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MD3002 Anatomy > Jejunum, Ileum and large intestine > Flashcards

Jejunum, Ileum and large intestine Flashcards

1
Q

Where do the jejunum and ilem lie in the abdomen?

A
  • Jejunum in the upper left abdomen

- Ileum lower right and partly in the pelvis

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2
Q

After the duodenum how much of the small intestine is jejunum and ileum?

A
  • Proximal 40% jejunum
  • Distal 60% ileum
    Gradual change from jejunum to ileum
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3
Q

What is the border of the jejunum and duodenum called?

A

The duodenojejunal junction

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4
Q

What does the jejunum and ileum hang from the posterior abdominal wall by?

A

The mesentary

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5
Q

What structures does the mesentary cross near the midline?

A
  • Its base crosses the 3rd part of the duodenum
  • Aorta
  • IVC
  • Right gonadal vessels
  • Right ureter
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6
Q

What structures are found within the mesentary?

A
  • Branches of the superior mesenteric artery, forming anastomotic arteries
  • Branches of the superior mesenteric vein
  • Lymph vessels
  • Nerves
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7
Q

How many layers does the mesentary have?

A

2

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8
Q

What are the differences between the jejunum and ileum?

A
  • Jejunum wide, ileum narrow
  • More plica circulares in jejunum
  • The ileum contains MALT as well as numerous peyer’s patches
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9
Q

Describe the shape of the ileocaecal valve

A
  • Rudimentary structure

- Consists of 2 horizontal folds of mucous membrane that project aroun the orifice of the ileum

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10
Q

What is the function of the ileocaecal valve?

A

To limit the reflux of colonic contents into the ileum and possibly control the flow of ileal contents into the caecum

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11
Q

What are jejunal and ileal arteries branches of?

A

Superior mesenteric

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12
Q

What does the superior mesenteric artery supply?

A

The midgut (from the ampulla of Vater in duodenum to 2/3 along the transverse colon)

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13
Q

What are the differences between the vascular supply of the jejunum and ileum?

A
  • Ileum
    1 or 2 arcades with long vasa recta in its mesentary
  • Ileum
    Many arcades with short vasa recta in its mesentary
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14
Q

What do the jejunal and ileal veins drain into?

A

The superior mesenteric vein that eventually forms the portal vein

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15
Q

What is the lymph drainage from peyer’s patches to the cisterna chyli?

A
  • Peyer’s patches
  • Superior Mesenteric nodes
  • Intestinal trunk
  • Cisterna chyli
    lacteals drain into lymph vessels then cisterna chyli
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16
Q

What is the NERVE SUPPLY of jejunum and ileum?

A
  • Sympathetic from greater and lesser
  • Vagus
    Combine to make coeliac plexus -> superior mesenteric plexus -> myenteric and submucosal plexus
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17
Q

What parts of the colon are in the peritoneum and what parts are not?

A
  • The ascending and descending colon are secondarily retroperitoneal
  • Transverse and sigmoid colon
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18
Q

What are the 3 taenia coli?

A

Thickened smooth muscle fibres

  • Free
  • Mesenteric
  • Omental
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19
Q

What are haustra?

A

small segmented pouches of bowel separated by the haustral folds. They are formed by circumferential contraction of the inner muscular layer of the colon
mobile

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20
Q

What are peyer’s patches?

A

Small masses of lymphatic tissue found throughout the ileum region of the small intestine

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21
Q

What are appendices epiploicae?

A

Small pouches of the peritoneum filled with fat and situated along the colon, but are absent in the rectum

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22
Q

Where is the caecum located in the large intestine?

A
  • Inferior to the opening of the ileocecal valve
  • In the right iliac fossa
  • Covered by peritoneum but not on a mesentary
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23
Q

Where do the 3 taeniae coli converge?

A

The appendix

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24
Q

What is the submucosa of the veriform appendix full of?

A

Lymphoid tissue

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25
Q

What is at McBurney’s point?

A

The root of the appendix

26
Q

Where can the appendix be found?

A

One of numerous anatomical positions:

  • Retrocaecal (65%)
  • Pelvic (30%)
  • Subcaecal
  • Retroileal
  • Pre-ileal
27
Q

What does the large intestine include?

A
  • Caecum
  • Ascending colon
  • Hepatic (right coli) flexure
  • Transverse colon
  • Splenic (left colic) flexure
  • Descending colon
  • Sigmoid colon
28
Q

Where are there portocaval anastomoses in the colon?

A

Posteriorly to ascending and descending colon

29
Q

Where is the ascending colon found?

A
  • Right lumbar region
  • Between caecum nd hepatic flexure
  • Secondarily retroperitoneal
30
Q

Where is the right paracolic gutter formed?

A

Between the right side of the ascending colon and posterior abdominal wall

31
Q

What is the transverse colon suspended by?

A

Transverse mesocolon, it is intraperitoneal

32
Q

What is the mesocolon?

A

The mesentary of the colon

33
Q

Where does the transverse mesocolon cross the pancrease?

A

The root of the transverse mesocolon crosses the inferior edge of the pancreas

34
Q

What is a paracolic gutter?

A

Recesses between the abdominal wall and the colon. - Clinically important because they allow a passage for infectious fluids from different compartments of the abdomen

35
Q

Where is the left paracolic gutter formed?

A

Between the left side of the descending colon and posterior abdominal wall

36
Q

Is the sigmoid colon intra or retroperitoneal

A

Intraperitoneal

37
Q

What is the sigmoid colon suspended by?

A
  • Sigmoid mesocolon

- Long; making volvulus more common in sigmoid colon

38
Q

Where does the sigmoid colon become continous with the rectum?

A

The 3rd sacral vertebra

39
Q

Where does the rectum end?

A

The pelvic diaphragm

40
Q

How long is the anal canal?

A

~ 4cm

41
Q

Where is the rectum located in relation to the peritoneum?

A
  • Upper 1/3 intraperitoneum

- Lower 2/3 retroperitoneal

42
Q

What structures does the rectum lack?

A
  • Taenia
  • Haustra
  • Appendices epiploica
43
Q

What is the function of the rectum?

A

To store faeces

44
Q

Where does the superior mesenteric artery originate?

A

Lower border of L1 vertebra

45
Q

Where are the nodes roughly located?

A

Origins of the superior and inferior mesenteric arteries

46
Q

What does the superior mesenteric artery supply?

A
  • Part of large intestine:
    from veriform appendix to
    proximal 2/3 of transverse colon
47
Q

What are the branches of the superior mesenteric artery and what do they supply?

A 
- Middle colic artery: 
Transverse colon 
- Right colic artery 
Ascending colon 
- Illeocolic artery
CAecum 
- Appendicular artery 
A terminal artery that runs close and parallel to the appendix
48
Q

Where does the inferior mesenteric artery arise?

A

From the aorta at L3

49
Q

What do the branches of the inferior mesenteric artery supply?

A
  • Distal 1/3 of the transverse colon
  • Splenic fissure
  • Descending colon
  • Sigmoid colon
50
Q

What are the main branches of the inferior mesenteric artery?

A
  • Left colic artery
    Splenic fissure, descending colon
  • Sigmoid artery
    Sigmoid colon
51
Q

Where does the inferior mesenteric artery end?

A

At the superior rectal artery supplying the rectum and anal canal

52
Q

What is the marginal artery?

A
  • An anastomosis between inferior and superior mesenteric arteries
  • Forms a collateral circulation should the inferior mesenteric artery become obstructed
53
Q

What do the veins of the colon eventually drain into?

A

Portal vein

54
Q

Nerve supply of the colon

A

Greater lesser and least splanchnic nerves

VAgus or sacral 2 -4

55
Q

What is the coeliac trunk/foregut nerve supply?

A
  • Symp T5-9 (greater splanchnic)

- Vagus

56
Q

What is the superior mesenteric/midgut nerve supply?

A
  • Symp T10-11 (lesser splanchnic)

- Vagus

57
Q

What is the inferior mesenteric/hindgut nerve supply?

A
  • Symp T12-L3 (least splanchnic and lumbar splanchnic nerves)
  • Para: S2-4
58
Q

Where will celiac trunk pain refer?

A

Epigastric region (T7-9)

59
Q

Where will superior mesenteric pain refer?

A 
Periumbilical region (T10-11)
- Appendicitis pain in first 6-8hrs
60
Q

Where will pain from the inferior mesenteric refer?

A

T12

61
Q

Where will pain from the inferior mesenteric refer?

A

T12

62
Q

Where is pain referred from the Jejunum and ileum?

A

Periumbilical (T10)

MD3002 Anatomy (14 decks)

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