GI

Question 1

Where is the appendix attached & what does it contain?

Answer 1

Attached to posteromedial caecum & mesoappendix suspends it from terminal ileum. Contains lymphoid tissue.

Question 2

Where is the free end of the appendix most commonly located?

Answer 2

In retrocaecal position (behind the caecum).

Question 3

Name the 7 positions the free end of the appendix can be located in.

Answer 3

Pre-ileal, post-ileal, sub-ileal. Pelvic. Subcaecal, paracaecal, retrocaecal.

Question 4

What is McBurney’s point and where is it?

Answer 4

1/3 distance from right anterior superior iliac spine to umbilicus. It is where the retrocaecal head of appendix is and most common site of tenderness in appendicitis.

Question 5

Describe the arterial supply of the appendix.

Answer 5

Appendicular artery (from ileocolic branch of superior mesenteric artery) in the mesoappendix.

Question 6

Describe the nerve supply to the appendix.

Answer 6

Ileocolic branch of superior mesenteric plexus supplies autonomous sympathetic & parasympathetic, & runs with ileocolic artery.

Question 7

Describe the lymphatic drainage of the appendix.

Answer 7

Lymph nodes in the mesoappendix; ileocolic lymph nodes surrounding the ileocolic artery.

Question 8

In what regions of the abdomen are initial & later pain from appendicitis?

Answer 8

Starts in the umbilical region then moves to the right lower quadrant.

Question 9

Which embryological structure is the appendix formed from & what relevance does this have?

Answer 9

Midgut- this is why it is supplied by superior mesenteric branches.

Question 10

Describe the venous drainage of the appendix.

Answer 10

Appendicular vein, in the mesoappendix.

Question 11

What is the type and function of saliva secreted by the parotid gland?

Answer 11

Serous saliva (watery enzyme-rich solution)
Lubricates & aids food breakdown

Question 12

Describe the 4 boundaries of the parotid gland.

Answer 12

superior: zygomatic arch
inferior: inferior border of mandible
anterior: masseter muscle
posterior: external ear & sternocleidomastoid

Question 13

Describe the structure of the parotid gland

Answer 13

bilateral, lobular & irregular

Question 14

Describe the path of the Stensen duct, which drains the parotid gland.

Answer 14

anterior surface of parotid -> masseter muscle -> buccinator -> 2nd upper molar

Question 15

Describe the nerve which passes through the parotid gland.

Answer 15

Facial nerve- splits into 5 branches here for facial expression. It splits the parotid into deep and superficial lobes.

Question 16

Describe the vasculature of the sublingual glands.

Answer 16

Arterial: sublingual & submental, from lingual & facial, from ECA
Venous: sublingual & submental, to lingual & facial, to internal jugular

Question 17

Describe the ducts associated with the sublingual glands.

Answer 17

Minor: Rivinus, 8-20 on each side, open onto sublingual folds
Major: Bartholin, large accessory duct only in some people. inferior sublingual-> medial submandibular duct which drains into sublingual papillae

Question 18

Describe the joining of the sublingual glands.

Answer 18

They join anteriorly at the lingual frenulum. Superior to the join is the sublingual fold, a mucous membrane from posterolateral glands to sublingual papillae either side of lingual frenulum.

Question 19

Describe the anatomical position of the sublingual glands.

Answer 19

Almond shapes under tongue forming the sublingual fossa (a shallow groove on the medial mandible)
Lateral border: mandible
Medial border: genioglossus tongue muscle
Submandibular duct & lingual nerve run medially.

Question 20

Describe the function of the sublingual glands.

Answer 20

Provide 3-5% of salivary volume.

Mixed, mostly mucous secretions for lubrication, moisture & initial digestion.

Question 21

Describe the function of the submandibular glands.

Answer 21

Mixed serous & mucous secretion for lubrication during mastication, swallowing & digestion.

Question 22

Describe the position of the submandibular glands.

Answer 22

In the anterior submandibular triangle, hooks round myohyloid muscle.
superior border: inferior mandible body
anterior border: anterior digastric muscle belly
posterior border: posterior digastric muscle belly

Question 23

Describe the structure of the submandibular glands.

Answer 23

pair of long flattened hooks with superficial & deep arms

superficial: bigger, outside oral cavity, partly in submandibular fossa inferior to posterior mandible
deep: hooks round posterior mylohyoid through triangular aperture & enters oral cavity. on lateral surface of hypoglossus (lateral to tongue)

Question 24

Describe the submandibular duct of the submandibular gland.

Answer 24

Wharton’s duct is 5cm long. starts from deep gland between mylohyoid, hypoglossus & genioglossus muscles. moves anteromedially & ascends. opens bilaterally as 1-3 orifices on a sublingual papilla.

Question 25

Describe the vasculature and nearby nerves of the submandibular gland.

Answer 25

Arteries: submental (from facial) & sublingual (from lingual)
Veins: facial->internal jugular & sublingual->lingual->internal jugular.
Nearby nerves: lingual, hypoglossal, branch of facial.