PBL 1: Stomach and peptic ulcer disease

Question 1

Failure of the ________ to open, is termed achalasia?

Answer 1

Lower oesphageal sphincter.

Achalasia: failure to open of the LOS during swallowing, leads to backup of food within the oesphagus

Question 2

Which cells set the Basal Electrical Rhythm (BER) of the GI tract?

Answer 2

Cells of Cajal

Question 3

What are the 4 anatomical regions of the stomach?

Answer 3

1. Cardia
2. Body
3. Fundus
4. Pyloric

Question 4

Name these parts of the stomach?

Answer 4

Question 5

The pyloric region can be subdivided into two parts. Name these parts?

Answer 5

• Pyloric antrum
• Pyloric canal

Question 6

Name these parts of the stomach?

Answer 6

Question 7

Name the two sphincters that are in close proximity to the stomach?

Answer 7

1. Lower oesophageal sphincter
2. Pyloric sphincter

Question 8

What is the function of the lower oesphageal sphincter?

Answer 8

Prevents the reflux of gastric contents

Protects the oesophagus from reflux of the gastric contents

Question 9

What is the function of the pyloric sphincter?

Answer 9

Controls the flow of gastric contents into the duodenum.

Question 10

What is the omenta?

Answer 10

• It is a fold of peritoneum connecting the stomach with other abdominal organs
• Visceral peritoneum covers the surface of the stomach and reflects backwards at the greater curvature becoming the omenta.
• Two layers of peritoneum – four membrane layers

Question 11

How many membranous layers is there in the omenta?

Answer 11

4 membrane layers

The peritoneum folds back on itself i.e. two layers of peritoneum

Each peritoneum has 2 membrane layers: visceral and parietal

Question 12

There are two types of omentum. Name them?

Answer 12

1. Greater omentum
2. Lesser omentum

Question 13

The greater omentum is made up of peritoneum reflected at the ____ curvature of the stomach

Answer 13

Greater

Question 14

The lesser omentum is made up of peritoneum reflected at the ____ curvature of the stomach

Answer 14

Lesser curvature of the stomach

Question 15

Label each omentum

Answer 15

Question 16

Describe the rugae?

Answer 16

Located on the surface of the stomach

Long longitudinal folds, like wrinkles, that allow the stomach to distent.

Question 17

Anterior surface of the stomach is in contact with which structures?

Answer 17

The diaphragm (at the fundal region), the anterior abdominal wall and the left lobe of the liver

Question 18

Which regions in the 9 regions of the abdomen is the stomach and duodenum located in?

Answer 18

The epigastric and umbilical region

Question 19

Name the branches of the coeliac trunk?

Answer 19

Good mnemonic to learn this is left hand side:

Left: Left gastric artery

Hand: common Hepatic artery

Side: Splenic artery

Question 20

Names these branches of the coeliac trunk?

Answer 20

Question 21

What are the branches of the common hepatic artery?

Answer 21

• the right gastric artery
• The gastroduodenal artery.

Question 22

Name these arteries?

Answer 22

Question 23

After the common hepatic artery gives off the gastroduodenal artery branch it changes its name to what?

Answer 23

Proper hepatic artery

Question 24

The proper hepatic artery enters the porta hepatis where it splits into which two arteries?

Answer 24

The left and right hepatic arteries.

Question 25

What is the arterial supply to the lesser curvature of the stomach

Answer 25

Supplied by the left gastric artery and the right gastric branch of the hepatic artery.

Question 26

What is the arterial supply to the greater curvature of the stomach

Answer 26

Supplied by the short gastric arteries and the right and left gastro-omental arteries.

Question 27

What are the 4 layers of the stomach?

Answer 27

1. Mucosa (innermost layer) 2. Submucosa 3. Muscularis externa 4. Serosa (outermost layer)

Question 28

What are the subdivision layers of the mucosa layer of the stomach?

Answer 28

Surface epithelium (inner) Lamina propria Muscularis mucosa (outer)

Question 29

What are the subdivision layers of the muscular externa layer of the stomach?

Answer 29

1. Oblique muscle layer (innermost) 2. Circular muscle layer 3. Longitudinal muscle layer

Question 30

Name these layers of the stomach?

Answer 30

Question 31

What is the difference between gastric pits and gastric glands?

Answer 31

Gastric pits dot the surface of the mucosa (made primarily of mucus cells), and mark the entry to each gastric gland. Gastric glands contain secretory cells that are involved in producing the gastric secretions e.g. HCl

Question 32

What are the two types of gastric glands?

Answer 32

Oxyntic and pyloric gastric glands

Question 33

Describe the oxyntic gastric glands?

Answer 33

Found in the fundus and the body of the stomach. Predominately made up of parietal and chief cells. This area is important in the digestion of the bolus.

Question 34

Describe the pyloric gastric glands?

Answer 34

Found in the antrum of the pyloric region. Composed predominately by mucus secreting cells, G cells, D cells and enterochromaffin cell. Lesser function in digestion that oxyntic gastric glands

Question 35

Which drug acts on the final stage of acid secretion in parietal cells of the stomach?

Answer 35

Proton Pump Inhibitors

Question 36

Describe the layers of the duodenum?

Answer 36

**Innermost** Mucosa Lamina epithelium Lamina propria Lamina Muscularis Submucosa Muscularis externa Circular Longitudinal **Outermost**

Question 37

What are the names of the glands found in the duodenum that is important in neutralising the gastric acid?

Answer 37

Brunner's glands Secretes bicarbonate to neutralise the gastric acid.

Question 38

Which layer does the Brunner's glands of the duodenum reside in?

Answer 38

Submucosa layer

Question 39

Name these layers and anatomical structures of the duodenum?

Answer 39

Question 40

Gastrin is produced by which cells?

Answer 40

G cells

Question 41

Somatostatin is produced by which cells?

Answer 41

D cells

Question 42

hydrochloric acid is produced by which cells?

Answer 42

Parietal cells

Question 43

Which cells in the stomach produce histamine?

Answer 43

Enterochomaffin-like cells

Question 44

Cholecystokinin (CCK) is produced where in the ailmentary tract?

Answer 44

Duodenum and jejunum

Question 45

What is the epithelium that lines the stomach?

Answer 45

Simple columnar epithelium

Question 46

The surface of the epithelium of the stomach is covered with mucus. Why is this important?

Answer 46

Mucusa adheres to the surface epithelium and protects the stomach lining from the corrosive gastric juices of the gastric glands

Question 47

What does G cells in the stomach secrete?

Answer 47

Produce gastrin (hormone)

Question 48

Where are G cells located?

Answer 48

Located in the pyloric antrum and the duodenum

Question 49

What is the function of gastrin?

Answer 49

Stimulates the: * Parietal cells * Releases hydrochloric acid and intrinsic factors * Chief cells * Release of pepsinogen * Enterochromaffin-like cells * Release of histamine

Question 50

# Fill in the blanks? Orange= cells Blue= products

Answer 50