Anatomy of the GI Part 2

Question 1

What is the vertebral level of the oesophageal hiatus?

Answer 1

T10

Question 2

What structures go through the oesophageal opening?

Answer 2

Oesophagus, vagus nerve,left inferior phrenic vessels and the oesophageal arteries (from the left gastric arteries)

Question 3

What are the two orifices of the stomach?

Answer 3

Cardiac opening and pyloric opening

Question 4

What are the two curvatures of the stomach?

Answer 4

Greater and lesser curvatures

Question 5

What are the two surfaces of the stomach?

Answer 5

Anterior and posterior

Question 6

What is the pyloric sphincter?

Answer 6

A thickened ring of muscles

Question 7

What is the function of the pyloric sphincter?

Answer 7

To control movement of contents from the stomach to the duodenum

Question 8

What are the rugae formed from?

Answer 8

The mucosal layer of the stomach

Question 9

In which parts of the stomach are the rugae most apparent?

Answer 9

Body and antrum

Question 10

What structures form the stomach bed (posterior wall of the lesser sac)

Answer 10

Left dome of the diaphragm, pancreas, spleen, L. kidney, L. adrenal gland, colon, mesocolon and splenic artery

Question 11

What is the effect of increased vagal stimulation on the pylorus?

Answer 11

It stimulates opening of the pylorus (relaxation)

Question 12

Which group of lymph nodes will the 4 primary nodes eventually drain into?

Answer 12

Coeliac group

Question 13

What is the effect of increased vagal stimulation on gastric secretion?

Answer 13

Stimulation of watery secretion

Question 14

What are the three parts of the small intestine?

Answer 14

Duodenum, jejunum and Ileum

Question 15

Which part of the small intestine receives the opening of the bile and pancreatic duct?

Answer 15

Duodenum (2nd part)

Question 16

How is the duodenum peritonised?

Answer 16

Retroperitoneal

Question 17

How is the jejunum peritonised?

Answer 17

Intraperitoneal

Question 18

How is the ileum peritonised?

Answer 18

Intraperitoneal

Question 19

What are the characteristics of the jejunum?

Answer 19

Deep red in colour, thick/heavy wall, greater vascularity, long vasa recta, large loops of arcades, little fat in the mesentery and large/tall circular folds

Question 20

What are the characteristics of the ileum?

Answer 20

Pale pink, thin/light wall, little vascularity, short vasa recta, short loops of arcades, more fat in the mesentery and no circular folds

Question 21

Which part of the autonomic nervous system stimulates the reduction of secretions and motility of the intestine and acts as a vasoconstrictor?

Answer 21

Sympathetic

Question 22

How is the large intestine structure different to the small intestine?

Answer 22

Shorter/wider, no circular folds, microvilli and bands of muscle

Question 23

How is the caecum peritonised?

Answer 23

Intraperitoneal

Question 24

How is the ascending colon peritonised?

Answer 24

Retroperitoneal

Question 25

How is the transverse colon peritonised?

Answer 25

Retroperitoneal

Question 26

How is the descending colon peritonised?

Answer 26

Retroperitoneal

Question 27

How is the sigmoid colon peritonised?

Answer 27

Intraperitoneal

Question 28

In which abdominal region is the caecum and appendix located?

Answer 28

Right Iliac fossa

Question 29

What is McBurney's point?

Answer 29

1/3 of the distance from the anterior superior iliac sine to the umbilicus - most tender point in appendicitis as it is the common location of the base of the appendix

Question 30

What is the role of the pelvic floor in maintaining faecal continence?

Answer 30

The muscles surround the anal canal and maintain tone keeping it closed

Question 31

What other structures (besides the pelvic floor) are involved in faecal continence?

Answer 31

Internal and external sphincter

Question 32

Which omentum are the hepatoduodenal and hepatogastric ligaments a part of?

Answer 32

Lesser omentum

Question 33

What is the falciform ligament?

Answer 33

Ligament that attaches the liver to the anterior wall and separates the right and left lobes

Question 34

What structure in the free edge of the falciform ligament is a remnant of an embryonic blood vessel?

Answer 34

Round ligament - umbilical vein

Question 35

How many layers of peritoneum are present in the greater omentum?

Answer 35

Four

Question 36

What function gives the greater omentum the name of abdominal policeman

Answer 36

It surrounds any inflamed/infected parts of the abdomen and prevents it spreading

Question 37

What are the paracolic gutters?

Answer 37

Channels that run between the colon and abdominal walls

Question 38

Where are the paracolic gutters located in relation to the large intestine?

Answer 38

Posterior to the large intestine alongside the ascending and descending colon

Question 39

What is the clinical significance of the paracolic gutters?

Answer 39

They allow the accumulation and passage of infectious fluids between compartments

Question 40

Name three abdominal viscera which lie in the free edge of the mesentery?

Answer 40

Small intestine (jejunum/ileum), large intestine (transverse/sigmoid) and mesoappendix

Question 41

What muscle types form the muscularis externa of the oesophagus?

Answer 41

Upper 1/3 is skeletal | Lower 2/3 is smooth muscle

Question 42

What kind of epithelium lines the oesophagus?

Answer 42

Non-keratinised stratified squamous epithelium

Question 43

What type of muscle is the muscularis mucosae?

Answer 43

Smooth muscle

Question 44

What are the layers of the oesophagus?

Answer 44

Mucosa, lamina propria, muscularis mucosae and muscularis externa

Question 45

Which secretory cells are present in the gastric pits?

Answer 45

``` Chief cells (pepsinogen) and parietal cells (HCl and intrinsic factor) Goblet cells ```

Question 46

What are the large folds that extend into the lumen of the small intestine?

Answer 46

Plicae

Question 47

What are the finger like projections found in the small intestine called?

Answer 47

Villae

Question 48

What type of epithelium lines the small intestine?

Answer 48

Simple columnar epithelium

Question 49

What type of muscle is the muscularis mucosae of the small intestine?

Answer 49

Smooth muscle

Question 50

What are the layers of the small intestine?

Answer 50

Surface epithelium,submucosa (lamina propria and muscularis mucosae) and muscularis externa

Question 51

In which parts of the gut do the glands extend down beyond the muscularis mucosae?

Answer 51

Oesophagus and duodenum

Question 52

What is the function of goblet cells?

Answer 52

Secretion of mucous

Question 53

What is the transpyloric plane?

Answer 53

Transverse line 1/2 between the jugular notch and the upper border of the pubic symphysis

Question 54

How do you locate the transpyloric plane on a patient?

Answer 54

Hand's breadth below the xiphoid process

Question 55

Which structures are present on the transpyloric plane?

Answer 55

Pylorus of the stomach, stomach, duodenum, pancreas, gallbladder and kidneys

Question 56

How is the spleen peritonised?

Answer 56

Intraperitoneal

Question 57

In which region of the abdominal cavity is the spleen located?

Answer 57

Left hypochondriac

Question 58

Does the spleen move with respiration?

Answer 58

Yes

Question 59

Name the structures in the hilum of the spleen

Answer 59

Splenic artery, splenic vein and gastrosplenic ligament

Question 60

The tail of which organ is closely related to the hilum of the spleen?

Answer 60

Pancreas

Question 61

What are the functions of the spleen?

Answer 61

Stores WBCs, recycles RBCs, haematopoiesis and phagocytosis

Question 62

Is the pancreas an exocrine or endocrine gland?

Answer 62

Both

Question 63

How is the pancreas related to the duodenum?

Answer 63

It is located in the curve of the duodenum

Question 64

How is the pancreas peritonised?

Answer 64

Retroperitoneal

Question 65

Which vein is formed posterior to the neck of the pancreas?

Answer 65

Hepatic portal vein

Question 66

Into which part of the duodenum does the pancreatic duct open?

Answer 66

Duodenal papilla (2/3 of the duodenum)

Question 67

What is the bare area of the liver bare of?

Answer 67

Peritoneum

Question 68

Name 3 structures present in the porta hepatis?

Answer 68

R/L hepatic ducts, L/R hepatic arteries and portal vein

Question 69

What fold of peritoneum is wrapped around the structures present in the porta hepatis?

Answer 69

Falciform ligament (visceral)

Question 70

What structures are part of the extrahepatic biliary apparatus?

Answer 70

Hepatic ducts, common hepatic ducts, gallbladder, cystic duct and common bile duct

Question 71

Where is bile stored?

Answer 71

Gallbladder

Question 72

Where does bile enter the gut tube?

Answer 72

Duodenum

Question 73

What is the function of bile?

Answer 73

Digestion and absorption of fat and fat soluble vitamins

Question 74

What is Calot's cystohepatic triangle?

Answer 74

Triangular space formed by the cystic duct, common hepatic duct and inferior surface - contains the cystic artery

Question 75

What are the main histological features of the pancreas?

Answer 75

Islets of Langerhans, pure serous acini and small lobules surrounded by connective tissue septa

Question 76

What are the main histological features of the liver?

Answer 76

Cells are arranged in sheets converging towards the centre and portal areas which contain the blood vessels and ducts

Question 77

What are the two main parts of the spleen?

Answer 77

Red pulp and white pulp

Question 78

What is the main content of the white pulp in the spleen?

Answer 78

Lymphocytes and macrophages

Question 79

What is the main content of the red pulp in the spleen?

Answer 79

Vascular anastomoses and cords of cells

Question 80

Which costal cartilage is the surface marking of the gallbladder?

Answer 80

9

Question 81

Does the liver move with respiration?

Answer 81

Yes

Question 82

Which ribs are related to the spleen?

Answer 82

9, 10 and 11 - midaxillary

Question 83

Which abdominal plane crosses the pancreas and what part of the pancreas does it go through?

Answer 83

Transpyloric through the neck of the pancreas