Intestines

Question 1

The mesentery attachments and length

Answer 1

Ileocecal junction and duojejunal flexure

15cm

Question 2

Small intestine length, proportions, time food spends here

Answer 2

6m
Duo: 5%; Jeju: <40%; ileum: < 60%
3-6h

Question 3

Duodenal parts and features

Answer 3

1st: intraperitoneal; runs up and backwards ; smooth walls
2nd (laterally inverted c) : retroperitoneal; plicae circulares; bile duct enters
3rd (straight) : retroperitoneal; plicae circulares; sma crosses in front
4th (n shape): retroperitoneal; plicae circulares; duojejunal flexure

Question 4

Suspensory ligament of treitz

Answer 4

From DJF to diaphragm

Question 5

Relations of duodenum

Answer 5

Head+uncinate process of pancreas in curve of duodenum
Posterior: gastroduodenal artery (perforation of du odenum due to ulcer-> acid burns through artery-> haemorrhage)
Lateral to 2nd part: right kidney; mesentery of transverse colon here
Anterior to 3rd: SMA

Question 6

Jejunum characteristics

Answer 6

Intraperitoneal 
More plicae circulares than duodenum 
Brunner’s glands secrete mucin 
Thin mesentery 
Short anastamotic arcade loops
Long vasa recta

Question 7

Ileum characteristics

Answer 7

Plicae semilunaris 
Intraperitoneal 
Peyer’s patches: lymphoid tissue 
Fatty mesentery 
More anastamotic arcades, shorter vasa recta

Question 8

Which level does aorta pass through diaphragm

Answer 8

T12

Question 9

Lymphatic drainage of gut

Answer 9

Celiac: right+left gastric/splenic/ left gastroepiploic/pyloric
Celiac + IMN (hindgut)+ SMN (midgut) -> cisterns chyli-> thoracic duct

Question 10

Duodenal arterial supply

Answer 10

Supraduodenal 
Superior pancreaticoduodenal (from gastroduodenal) 
Inferior pancreaticoduodenal (from SMA)

Question 11

Jejunal/ileal arterial supply

Answer 11

SMA

Question 12

Large intestine function and time foods in here and features

Answer 12

Absorb water and electrolytes
12-24h
Plicae semilunaris

Question 13

Large intestine parts

Answer 13

Made of teniae coli (3 thickened longitudinal muscle strips-> puckering of colon called HAUSTRA)
Haustra’s saclike divisions of circular muscle
Epiploic appendages are fat-filled omental appendices

Question 14

Intraperitoneal parts of large intestine

Answer 14

Transverse

Sigmoid

Question 15

Appendix arterial supply + location

Answer 15

Appendicular artery

McBurney’s point: 2/3 from belly b to ASIS

Question 16

Midgut arterial supply

Answer 16

SMA (L1) 
Jejunal (Jejunum) 
Ileal (ileum) 
Ileocolic (caecum + appendix + ascending colon) 
Right colic (ascending) 
Middle colic (proximal 2/3 of tc)

Question 17

Hindgut arterial supply

Answer 17

IMA (L3)
Left colic (distal 1/3 of tc)
Sigmoidal (descending + sigmoid)
Superior rectal

Question 18

Marginal artery constituents and it gives rise to…

Answer 18

Ileocolic 
Right colic 
Middle colic 
Left colic 
Sigmoidal 
-> marginal artery -> vasa recta

Question 19

Sympathetic innervation of gut

Answer 19

Greater thoracic splanchnic T5-9: supply foregut+ midgut; synapse in celiac + SM ganglia; presynaptic fibres May reach suprarenal medulla
Lesser thoracic splanchnic T10-11: supply midgut + renal plexus; synapse in SM ganglia + aorticorenal ganglia
Least splanchnic nerves T12-L2: T12 supplies renal plexus/L1-2 supply hindgut

Question 20

Parasympathetic innervation

Answer 20

CNX -> superior/inferior Vagal ganglion-> foregut + midgut

S2-4 pelvic splanchnic nerves -> inferior hypogastric plexus -> hindgut