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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
What is at McBurney's point?
The root of the appendix
26
Where can the appendix be found?
One of numerous anatomical positions: - Retrocaecal (65%) - Pelvic (30%) - Subcaecal - Retroileal - Pre-ileal
27
What does the large intestine include?
- Caecum - Ascending colon - Hepatic (right coli) flexure - Transverse colon - Splenic (left colic) flexure - Descending colon - Sigmoid colon
28
Where are there portocaval anastomoses in the colon?
Posteriorly to ascending and descending colon
29
Where is the ascending colon found?
- Right lumbar region - Between caecum nd hepatic flexure - Secondarily retroperitoneal
30
Where is the right paracolic gutter formed?
Between the right side of the ascending colon and posterior abdominal wall
31
What is the transverse colon suspended by?
Transverse mesocolon, it is intraperitoneal
32
What is the mesocolon?
The mesentary of the colon
33
Where does the transverse mesocolon cross the pancrease?
The root of the transverse mesocolon crosses the inferior edge of the pancreas
34
What is a paracolic gutter?
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
Where is the left paracolic gutter formed?
Between the left side of the descending colon and posterior abdominal wall
36
Is the sigmoid colon intra or retroperitoneal
Intraperitoneal
37
What is the sigmoid colon suspended by?
- Sigmoid mesocolon | - Long; making volvulus more common in sigmoid colon
38
Where does the sigmoid colon become continous with the rectum?
The 3rd sacral vertebra
39
Where does the rectum end?
The pelvic diaphragm
40
How long is the anal canal?
~ 4cm
41
Where is the rectum located in relation to the peritoneum?
- Upper 1/3 intraperitoneum | - Lower 2/3 retroperitoneal
42
What structures does the rectum lack?
- Taenia - Haustra - Appendices epiploica
43
What is the function of the rectum?
To store faeces
44
Where does the superior mesenteric artery originate?
Lower border of L1 vertebra
45
Where are the nodes roughly located?
Origins of the superior and inferior mesenteric arteries
46
What does the superior mesenteric artery supply?
- Part of large intestine: from veriform appendix to proximal 2/3 of transverse colon
47
What are the branches of the superior mesenteric artery and what do they supply?
``` - 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
Where does the inferior mesenteric artery arise?
From the aorta at L3
49
What do the branches of the inferior mesenteric artery supply?
- Distal 1/3 of the transverse colon - Splenic fissure - Descending colon - Sigmoid colon
50
What are the main branches of the inferior mesenteric artery?
- Left colic artery Splenic fissure, descending colon - Sigmoid artery Sigmoid colon
51
Where does the inferior mesenteric artery end?
At the superior rectal artery supplying the rectum and anal canal
52
What is the marginal artery?
- An anastomosis between inferior and superior mesenteric arteries - Forms a collateral circulation should the inferior mesenteric artery become obstructed
53
What do the veins of the colon eventually drain into?
Portal vein
54
Nerve supply of the colon
Greater lesser and least splanchnic nerves | VAgus or sacral 2 -4
55
What is the coeliac trunk/foregut nerve supply?
- Symp T5-9 (greater splanchnic) | - Vagus
56
What is the superior mesenteric/midgut nerve supply?
- Symp T10-11 (lesser splanchnic) | - Vagus
57
What is the inferior mesenteric/hindgut nerve supply?
- Symp T12-L3 (least splanchnic and lumbar splanchnic nerves) - Para: S2-4
58
Where will celiac trunk pain refer?
Epigastric region (T7-9)
59
Where will superior mesenteric pain refer?
``` Periumbilical region (T10-11) - Appendicitis pain in first 6-8hrs ```
60
Where will pain from the inferior mesenteric refer?
T12
61
Where will pain from the inferior mesenteric refer?
T12
62
Where is pain referred from the Jejunum and ileum?
Periumbilical (T10)

MD3002 Anatomy (14 decks)

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