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Anatomy II > Stomach And Intestines > Flashcards

Stomach And Intestines Flashcards

1
Q

The lesser omentum can be divided into two structures, what structures?

A

A thick hepatoduodenal ligament and a thinner hepatogastric ligament

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2
Q

What are the three muscular layers of the stomach?

A

Outer longitudinal, middle circular and inner oblique

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3
Q

Does the stomach lie intraperitoneally?

A

Yes

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4
Q

Which part of the stomach contains air?

A

Fundus

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5
Q

What are the arteries supplying the stomach?

A

Left gastric artery (celiac trunk) and right gastric artery (hepatic artery proper from celiac trunk) for the vascular arch of the lesser curvature. Right gastric artery lies in the hepatogastric ligament.

The vascular artery at the greater curvature is formed by the gastric-omental arteries. Left gastric-omental artery (from splenic artery) anastomoses with the right gastric-omental artery (from gastroduodenal artery)

Fundus of stanch recieves branches from the small gastric arteries (from splenic artery)

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6
Q

What are the three main branches of the celiac trunk?

A

Common hepatic artery, left gastric artery and splenic artery

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7
Q

From which artery does the right gastric artery ranch from?

A

Proper hepatic artery

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8
Q

From which artery does the gastroduodenal artery breach from?

A

Common hepatic artery

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9
Q

What arteries supply the lesser curvature of the stomach?

A

Left gastric artery and right gastric artery

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10
Q

Which arteries supply the fundus of the stomach?

A

Short gastric arteries from the splenic artery

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11
Q

Which arteries supply the greater curvature of the stomach?

A

The right gastric-omental artery (from the gastroduodenal artery) and the left gastro-omental artery (from the splenic artery)

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12
Q

The posterior wall of the stomach is supplied by which artery?

A

Posterior gastric artery from the splenic artery

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13
Q

At which level is the celiac trunk?

A

T12

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14
Q

At what level does the aorta bifurcate?

A

L4

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15
Q

Where does the inferior mesmeric vessels arise?

A

L3-L4

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16
Q

What is the innervation of the stomach?

A

Parasympathetic: anterior surface: left vagus nerve, posterior surface: right vagus nerve.

Sympathetic: celiac nerve plexus

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17
Q

What is the venous drainage of the stomach?

A

Left gastric vein or splenic and inferior mesenteric. They all go to hepatic portal vein.

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18
Q

What are the four parts of the duodenum?

A

Superior, descending, horizontal and ascending

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19
Q

What are the flexures of the duodenum?

A

Superior duodenal flexure, inferior duodenal flexure and duodeno-jejunal flexure

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20
Q

At what level does the duodenum begin?

A

L1

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21
Q

Which parts of the duodenum is intraperitoneally?

A

The superior part

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22
Q

Which parts are situated retroperitoneally?

A

Descending, horizontal and ascending part

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23
Q

What travels in the superior duodenal fold?

A

Inferior mesenteric vein

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24
Q

What is the ligament called that does from the ascending part of the duodenum to the right crux of diaphragm?

A

Suspensory ligament or ligament of Treitz

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25
Q

On what part of the duodenum does the longitudinal fold appear?

A

Descending part

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26
Q

What opens up on the longitudinal fold of the duodenum?

A

Major papilla: (bile duct and pancreatic duct) (vater’s)

Minor papilla: accessory pancreatic duct (of Santorini)

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27
Q

What are the mucosa of the duodenum like?

A

Folds of Kerckring. They increase the surface area and consist of mucosa and submucosa

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28
Q

The duodenum surrounds which structure?

A

The head of the pancreas

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29
Q

What is the arterial supply of the duodenum?

A

Anterior and posterior pancreaticoduodenal artery (from gastroduodenal artery) + inferior pancreaticoduodenal artery (from superior mesenteric artery). They unite to form a vascular loop -> connection between celiac trunk and superior mesenteric.

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30
Q

Through which veins is the duodenum drained?

A

Splenic vein and superior mesenteric vein into the hepatic portal vein.

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31
Q

Why is the duodenum supplied by two different arterial trunks?

A

It originates from foregut (celiac artery) and midgut (superior mesenteric artery)

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32
Q

What is the nerve innervation of the duodenum?

A

Extrinsic: vessels around mesenteric vessels
Parasympathetic: vagal trunk
Sympathetic: celiac ganglia and superior mesenteric ganglion

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33
Q

What is the Meckels diverticulum a remnant of?

A

Embryonic vitelline duct

34
Q

Is the small intestine intraperitoneally?

A

Yes

35
Q

From where to where does the Roos of mesentery go?

A

Duodeno-jejunal flexure to the right iliac fossa

36
Q

What is the arterial supply of the small intestine?

A

Superior mesenteric artery. About 4-5 jejnual branches and 12 ileal branches

37
Q

What are the interconnections between the small intestinal arteries called?

A

Arcades

38
Q

The branches passing from the arcades to the intestinal wall are called?

A

Terminal branches (vasa recta)

39
Q

What veins does the small intestine empty into?

A

Superior mesenteric vein -> hepatic portal vein

40
Q

Nerve innervation of the small intestine

A

Extrinsic: nerve plexuses along mesenteric arteries
Parasympathetic: vagal trunks
Sympathetic: celiac ganglia and superior mesenteric ganglion

41
Q

Branches of the superior mesenteric artery

A
  • inferior pancreaticoduodenal artery
  • jejunal and ileal arteries (14-20)
  • ileocolic artery with posterior and anterior decal arteries and appendicular artery
  • right colic artery
  • middle colic artery
42
Q

What are the divisions of the large intestine?

A
  • cecum
  • ascending colon
  • transverse colon
  • descending colon
  • sigmoid colon
  • rectum
43
Q

What three teniae do we have on the large intestine?

A
  • free tenia
  • omental tenia
  • mesocolic tenia
44
Q

What is the teniae?

A

The longitudinal layer of muscularis externa in large intestine (not in rectum or veriform appendix)

45
Q

What are the fat “droplets” on the large intestines called?

A

Epiploic appendices (subserosal fatty tags)

46
Q

What are the “bulges” on the large intestines called?

A

Haustra

47
Q

What parts of the large intestine is intraperitoneally?

A
  • The cecum depends (free cecum of fixed cecum)
  • transverse colon
  • sigmoid colon
48
Q

By what is the transverse colon attached to the stomach?

A

Gastrocolic ligament

49
Q

Where does the greater omentum attach to?

A

The omental tenia on transverse colon

50
Q

Which tenia lies anteriorly on the cecum?

A

Free tenia

51
Q

What does the ileocolic and ileocecal lips create?

A

The ileocecal valve (Bauhin’s valve)

52
Q

Where is the McBurney’s point?

A

If you draw a line from the anterior superior iliac spine to the umbilicus, the base of the appendix will be 1/3 of the way to the umbilicus.

53
Q

Does the appendix lie intraperitoneally?

A

Yes, and it has its own mesoappendix

54
Q

What arteries supply the cecum?

A

Ileocolic artery from the superior mesenteric artery.

The ileocolic artery branches into the following arteries:

  • appendicular artery
  • anterior cecal artery
  • posterior cecal artery
  • ileal branches
55
Q

Venous drainage of the cecum?

A

Ileocolic vein -> superior mesenteric vein -> hepatic portal vein

56
Q

What is the arterial supply of the large intestine?

A

Until 2/3 of transverse colon:
Middle colic artery and right colic artery from superior mesenteric artery

From 1/3 of transverse colon and down:
Left colic artery, sigmoidal artery and superior rectal artery from inferior mesenteric artery

57
Q

What is the Sudeck’s point?

A

Anastomosing between superior rectal artery and sigmoidal artery

58
Q

What is true Arch of Riolan?

A

Left colic artery anastomoses with middle colic artery, communication between superior and inferior mesenteric arteries in the colon

59
Q

What nerves innervates the colon?

A

Parasympathetic: vagus (until 2/3 of transverse colon) and sacral spinal cord at the leve of S2 - S5 (from last 1/3 of transverse colon and down)

Sympathetic: superior mesenteric plexus or inferior mesenteric plexus

60
Q

What is the point separating the nerve innervation of the transverse colon called?

A

Canon-Boehm point

61
Q

At what level does the rectum begin?

A

S2 or S3

62
Q

At what level does the superior mesenteric artery branch from the aorta?

A

L1

63
Q

At what level does the sigmoid colon become continuous with the rectum?

A

S2 or S3

64
Q

In the saggital plane, how many flexures does the rectum have?

A

Two:

  • sacral flexure
  • anorectal flexure/perineal flexure
65
Q

The peritoneum of the rectum reflects on different structures in male and female, and create different pouches. What are those?

A

Male: the peritoneum reflects on the urinary bladder - rectovesical pouch
Female: the peritoneum reflects on the uterus - rectouterine pouch

66
Q

What is the peritoneal relationship of the rectum?

A

The upper portion of the rectum is retroperitoneal and the distal portion has no peritoneal covering.

67
Q

What are the components of the sphincter apparatus?

A

Internal anal sphincter (smooth muscle) and external anal sphincter (striated muscle). The external anal sphincter blends within the fibers of the levator ani muscle.

68
Q

What does the internal anal sphincter consist of?

A

It consist of smooth muscle.
It is a thickened continuation of the circular layer of the large intestine, about 2 cm long. It extends to the acutaneous line.

69
Q

What does the external anal sphincter consist of?

A

It consist of striated muscle and surrounds the smooth muscle of the inner anal sphincter.

It can be divided into three components:

  • subcutaneous part
  • superficial part
  • deep part

The external anal sphincter is connected by the anococcygeal body to the coccyx. Its inferior portion blends with the puborectalis part of the levator ani muscle.

70
Q

What is the junction between the anal canal and the rectum?

A

Anorectal junction on top of the anal columns

71
Q

Where does the pectinate line lie?

A

Under the anal columns

72
Q

Which artery supplies the hemorrhoidal/arteriovenous plexus in the rectum?

A

Superior rectal artery

73
Q

Which arteries supply the rectum?

A

Superior rectal artery - inferior mesenteric
Middle rectal artery - internal iliac
Inferior rectal artery - internal pudendal

74
Q

Which veins drain the rectum?

A

The veins draining the rectum anastomose to from the rectal venous plexus that surrounds it.

Venous drainage corresponds to arterial supply:

Superior rectal vein -> inferior mesenteric vein -> hepatic portal vein
Middle and inferior rectal vein -> internal iliac -> inferior vena cava

75
Q

What is the nerve innervation of the rectum?

A

Autonomic: sacral portion of the parasympathetic nervous system and the lumbar sympathetic trunk. Nerve fibers pass to the intestine via the inferior hypogastric plexus. Sensory innervation of the anal skin is by the inferior rectal nerves, which are branches of the pudendal nerve.

76
Q

Name the folds of the rectum

A

Superior transverse fold, middle transverse fold (Kohlrausch) fold and inferior transverse fold

77
Q

From where to where is the rectal ampulla?

A

From the middle rectal fold (Kohlrauch) to the anorectal junction

78
Q

From where to where is the anal canal?

A

The anal canal is located from under the rectoanal junction to distal perineal flexure.

79
Q

What produces the anal columns and sinuses?

A

Hemorrhoidal plexus in the submucosa

80
Q

What is the epithelium of the perinatal skin?

A

Stratified squamous epithelium with heavy pigmentation, apocrine sweat glands and hair follicles

81
Q

What is the epithelium of the anoderm (white zone)?

A

Stratified, non-keratinized squamous epithelium, which is intimately attached to the underlying internal anal sphincter - hence its whiteish appearance

82
Q

What is the epithelium at the anal columns?

A

Transitional zone: it is a mosaic pattern of colorectal mucosa, unilayered columnar epithelium and stratified squamous epithelium

Anatomy II (15 decks)

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