Flashcards in Hulka: Intestine Deck (78)
First portion of the small intestine
Where does the duodenum begin?
Where does it end?
after the pylorus of the stomach
ends at the ligament of Trietz
What is the duodenum considered in relation to the peritoneum?
It is retroperitoneal
How many divisions is the duodenum divided into?
The first portion of the duodenum is referred to as the duodenal (blank). How long is this segment? What is it continuous with? What is its relation to the peritoneum?
bulb; 2-3cm; pylorus; intraperitoneal
What three structures lie posterior to this first portion of the duodenum?
1. common bile duct
2. gastroduodenal artery
3. inferior vena cava
What can cause ulcers to develop in the duodenal bulb?
Increased acid from the stomach entering the bulb
Ulcers of the posterior side of the duodenum can perforate or bleed. What artery is typically the source of the bleeding?
The second portion of the duodenum is referred to as the (blank)
The C loop
How long is the second portion of the duodenum? What is its relation to the peritoneum?
What two significant things drain into the second portion of the duodenum? Through what structure do they enter?
common bile duct and pancreatic duct
enter through the ampulla of Vater
The third portion of the duodenum is referred to as the (blank) portion
Where does the third portion of the duodenum end?
Where the superior mesenteric vessels cross
The third portion of the duodenum is where the duodenum proceeds over the (blank) from right to left
Where does the fourth portion of the duodenum begin? Where does it end?
Begins to the left of the superior mesenteric vessels
Ends at the ligament of Trietz
How long is the fourth portion of the duodenum in length? What is it referred to as?
2-3cm; ascending portion
The fourth portion of the duodenum becomes the (blank)
2 arteries that supply the duodenum
superior pancreaticoduodenal from the gastroduodenal artery
inferior pancreaticoduodenal from the SMA
Where does most of the venous drainage from the duodenum go?
into the superior mesenteric vein to enter the portal system (recall, blood from bowels is filtered by the liver before entering the IVC)
What is malrotation of the gut? What is a symptom of this?
When the intestine fails to return to the fetus in a rotated position during development; bilious vomiting
Where do the jejunum and ileum begin and end?
Begin at the ligament of Trietz and end at the ileocecal valve
How long are the jejunum and ileum together? How much of the total is thought to be jejunum?
6-7 meters; first 2/5ths
External differences between the jejunum and ileum
jejunum is thicker and more muscular
jejunum is more proximal
ileum is more distal
Internal differences between jejunum and ileum
circular folds (plicae) are large and well developed in the jejunum
What do the jejunum and ileum hang from?
A mesentery with blood vessels and lymphatics
Emanates from superior mesenteric vessels and fans out with the bowel along the edge of the mesentery
Root of mesentery
When you lift up the transverse colon, what do you expose? (PIMP question)
ligament of Trietz
What artery supplies the entire jejunum and ileum?
Superior mesenteric artery
How many branches does the SMA branch into to supply the jejunum and ileum?