Introduction to lower GI tract

Question 1

What causes the ‘ball’ like appearance of the large inrtestines

Answer 1

Teniae coli

Question 2

What are the fatty deposits on the large intestine called

Answer 2

Omental appendices

Question 3

What are the sac/ball like appearances of the large intestine called

Answer 3

Haustra

Question 4

What is the blood supply if the transverse colon

Answer 4

SMA and IMA

Question 5

What are the main branches of the Superior Mesenteric Artery (in descending order)

Answer 5

Middle colic
Right colic
Ileocolic
Appendicular atrtery

Question 6

What are the branches of the Inferior Mesenteric artery (in descending order)

Answer 6

Left colic
Sigmoid artery
superior rectal artery

Question 7

What forms the portal vein

Answer 7

Superior mesenteric vein +

inferior mesenteric vein and splenic vein combine

Question 8

Where will lymph in the large intestines drain into

Answer 8

Epicolic lymph nodes which then drain into paracolic lymph nodes then intermediate lymph nodes then either SM or IM lymph nodes

Question 9

Parasympathetic innervation of large intestine before end of transverse colon and CN number

Answer 9

Vagus nerve (CN10)

Question 10

Sympathetic innervation of large intestine

Answer 10

Thoracic splanchnic nerves or the lumbar splanchnic nerves (CNX)

Question 11

Parasympathetic innervation of large intestine after transverse colon

Answer 11

Pelvic splanchnic nerves (S2-S4)

Question 12

Surface projections of liver and how is it like when the person is standing

Answer 12

Deep to ribs 7-11

When standing, it is located more inferiorly

Question 13

Surface projections of the gallbladder

Answer 13

Tip of the 9th right rib, midclavicular plane

Question 14

What branches off the hepatic artery proper

Answer 14

R&L hepatic arteries

Question 15

What branches off the r hepatic artery

Answer 15

Cystic artery (however some variation can mean some people it branches off L)

Question 16

What duct comes off the gallbladder and what does this form

Answer 16

Cystic duct continues and becomes bile duct

Question 17

What joins the cystic duct to become the bile duct

Answer 17

Common hepatic duct (made of R&L hepatic ducts)

Question 18

What makes the common hepatic duct

Answer 18

R&L hepatic ducts

Question 19

What is the falciform ligament

Answer 19

Ligament on liver which connects the liver to the abdominal wall

Question 20

What is the area of the liver where structures leave and enter

Answer 20

Porta hepatis

Question 21

What vessels enter/leave the porta hepatis

Answer 21

POrtal vein
Hepatic artery
Lymphatics

Question 22

What nerves enter the porta hepatis

Answer 22

Hepatic nerve plexus

Question 23

What ducts leave the porta hepatis

Answer 23

Hepatic duct

Question 24

What are the lobes of the liver

Answer 24

Right
LEft
Cuadate
Quadrate

Question 25

how many surgically resectable hepatic segments are there

Answer 25

8

Question 26

Where are the sites of portal-systemic anastomoses

Answer 26

• Inferior oesophagus
• Anal canal
• Paraumbilical region
• Bare areas of secondarily retroperitoneal viscera (ascending and descending colon)

Question 27

Why are portal-systemic anastomoses important

Answer 27

If portal circulation through liver is diminished or obstructed, then blood from GI tract can still reach the heart and IVC

Question 28

Surface projections of pancreas

Answer 28

Neck:overlies L1 and L2
Head: right and inferior to transpyloric plane
Tail: left and superior to transpyloric plane

Question 29

Surface projections of spleen

Answer 29

ULQ, LH

-Associated posteriorly with ribs 9-11

Question 30

Should pancreas and spleen be palpable

Answer 30

No

Question 31

How does the pancreas enter the duodenum

Answer 31

The main pancreatic duct becomes the hepatopancreatic ampulla

This enters the duodenum in major duodenal papilla