Abdominal Midgut and Hindgut Flashcards

1
Q

What are the similaritries and differences between the structural features of the jejunum and Ileum?

A

Similarities

  • Both are intraperitoneal (surrounded by mesentery)

Differences

  • Jejunum makes up the proximal 2/3’s of SI. Ileum makes up the distal 3/5’s of SI.
  • Jejunum contains mucosal folds (plicae circulares). Ileum does not
  • Jejunum has long vasa recta. Ileum has short vasa recta
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2
Q

What are the parts of the large intestine

A

Cecum

Ascending colon

Transverse colon

Descending colon

Sigmoid colon

Rectum

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3
Q

What regulates the passage of ileal contents into the cecum

A

Ileocecal valve

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4
Q

Distinguish whether the ascending, transverse and descending colon are Intraperitoneal or Secondarily retroperitoneal

A

Secondarily retroperitoneal - Ascending and descending colon

Intraperitoneal - Transverse colon

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5
Q

What suspends the transverse colon to the posterior wall

A

Transverse mesocolon mesentery

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6
Q

What suspends the sigmoid colon

A

sigmoid mesocolon

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7
Q

Where is the appendix located

A

Attached to posterior-medial part of cecum

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8
Q

What part of the LI is defined as both retroperitoneal and subperitoneal (below peritoneum in pelvic floor)

A

Rectum

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9
Q

What is the primary arterial supply to the midgut and hindgut

A

Superior and Inferior mesenteric artery

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10
Q

What does the SMA supply

A

Pancreas and duodenum

Small Intestine

Cecum

Ascending and transverse colon

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11
Q

What does the IMA supply

A

Descending and sigmoid colon

Superior rectum

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12
Q

Where does the SMA arise

A

L1 level of aorta

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13
Q

What branches of the SMA and Celiac trunk anastomose with each other

A

Inferior pancreaticoduodenal arteries of the SMA w/ gastroduodenal branches from the celiac trunk

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14
Q

What are the inestinal branches of the SMA

A

Jejunal A.

Ileal A.

Ileocolic A.

Right colic A.

Middle colic A.

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15
Q

Where does the IMA arise

A

Aorta at L3

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16
Q

What are the inestinal branches of IMA

A

Left colic A.

Sigmoidal As.

Superior rectal A.

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17
Q

What is the marginal artery

A

One large artery that forms from the anastomosis between SMA and IMA that helps prevent ischemia by providing and alternate route if there’s damage/obstruction to SMA or IMA

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18
Q

What is the blood supply to the rectum

A

Superior rectal a.

Middle rectal a.

Inferior rectal a.

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19
Q

Where does the superior rectal a. branch from

A

Inferior mesenteric artery

20
Q

Where does the middle rectal a. branch from

A

Internal iliac a. (in pelvic cavity)

21
Q

Where does the Inferior rectal a. branch from

A

Internal pudendal a. (in perineum)

22
Q

What is the hepatic portal vein and where does it begin

A

It carries blood from the gastrointestinal tract, gallbladder, pancreas and spleen to deliver nutrients, bacteria and toxins to the liver to process and detoxified before being sent out to the systemic circulation.

It begins where the Superior Mesenteric V. and the Splenic V. join

23
Q

Where does the portal venous system anastomose with the systemic system

A

Gastroesophageal plexus

Umbilicus

Rectal venous plexus

24
Q

Decreased blood flow to the liver (heptaic hypertension) can cause what at the portal venous system anastomoses?

A

Varices

25
Q

What are Thoracic splanchnics

A

Nerves that carry presynaptic axons from the spinal cord (T5-L1) to postsynaptic neurons located in aortic collateral ganglia

26
Q

List the thoracic splanchnic nerves

A

Greater splanchnic n.

Lesser splanchnic n.

Least splanchnic n.

Lumbar splanchnic n.

Sacral splanchnic n.

27
Q

What fibers do the greater splanhcnic nerve carry and where do they synapse

A

T5-T9 presynaptic axons from the spinal cord to the celiac ganglia

28
Q

What organs does the post-synaptic neuron from the Celiac ganglia innervate

A

Gallbladder

Stomach

Pancreas

Liver

29
Q

What fibers does the lesser splanhcnic nerve carry and where do they synapse

A

Pre-synaptic fibers from T10-T11 that synapse at the superior mesenteric ganglion

30
Q

What organs does the post-synaptic neuron from the superior mesenteric ganglion innervate

A

Small intestine

Cecum

Appendix

Ascending colon

Transverse colon

31
Q

What fibers do the least splanhcnic nerve carry and where do they synapse

A

Pre-synaptic fibers from T12 that syanpse in the Aorticorenal gangla

32
Q

What organs does the post-synaptic neuron from the aorticorenal ganglia innervate

A

Kidney and suprarenal glands

33
Q

What is the origin of the lumbar splanchnics

A

L1-L5

34
Q

Lumbar splanchnics originating from L1-L2 syanpse where

A

Superior mesenteric ganglion & inferior mesenteric ganglion

35
Q

What organs do the post-synaptic neurons from the inferior mesenteric ganglia innervate

A

Descending colon

Sigmoid colon

Rectum

36
Q

Lumbar splanchnic originating from L3-L5 synapse where and what organs do they innervate?

A

Hypogastric plexus/ganglia

Innervate Rectum & anus

37
Q

What fibers do the sacral splanhcnics carry and where do they synapse

A

Carry presynaptic axons from sacral sympathetic chain (S1-S5)to hypogastric ganglia

38
Q

What organs are innervates by post-synaptic fibers from the hypogastric ganglua

A

Rectum

Anus

Pelvic Organs

39
Q

What fibers make up the vagus nerve and where do they synapse

A

Presynaptic parasympathetic fibers that travel through the celiac ganglion and superior mesenteric ganglion to syanpse with post-synaptic fibers in the target organ.

40
Q

What fibers make up the Pelvic splanhnics and where do they synapse

A

Presynaptic fibers from the sacral spinal nerves that travel through the hypogastric plexus and synapse with postsynaptic parasympathetic fibers within the target organ

41
Q

Where do pelvic splanchnic nerves synapse

A

Descending colon

sigmoid colon

rectum

anal canal

urogenital organs

organs in perineum

42
Q

Differentiate between the sacral splanchnic nerves and the pelvic splanchnic nerves

A

Sacral = Sympathetic = S1-S5 - Synapse in inferior hypogastric plexus

Pelivic = Parasympathetic = S2-S4 - Synapse in target organ

43
Q

What is somatic pain

A

Pain from irritation of parietal peritoneum. Brain interprets pain as though it’s coming from the skin of that same dermatome that is hurting.

44
Q

What is visceral pain

A

Pain from the organ itself. Pain originates within the organ and is transmitted via splanchnic nerves in the spinal cord

45
Q

Which type of pain is acute and often well localized

A

Somatic pain

46
Q

Which type of pain is poorly localized but radiates to same dermatime level receiving visceral afferents from the organ

A

Visceral pain