GI Anatomy 3

Question 1

On which side of the liver is the caudate lobe of the liver and what is it bounded by?

Answer 1

1) Visible on the posterior visceral surface of the liver
2) Bounded on the left by fissure for the ligamentum venosum (remnant of sinus venosus)
3) Bounded of the right by the groove for the vena cava

Question 2

On which side of the liver is the quadrate lobe visible and what is it bounded by?

Answer 2

1) Visible on the anterior part of the visceral surface of the liver
2) Bounded on the left by fissure for the ligamentum teres
3) Bounded on the right by the fossa for the gall bladdr

Question 3

What are the segments of the biliary tree?

Answer 3

1) Bile canaliculi
2) Eventually drain into left and right hepatic ducts
3) Join (usually at the porta hepatis) to form the common hepatic duct
4) Joined by cystic duct to form the common bile duct

Question 4

What is the relative positions of the components of the portal triad?

Answer 4

Portal vein closest to IVC

Bile duct and hepatic artery proper anterior

Question 5

Where does the common bile duct run after it leaves the free edge of the lesser omentum?

Answer 5

1) Posterior to the first part of the duodenum
2) Then enfolded by the head of the pancreas
3) Unites with the pancreatic duct to form the hepatopancreatic ampulla

Question 6

What is the blood supply to the gall bladder?

Answer 6

Cystic artery from the right hepatic artery (a branch of the hepatic artery proper)

Question 7

What are the 3 parts of the gall bladder?

Answer 7

1) Fundus
2) Body
3) Neck

Question 8

What are the peritoneal attachments of the duodenum?

Answer 8

First 2.5 cm is intraperitoneal

The rest is retro peritoneal

Question 9

What are the 4 parts of the duodenum and where do they run from?

Answer 9

1) First part: Pyloric orifice of stomach to the right of the neck of the gall bladder (the right of the body of L1 vertebra)
2) Second part: Descending part: Neck of gall bladder to the lower border of L3
3) Third part: Inferior part: crosses IVC, aorta and vertebral column
4) Fourth part: Ascending part: Passes to the upper border of L2

Question 10

Where does the first part of the duodenum pass relative to the bile duct, gastroduodenal artery, portal vein and IVC?

Answer 10

Anterior

Question 11

Where does the inferior part of the duodenum pass relative to the superior mesenteric artery and vein?

Answer 11

Posterior

Question 12

What is the blood supply to the duodenum?

Answer 12

1) Branches from the gastroduodenal artery (from celiac trunk)
2) Branches from the inferior pancreaticoduodenal artery (from superior mesenteric artery)
3) The first jejunal branch (from the superior mesenteric artery)

Question 13

What is the peritoneal attachments of the pancreas?

Answer 13

Retroperitoneal

Question 14

What are the parts of the pancreas?

Answer 14

1) Head
2) Neck
3) Body
4) Tail

Question 15

Where does the uncinate process of the pancreas lie in relation to the superior mesenteric vein and artery?

Answer 15

Posterior to the vessels

Question 16

The major duodenal papilla marks the boundary between which 2 portions of the GIT?

Answer 16

Foregut and midgut

Question 17

What is the blood supply to the pancreas?

Answer 17

1) Pancreaticoduodenal arteries (from the gastroduodenal artery)
2) Pancreatic arteries (from the splenic artery)
3) Inferior pancreaticoduodenal artery (from the superior mesenteric)

Question 18

Where does the stomach lie in relation to the pancreas?

Answer 18

Anteriorly and superiorly

Question 19

What effects might you expect from carcinoma of the head of the pancreas and why?

Answer 19

1) Weight loss and malnourishment (few enzymes)
2) Jaundice (blockage of bile duct)
3) Vomiting (Blockage of GI tract)
4) Dark urine and pale stools (excess bilirubin in the urine and none can leave via the bile duct)
5) Diabetes (possible disruption of endocrine function)

Question 20

Why is carcinoma of the pancreatic head often inoperable?

Answer 20

Because the cancer encases the arterial vessels and arterial reconstruction is not a feasible option

Question 21

In which region of the abdomen does the spleen lie?

Answer 21

In the left hypochondrium

Question 22

To which ribs is the spleen related?

Answer 22

Lies against diaphragm in the area of rib 9 to 10

Question 23

What vertebral level does the spleen lie at?

Answer 23

L1 ie. in the transpyloric plane

Question 24

How many branches does the splenic artery divide into before it enters the spleen?

Answer 24

4 or 5

Question 25

Which branches from the splenic artery supply the stomach?

Answer 25

Short gastric arteries

Question 26

In what is the tail of the pancreas embedded?

Answer 26

The hilum of the spleen

Question 27

The blood vessels and the tail of the pancreas run towards the spleen in what?>

Answer 27

The linorenal ligament

Question 28

At what vertebral level does the aorta pass behind the diaphragm?

Answer 28

T12

Question 29

At what vertebral level does the IVC pass into abdomen?

Answer 29

T8

Question 30

At what vertebral level does the aorta bifurcate?

Answer 30

L4

Question 31

What is the course of the right and left renal veins?

Answer 31

Right renal vein passes straight into hilum of the kidney | Left renal vein passes over the abdominal aorta and into hilum of kidney

Question 32

What are the positions of the abdominal aorta and the IVC relative to eachother?

Answer 32

The abdominal aorta lies to the left of the IVC

Question 33

What are the relative positions of the renal vein, artery and renal pelvis at the hilum of the kidney?

Answer 33

Renal vein is most anterior Renal artery is posterior to the renal vein Renal pelvis is most posterior

Question 34

What does the renal pelvis do and give rise to?

Answer 34

Collects all the urine produced by the kidneys and gives rise to the ureter

Question 35

What are renal columns?

Answer 35

Bands of cortex which pass into the medulla

Question 36

What are renal pyramids?

Answer 36

Sections of medulla which lie inbetween the renal columns of the cortex

Question 37

How many minor calices give rise to major calices?

Answer 37

2/3/4 minor calices would give rise to one major calyx

Question 38

How many major calices do we have that give rise to the renal pelvis?

Answer 38

2/3

Question 39

On what surfaces of the kidneys do the suprarenal glands sit?

Answer 39

On the supramedial surfaces

Question 40

What is perinephric fats?

Answer 40

Sits around the fibrous capsule of the kidney

Question 41

From what does the psoas muscle originate and what does it pass towards?

Answer 41

Originates from the lateral surfaces of the lumbar vertebrae | Runs towards the lower limb

Question 42

Which muscle sits within the iliac fossa?

Answer 42

The iliacus

Question 43

The iliacus muscle and psoas muscle unite to form what? Where does this pass and what is its role?

Answer 43

Iliacus muscle joins with the psoas muscle to form the iliopsoas muscle, the joint tendon from these 2 muscles passes to the femur, this muscle is an important flexur of the thigh

Question 44

What is the quadratus lumborum muscle and where does it originate from and pass to?

Answer 44

Quadrangular shaped muscle on the posterior abdominal wall, superior to the iliacus muscle Originates from the 12th rib and passes inferiorly towards the iliac crest

Question 45

What are the 3 nerves which run on the posterior abdominal wall on which the kidney sits? What are there relative positions, what kind of nerves are they and what do they supply?

Answer 45

1) Most superiorly = Subcostal nerve (T12) 2) Inferior to that = Ileohypogastric nerve (L1) 3) Inferior to that = ileoinguinal nerve (L1) Both the ileohypogastric and ileoinguinal branch from L1 All 3 are somatic nerves and supply the body wall, motor to the muscles of anterior lateral aspects of body wall and sensory from the skin

Question 46

At what point does the ureter pass into the pelvis?

Answer 46

At the bifurcation of the common iliacs into internal and external iliacs

Question 47

What muscle does the ureter pass along as it courses from the renal pelvis to the pelvis?

Answer 47

The psoas muscle

Question 48

What 3 paired bones make up the pelvic bone and where do they join?

Answer 48

1) Ilium 2) Pubis 3) Ischium Join at the acetabulum Also have the sacrum bone

Question 49

As the falciform ligament runs towards the liver, what lies on the posterior surface of the liver and what is it a remnant of?

Answer 49

The ligamentum venosum Remnants of the ductus venosus in the embryo which was to bypass the liver in the embryo as blood had already been detoxified by the mother

Question 50

What are the 'peritoneal attachments' of the inferior mesenteric artery?

Answer 50

Runs retroperitoneally

Question 51

What arteries branch off the inferior mesenteric?

Answer 51

1) Left colic (runs up towards splenic flexure) 2) Sigmoidal 3) Superior rectal

Question 52

What are the relative positions of the inferior mesenteric vein and artery?

Answer 52

The inferior mesenteric vein lies to the left of the inferior mesenteric artery

Question 53

What parts of the GIT does the inferior mesenteric vein receive blood from?

Answer 53

1) Rectum 2) Sigmoid colon 3) Splenic flexure

Question 54

What does the inferior mesenteric vein drain into?

Answer 54

The splenic vein

Question 55

Where do the hepatic duct and the cystic duct unit to form the common bile duct?

Answer 55

Some way along the free edge of the lesser omentum

Question 56

The greater omentum runs from where to where?

Answer 56

The greater curvature of the stomach to the transverse colon

Question 57

At what vertebral level does the oesophagus enter the abdomen?

Answer 57

T10

Question 58

What are the 5 parts of the stomach?

Answer 58

1) Cardia - opening of oesophagus into stomach = cardiac orifice 2) Fundus 3) Body 4) Antrum (or pyloric antrum) 5) Pylorus

Question 59

The left and right gastric arteries come off where?

Answer 59

Left gastric - direct branch of celiac trunk | Right gastric - off the common hepatic artery

Question 60

The left and right gastro-omental arteries come off where?

Answer 60

Left gastro-omental - off the splenic artery | Right gastro-omental - off the gastroduodenal artery (off common hepatic artery)

Question 61

What are the relative positions of the superior mesenteric artery and vein?

Answer 61

``` Left = superior mesenteric artery Right = superior mesenteric vein ```

Question 62

What are the 2 features of the blood vessels running towards the jejunum and ilium?

Answer 62

1) Arterial arcades | 2) Vasa vecta - straight arteries that run from the arterial arcades to the SI

Question 63

Where do veins from the jejunum and ileum run?

Answer 63

Parallel to arteries and return digested food to superior mesenteric vein which ultimately unites with the splenic vein to form the portal vein

Question 64

What 3 vessels come off the superior mesenteric to supply the colon?

Answer 64

1) Middle colic - runs up and through the transverse mesocolon to supply the transverse colon 2) Right colic - Runs across abdomen and heads to ascending colon and hepatic flexure 3) Ileocolic - gives off branches to the distal ileum and the cecum, the appendix also receives a branch from the ileocolic artery

Question 65

What does the conjoint tendon insert into?

Answer 65

The pelvic bone

Question 66

What is the peritoneal cavity?

Answer 66

Space between the parietal and visceral peritoneum

Question 67

What are the ovaries covered in?

Answer 67

Peritoneum

Question 68

The liver develops within what structure?

Answer 68

The ventral mesentery

Question 69

what is the gastrocolic ligament made up of?

Answer 69

The greater omentum and the transverse mesocolon

Question 70

Where does the external oblique muscle extend from and what does it attach to?

Answer 70

The lower 8 ribs | Attaches to the iliac crest and forms the inguinal ligament which runs from the ASIS to the pubic tubercle

Question 71

Where does the internal oblique extend from superiorly, posteriorly and inferiorly?

Answer 71

Superiorly, costal margin Posteriorly the thoracolumbar fascia Inferiorly the iliac crest and lateral 2/3 of the inguinal ligament

Question 72

Where does the tranverse abdominis extend from superiorly, posteriorly and inferiorly?

Answer 72

Superiorly - the costal margin Posteriorly - the thoracolumbar fascia Inferiorly - Iliac crest and the lateral 1/3 of the inguinal ligament

Question 73

What nerves supply the muscles of the anterior abdominal wall?

Answer 73

Anterior rami of the intercostal nerves - T7-T12 | Also have contributions from the iliohypogastric and ilioinguinal nerves (L1) which run posterior to the kidney

Question 74

Why, when the spleen enlarges, does it not travel inferiorly but travels anteriorly and diagonally?

Answer 74

Because the phrenicocolic ligament prevents it from enlarging inferiorly

Question 75

What are the peritoneal arrangements of the ascending and descending colon?

Answer 75

Secondarily retroperitoneal