Spleen, Pancreas and Small Intestines

Question 0

In which division of the abdominal cavity is the spleen located?

Answer 0

Left hypochondriac region (left upper quadrant)

Question 1

What are the functions of the spleen?

Answer 1

Prenatal fxn: Hematopoietic organ
After birth fxn: identify, remove and destroy expended RBCs and broken down platelets; recycles iron and globin

Site of WBC proliferation and immune surveillance and response
Blood reservoir

Question 3

The spleen lies under the cover of which ribs?

Answer 3

Left 9th -11th ribs

Question 4

T/F

The spleen will most likely be damaged if the right-side lower ribs or upper lumbar transverse processes are fractured.

Answer 4

F

If the LEFT side lower ribs and transverse processes are injured, the spleen will most likely be injured.

Question 5

T/F

A normal healthy spleen will most likely be palpable.

Answer 5

F.

The spleen is usually not palpable.

Question 6

Describe a normal and abnormal percussion sound of the spleen.

Answer 6

Normal: dull area over the 9th-11th ribs, should not go over the midaxillary line
Abnormal: dull area extension over the 9th-11th ribs

Question 7

Where does the gastrosplenic ligament attach?

Answer 7

From the hilum of the spleen to the left part of the greater curvature

Question 8

What does the gastrosplenic ligament contain?

Answer 8

Short gastric arteries and the left gastroepiploic artery

Question 9

Describe the surface impressions of the spleen.

Answer 9

Colic impression: lies on the phrenicocolic ligament and the left flexure of the colon

Pancreatic impression: splenic hilum is related to the tail of the pancreas; constitutes the left boundary of the omentum

Question 10

Where does the splenorenal ligament attach?

Answer 10

From the front upper half of the left kidney to the hilum of spleen

Question 12

Arterial supply of the spleen

Answer 12

Splenic artery, left and right gastroepiploic arteries

Question 13

What drains the spleen?

Answer 13

Splenic vein

Question 15

Where does the splenic lymphatic vessels leave?

Answer 15

Splenic hilum

Question 16

Where do the nerves of the spleen originate from?

Answer 16

Coeliac nerve plexus

Question 17

The pancreas can be found in which abdominal regions?

Answer 17

Epigastric and left hypochondriac regions

Question 18

T/F

The pancreas is a retroperitoneal organ.

Answer 18

T

It crosses L1-L2 vertebral bodies.

Question 19

The pancreas is divided into four parts. What are these parts?

Answer 19

Head, neck, body, tail

Question 20

T/F

The posterior portion of the pancreas is covered with peritoneum.

Answer 20

F.

Only the anterior portion of the pancreas is covered with peritoneum. The posterior portion is devoid of peritoneum.

Question 21

What arteries supply the head of the pancreas?

Answer 21

Anterior and posterior superior pancreaticoduodenal arteries (from gastroduodenal artery)
Anterior and posterior inferior pancreaticoduodenal arteries (from SMA)

Question 22

What arteries supply the body and tail of the pancreas?

Answer 22

Dorsal, inferior, and great pancreatic arteries

Question 23

What veins drain the pancreas?

Answer 23

Pancreatic veins (tributaries of the splenic and SMV)

Question 24

T/F

Most of the lymphatics of the pancreas terminate at the pancreaticosplenic lymph nodes.

Answer 24

T

Question 25

Where can one find the pancreaticosplenic lymph nodes?

Answer 25

It lies on the splenic artery.

Question 26

What innervates the pancreas?

Answer 26

Abdominopelvic splanchnic nerves and the CN X

Question 27

Pancreatic secretions is mediated by which hormones?

Answer 27

Secretin and Chocystokinin

Question 28

T/F

The duct of santorini is the main pancreatic duct, while the duct of santorini is the minor pancreatic duct.

Answer 28

F.

The duct of the wirsung is the main pancreatic duct while the duct of santorini is the minor pancreatic duct.

Question 29

The small intestines is from the ____ to the ____.

Answer 29

Pylorus to the ileocecal valve

Question 30

T/F

The jejunum is the proximal 2/5 and the ileum is the distal 3/5.

Answer 30

T.

The ileum and jejunum is attached to the posterior abdominal wall by messentery.

Question 31

What are the three divisions of the small intestines.

Answer 31

Duodenum, jejunum, ileum

Question 32

Describe the plicae circulares.

Answer 32

Valves of Kerkring;

Large crescentic folds which project into the intestinal lumen

Question 33

What are the four portions of the duodenum?

Answer 33

1st part: Superior Duodenum
2nd part: Descending Duodenum
3rd part: Transverse Duodenum
4th part: Ascending Duodenum

Question 34

T/F

The superior duodenum is covered by the peritoneum anteriorly but bare posteriorly.

Answer 34

T.

Question 35

Trace the venous drainage of the small intestines

Answer 35

Superior pancreaticoduodenal vein –> portal vein

Inferior vein –> superior mesenteric vein

Question 36

Differentiate the Proximal Jejunum and the Distal Ileum in terms of fat deposit, vascular branching, presence of peyer’s patches and number of folds

Answer 36

Fat deposit in mesentery: jejunum < ileum
Marked tendency toward anastomosis of arterial and vascular arcades in the mesentery: jejunum < ileum
Peyer’s patches: jejunum (+), ileum (-)
intestinal folds: jejunum > ileum

Question 37

What can be found on the antimesenteric border of the ileum?

Answer 37

Peyer’s patch

Question 38

T/F

Injury caused by trauma to the ileum and jejenum is more serious compared to trauma to the duodenum.

Answer 38

F.
Impact caused by blunt force trauma to the jejunum and ileum is cushion by its ability to move freely compared yo the duodenum.

Question 39

When a tumor blocks the exit of secretions from the pancreas and bile duct, the patient will exhibit ____.

Answer 39

Jaundice and chalk-coloured stool

Question 40

What fits snugly in the curve of the duodenum?

Answer 40

The head of the pancreas

Question 41

What separates the head and body of the pancreas?

Answer 41

Pancreatic incisurs (formed by the SMV)

Question 42

This is a projection from the inferior part of the pancreatic head

Answer 42

Uncinate process

Question 43

The pancreas is related to which vessels?

Answer 43

It rests posteriorly on the IVC, Right and left renal veins.

Question 44

The anterior surface of the neck is related to the ___.

Answer 44

Pylorus of the stomach

Question 45

T/F

The body of the pancreas is devoid of peritoneum and is in contact with the SMV, aorta, L suprarenal gland and L kidney

Answer 45

T

Question 46

Significance of the (hepatopancreatic) Ampulla of Vater

Answer 46

Area where the main pancreatic duct unites with the common bile duct;
Opens at the 2nd portion of the duodenum

Question 47

This is the site of digestion and food absorption

Answer 47

Small intestines

Question 48

Which part of the small intestines is most vulnerable to trauma and why?

Answer 48

Since the duodenum is rigidly fixed to the posterior abdominal wall, it cannot move away from the crushing impacts, making it more susceptible to damage.

Question 49

T/F

The superior mesenteric artery can be ligated.

Answer 49

F.
The SMA supplies the blood to the gut region (from the duodenum to the left colic). An occlusion will result to the death of all or part of this.

Question 50

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

Answer 50

Mesentery of the small intestines
note: the root of the mesentery allows the entraince and exit of branches of the SMA and SMV, lymph vessels, and nerves into th space between the layers.

Question 51

What separates the renal and phrenic surfaces of the spleen?

Answer 51

Splenic artery