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Year 2 > GI HARC booklet > Flashcards

GI HARC booklet Flashcards

1
Q

What are some of the structures responsible for ingestion, chewing and swallowing as initial digestion of food

A

These structures include part of the mouth, the salivary glands, the pharynx and oesophagus.

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2
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3
Q

The foramen cecum is an embryological remnant – what does it mark the site of

A

The thyroglossal duct – formed during the embryological descent of the thyroid gland from the floor of the pharynx.

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4
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5
Q

Cysts under the tongue are likely a result of the blockage of which ducts?

A

Sublingual – opens into mouth by numerous small ducts

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6
Q

The parotid gland is divided into superficial and deep lobes by which structure? Are you able to identify this on the prosection/model?

In relation to Q3, how might the symptoms of a malignant tumour of the parotid gland present in the face?

A

Facial nerve

Unilateral facial paralysis

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7
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A
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8
Q

What is the function of temporomandibular?

A

The temporomandibular joints allow for opening and closing of the mouth and complex chewing or side-to-side movements of the lower jaw.

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9
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10
Q

• Temporalis • Masseter • Lateral pterygoid • Medial pterygoid • Digastric • Geniohyoid • Mylohyoid

Can you determine which are involved in the movements of depression, elevation, protrusion and retraction?

A

Temporalis - elevates the mandible (closing the mouth), retracts the mandible, pulling the jaw posteriorly;

Masseter - elevates the mandible (closing the mouth);

Lateral pterygoid - protract the mandible, pushing the jaw forwards;

Medial pterygoid - elevates the mandible (closing the mouth),

Digastric - depresses the mandible and elevates the hyoid bone

Geniohyoid depresses the mandible and elevates the hyoid bone;

Mylohyoid - elevates the floor of mouth;

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11
Q

• Temporalis • Masseter • Lateral pterygoid • Medial pterygoid • Digastric • Geniohyoid • Mylohyoid

What are the important nerves involved in innervation of these muscles?

A

Trigeminal – mandibular branch

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12
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13
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14
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15
Q

• Oral cavity • Oropharyngeal isthmus • Nasopharynx • Oropharynx • Laryngopharynx • Soft palate

Lies above the soft palate. On the lateral wall is the opening of the auditory tube

A

Nasopharynx

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16
Q

• Oral cavity • Oropharyngeal isthmus • Nasopharynx • Oropharynx • Laryngopharynx • Soft palate

Separated into two regions by the upper and lower dental arches: the outer area lies between the dental arches and the deep surfaces of the cheeks and lips; the inner area is enclosed by the dental arches.

A

Oral cavity

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17
Q

• Oral cavity • Oropharyngeal isthmus • Nasopharynx • Oropharynx • Laryngopharynx • Soft palate

A mobile fold attached to the posterior border of the hard palate. Its free posterior border presents in the midline a conical projection called the uvula.

A

Soft palate

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18
Q

• Oral cavity • Oropharyngeal isthmus • Nasopharynx • Oropharynx • Laryngopharynx • Soft palate

Its lateral wall is formed by the thyroid cartilage and the thyrohyoid membrane.

A

Laryngopharynx / hypopharynx

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19
Q

• Oral cavity • Oropharyngeal isthmus • Nasopharynx • Oropharynx • Laryngopharynx • Soft palate

The floor is formed by the posterior one third of the tongue and the interval between the tongue and the epiglottis

A

Oropharynx

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20
Q

• Oral cavity • Oropharyngeal isthmus • Nasopharynx • Oropharynx • Laryngopharynx • Soft palate

Marks the boundary between the mouth and the pharynx, located between the two palatoglossal arches

A

Oropharyngeal isthmus

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21
Q

At what vertebral level does the oesophagus pass through the diaphragm?

A

T10

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22
Q

The oesophageal tributaries of the azygous veins anastomose with the oesophageal tributaries of the left gastric vein. Where does this anastomosis occur? What might be the clinical presentation of liver cirrhosis with reference to the oesophagus?

A

Lower third of oesophagus: varicose oesophageal veins due to portal hypertension, which may rupture during the passage of food, causing hematemesis

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23
Q

• Stomach • Duodenum • Liver • Gall bladder • Oesophagus • Ileum • Jejunum • Caecum • Appendix • Ascending colon • Transverse colon • Descending colon • Pancreas • Spleen

Which of the structures above are variable in their position? Why is this?

A

Stomach, 1st part duodenum, ileum, jejunum, caecum and appendix, transverse colon. Intraperitoneal.

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24
Q

• Stomach • Duodenum • Liver • Gall bladder • Oesophagus • Ileum • Jejunum • Caecum • Appendix • Ascending colon • Transverse colon • Descending colon • Pancreas • Spleen

Which of the viscera are retroperitoneal?

A

Ascending and descending colon, pancreas (except tail), duodenum (except 1st part)

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25
Q

With reference to the foregut, midgut and hindgut derivatives, what are the 3 branches of the abdominal aorta that supply these parts of the GI tract. Identify these on the prosections. In which mesenteries do they travel?

A

Celiac - Left gastro-epiploic artery (which courses along the greater curvature between the layers of the greater omentum). The hepatic artery proper ascends in the free edge of the lesser omentum to the liver. The right gastro-epiploic artery courses between the layers of the greater omentum.

SMA - Enters the upper portion of the small bowel mesentery and runs along the root of the mesentery inferiorly to the right.

IMA - Becomes the superior rectal artery, which passes between the layers of the sigmoid mesocolon to reach the rectum.

26
Q
A
27
Q

What is it? What would be the clinical presentation of this condition?

A

Narrowing of the pyloric canal. Due to hypertrophy of the muscle surrounding the opening of the pylorus. Projectile vomiting, dehydration, failure to gain weight

28
Q

What is the difference between stenosis and atresia?

A

Stenosis is narrowing, atresia is more commonly an absence of a passage

29
Q

What surrounding structures might this affect?

A

Duodenum: wraps around it. May lead to constriction or even atresia. Failure to thrive after birth and vomiting

30
Q

what is alimentary canal?

A

he whole passage along which food passes through the body from mouth to anus during digestion

31
Q

What is the longetst part of teh alimentary canal?

A

small intestine

32
Q
A
33
Q

Where does the root of ‘The mesentery’ of the small intestine extend to and from? How does this relate to the length of the small intestine?

A

The root of the mesentery attaches to the posterior abdominal wall, and is approximately 9 inches (23cm) long. In comparison the coils of the small intestine are said to be 6-7m long, hence the ‘fan-shape’ of the mesentery itself. It attached from the duodenojejunal junction to the ileocecal junction

34
Q

What does the root of ‘The mesentery’ of the small intestine permit the passage of?

A

It permits the passage of the superior mesenteric vessels.

35
Q

TRUE OR FALSE

The duodenum is approximately 25cm in length

A

TRUE

36
Q

TRUE/FALSE

The bile duct and pancreatic ducts open into the first part of the duodenum

A

FALSE

37
Q

TRUE/FALSE

The duodenum is located in the epigastric and umbilical regions

A

TRUE

38
Q

TRUE/FALSE

The quadrate lobe of the liver lies anterior to the first part of the duodenum

A

TRUE

39
Q

TRUE/FALSE

The head of the pancreas lies lateral to the second part of the duodenum

A

FALSE

40
Q

TRUE/FALSE

The upper half of the duodenum is supplied by the superior pancreaticoduodenal artery, a branch of the gastroduodenal artery

A

TRUE

41
Q

Duodenal ulcers tend to occur either anteriorly or posteriorly. In relation to the blood supply to the duodenum, posterior duodenal ulcers may erode directly onto which arteries?

What might be the result of this?

A

A posterior ulcer might erode through the gastroduodenal artery, or more commonly onto the posterior superior pancreaticoduodenal artery,

Which can produce torrential haemorrhage. This may be fatal.

42
Q

. Occlusion of the superior mesenteric artery would result in death of a large part of the GI tract. Which parts?

What might be the cause of this occlusion?

A

From 2nd part of duodenum to 2/3rds way along the transverse colon.

May be caused by embolus, thrombus, aortic dissection or abdominal aneurysm.

43
Q
A
44
Q

Folds of peritoneum close to the cecum produce __ peritoneal recesses.

A

3

45
Q
A
46
Q

Folds of peritoneum close to the cecum produce 3 peritoneal recesses. What are they?

A

Superior ileocecal

Inferior ileocecal

Retrocecal

47
Q
A
48
Q

Another name fro omphalocoeles?

A

exomphalos

49
Q

What is omphalocoeles?

A

congenital abdominal wall defects at the base of the umbilical cord insertion, with herniation of gut (or occasionally other structures) out of the fetal abdomen.

50
Q

What is Gastroschisis

A

Gastroschisis refers to an extra-abdominal herniation (evisceration) of fetal or neonatal bowel loops (and occasionally portions of the stomach and or liver) into the amniotic cavity through a para-umbilical anterior abdominal wall defect.

51
Q

During a sigmoidoscopy, the sigmoidoscope is inserted into the anus and anal canal, and passed along the long axis of the canal.

At the point of the ampulla of the rectum, in which direction should the sigmoidoscope be guided in order to follow the sacral curve of the rectum?

A

Posterior

52
Q

During a sigmoidoscopy, the sigmoidoscope is inserted into the anus and anal canal, and passed along the long axis of the canal.

At the rectosigmoid junction, in which direction should the sigmoidoscope be guided?

A

Anterior and to the left

53
Q

During a sigmoidoscopy, the sigmoidoscope is inserted into the anus and anal canal, and passed along the long axis of the canal.

Where would the area of pain or discomfort experienced by the patient be?

A

Referred to the skin of the anterior abdominal wall, just below the umbilicus (T11).

54
Q
A
55
Q

The chief arterial supply to the rectum is the _____ _______ _____, a continuation of the _____ _____ ______

A

The chief arterial supply to the rectum is the superior rectal artery, a continuation of the inferior mesenteric artery

56
Q

In relation to this organisation of the rectal veins, consider internal v external haemorrhoids.

Which are caused by varicosities of the superior rectal vein?

A

Internal

57
Q

Anatomically, a haemorrhoid consists of which structures?

A

A fold of mucous membrane and submucosa containing a varicosed tributary of the superior rectal vein and a tributary of the superior rectal artery.

58
Q

Where is the pain from internal haemorrhoids felt?

A

Nowhere - because they occur in the upper half of the anal canal, where mucous membrane is innervated by autonomic afferent nerves, and are thus painless. The innervation means that there is sensation to stretch, however, which sometimes presents as an aching sensation rather than pain.

59
Q

From the list below, identify which of the descriptions refers to the upper (U) of lower (L) anal canal:

  • It is lined by columnar epithelium
  • It is lined by stratified, squamous epithelium
  • The nerve supply is from the inferior rectal nerve
  • The arterial supply is from the inferior rectal artery
  • The nerve supply is from the autonomic hypogastric plexus
  • The arterial supply is from the superior rectal artery
A
  • It is lined by columnar epithelium U
  • It is lined by stratified, squamous epithelium L
  • The nerve supply is from the inferior rectal nerve L
  • The arterial supply is from the inferior rectal artery L
  • The nerve supply is from the autonomic hypogastric plexus U
  • The arterial supply is from the superior rectal artery U
60
Q

Which nerve would need to be blocked in order to anaesthetise the external anal sphincters and perianal skin?

A

Inferior rectal and perineal branch of the 4th sacral nerve

61
Q
A

Year 2 (33 decks)

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