Stomach and Bowel Flashcards
How is the jejunum connected to PAW?
SI Mesentery
Which part of LI are intraperitoneal?
Transverse and Sigmoid Colon
What is the lesser sac?
Peritoneal sac posterior to stomach and LO. Communicates with GS through epiploic foramen
What lies in free border of LO?
HA, HPV and BDuct
What are the 4/5 main regions of the stomach?
1) Cardia
2) Fundus
3) Body
4) Antrum
5) Pylorus
Which vertebral levels does stomach lie in?
T7 to L3
What are the folds called on internal stomach surface?
Rugae
What are the 2 stomach sphincters and which one is physiological? (Muscular function)
1) Inferior Oesophageal Sphincter (Phys)
2) Pyloric Sphincter
(Controls chyme exit from stomach)
Where does foregut end and midgut begin?
Major duodenal papilla (2nd part)
Stomach GC blood supply? (2)
1) Short gastrics
2) L&R Gastro-epiploic arteries
Stomach LC blood supply? (2)
L&R Gastric Arteries
What is right gastric and right gastro-epiploic branch of?
1) RG: Proper hepatic from CHA from coeliac trunk
2) RGE: Terminal branch of GD artery, from common HA from CT
What is LGE artery a branch of?
Splenic artery from coeliac trunk
Where does venous blood from GI tract, liver and spleen drain into?
HPV (to liver)
What are the innervations of stomach?
1) T5-9 Sympathetic
2) Vagus Parasympathetic
Where does oesophagus pass through stomach? And what structures pass alongside?
1) T10
2) Vagus nerve, oesophageal arteries/veins
Which nerve is anterior and posterior to abdominal oesophagus?
1) LV: Anterior
2) RV: Posterior (LARP)
What are the small folds of mucosa inside the SI?
Plicae circulares
What are Peyer’s patches and where are they found?
Large, submucosal lymph nodes
Ileum
Are jejunum and ileum retro or intra peritoneal?
Intra
Which part of intestine has thicker wall out of Jejunum and Ileum?
Jejunum
What are 5 characteristics of the Jejunum?
Ten Lanky Lads play rugby
1) Thick intestinal walls
2) Longer vasa recta
3) Less arterial arcades
4) Pronounced plicae circulates
5) Red in colour
What are the 5 characteristics of the Ileum?
1) Thin intestinal walls
2) Shorter vasa recta
3) More arterial arcades
4) Peyer’s patches
5) Pink in colour
What is Meckel’s diverticulum and where found?
1) Attachment of mid-gut to yolk sac embryonic remnant
2) 1M from term of ileum
Where does midgut start and end? And blood supply?
1) 3rd part of duodenum to 2/3 of TC
2) SMA
What are the 3 main branches of SMA?
1) Right Colic
2) Middle Colic
3) Ileo Colic
Where does right and middle colic supply?
1) Right: Ascending Colon
2) Middle: Transverse Colon
Into which vein does blood from the jejunum and ileum drain and what is the final destination of the blood?
Drains into the superior mesenteric vein.
This vein combines with the splenic vein to form the hepatic portal vein which then goes on to the liver.
What is the innervation of SI?
1) Sympathetic: Lesser Splanchnic (T10-11)
2) Parasympathetic: Vagus
4 adaptations of SI for large SA for absorption of nutrients in intestine?
1) Plicae circularis
2) Coiled length
3) Villi
4) Microvilli
What is caecum’s peritoneal position? And blood supply and venous drainage?
1) Intraperitoneal
2) Ileocolic artery and Ileocolic vein –>SMV
Ascending colon blood supply and vd?
1) Ileocolic and right colic arteries
2) Ileocolic and right colic veins
Descending colon blood supply and VD?
1) Left colic and superior sigmoid arteries
2) Inferior Mesenteric vein
Transverse colon blood supply and VD?
1) Middle colic artery
2) SMV
Sigmoid colon blood supply and VD?
1) Sigmoid arteries
2) IMV (L3)
3 adaptations of LI?
1) Appendices epiploicae
2) Tenia Coli
3) Haustrations
What are Tenia Coli?
3 strips of longitudinal muscle on outer surface of LI
What are haustrations?
Sacculations from where tenia coli contract to shorten wall of bowel
What are appendices epiploicae?
Small pouches of peritoneum with fat, where BV enter bowel to supply mucosa
Hindgut innervation?
1) Sympathetic: Least Splanchnic (T12)
2) Para: S2-4
Give 4 locations where the distal end of the appendix may lie.
- In the pouch of Douglas.
- Behind the caecum.
- Behind the umbilicus.
- Below the liver.
What is marginal artery of Drummond and significance?
1) Artery forms anastomoses between SMA and IMA
2) If occlusion in IMA, blood can be supplied to LI via SMA through MAD
