GI

Question 1

Where would you insert a needle for paracentesis?

Answer 1

Lateral to the rectus sheath

Question 2

Why must you insert the needle in paracentesis lateral to the rectus sheath?

Answer 2

To avoid the inferior epigastric vessels

Question 3

Which artery does the inferior epigastric artery arise from?

Answer 3

The external illiac artery (just medial to the deep inguinal ring)

Question 4

What is a condensation?

Answer 4

Double layers of peritoneum that attach organs to each other or to the abdominal wall

Question 5

What attaches the liver to the anterior abdo wall?

Answer 5

Falciform ligament

Question 6

Where does the lesser omentum attach?

Answer 6

Stomach to liver

Question 7

Where does the greater omentum attach?

Answer 7

Stomach to transverse colon

Question 8

How does the greater sac communicate with the lesser sac?

Answer 8

Through the omental foramen

Question 9

What is the other name for the lesser sac?

Answer 9

Omental bursa

Question 10

Where is the portal triad?

Answer 10

Within the free edge of the lesser omentum

Question 11

What are the pouches in the male?

Answer 11

Retrovesical

Question 12

What are the pouches in the female?

Answer 12

Uterovesical 
Rectouterine (pouch of douglas)

Question 13

Where do sympathetic nerves leave the spinal cord in to supply the abdominal organs

Answer 13

T5 to L2

Question 14

What happens to sympathetic nerves in the abdomen in the sympathetic chain?

Answer 14

Do not synapse

Enter the abdominopelvic splanchnic nerves

Question 15

Where so sympathetci nerves fibres synapse for the abdo organs?

Answer 15

Prevertebral ganglia which are anterior to the aorta at the exit point of the major branches of the abdo aorta

Question 16

How do the sympathetic nerve fibres reach the abdo organs?

Answer 16

Postsynaptic nerve fibres pass from prevertebral ganglia onto the surface of the artrial branches leaving the aorta.
In the periarterial plexus they ‘travel along’ the arteries to the organs

Question 17

How is the adrenal gland nerve supply unique?

Answer 17

Thes sympathertic nerves leave the spinal cord in the adominopelvic splanchnic at T10-L1 but they do not synpase at the prevertebral ganglia. Instead they travel along the periarterial plexus and synapse directly onto the organ

Question 18

How do parasympathetic nerve fibres reach the abdo organs?

Answer 18

Cranial nerve X
Travel towards and into the periarterial plexis.
Carried to argans, synsapse in the ganglia

Question 19

Where does the vagus nerve supply up to in the GI tract

Answer 19

Distal end of the transverse colon

Question 20

What supplies the descending colon and anal canal parasympathetically

Answer 20

Pelvic splanchnic nerves (S2, 3, 4)

Question 21

Where do visceral afferents from the foregut enter the spinal cord?

Answer 21

T6, -T9

Question 22

Where do visceral afferents enter the spinal cord from the midgut organs

Answer 22

T8-T12

Question 23

Where do visceral afferents from teh hingut organs enter the spinal cord?

Answer 23

T10-L2

Question 24

What group of nerves supplies the body wall of the abdomen?

Answer 24

Thoracoabdominal nerves

Question 25

How do the thoracoabdominal nerves arise?

Answer 25

7th to 11th intercostal nerves travel anteriorly and then their terminal branches leave the intercostal spaces between the internal oblique and transversus abdominus

Question 26

Name the three thoracoabdominal nerves

Answer 26

Subcostal (T12) Iliohypogastric (L1 first half) Ilioinguinal (L1 second half) All anterior ramuses

Question 27

What is the other name for jaundice?

Answer 27

Icterus

Question 28

Where does the breakdown of redblood cells occur?

Answer 28

Spleen

Question 29

What is in the portal triad?

Answer 29

Common bile duct Hepatic artery Hepatic portal vein

Question 30

Which ribs could result in piercing the sleen?

Answer 30

Ribs 9-11

Question 31

Which arteries run along the greater curvature of the stomach?

Answer 31

Right and left gastro omental

Question 32

How many functional segments are in the liver?

Answer 32

eight

Question 33

How many anatomical lobes are in the liver?

Answer 33

Four

Question 34

What is morrison's pouch?

Answer 34

Hepatorenal recess

Question 35

How does the liver attach to the diaphragm?

Answer 35

Coronary ligaments

Question 36

What is tehe man of the ligament which is a remnant fot he embryoogical umbilical vein

Answer 36

Ligamentum teres

Question 37

What vein drains the blood from the foregut structures to the hepatic portal vein?

Answer 37

Splenic vein

Question 38

How do the hindgut structures drain to the liver?

Answer 38

From the inferior mesenteric vein to the splenic vein

Question 39

How does the blood from midgut organs drain to the liver?

Answer 39

From the superior mesenteric vein to the hepatic portal cein

Question 40

What artery supplies the gall bladder?

Answer 40

Cystic artery

Question 41

What artery is the cystic artery a branch of?

Answer 41

Right hepatic artery (in most people)

Question 42

What aspect of the liver does the gallbladder lie on?

Answer 42

POsterior

Question 43

What level of the spinal cord do visceral afferents from the gallbladder enter?

Answer 43

T6-T9

Question 44

What is the name of the process in the head of the pancreas?

Answer 44

the uncinate process

Question 45

What organ surround the pancreas in a C shape?

Answer 45

Duodenum

Question 46

Where is the uncinate process?

Answer 46

Lies posterior to the superior mesenteric vessels

Question 47

How many parts are there of the duodenum?

Answer 47

four

Question 48

Name the four parts of the duodenum and say whether they are intra or retroperitoneal/

Answer 48

Superior- part intraperitoneal Descending (retroperitoneal) Horizontal (retro) Ascending (retro)

Question 49

what is the very first intra peritoneal part of the duodenun called

Answer 49

the duodenal cap

Question 50

What is the name of the highly folded mucosa in the jejunum?

Answer 50

Plicae circularis

Question 51

What are the specialised lymphatic vessels of the small interstine called?

Answer 51

Lacteals

Question 52

What organs do the lumbar lymph nodes drain?

Answer 52

Kidneys, post abdo wall, pelvis and lower limbs

Question 53

Which parts of the colon are retroperitoneal?

Answer 53

Ascending and descending

Question 54

Which flecture usually lies more superiorly?

Answer 54

Splenic

Question 55

Name the three distinct longitudinal muscles in the colon?

Answer 55

Teniae coli

Question 56

What is the name of the junction between the caecum and the appendix?

Answer 56

Appendiceal orifice

Question 57

Where is mcburney's point?

Answer 57

Third of the way from the right ASIS and the umbilucus

Question 58

Where is the most common position of the appendix?

Answer 58

Retrocaecal

Question 59

On which side of the IVC is the abdo aorta?

Answer 59

The left side

Question 60

Where does you internal iliac artery supply?

Answer 60

Pelvis/peroneum

Question 61

Where does you external iliac supply?

Answer 61

Lower limbs

Question 62

What are the three paired branches of the abdo aorta?

Answer 62

Adrenal renal Gonadal

Question 63

Name the branches of the SMA?

Answer 63

``` Ileal and jejunal arteries Appendicular Ileocolic Right colic MIddle colic Inferior pancreatico-duodenal artery ```

Question 64

What are the branches of the IMA?

Answer 64

Left colic Sigmoid colic Superior rectal

Question 65

What is the name of the arterial anastomoses between the SMA and IMA?

Answer 65

Marginal artery of drummond

Question 66

Where is the distal half of the anal canal supplied by

Answer 66

Internal iliac artery

Question 67

What branches of the internal iliac supply the most distal part of the GI tract?

Answer 67

Middle and inferior rectal arteries

Question 68

Where does the distal end of the oesophagus drain?

Answer 68

Hepatic portal vien

Question 69

Where does the more superior end of the oesophagus drain?

Answer 69

Azygous vein

Question 70

Where does the blood normal flow from the skin around the umbilicaus?

Answer 70

Inferior epigastric veins to the IVC

Question 71

Whar opens up in the liver to allow blood to flow through collaterals in portal hypertension?

Answer 71

Ligamentum teres

Question 72

What is the name of the pelvic floor muscles?

Answer 72

Levator ani

Question 73

When does the sigmoid colon become the rectum?

Answer 73

S3 'rectosigmoid junction'

Question 74

When does the rectum become the anal canal?

Answer 74

Anterior to the tip of the coccyx

Question 75

What is the name of the part of the rectum that's walls can relax to accomodate faeces?

Answer 75

Rectal ampulla

Question 76

Where is the rectal ampulla situated?

Answer 76

Just superior to the levator ani

Question 77

What kind of muscle is the levator ani muscle?

Answer 77

Skeletal

Question 78

What nerve supplies the levator ani?

Answer 78

A branch of the sacral plexus

Question 79

What part of the levator ani is particularly important for maintaining faecal continence?

Answer 79

Puborectalis muscle- contraction helps to maintain continence by decreasing the anorectal angle

Question 80

Name the two anal sphincters?

Answer 80

External anal sphincter (skeletal) | Internal anal sphincter (smooth

Question 81

Where is the internal anal sphincter?

Answer 81

Superior two thirds of the anal canal

Question 82

Where is the external anal sphincter?

Answer 82

Inferior two thirds of the anal canal

Question 83

What stimulates contraction of the external anal sphincter?

Answer 83

Pudendal nerve

Question 84

When does the voluntary contraction of the external anal sphincter occur?

Answer 84

In response to distention of the rectal ampulla (and internal sphincter relaxation)

Question 85

Where do sympathetic nerve fibres leave the sminal cord to innervate the rectum and anal canal?

Answer 85

T12-L2

Question 86

What is the combined anterior rami of the pudendal nerve?

Answer 86

S2, S3, S4

Question 87

What is the combined rami of the levator ani?

Answer 87

S3, S4

Question 88

Where do the the visceral affertn nerve fibres enter the spinal cord at from the rectum/anal canal?

Answer 88

Follow the pelvic splanchnic nerves- S2, S3, $

Question 89

From what plexus if the pudendal nerve a branch?

Answer 89

Sacral

Question 90

What does the pectinate line indicate?

Answer 90

The junction between the part of the GI tract formed by the endoderm and the skin formed by ectoderm

Question 91

What lymoh nodes drain the structures below the pectinate line?

Answer 91

Superficial inguinal lymoh nodes

Question 92

What lymoh nodes drain inferior pelvic structures?

Answer 92

Internal iliac nodes

Question 93

What lymoh nodes drain lower limb and more superior pelvic structures?

Answer 93

External iliac

Question 94

What lymph nodes drain lymoh from the external and internal iliac nodes?

Answer 94

Common illiac

Question 95

Where does lymoh from the common illiac lymph nodes drain?

Answer 95

Lumbar

Question 96

Where do the superifical inguinal nodes drain?

Answer 96

External inguinal nodes

Question 97

What is the name of the spaces on either side of the anal canl?

Answer 97

Ischioanal fossa (right and left fossae)

Question 98

What is an infection in the ischioanal fossa called?

Answer 98

An ischioanal abscess