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Gastrointestinal > The Intestines and The Anus > Flashcards

The Intestines and The Anus Flashcards

1
Q

The highest point of the abdomen is the highest point of the diaphragm which is at what vertebral level

A

T8

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2
Q

What is the most inferior part of the abdomen

A

Pelvic inlet

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3
Q

Pylorus, duodenum , jejunum , ileum , caecum , ascending Color , traverse colon , descending colon , sigmoid colon , rectum …

A

Anal canal

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4
Q

What are the two turning points of the large Intestine

A

Hepatic flexure and then splenic flexure

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5
Q

3 branches of the abdominal aorta supply the intestines
This is the celiac trunk
Sup. Mesenteric artery
Inf. mesenteric artery

What Levels do these break off the abdominal aorta and what do they supply

A

T12 forgut
L1 midgut
L3 hindgut

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6
Q

The superior mesenteric artery supplies the ascending colon and majority of transverse and small intestine so distal transverse colon is where the midgut ends
Which artery from the superior mesenteric artery anastomoses with branches of the inferior mesenteric artery so their is collateral circulation so if clot In IMA still works

A

Middle colic artery

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7
Q

Venous drainage runs back up to liver- liver uses that blood and then goes back into circulation - what vein takes this

A

Hepatic portal vein

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8
Q

Superior mesenteric vein drains midgut and join with splenic artery to form hepatic portal vein
The inferior mesenteric vein joins splenic vein at different point to then become hepatic portal vein
Forms what kind of letter

A

H

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9
Q

The small intestine is within the midline of the abdomen and is framed by the large intestine it has e part duodenum starting at pylorus at L1 and runs into real shape from left to right jejunum then ileum which occupies lower right quadrant with the caecum.
General direction of left upper to right lower
At what level is the dudoenojejunal junction

A

L3

The small interior ends in RIF ileocecal valve

L4 - bowel is just associated with itsel
L3 inferior poles of kidneys

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10
Q

In larger individuals with large central abdominal fat they can have a higher traverse colon. In thin individuals there is no far so how low could the transverse colon be

A

L5

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11
Q

Is the bowel intraperitoneal ?

A

Yes surrounded by blood vessels behind and mesenteric

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12
Q

What layers is the myenteric plexus between

A

Muscularity externa - circular and longitudinal

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13
Q

What are valvulae connivents

A

Circular folds increase SA

Small intestine get villi

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14
Q

Duodenum is made up of 4 parts, superior , descending , horizontal and ascending which part Is intraperitoneal

A

Superior

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15
Q

Ampulla of vater

A

Bile duct enter the duodenum - bile is digestive juice and that has to enter the duodenum to help with digestion and this is said to correspond with embryo logical foregut

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16
Q

SMA will emerge just superior to where the left renal vein travels across the anterior face of the abdominal aorta - the runs to anterior part of duodenum

Left renal vein is visible just under what

A

Pancreatic tail

Aorta enters abdomen through diaphragm T12 than the IVC T8

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17
Q

Coeliac trunk supplies the foregut and has branches such as common hepatic artery and gastroduodenal artery which runs behind the superior part of the duodenum is this area prone to ulcers

A

Yes

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18
Q

Two differences between the jejunum and ileum

A

Jejunum has much thicker muscular wall. More circular in its lumen compared to the ileum

Ileal loops tend to lie in the inferior part of the abdomen and pelvis
Jejunum has less villi

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19
Q

Jejunum has 1-3 so fewer arterial arcades ( circles) and fewer and longer vasa recta

A

True ileum has 2-6 arcades and has numerous shorter and thinner vasa recta

20
Q

What are peyers patches ?

A

Aggregates of lymphoid tissue found in the luminal wall and are often palpable - bowel intussusception in children - bowel folds in ahead of it
Ileum has loads found through the length

21
Q

What is a plexus

A

Web of nerves - come from the spinal cord branch off and then come back together again - some are autonomic and some are soamticsly innervated

22
Q

Ganglion

A

2 neurones synapse together

23
Q

Greater splanchic nerve

A

t5-9

24
Q

Lesser splanchic nerve

A

T10-11

25
Q

Least splanchic nerve

A

T12

Sympathetic runs through splanchic nerves and parasympathetic through vagus nerves

26
Q

Where is most water is absorbed from undigested chyme

A

Large intestine

27
Q

4 distinct features that separate large intestine from small intestine

A

Larger diameter
Teniae coli - emerge from appendix and form 3 strands - merge again at rectum
Haustra
Omental appendices

28
Q

3 tenia coli

A

Mesocolic , omental and free tenia

Diverge. And then reconnect

29
Q

Haustra

A

Tenia coli smooth muscle and just have a tone of contracted they pull bits of the large vowel together to form pouches called haustra producing wrinkles Like bubbies and bulges

30
Q

What tool can you use to tell the difference between haustra and valvulae conniventes
Haustra don’t cross the whole width
Valvulae conniventes cross the whole width

A

X-ray

31
Q

Omental appendage

A

Little fat tags on the large intestine

32
Q

What parts of the large intestine are retoperiotneal

A

Ascending and descending

33
Q

Paracolic gutters

A

Potential space between the lateral surface of ascending surfaces of colon and peritoneal ,membrane at the side of them- path of least resistance so infection runs

34
Q

Rectum is 15cm - anal canal 4-5cm

Anal viaves secrete mucus and get faeces out of anal canal where are they found

A

Anal columns

35
Q

What is the denate line

A

Embrylogical divide between endoderm and ectoderm

Transfer of columnar epithelium to stratified squamous epithelium of skin

36
Q

What muscle supports rectum

A

Lavatory ani

37
Q

Ischiorectal fossa

Canal

A

Abscess

Ischial tuberous it and medially

Pudendal canal sup to inf
artery vein then nerve abscesses injur nerve
Gangrene

38
Q

Appendices pain

A

Travelling pain starts in midline as the visceral peritoneum is irritated . This layer only has a sensory supply from visceral to autonomic fibres so pain generalised to a dermatome. As inflammation worsens the parietal peritoneum irritated so pain localised to RIF where the appendices usually sits.
Umbilicus to right iliac fossa

39
Q

Diverticulitis is classically described as LIF maybe opposite in Asian, infection if one of the outpouchings - localised well
True or false

A

True

40
Q

Mcburnleys point is found where

What is this the common location for

A

Between the umbilical and antihero superior iliac spine - 1\3 from the ASIS
Appendix’s

41
Q

In small vs large vowel obstruction
Small bowel is pain central and valvulae conniventes cross all lumen and dilated bowel about 3cm
What happens in large bowel obstruction

A

Pain in normally in lower abdomen
Haustra do not cross the lumen
Dilated bowel to over 6cm

42
Q

Where does the small intestine finish

Enterocytes msot numerous cell - nutrient electrolyte and fluid absorption

A

Ileocecal valve

Terminal ileum absorbs bile salts and B12 special

All small bowls in intraperitoneal except distal 3 parts of the dudodneum

43
Q

Level of transverse colon

A

L3 - umbilical level

Left colic flexure more superior than right as liver not pushing down

Sigmoid colon is continuous with the rectum

44
Q

Sigmoid colon is continuous with the rectum at what vertebral level

A

S3

45
Q

In the intestines what parts are retoperitoneal

A

Ascending , descending colon and distal 3 parts of the duodenum

Rectum and anus are sub peritoneal

46
Q

The parasympathetic fibres in the juejunum and ileum derive from what

A

Posterior cabal trunk

47
Q

Where the internal sphincter ( autonomic ) and external sphincter ( somatic ) meet is called

A

Anorectal ring

Gastrointestinal (7 decks)

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