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Flashcards in The gut Deck (30)
1

What are the structures in place preventing reflux of stomach contents up oseophagus?

- Lower oesophageal sphincter

- Diaphragmatic crura

- Angle of His

- Phreno-oesophageal ligament

- Viscera (intra-abdominal pressure)

- Thick mucosa at gastro-oesophageal junction

2

What are the locations of reflections of the parietal peritoneum?

- Falciform and coronary ligaments of the liver

- Greater omentum

- Lesser omentum

- Gastrosplenic ligament

- Lineorenal ligament

- Small bowel mesentery

3

What are the regions of the peritoneal cavity?

- Greater sac

- Lesser sac

- Epiploic foraman (connection)

4

What are the sections of the peritoneal cavity divided by the transverse colon and asociated mesentery?

- Supracolic compartment

- Infracolic compartment

5

What are the different parts of the stomach?

- Cardia

- Fundus

- Body

- Antrum

- Pylorus

6

What are the different parts of the borders of the stomach?

- Greater curvature

- Angular incisura

- Lesser curvature

- Angle of His

7

What is the blood supply of the stomach?

1. Left gastric artery

2. Splenic artery:

- Short gastric artery

- Left gastroepiploic artery

3. Common hepatic artery:

- Right gastric artery

- Gastroduodenal artery (right gastroepiploic artery)

8

What is the parasympathetic supply to the stomach?

- Vagus nerve (anterior and posterior vagal trunk)

- Functions include:

1. Increase gastric motor activity

2. Increase secretion

3. Open pyloric sphincter

9

What is the sympathetic supply to the stomach?

- Greater splanchnic (via coeliac plexus)

- Functions include:

1. Reduces gastric blood supply

2. Reduces gastric motor activity 

3. Reduces gastric secretion

10

What is the lymphatic drainage of the stomach?

Pre-aortic coeliac lymph nodes

11

What is the structure of the greater omentum?

- Consists of 4 layers of visceral peritoneum.

- Attached to the greater curvature of the stomach.

- Hangs over transverse colon, jejunum and ilium like apron.

12

What is the structure of the lesser omentum?

- Consists of 2 layers of visceral peritoneum

- Attached to the lesser curvature of the stomach

- Its free edge makes up anterior wall of epiploic foraman

13

What are the ligaments that make up the lesser sac?

- Gastrohepatic

- Gastroduodenal

14

What are the contents of the epiploic foraman?

- Hepatic portal vein (posterior)

- Common bile duct (right)

- Hepatic artery (left)

15

What are the contents of the gastrosplenic ligament? 

- Short gastric artery

- Left gastroepiploic artery

16

What are the divisions of the duodenum?

- Superior (5 cm)

- Descending (8 cm)

- Inferior (10 cm)

- Ascending (2.5 cm)

17

What are the relations of the superior part of the duodenum?

- First half intraperitoneal, rest retroperitoneal.

- Anterior: Liver and gallbladder.

- Superior: Epiploic foraman.

- Inferior: Pancreas.

18

What are the relations of the descending part of the duodenum?

- Right of IVC and vertebral column.

- Common bile duct and main panreatic duct drains into this part via ampulla of Vater and major duodenal papilla (defining boundary between foregut and midgut) on posteromedial side.

- Accessory pancreatic duct drains into minor duodenal papilla superior to major.

- Medial: Pancreas.

- Lateral: Ascending colon.

19

What are the relations of the inferior part of the duodenum?

- Crosses IVC and aorta at level L3.

- Largest section of duodenum.

- Anterior: Small bowel mesentery, superior mesenteric vessels.

- Left: Left kidney and ureter.

- Superior: Body of pancreas.

 

20

What are the relations of the ascending part of the duodenum?

- Ends at T2 at the duodenojejunal flexure.

- Partly retroperitoneal and partly intraperitoneal.

- Anterior: Transverse colon/mesocolon.

- Left: Left kidney and ureter.

- Superior: Body of pancreas.

21

What are the relations of the root small bowel mesentery?

- Starts superiorly on left side at level L2 at duodenojejunal flexure.

- Ends in front of the sacroiliac joint.

- Root is ~15cm long.

22

What are the features of the jejunum?

- Upper 2/5 

- Located in umbilical region

- Thick red walls and wider lumen

- Fewer vascular arcades

- Less fatty mesentery

- Tall villi and deep crypts

- Thich vascular mucosa

- Few lymphoid follicles

23

What are the features of the ilium?

- Lower 3/5

- Suprapulic region and pelvis

- Thinner pink walls and narrower lumen

- Numerous vascular arcades

- Lots of fat in mesentery

- Shorter villi and shallower crypts

- Thinner vascular mucosa

- Peyer's patches

24

What is the blood supply of the small intestine?

1. Duodenum:

- Superior pancreaticoduodenal artery (gastroduodenal artery)

- Inferior pancraticoduodenal artery (superior mesenteric artery)

2. Jejunum: Jejunal branches of SMA

3. Ilium: Ilial branches of SMA

25

What is the innervation of the small intestine?

Sympathetic is from lesser splanchnic

26

What is the lymphatic drainage of the small intestine?

Mesenteric nodes, pre-aortic lymph nodes and then cisterna chyli

27

What are the features of the colon?

- Taeniae coli

- Sacculations

- Appendices epiploicae

28

What are the structural features of the colon?

- Transverse and sigmoidal colon are intraperitoneal, rest are retroperitoneal.

- The hepatic flexure is located between ascending and transverse colon.

- The splenic flexure is located between transverse and descending colon.

- The para-colic gutters are located laterally to the ascendign and descending parts.

 

29

What is the blood supply to the colon?

- Caecum and appendix: Ileocolic artery

- Ascending colon: Right colic artery

- Transverse colon: Middle colic artery

- Descending colon: Left colic artery

- All anastomose to form marginal artery

- Sigmoidal colon: Sigmoidal artery

 

30

What is the lymphatic drainage of the colon?

Mesenteric nodes, pre-aortic nodes and the cisterna chyli