Lecture 10 - Alimentary 2 Flashcards Preview

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Flashcards in Lecture 10 - Alimentary 2 Deck (82):
1

Where does small intestine extend

Pylorus to ileocaecal valve

2

What does the small intestine consist of (3)

Duodenum, jejunum and ileum

3

What is the function of the small intestine

Digestion and absorption of nutrients

4

The entire duodenum is retroperitoneal true or false?

False

5

What section of the duodenum is not retroperitoneal?

The first 2-3 cms which are attached to the greater and lesser omenta

6

What is the shape of the duodenum? (2)

C-shaped with 4 parts that curve around the head of the pancreas

7

Where does the duodenum sit?

Above the level of the umbilicus

8

What are the permanent circular folds of the duodenum called?

Plicae

9

Where are the plicae most pronounced?

In the proximal duodenum

10

What do the plicae look like in contrast medium x-rays?

Feathery

11

What vein and duct are posterior to the duodenum?

Portal vein and bile duct

12

What organs are anterior to the superior duodenum (2)

Quadrate lobe of the liver and gallblader

13

What is the first part of the duodenum called in x-rays

Duodenal cap

14

Why is the duodenal cap shorter than it actually is in x-rays?

It has an oblique orientation

15

What is medial to the descending/second part of the duodenum

Head of the pancreas

16

Where do the bile duct and main pancreatic ducts empty into the duodenum?

The greater duodenal papilla

17

Where would the lesser duodenal papilla be anatomically if it existed for the accessory pancreatic duct

2 cm above the greater papilla

18

What is posterior to the descending duodenum?

Hilum of the right kidney

19

What is posterior to the horizontal/third part of the duodenum?

Upper right psoas

20

What vessels are anterior to the horizontal duodenum

superior mesenteric vessels

21

Where do the superior mesenteric vessels pass between

The uncinate process and the head of the pancreas

22

What is posterior to the ascending/fourth part of the duodenum?

Upper left psoas

23

Where is the duodenojejunal junction

The level of L2 just medial to the left kidney (easy to recognise by the appearance of a mesentery supporting the jejunum.

24

The duodenum is in general posterior to the transverse colon, true or false?

True

25

What fraction of the length of the small intestine are the jejunum and ileum

2/5 and 3/5

26

Where is the jejunum largely located?

Umbilical region

27

Where is the ileum mainly located?

Lower abdomen and pubic regions

28

Where is the first loop of jejunum usually coiled?

Between the left transverse colon and left kidney

29

Where does the jejenum and ileum extend?

From the duodenal flexure to the ileocaecal valve.

30

The transition from the ileum to the caecum is gradual true or false?

True

31

What is the mesentery attachment of the jejunum and ileum to the posterior abdominal wall called?

The root of mesentery

32

Which direction does the root of mesentery run?

Upper left to lower right

33

What is the shape of root of mesentery?

Fan-shaped

34

The internal transverse folds of the jejunum and ileum are temporary like the stomach folds, true or false?

False, they are not obliterated by distension

35

What comprises the walls of the jejunum and ileum (4)

Mucosa with villi, thin muscularis mucosa, submucosa and thick external muscle

36

Where do the vasa recta of the jejunum arise from?

Branches of the superior mesenteric artery

37

The jejunum has longer mesentery vasa recta then the ileum with few anastamoses, true or false?

True

38

The ileum has larger and longer folds than the jejunum, true or false?

False

39

The jejunum is thinner and less vascular walled than the ileum, true or false?

False

40

The mesentery of the ileum is less fatty than the jejunum true or false?

False

41

The jejunum has small and few aggregated lymph follicles (Payer's patches), true or false?

True

42

The jejunum has longer villi true or false?

True

43

What is the large intestine comprised of? (8)

Caecum, appendix; ascending, descending, transverse, sigmoid colon, rectum, anus

44

What is the function of the large intestine?

Absorption of water and ions

45

What are the sacculation/haustra

Regular expanded areas of the colon interspersed with constrictions

46

Where are the taenia not present

Appendix and rectum junction

47

What are the taenia coli

3 thickenings of the longitudinal part of the external muscle

48

What are three features of the large intestine?

Sacculation, taenia coli and epiploic/omental appendices

49

Where are the epiploic appendices present

Transverse and sigmoid colon

50

The appendix and rectum junction have epiploic appendices true or false?

False

51

Where is the caecum located?

In the right iliac fossa

52

The caecum is attached by mesentery true or false?

False

53

What usually surrounded caecum?

Peritoneum

54

When is the caecum not surrounded by the peritoneum?

Where it connects with the ileum and ascending colon

55

What is the caecum?

A blind intestinal pouch suspended from the ascending colon

56

What is behind the caecum?

The retrocaecal recess

57

Where is the junction between the caecum and ascending colon?

At the level of the ileocaecal valve

58

What likely facilitates the reflux of the bolus back into the ileum?

The tightening of frenulae rather than the contraction of the poorly developed muscle of the horizontal ileocaecal valve

59

What is the anatomical description of the horizontal ileocaecal valve

Posteromedial

60

What does the horizontal ileocaecal valve consist of?

two flaps called valves whose edges taper into horizontal elevations/frenulae

61

What is the gastroileal reflex

When food in the stomach initiates contraction of the small intestine and thus expulsion of ileal contents into the caecum

62

Where is the appendix often located? (3)

Retrocaecal recess or hanging down over the pelvic brim or close to the opening of the uterine tube in females

63

What point does the appendix open into the caecum? (2)

McBurney's point - junction of lateral and middle thirds of line joining umbilicus and anterior superior iliac spine (ASIS)

64

What is the appendix suspended on and what is this suspension attached to?

Mesoappendix, attached to the ileal mesentary

65

The appendix has a ring of lymphatic nodules in the mucosa and submucosa true or false?

True

66

Where does the ascending colon extend?

From the ileocaecal valve to the right colic flexure

67

Where is the right colic flexure? (3)

Anterior to the right kidney and descending duodenum and behind the fundus of the gallbladder

68

The ascending colon is always retroperitoneal true or false?

False, many up to 50% of individuals have ascending or even descending colon attached with little mesentery

69

What suspends the transverse colon?

Transverse mesocolon

70

Where is the transverse colon suspended between and how?

Colic flexures in an inverted arch

71

What does the transverse mesocolon attach to? (2)

Greater omentum and pancreas

72

Where is the anatomical position of the left colic flexure

anterior to the left kidney and below the spleen and pancreas

73

What attaches the left colic flexure to the diaphragm?

Phrenicocolic ligament

74

What is the function of the phrenicocolic ligament?

Provides support for the spleen

75

What is the pathway of the phrenicocolic ligament?

It passes laterally under the spleen and is continuous with the splenocolic ligament

76

Where does the descending colon span?

The left colic flexure to the pelvic inlet

77

What is the pathway of the descending colon (3)

Down the abdominal wall
Turns medially into left iliac fossa
Crosses structures

78

What structures does the descending colon cross (2)?

Testicular/ovarian vessels and external iliac vessels

79

Where does the sigmoid colon extend?

From the pelvic brim to S3 (middle of sacrum)

80

What shape does the sigmoid colon form?

A V-shape

81

Where does the sigmoid colon reside?

In the intersigmoidal recess behind the sigmoid mesocolon

82

What does the sigmoid colon overly? (2)

Left ureter and external iliac vessels.