GI - Class 2

Question 1

What are the two parts of the peritoneum?

Answer 1

visceral and parietal layer

Question 2

Define peritoneal cavity

Answer 2

Potential space between the parietal and visceral peritoneum that contains serous fluid

Question 3

Through which passage does the two sacs communicate?

Answer 3

epiploic foramen located behind the stomach

Question 4

Give examples of retroperitoneal organs

Answer 4

kidney, rectum, oesophagus, ascending and descending colon

Question 5

Give examples of intraperitoneal organs

Answer 5

stomach, liver, spleen, jejunum

Question 6

Define intraperitoneal organs

Answer 6

Organs completely surrounded by visceral peritoneum

Question 7

Define retroperitoneal organs

Answer 7

Organs covered on their anterior surface and therefore firmly attached to the posterior wall

Question 8

Define extraperitoneal organs

Answer 8

Structures in the abdomen-pelvic cavity which are not covered in peritoneum.

Question 9

Which layer of the peritoneum is more sensitive to heat, pain and pressure?

Answer 9

parietal layer

Question 10

What are the attachments of the greater omentum?

Answer 10

greater curvature of the stomach to the transverse colon

Question 11

What are the attachments of the lesser omentum?

Answer 11

lesser curvature of the stomach to the liver

Question 12

What is the innervation of the parietal peritoneum

Answer 12

Pain from the parietal peritoneum lining the abdominal wall is innervate by the lower 6 thoracic nerves and L1. Thus pain here is somatic and can be precisely localized . Rebound tenderness occurs.

Question 13

What is the innervation of the visceral peritoneum?

Answer 13

The visceral peritoneum is innervated by autonomic nerves. Pain is often referred, and is dull and poorly localized

Question 14

Where is pain referred to?

Answer 14

because the GI tract is a midline structure receiving bilateral nerve supply, pain is referred to the midline.

Question 15

What are the wall muscles of the posterior abdominal wall?

Answer 15

psoas major, iliac, quadrates lumborum

Question 16

What vertebral level is the opening for the IVC in the diaphragm

Answer 16

T8

Question 17

What vertebral level is the opening for the oesophagus in the diaphragm

Answer 17

T10

Question 18

What vertebral level is the opening for the aorta in the diaphragm

Answer 18

T12

Question 19

What are the 3 main branches of the abdominal aorta that supply the gut and what vertebral level do they occur?

Answer 19

celiac trunk (T12), superior mesenteric artery (L1) and inferior mesenteric artery (L3)

Question 20

What forms the IVC in the abdomen

Answer 20

hepatic portal vein

Question 21

At what vertebral level does the aorta bifurcate?

Answer 21

L4

Question 22

What artery supplies the foregut?

Answer 22

Celiac trunk

Question 23

What artery supplies the midgut?

Answer 23

SMA

Question 24

What artery supplies the hindgut?

Answer 24

IMA

Question 25

What two veins from the portal vein?

Answer 25

splenic vein and the superior mesenteric vein

Question 26

List 4 sites of portocaval anastomoses

Answer 26

In the distal oesophagus, retroperitoneal, rectal and paraumbilical

Question 27

What is the clinical significance of these portocaval anastomose

Answer 27

portal hypertension causes dilation of these anastomotic veins

Question 28

What is the sympathetic nerve supply to the abdominal viscera?

Answer 28

- Abdominopelvic splanchnic nerves (greater, lesser and least) - prevertebral sympathetic ganglion - abdominal aortic plexuses

Question 29

What is the parasympathetic nerve supply to the abdominal viscera?

Answer 29

- anterior and posterior vagal trunks (vagus nerve - 10th cranial nerve) - pelvic splanchnic nerves (S2, S3, S4)

Question 30

What is the effect of sympathetic innervation on GI activity?

Answer 30

Increased GI secretion, increased peristalsis and GI motility and vasodilation of blood vessels

Question 31

What is the effect of parasympathetic innervation on GI activity?

Answer 31

decreased GI secretion, decreased peristalsis and GI motility and vasoconstriction of blood vessels

Question 32

What is the effect of a vagotomy on gastric secretion?

Answer 32

decreased gastric secretion

Question 33

What is the difference between the greater, lesser and least splanchnic nerves and the pelvic splanchnic nerve

Answer 33

Greater, lesser and least splanchnic nerves have sympathetic innervation. Pelvic splanchnic nerve has parasympathetic innervation.

Question 34

What are splanchnic nerves?

Answer 34

Paired visceral nerves carrying fibers of the autonomic nervous system (visceral efferent fibers) as well as sensory fibers from the organs (visceral afferent fibers).

Question 35

What is the chief difference in the arrangement of ganglia in the sympathetic and parasympathetic nervous system?

Answer 35

sympathetic preganglionic fibers tend to be shorter than parasympathetic fibers and sympathetic fibers tend to form more synapses than parasympathetic fibers.

Question 36

The right kidney lies slightly at a lower level than the left kidney. What is the reason for this?

Answer 36

liver lies above the right kidney

Question 37

What is the anterior to posterior arrangement of the structures entering and leaving the hilum of the kidney?

Answer 37

Renal vein, renal artery, ureter

Question 38

How are the kidneys peritonised?

Answer 38

retroperitoneal

Question 39

What type of gland is the adrenal gland?

Answer 39

endocrine gland

Question 40

What is the anatomical location of the adrenal (suprarenal) glands?

Answer 40

superior to the kidney

Question 41

What is the difference between exocrine and endocrine glands.

Answer 41

endocrine glands secrete into the blood whereas exocrine glands secrete into ducts.

Question 42

What is the term used to describe the expanded upper part of the ureter

Answer 42

renal pelvis

Question 43

What 3 locations do the ureter constrict?

Answer 43

pelviureteric junction, pelvic brim, vesicoureteric junction

Question 44

How are the ureters peritonised?

Answer 44

retroperitoneal

Question 45

What is the function of the portal vein?

Answer 45

Transport venous blood from the spleen, pancreas, gall bladder and abdominal part of the GI tract

Question 46

How is the portal vein formed?

Answer 46

By the union of splenic vein with the superior mesenteric vein

Question 47

Where is the portal vein located?

Answer 47

Behind the neck of pancreas (L 2 vertebral level)

Question 48

What is the location of portocaval shunts

Answer 48

Anorectal junction, gastroesophageal junction and at the umbilicus

Question 49

During portal hypertension what occurs at the portocaval shunts

Answer 49

Anorectal junction - hemorrhoids Gastroesophageal junction - esophageal varices Umbilicus - caput medusa

Question 50

What is the parasympathetic innervation of the abdominal organs?

Answer 50

``` Vagus nerve (CN X) and pelvic splanchnic nerves (S2, S3, & S4) ```

Question 51

What is the sympathetic innervation of the abdominal organs?

Answer 51

abdominopelvic, splanchnic nerves (greater T5-T9, lesser T10-T11 and least T12) prevertebral sympathetic ganglia abdominal aortic plexus