GI II

where does the foregut transition to the midgut

major duodenal papilla

where does the midgut transition to the hindgut

distal 1/3 of transverse colon (left colic flexure)

the jejunum makes up what fraction of the midgut

proximal 2/5

the ileum makes up what fraction of the midgut

distal 3/5

what occurs in the jejunum and ileum

most absoprtion of nutrients

which quadrant is the duodenum in

RUQ

which quadrant does the jejunum occupy

LUQ

which quadrant does the ileum occupy

RLQ

what marks the transition from ascending colon to transverse colon

right colic flexure

what marks the transition between the transverse and descending colon

left colic flexure

main function of the large intestine

absoprtion of water from material passed from the small intestine

formation of solid feces

storage of feces until defecation

length of the large intestine

5 ft

the large intestine encircles the _

small intestine

parts of the large intestine

cecum (and appendix)

ascending colon

transverse colon

descending colon

sigmoid colon

rectum

anal canal

the cecum is a _

blind pouch

where does the small intestine attach to the large intestine

ileocecal junction

appendix is a _ of cecum containing lymphoid tissue

blind diverticulum

what is the appendix made of

lymphoid tissue

where is the appendix usually situation relatively

retrocecal

mesentery of appendix

mesoappendix

what spinal cord level is the rectosigmoid junction

S3

3 distinguishing features of the large intestine

teniae coli

haustra

omental appendices

what are teniae coli

three segregated narrow bands of longitudinal muscles on the walls of long intestine

where along the colon do teniae coli begin and end

begins at the base of the appendix

end at distal sigmoid colon

wht are haustra

sacculations formed because tineia coli are shorter than the bowel

the presence and orientation of teniae coli creates _

haustra

what are omental appendices

peritoneal-covered accumulation of visceral fat found on the colon

what is diverticulosis

presence of diverticula (bulging pouches) from the large intestine

the rectum is part of the _ (which area of the body)

pelvis

the anal canal is part of _ (which area of the body)

perinuem

what is the arterial supply to the foregut

celiac trunk

arterial supply to the midgut

superior mesenteric artery

arterial supply to the hindgut

inferior mesenteric artery

components of the midgut

1/2 of duodenum

jejunum

ileum

cecum and appendix

ascending colon

2/3 transverse colon

components of the hindgut

1/3 of transverse colon

descending colon

sigmoid colon

rectum

branches of the superior mesenteric artery

middle colic a

right colic a

ileocolic a

arterial supply of the appendix

appendicular a

where does the appendicular artery branch from

ileocolic artery

what arteries supply the jejunum and ileum

jejunal a

ileal a

features of the jejunal arteries

few arterial arcades

fewer and longer vasa recta

features of ileal arteries

more arterial arcades

more (but shorter) vasa recta

the superior rectal artery continues into the _

pelivs

main branches of the inferior mesenteric artery for the hindgut

left colic artery

superior rectal artery

sigmoid arteries

where do the sigmoid arteries arise from

inferior mesenteric artery

left colic artery

the marginal artery courses along _

ascending, transverse, descending parts of large intestne

arterial supply to the transverse colon

right colic a

middle colic a

left colic a

arterial supply of the descending colon

left colic a

arterial supply to the sigmoid colon

sigmoidal arteries

arterial supply of the ascending colon

colic branch of ileocolic a

anterior cecal a

posterior cecal a

right colic a

the marginal artery forms anastamoses between _

superior mesenteric a and inferior mesenteric a

the marginal artery can provide _

collateral circulation

where does the marginal artery supply a lot of collateral circulation

area of splenic flexure

what veins feed into the portal vein

superior mesenteric vein

splenic vein

what drains into the splenic vein

inferior mesenteric vein

where are the portal-systemic anastamoses (4)

esophageal vein - left gastric vein

para-umbilical vein - superficial epigastric vein

retroperitoneal veins - colic veins

superior rectal vein - rectal veins

lymphatics of the GI tract eventually pass to _

pre-aortic lymph nodes

what are the pre-aortic lymph nodes

celiac

superior mesenteric

inferior mesenteric

the hindgut drains into what lymph nodes

inferior mesenteric nodes

the midgut drains into what lymph nodes

superir mesenteric nodes

the foregut drains into which lymph nodes

celiac trunk

what is the path route of lymph flow in the GI tract

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

what supplies motor innervation to the GI tract

sympathetic and parasympathetic pathways

visceral sensory information from abdominal viscera is perceived as coming from _

other areas

what does sympathetic inneration of the GI tract do

vasoconstriction

decreased gut motility

source of sympathetic preganglionic fibers to the GI tract

splanchnic nerves

where are Sympathetic postganglionic cell bodies located in the GI tract

preverterbral ganglia

sympathetic postganglionic axons follow _

the blood supply to the GI tract

how do sympathetic post ganglionic axons travel in the GI tract

in peri-arterial plexuses

sympathetic post ganglionic axons travel with _ in the GI tract

parasympathetic and visceral sensory axons

what are the sympathetic prevertebral ganglia of the GI tract

celiac ganglion

superior mesenteric ganglion

inferior mesenteric ganglion

where does the greater splanchnic nerve synapse

celiac ganglion

Where does the lesser splanchnic nerve synapse?

superior mesenteric ganglion

Where does the least splanchnic nerve synapse?

renal plexus

where do lumbar splanchnic nerves synapse

inferior mesenteric ganglion

what effect does parasympathetic innercation have on the GI tract

increased gut motility

secretion of digestive juices

where are parasympathetic preganglionic cell bodies located

nuclei in the brainstem (vagus nerve)

S2-S4 spinal cord (pelvic splanchnic nerves)

preganglionic parasympathetic axons follow _ to the foregut and midgut

vagus nerve

preganglionic parasympathetic axons follow _ to the hindgut

pelvic splanchnic nerves (S2-S4)

where are parasympathetic postganglionic cell bodies found in the GI tract

intrinsic ganglia within the walls of their respective organs

how is visceral pain in the GI tract described

dull

diffuse

poorly localized

stimuli that cause visceral pain of the GI tract

ischemia

prolonged smooth muscle contraction (cramping)

distention (stretching, gas)

visceral pain axons follow _ pathways proximal to the middle of the sigmoid colon

sympathetic

visceral pain axons follow _ pathways distal to the middle of the sigmoid colon

parasympathetic (pelvic splanchnic. nerves)

pain pathways for most abdominal viscera follow _ fibers

sympathetic

where is somatic pain of the GI tract felt

dermatomes belonging to the same spinal cord level providing autonomic innervation to the affected organ

where is visceral pain of the foregut felt

epigastric region

where is visceral pain of the midgut felt

umbilical region

Where is visceral pain in the hindgut felt?

pubic region

what is the arterial supply to the foregut

which part of the small intestine is more vascularized

jejunum

how is the left colic flexure orientated with respect to the right colic flexure

superiorly

how to visually differ the sigmoid colon and rectum

sigmoid colon has tenia coli and omentic appendecies

what does the right colic artery supply

ascending colon

what does the middle colic artery supply

transverse colon

what does the ileocolic artery supply

distal ileum

cecum

what does the left colic artery supply

descending colon

1/3 of transverse colon

what does venous blood carry besides deoxygenated blood

nutrients and toxins

consequences of portal hypertension

- varices in lower esophagus, stomach, and rectum

- splenomegaly (spleen enlargement)

- ascites

- hepatic encephalopathy

where is the problem located in caput medusae

paraumbilical veins connecting with epigstric veins