Lecture 10

Question 1

The two ends of the small intestine are?

Answer 1

pylorus and ileocaecal valve

Question 2

3 components of the small intestine?

Answer 2

duodenum, jejunum, ileum

Question 3

Is the duodenum suspended or retroperitoneal?

Answer 3

retroperitoneal except for first part which is attached to greater and lesser omentum

Question 4

What is the 1st part of duodenum also known as?

Answer 4

duodenal cap

Question 5

What are the permanent circular folds in duodenum called?

Answer 5

plicae

Question 6

What empties at the greater duodenal papilla?

Answer 6

bile duct and main pancreatic duct

Question 7

Is the lesser duodenal papilla above or below the greater duodenal papilla?

Answer 7

Above by 2cm

Question 8

Relationship between duodenum and transverse colon

Answer 8

Duodenum is posterior

Question 9

How many parts to the duodenum and what are their names?

Answer 9

1 - superior
2 - descending
3 - horizontal
4 - ascending

Question 10

What are the flexures in the duodenum and where are they?

Answer 10

1-2: superior duodenal flexure
2-3: inferior duodenal flexure
4-jejunum: duodenojejunal

Question 11

Relationship between bile duct and main pancreatic duct?

Answer 11

Join together before entering greater duodenal papilla

Question 12

The greater duodenal papilla marks the site of which landmark?

Answer 12

Junction between foregut and midgut

Question 13

What is longer - jejunum or ileum?

Answer 13

ileum (3/5 cf 2/5)

Question 14

Where does jejunum start and ileum end?

Answer 14

duodenojejunal flexure and ileocaecal valve

Question 15

Are jejunum and ileum suspended or retro?

Answer 15

suspended by mesentery attached to posterior abdominal wall called the root of mesentery

Question 16

What folds are found in the jejunum and ileum?

Answer 16

permanent internal transverse folds

Question 17

How to distinguish between jejunum and ileum?

Answer 17

Jejunum has:

1. longer vasa recta and fewer arcades
2. less fatty mesentery
3. larger and longer folds (permanent internal transverse folds - ileum has almost no folds in distal part)

Question 18

Are Peyer’s patches more common in jejunum or ileum?

Answer 18

Ileum (but can also be found elsewhere in GI tract)

Question 19

What are the components of the large intesntine?

Answer 19

Caeceum/appendix, ascending, transverse, descending, sigmoid colon, rectum, anus

Question 20

What are three features of L intestine not found in S intestine?

Answer 20

1. sacculations
2. taenia coli (longitudinal external muscle)
3. epiploic/omental appendices

Question 21

Is the caecum suspended or retro?

Answer 21

Neither, it hangs off the ascending colon

Question 22

Where is the caecum located?

Answer 22

R iliac fossa

Question 23

What is posterior to the caecum

Answer 23

retrocaecal recess

Question 24

What joins caecum to the small intestine?

Answer 24

ileocaecal valve

Question 25

What is the relationship between valve and frenulae at the ileocaecal junction?

Answer 25

edges of the valves taper into horizontal elevations called frenulae

Question 26

How is reflux of bolus back into ileum from caecum prevented?

Answer 26

probably by tightening of frenulae rather than contraction of poorly developed muscle of valve

Question 27

How does food enter the caecum?

Answer 27

The gastroileal reflex is stimulated by the presence of food in the stomach and gastric peristalsis. Initiation of the reflex causes peristalsis in the ileum and the opening of the ileocecal valve

Question 28

Where is the appendix often found?

Answer 28

retrocaecal recess or hanging down over pelvic brim

Question 29

What is the name of and where is attachment of appendix to caecum?

Answer 29

Base of the appendix or McBurney's point - one-third of the distance from the right anterior superior iliac spine to the umbilicus

Question 30

What is the appendix suspended with?

Answer 30

mesoappendix (which attaches to ileal mesentery)

Question 31

What parts of the large intestine are suspended with what mesentery?

Answer 31

Transverse colon - transverse mesocolon | Sigmoid colon - sigmoid mesocolon

Question 32

What are the flexures in the large intestine called?

Answer 32

``` R colic (hepatic) flexure L colic (splenic) flexure ```

Question 33

The transverse mesocolon attaches the transverse colon to what?

Answer 33

greater omentum and pancreas

Question 34

What is the L colic flexure attached to and by what?

Answer 34

Diaphragm by the phrenicocolic ligament

Question 35

What is continuous with the phrenicocolic ligament?

Answer 35

splenocolic ligament

Question 36

Descending colon goes down into what space?

Answer 36

L iliac fossa

Question 37

Where are the ends of the sigmoid colon located?

Answer 37

pelvic brim to S3 (middle of sacrum)

Question 38

What is the space posterior to sigmoid mesocolon called?

Answer 38

intersigmoidal recess