Tutorial

Question 1

at what vertebral level does the superior part of the duodenum lie

Answer 1

L1

Question 2

name the three layers that form the mucosa of the stomach

Answer 2

epithelial layer
lamina propia
muscularis interna

Question 3

in which abdominal region is referred pain from the appendix and why

Answer 3

umbilical region, appendix is a midgut structure so pain fibres run with superior mesenteric artery, enter spinal cord T10-T11 and the dermatome for this region is in the umbilical region

Question 4

from which ganglion do postganglionic sympathetic fibres supplying the splenic flexure arrive

Answer 4

inferior mesenteric ganglion

Question 5

name, in order, the layers that a gastric ulcer will erode through from the lumen to the peritoneal cavity

Answer 5

muscosa, submucosa, tunica externa, serosa

Question 6

which artery is at risk if an ulcer in the second part of the duodenum perforates

Answer 6

gastroduodenal

Question 7

name three features that increases surface area for absorption in the small intestine

Answer 7

pilicae curculares, villi, and microvillib

Question 8

where does the mesentery of the transverse colon attach

Answer 8

pancreas to superior border of transverse colon

Question 9

where does lymph from the descending colon drain into

Answer 9

inferior mesenteric nodes and then to cysterna chyli, and thoracic duct

Question 10

which gross anatomical features are characteristic of the colon

Answer 10

tenaie coli, haustra, epiploic appendages

Question 11

name the two arteries that supply the descending colon

Answer 11

left colic, and sigmoid branches of IMA

Question 12

which cells of the gastric gland produce hydrochloric acid

Answer 12

parietal

Question 13

name the four parts of the duodenum

Answer 13

superior, descending, inferior and ascending

Question 14

name the artery that supplies the upper part of the duodenum and state the vessels from which it arises

Answer 14

superior pancreaticduodenal branch of gastroduodenal

Question 15

which arteries supply the ascending colon

Answer 15

iliocolic and right colic

Question 16

name the ligament that holds the duodenojejunal flexure in place

Answer 16

ligament of the duodenum or ligament of Trietz

Question 17

which lymph nodes does lymph from the gastric lymph nodes drain into

Answer 17

coeliac nodes

Question 18

which vessels unite to form the portal vein

Answer 18

superior mesenteric and splenic

Question 19

on a histological specimen how would you differentiate the ileum from the jejunum

Answer 19

Peyer’s patches in the ileum

Question 20

where does the lesser splanchnic nerve synapse

Answer 20

superior mesenteric ganglion

Question 21

name the artery that supplies the lower part of the duodenum and state the vessels from which it arises

Answer 21

superior pancreaticduodenal, branch of gastroduodenal

Question 22

what and where are Brunner’s glands

Answer 22

mucous (alkaline rich) secreting glands in the submuscosa of the duodenum

Question 23

which arteries supply the lesser curvature of the stomach

Answer 23

right and left gastric

Question 24

which splanchnic nerve carries sympathetic fibres to the coeliac ganglion

Answer 24

greater splanchnic nerve

Question 25

state two functions of cholecystokinin

Answer 25

relaxes the sphincter of oddi, causes contraction of the gall bladder, stimulates pancreatic acinar cells to secrete enzymes, stimulates liver to secrete bile, delays gastric emptyinh

Question 26

where does venous blood from the portal sinusoids drain to

Answer 26

central veins, hepatic veins, and IVC

Question 27

where does the accessory pancreatic duct drain into

Answer 27

first part of duodenum - superior

Question 28

name the ligament that separates the right lobe of the liver from the caudate lobe and state what it is a remnant of

Answer 28

ligamentum venosum. remnant of ductus venosum

Question 29

name the ligament that attaches the liver to the anterior abdominal wall

Answer 29

falciform

Question 30

which hormone stimulates the pancreatic duct cells to secrete water and bicarbonate

Answer 30

secretin

Question 31

which vessel does the cystic artery usually arise from

Answer 31

right hepatic arteryv

Question 32

describe the flow of bile from the left lobe of the liver when the sphincter of Oddi is closed

Answer 32

left hepatic duct, common hepatic duct, bile duct, cystic duct, gall bladder

Question 33

name three structures that leave impressions on the visceral surface of the liver

Answer 33

stomach, duodenum,. gallbladder

Question 34

which vessels contribute to the gastroesophageal anastamosis

Answer 34

oesophageal branches of the left gastric (portal) with oesophageal branches of middle third of oesophagus (systemic)

Question 35

name the ligament that encircles the bare area of the liver

Answer 35

coronary ligement

Question 36

which vessels contribute to the retroperitoneal anastomosis

Answer 36

veins of retroperitoneal (portal) with renal, lumbar and phrenic (systemic)

Question 37

which vessels contribute to the paraumbilical anastomosis

Answer 37

paraumbilical (portal) with superficial veins of abdominal wall (systemic)

Question 38

which hormone stimulates pancreatic acinar cells to secrete pancreatic enzymes

Answer 38

cholecystokinin

Question 39

which vessels contribute to the anorectal anastomosis

Answer 39

superior rectal veins (portal) with middle and inferior rectal veins (systemic)

Question 40

the spiral valve is a raised fold in the muscosa of the cystic duct, what is the function of this valve

Answer 40

keeps the cystic duct open so that bile can easily be diverted into the gall bladder

Question 41

the gall bladder concentrates bile, state two histological features that facilitate this

Answer 41

rugae, microvilli and rich vasculature in the submuscosa

Question 42

which arteries supply the head of the pancreas and where do they arise

Answer 42

superior pancreaticoduodenal from gastroduodenal and inferior pancreaticoduodenal from superior mesenterix

Question 43

which vessels contribute to the retroperitoneal anastomosis

Answer 43

veins of retroperitoneal organs (portal) with renal, lumber and phrenic (systemic)

Question 44

which three structures form a portal triad

Answer 44

branch of hepatic artery, branch of portal vein, and bile duct tributary

Question 45

which vessels unite to form the portal vein and where does this union occur

Answer 45

splenic and superior mesenteric veins, occurs posterior to the neck of the pancreas (level L1)

Question 46

which lymph nodes do efferent lymph vessels from the hepatic lymph nodes drain into

Answer 46

coeliac nodes

Question 47

name the ligament that runs in the free margin of the falciform ligament and state what it is the remnant of

Answer 47

ligamentum teres/round ligament - remnant of the umbilical vein

Question 48

where do the cystic veins drain into

Answer 48

portal vein

Question 49

name two veins that drain directly into the portal vein

Answer 49

left gastric, right gastric, cystic

Question 50

name two groups of lymph nodes that receive lymph from the abdominal wall above the level of the transumbilical plane

Answer 50

axillary, parasternal or anterior diaphragmatic nodes

Question 51

in addition to the superior and inferior epigastric arteries, name three other vessels that supply the anterolateral abdominal wall

Answer 51

musculophrenic, posterior intercostals, deep circumflex iliac

Question 52

which abdominal region contains the splenic flexure

Answer 52

left hypochondrium

Question 53

where does the greater omentum attach

Answer 53

greater curvature of the stomach and transverse colon

Question 54

which layer of the gastrointestinal tract is the myenteric plexus located

Answer 54

muscularis externa

Question 55

which ventral rami transmit sensory innervation from the umbilical region

Answer 55

T10 and T11

Question 56

which structures run in the free border of the lesser omentum

Answer 56

hepatic artery, bile duct and portal vein

Question 57

at what vertebral level does the abdominal aorta bifurcate into the common iliac vessels

Answer 57

L4

Question 58

at what vertebral level do the common iliac veins unite to form the IVC

Answer 58

L5

Question 59

which is the only nerve of the lumbar plexus that arises form the medial border of the psoas major

Answer 59

obturator nerve

Question 60

name two tributaries of the left renal vein

Answer 60

left gonadal, left suprarenal

Question 61

at what vertebral level does the superior mesenteric artery arise

Answer 61

L1

Question 62

from which vessel does the inferior epigastric artery arise

Answer 62

external iliac

Question 63

state the boundaries of the epiploic foramen

Answer 63

Ant - hepatoduodenal ligament Post - IVC Sup - liver Inf - first part of the duodenum

Question 64

name the muscle that extends and laterally flexes the verebral colum and fixes the 12th rib during inspiration

Answer 64

quadratus lumborum

Question 65

name the abdominal region bounded by the left and right midclavicular lines, subcostal and transtubercular plane

Answer 65

umbilical region

Question 66

what does the posterior wall of the rectus sheath consist of above the arcuate line

Answer 66

transversus abdominus and posterior laminar of internal oblique

Question 67

state the attachments of the inguinal ligament

Answer 67

anterior superior iliac spine and pubic tubercle

Question 68

which segements of the spinal cord contribute to the femoral nerve

Answer 68

L2,3,4

Question 69

where is McBurney's point and what is its clinical signifcance

Answer 69

one third laterally along a line between the umbilicus and the ASIS. it corresponds to the position of the base of the appendix

Question 70

which structure lies within the lateral umbilical fold

Answer 70

inferior epigastric artery

Question 71

which segments of the spinal cord contribute to the obturator nerve

Answer 71

L2,3,4

Question 72

between which layers of the abdominal wall do the nerves that supply it run

Answer 72

between transversus abdominus and internal oblique