Spotter Flashcards by Robert Claridge

Label A-D of the alimentary tract, and the layers they are comprised of.

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Label A-E of the small intestine.

A: Villi (in small intestine only!)

B: intestinal crypts (glands) bounded by a layer of pink smooth muscle

C: submucosa

D: muscularis externa

E: serosa (yellow here)

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Label the 4 layers of the colon (rectum) wall.

C: mucosa

A: submucosa

B: muscularis externa

D: serosa

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Label A-D in the colon.

A: lamina propria

B: epithelium

C: muscularis mucosae

D: submucosa

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Label A-D of the villus.

What type of epithelium lines this?

A: enterocytes (intestinal cells)

B: goblet cells

C: lamina propria (contains defence cells and fibroblasts)

D: smooth muscle (from underlying muscularis mucosae)

Simple columnar

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Label the cells on the base of the villus.

Arrows: plasma cells

Stars: lymphocytes (NB. some appear above epithelium BM = “interepithelial lymphocytes” - sample antigens in intestinal environmnet)

SM: smooth muscle

G: goblet cell

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What part of the alimentary tract is this?

What kind of cell is it lined with?

Label A, B and the arrow.

Oesophagus (oropharynx -> stomach)

Stratified squamous (against abrasion)

A: aerolar fibrocollagenous tissue of lamina propria

B: darker staning SM of muscularis mucosae

Arrow: lymphocytes in MALT

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Label A-D in the stomach.

What kind of cells are found as you go down? (4 types)

A: surface mucous cells

B: gastric pits

C: gastric glands

D: muscularis mucosae

Mucus neck cells (secrete mucus) -> Parietal cells (secrete HCl and IF) -> Endocrine cells (secrete hormones) -> Chief cells (secrete pepsinogen) - in base of pits

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Identify A-E in the stomach

A: parietal cell (round)

B: chief cell

C: gastric pit

D: mucous neck cell (paler)

E: lamina propria

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Label A-D of the oesophageal-gastric junction

A: gastric simple columnar, glandular mucosa

B: oesophageal stratified squamous epithelium

C: lamina propria

D: muscularis mucosae

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Label A-D of the small intestine.

What are the arrows and bracket indicating?

A: mucosa

B: submucosa

C: muscularis propria/externa

D: serosa

Arrows: villi

Bracket: plicae circulares (larger folds)

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Label the 3 types of cell found in the small intestine epithelium.

Arrows: goblet cells

Star: typical simple columnar enterocyte

Arrow head: MALT

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What type of structure is indicated here?

What kinds of cells are found here?

Crypts of Lieberkuhn in small intestine. Glands.

Enterocytes, SC, endocrine cell, paneth cell

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What type of cell is indicated here?

Paneth cell in Crypt of Lieberkuhn

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Label A-C in the large intestine.

How does it differ from the small intestine?

A: mucosa

B: submucosa

C: taenia coli (3 bands of longitudinal SM in muscularis externa)

No villi and longer glands

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What is G in the duodenum?

Brunner’s Glands, produce mucus-rich alkaline secretion

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What is the yellow arrow pointing to in the small intestine?

Peyer’s patches (GALT) - lymphoid follicles for protection, lymphocytes make it blue.

Note the submucosa going outwards, plicae circulares

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Label A and B in the large intestine.

A: tubular glands in mucosa (don’t stain well b/c lots of goblet cells there).

B: MALT/GALT

Note thin line of muscularis mucosae.

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Where are the following mucosa found?

A: small intestine - villi in crypts

B: oesophagus - stratifed squamous epithelium

C: stomach - thick mucosa and glandular portion at top, see gastric pits and extended glandular portions

D: large intestine - colon, simple tubular glands with lots of goblet cells

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Label the yellow, blue and red structures.

Yellow = innermost intercostal

Blue = internal intercostal

Red = external intercostal (finishes mid-clavicular)

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Label A-F (nerve supply to abdomen).

What are the dermatome landmarks of the nerve supply to the abdomen?

A: subcostal

B: iliohypogastric

C: ilioinguinal

D: Obturator

E: Femoral

F: genitofemoral

T7 - xiphoid, T10 - umbillicus, T12 - subcostal nerve, L1 - iliohypogastric and ilioinguinal nerves (both part of lumbar plexus).

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Label A-E

A: rectus abdominis

B: linea alba

C: ASIS

D: inguinal ligament

E: tendinous intersection

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Label A-E of the spermatic cord

A: genital branch of genitofemoral nerve

B: testicular artery

C: ductus deferens

D: pampiniform venous plexus

E: ilioinguinal nerve

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Label A-D

A: ductus deferens

B: testicular vessels

C: genitofemoral nerve

D: ilioinguinal nerve

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Label A-G

A: internal spermatic fascia B: cremaster muscle C: external spermatic fascia D: transverse fascia E: transverse abdominis F: internal oblique G: external oblique

Label A-C

A: oral cavity B: pharynx C: oesophagus

Label 1-4 and state their functions.

**1: Lips** - control entry/exit to mouth **2: Teeth** - moved by muscles of mastication, break down food mechanically **3: Salivary glands** - chemically digest food **4: Tongue** - moves food to back of mouth **5: Soft palate** - prevents food passing to nasal cavity **6: Tonsils** - immunological defence

Label A-D of the skull.

**A: coronoid process** **B: ramus** **C: mandibular foramen** - *mandibular branch of trigeminal runs through* **D: mental foramen** - *inferior alveolar nerve runs through (branch of mandibular nerve)*

Label A-D What does C do?

A: styloid process B: stylohyoid ligament **C: hyoid** D: thyroid cartilage Floating bone in neck, **not directly articulated** with any bones. Connected by a membrane to larynx. Lots of muscles attach to hyoid bone, moving it up/down with larynx following.

Label the muscles A and B, and the nerve branches 1-5.

**A: orbcularis oris** (sphincter muscle) **B: buccinator** (makes up cheek) **C: orbicularis oculi** **D: frontalis** (raises eyebrows) *All innervated by facial nerve, coming out of stylomastoid foramen* **FACIAL NERVE** - 1: temporal 2: zygomatic 3: buccal 4: mandibular 5: cervical

What is wrong with this man?

Damaged facial nerve = **Bell's palsy**. Facial nerve often injured in relation to parotid gland/idiopathic. One sided facial droop. **Paralysis of lower motor neurone, no forehead sparing on LHS.**

Label A-E

A: superior alveolar nerve B: inferior alveolar nerve C: mandibular foramen D: lingual nerve E: mental foramen

Label A-D

A: temporalis B: masseter C: lateral pterygoid D: medial pterygoid

Label the sphenoid bone, and describe what is attached to the parts.

A: lateral pterygoid plates B: medial pterygoid plates Medial and lateral pterygoid muscles both attach to **lateral pterygoid** plate but medial muscle attaches to **medial side of lateral plate**, and lateral muscle to lateral side.

Label A-C

A: opening of **sublingual** duct B: opening of **submandibular** duct C: **frenulum** of tongue

Label the extrinsic muscles of the tongue. What are they all innervated by?

A: palatoglossus B: stylolglossus C: hyoglossus D: genioglossus (chin to tongue) **HYPOGLOSSAL NERVE!**

Label A-C What is A's purpose? What forms the V shape?

A: vallate papillae B: foramen caecum C: lingual tonsil Specialised taste buds. Sulcus terminalis (forms the boundary between the 2/3 and 1/3)

Label the following nerves

A: lingual (mandibular nerve) B: chordae tympani (facial nerve) C: glossopharyngeal D: hypoglossal

Label A-D What are the signs if: a) LMN lesion of **vagus** nerve b) LMN lesion of **hypoglossal** nerve Describe C

A: palatoglossal arch (contains palatoglossal muscle) B: palatopharyngeal arch (contains palatopharyngeal muscle) C: palatine tonsil D: uvula a) **uvula** deviates **away** from lesion b) **tongue** deviates **towards** lesion Collections of lymphoid tissue on each side of the oropharynx, between palatine arches.

What innervates 1-5?

1) **Facial** nerve 2) **Mandibular** branch of trigeminal nerve 3) **Facial** and **glossopharyngeal** nerves 4) **Hypoglossal** nerve 5) **Vagus** nerve

Label the parts of the pharynx. What provides sensory innervation of the pharynx?

A: nasopharynx (ends at uvula) B: oropharynx (ends at tip of epiglottis) C: laryngopharynx (ends at cricoid cartilage) **Glossopharygeal nerve**

Label A-E

A: superior constrictor B: middle constrictor C: inferior constrictor D: superior oesophageal sphincter E: stylopharyngeus

Label A-F What does B do?

A: **pharyngeal tonsil** (adenoids) B: opening of the Eustachian tube C: salpingopharyngeal fold D: **Lingual tonsil** E: Soft palate F: **Palatine tonsil** *The 3 tonsils form protective ring around the cavities* Connects pharynx to ear = equilibriates the pressure between the 2

Label A-G

A: hepatic lobule B: portal tract C: sinusoids D: central vein E: hepatic artery F: bile duct G: portal vein

What are outlined? What is the region called in which the larger vascular and biliary components travel? Name the 3 major components located in the portal tract Where is the central vein?

Hepatic lobule Portal tract Bile duct, hepatic artery, portal vein Centre of lobule

Identify A-D. What kind of collagen is stained black?

A: central vein B: portal tract C: hepatocytes D: sinusoids Collagen **type III** or **reticulin**

What is the structure in the centre of the field? (NB in liver) Whatis found between the cords of the hepatocytes?

Central vein Hepatic sinusoids

Identify A-C of the portal tract. Which direction does blood and bile flow?

A: bile duct (cuboidal epithelium) B: hepatic artery (muscular wall) C: portal vein (thin wall, wide lumen) Blood: from portal tract into **sinusoids**. Bile: from hepatocytes in bile duct towards **duodenum**. So opposite.

Label the types of hepatocyte cell death and their clinical significance

A: zonal: paracetamol poisioning/cardiac failure B: bridging: severe hepatitis C: interface hepatitis: autoimmune hepatitis D: apoptotic: acute viral hepititis

What can you see in this histology of mild chronic hepatitis?

Lymphocyte infiltrate (arrows) (confined to portal tract)

What can you see in this histology of hepatitis?

Portal tract (PT) expansion with **inflammatory cells** and **fibrous tissue**. There is **interface hepatitis** with **spillover** of inflammation into adjacent parenchyma.

What can you see in this liver histology?

Acute viral hepatitis showing destruction of lobular **architecture**, **inflammatory cells in the sinusoids**, and **hepatocyte apoptosis** (arrow).

What are A and B in this liver specimin from a chronic alcoholic patient?

A: regeneration nodule B: fibrocollagenous tissue

What is the most likely diagnosis of this liver tumour?

Hepatocellular carcinoma

Label A-F. What is the blue area? What is the green area? What is the orange area?

A: lesser omentum B: falciform ligament C: stomach D: greater omentum E: visceral peritoneum F: parietal peritoneum Blue: lesser sac Green: supracolic of greater sac Orange: infracolic of greater sac

What is this?

Lesser omentum - from inferior liver to lesser curvature of the stomach

What are the following indicating (and state where they go to and from): a) green arrow b) blue arrow c) pink arrow

a) Greater omentum - from stomach (greater curvature) to transverse colon b) Transverse mesocolon - from transverse colon to posterior body wall c) Mesentary - from small intestine to posterior body body wall

Label the subdivisions of the peritoneal cavity.

a) **supracolic compartment** (contains stomach, liver, spleen) b) **infracolic compartment** (contains small intesting, ascending and descending colon) c) R infracolic gutter d) L infracolic gutter * Fluid passes through greater sac if someone is standing - fluid drains down through peritoneal cavity towards pelvis.*

Label A-F

A: L gastric B: R gastric C: gastroduodenal D: R gastroepiploic E: L gastroepiploic F: short gastric (off of splenic artery) *NB: splenic artery = retroperitoneal*

Label A-E of the superior mesenteric artery.

A: marginal artery (forms anastomoses between superior and inferior mesenteric) B: middle colic C: R colic D: ileocolic (artery to caecum) E: appendicular F: jejunal and ileal branches

Label A-E on this angiogram of the superior mesenteric artery.

A: middle colic B: R. colic C: iliocolic D: SMA E: arterial arcades F: jejunal branches

Label A-D of the inferior mesenteric artery.

A: marginal artery B: L colic (goes to descending colon) C: sigmoid D: superior rectal

Label A-E on this angiogram of the inferior mesenteric artery.

A: L colic B: IMA C: Marginal artery D: sigmoidal branches E: superior rectal

Label A-D

A: hepatic portal vein B: superior mesenteric vein (goes behind pancreas and up to liver) C: splenic vein D: inferior mesenteric vein

Label A-G What does the portal tract consist of?

**A: portal vein** **B: bile duct** (goes in opposite direction to portal vein, biliary epithelial cells make bile) **C: hepatic arteriole** **D: hepatocyte** **E: Kupffer cell** - specialised macrophage **F: sinusoid** (leaky - allows transfer of molecules and helps cells move) **G: central vein** - leads to 3 hepatic veins which drain to inferior vena cava Hepatic portal vein, hepatic artery, bile duct

Label A-E

**A: gastric pit** **B: mucus cell** **C: parietal cell** (produce acid) **D: chief cell** (produce pepsinogen) **E: G cell** (secretes gastrin - hormonal regulation of other cells)

Label A-E on the visceral surface of the liver What structres does D contain?

A: quadrate lobe (square shape) B: caudate lobe (has tail) C: ligamentum venosum D: porta hepatis _{(deep fissure in the inferior surface of the liver through which all the neurovascular structures (except hepatic veins) and hepatic ducts enter or leave the liver)} E: IVC **Portal triad:** bile duct + hepatic artery proper + portal vein, and **lymph nodes** and **autonomic fibres**

What are A-C, and what are they seen here through?

A: portal vein B: hepatic artery C: bile duct Free border of lesser omentum (anterior to epiploic foramen). NB. lesser omentum = hepatoduodenal and hepatogastric ligaments

What can you see here?

L: oesophageal varices v. obvious R: splenomegaly

What can you see here?

Red arrow and A: ascites B: gallbladder

Label A-H, the veins of the rectum and anal canal

A: internal iliac vein B: middle rectal vein C: inferior rectal vein D: inferior mesenteric vein E: Superior rectal vein F: internal venous plexus G: external venous plexus H: pectinate (dentate) line

Label A-F of the biliary tree

A: cyctic duct (contains spiral valve) B: L + R hepatic ducts C: common hepatic duct D: bile duct E: (hepatopancreatic) **ampulla of Vater** F: major duodenal papilla surrounded by **sphincter of Oddi**

Label the blood supply to the gall bladder

**A:** Calot's triangle (formed by inferior border of liver, cystic and hepatic ducts **B:** Cystic artery **C:** R and L hepatic arteries **D:** Common hepatic artery

Label A-C in this endoscopic retrograde cholangiopancreatography (ERCP)

A: cystic duct B: hepatic duct C: pancreatic duct

What are A and B in this ultrasound slide (positve FAST scan)?

A: fluid in potential peritoneal space = makes it a real space. Could be blood or ascites. B: R kidney

Label A-D of this kidney transverse section.

A: pararenal fat B: renal capsule C: perirenal fat (surrounds kidney) D: renal fascia (**gerota's facia**) E: abdominal muscles F: quadratus laborum G: psoas

Label A - C on this para-sagittal section (RHS) of the kidney.

A: hepatorenal recess B: fascia and fat (kidney in own layer of deep fascia) C: peritoneum

What can you see here? What could have caused this?

Trauma to back e.g. kick

Label A-F of the kidney

A: cortex B: medullary pyramid C: minor calyx D: major calyx E: pelvis F: renal papilla

Label A-E

A: aorta B: duodenum C: R renal vein D: pancreas E: spleen

Label A-E

A: levator ani (pelvic floor) B: detrusor muscle C: trigone D: internal urethral orifice E: external urinary sphincter (voluntary)

Label A-F

A: ureteric orifice B: trigone C: internal urethral orifice D: prostate E: voluntary external sphincter F: (from top to bottom) prostatic, membranous and spongy urethra

Label A-D in the glomerulus

A: DCT B: macula densa C: extraglomerular mesangial cells D: JG cells

What is A in the thyroid?

Colloid

Label A-C. In what bone does the pituitary lie?

A: pituitary fossa B: hypothalamus C: pituitary gland (ant) Sphenoid bone

Identify the most prominent cell type in this photomicrograph (A). What is B?

A. Chief cell (prod PTH) B. Oxyphil

Name the four layers labelled A-D in these two photomicrographs of the adrenal gland.

A- Zona glomerulosa B- Zona fasciculata C- Zona reticularis D- Medulla

Identify the structures labelled C and D in these images of the adrenal gland.

C- zona reticularis cells are relatively small and have few lipid droplets than other cortical layer therefore stain darker D- medulla

What is the arrow indicating in this image of Hashimoto's thyroiditis?

Lymphoid follicle

Normal thyroid gland on the L. What does the one on the R show?

Thyrotoxic hyperplasia as a result of Graves' disease: follicular cells taller and larger nuclei, colloid shows scalloping (S) (= increased use of stored colloid to produce T4) follicules smaller and may bunch up (P) = papillae

Label A-F in the cavernous sinus

A) internal carotid B) CN III (oculomotor) C) CN IV (trochlear) D) CNV (trigeminal) - V₁ (opthalmic) E) CNV (trigeminal) - V₂(maxillary) F) CN VI - (abducens) *Pituitary tumour compresses cranial nerves first*

Label the following structures anterior to the thyroid gland.

A: hyoid B: thyroid C: cricoid D: thyrohyoid E: sternothyroid F: omohyoid (attached to scapula - omo = shoulder) G: sternohyoid *Also suprahyoid = contract and pull up hyoid, larynx follows. Infrahyoid = ovelies the 4 muscles in the picture*

Label the blood supply to the pancreas.

A) common hepatic B) gastroduodenal C) superior pancreatoduodenal (supplies mostly head) D) inferior pancreatoduodenal (first banch off superior mesenteric, anastamoses with superior pancreatoduodenal) E) splenic artery (gives off F, supplies most of body and tail) F) transverse pancreatic

Label A-G

A) cystic duct B) L and R hepatic ducts C) common hepatic duct D) common bile duct (runs down in free border of lesser omentum) E) hepatopancreatic ampulla F) minor duodenal papilla G) major duodenal papilla (drains tail, body and head of pancreas) *Accessory duct drains ulcinate process*

Spotter Flashcards

(94 cards)