Usmle Gi Step 1

Front 1

Name the ligament that connect the liver to the anterior abdominal wall.

Back 1

falciform ligament

Front 2

What structure does the falciform ligament contain?

Back 2

ligamentum teres

Front 3

What ligament connects the liver to the duodenum?

Back 3

hepatoduodenal

Front 4

What structures are contained in the hepatoduodenal ligament?

Back 4

hepatic artery, portal vein, common bile duct

Front 5

What ligament connects the greater and lesser sacs?

Back 5

hepatoduodenal ligament

Front 6

What ligament connects the liver to lesser curvature of stomach?

Back 6

gastrohepatic ligament

Front 7

What ligament separates the right greater and lesser sacs?

Back 7

gastrohepatic artery

Front 8

What ligament can be cut during surgery to access the lesser sac?

Back 8

the gastrohepatic artery

Front 9

What ligament connects the greater curvature and the transverse colon?

Back 9

the gastrocolic ligament

Front 10

What structures are contained in the gastrocolic ligament?

Back 10

gastroepiploic arteries

Front 11

What ligament connects the greater curvature of the stomach and the spleen?

Back 11

gastrosplenic

Front 12

Which ligament separates the left greater and lesser sacs?

Back 12

the gastrosplenic

Front 13

What structures does the gastrosplenic ligament contain?

Back 13

short gastric arteries

Front 14

What ligament connects the spleen to posterior abdominal wall?

Back 14

splenorenal ligament

Front 15

What structures are contained in the splenorenal ligament?

Back 15

the splenic artery and vein

Front 16

What are the layers & their roles of the gut mucosa?

Back 16

epithelium (absorption), lamina propria (support), muscularis mucosae (motility)

Front 17

What does the submucosa contain?

Back 17

Meissner's plexus (aka submucosal nerve plexus)

Front 18

What does the muscularis externa include?

Back 18

Myenteric nerve plexus (aka Auerbach's)

Front 19

Which portion of the gut has the most frequent slow waves?

Back 19

duodenum

Front 20

Which portion of the gut has the least frequent slow waves?

Back 20

stomach

Front 21

What type of epithelium does that esophagus have?

Back 21

nonkeratinized stratified squamous

Front 22

Where do you find Brunner's glands and crypts of Lieberkuhn?

Back 22

duodenum

Front 23

Which part of the small intestine has the largest number of goblet cells?

Back 23

jejunum

Front 24

Where do you find Peyer's patches?

Back 24

in the ileum

Front 25

Which part of the gut has crypts but no vili?

Back 25

colon

Front 26

Which part of the esophagus has striated muscle?

Back 26

upper 1/3

Front 27

Which part of the esophagus has striated and smooth muscle?

Back 27

middle 1/3

Front 28

Which part of the esophagus has smooth muscle only?

Back 28

lower 1/3

Front 29

Name the order of superior mesenteric, testicular/ovarian, inferior mesenteric, and renal arteries from superior to inferior

Back 29

superior mesenteric, renal, testicular/ovarian, inferior mesenteric

Front 30

Which nerve provides parasympathetic innervation to the foregut and midgut?

Back 30

vagus

Front 31

Which nerve provides parasympathetic innervation to the hindgut?

Back 31

pelvic n.

Front 32

The foregut is found at what vertebral level?

Back 32

T12/L1

Front 33

The midgut is found at what vertebral level?

Back 33

L1

Front 34

The hindgut is found at what vertebral level?

Back 34

L3

Front 35

Where does the foregut end and the midgut start?

Back 35

halfway through the duodenum

Front 36

Where does the midgut end and the hindgut start?

Back 36

after 2/3 of the transverse colon, midgut ends

Front 37

If you had a blockage in the aorta above the celiac trunk, how could the blood get around it?

Back 37

subclavian artery --> superior epigastric --> inferior epigastric --> external iliac

Front 38

If you had a blockage in the aorta below the celiac trunk but above the SMA, how could the blood get around it?

Back 38

celiac trunk --> common hepatic --> gastroduodenal --> superior pancreatoduodenal --> inferior pancreatoduodenal --> SMA

Front 39

If you had a blockage in the aorta below the SMA, how could blood get around it?

Back 39

SMA--> middle colic artery --> left colic artery --> IMA

Front 40

If you had a blockage in the aorta below the IMA, how could blood get around it?

Back 40

IMA --> superior rectal --> middle rectal --> left internal iliac

Front 41

Ulcer in posterior wall of first part of duodenum could involve which artery?

Back 41

gastroduodenal

Front 42

Ulcer in anterior wall of 3rd part of duodenum could involve?

Back 42

SMA

Front 43

Describe the portal and systemic vessel that anastamose, causing esophageal varices

Back 43

portal- left gastric, systemic- esophageal vein

Front 44

Describe the portal and systemic vessel the anastamose, causing caput medusae

Back 44

portal- paraumbilical vein, systemic- superficial & inferior epigastric veins

Front 45

Describe the portal and systemic vessel that anastamose, causing internal hemorrhoids

Back 45

portal- superior rectal, systemic- middle and inferior rectal veins

Front 46

Name two places you can put a shunt to relieve portal hypertension.

Back 46

1) splenic vein to left renal vein
2) portal vein to hepatic vein --> IVC (TIPS)

Front 47

Describe the difference histologically between above the pectinate line and below it

Back 47

above- glandular epithelium
below- squamous epithelium

Front 48

Describe the different in embryological derivation above the pectinate line and below it

Back 48

above- endoderm, below- ectoderm

Front 49

Desribe the arterial supply to the rectum above the pectinate line

Back 49

superior rectal artery, which is a branch of the IMA

Front 50

Describe the arterial supply to the rectum below the pectinate line

Back 50

inferior rectal artery, which is a branch of the internal pudendal artery

Front 51

What's the venous drainage of the rectum above the pectinate line?

Back 51

superior rectal vein --> inferior mesenteric vein --> portal system

Front 52

What's the venous drainage of the rectum below the pectinate line?

Back 52

inferior rectal vein --> internal pudendal vein --> internal iliac vein --> IVC

Front 53

Why are internal hemorrhoids not painful but external hemorrhoids are?

Back 53

Internal receive visceral innervation, eternal receive somatic innervation (inf. rectal nerve which is a branch of the pudendal)

Front 54

Cancer in the descending colon would metastasize to which LNs?

Back 54

inferior mesenteric

Front 55

Which zone of the liver is most susceptible to hypoxia?

Back 55

zone 3 (last one to get blood)

Front 56

What's the difference between the ampulla of vater and the sphincter of oddi?

Back 56

ampulla of vater is the lumen of the duct, sphincter of oddi is the sphincter around the duct; duct is going from pancreas into duodenum

Front 57

Tumors where in the pancreas might block the bile duct?

Back 57

The head of the pancreas

Front 58

Describe the organization of the femoral region from lateral to medial

Back 58

Nerve, artery, vein, empty space, lymphatic (NAVEL)

Front 59

which structures are found in the femoral triangle?

Back 59

femoral vein, artery, nerve

Front 60

Which structures are found in the femoral sheath?

Back 60

femoral artery, nerve, and deep inguinal lymph nodes

Front 61

What is a hiatal hernia?

Back 61

Stomach herniates upward through the esophageal hiatus of the diaphragm

Front 62

What's the difference between a hital hernia and a paraesophageal hernia?

Back 62

Hiatal- stomach pulled up through diaphragm, making GE junction even more superior

Paraesophageal- stomach pulled up alongside GE junction, so the GE junction is still in the same place but the stomach is popping up through the diaphragm next to it

Front 63

What sx would you see with a hiatal hernia?

Back 63

chronic regurgitation and heartburn, also "hourglass stomach"

Front 64

Which type of hernia is covered by all three layers of fascia?

Back 64

indirect

Front 65

Which type of hernia is covered only by external spermatic fascia?

Back 65

direct

Front 66

Which type of hernia is a leading cause of bowel incarceration?

Back 66

femoral hernia

Front 67

Name the hormone:
secreted by G cells in the antrum of the stomach

Back 67

gastrin

Front 68

Name the hormone:
increases gastric H+ secretion, growth of gastric mucosa, and gastric motility

Back 68

gastrin

Front 69

Name the hormone:
increased release due to stomach distention/alkalinization, amino acids, peptides, vagal stimulation, and decreased release when stomach pH drops < 1.5

Back 69

gastrin

Front 70

Name the hormone:
Increased in zollinger ellison syndrome

Back 70

gastrin

Front 71

Name the hormone:
Phenylalanine and tryptophan are potent stimulators

Back 71

gastrin

Front 72

Name the hormone:
Secreted by I cells in the duodenum and jejunum

Back 72

cholecystokinin

Front 73

Name the hormone: increases overall pancreatic secretion, increases gallbladder contraction, decreases gastric emptying, and increases growth of the exocrine pancreas

Back 73

CCK

Front 74

Name the hormone:
increased by fatty acids and amino acids

Back 74

CCK

Front 75

What type of neural pathways does CCK activate in the pancreas?

Back 75

muscarinic

Front 76

Name the hormone:
Secreted by S cells in the duodenum

Back 76

secretin

Front 77

Name the hormone:
Increases pancreatic HCO3 secretion, decreases gastric acid secretion, increases bile secretion, and increases the growth of the exocrine pancreas

Back 77

secretin

Front 78

Name the hormone:
increased by acid & fatty acids in the lumen of the duodenum

Back 78

secretin

Front 79

Why is it important to neutralize the acid in the duodenum?

Back 79

so pancreatic enzymes can work

Front 80

Name the hormone:
Secreted by D cells in the pancreatic islets and GI mucosa

Back 80

somatostatin

Front 81

What's a synthetic analogue to somatostatin?

Back 81

octreotide

Front 82

Name the hormone:
decreases gastric acid and pepsinogen secretion, decreases pancreatic and small intestine fluid secretion, decreases gallbladder contraction, decrease insulin and glucagon release

Back 82

somatostatin

Front 83

Name the hormone:
increased by acid, decreased by vagal stimulation

Back 83

somatostatin

Front 84

What is somatostatin used to treat (4)?

Back 84

carcinoid tumor, zollinger ellison syndrome, insulinoma, glucagonoma

Front 85

Name the hormone:
Secreted by K cells (duodenum, jejunum)

Back 85

GIP aka glucose dependendent insulinotropic peptide

Front 86

Name the hormone:
Decreases gastric H+ secretion & increase insulin release

Back 86

GIP

Front 87

Name the hormone:
Increased by fatty acids, amino acids, and oral glucose

Back 87

GIP

Front 88

Which is used more quickly, oral glucose or IV?

Back 88

oral

Front 89

Name the hormone:
Released by parasympathetic ganglia in sphincters, gallbladder, and small intestine

Back 89

VIP

Front 90

Name the hormone:
Increases intestinal water and electrolyte secretion, increases relaxation of smooth muscle and sphincters

Back 90

VIP

Front 91

Name the hormone:
Increased by distention and vagal stimulation, decreased by somatostatin and adrenergic input

Back 91

VIP

Front 92

What's the the name for a non alpha, non beta, islet cell pancreatic tumor that causes copious diarrhea?

Back 92

VIPoma

Front 93

Name the hormone:
causes smooth muscle relaxation, including lower esophageal sphincter

Back 93

NO

Front 94

Loss of what chemical i the ss implicated in increased lower esophageal tone of achalasia?

Back 94

NO

Front 95

Name the hormone:
Produced by the small intestine, causes migrating motor complexes

Back 95

motilin

Front 96

motilin is stimulated by what class of antibiotics?

Back 96

macrolides

Front 97

When is motilin increased?

Back 97

in fasting state

Front 98

Name the hormone:
Produced by parietal cells in the stomach, binds vitamin B12

Back 98

IF

Front 99

Name the hormone:
Produced by parietal cells in the stomach, decreases stomach pH

Back 99

gastric acid

Front 100

Name the hormone:
Increased by histamine, ACh, gastrin
Decreased by somatostatin, GIP, prostaglandin, secretin

Back 100

gastric acid

Front 101

Name the hormone:
Secreted by the chief cells of the stomach

Back 101

pepsin

Front 102

Name the hormone:
Required for protein digestion; secreted by stomach

Back 102

pepsin

Front 103

What catalyzes pepsinogen --> pepsin?

Back 103

H+

Front 104

Name the hormone:
produced by mucosal cells in the stomach, duodenum, salivary glands, pancreas, and Brunner's glands

Back 104

HCO3-

Front 105

Name the hormone:
Increased in the presence of secretin

Back 105

HCO3-

Front 106

Which salivary gland secretes the most serous mucus?

Back 106

parotid (Serous on the Sides)

Front 107

Which salivary gland secretes the most mucinous mucus?

Back 107

sublingual (Mucinous in the Middle)

Front 108

Salivary gland is stimulated by what type of nerves?

Back 108

Both sympathetic (T1-T3) and parasympathetic (facial/glossopharyngeal n.) activity

Front 109

When is saliva more hypotonic?

Back 109

At a low flow rate- bc there's more time reabsorb Na+ and Cl-

Front 110

When is saliva more isotonic?

Back 110

At a high flow rate- bc there's less time to reabsorb Na+ and Cl-

Front 111

What nerve runs through the parotid gland and can be damaged during surgery?

Back 111

CN VII