B15 Passmed Questions Flashcards
What are the intraperitoneal organs?
Stomach
1st part of duodenum, Jejunum, Ileum
Transverse colon
Sigmoid colon
Liver
Spleen
Tail of pancreas
Lined with Serosa.
What are the retroperitoneal organs?
2nd, 3rd, 4th part of duodenum
Ascending colon, Descending colon
Pancreas excluding tail
Oesophagus
Kidneys and ureter
Aorta, Inferior vena Cava
Lined with adventitia.
What is the role of VIP?
Vasoactive intestinal peptide is responsible for relaxation of smooth muscle of the intestine. In response to gastric acid by stimulating D cells for somatostatin release from the stomach and duodenum. Somatostatin causes reduced insulin and glucagon secretion, reduces pancreatic enzyme secretion and PROMOTES mucous production in the stomach.
What is Secretin?
Produced by S cells in the duodenum. It responds to gastric acid entry by stimulating bicarbonate production from the pancreas. It has a tropic effect on pancreatic acinar cells that produce digestive enzymes.
What is Zollinger-Ellison syndrome?
Gastrin secreting tumour in the pancreas which leads to trophy and hyperplasia of the parietal cells that causes gastric and peptic ulcers. This can present as heartburn and central chest pain, worse when lying down.
How to test for Zollinger-Ellison syndrome?
Secretin administration, in order to monitor gastric acid levels.
—> Secretin is responsible for the production of pancreatic bicarbonate secretions to reduce gastric acid levels.
What are the effects of CCK?
Produced from i cells in the duodenum for fat and protein digestion via to:
—> Increase pancreatic secretion of lipase, protease and bicarbonate
—> Relaxation of Sphincter of Oddi
—> Aid in fat digestion via contraction of gall bladder
—> Reduce gastric emptying
What are oxyntic cells?
Parietal cells of the stomach which produces HCL- and intrinsic factor.
Role of the submucosal nerve plexus?
Blood flow to mucosa and increased secretion and mucosal folds.
What is the blood supply to the head of the pancreas?
Pancreaticoduodenal artery, which arises from the gastroduodenal artery.
What is the epiploic foramen?
AKA foramen of Winslow which is located between the greater and lesser omentum of the stomach
What is a direct inguinal hernia?
Protrusion of the bowel through Hesselbach’s triangle due to a weakness in the floor of the inguinal canal. It passes through the transversalis fascia to the superficial inguinal ring, medial to the inferior epigastric artery.
What is an indirect inguinal hernia?
Protrusion of the bowel through the deep inguinal ring to the superficial inguinal ring, lateral to the inferior epigastric artery. It is the most common type of hernia which occurs due to a birth defect.
What does the inguinal canal contain?
Round ligament.
What are the boundaries of Hesselbach’s triangle?
The boundaries are
Medially: Rectus abdominal
Laterally: Inferior epigastric vessels
Inferiorly: Inguinal ligament
What are the boundaries of the inguinal canal?
What does the inguinal canal contain in males?
Spermatic cord and ilioinguinal nerve.
What does the inguinal canal contain in females?
Round ligament of uterus and ilioinguinal nerve.
What level does the inferior mesenteric artery arise?
L3 to supply the distal transverse colon to the rectum up to the pectinate line. It gives off the left colic artery at its origin in L3 and the sigmoid branches.
What does shortness of breath and frequent travel increase the risk of?
Pulmonary embolism, which can be treated with a filter in the IVC. IVC is located posteriorly to the peritoneum.
Where does the inferior epigastric artery originate?
External iliac artery.
What is the most likely site for a complete large bowel obstruction?
Caecum.
What are the contents of the femoral canal?
NAVEL from lateral to medial:
Nerve
Artery
Vein
Empty space
Lymphatics
What is the femoral sheath?
CCOntains the femoral artery, femoral vein and femoral lymphatics, located in the femoral triangle.