large folds in the mucosal layer to increase absorptive surface area (jejunum and ileum)
plica
finger like projections that are covered with columnar epithelium and goblet cells (jejunum and ileum)
villi
fats that have been absorbed and combined with protein to make them soluble, are too large to enter blood capillaries and must enter the lacteal and then from lymphatics go to blood (jejunum and ileum)
chylomicrons
major artery of the jejunum and ileum is
superior mesenteric artery
the jejunum and ileum are structures of ____ in origin
midgut
what two branches does the superior mesenteric artery give off that go to the jejunum and ileum
- arterial arcades (arcuate arteries)
2. vasa recta (straight arteries)
vessels that directly vascularize the small intestinal loops and project from the arcuate arteries
vasa recta (straight arteries)
venous return is through the ileal and jejunal veins which eventually drain into the
superior mesenteric vein
the superior mesenteric vein join with ____ to from the ___
splenic vein
portal vein
what makes up the portal vein
superior mesenteric vein and splenic vein
the jejunum has ____ vasa recta
long
the ileum has ___ vasa recta
short
sympathetic innervation of the jejunum and ileum
superior mesenteric ganglia (pregang nerve: lesser splanchnic T10-T11)
what is the sympathetics function for the jejunum and ileum
decrease motility in the intestine
parasympathetic innervation of the jejunum and ileum
posterior vagal trunk
what is the parasympathetic function for the jejunum and ileum
stimulate motility and secretions of the intestines
pain sensation is NON EXISTENT, however ______ is perceived as colic in the jejunum and ileum
distention
what makes up the large intestine
cecum, appendix, ascending, transverse, descending and sigmoid colon, rectum, and upper anal canal
sacculations found on the colon
haustra
3 longitudinal bands of muscle along the length of the large intestine, forms the haustra and helps propel the bolus during peristalsis
teniae coli
fatty projections attached to the teniae coli
omental appendices (epiploic)
the cecum is found in what quadrant and what arterial supply
RLQ, ileocolic artery (45* down to the right)
innervation of the cecum (para and sym)
para- vagus
sym - superior mesenteric ganglia: preganglionic fibers - lesser splanchnic nerve
partial invagination of the ileum into the cecum, producing two folds that cover the passage of the ileum to the cecum
ileocecal valve
a diverticulum attached to the cecum with an appendicular arterial branch providing blood from the ileocolic artery
appendix
in the young the appendix is a ____, in the elderly the mucosa becomes mostly ___
lymphoid structure
fibrotic
sensory pain fibers follow the sympathetics along the ___ spinal level for the appendix
T10
the ascending colon is a _____ structure
retroperitoneal
the arterial supply of the ascending colon is by the ____ and MAINLY the _____
ileocolic arteries
right colic arteries
the transverse colon is a ____ structure
intraperitoneal
the transverse colon is associated with the ____ and ____ colic flexure
right and left
main arterial supply of the transverse colon is provided by
middle colic artery
what is the terminal branch of the superior mesenteric artery
middle colic artery
innervation of the ascending 2/3 of the transverse colon
sym: superior mesenteric prevertebral ganglion
para: vagus nerve up to the left colic flexure
the descending colon is a _______ structure
retroperitoneal
what is the arterial supply of the descending colon
left colic artery from inferior mesenteric artery
what is the arterial supply of the sigmoid colon
left colic and sigmoid arteries
what is the arterial supply of the rectum
superior rectal artery
innervation of the descending and sigmoid colon
sym: superior hypogastric plexus using INFERIOR MESENTERIC PLEXUS ON IMA
para: pelvic splanchnic nerves (S2-S4)
what are the 4 parts of the pancreas
- head (uncinate process)
- neck
- body
- tail
the main pancreatic duct begins at the ______ of the pancreas to the ____ where it exits and meets the
tail
head
bile duct
main pancreatic duct + bile duct =
hepatopancreatic ampulla of Vater
hepatopancreatic ampulla of Vater empties into the
descending portion of the duodenum
what controls the flow of bile and pancreatic fluids into the duodenum
sphincter of Oddi
the pancreas is ____ derived
foregut
body and tail of the pancreas is supplied by what artery
splenic artery
head and neck of pancreas is supplied by what arteries
gastroduodenal and pancreaticoduodenal arteries
innervation of the pancreas
sym: celiac ganglion
para: vagus nerve
what arteries supply the liver
hepatic arteries (O2 rich)
what vein supplies the liver
portal vein (nutrient rich)
what venous supply drains the liver
inferior vena cava
failure of liver: where are the two anastomotic sites
- esophagus
2. rectum
anastomotic site: the esophageal branch of the _____ anastomoses with the esophageal veins that drain into the ______
left gastric vein (portal) azygos vein (systemic)
anastomotic site: middle and inferior rectal veins (systemic) anastomoses with the _______ which drains into the IMV (portal)
superior rectal vein
superficial veins of the anterior abdominal wall that connect to the left branch of the portal vein travel though _______ accompanying the __________
paraumbilical veins:
falciform ligament
ligamentum teres of the liver
veins of the colon, pancreas, duodenum, and liver anastomose with the
renal, lumbar, and phrenic veins (retroperitoneal veins)
lesser omentum attaches the liver to the stomach and duodenum via
hepatogastric and hepatoduodenal ligaments (portal triad)
to the right of the lesser omentum is the opening of the
omental foramen
what is the recess called posterior to the liver
hepatorenal recess
innervation of the liver
para - vagus
sym - celiac ganglia
bare area where no visceral peritoneum covers; this region that touches the diaphragm is called
septum transversum
R/L hepatic ducts empty into the
common hepatic duct
empties the gall bladder biliary content into the common bile duct
cystic duct
formed by the union of the cystic duct and the common hepatic duct
common bile duct
prevents bile from entering the duodenum when contracted
choledochal sphincter (end of bile duct)
what are the three parts of the gallbladder
- fundus
- body
- neck
what supplies the gallbladder and the cystic duct
cystic artery
what does the cystic artery arise from
R hepatic artery
drain blood from the gallbladder and the ducts into the liver
cystic veins
innervation of the gall bladder
para - vagus and CCK
sym - celiac plexus
sensory - R phrenic n
what is the largest lymphoid organ
spleen
spleen is attached to the stomach via
gastrosplenic ligament
spleen is attached to the L kidney via
splenorenal ligament
gastrosplenic and splenoreneal ligament are _______ derivatives
dorsal mesentery
artery and vein that supplies the spleen
splenic artery and vein
sympathetic innervation of spleen
celiac plexus