Week2

Question 1

The three major salivary glands are the submandibular, the sublingual, and the parotid glands

The submandibular gland is a __ acinus gland with mucous and ___ cells

The sublingual gland is a ___ acinus gland and has what function?

The parotid gland is a __ acinus gland and secretes ___ via plasma cells

*** If you see serous demilune cells, think ___

Answer 1

Mixed, serous demilune

Mucous, lubricates oral cavity

Serous, IGA

Submandibular *** PROBS A TEST QUESTION

Question 2

All three of the salivary glands dump into the intercalated ducts, and then to the ___ duct, which is involved in transport of ions and water

**AKA stuff gets modified by the duct system

Acini -> Intercalated -> Striated -> Intralobular -> Interlobular -> Lobar -> Main duct

Answer 2

Straited duct

Question 3

The function of the saliva is three fold

1) It ___ the mucosa
2) It has a ___ function which depends on the antibacterial functions of three constituents of saliva including ___, which attacks the walls of bacteria, ___ which chelates iron necessary for bacterial growth, and ___ which neutralizes bacteria and viruses
3) It also has a digestive function that relies on ___, which initiates the digestion of carbs in the oral cavity, and ___, which participates in the hydrolysis of dietary lipids

Answer 3

Lubricates

Protective, Lysozymes, Lactoferrins, and IGA

Digestive function

Amylase, Lingual lipase

Question 4

The target for Rabies and Mumps virus is the ___ gland

Answer 4

Parotid

Question 5

The pancreas is a combined endocrine and exocrine gland.

The endocrine component is the ___ and is mainly regulated by glucose metabolism

The exocrine component is served by its __ cells which secrete the digestive enzymes into the intercalated ducts and ___ cells are involved with the GI part and are continuous with the low cuboidal epithelial lining of the intercalated duct and characteristic for the pancreas via secreting mucin to keep duct lubricated and secreting bicarbonate

Answer 5

Islets of Langerhans

Acinar, Centroacinar cells

Question 6

Remember from before, ___ that is produced by gastroenteroendocrine cells (G-cells) of the duodenal mucosa bind to specific receptors of pancreatic acinar cells and stimulates the release of zymogens

___ also helps to increase the flow of pancreatic fluid via acting on the cells of the duct system (centroacinar cells) to help stimulate bicarbonate solution

__ stimulation can also cause Ach to be released and enzymes secreted into the acinar lumen

** So CCK = acts on ___ cells and Secretin acts on the __ system cells

Answer 6

CCK

Secretin

Vagal (via parasympathetic nerve)

Pancreatic acini, intercalated duct

Question 7

If the zymogens released into the pancreas are activated to early, or if the trypsin inhibitor (which prevents the activation of trypsin and other proteolytic enzymes in the acinar lumen and ducts) is defective, then the disease ___ can occur aka autodigestion of the pancreatic acini

Answer 7

Acute pancreatitis

Question 8

The structural and functional unit of the liver is the ___.

Blood pools from a mixture of the ___ and ___ into sinusoidal spaces (small blood vessels), surrounded by hepatocytes, which then gets collected via a central venule.

Blood and Bile flow through ___ directions because bile is made by the hepatocytes (which surround the sinusoidal spaces) and it moves out to the bile duct

Answer 8

Hepatic lobule

Hepatic portal vein, proper hepatic artery

Opposite

Question 9

There are some specialized cells within the sinusoids that are not hepatocytes including macrophages called __ cells that are involved in the breakdown and recycling of old red blood cells.

**Blood drains from hepatocytes -> small bile ducts -> common hepatic duct -> common bile duct (once combined with the cystic duct) -> Duodenum

The endothelium which lines the liver sinusoids is fenestrated and does not have a continuous basement membrane (discontinuous capillaries) and therefore it is very easy for leakage to occur. The space between the fenestrated endothelium and cords is called the space of __, and blood can move through these spaces and absorbed via microvilli on the hepatocytes to bring in protein and other plasma components

Hepatic __ cells are located at intervals within the space of Disse and function as a storage site for __ and ___

Answer 9

Kupffer

Disse

Hepatic stellate cells (ITO cells), fat and vitamin A

Question 10

Bile, produced by hepatocytes, flows in the opposite direction of the blood. It is transported through bile ___ into the canal of ___ and then into the bile duct in the portal triad space

Answer 10

Canaliculi, Hering (also called cholangiole)

Question 11

___ is secretion into the blood stream and ___ is secretion into a duct

Hepatocytes can be endocrine and exocrine, and the ___ domain is where absorption of blood-borne substances occurs and the secretion of plasma proteins occurs via microvilli extending into the space of Disse

** Hepatocytes also contain SER

Answer 11

Endocrine, exocrine

Basolateral domain

Question 12

___ is a mixture of organic and inorganic substances produced by hepatocytes and the ___ stores, concentrates, and releases bile

The ___ is what allows bile to move into the gallbladder through the ampulla of Vater (Hepatopancreatic Ampulla)

Answer 12

Bile

Gallbladder

Sphincter of odi

Question 13

Exocrine glands, which secrete their products directly into ducts, can be divided into simple, simple and branched, or compound (aka branched).

These glands can be further divided into tubular or alveolar glands and depending on what type of product they release, they can be either ___ (thick and rich in glycoprotein secretion) or ___ (watery fluid)

Finally, these glands can have different secretory mechanisms, if they release the product via exocytosis, it’s called ___, if they release an entire whole cell as the secretory product it’s called ___, and if the products is released with a small amount of the apical cytoplasm of the secretory cell it’s called ___

What type of cells are Salivary gland cells?

Answer 13

Mucous, serous

Merocrine, Holocrine, Apocrine

Branched tubuloalveolar glands

Question 14

For the posterior abdominal wall muscles, the __ and __ muscles help you flex your thigh at the hip.

The ___ and ___ muscles fixes the ___ rib during deep ___

Answer 14

Psoas Major and Iliacus

Psoas minor and Quadratus Lumborum, 12th, inspiration

Question 15

____ is when a patient presents with lumbosacral pain, difficulty standing up straight and pain in the contralateral gluteal region

Answer 15

Psoas Syndrome

Question 16

What are the three peripheral origins that insert onto the central tendon?

The right and left Crus of the diaphragm meet at the ____, and the right Crus is longer and forms the muscular ___ hiatus

The ___ ligament connects the two crura anterior to the aortic hiatus

Answer 16

Sternal origin (xiphisternal joint), Costal origin (costal margin), and Vertebral origin (Vertebral body T12)

Aortic Hiatus, Esophageal

Median arcuate ligament

Question 17

There are three arcuate ligaments, the Median forms an opening for the ___, the Medial forms an opening for the ____, and the lateral arcuate ligament forms and opening for the ___

** The ___ and __ muscles have close relationships with many abdominal structures

Answer 17

Aortic Hiatus, Gap for Psoas Major M. and sympathetic trunk, Gap for Quadratus Lumborum M. And subcostal nerve and vessels

Psoas Major, and Iliacus

Question 18

There are various sites for a diaphragmatic hernia.

___ hernias occur between the sternal and costal parts of the diaphragm in the Sternocostal Triangle (also called anterolateral gap)

The other type is a __ Hernias and this occur in the ___ triangle, located between the ___ rib and the ___

___ Hernias are when the pleuroperitoneal membranes fail to fuse with other components of the diaphragm (Left posterolateral defect)

Answer 18

Parasternal Hernias

Pleuroperitoneal Hernias, Lumbocostal, 12th Rib, Diaphragm

Congenital Diaphragmatic

Question 19

What three arteries supply blood to the superior surface of the diaphragm?

What arteries supply blood to the inferior surface of the diaphragm?

Answer 19

Pericardiacophrenic, Musculphrenic, and Superior Phrenic A

Inferior Phrenic A

Question 20

The ONLY motor innervation to the diaphragm is via the __ nerve, C___

The sensory innervation to the central portion (central tendon) is the __ nerve and to the peripheral portion it’s the __ nerve

Answer 20

Phrenic (C3, C4, C5)

Phrenic, Intercostal

Question 21

Lymph drainage on the superior surface of the diaphragm goes either to the ___ nodes if it’s from the Anterior or Middle Diaphragmatic Nodes, or the to __ nodes if it’s from the Posterior Diaphragmatic Nodes

The inferior surface has the __ and __ nodes

Answer 21

Parasternal Nodes (**think sternum is more anterior), Mediastinal Nodes

Celiac nodes and Superior Lumbar nodes

Question 22

** ONE OF THESE WILL BE ON THE TEST

If cancer is found in the lumbar lymph nodes (aka Para-aoritc lymph nodes), it is ___ cancer

If cancer is found in the superficial inguinal lymph nodes, it is __ cancer

Above the pectinate line, the lymph is drained into __ nodes, and below it’s drained into __ nodes

Answer 22

Testicular Cancer

Scrotal Cancer

Internal Iliac Nodes, Superficial Inguinal Nodes

Question 23

Going back to Paracolic Gutter stuff and the free flow of fluid between the supracolic and infracolic compartment, the ___ ligament, which connects the colon with the diaphragm, prevents the spread of fluid ____ on the __ side of the body

Answer 23

Phrenicocolic ligament, superiorly

Left (via left paracolic gutter)

Question 24

What 4 nodes merge to drain lymph into the intestinal lymphatic trunk?

The Cisterna chyli receives drainage from what three trunks?

Answer 24

Inferior and superior mesenteric nodes and celiac nodes (These three make up Pre-Aortic group), and the lumbar lymph nodes (Para-aortic)

Lumbar trunks (left and right), Intestinal trunk, Descending thoracic trunk

Question 25

The lumbar plexus is ventral primary rami and goes from __ to ___ and the lumbar plexus becomes the first branch of the sacral plexus and lumbosacral trunk at ___ and ___

Answer 25

T12-L4(L5) L4-L5

Question 26

Name the vertebral segments for all the nerve stuff we need to know of the Lumbar Plexus 1) Subcostal 2) Iliohypogastric 3) Ilioinguinal 4) Genitofermoal 5) Lateral femoral cutaneous 6) Obturator anterior divisions 7) Femoral posterior divisions 8) Lumbosacral trunk

Answer 26

1) T12 2) L1 (sometimes T12) 3) L1 4) L1 and L2 5) L2 and L3 6) L2 and L3 and L4 7) L2 and L3 and L4 8) L4 and L5

Question 27

Autonomic plexuses are collections of sympathetic _____ axons and parasympathetic ___ axons as well as some visceral sensory axons Preganglionic sympathetic fibers for the abdominopelvic splanchnic nerves originate from the spinal cord at __ - __

Answer 27

Postganglionic, Preganglionic T5-L2 (L3)

Question 28

If you want to get autonomics, aka sympathetics to the gut, how would you do so?

Answer 28

Splanchnic nerve pathway

Question 29

General visceral afferents (GVAs) aka pain fibers, travel with sympathetic ___s If you feel pain on the right side of your body around T6, it's most likely ___ pain Pain on the right side of the body around T10-T12 could be what two organs? Pain on the left side of the body around T5-T9 could be what organ?

Answer 29

GVEs (General Visceral efferents) Gallbladder Cecum or Appendix Stomach

Question 30

The abdominal reflex (light stroking of lower abdominal wall causing a rippling of the underlying abdominal muscles) is caused by the ___ nerve The cremasteric reflex is caused by stroking the adjacent medial thigh, which is sensed via the ___ nerve and ___ nerve that innervates this portion. ** Note, this would be considered the ___ limb of the cremasteric reflex When these sensory fibers get activated, they synapse in the spinal cord and activate the motor fibers of the ___ nerve, which causes the cremaster muscle to contract and elevate ** Note, this would be considered the __ limb of the cremasteric reflex

Answer 30

Iliohypogastric Ilioinguinal and femoral branch of the genitofemoral nerve, afferent (sensory) Genital branch of the genitofemroal nerve, Efferent (motor)

Question 31

The vagus nerve, that supplies parasympathetic innervation, is also referred to as cranial nerve __

Answer 31

Ten (X)

Question 32

The epithelial lining and glands are made from ___ and the lamina propria, submucosa, muscularis layers and serosa adventitia is from ___

Answer 32

Endoderm, splanchnic mesoderm

Question 33

**** The falciform ligament and lesser omentum are created from ___ mesentery, along with the liver **Note that the liver divides the ventral mesentery into the __ and ___, and it forms as an out-pocketing of the foregut The spleen is derived from ___ mesentery The gallbladder and bile ducts come from ___ mesentery Remember, pancreas has two parts that develop from ventral (major pancreatic duct) and dorsal (accessory pancreatic duct) mesentery

Answer 33

Ventral Falciform ligament and lesser omentum Dorsal Ventral

Question 34

During development of the esophagus, the lungs bud off of it and eventually they should detach, however a small part remains connected and this is referred to as a tracheoesophageal septum. If this does not occur, it is called a ___ and if the upper esophagus ends in a blind pouch, it's called an ___ The esophagus can also be narrowed, called esophageal stenosis, or completly blocked off, called esophageal ___

Answer 34

Tracheoesophageal fistula (TEF), aplasia, atresia

Question 35

For the stomach, the __ surface grows faster than the __ surface and at the same time it rotates clockwise ******** If you see a baby with projectile vomiting, and no bile (not green) then the problem is ___ Don't get this confused with the presentation of a child who also projectile vomits, but their vomit is green (aka it has bile in it). This problem is called ___

Answer 35

Dorsal (greater curvature), ventral (lesser curvature) Hypertrophic pyloric stenosis Duodenum atresia (completely blocked) ** This occurs in the second or third part of the stomach, so bile has gotten in there ^** If the ileum or jejunum is also blocked, this could result in the bile vomit as well aka ******malrotation or a volvulus would also cause this condition****** ^* Presents with double bubble sign

Question 36

During development, you have the umbilical vein carrying blood from the placenta to to the ___ and then into the IVC. When you cut off the umbilical vein after birth, you no longer need the ductus venosus as well and becomes the ___

Answer 36

Ductus venosus, ligamentum venosum

Question 37

**** PROBS A TEST QUESTION An atresia (complete closure) of the biles ducts causes no bile to go from the liver into the GI system. This causes pale stool (since not bile is getting into intestines), dark urine (since bilirubin is being filtered by the kidney), and Jaundice (due to the high levels of bilirubin in the blood) and this is called ___

Answer 37

Extrahepatic biliary atresia

Question 38

A ___ pancreas is when the ventral and dorsal pancreatic buds form a ring around the duodenum instead of coming together properly and this presents as a duodenal obstrution

Answer 38

Annular

Question 39

An ___ atresia occurs in the proximal ___, has a short intestine and the portion distal to the defect is coiled around the mesenteric remnant

Answer 39

Apple peel Jejunum

Question 40

Abnormally positioned viscera, leading to increased risk of entrapment of portions of the intestine is called ___ and a characteristic feature of this is ___ (peritoneal tissue that attatches the cecum to the abdominal wall and creates an obstruction of the duodenum Abnormal twisting of the intestines, that compromises the intestine or the blood flow is called a ___

Answer 40

Malrotation Ladd's bands Volvulus

Question 41

The enfolding of one segment of the intestine within another is ___

Answer 41

Intussusception

Question 42

*** ONE OF THESE WILL BE A TEST QUESTION A ___ is a herniation of the gut contents, into the umbilical cord, that does not return to the body AND IS INCASED IN A MEMBRANOUS SAC ^ FUCKING KNOW THAT IF IT'S ENCASED IN A MEMBRANOUS SAC, IT'S AN OMPHALOCELE A ___ is a herniation of the gut contents out into the amniotic cavity due to a defect in the anterior abdominal wall musculature to close during folding ^ KNOW THAT IF IT IS FREE IN THE AMNIOTIC CAVITY AKA GUT CONTENTS NOT SURROUNDED BY A MEMBRANE AKA NOT CONTAINED WITHIN THE UMBILICAL CORD, IT IS A GASTROSCHISIS

Answer 42

Omphalocele Gastroschisis

Question 43

A defect in the musculature of the anterior abdominal wall (deficient or absent, urinary tract anomalies, and undescended testicles (cryptorchidism) lead to a diagnosis of ___ ^ Not due to a defect in the closure of the anterior abdominal wall like in gastroschisis, it's due to the fact that the wall itself is absent or weak

Answer 43

Prune belly (or Eagle-Barrett) syndrome ^ Called PBS

Question 44

** THIS IS A BILLION PERCENT GOING TO BE ON THE TEST The Vitelline duct, which is a connection out to the yolk sack when the yolk sack was pulled out into the umbilical cord, sometimes does not close off like it should and this can forms an outpocketing of the ileum, called Meckel's diverticulum So once again, KNOW THAT MECKEL's DIVERTICULUM AKA ILEAL DIVERTICULUM IS A REMNANT OF THE VITELLINE DUCT If feces is leaking from the umbilicus, think ____

Answer 44

Vitelline duct, Meckel's diverticulum Vitelline fistula (also called umbilical fistula, and Dr. Cole referred to it as a Ileal/Meckel's fistula)

Question 45

The failure of neural crest cells to migrate during intestinal development down to the hindgut (most common) to form the __ ganglion cells, causing no Myenteric plexus to form (since the neural crest cells are suppose to become the ganglion cells), is ___ disease This is a motor disorder of the colon that causes a functional intestinal obstruction and affects BOTH plexuses and without ____ innervation, the **colon can't relax or undergo peristalsis **

Answer 45

Colonic, Hirschsprung disease Parasympathetic

Question 46

Anorectal malformations can occur via abnormalities in the formation of the cloaca and/or urorectal septum. They can be classified as __ if the anal canal ends as a blind sac BELOW the pelvic diaphragm and are ___ if the blind pouch ends ABOVE the pelvic diaphragm Which one is better?

Answer 46

Low, High Low, because the pelvic diaphragm contributes to fecal contents

Question 47

Name the enzyme 1) Stimulates gastric acid secretion 2) Stimulates secretion of pancreatic enzymes 3) Stimulates secretion of water and bicarbonate 4) Strong stimulant of appetite and growth hormone 5) Inhibits gastric secretion and mobility

Answer 47

1) Gastrin 2) Cholecystokinin (CCK) 3) Secretin 4) Ghrelin 5) Gastric inhibitory peptide

Question 48

Intestinal glands (large and small intestines) are called ___, so if you see this then think of the enterocytes, goblet cells, paneth cells, and G-cells... ** Don't confuse this with gastric glands that contain different cell types and are located ONLY in the stomach!

Answer 48

Crypts of Lieberkuhn

Question 49

The exocrine function of the pancreas is served by ___ cells that secrete digestive enzymes into the intercalated ducts and the duct cells called ___ cells that supply an alkaline buffer solution

Answer 49

Pancreatic acinar, centroacinar

Question 50

The exocrine function of the pancreas is served by ___ cells that secrete digestive enzymes into the intercalated ducts and the duct cells called ___ cells that supply an alkaline buffer solution

Answer 50

Pancreatic acinar, centroacinar