Small Intestine: Duodenum Flashcards
Length of Duodenum
10 inches long
length of 1st part duodenum
2 inches long
2,3,4,1
Length of 2nd part duodenum
3 inches long
2,3,4,1
Length of 3rd part duodenum
4 inches long
2,3,4,1
Length of 4th part duodenum
1 inch long
2,3,4,1
Site of duodenum
Partially in Epigastric region & partially in umbilical region
Beginning of 1st part duodenum
from pyloric end of stomach, 1/2 inch right to midline at transpyloric plane (L1 vertebra) level
2nd Part of duodenum ends at level —-
L3 Vertebra
3rd part duodenum is horizontal, extending to the left at level —
L3 vertebra
End of 4th part duodenum
at Duodenojejunal flexure, 1 inch left to midline, at level L2 vertebra
Describe peritoneal Covering of duodenum
- Duodenum is retroperitoneal
- Peritoneum covers Anterior & peripheral parts of duodenum
- except 1st inch of 1st part as it’s mobile, so completely covered
Ant, post, sup, inf relations of 1st inch 1st part duodenum
Ant:
* Greater sac
* Quadrate lobe of liver
Post:
* Neck of Pancreas
* Lesser sac
Sup:
* Lesser Omentum ( Containing
* Common Bile Duct
* Hepatic A
* Portal vein )
* epiploic Foramen
Inferior:
* Head of Pancreas
* Greater omentum (attachement)
Ant, post, inf relations of 2nd inch 1st part duodenum
Ant:
* Quadrate lobe of liver (like 1st inch)
* Lesser Sac (like 1st inch)
* Neck of gall bladder
Post:
* Gastroduodenal A
* Common bile duct
* Portal V
* IVC
Inf: head of Pancreas
2nd, 3rd & 4th part duodenum common anterior relation
Coils of jejunum
Ant, post, med, lat relations of 2nd part duodenum
Ant:
* Upper part: lesser sac + inf surface of right lobe of liver
* Middle part: transverse colon
* Lower Part: coils of jejunum
Post:
* Hilum of right kidney
* right Renal Vessels
* Right pelvis ureter
* Right psoas major
Med:
* Head of pancreas
* Sup & inf pancreaticoduodenal A
* Ampulla of Vater
Lat:
* Right lobe of liver
* Right Colic Flexure
* Ascending Colon
Ant, post, sup, inf relations 3rd part duodenum
Ant:
* Root of Small intestine mesentery containing Sup. mesenteric vessels
* Coils of jejunum
Post:
* IVC
* Aorta
* Inferior Mesenteric A origin
* Right ureter
* Right psoas major
* Right Gonadal A
Sup:
* Head of pancreas & uncinate process
Inf: coils of jejunum
Ant, post, med, lat relations 4th part duodenum
Ant:
* Coils of jejunum
Post:
* Left gonadal A
* Left sympathetic Chain
Med:
* uncinate process
* head of pancreas
* Abdominal Aorta
Lat:
* Coils of jejunum
* Hilum of left kidney
Describe Arterial Supply of duodenum
1st part 1st inch:
* Supraduodenal A (br from gastroduodenal A/ Hepatic A)
* Additional supply from Right gastric & right gastro-epiploic A
1st part 2nd inch & 2nd part upper 1/2:
* Superior pancreaticoduodenal (from gastroduodenal A)
Rest of Duodenum:
* Inferior pancreaticoduodenal A (from sup. mesenteric A)
Clinical points for duodenum
- marked at operation by ligament of Treitz
- most common site for peptic Ulcer
