Clinical Anatomy of the GI Tract

Question 1

innervation to oesophagus

Answer 1

oesophageal plexus (made of vagus and sympathetics)

Question 2

what are the three oesophageal constrictions

Answer 2

1. level of cricoid cartilage, juncture with pharynx
2. where the aorta and left main bronchus cross
3. diaphragmatic sphincter

Question 3

what cell type makes up oesophagus mucosa

Answer 3

stratified squamous

Question 4

what is the outer layer of the oesophagus

Answer 4

adventitia

Question 5

how do you investigate dysphagia

Answer 5

barium swallow
endoscopy

Question 6

why is hoarseness a feature of oesophageal cancer

Answer 6

due to damage to the left recurrent laryngeal nerve which runs near the oeosphagus

Question 7

what vein carries blood from the lower oesophagus to the portal system

Answer 7

coronary vein

Question 8

how does liver cirrhosis cause varices

Answer 8

liver cirrhosis leads to portal hypertension
so blood is shunted backwards away from the liver
so the blood travels through gastric and oesophageal veins and causes varices as it tries to get back to the IVC

Question 9

what else can cause varies other than liver cirrhosis

Answer 9

blockage in vessels (E.g. blood clot_

Question 10

how are gastric varices treated

Answer 10

thrombin injections

too big to use bands

Question 11

where on the stomach do varices form

Answer 11

fundus

Question 12

what is the outermost layer of the stomach wall

Answer 12

serosa

Question 13

what cells secrete HCl and what else do they secrete

Answer 13

parietal cells
also secrete intrinsic factor

Question 14

function of intrinsic factor

Answer 14

absorption of B12

Question 15

what happens if you don’t produce intrinsic factor

Answer 15

become B12 deficient and develop pernicious anaemia

Question 16

what do chief cells secrete in the stomach

Answer 16

pepsinogen
rennin
lipases

Question 17

what do enteroendocrine cells secrete in the stomach

Answer 17

gastrin
cholecystokinin
secretin
serotonin
glucagon

Question 18

function of cholescystekinin

Answer 18

stimulates secretion of bile from the gallbladder into duodenum when food is eaten

Question 19

what is a common site of ulceration in the duodenum and what nearby structure does it often also include

Answer 19

posterior aspect of first part of duodenum
often includes gastroduodenal artery

Question 20

where might the gastric cancer invade and what needs to be considered if it has

Answer 20

coeliac axis
metastasis

Question 21

symptoms of head of pancreas cancer

Answer 21

back pain
painless jaundice
weight loss

Question 22

abdominal pain after eating food can be caused by

Answer 22

gut ischaemia due to narrowing of arteries