Week 2 Flashcards
Name the three parts of the small intestine
- Duodenum
- Jejunum
- Ileum
Internal appearance of the duodenum
First part- mucosa is smooth( dilation of the tube after the pyloric sphincter)
Second-fourth part: circular folds from mucosa and submucosa(spiral chyme as it moves down)
Major duodenal papilla
- opening to secrete mucous
- near head of the pancreas
- common bile duct and principal pancreatic duct
- contains opening to hepatopancreatic ampulla
- longitudinal fold
Minor duodenal papilla
- about an inch superior to the major duodenal papilla
- donations opening to accessory pancreatic duct
- pretty insignificant, can be absent and everything else just flow to major duodenal papilla
General about jejunum and ileum
- freely mobile
- attaches to posterior abdominal wall by the mesentery of the small intestine
Number of arcades of the mesentery for j and I
J-1-2
I-3 or more
Vasa reacts of the mesentery differences for j and I
J-long
I-short
Circular folds for j and I
J- large and many
I- small and few
Arcades of the mesentery definition
Where intestinal branches anastomose
Horological differences between 3 parts of the small intestine
Duodenum- Bruner’s glands: of the submucosa and secrete mucus
Ileum- Peyer’s patches: lymphatic nodules from mucosa(lamina propria) and submucosa. Can contain 10-100
Jejunum-neither
Pancreas exocrine portion
-makes up 99% of the pancreatic cells
Acini
- clusters of exocrine cells that produce digestivev enzymes which flow into the GI tract through a network of ducts.
- cells associated with acinar cells produce sodium bicarbonate which makes the fluid alkaline and helps neutralize the pH from the HCL
Pancreatic juice
- collective secretions from the exocrine cells
- digest carbohydrates, proteins and fats
Hepatopancreatic ampulla
- combination of main pancreatic duct and common bile duct
- enters the duodenum
- visible within the duodenum as the major duodenal papilla
- muscle around it is the hepatopancreatic ampulla sphincter
Accessory pancreatic duct
- smaller than hepatopancreatic ampulla
- enters the dupdenum at the minor duodenal papilla
Path of bile flow
- Right and left hepatic ducts
- common hepatic duct(joined by cystic duct)
- common bile duct(joined by pancreatic duct)
- hepatopancreatic ampulla
- into the duodenum through major duodenal papilla
External features of the large intestine
- teniae coli: 3 longitudinal strips of smooth muscle(mesocolic, free, omental)
- Omental appendices: fat pockets off coli
- Haustra: pouches made because coli is shorter than large intestine so it shrinks it up
Ileal orifice
- located in medial wall of cecum
- superior and inferior lips form ilrocecal valve(dead people) and ileal papilla(in living)
- keeps things from coming into the cecum too quickly
orifics of the appendix
-inferior to the ileal orifice
Histology of the large intestine
-goblet cells are hella abundant in the large intestine
Appendix
- contains large grouping of lymphatic nodules(same structure as peyer’s patches but not called that)
- located in lamina propria of mucosa and a small amount in submucosa
Appendicitis
- appendix can have a variety of positions so location of pain is not always the same
- starts as mild pain near the umbilicus(sensory fibers for pain are at T10)
- later pain is worse and is USUALLY located in RLQ at McBurney’s Point
- normal for nausea and vomit
McBurney’s point
-1/3 the distance from the anterior superior iliac spine to the umbilicus
Superior mesenteric artery
- Lower than celiac trunk
- L1
- unpaired branch of the abdominal aorta
- supplies blood differently from each branch
Inferior pancreaticoduodenal artery
- branch of SMA
- supplies: lower part of pancreas and distal half of duodenum
Middle colic artey
- branch of SMA
- Supplies: proximal 2/3 of transverse colon
Right colic artery
- branch of SMA
- Supplies: ascending colon and beginning of transverse colon
Ileocolic artery
- branch of SMA
- Supplies: terminal ileum, cecum, appendix, and beginning of ascending colon
Intestinal/Jejunal and ileal arteries
- branch of SMA
- forms arterial arcades which give rise to straight arteries that supple intestinal wall
- theres like 12 of them and they are the only ones that go to the left when they branch
Inferior mesenteric artery
- L3
- unpaired branch of abdominal aorta
- supplies differently from 3 branches
Left Colic artery
- branch of IMA
- Supplies: distal 1/3 of transverse colon and descending colon
Sigmod arteries
- branch of IMA
- Supplies: sigmoid colon
Superior rectal arteries
- branch of IMA
- Supplies: rectum and upper half of anal canal
Name the branches of SMA
- Inferior pancreaticodeudenal artery
- Middle colic artery
- right colic artery
- ileocolic artery
- intestinal/jejunal and ileal arteries
Name the branches of IMA
- Left colic artery
- sigmoid arteries
- Superior rectal arteries
