Anatomy- The Intestines

Front 1

Name the 3 parts of the small intestine.

Back 1

duodenum
jejunum
ileum

Front 2

Name the 4 parts of the duodenum.

Back 2

Superior part
Descending part
Horizontal part
Ascending part

Front 3

What is the clinical significance of the duodenum?

Back 3

duodenal cap: region where duodenal ulcers occur most frequently, close relations with pancreas

Front 4

During surgery, how is the duodenojejunal junction identified?

Back 4

from the Ligament of Trietz

Front 5

Important features of the superior part of the duodenum.

Back 5

duodenal cap seen by XRAY here, partial retroperitoneal

Front 6

Important features of the descending part of the duodenum.

Back 6

head of pancreas sits right in it's concavity, sphincter of Oddi guards major duodenal papilla, inferior duodenal flexure, retroperitoneal

Front 7

Important features of the horizontal part of the duodenum.

Back 7

retroperitoneal, right lower border of L3 to left side of aorta at L3.

Front 8

Important features of the ascending part of the duodenum.

Back 8

ascends on left part of aorta to end as duodenojejunal flexure, Ligament of Trietz, suspends from DDF to right crus of diaphragm

Front 9

What two arteries provide most of the blood supply for the small intestine?

Back 9

-celiac trunk
-superior mesenteric artery

Front 10

Describe the path of blood to the duodenum from the celiac trunk.

Back 10

celiac trunk--> common hepatic artery --> gastroduodenal artery --> superior pancreaticoduodenal artery

Front 11

What is the source of the inferior pancreaticoduodenal artery?

Back 11

superior mesenteric artery

Front 12

What is the innervation of the duodenum?

Back 12

ANS: greater/lesser splanchnics and vagus nerve --> celiac and superior mesenteric plexuses--> periarterial branches--> duodenum

Front 13

Describe the differences between the jejunum and ileum.

Back 13

jejunum: thicker walls, greater diameter, 1-2 arcades
ileum: mesentery thicker w/ more fat, complex arcardes

Front 14

What supplies blood to the jejunum and ileum?

Back 14

superior mesenteric artery branches
jejunal & ileal arteries: arcades
iliocolic arteries: lower ilum

Front 15

Describe the path of lymphatic drainage from the jejunum and ileum.

Back 15

superior mesenteric nodes--> celiac nodes--> cisterna chyli --> thoracic duct

Front 16

Are malignant tumors of the small intestine common?

Back 16

No

Front 17

What is an inguinal hernia?

Back 17

a loop of small intestine that herniates through superficial or deep inguinal rings

Front 18

Name 4 types of hernias.

Back 18

inguinal hernia, internal hernia, umbilical hernia, herniation into femoral ring

Front 19

Describe Meckel's diverticulum.

Back 19

common abnormality, remains of yolk stalk of embryo persists as a blind sac in adults, on or above cecum, can cause ulceration or bleeding

Front 20

Name 3 distinguishing characteristics of the large intestine.

Back 20

3 teniae coli, hausta, epiploic appendages

Front 21

What are the teniae coli?

Back 21

thickened bands of longitudinal smooth muscle:
free, omental, mesocolic

Front 22

What are haustra?

Back 22

sacculations of wall of colon between teniae coli

Front 23

Does the rectum have teniae coli, haustra, or epiploic appendages?

Back 23

No

Front 24

What is the peritoneal relationship of the cecum?

Back 24

intraperitoneal (but no mesentery)

Front 25

What is the location of the cecum?

Back 25

right iliac fossa

Front 26

Describe the ileo-cecal valve.

Back 26

consists of upper and lower lips, which at their ends continue as a fold, prevents food from passing too quickly from ileum

Front 27

What is the blood supply of the cecum?

Back 27

ileocecal artery from superior mesenteric artery

Front 28

What is the innervation of the cecum?

Back 28

superior mesenteric plexus

Front 29

What is the clinical significance of the cecum?

Back 29

cecum might have a subhepatic position due to an incomplete rotation of the gut during fetal life

Front 30

What is the peritoneal relationship of the appendix?

Back 30

intraperitoneal

Front 31

What is the blood supply to the appendix?

Back 31

appendicular artery from ileocolic artery

Front 32

In what 2 age groups is appendicitis especially uncommon?

Back 32

infants and elderly people

Front 33

Where is McBurney's point?

Back 33

junction of lateral and middle 1/3rd of a line from ASIS to umbilicus- base of the appendix, helps diagnosis

Front 34

What is the peritoneal relationship of the ascending colon?

Back 34

secondary retroperitoneal

Front 35

What is the blood supply for the ascending colon?

Back 35

ileocolic and right colic arteries from superior mesenteric artery

Front 36

What is the innervation of the ascending colon?

Back 36

superior mesenteric plexus

Front 37

What structure characterizes the ascending colon?

Back 37

right colic flexure

Front 38

What structure characterizes the transverse colon?

Back 38

left colic flexure

Front 39

What is the peritoneal relationship of the transverse colon?

Back 39

intraperitoneal

Front 40

Where does the greater omentum attach to the transverse colon?

Back 40

from right to left colic flexures

Front 41

What is the blood supply of the transverse colon?

Back 41

right and middle colic arteries from superior mesenteric artery
left colic artery from inferior mesenteric artery

Front 42

What is the innervation of the transverse colon?

Back 42

superior and inferior mesenteric plexuses

Front 43

Which colic flexure is higher and more acute?

Back 43

Left colic flexure

Front 44

What is the peritoneal relationship of the descending colon?

Back 44

secondary retroperitoneal

Front 45

What is the blood supply of the descending colon?

Back 45

left colic and superior sigmoid arteries from inferior mesenteric veins

Front 46

What is the sympathetic innervation of the descending colon?

Back 46

lumbar splanchnic nerves (L1-2), superior mesenteric plexus

Front 47

What is the parasympathetic innervation of the descending colon?

Back 47

pelvic splanchnic nerves (S2-4)

Front 48

What is the peritoneal relationship of the sigmoid colon?

Back 48

intraperitoneal

Front 49

What peritoneal relationship is the rectum?

Back 49

secondary retroperitoneal

Front 50

Where does the rectum begin?

Back 50

S3, within pelvic diaphragm

Front 51

Name the 2 anteroposterior curves of the rectum.

Back 51

sacral flexure: curve of sacrum and cocyx
perineal flexure: sling of puborectalis m. fits in this flexure and sphincters

Front 52

What is the ampulla of the rectum and what is its function?

Back 52

dilated terminal part of the rectum, holds fecal mass until defecation

Front 53

What is the bloody supply to the rectum?

Back 53

superior/middle rectal arteries from inferior mesenteric artery
inferior rectal a. from int. pudend. a.
median sacral artery