The Foregut

Question 1

Where does the foregut run from and to?

Answer 1

Phraynx to proximal duodenum

Question 2

Where does midgut run?

Answer 2

From distal duodenum to the proximal half of trnavserse colon

Question 3

Where does the hindgut run?

Answer 3

From the distal third of transverse colon to the rectum

Question 4

What does the small intestine include?

Answer 4

Duodenum

Jejunum

Ileum

Question 5

What does the large intestine include?

Answer 5

Caecum

Appendix

Colon

Question 6

What is the oesophagus?

Answer 6

Muscular tube

25cm long

Pharynx to stomach

Question 7

What are the 3 constrictions of the oesophagus?

Answer 7

Cervical

Thoracic

Diaphragmatic

Question 8

In which mediastinum is the oesophagus located

Answer 8

Posterior and superior

Question 9

What is the vertebral level of the oesophageal opening (hiatus) in the diaphragm?

Answer 9

T10

Question 10

What are the other structures which pass through the diaphragm at the oesophageal opening?

Answer 10

Oesophagus

Vagus nerve

Oesophagel branches of the left gastruc artery and vein

Lymphatics

Question 11

What is oesophageal varices?

Answer 11

The lower end of the oesophagus is one of the important sites for portosystemic anastomoses.

In portal hypertension, the anastomoses open and forms venous dilatations called oesophageal varices.

Their rupture causes severe and dangerous haematemesis

Question 12

What is the blood supply of the oesophagus?

Answer 12

Left gastric artery and left inferior phrenic artery

Question 13

What is the venous drainage of the oesophagus?

Answer 13

Portal and systemic systems

Left gastric vein- Porta

Oesophageal veins- Azygous vein so systemic

Systemic- Portal anastosmosis

Question 14

What is the lymohatic drainage of the oesophagus?

Answer 14

Left gastric lymph node to celiac nodes

Question 15

What is the stomach?

Answer 15

A muscular bag forming the widest and most distendible part of the digestive tube

Question 16

Answer 16

Question 17

Where does the lesser omentum extend from?

Answer 17

Lesser curvature to liver

Question 18

Where does the greater omentum extend from?

Answer 18

Greater curvature to beginning of duodenum

Question 19

What is the pyloric sphincter?

Answer 19

Band of smooth muscle at the junction between the pylorus of the stomach and the duodenum of the small intestine

Question 20

What is the function of the pyloric sphincter?

Answer 20

Digestion where it acts as a valve to controls the flow of partially digested food from the stomach to small intestine

Question 21

The pyloric sphincter is formed from the thickening of which layer of gut tube?

Answer 21

Inner circular layer

Question 22

What is pyloric stenosis?

Answer 22

Some children are born with a condition called congenital pyloric stenosis.

This is a narrowing of the opening from the stomach to the first part of the small intestine (the pylorus).

Symptoms include projectile vomiting without the presence of bile.

Question 23

Answer 23

Question 24

What are the gastric folds formed from?

Answer 24

Tissue- mucosal and submucosal

They are most apparent in the pylroic part and greater curvature

Question 25

What are the 3 branches of the coeliac trunk?

Answer 25

Left gastric artery

Splenic artery

Common hepatic artery

Question 26

Answer 26

Question 27

What is venous drainage of the stomach done by?

Answer 27

The portal system

Question 28

What are the 4 main veins draining the stomach?

Answer 28

1. Left gastric vein which drains into the hepatic portal vein.
2. Right gastric vein which drains into the hepatic portal vein.
3. Left gastro-omental which drains first to the splenic vein then to the hepatic portal vein.
4. Right gastro-omental which drains first to the superior mesenteric vein then to the hepatic portal vein.

Question 29

What group of nodes do the central group ofnodes drain to?

Answer 29

Pre aortic nodes at T12

Question 30

What is the parasympathetic nerve supply of the stomach come from?

Answer 30

Vagus nerve

Question 31

What does the sympathetic supply of the stomach come from?

Answer 31

great splanchnic nerve (t6-t9) pass through the celiac plexus

Question 32

What is the effect of increased vagal stimulation on the stomach?

The pylorus?

Gastric secretion?

Answer 32

Increasing pyloric opening

Promotes gastric empyting

Question 33

What does the arrangement of the vagal branches to the stomach allow?

Answer 33

For highly selective vagotomy to be used to treat over- active gastric acid secretion.

This denervates the fundus and body, decreasing secretion, while the supply to the antrum remains so preserving essential gastric motility.

Question 34

What is the duodenum?

Answer 34

C shaoed structure which continues from the pyloric sphincter of the stomach

The duodenum is the first part of the small intestine

Question 35

How many parts does the duodenum have?

Answer 35

Superior

Descending

Inferiror

Descending

Question 36

What organ sits within the C shape of the duodenum?

Answer 36

Pancreas

Question 37

How is the duodenum peritonised?

Answer 37

Retroperiotnal

Question 38

There is a small opening in the duodenum where pancreatic and bile fluids enter the gut tube. What is this opening called?

Answer 38

Major duodenal papilla which is the eminence that the hepatopancreatic ampulla opens into

Question 39

• What two structures come together at the major duodenal papilla?

Answer 39

Main pancreatic duct

Common bile duct

Question 40

What is the sphincter that controls the opening called?

Answer 40

Sphincter of oddie