07-03 GIT Gx Small Intestine, Pancreas, Spleen Flashcards Preview

ANATOMY > 07-03 GIT Gx Small Intestine, Pancreas, Spleen > Flashcards

Flashcards in 07-03 GIT Gx Small Intestine, Pancreas, Spleen Deck (103)
1

3 parts of the small intestine

duodenum, jejunum, ileum

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first and shortest part of the intestine; widest and most fixed part

duodenum

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duodenum: Considered partially
retroperitoneal, except

first 2.5cm

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duodenum shape

C-shaped

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duodenum begins at __ and ends at ___

pylorus;
duodeno-jejunal junction (flexure)

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4 parts of duodenum

1) first part (superior) or duodenal bulb
2) second part (descending)
3) third part (horizontal)
4) fourth part (ascending)

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first part of duodenum (duodenal bulb) lies anterolateral to the

body of the L1 vertebra

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most movable part of the duodenum

1st part (superior) or duodenal bulb

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(duodenum) has a mesentery and is mobile and attached to this part (greater omentum and hepatoduodenal ligament)

proximal half

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(duodenum) has no mesentery and is immobile (fixed to the posterior abdominal wall)

distal half

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(duodenum) common bile duct and main pancreatic duct enter the posteromedial wall of the ____ obliquely and unite to form the hepatopancreatic ampulla (of Vater)

duodenum 2nd part (descending)

--also note: has no mesentery and retroperitoneal

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(duodenum) located 8-10cm distal to the pylorus

major duodenal papilla

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(duodenum) located 6-8cm distal to the pylorus

lesser duodenal papilla

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(duodenum) duodenum part at the level of L3 vertebra

third part (horizontal)

also note: adherent to the posterior abdominal wall

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meets the jejunum at the duodenojejunal flexure

duodenum 4th part (ascending)

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(duodenum) a fibromuscular band supporting the duodenojejunal flexure

Ligament of Treitz (suspensory muscle of duodenum)

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(duodenum) arteries of the duodenum arise form the

celiac trunk and
superior mesentery artery (SMA)

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(duodenum) embryological - foregut - supplied by

celiac trunk

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(duodenum) embryological - midgut - supplied by

SMA

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(duodenum) supplies the duodenum PROXIMAL TO THE ENTRY OF BILE DUCT into the descending part of the duodenum

celiac trunk -> gastroduodenal artery -> superior pancreaticoduodenal artery

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(duodenum) supplies the duodenum DISTAL TO THE ENTRY OF BILE DUCT

SMA -> inferior pancreaticoduodenal artery

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(duodenum) location of anastomosis f the superior and inferior panccreaticoduodenal arteries

between the entry of the bile duct and the junction of the descending and inferior parts of the duodenum

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(duodenum) lies in the curve between the duodenum and the head of the pancreas and supply both structures

pancreaticoduodenal arteries

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(duodenum) veins of the duodenum drain into the HEPATIC PORTAL VEIN, some directly and others indirectly, through the

superior mesenteric and
splenic veins

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(duodenum) superior pancreaticoduodenal vein will drain into the

portal vein (directly)

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(duodenum) inferior pancreaticoduodenal vein will drain to

superior mesenteric vein (SMV),

...SMV will then drain to the portal vein.

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(duodenum) Drain upward - pancreaticoduodenal lymph nodes to..

gastroduodenal nodes
celiac nodes

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(duodenum) Drain downward - pancreaticoduodenal lymph nodes to...

superior mesenteric plexus

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duodenal sympathetic innervation derive from ___ via __-

vagus and
greater and lesser (abdominopelvic) splanchnic nerves via

celiac & mesenteric plexuses

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mobile portion of the duodenum

first 2cm of the superior part

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part of duodenum crossed by SMA and SMV

3rd

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hepatopancreatic ampulla opens at which part of the duodenum?

ascending

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.This structure indicates the junction of the distal part of the duodenum and the proximal part of the jejunum:

Ligament of Treitz

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Marks anatomical union of (common) bile duct & Duct of Wirsung:

Vater

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The blood supply of the duodenum that is PROXIMAL to the entry of the bile duct comes from the:

Superior pancreaticoduodenal artery

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marks the end of the duodenum and the beginning of the jejunum

Ligament of Treitz

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ave. length of duodenum

25cm

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most blood supply of the small intestine comes from

SMA

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opening into the pancreatic and common bile duct is found in which portion of the duodenum?

2nd..


the ducts enters it posteromedial wall.

40

jejunum begins at

duodenojejunal flexure;

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ileum ends at

the ileocecal junction

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most of jejunum lies in which quadrant

lower upper quadrant (LUQ)

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most of ileum lies in which quadrant

right lower quadrant (RLQ)

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fan-shaped fold of peritoneum that attaches the jejunum and ileum to the posterior abdominal wall

mesentery

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Usually arises at the level of L1 vertebra, 1 cm inferior to the coeliac trunk;

-supplies jejunum and ileum via jejunal and ileal arteries

Superior mesenteric artery

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Unites with the splenic vein to form the portal vein;

drains the jejunum and ileum

Superior mesenteric vein

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lymphatic drainage of jejunum and ileum

superior mesenteric nodes

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Sympathetic supply of jejunum & ileum

Greater and lesser splanchnic nerve

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Parasympathetic supply of jejunum & ileum

Posterior vagal trunk via the coeliac plexus

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thick and heavy wall - jejunum or ileum?

jejunum

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greater vascularity - jejunum or ileum?

jejunum

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long vasa recta - jejunum or ileum?

jejunum

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many short loops of arcades - jejunum or ileum?

ileum

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more fat in mesentery - jejunum or ileum?

ileum

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large, tall, and closely packed circular folds - jejunum or ileum?

jejunum

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many lymphoid nodules (Peyer's patches) - jejunum or ileum?

ileum (distal part)

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circular folds are absent in which part of the ileum?

distal part

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wider caliber - jejunum or ileum?

jejunum

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length of duodenum

20 cm

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length of jejunum

100-110 cm

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length of ileum

150-160 cm

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In autopsies and cadaveric dissections, the average length of the jejeunum and ileum combined is:

6-7 meters

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ileal diverticulum is also called

Merkel diverticulum

note: disease of 2's

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(jejunum & ileum) Remnant of obliterated vitelline duct of embryonic life

Merkel diverticulum

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pancreas etymology

Greek
pan (all) &
kreas (flesh)

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pancreas length & shape

12-15 cm long J-shapes (like a Hockey stick), soft, lobulated, retroperitnoal organ

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location of pancreas

retroperitoneal;
level of L1-L2;
umbilical, epigastric, and left hypochondriac region

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4 parts of pancreas

head, neck, body, tail

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which part of pancreas?
snug up against the second and third parts of
duodenum

head

70

lower portion extending inferiorly from the head of pancreas

uncinate process

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directly anterior to superior mesenteric artery (SMA) and veins,
and the portal vein. which part of pancreas?

neck

72

which part of pancreas passes over the aorta and L2 vertebra

body

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which part of pancreas extends into the SPLENICORENAL LIGAMENT, associated with the spleen

tail

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main pancreatic duct normally joins with common bile duct

Duct of Wirsung

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accessory pancreatic duct which opens into the duodenum at the summit of the minor duodenal papilla

Duct of Santorini

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arterial supply of pancreas is derived MAINLY from

branches of tortuous SPLENIC artery

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blood supply of head of pancreas

Superior pancreaticoduodenal (anterior and
posterior) from Gastroduodenal &

inferior pancreaticoduodenal (anterior and posterior) from superior mesenteric

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blood supply of body and tail of pancreas

splenic, great pancreatic, dorsal and caudal pancreatic artery

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venous drainage of head of pancreas

Superior pancreaticoduodenal (anterior and
posterior) drain into the Portal Vein, Inferior pancreaticoduodenal (anterior and posterior) drain into the superior mesenteric vein

80

venous drainage of body and tail of pancreas

numerous small veins drain directly into the splenic vein

81

lymphatic drainage of pancreas. Most of them end in the ____ that lie along the _____ on the superior border of the pancreas

pancreaticosplenic nodes;

splenic artery

82

lymphatic drainage of pancreas. some vessels end in

pyloric lymph nodes

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lymphatic drainage of pancreas. efferent vessels from these nodes drain to the celiac lymph nodes and superior mesenteric lymph nodes via the

hepatic lymph nodes

84

nerve supply of pancreas derived from

vagus and splanchnic nerves

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(pancreas) pain fibers are carried by the

splanchnic nerves

86

(pancreas) The sympathetic and parasympathetic fibres reach the gland by passing along the arteries of the..

celiac and superior mesenteric plexuses

87

main pancreatic duct opens into what part of the duodenum

2nd

88

referred pain from the pancreas will usually manifest as pain in the ..

back

89

spleen location

upper left quadrant, left hypochondriac region;
Lies relative to the 9th and 11th ribs

90

largest of the lymphatic organs

spleen

(but it is not a vital organ/not necessary to sustain life)

91

can be found on the inferomedial part of the gastric impression;
transmits the splenic vessels and nerves and provides attachment to the gastrosplenic and splenorenal (lienorenal) ligaments.

splenic hilum

92

anteriorly related to the spleen

stomach

93

posteriorly related to the spleen

left part of the diaphragm, which separates it from the pleura, lung;
ribs 9-11

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inferiorly related to the spleen

left colic flexure

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medially related to the spleen

left kidney

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Kidney is deep to spleen, connected by

splenorenal ligament (lienorenal)

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(spleeN) Stomach is medial to spleen, connected by

gastrosplenic ligament (gastrolienal)

98

(spleeN) Short gastric and left gastroepiploic vessels run in the;

CONNECTS THE SPLEEN TO THE GREATER CURVATURE OF THE STOMACH :)

gastrosplenic ligament (gastrolienal)

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(spleeN) Splenic artery and vein run in the

splenorenal ligament (lienorenal)

100

Primary blood supply of spleen

SPLENIC artery which is the largest branch of the CELIAC trunk)

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Venous drainage of spleen

SPLENIC vein which unites with superior mesenteric vein to form the portal vein

102

splenic lymphatic vessels

pancreaticosplenic lymph nodes
en route to the celiac nodes

103

nerves of the spleen derived mainly from

CELIAC PLEXUS