Met Anatomy 2

Question 1

The anterior and intermediate lobes are [], as they have a different embryological origin, so they synthesise their own hormones, but are regulated by the [] via the [] portal system

Answer 1

The anterior and intermediate lobes are glandular, as they have a different embryological origin, so they synthesise their own hormones, but are regulated by the hypothalamus via the hypophyseal portal system

Question 2

The [] forms just anterior to the infundibulum of the pituitary, and therefore sits just [] to the pituitary gland.

Hence, tumours of the pituitary gland can cause visual field defects - most commonly bitemporal hemianopia.

Answer 2

The optic chiasm forms just anterior to the infundibulum of the pituitary, and therefore sits just superior to the pituitary gland.

Hence, tumours of the pituitary gland can cause visual field defects - most commonly bitemporal hemianopia.

Question 3

Label A-E

Answer 3

A: pineal gland
B: interthalamic adhesion
C: sphenoid bone
D: infundibulum
E: hypothalamus

Question 4

Which of the following is where axons from the hypothalmic neurons travel down to the posterior pituitary?

A
B
C
D
E

Answer 4

Which of the following is where axons from the hypothalmic neurons travel down to the posterior pituitary?

A
B
C
D
E

Question 5

Which of the following is passes through the thirds ventricle?

A
B
C
D
E

Answer 5

Which of the following is where axons from the hypothalmic neurons travel down to the posterior pituitary?

A
B
C
D
E

Question 6

Which of the following is responsible for melatonin & therefore circadiuan rhythm

A
B
C
D
E

Answer 6

Which of the following is responsible for melatonin & therefore circadiuan rhythm

A
B
C
D
E

Question 7

Look at this midsagittal slice taken from an MRI scan of the brain below. Which structure looks enlarged?

Hypothalamus
Pituitary
Thalamus
Pineal gland

Answer 7

Look at this midsagittal slice taken from an MRI scan of the brain below. Which structure looks enlarged?

Hypothalamus
Pituitary
Thalamus
Pineal gland

The pituitary gland appears moderately enlarge. Here, we can see it filling the sella turcica, and we can see the hypothalamus displaced superiorly

The hypothalamus itself appears normal, as do the thalamus and pineal gland, which are just about visible.

Question 8

Answer 8

Question 9

Which brain structure is responsible for regulating anterior pituitary hormone synthesis? [1]

Answer 9

Acceptable responses: hypothalamus

The hypothalamus regulates the production of anterior pituitary hormones by releasing hypothalamic hormones into the hypothalamo-pituitary portal circulation.

Note that the pituitary releases its hormones into the systemic circulation via the hypophyseal veins.

Question 9

Which brain structure is responsible for regulating anterior pituitary hormone synthesis? [1]

Answer 9

Acceptable responses: hypothalamus

The hypothalamus regulates the production of anterior pituitary hormones by releasing hypothalamic hormones into the hypothalamo-pituitary portal circulation.

Note that the pituitary releases its hormones into the systemic circulation via the hypophyseal veins.

Question 10

Which bone must be drilled through in pituitary surgery?

Ethmoid
Frontal
Temporal
Sphenoid

Answer 10

Which bone must be drilled through in pituitary surgery?

Ethmoid
Frontal
Temporal
Sphenoid

This operation is known as transnasal, transsphenoidal hypophysectomy. An endoscope is passed into the nasal cavity, the mucosa is stripped away from the bone, and the surgeon drills through the sphenoid bone to visualise the pituitary from below. The procedure has revolutionised pituitary surgery, as it was previously very difficult to access the pituitary.

Question 11

During a thryroidectomy the recurrent laryngeal nerve is damaged.

How would you expect this present in the patient?

Hoarse voice
Aphonic
Monotonous voice

Answer 11

During a thryroidectomy the recurrent laryngeal nerve is damaged.

How would you expect this present in the patient?

Hoarse voice
Aphonic
Monotonous voice

The recurrent laryngeal nerve innervates the muscles of the larynx (apart from cricothyroid). Damage to one nerve results in a hoarse voice, and damage to both would result in aphonia

Question 12

What glands are found on the posterior surface of the thyroid gland?

Answer 12

Acceptable responses: Answer 1, parathyroid gland, parathyroid glands, parathyroids, parathyroid

Question 13

Label 1-5

Answer 13

1: omohyoid
2: sternohyoid
3: thyroid gland
4: recurrent laryngeal nerve
5: superior thyroid artery

Question 14

A 35 year old male presents with a left cervical mass, that had grown within about 8 weeks. His MRI is shown below.

Based on this, what signs would you expect his to present with?

Hoarse voice
Dysphagia
Dyspnea

Answer 14

A 35 year old male presents with a left cervical mass, that had grown within about 8 weeks. His MRI is shown below.

Based on this, what signs would you expect his to present with?

Hoarse voice
Dysphagia
Dyspnea

Question 15

Which adrenal gland is pyramidal?

Left
Right

Answer 15

Which adrenal gland is pyramidal?

Left
Right

Question 16

Is the pancreas intra or retroperitoneal?

Intraperitoneal
Retroperitoneal

Answer 16

Is the pancreas intra or retroperitoneal?

Intraperitoneal
Retroperitoneal

The pancreas has both intraperitoneal and retroperitoneal portions.

The head, neck and body are retroperitoneal and the tail is intraperitoneal.

Question 17

Answer 17

Question 18

Brian has an abdominal examination. Which of the following statements best describes a normal Liver examination?

A healthy liver is not easily palpable
A healthy liver can be palpated during expiration only
The Liver is palpated most easily posteriorly

Answer 18

Brian has an abdominal examination. Which of the following statements best describes a normal Liver examination?

A healthy liver is not easily palpable
A healthy liver can be palpated during expiration only
The Liver is palpated most easily posteriorly

Question 19

The liver has an anterior/superior surface and an inferior/visceral surface. It is divided into 4 lobes. Remind yourself of the lobes on the flashcards below.

Answer 19

Question 20

Which structure separates the left lobe from the quadrate lobe?

Gall bladder
Ligamentum teres
IVC
Falciform ligament

Answer 20

Which structure separates the left lobe from the quadrate lobe?

Gall bladder
Ligamentum teres
IVC
Falciform ligament

The ligamentum teres (round lig of liver) runs between the left and quadrate lobes.

Question 21

What foetal structure is the ligamentum teres a remnant of? [1]

Answer 21

Acceptable responses: umbilical vein, left umbilical vein

Question 22

Which structures are within the Porta hepatis?

Hepatic artery proper
Common hepatic artery
Hepatic vein
Hepatic portal vein
Common bile duct

Answer 22

Which structures are within the Porta hepatis?

Hepatic artery proper
Common hepatic artery
Hepatic vein
Hepatic portal vein
Common bile duct

Question 23

Which blood vessel provides 75% of the blood supply for the Liver

Hepatic artery proper
Common hepatic artery
Hepatic vein
Hepatic portal vein
Common bile duct

Answer 23

Which blood vessel provides 75% of the blood supply for the Liver

Hepatic artery proper
Common hepatic artery
Hepatic vein
Hepatic portal vein
Common bile duct

Question 24

Answer 24

Question 24

Answer 24

Question 25

When blood flow through the portal system is obstructed, the pressure within portal system increases. In portal hypertension, blood may be re-directed through the porto-systemic anastomoses (as these are now under a lower pressure).

If a large volume of blood passes through these anastomoses, the veins can become abnormally dilated – known as varices. Rupture of [] or [] varices can result in fatal blood loss.

Answer 25

When blood flow through the portal system is obstructed, the pressure within portal system increases. In portal hypertension, blood may be re-directed through the porto-systemic anastomoses (as these are now under a lower pressure).

If a large volume of blood passes through these anastomoses, the veins can become abnormally dilated – known as varices. Rupture of oesophageal or rectal varices can result in fatal blood loss.

Question 26

Brian has right sided heart failure. Into which vessels will blood back up?

Pulmonary trunk
Pulonary veins
IVC
SVC

Answer 26

Brian has right sided heart failure. Into which vessels will blood back up?

Pulmonary trunk
Pulonary veins
IVC
SVC

Question 26

Brian has right sided heart failure. Into which vessels will blood back up?

Pulmonary trunk
Pulonary veins
IVC
SVC

Answer 26

Brian has right sided heart failure. Into which vessels will blood back up?

Pulmonary trunk
Pulonary veins
IVC
SVC

Question 27

[] is liver dysfunction due to venous congestion, usually due to congestive heart failure.

The gross pathological appearance of a liver affected by chronic passive congestion is “[]” like a grated nutmeg.

Answer 27

Congestive hepatopathy is liver dysfunction due to venous congestion, usually due to congestive heart failure.

The gross pathological appearance of a liver affected by chronic passive congestion is “speckled” like a grated nutmeg.

The dark spots represent the dilated and congested hepatic venules and small hepatic veins. It is therefore often referred to as nutmeg liver.

Question 28

What is the clearest sign of congestive hepatopathy are on Brian’s CT?

Answer 28

Acceptable responses”: Answer 1, Enlarged IVC, Dilated IVC, Enlarged Inferior vena cava, Dilated inferior vene cava