Block 3 Flashcards

1
Q

Sumatripan

A

Serotonin agonist for vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Lingual nerve

A

Branch of mandibular nerve which provides sensory innervation to anterior 2/3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which structure lies close to the parotid gland?

A

Facial nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the blood supply to the salivary glands?

A

External carotid artery and retromandibular vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where does IVC exit?

A

T8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is normal gastirc ph?

A

2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is released with gastrin?

A

Pepsin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When is gastric inhibitory peptide released?

A

In response to fatty acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the effect of vasointestinal polypeptide?

A

Produced by small intestines and pancreas, Inhibits gastric acid secretion by stimulating somatostatin release.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Inguinal ligament origin

A

Arises from the external oblique aponeurosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which vessel lies behind the clavicle?

A

Subclavian vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Level of hyoid bone

A

C3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Angle of Louis

A

Manubriosternal angle which is important indicator for the aortic arch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What lies medial to the dorsalis pedis artery?

A

Extensor hallucis longus tendon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where does the inferior thyroid artery originate?

A

Thyrocervical trunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Location of chemoreceptor trigger zone

A

Medulla in the floor of 4th ventricle outside the blood brain barrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where does aorta bifurcation occur into left and right common iliac arteries?

A

L4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Glossopharyngeal nerve

A

Sensation to posterior 1/3 of tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Carotid sheath components

A

Common carotid artery, Internal carotid artery, Internal jugular vein, Vagus nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Carotid sheath

A

Lies between sternocleoidomastoid and vertebrae. Anteriorly- pretracheal fasica, ansa cervicalis, vagus and hypoglossal nerves. Posteriorly formed-prevertebral fascia.Internal jugular vein, common carotid artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Vocal folds

A

Innervated by recurrent laryngeal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Innervation of stylohyoid

A

Facial nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the blood brain barrier not hghly permeable to?

A

Hydrogen ions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which cahnnels are open during depolarisation?

A

Voltage gated na+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which channles are open in repolarisation?

A

Voltage gated K+ channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which channels are open in hyperpolarisation?

A

Voltage gated Na+ channels that will close

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the effect of cholecystokinin?

A

Increases gall bladder contraction and relaxation of sphincter of Oddi espeically after eating fatty food that can cause vomiting. It is produced by pancreatic and small intestine I cells and can cause pain in right abdominal region. It reduces gastric emptying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the effect of cholecystokinin?

A

Increases gall bladder contraction and relaxation of sphincter of Oddi espeically after eating fatty food that can cause vomiting. It is produced by pancreatic and small intestine I cells and can cause pain in right abdominal region. It reduces gastric emptying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

S cells

A

Found in the duodenum and jejunum and roduce secretin to increase bicarbonate, water and electroyltes in pancreatic secretionspancreatic fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Effect of somatostatin

A

Inhibits histamine for gastric acid secretion, glucagon and insulin release, glucose in blood, lipolysis and bicarbonate. It inhibits gall bladder emptying and growth hromones. It decreases volume of secretion and inhibits release of TSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Where is secretin released?

A

S cells in duodenum and jejunum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What forms the external spermatic fascia?

A

External oblique aponeurosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the effect of prostaglandin?

A

Decrease gastric acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Pain in right upper oquadrant and intolerance to fatty foods

A

Gallstone. cholestasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What reduces iron absorption?

A

Wholegrains, tea, coffee and wine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What increases iron absorption?

A

Gastric acid secretion, vitamin C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What increases pancreatic enzyme secretion?

A

Cholecystokinin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What increases secretion of water and electroyltes in pancreatic secretions?

A

Secretin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Gastrin

A

Prodcued by G cells in stomach antrum. Binds to parietal cells CCK2 receptors to free Ca2+ storesCauses increase in acid secretion, gastric motility, pepsinogen and parietal cell maturation. M3 receptors on parietal cells are stimualted by acetylcholine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Which hormone is an indicator for pancreatic insufficiency?

A

Secretin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Which cells are in fundus?

A

Parietal cells and chief cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What inhibits gastirc acid secretion?

A

Nausea and stympathetic innervation, somatostaitn, cholecystokinin and secretin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What increases gastric acid secretion?

A

Vagus nerve, histamine release.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What causes Na+.K+ exchange in salivary ducts?

A

Aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Where are bile salts absorbed?

A

Terminal ileum which is malabsorbed in Crohn’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the innervation to the parotid gland?

A

Glossopharyngeal nerve

46
Q

What controls endocrine cells of the pancreas?

A

Pancreatic polypeptide

47
Q

What contracts behind food in oesophagus?

A

Circular smooth muscle

48
Q

What propels food in the oesophagus?

A

Longitudinal smooth muscle

49
Q

Where does anti-peristaltic waves occur?

A

In colon to maximise absoprtion

50
Q

What is used to reduce diarrhoea?

A

Issues with pancretic exocrine function

51
Q

What do chief cells produce?

A

Lipase and pepsinogen

52
Q

What stimulates bile flow from liver to gallbladder?

A

Secretin

53
Q

How are hydrogen ions produced by parietal cells?

A

Carbonic anhydrase

54
Q

What is released in the cephalic phase?

A

HCL and gastrin from G cells

55
Q

Which phase is acid secretion lowest?

A

intestinal phase

56
Q

What is the effect of excess gastrin?

A

Malabsorption that leads to diarrhoea, weight loss

57
Q

Umbilical vein progenitor

A

Ligamentum teres

58
Q

Ductus venosus progenitor

A

Ligamentum venosus

59
Q

Divison between foregut and midgut

A

Proximal duodenum

60
Q

Foregut

A

Supplied by coeliac trunk, includes the oesophagus, liver, spleen, stomach proximal duodenum

61
Q

Divison between midgut and hindgut

A

Splenic flexure- hindgut begins with the descending colon

62
Q

Midgut

A

Supplied by superior mesenteric artery and begins with distal duodenum, jejunum, ileum, caecum, appendix, ascending colon, transverse colon

63
Q

Hindgut

A

Supplied by inferior mesenteric artery and begins with descending colon, sigmoid colon, rectum, and superior anal canal

64
Q

Where is vitamin K absorbed?

A

Colon

65
Q

Hstology of oesophagus

A

Stratified squamous epithelia

66
Q

Histology of oesophageo-gastric junction

A

Simple columnar epithelia

67
Q

Histology of upper oesophagus

A

Skeletal muscle- cricopharyngeal and inferior constrictor muscle

68
Q

Histology of lower oesophagus

A

Smooth muscle- reinforced by right diaphragmatic crus

69
Q

Chemoreceptor trigger zone

A

Area in fourth ventricle which induces vomiting. Doapmine, serotonin, acetylcholine, opioids and substance P are involved.

70
Q

What are the blood supplies to the liver?

A

Hepatic artery and hepatic portal vein

71
Q

Where does the hepatic artery receive blood?

A

Oxygenated, so it receives blood from general criculation such as pulmonary artery and coeliac trunk.

72
Q

What is the majority of liver blood supply?

A

Hepatic portal vein

73
Q

What does the portal vein transmit?

A

Nutrient rich blood which is poor in oxygen from the organs

74
Q

Where does the heaptic vein drain?

A

Into the IVC

75
Q

Functional unit of liver?

A

Lobule

76
Q

Where do the contents of the liver drain?

A

Into the hepatic vein or lymphatic system via the sinusoids.

77
Q

What are the features of the sinusoids?

A

Hexagonal endothelial channels which receive mixed blood from hepatic artery and portal vein to drain into the hepatic vein. They contain pores to allow nutrients to pass. The lumen of the endothelium contains Kuppfer cells. The lobules have connective tissues.

78
Q

Perivenous end

A

Lower oxygen conc closest to the central vein. Site of glycolysis, glycogenesis, lipgenesis, ketogenesis and glutamine and bile acid biosynthesis. Drug metabolism phase 1 and phase 2 (conjugation) occur here

79
Q

Periportal end

A

Higher oxygen conc for gluconeogenesis, cholesterol and urea biosynthesis

80
Q

Where does bile enter gall bladder?

A

Cystic duct, which receives bile from common bile duct

81
Q

Where does cholestasis occur?

A

Hartmann’s pouch, mucosal fold in neck ofgall bladder.

82
Q

Where does bile leave the gall bladder?

A

Common bile duct

83
Q

What forms the common bile duct?

A

Cystic duct and common hepatic duct

84
Q

What forms the common hepatic duct?

A

Left and right hepatic duct

85
Q

Where does bile enter the duodenum?

A

Major duodenal papilla. Papilla is at the end of the ampulla channel. Common bile duct combines with pancreatic duct and they are regulated by sphincter of Oddi.

86
Q

What substance flows in the opposite direction to blood in the liver?

A

Bile.

87
Q

What produces bile?

A

Hepatocytes

88
Q

Location of Kuppfer cells

A

Lumen of sinusoid enodthelium

89
Q

What is the space of Disse

A

Space between hepatocytes and endothelium/sinusoids

90
Q

What is portal hypertension?

A

When there is inflammation or scarring of the liver which increases blood pressure in the liver and may cause backflow.

90
Q

Where are the products or liver stores released into the blood?

A

From hepatocytes, it is released into the space of Disse.

91
Q

What is the alternative drainage to the hepatic vein in the sinusoids?

A

Lymphatic system.

92
Q

Location of caudate lobe?

A

Between IVC fissure and ligamentum venousum between left and right lobe

93
Q

What is ligamentum venosus?

A

Remnant of the ductus venousus and is attached to the portal vein

94
Q

Location of quadrate lobe

A

Below portal hepatis in the right lobe

95
Q

What is the histology of the gall bladder?

A

3 layers- mucosa, muscularis externa and serosa. There is no submucosa.

96
Q

What is mucosa of gall bladder?

A

Microvilli, simple columnar epithelia and lamina propia below but no goblet cells.

97
Q

What is the lamina propia?

A

Lies underneath epithelia and above the muscle layer, which provides blood suppyly to epithelia and allow it to change shape with smooth muscle contractions.

98
Q

What is muscularis externa of gall bladder?

A

Smooth muscle in random orientation and connective tissue.

99
Q

What is the serosa of the gall bladder?

A

Mesothelium connective tissue layer contianing BV, Lymphatic vessels and adipose tissue.

100
Q

Which part of the gall bladder is attached to the liver?

A

Adventitia- where it is not attached to the iver, it has the serosa layer instead.

101
Q

How are amino acids transported into epithelia of small intestine?

A

Carrier protein which co-trnasports amino acids and sodium ions. If it is a di or tripeptide, they will be hydrolysed by intracellular enzymes.

102
Q

Duct of Wirsung

A

Joins pancreas to common bile duct to release secretions

103
Q

Histology of large intestine?

A

Mucosa with columnar eptuhelia, goblet cells, lamina propia and no villi. It has a submucosa for BV and nerves. Muscularis propia and serosa

104
Q

What is the layers of the muscularis propia?

A

inner circular and outer longitudinal muscle which lie beneath lamina propia and form outermost mucosa layer. Separated from muscularis propia by submucosa.

105
Q

What is the layers of muscularis externa/propia?

A

Inner oblique muscle, middle ciruclar muscle and outer longitudinal muscle. In the large intestine, tthe outer longitudinal muscle forms the taeniae coli.

106
Q

Histology of oesophagus

A

Mucosa, muscularis mucosa, submucosa, muscarlis propia/externa and serosa

107
Q

What is the mucosa of the oesophagus?

A

Stratified squamous non keratinising eptihelia, lamina propia. It does not have goblet cells unless it is diseased called Barrett’s

108
Q

What level is the gastroesphagueal junction?

A

T11/T12

109
Q

Mechanism of acid secretion?

A

CO2 and H20 enter the parietal celland converted by carbonic anhydrase to HCO3- and H+. Acid is released as H+ via H+/K+ exchanger proton pump. Aklaline tide occurs to maintain pH for basolateral membrane where CL- is pumped in in exchange for HCO3- out which causes temporary pH increase.

110
Q

What pH must the stomach acid be to treat ulcers?

A

Above 3

111
Q
A