Block 3 Flashcards
1
Q
Sumatripan
A
Serotonin agonist for vomiting
2
Q
Lingual nerve
A
Branch of mandibular nerve which provides sensory innervation to anterior 2/3
3
Q
Which structure lies close to the parotid gland?
A
Facial nerve
4
Q
What is the blood supply to the salivary glands?
A
External carotid artery and retromandibular vein
5
Q
Where does IVC exit?
A
T8
6
Q
What is normal gastirc ph?
A
2
7
Q
What is released with gastrin?
A
Pepsin
8
Q
When is gastric inhibitory peptide released?
A
In response to fatty acids
9
Q
What is the effect of vasointestinal polypeptide?
A
Produced by small intestines and pancreas, Inhibits gastric acid secretion by stimulating somatostatin release.
10
Q
Inguinal ligament origin
A
Arises from the external oblique aponeurosis
11
Q
Which vessel lies behind the clavicle?
A
Subclavian vein
12
Q
Level of hyoid bone
A
C3
13
Q
Angle of Louis
A
Manubriosternal angle which is important indicator for the aortic arch
14
Q
What lies medial to the dorsalis pedis artery?
A
Extensor hallucis longus tendon
15
Q
Where does the inferior thyroid artery originate?
A
Thyrocervical trunk
16
Q
Location of chemoreceptor trigger zone
A
Medulla in the floor of 4th ventricle outside the blood brain barrier
17
Q
Where does aorta bifurcation occur into left and right common iliac arteries?
A
L4
18
Q
Glossopharyngeal nerve
A
Sensation to posterior 1/3 of tongue
19
Q
Carotid sheath components
A
Common carotid artery, Internal carotid artery, Internal jugular vein, Vagus nerve
20
Q
Carotid sheath
A
Lies between sternocleoidomastoid and vertebrae. Anteriorly- pretracheal fasica, ansa cervicalis, vagus and hypoglossal nerves. Posteriorly formed-prevertebral fascia.Internal jugular vein, common carotid artery
21
Q
Vocal folds
A
Innervated by recurrent laryngeal nerve
22
Q
Innervation of stylohyoid
A
Facial nerve
23
Q
What is the blood brain barrier not hghly permeable to?
A
Hydrogen ions
24
Q
Which cahnnels are open during depolarisation?
A
Voltage gated na+
25
Which channles are open in repolarisation?
Voltage gated K+ channels
26
Which channels are open in hyperpolarisation?
Voltage gated Na+ channels that will close
27
What is the effect of cholecystokinin?
Increases gall bladder contraction and relaxation of sphincter of Oddi espeically after eating fatty food that can cause vomiting. It is produced by pancreatic and small intestine I cells and can cause pain in right abdominal region. It reduces gastric emptying
27
What is the effect of cholecystokinin?
Increases gall bladder contraction and relaxation of sphincter of Oddi espeically after eating fatty food that can cause vomiting. It is produced by pancreatic and small intestine I cells and can cause pain in right abdominal region. It reduces gastric emptying
28
S cells
Found in the duodenum and jejunum and roduce secretin to increase bicarbonate, water and electroyltes in pancreatic secretionspancreatic fluid
29
Effect of somatostatin
Inhibits histamine for gastric acid secretion, glucagon and insulin release, glucose in blood, lipolysis and bicarbonate. It inhibits gall bladder emptying and growth hromones. It decreases volume of secretion and inhibits release of TSH
30
Where is secretin released?
S cells in duodenum and jejunum
31
What forms the external spermatic fascia?
External oblique aponeurosis
32
What is the effect of prostaglandin?
Decrease gastric acid secretion
33
Pain in right upper oquadrant and intolerance to fatty foods
Gallstone. cholestasis
34
What reduces iron absorption?
Wholegrains, tea, coffee and wine.
35
What increases iron absorption?
Gastric acid secretion, vitamin C
36
What increases pancreatic enzyme secretion?
Cholecystokinin
37
What increases secretion of water and electroyltes in pancreatic secretions?
Secretin
38
Gastrin
Prodcued by G cells in stomach antrum. Binds to parietal cells CCK2 receptors to free Ca2+ storesCauses increase in acid secretion, gastric motility, pepsinogen and parietal cell maturation. M3 receptors on parietal cells are stimualted by acetylcholine
39
Which hormone is an indicator for pancreatic insufficiency?
Secretin
40
Which cells are in fundus?
Parietal cells and chief cells
41
What inhibits gastirc acid secretion?
Nausea and stympathetic innervation, somatostaitn, cholecystokinin and secretin
42
What increases gastric acid secretion?
Vagus nerve, histamine release.
43
What causes Na+.K+ exchange in salivary ducts?
Aldosterone
44
Where are bile salts absorbed?
Terminal ileum which is malabsorbed in Crohn's disease
45
What is the innervation to the parotid gland?
Glossopharyngeal nerve
46
What controls endocrine cells of the pancreas?
Pancreatic polypeptide
47
What contracts behind food in oesophagus?
Circular smooth muscle
48
What propels food in the oesophagus?
Longitudinal smooth muscle
49
Where does anti-peristaltic waves occur?
In colon to maximise absoprtion
50
What is used to reduce diarrhoea?
Issues with pancretic exocrine function
51
What do chief cells produce?
Lipase and pepsinogen
52
What stimulates bile flow from liver to gallbladder?
Secretin
53
How are hydrogen ions produced by parietal cells?
Carbonic anhydrase
54
What is released in the cephalic phase?
HCL and gastrin from G cells
55
Which phase is acid secretion lowest?
intestinal phase
56
What is the effect of excess gastrin?
Malabsorption that leads to diarrhoea, weight loss
57
Umbilical vein progenitor
Ligamentum teres
58
Ductus venosus progenitor
Ligamentum venosus
59
Divison between foregut and midgut
Proximal duodenum
60
Foregut
Supplied by coeliac trunk, includes the oesophagus, liver, spleen, stomach proximal duodenum
61
Divison between midgut and hindgut
Splenic flexure- hindgut begins with the descending colon
62
Midgut
Supplied by superior mesenteric artery and begins with distal duodenum, jejunum, ileum, caecum, appendix, ascending colon, transverse colon
63
Hindgut
Supplied by inferior mesenteric artery and begins with descending colon, sigmoid colon, rectum, and superior anal canal
64
Where is vitamin K absorbed?
Colon
65
Hstology of oesophagus
Stratified squamous epithelia
66
Histology of oesophageo-gastric junction
Simple columnar epithelia
67
Histology of upper oesophagus
Skeletal muscle- cricopharyngeal and inferior constrictor muscle
68
Histology of lower oesophagus
Smooth muscle- reinforced by right diaphragmatic crus
69
Chemoreceptor trigger zone
Area in fourth ventricle which induces vomiting. Doapmine, serotonin, acetylcholine, opioids and substance P are involved.
70
What are the blood supplies to the liver?
Hepatic artery and hepatic portal vein
71
Where does the hepatic artery receive blood?
Oxygenated, so it receives blood from general criculation such as pulmonary artery and coeliac trunk.
72
What is the majority of liver blood supply?
Hepatic portal vein
73
What does the portal vein transmit?
Nutrient rich blood which is poor in oxygen from the organs
74
Where does the heaptic vein drain?
Into the IVC
75
Functional unit of liver?
Lobule
76
Where do the contents of the liver drain?
Into the hepatic vein or lymphatic system via the sinusoids.
77
What are the features of the sinusoids?
Hexagonal endothelial channels which receive mixed blood from hepatic artery and portal vein to drain into the hepatic vein. They contain pores to allow nutrients to pass. The lumen of the endothelium contains Kuppfer cells. The lobules have connective tissues.
78
Perivenous end
Lower oxygen conc closest to the central vein. Site of glycolysis, glycogenesis, lipgenesis, ketogenesis and glutamine and bile acid biosynthesis. Drug metabolism phase 1 and phase 2 (conjugation) occur here
79
Periportal end
Higher oxygen conc for gluconeogenesis, cholesterol and urea biosynthesis
80
Where does bile enter gall bladder?
Cystic duct, which receives bile from common bile duct
81
Where does cholestasis occur?
Hartmann's pouch, mucosal fold in neck ofgall bladder.
82
Where does bile leave the gall bladder?
Common bile duct
83
What forms the common bile duct?
Cystic duct and common hepatic duct
84
What forms the common hepatic duct?
Left and right hepatic duct
85
Where does bile enter the duodenum?
Major duodenal papilla. Papilla is at the end of the ampulla channel. Common bile duct combines with pancreatic duct and they are regulated by sphincter of Oddi.
86
What substance flows in the opposite direction to blood in the liver?
Bile.
87
What produces bile?
Hepatocytes
88
Location of Kuppfer cells
Lumen of sinusoid enodthelium
89
What is the space of Disse
Space between hepatocytes and endothelium/sinusoids
90
What is portal hypertension?
When there is inflammation or scarring of the liver which increases blood pressure in the liver and may cause backflow.
90
Where are the products or liver stores released into the blood?
From hepatocytes, it is released into the space of Disse.
91
What is the alternative drainage to the hepatic vein in the sinusoids?
Lymphatic system.
92
Location of caudate lobe?
Between IVC fissure and ligamentum venousum between left and right lobe
93
What is ligamentum venosus?
Remnant of the ductus venousus and is attached to the portal vein
94
Location of quadrate lobe
Below portal hepatis in the right lobe
95
What is the histology of the gall bladder?
3 layers- mucosa, muscularis externa and serosa. There is no submucosa.
96
What is mucosa of gall bladder?
Microvilli, simple columnar epithelia and lamina propia below but no goblet cells.
97
What is the lamina propia?
Lies underneath epithelia and above the muscle layer, which provides blood suppyly to epithelia and allow it to change shape with smooth muscle contractions.
98
What is muscularis externa of gall bladder?
Smooth muscle in random orientation and connective tissue.
99
What is the serosa of the gall bladder?
Mesothelium connective tissue layer contianing BV, Lymphatic vessels and adipose tissue.
100
Which part of the gall bladder is attached to the liver?
Adventitia- where it is not attached to the iver, it has the serosa layer instead.
101
How are amino acids transported into epithelia of small intestine?
Carrier protein which co-trnasports amino acids and sodium ions. If it is a di or tripeptide, they will be hydrolysed by intracellular enzymes.
102
Duct of Wirsung
Joins pancreas to common bile duct to release secretions
103
Histology of large intestine?
Mucosa with columnar eptuhelia, goblet cells, lamina propia and no villi. It has a submucosa for BV and nerves. Muscularis propia and serosa
104
What is the layers of the muscularis propia?
inner circular and outer longitudinal muscle which lie beneath lamina propia and form outermost mucosa layer. Separated from muscularis propia by submucosa.
105
What is the layers of muscularis externa/propia?
Inner oblique muscle, middle ciruclar muscle and outer longitudinal muscle. In the large intestine, tthe outer longitudinal muscle forms the taeniae coli.
106
Histology of oesophagus
Mucosa, muscularis mucosa, submucosa, muscarlis propia/externa and serosa
107
What is the mucosa of the oesophagus?
=
Stratified squamous non keratinising eptihelia, lamina propia. It does not have goblet cells unless it is diseased called Barrett's
108
What level is the gastroesphagueal junction?
T11/T12
109
Mechanism of acid secretion?
CO2 and H20 enter the parietal celland converted by carbonic anhydrase to HCO3- and H+. Acid is released as H+ via H+/K+ exchanger proton pump. Aklaline tide occurs to maintain pH for basolateral membrane where CL- is pumped in in exchange for HCO3- out which causes temporary pH increase.
110
What pH must the stomach acid be to treat ulcers?
Above 3
111
