Abdomen/GIT

Question 1

What muscle is the most superficial muscular layer and in which direction do its fibres fun?

Answer 1

External oblique and its fibres run inferiorly from lateral to medial

Question 2

All the muscular layers of the abdominal wall form apopneuroses across the medial part of the abdominal anterior wall - what do they form?

Answer 2

The linea alba (white line)

Question 3

What muscle lies beneath external oblique and in what direction do its fibres run?

Answer 3

Internal oblique and at 90 degrees to external oblique fibres

Question 4

What is the deepest muscular layer in the abdomen? What direction does its fibres run?

Answer 4

Transverse abdominus - fibres run transversely

Question 5

What muscle forms the “six pack”? What is it enveloped by?

Answer 5

Rectus abdominus rectus sheath (the apopneuroses)

Question 6

What blood vessel supplies the inferior abdominal wall?

Answer 6

Inferior epigastric artery, deep circumflex iliac arteries - branches of the external iliac artery

Question 7

What blood vessel supplies the superior abdominal wall?

Answer 7

Superior epigastric artery

Question 8

What is the venous drainage of the inferior part of the abdominal wall?

Answer 8

3 inguinal veins (superficial) drain into the greater saphenous vein

Question 9

What is the venous drainage of the superior part of the abdominal wall?

Answer 9

Superficial epigastric vein

Question 10

What is peritoneum?

Answer 10

Thin single celled layer of mesothelium

Question 11

What is parietal peritoneum?

Answer 11

The mesothelium that covers the internal surfaces of the abdominal wall

Question 12

What is visceral peritoneum?

Answer 12

The mesothelium that envelops the abdominal viscera

Question 13

What is mesentery?

Answer 13

A double layered flap of peritoneum connects viscera to abdominal wall - contains blood vessels, nerves and lymphatics and fat stores

Question 14

What is an omentum and what are the two omentums?

Answer 14

Double layered peritoneum that connects stomach to other organs: greater and lesser

Question 15

Where does the greater omentum run?

Answer 15

Starts from greater curvature of the stomach and proximal part of duodenum –> hangs like an apron and passes back up to the transverse colon

Question 16

Where does the lesser omentum run?

Answer 16

Between the liver and the lesser curve of the stomach

Question 17

What does the inguinal canal connect and why is it clinically significant?

Answer 17

Connects the abdomen to the scrotum and is significant as it is a weak spot prone to herniation

Question 18

What are the four main layers of the GIT moving from the lumen outwards?

Answer 18

Mucosa, sub-mucosa, Muscularis and Serosa

Question 19

Briefly describe the mucosal layer of the GIT

Answer 19

Epithelial layer, underneath which is a connective tissue layer called the lamina propria - contains GALT, the innermost layer is the muscularis mucosa and is the innermost layer of smooth muscle.

Question 20

Describe the submucosa of the GIT

Answer 20

Layer of dense connective tissue, contains nervous plexuses as well as main blood and lymph vessels

Question 21

Describe the muscularis layer of the GIT

Answer 21

Two layers of smooth muscle: inner circular and outer longitudinal layer

Question 22

Describe the serosa of the GIT

Answer 22

Loose connective tissue, adipose tissue and blood and lymph vessels surrounded by mesothelium

Question 23

What type of epithelium lines the oesophagus?

Answer 23

Non-keratinised squamous epithelium

Question 24

Describe the epithelium of the stomach

Answer 24

Single layered columnar epithelium with main invaginations that extend into the lamina propria (gastric pits)

Question 25

What is the name for the folds in the stomach area and what is their function?

Answer 25

Rugae - to increase SA

Question 26

What are the 4 sections of the stomach?

Answer 26

The cardia, fundus, body and pylorus

Question 27

What are pilae circularis and where in the GIT are they most prominent?

Answer 27

Permanent folds in the mucosa - prominent in jejenum

Question 28

What is the defining feature of the apical brush border?

Answer 28

Densely packed microvilli

Question 29

What are Peyers patches?

Answer 29

Aggregates of lymphoid material - containing APC's

Question 30

What are Paneth cells?

Answer 30

Exocrine cells that secrete lysozomes - antimicrobial

Question 31

What are Brunners glands? What are they a defining feature of?

Answer 31

Deep coiled glands that secrete alkaline mucus Duodenum

Question 32

What artery supplies the upper third (cervical) section of the oesophagus?

Answer 32

Inferior thyroid artery

Question 33

Which artery supplies the middle third (thoracic) section of the oesophagus?

Answer 33

Oesophageal brances from aorta and bronchial arteries

Question 34

Which artery supplies the lower third (abdominal) oesophagus?

Answer 34

Branches from left inferior phrenic and left gastric artery

Question 35

At what vertebral level does the duodenum start?

Answer 35

About L1

Question 36

What gives the sympathetic innervation of the stomach?

Answer 36

The coeliac plexus (T6-T9)

Question 37

What is the parasympathetic innervation of the stomach?

Answer 37

Vagus nerve

Question 38

What are the 3 parts of the small intestine in order?

Answer 38

Duodenum, jejenum and ileum

Question 39

What is the blood supply to the foregut?

Answer 39

Coeliax axis

Question 40

What is the blood suppy to the midgut?

Answer 40

superior mesenteric axis

Question 41

What divides the left and right lobes of the liver?

Answer 41

The falciform ligament

Question 42

What duct connects the gallbladder and the common hepatic duct?

Answer 42

The cystic duct

Question 43

Where do the pancreatic duct and common bile duct meet?

Answer 43

In the second part of the duodenum at the ampulla of vater

Question 44

What are the intrinsic muscles of the tongue?

Answer 44

superior and inferior: longitudinal, transverse and vertical

Question 45

What are the extrinsic muscles of the tongue?

Answer 45

geniglossus, hypoglossus, palatoglossus and styloglossus

Question 46

What are the three extrinsic salivary glands that lie outside of the oral mucosa?

Answer 46

Parotid, submandibular and sublingal

Question 47

What are the two layers of the peritoneum?

Answer 47

Parietal and visceral

Question 48

What is the most fixed part of the small intestine?

Answer 48

Duodenum

Question 49

How does the pancreas lie within the abdomen?

Answer 49

Retroperitoneally

Question 50

Why is the ascending colon retroperitoneal?

Answer 50

As only its front and sides are covered with peritoneum

Question 51

What does the inguinal canal "follow" in men and women?

Answer 51

In men: spermatic cord Women: round ligament of the uterus

Question 52

What is the inguinal canal?

Answer 52

An oblique passage through the lower anterior abdominal wall - not a true canal but a series of non overlapping holes in the musculo fascial layers

Question 53

What is the body's largest lymphatic organ?

Answer 53

The spleen

Question 54

What connects the spleem to the upper part of the greater curvature of the stomach

Answer 54

The gastro-splenic ligament

Question 55

What connects the spleen to the left kidney?

Answer 55

The lineo-renal ligament

Question 56

What are the three major openings in the diaphragm?

Answer 56

The aortic, oesophageal and vena caval openings

Question 57

What are the single branches of the abdominal aorta?

Answer 57

Coeliac artery and superior and inferior mesenteric

Question 58

What artery supplies the stomach and lower end of the oesophagus?

Answer 58

The left gastric artery

Question 59

What is the main artery that provides branches to the pancreas and fundus of the stomach?

Answer 59

Splenic artery

Question 60

What artery supplies the gall bladder and what is it a branch of?

Answer 60

Cystic artery - right branch of the hepatic artery

Question 61

What are the branches of the hepatic artery?

Answer 61

Cystic artery, gastroduodenal artery and right gastric artery

Question 62

What artery supplies the midgut? (2nd part of duodenum --\> half way along the transverse colon)

Answer 62

The superior mesenteric artery

Question 63

What does the inferior mesenteric artery supply?

Answer 63

Hind gut: middle of transcerse colon to superior part of the anal canal

Question 64

What forms the inferior vena cava?

Answer 64

The two common iliac veins

Question 65

What does the alimentary tract and its derivatives drain via?

Answer 65

The hepatic portal system

Question 66

What does the external iliac artery become?

Answer 66

The femoral artery

Question 67

What are the 4 narrowings of the oesophagus?

Answer 67

Where pharynx becomes continuous with proximal oesophagus Where aortic arch crosses Where it is compressed by left main bronchus Where it passes through the diaphragm