Anatomy

Question 1

What is the portal triad, and what contains it?

Answer 1

The Hepatoduodenal ligament contains the portal triad, and it contains the Hepatic Artery, the Common bile duct, and the Portal Vein.

Question 2

What ligament connects the liver to the anterior abdominal wall?

Answer 2

The falciform ligament

Question 3

What gastrosplenic ligament connects what structures?

Answer 3

The greater curvature of the stomach to the spleen.

*its one of the 2 ligaments that needs to be cut in order to remove the spleen, along with the splenorenal ligament.

Question 4

Whats ligaments need to be cut to be able to remove the spleen?

Answer 4

2 ligaments that need to be cut in order to remove the spleen are: Gastrosplenic ligament along with the Splenorenal ligament.

Question 5

What does the Splenorenal ligament connect?

Answer 5

It connects the spleen to the posterior abdominal wall, and the wall of the peritoneal cavity.

Question 6

What is the function of the gastrohepatic ligament?

Answer 6

It connects the lesser curvature of the stomach with the liver.

Question 7

What is the function of the hepatoduodenal ligament?

Answer 7

It contains the portal triad but it also connects the liver to the duodenum.

Question 8

What structures are considered retroperitoneal?

Answer 8

A - Adrenal glands
D - Duodenum
U - Ureters
C - Colon: descending and ascending only
K - Kidneys 
P - Pancreas 
E - Esophagus 
A - Aorta
R - Recrum

Question 9

These organs are derived from endoderm—> arises from the hepatic diverticulum—> and develops on the ventral surface of the foregut, giving rise to 4 structures:

The dorsal side of the foregut gives rise to:

Answer 9

• Liver
• Gallbladder and biliary tree
• Ventral pancreatic bud (becomes the head of the pancreas)

Dorsal pancreatic bud gives rise to the body and tail of the pancreas

Question 10

This organ arises from the dorsal mesentery of the stomach, it’s a mesodermal structure, and its blood supply comes from the artery of the foregut (celiac trunk)…?

Answer 10

Spleen

Question 11

What are the 2 nervous tissue bundles that run through the GI tract and where are they located?

Answer 11

Meissner’s plexus - Submucosa

Auerbach plexus - outer layer of muscularis externa

Question 12

Embryology - forgut describes what structures?

Answer 12

Pharynx to duodenum

Question 13

Embryology - midgut describes what structures?

Answer 13

Duodenum to proximal 2/3 of transverse colon.

Question 14

Embryology - hindgut describes what structures?

Answer 14

Distal 1/3 of transverse colon to anal canal above the pectinate line.

Question 15

During midgut development, what week does the physiologic midgut herniate through the umbilical ring?

Answer 15

6th week

Question 16

During midgut development, what week does the abdominal cavity return + rotate around superior mesenteric artery (SMA) a total of 270 degrees, counterclockwise?

Answer 16

10th week

Question 17

Developmental defects due to failure of Rostral fold closure causes what?

Answer 17

Sternal defects

Question 18

Developmental defects due to failure of Lateral fold closure causes what?

Answer 18

Omphamocele, gastroschisis

Question 19

Developmental defects due to failure of Caudal fold closure causes what?

Answer 19

Bladder exstrophy

Question 20

What describes: extrusion of abdominal contents through abdominal folds (typically right of umbilicus); not covered by peritoneum (not covered by a sac), and liver never found protruding. What pathology is at hand?

Answer 20

Gastroschesis

Question 21

What term describes the following defect - persistence of herniation of abdominal contents into umbilical cord, sealed by peritoneum and amnion (covered by a sac). Liver often protrudes out.

Answer 21

Omphamocele

Question 22

The newborn patient presents bilious vomiting and abdominal distention within the first 1-2 days of life. In addition, failure to recanalize —> dilation of stomach and proximal duodenum (“double bubble” on X-ray). Associated with Down syndrome.

Answer 22

Duodenal atresia

Question 23

The newborn patient presents bilious vomiting and abdominal distention within the first 1-2 days of life. In addition, disruption of mesenteric vessels —> ischemic necrosis —> segmental resorption (bowel discontinuity or “apple peel”).

Answer 23

Jejunal and ileal atresia

Question 24

To which lymph nodes do the following lymph nodes drain?
-Rectum

-External Anus

Answer 24

Rectum- internal iliac nodes

Ext. anus- Superficial inguinal nodes

Question 25

To which lymph nodes do the following lymph nodes drain?
-Testes

-Scrotum

Answer 25

Testes- para-aortic nodes

Scrotum- superficial inguinal nodes

Question 26

What structure connects the greater curvature of the stomach and the transverse colon?? What structures does it contain?

Answer 26

Gastrocolic ligament

—> contains the Gastroepiploic arteries (part of greater omentum)

Question 27

Posterior duodenal ulcers that perforate can cause hemorrhagic damage to what vessel?

Answer 27

Gastroduodenal artery

Question 28

Anterior duodenal ulcers that perforate can cause hemorrhagic damage to what?

Answer 28

Anterior abdominal cavity and can cause “pneumoperitoneum”

Question 29

A 24 yo presents to the ED due to hematemesis. Pt was binge drinking, became nauseated and began vomiting repeatedly. PE shows mild epigastric tenderness. Endoscopy reveals a longitudinal mucosal laceration in the distal esophagus with active bleeding. Endoscopic treatment is performed but he bleeding recurs. Angiography w/ transarterial embolization is planned. A distal branch of which of the following vessels is most likely to be embolized during this patient’s procedure?

Answer 29

Left Gastric Artery