Spleen, Pancreas and Small Intestines Flashcards
In which division of the abdominal cavity is the spleen located?
Left hypochondriac region (left upper quadrant)
What are the functions of the spleen?
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
The spleen lies under the cover of which ribs?
Left 9th -11th ribs
T/F
The spleen will most likely be damaged if the right-side lower ribs or upper lumbar transverse processes are fractured.
F
If the LEFT side lower ribs and transverse processes are injured, the spleen will most likely be injured.
T/F
A normal healthy spleen will most likely be palpable.
F.
The spleen is usually not palpable.
Describe a normal and abnormal percussion sound of the spleen.
Normal: dull area over the 9th-11th ribs, should not go over the midaxillary line
Abnormal: dull area extension over the 9th-11th ribs
Where does the gastrosplenic ligament attach?
From the hilum of the spleen to the left part of the greater curvature
What does the gastrosplenic ligament contain?
Short gastric arteries and the left gastroepiploic artery
Describe the surface impressions of the spleen.
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
Where does the splenorenal ligament attach?
From the front upper half of the left kidney to the hilum of spleen
Arterial supply of the spleen
Splenic artery, left and right gastroepiploic arteries
What drains the spleen?
Splenic vein
Where does the splenic lymphatic vessels leave?
Splenic hilum
Where do the nerves of the spleen originate from?
Coeliac nerve plexus
The pancreas can be found in which abdominal regions?
Epigastric and left hypochondriac regions
T/F
The pancreas is a retroperitoneal organ.
T
It crosses L1-L2 vertebral bodies.
The pancreas is divided into four parts. What are these parts?
Head, neck, body, tail
T/F
The posterior portion of the pancreas is covered with peritoneum.
F.
Only the anterior portion of the pancreas is covered with peritoneum. The posterior portion is devoid of peritoneum.
What arteries supply the head of the pancreas?
Anterior and posterior superior pancreaticoduodenal arteries (from gastroduodenal artery)
Anterior and posterior inferior pancreaticoduodenal arteries (from SMA)
What arteries supply the body and tail of the pancreas?
Dorsal, inferior, and great pancreatic arteries
What veins drain the pancreas?
Pancreatic veins (tributaries of the splenic and SMV)
T/F
Most of the lymphatics of the pancreas terminate at the pancreaticosplenic lymph nodes.
T
Where can one find the pancreaticosplenic lymph nodes?
It lies on the splenic artery.
What innervates the pancreas?
Abdominopelvic splanchnic nerves and the CN X
Pancreatic secretions is mediated by which hormones?
Secretin and Chocystokinin
T/F
The duct of santorini is the main pancreatic duct, while the duct of santorini is the minor pancreatic duct.
F.
The duct of the wirsung is the main pancreatic duct while the duct of santorini is the minor pancreatic duct.
The small intestines is from the ____ to the ____.
Pylorus to the ileocecal valve
T/F
The jejunum is the proximal 2/5 and the ileum is the distal 3/5.
T.
The ileum and jejunum is attached to the posterior abdominal wall by messentery.
What are the three divisions of the small intestines.
Duodenum, jejunum, ileum
Describe the plicae circulares.
Valves of Kerkring;
Large crescentic folds which project into the intestinal lumen
What are the four portions of the duodenum?
1st part: Superior Duodenum
2nd part: Descending Duodenum
3rd part: Transverse Duodenum
4th part: Ascending Duodenum
T/F
The superior duodenum is covered by the peritoneum anteriorly but bare posteriorly.
T.
Trace the venous drainage of the small intestines
Superior pancreaticoduodenal vein –> portal vein
Inferior vein –> superior mesenteric vein
Differentiate the Proximal Jejunum and the Distal Ileum in terms of fat deposit, vascular branching, presence of peyer’s patches and number of folds
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
What can be found on the antimesenteric border of the ileum?
Peyer’s patch
T/F
Injury caused by trauma to the ileum and jejenum is more serious compared to trauma to the duodenum.
F.
Impact caused by blunt force trauma to the jejunum and ileum is cushion by its ability to move freely compared yo the duodenum.
When a tumor blocks the exit of secretions from the pancreas and bile duct, the patient will exhibit ____.
Jaundice and chalk-coloured stool
What fits snugly in the curve of the duodenum?
The head of the pancreas
What separates the head and body of the pancreas?
Pancreatic incisurs (formed by the SMV)
This is a projection from the inferior part of the pancreatic head
Uncinate process
The pancreas is related to which vessels?
It rests posteriorly on the IVC, Right and left renal veins.
The anterior surface of the neck is related to the ___.
Pylorus of the stomach
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
T
Significance of the (hepatopancreatic) Ampulla of Vater
Area where the main pancreatic duct unites with the common bile duct;
Opens at the 2nd portion of the duodenum
This is the site of digestion and food absorption
Small intestines
Which part of the small intestines is most vulnerable to trauma and why?
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.
T/F
The superior mesenteric artery can be ligated.
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.
What attaches the jejunum and ileum to the posterior abdominal wall?
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.
What separates the renal and phrenic surfaces of the spleen?
Splenic artery