Posted by lae2 on October 13, 2021 at 17:59:58:
Discuss the anatomy of the midgut and superior mesenteric artery, including viscera, mesenteries, vasculature, innervation, lymphatics and relationships.
Discuss the anatomy of the hindgut and inferior mesenteric artery, including viscera, mesenteries, vasculature, innervation, lymphatics and relationships.
True False Questions
The midgut begins immediately distal to the major duodenal papilla and ends immediately proximal to the distal one-third of the transverse colon.
The hepatic flexure is at the L2 vertebral level and the splenic flexure is at the L1 vertebral level.
The ascending and descending colon are retroperitoneal and the transverse colon is intraperitoneal.
The middle colic and left colic arteries anastomose within the transverse mesocolon.
The superior anterior posterior pancreaticoduodenal arteries anastomose with the inferior anterior posterior pancreaticoduodenal arteries at a location immediately distal to the major duodenal papilla.
Lymphatic drainage from the right colic flexure is toward superior mesenteric nodes, whereas lymphatic drainage from the left colic flexure is toward inferior mesenteric nodes.
The most distal location along the alimentary canal that vagal nerve derived fibers of the superior mesenteric plexus drive peristalsis is immediately proximal to the distal one-third of the transverse colon.
The superior mesenteric artery, once passing through the pancreatic incisure, then passes anterior to the left renal vein and anterior to the horizontal duodenum.
The ligament of Treitz is a hybrid ligament having skeleton muscle innervated by the phrenic nerve and smooth muscle innervated by sympathetic nerves.
Gastrointestinal bleeding proximal to the ligament of Treitz is defined an upper gastrointestinal bleed, whereas gastrointestinal bleeding distal to the ligament of Treitz is defined as a lower gastrointestinal bleed.
The ligament of Treitz suspends the duodenojejunal junction and may have a role in controlling gastrointestinal motility.
An abdominal aortic aneurysm may compress the left renal vein and the horizontal duodenum against the superior mesenteric artery (nutcracker syndrome) causing green vomitus and a swollen left scrotum.
Although the intestinal arcades provide anastomoses within the mesentery, the vasa recta are end arteries and thus, disruption of blood to the vasa recta arteries cause ischemic pain and possible necrosis.
The marginal artery of Drummond is fed by branches from the superior and inferior mesenteric arterial distributions.
The ileocolic artery follows a retroperitoneal pathway toward the ileocecal junction.
The appendicular artery, a branch of the ileocolic artery, travels through the mesoappendix.
The venous drainage of the midgut is by the superior mesenteric vein; a vein of the portal system.
The arterial blood supply to the hindgut is provided by the inferior mesenteric artery.
The most proximal location of the hindgut where stasis is driven by the inferior mesenteric plexus is immediately distal to the proximal two-thirds of the transverse colon.
The most distal location of the hindgut that stasis is driven by the inferior mesenteric plexus is near the dentate line of the anal canal.
The most proximal location along the hindgut where peristalsis is driven by fibers derived from pelvic splanchnic nerves is immediately distal to the proximal two-thirds of the transverse colon.
The most distal location along the hindgut where peristalsis is driven by fibers derived from pelvic splanchnic nerves is near the dentate line of the anal canal.
Lymphatic drainage of the anal canal proximal to the dentate line is to inferior mesenteric nodes and to internal iliac nodes (superior and middle rectal vessels).
Lymphatic drainage of the anal canal distal to the dentate line is to internal iliac nodes and to superficial inguinal nodes (inferior rectal and external pudendal vessels).
The right paracolic gutter provides a fluid pathway from the hepatorenal recess to the rectouterine pouch in the female and to the rectovesicle pouch in the male.
The left colic artery travels a retroperitoneal pathway toward splenic flexure and the enters the transverse mesocolon to become intraperitoneal.
The superior rectal artery, a terminal branch of the inferior mesenteric artery, crosses the pelvic brim and then divides into left and right superior rectal arteries.
The primary venous drainage of the hindgut is by way of the inferior mesenteric artery and is of the portal system.
Taenia coli, semilunar folds, and appendices epiploica are characteristics of the large intestine.
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