Revision questions

Question 1

Where is the stomach located?(use nomina anatomica etc)

Answer 1

It lies in the right and left upper quadrants

Question 2

What is the main cause of gastric ulcers?

Answer 2

Infection of helicobacter pylori

Question 3

Name three functions of the stomach

Answer 3

retain food, maceration of food, partial digestion

Question 4

List three important anatomical differences between the small and large intestine

Answer 4

The large intestine has omental appendices(small projections), teniae coli(distinct longitudinal bands), and haustra (sacculations of the wall of the colon between the teniae)
The large intestine is also much wider in diameter

Question 5

Where is the descending part of the duodenum located? (Use vertebra level, nomina anatomica and other organs/structures)

Answer 5

The descending part of the duodenum lies to the right of the L1-L3 vertebrae. It runs around the head of the pancreas

Question 6

Most of the small intestine receives its blood supply from branches of a single artery. The artery that supplies most of the small bowel is the; 
A. Middle colic
B. Celiac
C. Gastroduodenal
D. Inferior mesenteric
E. Superior Mesenteric

Answer 6

E. Superior mesenteric

Question 7

Which structures are supplied by arteries branching from the celiac trunk?
A. Duodenum, pancreas, kidneys, liver, stomach
B. Spleen, Stomach, gallbladder, transverse colon
C. Gallbladder, liver, duodenum, pancreas, transverse colon
D. Stomach, liver, pancreas, duodenum, spleen

Answer 7

D. Stomach, liver, pancreas, duodenum, spleen

Question 8

What is volvulus of the sigmoid colon? What are its clinical features?

Answer 8

Rotation and twisting of the loop of the sigmoid colon. Clinical features are obstruction of the lumen of the descending colon and sigmoid colon. Constipation, and the absence of blood flow are often seen, as well as a collection of compressed feces or necrosis

Question 9

What is diverticulosis? What would be the best way to detect and diagnose diverticulitis?

Answer 9

Diverticulosis is a disorder in which pockets of mucosa in the colon develop. It can be diagnosed using a colonoscopy.

Question 10

How does pain develop when having appendicitis/where can pain be felt?

Answer 10

The pain developes as a vague pain in the periumbilical region. Later severe pain in the right lower quadrant.

Question 11

The inferior mesenteric artery originates from which artery?

Answer 11

Abdominal aorta

Question 12

The inferior mesenteric artery originates at which height?

Answer 12

At L3 level

Question 13

Define the term increased intestinal permeability

Answer 13

When the intestinal barrier dysfunctions, causing chronic low-grade inflammation due to microbes

Question 14

Which of the following structures together form the portal triad in the hepatoduodenal ligament?
A. Hepatic artery, superior mesenteric vein, and pancreatic duct
B. Hepatic artery, portal vein, common bile duct
C. Celiac trunk, inferior mesenteric vein, common bile duct
D. Celiac trunk, superior mesenteric vein and common bile duct
E. Celiac Trunk, portal vein and pancreatic duct

Answer 14

B. Hepatic artery, portal vein, common bile duct

Question 15

The pancreas is surrounded by several
structures. Which of the following
combinations is correct:
a. Liver, stomach, duodenum, left kidney.
b. Liver, aorta, duodenum, spleen.
c.Aorta, duodenum, spleen, left kidney.
d. Aorta, stomach, spleen, transverse colon.

Answer 15

c. Aorta, duodenum, spleen, left kidney.

d. Aorta, stomach, spleen, transverse colon.

Question 16

The common bile duct and major 
pancreatic duct join to form the:
a. hepatic duct
b. common hepatic duct
c. cystic duct
d. cisterna chyli
e. ampulla of Vater

Answer 16

e. ampulla of Vater

Question 17

Explain how liver cirrhosis can lead to

portal hypertension.

Answer 17

The scarring and fibrosis of cirrhosis obstruct the hepatic portal vein, causing pressure in the vein to rise

Question 18

Portal hypertension can be diagnosed
by several clinical features, name at least
three symptoms caused by portal
hypertension.

Answer 18

1. Gastrointestinal bleeding
2. Ascites, accumulation of fluid in the abdomen
3. Encephalophaty, confusion and forgetfullness

Question 19

What surgical procedure could alleviate
the symptoms of portal hypertension?
(name two possibilities)

Answer 19

Transjugular intrahepatic portosystemic shunt (TIPS), a
radiological procedure in which a stent (a tubular device) is
placed in the middle of the liver.
Distal splenorenal shunt (DSRS), a surgical procedure that
connects the splenic vein to the left kidney vein in order to
reduce pressure in your varices and control bleeding.

Question 20

A gallstone can cause pancreatitis. Where is 
the gallstone most likely located?
A. Hepatic duct
B. Ampulla of vater
C. Common hepatic duct
D. Cystic duct
Explain why

Answer 20

B. Ampulla of Vater, as this is the most narrow part of the biliary passages

Question 21

Where is the liver located? Use
nomina anatomica, quadarants and other
organ/structures to complete your
answer.

Answer 21

It lies mainly in the right upper quadrant of the abdomen, around ribs 7-11.

Question 22

Where is the gallbladder located? (use
costal cartilage level, nomina anatomica
and other structures to complete your
answer

Answer 22

The gallbladder is located behind the costal cartilage of false ribs 11 & 12, below the liver and right from the stomach.

Question 23

2. Where would you place your needle to perform a lumbar puncture and why?

Answer 23

Below L2. This is done because after L2 the spinal cord ends as a solid structure. After L2 there are many separate nerve strands bathed in CSF. It is thus much safer to puncture into the space where there is a lot of fluid than to possibly damage the solid cord higher up the spine.

Question 24

What is the difference between a somatic and a visceral nerve?

Answer 24

A somatic nerve is a nerve of voluntary motion, while a visceral nerve is not

Question 25

And what is the difference between an afferent and an efferent nerve?

Answer 25

An afferent nerve transmits impulses to the CNS. An efferent nerve carries impulses away from the CNS.

Question 26

The pelvic splanchnic nerves serve which five organs?

Answer 26

Urinary bladder, penis, clitoris, rectum, descending colon

Question 27

What is the difference in function between dorsal and ventral rami?

Answer 27

The dorsal rami carries visceral motor, somatic motor, and somatic sensory information to and from the skin and muscles of the back. The ventral rami carry visceral motor, somatic motor, and sensory information to and from the structures in the body wall, ventrolateral body surface, and limbs.

Question 28

Injuries to the upper plexus and lower plexus are more common than injuries to the middle rami. Is there an anatomical explanation for this?

Answer 28

The upper and lower plexus are located more towards the skin, which makes them more vulnerable to injury than the middle plexus.

Question 29

What are the distinct functions of the 12 cranial nerves?

Answer 29

CN 1- olfactory nerve, sense of smell CN 2- optic nerve, transmits information gathered from vision CN 3- oculomotor nerve, controls muscle movements of the eyes CN 4- trochlear nerve, controls eye movement allowing the eye to point downward and inward CN 5- Trigeminal nerve, helps in chewing and clenching teeth; gives sensation to most parts of the face, including the cornea of the eye, mucosa of the nose and teeth. CN 6- abducens nerve, controls the movement to turn the eyes outward CN 7- Facial nerve, movement of muscles for facial expressions ; movement of lacrimal, submaxillary and submandibular glands; provides sensation of the external ear and sensation of taste CN 8- vestibulocochlear nerve, helps in maintaining balance by sensing changes in the position of the head with regards to gravity; helps with hearing CN 9- glossopharyngeal nerve, receives sensory information from the throat, tonsils, middle ear and back of tongue; provides movement to the stylopharyngeus, allowing the throat to shorten or widen. CN 10- Vagus nerve, provides sensation to the outer ear, throat, heart and abdominal organs; provides movement to the throat; regulates heart rhythm ; innervates smooth muscle in GI tract and respiratory system CN 11- accessory nerve, allows rotation, extension, and flex of the neck and shoulders, CN 12- hypoglossal nerve, supplies the tongue muscles

Question 30

What is special about the course of the recurrent laryngeal nerve?

Answer 30

It moves in opposite direction of the vagus nerve from which it branches

Question 31

10. Beginning at the axon membrane, name the layers of connective tissue that build up to make a peripheral nerve.

Answer 31

Myelin sheath formed by Schwann cells or Schwann cells without myelin Endoneurium Perineurium Epineurium

Question 32

What is the function of a lymph node? 3 parts

Answer 32

Filter the lymph, produce lymphocytes and kill pathogens to provide immune defense

Question 33

What is an enlarged lymph node, and what can the caused?

Answer 33

Enlarged lymph nodes means there is inflammation of a lymph node, often caused by a viral infection or an infection in an area nearby the lymph node.

Question 34

Which anatomical characteristic ensures that the flow of lymph through a lymph node is slow? Why is this desirable?

Answer 34

The lymph node has fewer efferent than afferent vessels, so it slows down inside the lymph node before exiting. This is desirable because it allows for immunosurveillance to occur

Question 35

A woman has cancer in the superior lateral quadrant of her left breast. In which lymph nodes is it likely to find cancer cells?

Answer 35

Axillary lymph nodes, such as the sentinel lymph node

Question 36

Define Polymastia, Polythelia, Amastia, | Gynecomastia

Answer 36

Polymastia; the person has an additional breast that can occur with or without nipples and areoles. Polythelia; the person has an additional nipple Amastia; condition in which breast tissue and nipple are not developed. Gynecomastia; condition in which one or both breasts abnormally enlarge without cancerous cells, due to an hormone inbalance between estrogen and androgen.

Question 37

2. The kidneys are not aligned on the same height, explain why and which kidney is the highest.

Answer 37

The left kidney is highest. The right kidney lies lower due to the presence of the liver

Question 38

3. At which height is the left kidney situated (use vertebral level)

Answer 38

L1-L3

Question 39

At which height is the right kidney situated when an adult stands in upright position: A. Thoracic vertebrae 8 – 10 B. Thoracic vertebrae 10 – 12 C. Thoracic vertebra 12 – lumbar vertebra 3 D. Lumbar vertebrae 2 – 4

Answer 39

C. Thoracic vertebrae 12 - lumbar vertebrae 3

Question 40

Define a renal cyste? What are the main clinical features?

Answer 40

A renal cyst is when a sac of fluid forms in the kidney. | Clinical features include acute pain, increased size of kidneys

Question 41

What is renal entrapment syndrome?

Answer 41

Renal entrapment syndrome is a disorder in which the abdominal aorta and the superior mesenteric artery squeeze the left renal vein.

Question 42

What are calculi? What are its clinical features?

Answer 42

Calculi are stones, usually made of mineral salts that form in the kidney. The clinical futures are often one or more stones, that can cause irritation of the nearby tissue, obstruction of an opening or duct, and more infections.