case 4 anatomy Flashcards by Treesa James

Q

Contents of Midgut

A

Distal ½ of the duodenum, the jejunum, ilium, cecum, appendix, ascending colon, hepatic flexure, and proximal 2/3 of the transverse colon

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Q

Arterial Supply to Midgut

A

Superior mesenteric artery

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Q

Sympathetic Innervation of Midgut

A

Lesser splanchnic nerves (T10-11)

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Q

ParaSympathetic Innervation of Midgut

A

Vagus

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Q

Contents of Hindgut

A

Distal 1/3 of transverse colon, splenic flexure, descending colon, sigmoid colon, rectum

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Q

Arterial supply to hindgut

A

IMA

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Q

Sympathetic Innervation of Hindgut

A

least splanchnic nerve and Lumbar splanchnic nerves (T12-L2)

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Q

Parasympathetic Innervation of Hindgut

A

Pelvic splanchnic nerve (S2-S4)

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Q

Which has thicker wall and wider lumen: jejunum or ileum

A

Jejunum

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Q

Difference in arcades and vasa recta between jejunum and ileum

A

Jejunum: fewer arcades and longer vasa recta
Ileum: more arcades and shorter vasa recta

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Q

Which branches of the superior mesenteric artery supply the jejunum and ileum?

A

jejunal and ileal branches

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Q

What are pilcae circulares

A

Circular mucosal folds in the small intestine

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Q

arrangement of plicae circulares across small intestine

A

not found at the start of the duodenum.
In the horizontal & ascending parts of the duodenum and the upper ½ of the jejunum, they are large and numerous.
From the middle of the jejunum to the middle of the ileum, they diminish considerably in size.
In the lower part of the ileum, they almost entirely disappear, which is why this part of the intestine is thinner.

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Q

Name the intestinal glands that project into lamina propria

A

Crypts of lieberkuhn

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Q

What are peyer’s patches and where are they located?

A

Closely packed small groups of lymph nodes in the mucosal and submucosal layers of distal ileum

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Q

Intraperitoneal or retroperitoneal:

Caecum

A

Intraperitoneal

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Q

Intraperitoneal or retroperitoneal:

Appendix

A

Intraperitoneal

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Q

Intraperitoneal or retroperitoneal:

Ascending colon

A

Retroperitoneal

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Q

Intraperitoneal or retroperitoneal:

Transverse colon

A

Intraperitoneal

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Q

Intraperitoneal or retroperitoneal:

Descending colon

A

Retroperitoneal

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Q

Intraperitoneal or retroperitoneal:

Sigmoid colon

A

Intraperitoneal

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Q

Intraperitoneal or retroperitoneal:

Rectum

A

Upper 1/3 - intraperitoneal, middle 1/3 - retroperitoneal, lower 1/3 - infraperitoneal

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Q

Attachments of transverse mesocolon

A

Attaches to transverse colon and to the posterior wall of the abdominal cavity.

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Q

Name the gutters that are important in the spread of infection and cancer because they allow a passage for infectious fluids from different areas of the abdomen.

A

left medial (infracolic), left lateral, right medial (infracolic), and right lateral paracolic gutter

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Which 3 bands of longitudinal muscles make up the teniae coli?

mesocolic tenia, free tenia and the omental tenia

What and where is the marginal artery?

marginal artery is an artery that anastomoses the superior mesenteric artery with the inferior mesenteric artery. The splenic flexure is supplied by both the superior & inferior mesenteric arteries, and so it is the marginal artery that carries this blood supply.

Where is the McBurney's point?

base of the appendix is located at McBurney's point. McBurney's point is on the right side of the abdomen, 1/3 of the distance from the anterior superior iliac spine to the umbilicus.

Note the position of the hepatic flexure

At the level of the 9th and 10th ribs

Position of transverse colon is very variable, but likely to be

inferior to the level of the iliac crests along with its mesentery (transverse mesocolon)

At which vertebral level does Rectum begin?

S3

How is the internal aspect of rectum arranged?

rectum has 2 or 3 lateral curves that form submucosal folds in the lumen, known as the valves of Houston.

Where does the rectum terminate and anal canal begin

At the levator an

Which two vessels unite to form the hepatic portal vein and where?

Superior mesenteric and splenic veins, posterior To the neck of pancreas

Hepatic portal vein runs to the liver in the _____ ligament

Hepatoduodenal

Which structures course through the hepatoduodenal ligament?

Hepatic portal vein, hepatic artery, common bile duct = portal triad

Where does hepatic portal vein terminate

IVC

Which veins anastomoses at the submucosa of the inferior oesophagus?

oesophageal branch of left gastric vein & oesophageal branches of Azygos vein. clinical consequence - oesophageal varices.

Which veins anastomoses at the submucosa of the anal canal?

superior rectal vein, middle rectal vein & inferior rectal vein. clinical consequence - rectal varices

Which veins anastomoses in the para umbilical region?

Para umbilical veins and superficial epigastric vein | Clinical consequence - caput medusae

Which veins anastomoses in the retroperitoneal region?

right colic, middle colic, left colic, renal, suprarenal, paravertebral & gonadal veins.

Lymphatic drainage of stomach

Superior 2/3: Left & right gastric nodes to aortic nodes. Right greater curvature & pylorus: Right gastroepiploic vessels drain into subpyloric nodes then into celiac nodes. Left greater curvature: Short gastric, splenic vessels, and superior pancreatic nodes into celiac nodes.

Lymphatic drainage of duodenum

Anterior lymph vessels drain into pancreatoduodenal nodes and then into pyloric nodes. Posterior lymph vessels drain into superior mesenteric lymph nodes. They then drain into celiac nodes.

Lymphatic drainage of liver

Parasternal nodes

Lymphatic drainage of pancreas

Pancreaticosplenic nodes, then pyloric nodes, and then either pancreaticoduodenal nodes or superior mesenteric nodes.

Lymphatic drainage of jejunum & ileum

Superior mesenteric nodes

Lymphatic drainage of caecum

Ileocolic nodes

Lymphatic drainage of ascending, transverse and descending colon

Paracolic nodes --> superior mesenteric artery

Lymphatic drainage of sigmoid colon

Inferior mesenteric nodes --> IMA

Lymphatic drainage of rectum

Upper: pararectal nodes Lower: internal iliac nodes

Where does lymph form GI tract eventually drain to?

Cisterna chyli, located lower end of thoracic duct --> left subclavian vein

Lymphatic drainage of anus

Upper: internal iliac nodes Lower: superficial inguinal nodes

Visceral innervation of foregut

Greater splanchnic nerve (T5-T9) | Dermatome: T6-T8. Epigastric region.

Visceral innervation of midgut

Lesser splanchnic nerve (T10-T11) | Dermatome: T9-T10. Periumbilical

Visceral innervation of hindgut

Descending & sigmoid colon - least and lumbar splanchnic nerves (T12-L2) Rectum - pelvic splanchnic (S2-S4) Dermatome: T11-L1 hypochondrium

Name the three branches of coeliac trunk

Splenic Left gastric Hepatic

Normal transit time for large intestine

18-24 hrs

How often are haustral contractions

Every 30 mins

Mass movements

2-3 times/day Persist for 30 mins Occurs mainly in transverse and descending colon

What are mass movements triggered by?

Gastrocolic reflex and duodenocolic reflex

Peritoneal organs are covered in serosa or adventitia?

Serosa

Retroperitoneal organs are covered in serosa or adventitia?

Adventitia