestine connect

A

Intraperitoneal section of the small intestine to the posterior abdominal wall

41
Q

What’s between the layers of the mesentery of the small intestine

A

Superior mesenteric vessels
Lymph nodes
Fat
Autonomic nerves

42
Q

What does the root of mesentery of the small intestine cross

A 
Ascending and inferior duodenum
Abdominal aorta
IVC
Right ureter
Right psoas major
Right testicular/ovarian vessels
43
Q

Compare the colour of the Jejunum and ileum

A

Jejunum is deep red

Ileum is pale pink

44
Q

Compare the diameter of the Jejunum and ileum

A

Jejunum is 2-4cm

Ileum is 2-3cm

45
Q

Compare the wall of the Jejunum and ileum

A

Wall of Jejunum is thick and heavy

Wall of ileum is thin and light

46
Q

Compare the vascularity of the Jejunum and ileum

A

Jejunum is more vascular than the ileum
Vasa recta are longer in the jejunum
Jejunum has fewer arcades with larger loops

47
Q

Compare the fat in the mesentery of the Jejunum and ileum

A

Ileum has more

48
Q

Compare the plicae circulares of the Jejunum and ileum

A

In the Jejunum they are large, tall and closely packed
In the ileum they are low and sparse
They are absent in the distal ileum

49
Q

Compare the number of peyer’s patches in the Jejunum and ileum

A

Ileum has more

50
Q

Link embryological origins of the small intestine to their blood supply

A

Duodenum proximal to the bile duct is derived from the foregut therefore it’s supplied by the coeliac trunk
Duodenum distal to the bile duct, Jejunum and ileum are derived from the midgut therefore they’re supplied by the superior mesenteric vessels

51
Q

Arterial supply of the duodenum proximal to the bile duct

A

Coeliac trunk -> gastroduodenal -> superior pancreaticoduodenal artery

52
Q

Arterial supply of the duodenum distal to the bile duct

A

Abdominal aorta -> superior mesenteric artery -> inferior pancreaticoduodenal artery

53
Q

Venous drainage of the duodenum

A

Pancreaticoduodenal veins follow the arteries into the hepatic portal vein, either:
Directly
Indirectly - superior mesenteric vein and splenic vein

54
Q

Arterial supply of the Jejunum

A

Abdominal aorta -> SMA -> jejunal artery

55
Q

Arterial supply of the ileum

A

Abdominal aorta -> SMA -> ileal artery

56
Q

Where does the SMA arise

A

Level of the L1 vertebra about 1cm inferior to the coeliac trunk

57
Q

What do the jejunal and ileal arteries form

A

Arterial arcades which give rise to vasa recta

58
Q

Venous drainage of the Jejunum and ilium

A

Superior mesenteric vein

GI (19 decks)

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