GIT Viscera (Stomach, Intestines)

1.A middle aged man visited the surgical OPD with history of bleeding per anum since three months. On clinical examination he was found to have internal hemorrhoids. From your knowledge of anatomy describe the anal canal under the following headings:  Mucosal anatomy  sphincteric muscles  blood supply  clinical aspects

2.Describe the Anal canal under the following Headings

• a) Extent of the Canal
• b) Interior features of the Anal canal
• c) Blood and Nerve supply of the Anal canal
• d) Anatomical basis of haemorrhoids

3.During endoscopy, the doctor identified an ulcer in the organ situated in epigastric region, identified as stomach. Describe stomach under following

• a) Presenting parts and relations
• b) blood supply and lymphatic drainage
• c) applied aspects

4.A 62 years old man with progressive weight loss complains of pain and bleeding near the anal orifice. His condition is diagnosed as carcinoma of the anal canal. At this stage of the disease, the neoplasm is located entirely below the pectinate line. Based on your anatomical knowledge, answer the following questions: • To which group of lymph nodes, cancer from this part of anal canal is likely to spread. • Name the nerve carrying pain sensation from this part of the anal canal. • Describe briefly describe the interior of the anal canal with the help of a diagram • How the development, arterial supply, venous and lymphatic drainage and the nature of the epithelial lining of the anal canal differ from each other above and below pectinate line. • What is the clinical significance of knowing the venous drainage of the anal canal

1.Second part of duodenum

2.Blood supply and lymphatic drainage of stomach

3.Duodenum – parts, relations, openings, blood supply

4.Duodenum

1.Interior of anal canal

2.Explain the various positions of vermiform appendix and its applied anatomy

3.Vermiform appendix

4.Lymphatic drainage of stomach and its applied importance

1.Transverse section through the trans pyloric plane

2.Most common position of vermiform appendix

3.Stomach bed

1.Failure of differentiation of the individual organs derived from the embryonic foregut would cause malformation of which of the following organs

• 1) Gall bladder
• 2) Oesophagus
• 3) Stomach
• 4) Ascending colon
• a) 1, 2, 3
• b) 1, 3, 4
• c) 1, 2, 4
• d) 2, 3

2.Which of the following statements are true regarding anal canal

• 1) Internal painless piles arise from the lower cutaneous part of anal canal
• 2) Lower part of anal canal drains into Superficial Inguinal lymph nodes.
• 3) Autonomic nervous system supplies the lower part of anal canal.
• 4) Lower part of anal canal receives blood supply mainly from inferior rectal artery
• a) 2, 3, 4
• b) 1, 2, 3
• c) 2, 4
• d) 1, 3

3.All of the following are derived from hindgut EXCEPT

• a) Rectum
• b) Appendix
• c) Descending colon
• d) Sigmoid colon

4.Which of the following statement/s is /are true about the pectinate line of anal canal?

• i) Represents embryologically two different sources of development
• ii) Below the line the anal canal is supplied by inferior rectal vessels
• iii) Lymphatics from the anal canal inferior to the line drain into internal iliac nodes
• iv) Part of the anal canal superior to the line is insensitive to pain
• a) i, ii, iii
• b) i, iii, iv
• c) i, ii, iv
• d) i, ii

5.Which part of the duodenum is involved in this boy

• a) First
• b) Second
• c) Third
• d) Fourth