Anatomy: GI tract Flashcards
1
Q
Most reabsorption of water occurs in which part of the digestive canal?
A
Ascending colon
2
Q
During fluoroscopy, the esophagus normally has three constrictions where adjacent structures produce impressions. What are they?
A
Cervical, thoracic (bronco-aortic) and diaphragmatic constriction
3
Q
What causes the cervical constriction of the esophagus?
A
Cricopharyngeaus muscle
4
Q
What causes the thoracic constriction of the esophagus?
A
Arch of the aorta and left main bronchus
5
Q
What causes the diaphragmatic constriction of the esophagus?
A
Esophageal hiatus of the diaphragm
6
Q
The circular muscle of the esophagus is (internal/external).
A
Internal
7
Q
The longitudinal muscle of the esophagus is (internal/external).
A
External
8
Q
The superior one third of the external longitudinal muscle of the esophagus is (voluntary/smooth/mixed).
A
Voluntary
9
Q
The inferior third of the external longitudinal muscle of the esophagus is (voluntary/smooth/mixed).
A
Smooth
10
Q
The middle third of the external longitudinal muscle of the esophagus is (voluntary/smooth/mixed).
A
Mixed
11
Q
The internal muscle of the esophagus is (circular/longitudinal).
A
Circular
12
Q
The external muscle of the esophagus is (circular/longitudinal).
A
Longitudinal
13
Q
Which part of the esophagus has voluntary muscles?
A
Superior third
14
Q
Which part of the esophagus has longitudinal smooth muscle?
A
Inferior third
15
Q
Which part of the esophagus has both voluntary and smooth longitudinal muscle?
A
Middle third
16
Q
The esophageal hiatus is on which crus of the diaphragm?
A
Right
17
Q
The esophageal hiatus is at which vertebral level?
A
T10
18
Q
The termination of the esophagus is at which level?
A
T11
level of 7th left costal cartilage
19
Q
The ligament attaching the esophagus to the esophageal hiatus
A
Phrenicoesophageal ligament
20
Q
How much food is the stomach of a typical adult capable of holding?
A
2-3 L
21
Q
The part of the stomach surrounding the cardial orifice
A
Cardia
22
Q
The superior opening or inlet of the stomach
A
Cardiac orifice
23
Q
Level of the cardial orifice in the supine position
A
6th left costal cartilage
T11
24
Q
The dilated superior part of the stomach that is related to the left dome of the diaphragm and is limited inferiorly by the horizontal plane of the cardial orifice
A
Fundus
25
The cardial notch is between the esophagus and the fundus. T/F
T
26
The inferior opening or outlet of the stomach
Pyloric orifice
27
The part between pyloric antrum and pyloric orifice
Pyloric canal
28
The junction of the pyloric part and the body of the stomach
Angular incisure
29
The shorter concave right border of the stomach
Lesser curvature
30
The longer convex left border of the stomach
Greater curvature
31
The longitudinal ridges or wrinkles of the gastric mucosa
Gastric folds
32
The three sections of the small intestines
Duodenum, jejunum, ileum
33
Shortest part of the small intestine
Duodenum
34
The second part of the small intestine
Jejunum
35
The first part of the small intestine
Duodenum
36
The duodenum is the widest and most fixed part of the small intestines. T/F
T
37
The duodenum form a C-shaped course around which organ?
Pancreas
38
Where do the duodenum and the jejunum meet?
Duodenojejunal flexure (junction)
39
The duodenojejunal flexure level
L2
40
Four parts of the duodenum
Superior (first), descending (second), inferior (third), ascending (fourth)
41
The free part of the duodenum
Ampulla
42
Which part of the duodenum has the major duodenal papilla?
Descending (second) part
43
The descending part of the duodenum is all retroperitoneal. T/F
T
44
The ampulla is in which of the four parts of the duodenum?
Superior (first) part
45
Which part of the duodenum has mesentery?
Ampulla
46
Which part of the duodenum is retroperitoneal?
All but the ampulla
47
The suspensory muscle of the duodenum (ligament of Treitz) attaches which part of the duodenum?
Inferior (third) and ascending (fourth) part
48
There is no clear demarcation between jejunum and ileum. T/F
T
49
Where does the ileum end?
Ileoceccal junction
50
Parts of the large intestine (8)
Cecum, appendix, ascending colon, descending colon, transverse colon, sigmoid colon, rectum, anal canal
51
Fatty omentum-like projections of the large intestines
Omental appendices
52
Thickened bands of smooth muscle representing most of the longitudinal coat of the large intestines
Teniae coli
53
Three types of teniae coli
Mesocolic tenia, omental tenia, free tenia
54
Sacculations of the wall of the colon between the teniae
Haustra
55
What are omental appendices?
Small, fatty omentum-like projections of the large intestines
56
Which are the mesocolic tenia?
The longitudinal bands to which transverse and sigmoid mesocolon attach
57
Which are omental tenia?
The longitudinal bands to which the omental appendices attach
58
Which are free tenia?
To which neither mesocolon nor omental appendices attach
59
The haustra is formed because of the tonic contraction of which structure of the large intestine?
Teniae coli
60
The cecum is in which quadrant of the abdomen?
Right lower
61
The cecum has mesentery. T/F
F
It is almost entirely enveloped by peritoneum and can be lifted freely, but has no mesentery. It is usually bound to the lateral abdominal wall by one or more cecal folds of peritoneum
62
Opening that connects the ileum and the cecum
Ileocecal orifice
63
A blind intestinal diverticulum that contains masses of lymphoid tissue
Appendix
64
The position of the appendix is variable. T/F
T
65
The four parts of the colon
Ascending, transverse, descending, sigmoid
66
The flexure between the ascending colon and the transverse colon
Right colic (hepatic) flexure
67
The flexure between the descending colon and the transverse colon
Left colic (splenic) flexure
68
The ascending colon is wider than the cecum. T/F
F
It is narrower.
69
Which parts of the colon is secondarily retroperitoneal?
Ascending and descending colons
70
Which parts of the colon is intraperitoneal?
Transverse and sigmoid colon
71
Which is more mobile: left or right colic flexure?
Right
72
Which is higher: left of right colic flexure?
Left
73
The space between ascending colon and the adjacent lateral abdominal wall
Right colic gutter
74
The space between the descending colon and the adjacent lateral abdominal wall
Left colic gutter
75
The longest part of the large intestine
Transverse colon
76
The most mobile part of the large intestine
Transverse colon
77
The attachment of the transverse colon to the diaphragm
Phrenicocolic ligament
78
The S-shaped part of the large intestine
Sigmoid colon
79
Which parts of the large intestine has a mesentery?
Transverse and sigmoid colon
80
The mesentery of the sigmoid colon
Sigmoid mesocolon
81
The mesentery of the transverse colon
Transverse mesocolon
82
In a radiograph of a person standing upright, the gas in the stomach will be in the:
A. Cardia
B. Fundus
C. Body
D. Ampulla
B
83
What is the anatomical demarcation that separates the stomach from the esophagus at the gastroesophageal junction?
A. Z-line
B. M-line
C. E-line
D. G-line
A
84
Which organ is in direct contact with the body of gallbladder?
A. visceral part of the liver
B. transverse colon
C. superior duodenum
D. AOTA
D
85
Serves as an important oncologic barrier to primary and lymphatic spread to extrarectal pelvic tissues
Mesorectum
86
Anchors the duodenojejunal junction posteriorly to the right crus of the diaphragm:
Ligament of Treitz
87
The parts of the greater omentum are the following except
A. Gastrocolic ligament
B. Gastrophrenic ligament
C. Hepatoduodenal ligament
D. Gastrosplenic ligament
C
88
Opening of common bile duct
A. 1st part
B. 2nd part
C. 3rd part
D. 4th part
B
89
Segment of the stomach – posterosuperior, found at the upper left quadrant
A. Antrum
B. Fundus
C. Body
D. Pylorus
B
90
The most fixed part of intestine
A. Duodenum
B. Ileum
C. Jejunum
D. NOTA
A
91
The __ segment that is attached to the posterior abdominal wall in the right inguinal area and not suspended in the posterior abdominal wall
A. Cecum
B. Duodenum
C. Jejunum
D. Ileum
D/A
92
“Jackson’s veil”; obstruction in the:
```
A. Ascending colon
B. Descending colon
C. Transverse colon
D. Sigmoid colon
E. Rectum
```
A
93
During colonoscopy of a patient, a consultant gastroenterologist asks what you see on the monitor. Based from the triangular mucosal folds you see on the screen, in which segment of the colon is the endoscope
currently located?
A. descending colon
B. transverse colon
C. sigmoid colon
D. ascending colon
B
94
What part of the colon is most prone to twisting itself?
```
A. transverse
B. descending
C. sigmoid
D. Rectum
E. Rectosigmoid
```
C
95
Patient was clinically diagnosed to have appendicitis. What is the best way to locate the appendix?
```
A. McBurney’s Point
B. The point where the 3 tenia coli meet
C. Midpoint of the imaginary line from the ASIS to the navel
D. below the transverse colon
E. point of maximum tenderness
```
A/E
96
While attempting full mobilization of rectum during rectal cancer surgical procedure, urine is seen leaking in pelvic cavity, what fascial sheath is lysed/cut that may have resulted in the leakage?
A. Waldeyer’s fascia
B. Dennonvilier’s fascia
C. Rectovesical fascia
D. Lateral stalk
B
97
Gallstones ulcerate posterior wall of gallbladder into:
a. Ileum
b. Colon
c. AOTA
d. NOTA
B
98
Mediolateral episiostomy takes a longer time to heal due to injury to the following muscles except:
A. levator ani
B. superficial transverse perineum
C. bulbocavernosus
D. external anal sphincter
D
99
The second portion of the duodenum may very occasionally be compressed by the superior mesenteric
vessels passing over it and by the drag in the mesentery over it. T/F
F
It should be third portion of the duodenum. Compression of the third portion of the duodenum by the abdominal aorta (AA) and the overlying superior mesenteric artery can cause SMA Syndrome.
100
A stone impacted at the ampulla of vater must be approached via an incision in the 4th duodenum. T/F
F
The Ampulla of Vater is the opening of the common bile and pancreatic ducts which is located at the SECOND part of the duodenum
101
Hemorrhage during cholecystectomy (removal of the gallbladder) may be controlled by compressing the hepatic artery by the finger and thumb where it lies in the
anterior part of the Foramen of Winslow. T/F
T
The anterior border of the Foramen of Winslow includes the common bile duct and hepatic vessels. This is the free border unbounded by peritoneum.
102
The duct of Santorini drains the anterosuperior part of the head of the pancreas including the uncinate process. T/F
T
The duct of Santorini is the accessory pancreatic duct that drains the head and uncinate processes of the pancreas which are located already close to the second
part of the duodenum. The duct of Wirsung traverses the whole pancreas and drains the body and tail.
103
The gastric cushion of air distends the left dome of the diaphragm just as the right dome is cushioned by the convexity of the liver. T/F
T
The fundus of the stomach, which is the most superior part, is the common site of gastric air which pushes the left dome upward. This is close to the exitpoint of the esophagus at the T10 level.
104
A gallstone impacted in the supraduodenal part of the duct may be extracted by opening the duct directly in the greater omentum.
*
105
In a plain radiograph, the ff describe the small intestine except:
a. central
b. peripheral
c. valves of Kerkring at the lumen
d. NOTA
B
106
The following are examined in a plain radiograph of the abdomen, except:
a. Gas pattern
b. Extraluminar air
c. Soft tissue masses
d. Calcifications
e. None
C
107
The fixed terminal part of the large intestine
Rectum
108
At what level does the esophagus pierces the diaphragm
A. T8
B. T10
C. T12
D. L1
B
109
Which normally does NOT have gas in its lumen?
A. Stomach
B. Rectum
C. Sigmoid
D. Gall bladder
D
110
Which of the following is the enzyme responsible for secretion of HCL by the parietal cell?
a. Na-K-ATPase
b. H-K-ATPase
c. Carbonic anhydrase
d. Adenylate cyclase
B
111
Which of the following is true of fructose absorption in the apical membrane
a. It is inhabited by the absorption of glucose of galactose
b. It is facilitated by SGLT1
c. It is independent of sodium concentration
d. It requires a passive diffusion transport mechanism
C
112
Transport of galactose in the apical membrane
is an example of:
a. Primary active transport
b. Secondary active transport
c. Facilitated transport
d. Passive diffusion
B
113
A patient sustained a stab wound in the right subcostal area. On exploration, the kidney was lacerated at its anteromedial surface. The following are possible expected associated injuries. Which is unlikely?
A. perforation of the hepatic flexure of the colon
B. perforation of the third part of the duodenum
C. laceration of the inferior surface of the liver
D. transection of the renal pelvis
B
114
