MET EOYS2

Question 1

explain the whole gut honing mechanism x

Answer 1

• dendritic cells produce retinoic acid (vitamin A) which induce gut homing T cells to express α4β7 and CCR9.
• Epithelial cells lining gut home T cells by expression of CCL25 (ligand for CCR9) while endothelial cells express MadCAM (ligand for α4β7).

Question 2

Answer 2

Question 3

Answer 3

Question 4

which of the following is the linear alba?

A
B
C
D
E
F

Answer 4

which of the following is the linear alba?

A
B
C
D
E
​F

Question 5

which of the following is the inguinal ligmanet?

A
B
C
D
E
F

Answer 5

which of the following is the inguinal ligmanet?

A
B
C
D
E
F

Question 6

which of the following is the external oblique?

A
B
C
D
E
F

Answer 6

which of the following is the external oblique?

A
B
C
D
E
F

Question 7

which of the following is the rectus abdominus?

A
B
C
D
E
F

Answer 7

which of the following is the rectus abdominus?

A
B
C
D
E
F

Question 8

which of the following is the tendinous intersections?

A
B
C
D
E
F

Answer 8

which of the following is the tendinous intersections?

A
B
C
D
E
F

Question 9

which of the following is the tendinous intersections?

A
B
C
D
E
F

Answer 9

which of the following is the tendinous intersections?

A
B
C
D
E
F

Question 10

which of the following is the rectus abdominus?

A
B
C
D
E
F

Answer 10

which of the following is the rectus abdominus?

A
B
C
D
E
F

Question 11

which of the following is the external oblique?

A
B
C
D
E
F

Answer 11

which of the following is the external oblique?

A
B
C
D
E
F

Question 12

which of the following is the inguinal ligmanet?

A
B
C
D
E
F

Answer 12

which of the following is the inguinal ligmanet?

A
B
C
D
E
F

Question 13

which of the following is the linear alba?

A
B
C
D
E
F

Answer 13

which of the following is the linear alba?

A
B
C
D
E
​F

Question 14

Answer 14

Question 15

the linea albal is formed by the aponeuoreses of which muscles?

Answer 15

Formed by aponeuroses of external oblique, internal oblique and transversus abdominis

Question 16

describe the structure of the rectus sheath

a) above arcuate line
b) below arcuate line

Answer 16

• *rectus sheath:**
• surrounds rectus abdominis muscle
• made from: aponeuroses of external oblique, internal oblique and transverse abdominis
• structure:
• *a) above arcuate line**
  i) external oblique aponeuroses runs anterior to rectus abdmonis & inserts into the midline: forms linea alba
  ii) i_nternal oblique aponeuroses splits in half_: half goes anterior of rectus abdominis, other half goes posterior. again insets onto linea alba
  iii) transversus abdominis runs posterior to rectus abdominis
  iv) transversalid fascia runs posterior to rectus abdominis
• *b) below arcuate line:**
  i) all of aponeuroses run anterior to rectus abdominis
  ii) transveralis fascia runs posterior to rectus abdominis

Question 17

what is the blood supply to the abdominal wall like? (3) where from?

Answer 17

sinternal thoracic artery –> superior epigastric artery
external iliac artery –> inferior epigastric artery
lower intercost and lumbar arteries - blood to lateral aspect of ab wall.

Question 18

what two anatomical features are found under the inguinal ligament? [2]

Answer 18

• under inguinal ligament:
  a) passageway for the femoral artery, vein and nerve pass & enter thigh.
  b) spermatic cord:

Question 19

why is water needed in the digestive system? (4)

Answer 19

Hydrolysis reactions of digestion

Facilitation of absorption (brings products of digestion into close proximity to microvilli)

Facilitation of propulsion of gut contents

Combination with mucin granules to make mucus

Question 20

in the production / break down of glucagon, glycogen synthase and glycogen phosphorylase are made active / inactive by the addition of what?

Answer 20

glycogen synthase is activated by removing P, inactivated by adding P

glycogen phosphorylase is activated by adding P, inactivated by removing b

therefore work antagonistically !

Question 22

extrinisc innervation of the GI tract:

• which nerve controls communication between gut and CNS?
• after enetering the brain stem, where does & synapse?

Answer 22

extrinsic innervation - vagus nerve mediates communication gut and CNS

• has central terminals that enter brain stem and synapse to neurons of nucleus tractus solitarus

Question 23

Clostridium difficile:

a) associated / caused by what?
b) results in what symptoms? (2)
c) treatment? (3)

Answer 23

Clostridium difficile:

a) associated / caused by: broad spectrum antiobiotic usage - opportunistic overgrowth
b) results in: watery diarrhoea & abdominal pain
c) treatment: stop antibiotic use, vancomycin, fecal microbiota transfer

Question 24

link between gut and brain:
what two things have been shown to be altered in brain as a result of altered gut microbiota?

Answer 24

• activity of macrophages / microglia within brain
• development and plasticity in brain (leads to ageing)

Question 25

blue and purple muscles?

Answer 25

blue: **pectoralis major** purple: **serratus minor**

Question 26

what are the attachment points for the external oblique? [3] what is the inguinal ligament? - between which two points does it lie? (2)

Answer 26

attachment site of external oblique - **lower part of ribs - the anterior superior iliac spine (ASIS for short) - external pubic tubercle** inguinal ligament: - the inferior border of the external oblique’s aponeurosis (**between ASIS & pubic tubercle**) and it rolls under itself to create the inguinal ligament.

Question 27

what are the two oesophageal sphincters? which one is an anatomical sphincter, which one is a physiological sphincter? how do they make sure they are sphincters/

Answer 27

**_upper oesophageal sphincter_:** produced by skeletal muscle **cricopharyngeus.** _anatomical sphincter_ * *_lower oesophageal sphincter:_** looks the same as oesophagus. _physiological sphincter._ aided by: a) **acute angle** of stomach enter b) right curs of the diaphragm: **pinch-cock** effect

Question 28

whats 1-5?

Answer 28

1: **soft palate:** roof of th eoral cavity 2. **uvula:** midleine extension of the mucosa of the soft palate 3 **palatine tonsil:** found between the two arches of mucosa that project down from soft palate 4 **palatopharyngeal arch:** lie postierior to palatine tonsils 5. **palaoglossal arch:** lies anterior to palatine tonsils

Question 29

label 1-3

Answer 29

1: posterior belly of digastric muscle 2: mylohyoid muscle (cut) 3: geniohydoid muscle

Question 30

label 1-3

Answer 30

1: posterior belly of digastric muscle 2: mylohyoid muscle (cut) 3: geniohydoid muscle

Question 31

name the three papillae in the tongue which have taste buds (2)

Answer 31

* *- fungiform papillae**: located anteriorly * *- filiform papillae**: loacted centrally * *- circumvallate papillae:** located posteriorly fungiform and circumvallate = taste buds

Question 32

which of the following is foramen cecum of tongue? A B C D E

Answer 32

which of the following is foramen cecum of tongue? A B C **D** E

Question 33

which of the following is foliate papillae? A B C D E

Answer 33

which of the following is foliate papillae? **A** B C D E

Question 34

which of the following is lingual tonsil? A B C D E

Answer 34

which of the following is lingual tonsil? A B **C** D E

Question 35

which of the following is vallate papillae? A B C D E

Answer 35

which of the following is vallate papillae? A **B** C D E

Question 36

which of the following is the foramen cecum ? A B C D E

Answer 36

which of the following is the foramen cecum ? A B C D **E**

Question 37

label 1-4 of the suprahyoid

Answer 37

1: thyrohyoid muscle 2: sternothryoid muscle 3: sternohyoid muscle 4: omohyoid muscle

Question 38

label 1-4 of the suprahyoid

Answer 38

1: thyrohyoid muscle 2: sternothryoid muscle 3: sternohyoid muscle 4: omohyoid muscle

Question 39

what is the differnece in the role of the intrisic and extrinsic muscles of mouth?

Answer 39

intrinsic muscle: change shape extrinsic muscle: change position

Question 40

upper oesophageal sphincter is made from which muscle?

Answer 40

EOS: **cricopharnyngeus muscle**

Question 41

Which muscle of mastication opens the mouth? Which muscles of mastication close the mouth?

Answer 41

**- Lateral pterygoid** muscles: open the mouth - the **temporalis, massester and medial pterygoid muscles** help close the mouth

Question 42

for **anterior 2/3 tongue:** which nerve supplies the a) special sensory (taste) b) general sensory (pressure etc) c) motor sensory?

Answer 42

**_anterior 2/3 tongue:_** nerve supplies the a) special sensory (taste): **CN VII - facial nerve** b) general sensory (pressure etc): **CN V - trigeminal nerve (V3, mandibular nerve)** c) motor sensory: **hypoglossal nerve - CN XII** _for **posterior 1/3 tongue:**_ nerve supplies the a) special sensory (taste): **glossopharnyngeal nerve (CN IX)** b) general sensory (pressure etc): **glossopharnyngeal nerve (CN IX)** c) motor sensory: **hypoglossal nerve - CN XII**

Question 43

label 1-5

Answer 43

1: **posterior 1/3 tongue** 2: **anterior 2/3 tongue / body** 3: **sulcus terminalis** 4: **median sulcus 5 foramen cecum**

Question 44

label 1-5

Answer 44

1: **posterior 1/3 tongue** 2: **anterior 2/3 tongue / body** 3: **sulcus terminalis** 4: **median sulcus 5 foramen cecum**

Question 45

the muscles in the pharynx are innervated by which nerve, except for the stylopharnygeal muscle - which is innervated by which nerve?

Answer 45

- all pharynx muscles innervated by: **vagus nerve** EXCEPT: - **stylopharyngeus** muscles which is innervated by the **glossopharyngeal nerve (CNIX).**

Question 46

1. There is a transition from skeletal to smooth muscle as you move in which direction? 2. in the oesophagus, there is an inner ?? layer - contraction of this muscle cause what? 3. There is also an outer ?? layer of muscle, contraction of which causes what?

Answer 46

1. There is a transition from **skeletal** to **smooth** **muscle** as you move distally. 2. There is an **inner** **circular** layer - contraction of this muscle **_increases luminal pressure_**. 3. There is also an **outer** **longitudinal** layer of muscle, contraction of which causes s**hortening of the oesophagus.**

Question 47

what is the motor and sensory innervation to the pharynx? [2]

Answer 47

baso: - sensory innervation = CNIX - motor inneration = CNX

Question 48

name of the sphincter muscle which encircles the mouth:? [1]

Answer 48

name of the sphincter muscle which encircles the mouth: **orbicularis oris**

Question 49

what anatomical features of the colon ensure that peristalsis is modified? [2] how does bolus move along colon? (2)

Answer 49

_what anatomical features of the colon ensure that peristalsis is modified?_ - get bulges of outer circular muscle (haustra), which are held together by three bands of circular muscle: **taenia** **- taenia can contract in either direction** _how does bolus move along colon? (2)_ **- constrictive ring occurs (**giant migrating concentration) and **haustra disappear (!)** from a portion of the ascending colon ~20cm of the colon distal to the constrictive ring lose their haustrations and **contract as a unit,** propelling faecal material into the transverse colon

Question 50

which part of muscaluris muscosa 1. becomes internal anal sphincter? 2 extends over sphincter & attaches to CT? 3. becomes external anal sphincter?

Answer 50

which part of muscaluris muscosa: * *circ muscle**: becomes internal anal sphincter * *long muscle**: extends over sphincter & attaches to CT * *skeletal muscle:** external anal sphincter

Question 51

which hormone is released when have hypocalcemia? what is it effects? (3) what is 1. inhibited by?

Answer 51

fall in calcium: **PTH** (parathryoid hormone) rises - restores calcium back to normal by: - Increased renal Ca++ reabsorption. - Increased bone Ca++ release. - Increased gut absorption via release of vitamin D (1,25vitD). The release if PTH is inhibited by raised **Ca++ levels.**

Question 52

IgD - role? - shape?? - how common? - contains?

Answer 52

IgD - role: antigen receptor on B cells that have not been exposed to antigens. - activates basophils and mast cells = make antimicrobrial factors - activates B cells - how common: very low levels 1

Question 53

which nerve provides sensory innervation for the entire face? - how is it split up? (3) - which of ^ supply superior teeth? - which of ^ supply inferior teeth?

Answer 53

* *trigeminal nerve (CN V):** - ophthalamic (V1) - maxillary (V2) - mandibular (V3) - maxillary V2 ---\> **superior alveolar nerve:** supplies superior teeth - mandible V3 ---\> **inferior alveolar nerve (** --\> mental nerve) supplies inferior teeth