Mid + Hindgut

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Last updated: May 10, 2026

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Hint	Hint
Lumen of Jejunum (vs Ileum)	Wide
Walls of Jejunum (vs Ileum)	Thick
Plicae Circulares (folds) Jejunum (vs Ileum)	Dense
Jejunum blood Supply - arcades + vasa recta (vs ileum)	Few arterial arcades, long vasa recta
Peyer's Patches (lymphoid follicle clusters) Jejunum (vs Ileum)	Few
Mesenteric fat in Jejunum (vs Ileum)	Less

Meckel's diverticulum	Congenital bulge of ilium - failure of vitelline duct obliteration
Hernia medial to inferior epigastric vessels. Does not traverse entire inguinal canal, doesn't enter scrotum	Direct Inguinal Hernia (acquired)
Hernia lateral to inf. epigastric vessels.Traverses entire inguinal canal, enters scrotum	Indirect Inguinal Hernia (congenital)

Appendix intra or retroperitoneal? Suspended by what?	intraperitoneal, mesoappendix
McBurney's Point location	lateral third from ASIS to umbilicus
Ascending Colon intra or retroperitonal?	secondary retroperitoneal
Blood Supply to Ascending colon	Right Colic Artery
Point where midgut becomes hindgut	2/3 distally along transverse colon

Transverse colon intra/retroperitoneal? Level?	Intraperitoneal, L1
Transverse colon closely associated with what structure?	Greater omentum
Transverse colon blood supply (+ arises from where?)	Middle Colic Artery, SMA

SMA branches (from jejunum to transverse colon)	Jejunal
SMA branches	Ileal + ileocolic

Hint	Answer
SMA branches	Middle colic
SMA branches	Right colic

Hepatic Portal Vein formed of what?	Superior mesenteric vein and splenic vein
SNS innervation of midgut	Lesser thoracic splanchnic nerves
PNS innervation of midgut	Vagus
Plexuses modulated by ANS	Submucosal and myenteric plexus in intestinal walls

Last part of Hindgut + dividor	Upper half of anal canal, pectinate line
Descending Colon intra or retroperitoneal usually?	Secondary retroperitoneal
Level of rectosigmoid junction	S3

2 Factors that help maintain continence	Anorectal flexure angle
Factors that help maintain continence	Ampulla of rectum

Epithelium superior + inferior to pectinate line	Columnar + stratified squamous
Arterial supply + venous drainage superior + inferior to pectinate line	Superior rectal, middle and inferior rectal
Nervous supply superior + inferior to pectinate line	Inferior hypogastric plexus, Inferior rectal from pudendal nerve
Lymphatic drainage superior + inferior to pectinate line	Internal iliac nodes, superficial inguinal nodes
What vertebral level does IMA arise from AA	L3

Branches of IMA (4)	Left Colic (and ascending + descending)
Branches of IMA	Sigmoid

Hint	Answer
Branches of IMA	Superior rectal
Branches of IMA	Marginal artery

What acts as the collateral supply for hind and midgut?	Marginal artery of Drummond allows anastomosis between SMA and IMA
Where does middle rectal artery arise from?	Internal iliac
Where does inferior rectal artery arise from	Internal Pudendal

Superior rectal vein drainage	Inferior mesenteric vein (portal system)
Middle rectal vein drainage	Internal iliac (systemic)
Inferior rectal vein drainage	Internal Pudendal (systemic

Lymphatic Drainage of Hindgut	intestinal lymphatic trunk and cisterna chyli

Where is gallbladder pain often referred to	back of the shoulder
Effects of portal hypertension in terms of blood flow systems	Blood flows from portal system to systemic vein system and dilation can cause rupture

4 Major Anastomoses between portal and systemic circulations. Causes varices/signs	Oesophageal branches of azygos + left gastric vein
4 Major Anastomoses (anorectal)	superior and inferior rectal veins
4 Major Anastomoses (caput medusa)	paraumbilical veins and periumbilical superficial epigastric veins
4 Major Anastomoses (gastric varices)	left gastric and short gastric veins to oesophageal plexus
Hard to drain cos of high portal pressure	Splenic vein causing splenomegaly

What's cholelithiasis?	Gallstone formation
Associations of gallstones	female, fair, fat, forty, fertile