What are the four parts of the duodenum?
Superior, Descending, Inferior, Ascending
What is the most common site for peptic ulcer?
The second part of the duodenum (descending)
What causes peritonitis?
Anterior ulcers that may present with a free perforation of the duodenum
What causes loss of blood and peritonitis?
Posterior ulcers more often lead to gastrointestinal hemorrhage (pancreaticoduodenal artery erosion)
What arteries suply the duodenum?
The superior and Inferior pancreaticoduodenal
What does the superior and Inferior pancreaticoduodenal arise from?
Gastrodudenal and superior mesenteric respectively.
What artery lies directly behind the first portion of the duodenum?
The gastroduodenal artery
Where does the common bile duct and pancreatic duct enter the duodenum?
The posteromedial aspect of the second part of the duodenum
What is the name of the dilation formed the by the junction of the common bile duct and the main pancreatic duct?
The hepatopancreatic ampulla (Sphincter of Oddi/Vater)
How does the jejunum differ in appearance from the ileum?
The jejunum has, thicker walls, a larger diameter, more vascular, larger and more developed plicae circularis, longer vasa rectae
Describe the Cecum
Blind-ended pouch located in the right iliac fossa that is inferior to ileocecal junction. it is intraperitoneal (has no mesentery) and the vermiform appendix attaches to its posteromedial surface (3 teniae coli converge at base of appendix).
State the portion of the large intestine that has the widest diameter?
The cecum and as a result it is the site most likely for colonic perforation
What is the arterial supply of the cecum?
The anterior and posterior cecal arteries (a branch of the ileocolic artery)
Describe blood flow from the superior mesenteric artery to the jejunum:
The aorta gives rise to the superior mesenteric artery which in turn gives off 15 to 18 jejunal and ileal branches that run between the 2 layers of mesentery. These 15 to 18 jejunal and ileal branches unite to form loops called arterial arcades. These arcades then form straight vessels (vasa recta) which enter the intestinal wall
What are the parts of the large intestine?
cecum with vermiform appendix, ascending colon, transverse colon, descending colon, sigmoid colon, rectum, anal canal
State 3 features that differentiate the large intestine from the small?
What structure marks the end of the small intestine?
What are teniae coli ?
3 thin bands of muscle which run longitudinally along the entire length of the ascending, transverse, descending colon
What are haustra?
Sacculations of large bowl which are created by contractions of taeniae coli
What are appendices epiploica?
Small fat-filled peritoneal sac along the taeniae coli
What are the three major branches of the inferior mesenteric?
Left colic, sigmoidal, superior rectal
What arteries supply the ascending colon?
The ileocolic and the right colic arteries (both branches of the superior mesenteric artery)
What is the marginal artery of Drummond?
The marginal artery of Drummond is a continuous arterial chain linking the vascular arcades of the entire colon.
What is the location of Griffith's point?
Griffith's point is located at the splenic flexor, the junction of the SMA and IMA vascular territories
What is the location Sudeck's point?
Sudeck's point is at the junction of the sigmoid colon and the rectum.