MRCS June 2/52

Question 1

what is the embryological origin of the lesser omentum?

Answer 1

ventral mesogastrium

Question 2

what is the embryological origin of the greater omentum?

Answer 2

dorsal mesogastrium

Question 3

what are the mesenteric attachments of the transverse colon

Answer 3

superiorly is the gastrocolic ligament that originates from greater curve of stomach and forms the greater omentum, posteriorly is the transverse mesocolon that originates from the spleen

Question 4

what is the free edge of the lesser omentum also called

Answer 4

the gastroepiploic foramen

Question 5

where is the lesser sac

Answer 5

behind the stomach

Question 6

what is the anterior wall of the lesser sac made from

Answer 6

the lesser omentum

Question 7

what is the inferior border of the lesser sac made from

Answer 7

the transverse mesocolon

Question 8

looking towards the feet, what direction does the foregut rotate during development?

Answer 8

clockwise direction

Question 9

describe the embryological path of the development of the GIT

Answer 9

foregut - midgut - hindgut
initially one tube with connection to vitelline duct
then midgut and hindgut extend into yolk stalk
rotation counterclockwise + convolution of midgut + outpouching of hindgut to form caecum
abdomen enlarges, intestines return to abdominal cavity
midgut returns and rotates quarter turn counterclockwise to end up under and on the left of hindgut
then hindgut returns and completes rotation to end up on the right of midgut

Question 10

which stage of life does rotation of midgut happen?

Answer 10

2nd month of embryo

Question 11

what is the structure that holds up the duodenal jejunal flexure?

Answer 11

ligament of trietz aka suspensory ligament

Question 12

what are the 2 ligaments attached to the spleen?

Answer 12

gastrosplenic ligament and lienorenal (splenorenal) ligament

Question 13

what are the ligaments of the liver anteriorly

Answer 13

falciform ligament
coronary ligaments
left and right triangular ligaments

Question 14

whats in the porta hepatis

Answer 14

portal vein
hepatic artery
hepatic duct

Question 15

where is the SMA in relation to the duodenum?

Answer 15

overlies anterior of 3rd part of duodenum

Question 16

where does the SMA originate in relation to the pancreas

Answer 16

originates posterior to the neck of the pancreas

Question 17

what vessel is on the right of the SMA

Answer 17

SMV

Question 18

where does the portal vein form in relation to the pancreas?

Answer 18

forms posterior to the superior part of the head of the pancreas, posterior to D1

Question 19

what part of the adrenal gland secret what ?

Answer 19

(superficial) zona glomerulosa -> mineral corticoids
zona fasciulata -> glucocorticoids
zona reticularis -> androgens
(deep)) medulla -> catecholamines

Question 20

what incision is used for femoral hernia?

Answer 20

mcevedy’s

Question 21

lymph drainage of rectum 1) sup to dentate line and 2) inf to dentate line

Answer 21

1) mesorectal nodes

2) inguinal nodes

Question 22

blood supply of rectum

Answer 22

superior 1/3

Question 23

what nerve is intimately associated with the middle meningeal artery

Answer 23

auricolotemporal nerve (v3)

Question 24

origin of middle meningeal artery?

Answer 24

MMA

Question 25

describe signs seen in klumpke’s palsy and what nerve roots are affected and how it happens

Answer 25

loss of wrist flexors, extended MCP, flexed ICP
supinated forearm
loss of sensation of medial aspect of forearm and hand
C8-T1 palsy
caused by hyperextension of shoulder/arm

Question 26

which joint facilitates forward flexion/extension and lateral flexion of the skull?

Answer 26

atlanto-occipital joint

Question 27

which joint facilitates rotation of the skull?

Answer 27

atlanto-axial joint

Question 28

which bone is superior atlas or axis?

Answer 28

atlas sites on top of axis