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MRCS B Anatomy Exam
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MRCS B Anatomy Exam MRCS B Anatomy Exam MRCS B Anatomy Exam
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MRCS B Anatomy ExamWhat are the four parts of the stomach? - ANS cardia, fundus, body, pylorus
How could you tell the difference between the jejunum and the ileum? - ANS The jejunum is larger,
thicker, more vascular and a darker red than the ileum.
It has longer vasa recta and fewer arcades.
How can you tell the difference between large and small bowel on an abdominal radiograph? - ANS
Large bowel has haustrae, which extend only a third of the way across the bowel from each side,
whereas small bowel has valvulae conniventes which traverse the complete distance.
Occasionally, location can help, with small bowel tending to be more central (beware a drooping
transverse colon!).
During an operative procedure, the colon can be further distinguished from small bowel by the presence
of the appendices epiploicae and taenia coli.
What are the functions of the pancreas? - ANS The pancreas has both exocrine and endocrine functions.
The pancreatic acini perform the exocrine functions, producing and secreting digestive enzymes.
The Islets of Langerhans perform the endocrine function:
Alpha cells - produce and secrete glucagon
Beta cells - produce and secrete insulin
Delta cells - produce and secrete somatostatin
,Gamma cells - produce pancreatic polypeptide
Describe the blood supply to the pancreas - ANS The pancreas has three main sources of blood supply:
The superior pancreaticoduodenal (from the gastroduodenal) and inferior pancreaticoduodenal (from
the superior mesenteric) arteries supply the head of the pancreas.
Pancreatic branches from the splenic artery supply the remainder of the pancreas.
Venous drainage follows arterial supply, to the superior mesenteric and portal veins, and the splenic
vein respectively.
What is Meckel's diverticulum? - ANS Meckel's diverticulum is the remnant of the embryological
vitellointestinal duct (which connects the midgut to the yolk sac).
Commonly it obeys the 'Rule of 2s': occurs in 2% of the population; is 2 inches long; occurs 2 feet from
the ileocaecal valve and is twice as common in males as in females. It should be looked for during all
appendicectomies when a normal appendix is found.
It is important as a Meckel's can cause a number of complications:
Acute inflammation - can often mimic appendicitis, and should always be looked for at laparoscopy
when a normal appendix is found.
Ulceration and bleeding - often the diverticulum is lined with hydrochloric acid producing gastric mucosa
Perforation
Intussusception
Obstruction
Littre's Hernia - when found in an inguinal or femoral hernia sac
, What are the relations of the kidney? - ANS The immediate relations to the kidney are:
Above - the diaphragm
Below - quadratus lumborum
Medially - psoas major
Laterally - transversus abdominis
antero-superiorly - adrenal glands
Each kidney has numerous anterior relations as seen here:
Which fascia surrounds the kidneys? - ANS Gerota's fascia
What are the surface markings of the liver? - ANS The liver can be visualized as a triangle. The superior
border of the liver is a line that runs from the fifth intercostal space midclavicular line on the left to the
fourth intercostal space midclavicular line on the right. Its lowest edge is found around the 10th right
costal cartilage in the mid axillary line
What is the blood supply to the liver? - ANS The liver receives a dual blood supply: 75% from the hepatic
portal vein carrying blood from the gastrointestinal tract to the liver and 25% from the hepatic artery,
which is a branch of the coeliac axis of the aorta.
What is the function of the gallbladder? - ANS Storing bile
Concentrating bile
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