GI Quiz

Question 1

What blood vessels supply the lesser curve of the stomach?

Answer 1

Left and right gastric arteries

Question 2

Where do the left and right gastric arteries arise from?

Answer 2

Left gastric artery arises from the coeliac trunk at T12- ascends to supply lesser curvature
Right gastric artery branches from the splenic artery (arising from the coeliac trunk)

Question 3

Which blood vessels supply the greater curve of the stomach?

Answer 3

Left and right gastroepiploic arteries

Question 4

At what vertebral level does the pyloric sphincter lie?

Answer 4

L1

Question 5

Which anatomical structures lie at L1 vertebral level?

Answer 5

Pyloric sphincter
Fundus of gallbladder
Neck of pancreas
Portal vein (behind neck of pancreas)
SMA origin from abdominal aorta
Hilum of kidneys

Question 6

How does the structure of the pyloric sphincter differ from the lower oesophageal sphincter? Which is more likely to suffer pathology?

Answer 6

Pyloric sphincter is much more muscular and bulky than the LOS- which has a smaller amount of smooth muscle and relies on other factors (right and left crus of the diaphragm) for competence. Therefore the LOS is more likely to experience pathology ie reflux.

Question 7

How many sections can the duodenum be divided into?

Answer 7

4 sections:
- first/superior
- second/ descending
- third/horizontal
- fourth/ascending

Arrangement in a ‘C’ shape, surrounding the head of the pancreas

Question 8

Which of the sections of the duodenum are retroperitoneal?

Answer 8

Sections 2-4

Question 9

Which section of the duodenum receives the common bile duct? What is this structure called?

Answer 9

Midway through the 2nd part of the duodenum. Released via the sphincter of oddi

Question 10

What is the significance of the 2nd portion of the duodenum apart from the location of the sphincter of oddi?

Answer 10

Boundary between the foregut and midgut— have different blood supplies and visceral pain referral

Foregut= greater splanchnic nerve and supplied by branches of the coeliac trunk (T12)
Midgut= innervated lesser splanchnic nerve and arterial supply from the superior mesenteric artery and branches.

Question 11

Which blood vessels supply the foregut?

Answer 11

Branches of the coeliac trunk- branches at T12 from the abdominal aorta
(Left gastric, splenic/branches, common hepatic/branches)

Question 12

Which visceral afferent are associated with the foregut?

Answer 12

Greater splanchnic nerve— T5-T9— causes Epigastric referred pain

Question 13

Which blood vessel is responsible for vasculature of the midgut?

Answer 13

Superior mesenteric artery- branches at L1

Question 14

Which visceral afferents are associated with the midgut?

Answer 14

Lesser splanchnic nerve—- T10-T11–umbilical referred pain

Question 15

What is the anatomical relationship between the head of the pancreas and the duodenum?

Answer 15

The head of the pancreas lies in the ‘C’ shape of the duodenum

Question 16

Which blood vessel supplies the pancreas?

Answer 16

Splenic artery

Question 17

Is the pancreas entirely retroperitoneal?

Answer 17

No. The head, neck and body are entirely retroperitoneal but the tail is closely associated with the spleen and is enveloped in part of the spleno-renal peritoneum.

Question 18

How many lobes does the liver have?

Answer 18

4:
Left, right, caudate (superior), quadrate (inferior)

Question 19

Which ligaments are associated with the liver?

Answer 19

Falciform- connects liver anteriorly to anterior abdominal wall
Coronal- separates left and right lobes
Triangular- connect liver to posterior abdominal wall

Question 20

What are the branches of the coeliac trunk?

Answer 20

Left gastric
Splenic
Common hepatic

Question 21

What are the branches of the SMA?

Answer 21

Middle colic
Right colic
Ileocolic

Question 22

What is the main artery supplying the hindgut? At what vertebral level does this branch from the abdominal aorta?

Answer 22

Inferior mesenteric artery
L3

Question 23

What are the branches of the inferior mesenteric artery?

Answer 23

Left colic
Sigmoidal
Rectal

Question 24

Identify the peritoneal recesses present in a female- describe their location

Answer 24

Vesicouterine pouch- between the bladder (anteriorly) and uterus (posteriorly)
Rectouterine pouch- between the uterus (anteriorly) and the rectum (posteriorly)

Rectouterine pouch is the deepest recess and hence will collect fluid in pathology

Question 25

What is the location and relevance of paracolic gutters?

Answer 25

Left and right paracolic gutters lie lateral to the contour of the ascending (right) and descending (left) colon.
Fluid ie blood can collect in these gutters and irritate the diaphragm. This causes sensation and perception of the pain in the Dermatomes of the spinal nerve roots represented in the phrenic nerve (C3,4,5) supplying the diaphragm—- referred pain in the shoulders.
Common in ruptured ectopic pregnancy or cholescystitis.