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YEAR 2 SEMESTER 2 ANATOMY > Small Intestine Week 6 FINISHED > Flashcards

Small Intestine Week 6 FINISHED Flashcards

1
Q

What are the relations of the 1st part of the duodenum?

A

Anteriorly
- Peritoneum, gall bladder and liver

Posteriorly
- Bile duct, gastroduodenal artery, portal vein, IVC

Superiorly
- Neck of the gall bladder

Inferiorly
- Neck of the pancreas

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2
Q

How long is the second part of the duodenum? Where does it pass from and to?

A

7-10cm

Passes from the superior duodenal flexure and then becomes the inferior duodenum flexure

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3
Q

Between which vertebra does the 2nd part of the duodenum pass?

A

Passes from L1 through to L3 Rt side

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4
Q

What are the relations of the 2nd part of the duodenum?

A

Anteriorly
Transverse colon, transverse
mesocolon, small intestine

Posteriorly
Hilum of the right kidney, renal vessels, ureter, psoas major

Medially
- Head of the pancreas, pancreatic duct, bile duct

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5
Q

What enters the 2nd part of the duodenum? Where does it enter?

A

Common bile duct and pancreatic duct enter the 2nd part of the duodenum

These two ducts unite to form the Hepatopancreatic ampulla

Enter the posteriomedial wall at the major duodenal papilla
- sphincter of Oddi or Hepatopancreatic sphincter

Also entering the 2nd part of the duodenum is the accessary pancreatic duct at the minor duodenal papilla

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6
Q

How long is the 3rd part of the duodenum and what does it cross anterior to?

A

6-8cm long

Crosses anterior to L3

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7
Q

What are the relations of the 3rd part of the duodenum?

A

Anteriorly
- SMA, SMV, small intestine

Posteriorly
- Rt psoas major, IVC, aorta, Rt ureter

Superiorly
- head of the pancreas, SMA, SMV

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8
Q

How long is the 4th part of the duodenum? What does it run along side and what vertebral level is it?

A

~ 5cm long
Begins Lt L3 , runs along the Lt side of the aorta
Angles sharply upwards to the level of L2

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9
Q

At what level does the 4th part of the duodenum angle sharp upwards and what does it then become?

A

Here it becomes the jejunum at the duodenojejunal flexure

level of L2, 2-3 cm to the left of the midline

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10
Q

What ar the relations of the 4th part of the duodenum?

A 
Anteriorly 
Small intestine (jejunum)

Posteriorly
- Lt psoas major, Lt margin of the aorta

Medially
head of the pancreas

Superiorly
- body of the pancreas

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11
Q

Is the duodenum retroperitoneal?

A

The duodenum lies almost completely behind the peritoneum of the posterior abdominal wall.

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12
Q

What is the arterial supply of the duodenum?

A

Arise from the celiac trunk and the SMA

Celiac trunk

  • gastroduodenal artery and its branch the superior pancreaticoduodenal arteries
  • these supply the duodenum proximal to the entry of the bile duct

SMA

  • inferior pancreaticoduodenal arteries
  • supplies the duodenum distal to the entry of the bile duct

Anastomosis between the superior and inferior pancreaticoduodenal arteries and hence the SMA and the celiac trunk

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13
Q

What is the venous drainage of the duodenum?

A

Duodenal veins follow arteries and drain into the portal vein

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14
Q

What is the nerve supply of the duodenum?

A

Sympathetics
- thoracic splanchnic nerves via the celiac and SMA plexuses (T5-9)

Parasympathetics - vagus CN X

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15
Q

Where do the ileum and the jejunum extend between?

A

Extends between the duodenojejunal flexure to the ileocecal junction

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16
Q

How long is the ileum and the jejunum?

A

Combined are 6-7 metres long ( jejunum 2/5 ths length, ileum 3/5ths)

17
Q

Where does the majority of the ileum lie? What about the jejeunum?

A

Most of the ileum lies in the right lower quadrant

Most of the jejunum lies in the left upper quadrant

18
Q

What attach the ileum and jejunum to the posterior abdominal wall?

A

These are attached to the posterior abdominal wall by the fan shaped small bowel mesentery

19
Q

How long in the root of the mesentery of the ileum and jejunum? What runs in the mesentery?

A

Root or origin is ~ 15 cm long

Between the layers of the mesentery - superior mesenteric vessels, lymph nodes, fat, autonomic nerves

20
Q

Arterial supply of the ileum and jejunum:

A

SMA - intestinal arteries
Arises from the abdominal aorta (level L1) 1cm inferior to the celiac trunk

15 -18 branches which run between the layers of the mesentery

21
Q

What is the venous drainage of the ileum and jejunum?

A

SMA -> drains into the portal vein which is the uniting of the SMA with the splenic artery

22
Q

What is the nerve supply of the ileum and duodenum?

A

Sympathetics T5-9 pass through the greater and lesser splanchnic nerves and synapse with post sympathetic neurons in the celiac and SM ganglia (egs of prevertebral ganglia)

Parasympathetic - vagus

SAME AS THE DUODENUM

23
Q

What are the effects of the different nervous supply for the ileum and jejunum?

A

Sympathetic stimulation generally

- reduces motility of the intestine
- reduces secretion
- vasoconstriction
- thus reducing digestion so energy can be diverted

Parasympathetic stimulation

- increase in motility and secretions
- restore intestinal activity following sympathetic 	stimulation

Sensory or visceral afferents
- are insensitive to most pain stimuli but are sensitive to distension (colic)

24
Q

What are the parts of the small intestine?

A

Duodenum, Jejunum, Ileum

25
Q

Where does the small intestine extend from and to?

A

Extends from the pylorus to the ileocecal junction where the ileum joins the first part of the large intestine (caecum)

26
Q

What is the first part of the small intestine?

A

The duodenum

27
Q

What is the shortest, widest and most fixed part of the of the small intestine?

A

The duodenum

28
Q

How long is the first part of the duodenum?

A

5cm long

29
Q

What is the bony relations to the first part of the duodenum?

A

Anterior and lateral to L1

30
Q

Which way does the 1st part of the duodenum pass?

A

Passes upwards and backwards (ie towards the posterior abdominal wall)

31
Q

What is the first 2cm of the first part of the duodenum called? Is it mobile?

A

First 2cm called the cap and is mobile, having a mesentery

32
Q

What parts of the duodenum have mesentery?

A

Only the 1st part

33
Q

What is on the superior part of the first part of the duodenum? What about the inferior part?

A

The proximal part superiorly find the hepatoduodenal ligament (part of the lesser omentum)

Inferiorly find the greater omentum

YEAR 2 SEMESTER 2 ANATOMY (21 decks)

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