10. Foregut 1

Question 1

Which organs make up the foregut? (6)

Answer 1

Distal oesophagus
Stomach 
Liver
Spleen
Proximal duodenum
Part of pancreas

Question 2

What is the arterial supply of the foregut?

Answer 2

Branches of the coeliac axis (aorta T12)

Question 3

Where does blood from the foregut drain to?

Answer 3

Portal vein

Question 4

Where does lymph from the foregut drain to?

Answer 4

Pre-aortic nodes at T12 (coeliac nodes)

Question 5

What are the layers of the stomach, from outer to inner?

Answer 5

Serosa
Muscularis externa (outer longitudinal, middle circular, inner oblique)
Submucosa
Mucosa

Question 6

What are the 3 main areas of the stomach?

Answer 6

Fundus
Body
Pyloric antrum

Question 7

What is the name given to the many folds within the inner surface of the stomach?

Answer 7

Rugae

Question 8

What are the 2 notches of the stomach?

Answer 8

Cardiac

Angular

Question 9

What is the arterial supply of the stomach?

Answer 9

Left gastric artery - branch of coeliac axis (T12)
Right gastric artery
R and L gastro-epiploic (omental)

Question 10

What are the 3 branches of coeliac axis?

Answer 10

Left gastric
Splenic
Common hepatic

Question 11

Which artery is the R gastric a branch of?

Answer 11

Hepatic artery

Question 12

At the lesser curvature of the stomach, which arteries anastomose?

Answer 12

R gastric and L gastric

Question 13

Apart from the stomach, what other structure does the L gastric artery supply?

Answer 13

Distal oesophagus

Question 14

Which artery is the short gastric artery a branch of?

Answer 14

Splenic artery

Question 15

What part of the stomach does the short gastric artery supply?

Answer 15

Fundus

Question 16

Which veins drain the stomach?

Answer 16

R and L gastric veins
R and L gastro-epiploic
Short gastric

Question 17

Which vein do the R and L gastric veins drain into?

Answer 17

Hepatic portal vein

Question 18

Which vein do the R and L gastro-epiploic veins drain into?

Answer 18

L - splenic then portal

R - superior mesenteric then portal

Question 19

Which vein does the short gastric vein drain into?

Answer 19

Splenic then portal vein

Question 20

What is the main lymphatic drainage of the stomach?

Answer 20

Pre-aortic nodes at root of coeliac axis (T12)

Then cisterna chyli then thoracic duct

Question 21

Name some local lymph nodes around the stomach? (5)

Answer 21

Gastro-omental
Gastric
Pyloric
Pancreaticosplenic
Pancreaticoduodenal

Question 22

What is the autonomic nerve supply of the stomach?

Answer 22

Coeliac plexus

Question 23

What is the parasympathetic nerve supply of the stomach?

Answer 23

Anterior and posterior vagal trunks

Question 24

What is the sympathetic nerve supply of the stomach?

Answer 24

Greater splanchnic nerve

Question 25

Is the duodenum intra or retro-peritoneal?

Answer 25

1st part - intra 2nd - 4th - retro Therefore, it is partially retroperitoneal

Question 26

What is the name given to the many folds of the duodenum?

Answer 26

Plicae circularis

Question 27

What is the ampulla of Vater?

Answer 27

Hepatopancreatic ampulla | Union of common bile duct and main pancreatic duct

Question 28

What is the sphincter of Oddi? And its function?

Answer 28

Hepatopancreatic sphincter Controls the flow of pancreatic and bile fluids into the duodenum

Question 29

What vertebral level is the duodenum usually found at?

Answer 29

1st part at trans-pyloric plane (between L1 and L2)

Question 30

Name some structures that are related to the 1st part of the duodenum. (5)

Answer 30

``` Liver Gall bladder IVC Bile duct Portal vein ```

Question 31

Name some structures that are related to the 2nd part of the duodenum. (4)

Answer 31

Transverse colon Right kidney Right ureter Pancreas

Question 32

Name some structures that are related to the 3rd part of the duodenum. (7)

Answer 32

``` Superior mesenteric vessels Jejunum Right ureter Right psoas IVC Aorta Pancreas ```

Question 33

Name some structures that are related to the 4th part of the duodenum. (4)

Answer 33

Root of mesentery Jejunum Aorta Left psoas

Question 34

What arteries supply the duodenum? And where do these arteries branch from?

Answer 34

Proximal part - superior pancreaticoduodenal (branch of gastroduodenal) Distal part - inferior pancreaticoduodenal (branch of superior mesenteric)

Question 35

Which veins drain the duodenum?

Answer 35

Superior - direct to portal Inferior - superior mesenteric then portal

Question 36

What nerves supply the duodenum?

Answer 36

Sympathetic - greater and lesser splanchnic | Parasympathetic - vagal

Question 37

Where is pain from the duodenum referred?

Answer 37

Epigastric region

Question 38

What is the lymphatic drainage of the duodenum?

Answer 38

Proximal - pre-aortic coeliac axis nodes at T12 Distal - pre-aortic superior mesenteric nodes at L1