Med Oradea - Anatomy II - Digestive System - Small Intestine And Abdominal Wall

C is backwards - the internal muscular layer is exterior, the circular muscular layer is interior

A is wrong- the jejunum has transversal folds and the ileum has vertical

D should be pretty clearly incorrect- if the mesentery connects the small intestine to the posterior abdominal wall (which it does), then it can't have relations with the intestines behind- so the intestinal border is in front, the parietal border is behind.

The first row: Right and left hypochondriac and epigastric (in the center)
The second row: Right and left colic, with the umbliical in the center
The third row: Right and left iliac fossa with the hypogastric in the center

Celiac plexus is just another name for solar plexus. But it does provide sympathetic innervation

If you know that the vagus supplies the parasympathetic innervation, then you know that B is wrong. Sympathetic innervation comes from the celiac ganglia (aka solar plexus, and from thoracic splanchnic nerves)

D is not really covered in our course, but it's there to help you remember the sympathetic innervation. The thoracic splanchnic nerves are sympathetic nerves, not parasympathetic. But the part about the paravertebral ganglia is true, and that's why these nerves are unusual- they synapse in the celiac ganglia which is what provides sympathetic innervation to the duodenum.

There is a single vertical fold in the duodenum that is determined by the coledoc duct. In the lower part of the fold, there is the greater duodenal papilla, containing Vater's ampoule. The coledoc and pancreatic (Wirsung's) ducts open here.

The lesser duodenal papilla is above the greater - the accessory pancreatic duct (Santonini) opens here

Jejunum and ileum are both mobile, duodenum is the fixed part

B is kind of a trick question, to help you remember- the duodenum is in the supramezocolic space, but the jejunum and ileum are in the inframezocolic. So it's not occasional- it's all the time.

B is backwards - the ileum is 60%, the jejunum is 40%

The interior of the duodenum has circular folds

C should be clearly incorrect, since the superior mesenteric artery is a branch of the abdominal aorta lower than the celiac trunk (which ultimately gives off the gastroduodenal artery). Remember that the gastroduodenal artery supplies the part of the duodenum near the pylorus, and gives off the superior pancreaticoduodenal further out

Gastroduodenal artery should be a cue as to why option B is wrong - the first part of the duodenum has relationships with the coleduc duct (remember greater duodenal papilla), portal vein, and gastroduodenal artery.

The liver is in front and above the first part of the duodenum, and in front and lateral of the second part

The first part has relations with the pancreas below and the liver above and in front

A is wrong- the superior mesenteric is correct but the superior colic is made up

Lymph is collected from the intestinal villi (which have lymphatic formations) and then drains to mesenteric lymph nodes and from there goes to cisterna chyli or pecquet. Apical nodes are in the thorax around the pectoral area.

Only the first part of the duodenum is retroperitoneal. It is shaped like a horseshoe, but the concavity is oriented upwards

The anterior abdominal wall is divisible into 9 compartments by a pair of vertical, midclavicular lines, an upper (bicostal) horizontal line, and a lower (bicrestal) horizontal line. The bicrestal line connects the anterior ends of the iliac crests

The second row has the right and left colic regions and the ombilical region in the center

Innervation of the jejunum and ileum is as follows: thoracic splanchnic nerves (sympathetic) arrive in the celiac plexus. Fibers leave the celiac plexus and are accompanied by the vagus (parasympathetic) nerve to form the superior mesenteric plexus, which distributes innervation to the jejunum and ileum

There are 6 duodenal fosses: Superior duodenal, inferior duodenal, superior (venous) paraduodenal, inferior (arterial) paraduodenal, superior duodenal-jejunal, and superior retroduodenal.

The aorta is behind of the third and fourth parts of the duodenum

The 3rd part is indeed transverse and the 4th part ascending, but in fact the left kidney only has relations with the 4th part (at least directly)

The stomach is above the 4th part of the duodenum, and the pancreas is above the 3rd part