Quiz 2

Question 1

Trigeminal nerve

Answer 1

nasopharynx

V

Question 2

Glossopharyngeal nerve

Answer 2

posterior third of tongue and oral pharynx

IX

Question 3

Superior laryngeal nerve

Answer 3

tongue base and inferior epiglottis to the vocal cords

Question 4

Recurrent laryngeal nerve

Answer 4

vocal cords distally

Question 5

Branches of Vagus nerve

Answer 5

remaining larynx and trachea

X

Question 6

esophagus cervical location

Answer 6

C6

Question 7

The esophagus passes through a space created by the ___________ of the diaphragm

Answer 7

right crus

Question 8

The external muscular coat of the esophagus is made up entirely of ________ muscles in the upper third, of __________________ muscles in the middle third (A and B), and of ___________ muscle in the lower third

Answer 8

skeletal

skeletal and smooth

purely smooth

Question 9

intrinsic innervation of the esophagus? Goes to?

Answer 9

• myenteric or Auerbach plexus
• submucosal or Meissner plexus

This system is a continuum that
extends from the esophagus to the anus?

Question 10

extrinsic innervation of the esophagus?

Answer 10

Sympathetic
-Act on myenteric plexus to modulate rather than control motor activity

Parasympathetic

• Causes esophageal muscular contraction
• Causes relaxation of LES

Question 11

Excitatory stimulation of UES occurs due to:

Answer 11

Inspiration
Gagging
Acidity of gastric contents
Valsalva maneuver
Esophageal distention

Question 12

UES tone is reduced by:

Answer 12

• Distention
• Belching
• Vomiting

Question 13

Chronic alcoholism can lead to:

Answer 13

Degeneration of the Auerbach plexus
LES hypotonia
Impaired esophageal peristalsis
Mallory Weis Tear

Question 14

Failure of the Lower esophageal sphincter tone to relax during swallowing accompanied with a lack of peristalsis

Answer 14

Achalasia

Question 15

Can get Barret Esophagus from?

Answer 15

• Chronic exposure to acidic gastric contents – GERD
• Chronic alcohol abuse
• Smoking

Question 16

Types of hiatal hernia?

Answer 16

• Sliding / Type I
• Paraesophageal / Type II
• Mixed / Type III
• Type IV

Question 17

which type of esophageal diverticula highest risk of aspiration?

Answer 17

Zenker, located in upper esophagus

Question 18

Daunorubicin and Doxorubicin/Adriamycin chemo drugs can cause?

Answer 18

chemotherapy induced cardiomyopathy

Question 19

Bleomycin chemo drug can cause?

Answer 19

Pulmonary fibrosis
Restrictive defect
Increased potential for oxygen toxicity

Question 20

The duodenum extends from the pylorus to the _________________.

Answer 20

ligament of treitz

Question 21

Layers of gastric wall

Answer 21

• Serosa (external) (smooth muscle)
• Muscularis Mucosae (smooth muscle)
• submucosa
• mucosa

Question 22

Acid release is mediated by:

Answer 22

• Vagal stimulation (acetylcholine)
• Gastrin release – G cells in response to gastric distention
• Histamine

Question 23

produces hydrochloric acid in the stomach

Answer 23

parietal cells (reduced by PPIs/H-blockers

Question 24

Therapeutic Meds for PUD

Answer 24

• PPIs
• H2.blockers
• sucralfate - binds to ulcer
• ABX
• misoprostol (synthetic prostaglandin) - prevents ulcers with NSAID use

Question 25

First line therapy for H.Pylori

Answer 25

PPI BID Clarithromycin amoxacillin or PPI BID Clarithromycin Metronidazole

Question 26

Gastric neoplastic disease types (and percentage)

Answer 26

- adenocarcinoma (95%) - lymphoma (4%) - leiomyosarcoma (1%)

Question 27

The Pancreas: exocrine function

Answer 27

- Secretes 1500-3000ml of pancreatic juice daily - Clear, colorless liquid with a pH of 8.3 - Ionic composition is Na+, K+, bicarb, chloride - Principle function is to adjust duodenal pH - Promotes optimal function of pancreatic enzymes

Question 28

The Pancreas: endocrine function

Answer 28

Direct (non-ductal) production of insulin and glucagon to meet physiologic need

Question 29

Presence of acid in the duodenum caueses release of?

Answer 29

secretin (causes release of Bicarb)

Question 30

presence of fat in the duodenum causes release of?

Answer 30

Cholecystokinin (causes secretion of enzymes)

Question 31

Causes of Pancreatitis

Answer 31

- Alcohol abuse - Direct or indirect trauma - Ulcerative penetration from adjacent structures - Infectious processes - Biliary tract disease - Metabolic disorders - Drug side effect

Question 32

Regulation of gallbladder contraction is primarily hormonal through the action of __________?

Answer 32

cholecystokinin (vagal stimulation also plays a role secondary to CCK)

Question 33

Three main functions of bile:

Answer 33

- Emulsify and enhance absorption of ingested fats and fat-soluble vitamins. - Provide an excretory pathway for bilirubin, drugs, toxins, and immunoglobulin A (IgA) - Maintain duodenal alkalization

Question 34

S/S of Cholecystitis:

Answer 34

- acute, severe, midepigastric pain that often radiates to right abdomen - Murphy sign -inspiratory effort accentuates the pain - increase in plasma bilirubin, alkaline phosphatase, amylase, and WBCs (can present after a very fatty meal)

Question 35

Charcot triangle ? indicative of what disease?

Answer 35

-fever, chills, upper quadrant pain Cholelithiasis/Choledocholithiasis

Question 36

Small intestine lengths:

Answer 36

- Duodenum ~ 20cm - Jejunum ~ 100cm - Ileum ~150cm

Question 37

The function of the _________, the ______ and the _________ is to increase the amount of surface area available for the absorption of nutrients

Answer 37

plicae circulares villi microvilli

Question 38

Chron's disease:

Answer 38

- Cobblestoning - fat wrapping - thickened wall - can be in random spots

Question 39

Ulcerative Colitis:

Answer 39

- Loss of haustra - pseudo polyps - crypt distortion - starts somewhere and continues on from there

Question 40

In the infant and adult it also destroys old red blood cells, recycles iron and globin and stores functional red blood cells, expelling them in response to a hemorrhage

Answer 40

spleen