Anatomy

Question 1

Borderline between foregut and midgut

Answer 1

duodenal papilla

Question 2

Blood supply of midgut

Answer 2

superior mesenteric artery

Question 3

Innervation of foregut

Answer 3

sympathetic; greater splanchnic nerve (T5-9 psinal cord segments)

Question 4

Dermatome of T5-T9

Answer 4

Epigastric region

Question 5

Parasympathetic innervation of midgut

Answer 5

vagus nerve

Question 6

Secondary retroperitoneal organs

Answer 6

All of those that are GI and retroperitoneal. Those that were intraperitoneal in embryonic development and became retroperitoneal later via folding.

Question 7

Main differences between jejunum and ileum

Answer 7

• Jejunum is thicker and more vascular - Jejunum wider lumen - Jejunum has circum mucosal folds that are large, tall, closely packed. - Peyer’s patches: aggregated lymphatic follicles in the lamina propria of the ileum and lower jejunum (MALT)

Question 8

Parasympathetic innervation of hindgut

Answer 8

S2-4

Question 9

Significance of the L colic flexure

Answer 9

Transition of parasympathetic innervation from vagus to S2,3,4 (midgut to hindgut)

Question 10

McBurney’s point

Answer 10

the base of the appendix. The tip of the appendix could be anywhere.

Question 11

Sympathetic innervation of gut results in….

Answer 11

inhibition of peristaltic movement. stress –> constipation.

Question 12

What happens to GIT sphincters in parasympathetic innervation?

Answer 12

Sphincters open up. Parasympathetic innervation induces peristalsis. S2-3-4 keeps the poo on the floor (peristaltic movement opens sphincter and poop comes out).

Question 13

Visceral afferent fibres travel with…

Answer 13

sympathetic visceral afferents for the most part… EXCEPT for visceral afferents that detect distension of stomach. Those travel w parasympathetic fibres to hypothalamus to tell us to stop eating.

Question 14

Referred pain…

Answer 14

Starts as dull pain in the midline. When inflammation worsens and begins to involve the peritoneum, then the pain becomes localized correctly and is ~sharp~.

Question 15

Answer 15

A: dura mater

B: arachnoid mater

b) subarachnoid space

Question 16

Answer 16

A: a branch of dorsal ramus

B: ventral ramus

C: dorsal root ganglion

Question 17

What what vertebral level does the spinal cord terminate?

Answer 17

It terminates at L1-L2

Question 18

At what vertebral level does the subarachnoid space terminate?

Answer 18

It extends past the end of the spinal cord (L1/L2) to the inferior border of S2 (interface with S3)

Question 19

Where goes the lymphatic drainage from the breast?

Answer 19

75% to axillary lymph nodes and the rest go to parasternal lymph nodes.

Question 20

Describe the innervation of the breast

Answer 20

supplied by the 2nd-6th intercostal nerves

The nipple is innervated by the 4th intercostal nerve.

Question 21

Describe the blood supply to the breast

Answer 21

The blood is supplied by the axillary artery, internal thoracic artery, and anterior intercostal arteries

Question 22

What is this artery?

Answer 22

The internal thoracic artery. It supplies the breast along with the axillary artery and the anterior intercostal arteries that branch from it.

Question 23

What are the boundaries of the thoracic inlet and outlet?

Answer 23

Inlet: T1, rib 1, sternum

Outlet: Closed by the diaphragm

Question 24

What is the anatomical and clinical importance of the plane from the sternal angle to T4/5 intervertebral disk? (4)

Answer 24

Important for counting ribs (articulates with rib II), bifurcation of trachea, beginning and end of aortic arch, top of middle mediastinum (and divides superior and inferior mediastinum).

Question 25

Describe the neurovascular contents of an intercostal space

Answer 25

Intercostal vein, artery, and nerve (in that order from posterior to inferior) (the posterior artery component arises from the aorta and the anterior component arises from the thoracic artery)

Question 26

Describe the course of an intercostal neurovascular bundle and the importance of this for intercostal nerve blocks and the insertion of chest drains.

Answer 26

The bundle travels along the top of each intercostal space in the costal groove of the rib above. Intercostal nerve is the anterior ramus of a thoracic spinal nerve (T1-T11) and is the least protected structure in the costal groove because it is at the bottom. \*\*\* look into this more

Question 27

Origin of the phrenic nerve and what it does

Answer 27

C3,4,5 keeps you alive! It innervates the diaphragm.

Question 28

What is the clnical importance of the fact that the pleural cavities rise above the level of the 1st rib?

Answer 28

Injuries of the neck may therefore implicate the lungs.

Question 29

At which vertebral level does the trachea bifurcate?

Answer 29

T4/5

Question 30

Answer 30

L and R coronary ostia (openings for coronary artery originating from aorta)

Question 31

what remnants of fetal circulation are still visible in the adult heart?

Answer 31

fossa ovalis (formerly: foramen ovale) ligamentum arteriousum (formerly: ductus arteriosus)

Question 32

Differences between heart chambers

Answer 32

R ventricle has moderator band Ventricles have papillary muscle with chrodae tendinae and trabeculae. Atria have musculi pectinati.

Question 33

Where does the esophagues pass the the diaphragm?

Answer 33

T10

Question 34

What indentations are normally seen in the esophagus on barium swallow

Answer 34

aorta, left main bronchus, left atrium.

Question 35

the diagnostic importance of the relationship between the esophagus with the arch of aorta, L main bronchus, and L atrium

Answer 35

fidelity of transesophageal achocardiogram

Question 36

Where does the trachea bifurcate

Answer 36

T4/5

Question 37

Clinical importance of the different sizes and courses of the L and R primary bronchi

Answer 37

Right is fatter and steeper. Means that it is more common for intubation to slip into R only or for foreign body to end up there.

Question 38

Course of Vagus nerve

Answer 38

Question 39

Origin, course, and function of phrenic nerve

Answer 39

c3-5; innervates diaphragm (and heart a bit)

Question 40

why can pathology of the thorax present as a change in voice?

Answer 40

bc L recurrent laryngeal nerve branches fromt he vagus nerve, which goal sall the way down to loop under the art of aorta and behind the ligamentum arteriosum before innervating the larynx.

Question 41

Parasympathetic and sympathetic divisions of the spinal column

Answer 41

Question 42

subcostal and transtubercular planes

Answer 42

Question 43

normal surface location of the appendix

Answer 43

RLQ.

Question 44

Dermatomes of the anterior abdominal wall

Answer 44

Intercostal nerves of T6-T11 Subcostal nerves T12 & L1

Question 45

Cutaneous innervation of the anterior abdominal wall

Answer 45

T1-T11

Question 46

Innervation of anterior abdominal musculature

Answer 46

Lol I don't know

Question 47

Positions of the inguinal rings

Answer 47

Deep inguinal ring is in the fascia tranversalis Superficial inguinal ring is in the external oblique aponeurosis

Question 48

Direct vs indirect inguinal hernias

Answer 48

Direct inguinal hernias bypass the deep inquinal ring to get into the inguinal canal

Question 49

What goes through the inguinal canal?

Answer 49

Male: spermatic cord Female: round ligament \*both contain remnants of the processes vaginalis

Question 50

Conjoint tendon

Answer 50

arises from the fusion of internal oblique aponeurosis and tranverse abdominus aponerosis, medial to inguinal canal

Question 51

Differentiate intraperitoneal vs retroperitoneal

Answer 51

intraperitoneal = suspended by mesentery Retroperitoneal = attached to the posterior abdominal wall

Question 52

name components of the GI system athat are intraperitoneal and retroperitoneal

Answer 52

Question 53

Components of dorsal mesentery

Answer 53

greater omentum, mesentery of small intestine, transverse mesocolon, signoid mesocolon, mesoappendix.

Question 54

hepatoduodenal ligament and its contents (3)

Answer 54

contents: hepatic portal vein, hepatic artery, common bile duct

Question 55

greater and lesser peritoneal sacs

Answer 55

Question 56

Innervation of the foregut

Answer 56

Celial ganglion on either side of the celiac arter (trunk). **Sympathetic** innervation T5-T9 (greater and lesser splanchnic nerves) and **parasympathetic innervation** from vagus nerve.

Question 57

Main features of the ileum

Answer 57

Thinner walls, no circular folds, many peyer's patches.

Question 58

what is the significance of the left colic flexture with respect to parasympathetic innervation

Answer 58

Parasympathetic innervation switches from vagus to S2-4

Question 59

Sympathetic and parasympathetic input to the prevertebral plexus and the route the fibres take to the viscera (I don't know)

Question 60

Innervation of the midgut

Answer 60

superior mesenteric ganglion near root of superior mesenteric artery. **Sympathetic** from T10-11 (lesser splanchnic) and **parasympathetic** from vagus nerve.

Question 61

Hindgut innervation

Answer 61

Inferior mesenteric ganglion near root of inferior mesenteric artery. **Sympathetic** from T12-L1 and **Parasympathetic** from S2-4.

Question 62

Be able to identify the greater sciatic foramen, lesser sciatic foramen, and obturator canal

Answer 62

Question 64

Name two of the three anatomical characteristics that differentiate the large intestine from the small bowel

Answer 64

Haustra coli, tenia coli, epiploic/omental appendages; also lumenal diameter

Question 65

The majority of the lymph generated in the breast structures drains into the

Answer 65

Axillary lymph nodes

Question 66

Which embryological regions are separated at the level of the major duodenal papilla?

Answer 66

Foregut & midgut

Question 67

Name and locate the subsections of the broad ligament

Answer 67

Question 68

Visualize the relationship between the ureter and the uterine artery

Answer 68

Question 69

Visualize the realtionship between the ureter and the vas deferens

Answer 69

Question 70

List the branches of the pudendal nerve

Answer 70

Dorsal nerve of penis or clitoris Perineal nerve Inferior rectal nerve

Question 71

Describe the position of the deep perineal pouch

Answer 71

Note its position relative to the perineal membrane and the superficial perineal pouch