Download SESSION 13 - Mesenteries, Bowel And Stomach

SESSION 13 - Mesenteries, Bowel And Stomach
1. Name four structures that are overlain by the attachment of the small bowel
mesentery.
2. What artery supplies the appendix?
3. You are looking for the appendix and it is not immediately apparent. What structures
in the wall of the caecum could you follow to find it?
4. Apart from blood vessels and fat, what two other structures would you expect to find
in the mesentery?
5. What are the appendices epiploicae? In what part of the bowel would you expect to
find them? In what part of the large bowel would you not expect to find them?
6. What is the definition of a portal (venous) system?
7. Which two important organs in the upper abdomen are not drained by the portal
system?
8. Which two large veins join to make the portal vein and where does this junction
occur?
9. The inferior mesenteric vein is remarkably constant in its position in the
retroperitoneum. Is it just to the left or right of the duodenojejunal junction?
10. How far along the transverse colon is the watershed for venous drainage and arterial
supply of the superior and inferior mesenteric veins and arteries? What other
significant event occurs at this site?
11. Portosystemic anastomoses become clinically important in liver disease associated
with portal hypertension. What are the systemic and portal contributions to each of
these sites:
(a) Lower rectum and upper anal canal
(b) Lower oesophagus
(c) Around umbilicus
(d) Bare area of liver
12. To lower the pressure in the portal system it is sometimes necessary to anastomose
two large branches of the systemic and portal systems. There are two sites where this
is convenient what are they?
13. The foregut is supplied by branches of the ……….. artery, the midgut by the ……..
artery and the hind gut by the ……… artery.
14. Knowing the three embryological divisions of the gut (see question 13) what is the
FIRST branch of the superior mesenteric artery?
15. What is the name of the artery that gives continuity between the supplies of the mid
and hind gut upon which surgeons rely at bowel surgery?
16. What are haustra and why do they form?
17. How long is the intra-abdominal oesophagus? What factors stop food regurgitating
from the stomach into it?
18. What do we call the condition when the upper part of the stomach slides up through
the diaphragm into the lower chest?
19. Which branch of the coeliac trunk supplies the lower third of the oesophagus?
20. How do the short gastric arteries arise? What part of the stomach do they supply?
What ligament do they run in and what accompanies them?
21. What two main vessels and one other structure lie in the lienorenal ligament?
22. Is there peritoneum between the spleen and left kidney?
23. What nerve makes the stomach contract and opens the pylorus?
24. In which three directions does the first part of the duodenum run?
25. Pain from the right side of the transverse colon is detected by the ……….. part of the
autonomic nervous system and because this part of the colon belongs to the ………
gut, the pain is carried by the ……… splanchnic nerves and hence is referred to
dermatomes T ….., ……, which are peri ……… in their distribution.
26. Referred pain from the intestine is always midline. Which are the only two organs in
the upper abdomen that could give unilateral referred pain?
27. What embryological remnant does a Meckel's diverticulum represent? What other
condition does an inflamed Meckel's diverticulum mimic?