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Gastrointestinal > Small and Large Intestine > Flashcards

Small and Large Intestine Flashcards

1
Q

What is the shape of the duodenum

A

C-shaped around the head of the pancreas

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2
Q

What is the duodenum continuous with

A

Pylorus of the stomach

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3
Q

Is the duodenum retro or intra peritoneal

A

Retroperitoneal

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4
Q

What is the major duodenal papilla and where is it found

A

Approx. 1/2 way along the internal wall of the duodenum

Opening for the bile duct and main pancreatic duct into the duodenum

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5
Q

What does the first half of the duodenum develop from

A

Embryological foregut

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6
Q

What supplies the first half of the duodenum

A

Branches from the coeliac trunk

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7
Q

What does the second half of the duodenum develop from

A

Embryological mid gut

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8
Q

What supplies the second half of the duodenum

A

Superior mesenteric artery

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9
Q

Which comes first the jejunum or ileum

A

Jejunum

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10
Q

What is continuous with the duodenum

A

Jejunum

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11
Q

Is the jejunum retro or intra peritoneal

A

Intraperitoneal

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12
Q

Is the ileum retro or intra peritoneal

A

Intraperitoneal

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13
Q

What is both the jejunum and ileum suspended from

A

Posterior abdominal wall by the mesentery of the small intestine

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14
Q

What are the jejunum and ileum derived from

A

Embryological midgut

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15
Q

Where does the jejunum lie

A

Left upper region

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16
Q

Where does the ileum lie

A

Right lower region

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17
Q

What features does the small intestine have for nutrient absorption

A

Vast surface area
Small intestine long
Mucosa folded (plicae circulares)
Mucosal folds bear villi
Microvilli

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18
Q

What is Meckel’s diverticulum

A

Blind ended diverticulum approx. 1m from its termination

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19
Q

What is the Meckel’s diverticulum a remnant of

A

Connection that was present between the midgut loop to the yolk sac

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20
Q

What is terminal ileum continuous with

A

Caecum

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21
Q

What is the junction called between the terminal ileum and caecum and where is it found

A

Ileocecal junction
R. iliac fossa

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22
Q

Define appendix

A

Small diverticulum that arises from the caecum

Contains lymphoid tissue

Connected to caecum by a small mesentery

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23
Q

What is the small mesentery called which connects the caecum to the appendix

A

Mesoappendix

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24
Q

What does the urge to defecate arise from

A

Contraction of rectal muscles

Relaxation of internal anal sphincter

Initial contraction of external anal sphincter

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25
What is the nerve supply of the external anal sphincter
Pudendal nerve S2,3,4 - allows concious control
26
Describe defecation
Rectum is distended the rectosphinteric reflex is initiated and relaxes the internal sphincter Then - relaxation of the external sphincter - contraction of abdominal wall muscles - relaxation of pelvic wall muscles Peristaltic waves facilitate movement of faeces through anal canal
27
What happens if defecation is not desired
Voluntary contraction of the external sphincter - usually enough to override the reflexes of anal distension initiates
28
Describe the Valsalva Manoeuvre
Defecation can be assisted by taking a deep breath and attempting to expel air against the glottis
29
What is the blood supply to the jejunum and ileum
Superior mesenteric artery Embedded within the mesentery
30
What is more pronounced in the jejunum
Plicae
31
What is the internal ileum characterised by
Peyer's patches - large submucosal lymph nodules
32
What is the role of the large intestine
Reabsorbs water from faecal material to form semi-solid faeces
33
What is the large intestine formed of
Caecum Appendix Ascending colon Transverse colon Descending colon Sigmoid colon Rectum Anal canal
34
What is the outer longitudinal muscle layer of the large intestine organised like
Three bands - taeniae coli Inner circular muscle layer forms budges - haustra
35
What is taeniae coli
Three bands of the outer longitudinal muscle layer of the large intestine
36
What are haustra
Bulges formed by the inner muscular layer of the large intestine
37
What are epiploic appendages
Fatty tags which mark the point at which blood vessels penetrate the intestinal wall
38
Describe the caecum What are its features? What does it have?
Peritoneum - but no mesentery Appendix
39
Describe the appendix
Contains lymphoid tissue Varies in length and position of tip is variable Connected to caecum by a small mesentery - mesoappendix
40
Describe the ascending colon
Runs vertically on right side of posterior abdominal wall - right paracolic gutter Retroperitoneal (secondary)
41
What is the bend in the ascending colon called
Hepatic flexure (right colic flexure)
42
Describe the transverse colon
Intraperitoneal - suspended to posterior abdominal wall by transverse mesocolon 1st 2/3 = midgut 2nd 1/3 = hindgut
43
What is the bend in the transverse colon
Splenic flexure Tethered to diaphragm by phrenicocolic ligament
44
Describe the descending colon
Runs left side of posterior abdominal wall in left paracolic gutter Retroperitoneal (secondary)
45
Describe sigmoid colon
Sinuous shape As it approaches midline makes a 90 degrees turn inferiorly = rectosigmoid junction Intraperitoneal - sigmoid mesocolon
46
At what level does the coeliac trunk leave the aorta
T12
47
What does the coeliac trunk supply
Foregut - oesophagus - stomach - first half of the duodenum - liver - gallbladder - bile ducts - pancreas - spleen
48
What does the superior mesenteric supply
Midgut - Second half of duodenum - small intestine - large intestine up to 2/3 away transverse colon - branches which supply pancreas
49
At what level does the superior mesenteric artery leave the aorta
L1
50
What does the inferior mesenteric artery supply
Hindgut - distal third of transverse colon - descending and sigmoid colon - rectum - upper part of anal canal
51
At what level does the inferior mesenteric artery supply
L3
52
What arteries are embedded in the mesentery of the small intestine
Jejunal and ileal branches Anastomose with each other to form loops of arteries - arcades which run the vasa recta - supply the intestinal wall
53
What are the branches of the superior mesenteric artery
Jejunal branches Ileal branches Ileocolic artery Right colic artery Middle colic artery
54
What does the ileocolic artery supply
Caecum Appendix Ascending colon
55
What does the right colic artery supply
Ascending colon
56
What does the middle colic artery supply
Transverse colon
57
What are the branches of the inferior mesenteric artery
Left colic artery Sigmoid branches Superior rectal artery (terminal branch)
58
What does the left colic artery supply
Transverse colon Descending colon
59
What forms the marginal artery
Middle colic artery (SMA) and left colic artery (IMA) anastomose along the distal 1/3 of transverse colon and splenic flexure
60
What is the lower rectum supplied by
Internal iliac arteries
61
What is the parasympathetic nervous supply to the foregut and midgut
Parasympathetic fibres - Vagus nerve
62
What is the parasympathetic nervous supply to the hindgut
Pelvis splanchnic nerves S2-4
63
What is the sympathetic innervation of the foregut
Greater splanchnic nerves T5-9
64
What is the sympathetic innervation of the midgut
Lesser splanchnic nerves T10-11
65
What is the sympathetic innervation of the hindgut
Least splanchnic nerves T12
66
What is the visceral innervation of the gut
Comes off the same as the sympathetic nerves

Gastrointestinal (12 decks)

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