MET EOYS4

Question 1

what two important things does niacin (B3) create? [2] roles?

Answer 1

• forms: NAD & NADP -> imporant hydrogen acceptors. when reduced forms: hydrogen donors

Question 2

iron metabolism:

• absorbed where in GI?
• function in the body? (2)
• stored where (2) and as what (1)?

Answer 2

iron metabolism:

• absorbed where in GI: duodenum (and proximal jejunum)
• function in the body: oxygen transport with Hb (1) myoglobin function in skeletal muscle
• stored: liver (1) & macrophages (1) as ferratin (1)

Answer 3

tryptophan

Question 4

describe the branches of the SMA (6)

Answer 4

1. inferior pancreaticoduedenal artery
2. jejnunal and ileal branches

3 middle colic artery

4. right colic artery
5. ileocolic artery -> appendicular artery

Question 5

describe pathway of common hepatic artery –> hepatic artery proper —> ?? :)

Answer 5

common hepatic artery: branches into

• gastroduodenal artery, which branches to give right gastroepiploic artery - which anastamoses with left gastroepiploic artery.
• right gastric artery (goes to less curvature of stomach). anastamoes with left gastric artery

after these two: becomes the hepatic artery proper; branches into:

• right hepatic artery –> cystic artery (gall bladder)
• left hepatic artery

Question 6

describe pathway of common hepatic artery –> hepatic artery proper —> ?? :)

Answer 6

common hepatic artery: branches into

• gastroduodenal artery, which branches to give right gastroepiploic artery - which anastamoses with left gastroepiploic artery.
• right gastric artery (goes to less curvature of stomach). anastamoes with left gastric artery

after these two: becomes the hepatic artery proper; branches into:

• right hepatic artery –> cystic artery (gall bladder)
• left hepatic artery

Question 7

Answer 7

A: jenunal
B: superior mesentric
C ileocolic

Question 8

what are the 3 branches of the IMA?

what connects the SMA & IMA?

Answer 8

inferior mesenteric artery branches:

• left colic artery
• sigmoidal artery
• superior rectal artery
• SMA & IMA connected by marginal artery

Question 9

what are the 3 branches of the IMA?

what connects the SMA & IMA?

Answer 9

inferior mesenteric artery branches:

• left colic artery
• sigmoidal artery
• superior rectal artery
• SMA & IMA connected by marginal artery

Question 10

Answer 10

Question 11

which veins dont go to liver & directly drain into IVC? (4)

Answer 11

• gonadal vein
• renal vein
• internal iliac vein
• external iliac vein

Question 12

Answer 12

Question 13

Answer 13

Question 14

Answer 14

Question 15

Answer 15

Question 16

Answer 16

A: left colic
B: sigmoidal
C: superior rectal

Question 17

what is transamination?
how does it occur?
where does it occur mostly?
what is the enyzme used for it

Answer 17

transamination: transfer of an amino group. new amino acids can be made by using the carbon skeleton of other amino acids and transferreing a new side chain on it

mechanism:

• keto acid / group (a.a but instead of the NH2, is replaced by C double bonded O) swaps with the amine of another amino acid
• requires an intermediary: pyridoxal phosphate (from vitamin B6)

location: liver

Enzyme: tranaminase

Question 18

what are glucogenic and ketogenic amino acids?

Answer 18

• *glutogenic**: can be converted to glucose by gluconeogenesis or enter the TCA
• can either be transaminated to oxaloacetate or pyruvate (or other intermediates that will form oxaloacetate):
• e.g. alanine or glutamate

ketogenic: can be converted to ketone bodies, these can feed into the TCA cycle, mostly via A-CoA or acetoacetyl-CoA.

Question 19

how is ammonia produced?

how is ammonia excreted from body ? why is it excreted?

Answer 19

• occurs as a reult of amino acids underoing deamination reactions (reactions where you lose amine groups): when amino acids are converted to other molecules, but there arent other molecules to pick up with NH4+ (which is toxic).

- remove the NH4+ via the urea cycle:

Question 20

the conversion of the glutamine (a.a) to glutmate and then a-ketoglutarate generates WHAT?

why might this conversion occur?

why is lots of NH4+ produced?

Answer 20

generates free ammonia (as NH4+)

• a-ketoglutarate is needed for TCA cycle for energy.
• Glutamine has 2 amino groups, glutmate has 1, a-keto glutarate has 0 - so each step removes/adds an amino group so the metabolism of glutamine releases a lot of ammonium.

Question 21

what is glutamine used for? (4)

Answer 21

 Source of fuel during fasting - especially in muscles and immune cells.

 Used for gluconeogenesis, esp. in kidney.

 Produces ammonia, which can act as buffer for unwanted protons.

 Glutamine has anti-inflammatory properties in the gut.

Overall: fuel, building block, needed for metabolites: a-ketoglutarate and glutamate.

Question 22

MoA of urea cycle:

a) what is the rate determining step?
b) what are the two amino groups required? for it
c) what is the key regulating enzyme?

Answer 22

Rate controlling step:

o HCO3- + NH4+ –> carbamoyl phosphate (via enzyme carbamoyl phosphate synthase 1)
o Requires 2 ATP.
o Controlled allosterically by glutamate metabolite: N-acetyl glutamate - this is formed in an excess of glutamate, so drives urea cycle.

b) the two amino groups required from: aspartate (1) & ammonia (1)

essentially is a shuttle reaction of NH4 into from aspartate and ammonia into urea

Question 23

what does the addition of ApoC2 and ApoE by HDLs do to chylomicrons? [2]

Answer 23

- ApoC2 added: allows chylomicrons to give its triglycerides to peripheral cells

- ApoE added: allows chylomicron remenant to be taken up by the liver to deliver FA & cholesterol

Question 24

the lesser omentum connects what? [2]

Answer 24

liver and spleen

Question 25

Answer 25

Question 26

label the anatomy thats undergoing forgut developement at 10 weeks

Answer 26

Question 27

Answer 27

get a fusion of the dorsal mesogastrium & the transverse mescolon !

Question 28

& what are the two pink arrows pointing at?

Answer 28

_- lesser omentum:_ **liver and stomach** - _gastrosplenic ligament_: **stomach and spleen** top pink arrow: **lesser sac** bottom pink arrow: **epiploic foramen**

Question 29

what is ascites?

Answer 29

ASCITES fluid in the cavity. This is caused by liver cirrhosis which prevents the production of albumen and so fluid leaves the vasculature et

Question 30

what is the name of this muscle? what is its role? where does it recieve motor innervation from?

Answer 30

= **stylopharnygeus** muscle - _function:_ **elevates** the pharnyx during swallowing - _innervation:_ **glossopharnygeal nerve**

Question 31

label the mandible - which part serves as the muscle attachment point and moves the mandible?

Answer 31

_- coronoid process:_ **muscle attachment** **point**

Question 32

what divdes the anterior and posterior portion of the tongue? [1] what is found at the point of ^ V shape? [1]

Answer 32

what divdes the anterior and posterior portion of the tongue? [1] **sulcus terminalis** what is found at the point of ^ V shape? [1] **foramen cecum**

Question 33

what are the 5 branches of the facial nerve? [5]

Answer 33

 Temporal  Zygomatic  Buccal  Mandibular  Cervical **Two Zulus Bit My Cat**

Question 34

the mesentary connects which two structures? [2] the greater omentum connects which two structures? [2]

Answer 34

small intestine to the posterior abdominal wall stomach (greater curvature) to transverse colon !!

Question 35

Answer 35

Question 36

what thoracic level are of the following? a) coeliac trunk b) SMA c) IMA d) aortic bifurcation

Answer 36

what thoracic level are of the following? * *a) coeliac trunk: L12 b) SMA: L1 c) IMA: L3 d) aortic bifurcation : L4**

Question 37

Three main branches of the coeliac trunk?

Answer 37

Left gastric Splenic Common hepatic

Question 38

which two arteries supply the lesser curvature of the stomach & what is their orgins? [2] which two arteries supply the greater curvature of the stomach & what is their orgins? [2] which artery supplies the fundus & origin?

Answer 38

_which two arteries supply the lesser curvature of the stomach & what is their orgins? [2]_ **Right gastric (from common hepatic) Left gastric (from coeliac trunk)** _which two arteries supply the greater curvature of the stomach & what is their orgins? [2]_ **Right gastroepiploic (from gastroduodenal) Left gastroepiploic (from splenic)** _which artery supplies the fundus & origin?_ **short gastric arteries (from splenic)​**

Question 39

what is this muscle?

Answer 39

cremaster muscle

Question 40

what are the layers of the spermatic cord? [3] where do each layer originate from [3]

Answer 40

superficial --\> deep: **external spermatic fascia** (from transveralis fascia) **cremaster muscle** (from internal oblique) **external spermatic fascia** (from external oblique)

Question 41

what is the difference betwenen a direct and indirect hernia? [2]

Answer 41

_what is the difference betwenen a direct and indirect hernia? [2]_ The difference is in the anatomical location: **Direct hernias protrude through the posterior (back) wall of the inguinal canal. Indirect hernias protrude through the inguinal ring**

Question 42

x ## Footnote direct hernias pass directly through which structure? [1]

Answer 42

direct hernias pass directly through: **hasslebachs triangle**

Question 43

1. how does the muscarlis externa / propria change in the oesphagus?

Answer 43

* *top 1/3 made from skeletal muscle** = swallowing * *bottom 1/3 made from smooth muscle** = peristalsis

Question 44

Answer 44

Question 45

to make glucose, you need a source of energy and carbon units. what are 3 sources of carbon that can be used in gluceoneogenesis? what are 2 sources of energy that can be used in gluceoneogenesis?

Answer 45

* *_sources of carbon:_** - **lactate** (from muscle - glycolysis). exported to liver can be made into pyruvate as a carbon source - **amino acids** - from muscle. (from proteolysis) sent to liver & can be made into pyruvate as a carbon source - **glycerol** (from lipolysis). sent to liver * *_sources of energy:_** - **ATP** (from glycolysis and Krebs cycle) - **fatty acids** (but cannot be used as C source !!)