:P

Question 1

the muscles in the pharynx are innervated by which nerve, except for the stylopharnygeal muscle - which is innervated by which nerve?

Answer 1

• all pharynx muscles innervated by: vagus nerve

EXCEPT:

• stylopharyngeus muscles which is innervated by the glossopharyngeal nerve (CNIX).

Question 2

what is the migrating motor complex?

where can it originate?

what is its functions? (2)

Answer 2

migrating motor complex: propagating contractions every 90-120 mins. 3 phases

• *originates**:
  a) stomach - vagus dependent
  b) small intestine - vagus independent

functions:

a) clear undigested material
b) prevents bacteria overgrowth

Question 3

what anatomical features of the colon ensure that peristalsis is modified? [2]

how does bolus move along colon? (2)

Answer 3

what anatomical features of the colon ensure that peristalsis is modified?
- get bulges of outer circular muscle (haustra), which are held together by three bands of circular muscle: taenia

- taenia can contract in either direction

how does bolus move along colon? (2)

- constrictive ring occurs (giant migrating concentration) and haustra disappear (!) from a portion of the ascending colon

~20cm of the colon distal to the constrictive ring lose their haustrations and contract as a unit, propelling faecal material into the transverse colon

Question 4

cardia and pyloric mucosa:

• where find?
• cell types?
• function?
• what are nuclei like?

Answer 4

cardia and pyloric mucosa:

• *- location**
  i) cardia: start / oesph -> stomach
  ii) pyloric: end / stomach -> duo

- cell types: columnar epithelium - mucous secreting cells

- function: protec the oesphageal epithelium and pyloric mucosa against gastric juices

- nuceli: small & close to basal domain

Question 5

Q

sensory innervation of the pharynx is from which nerve?

what are the constrictor muscles called in pharynx? - innervated by?

Answer 5

sensory innervation of the pharynx is from glossopharnygeal nerve

constrictor muscles: superior, middle and inferior constrictors. **vagus nerve innervation

_baso:

• sensory innervation = CNIX
• motor inneration = CNX_**

Question 6

3. which nerve plexuses do u find in the oesphagus? (2) and where do find them?

Answer 6

• *- meissner plexus:** submucosal tissue
• *- auerbach’s plexus:** myenteric - betweeen circ and long. muscle layer

Question 7

(in the whole body): rank antibodies in their order

Answer 7

IgG most common 75% of Ig are IgG

IgM 3rd most common but 1st to be made

IgA 2nd most common

IgD very low

IgE least common in serum as binds tightly to basophils and mast cells even before interacting with antigen

Question 8

name of the sphincter muscle which encircles the mouth:?

Answer 8

name of the sphincter muscle which encircles the mouth: orbicularis oris

Question 9

in the anal and rectal area what are the different cell types in:

colorectal zone?
anal transitional zone?
squamous zone?

Answer 9

in the anal and rectal area what are the different cell types in:

colorectal zone: simple columnar epi
anal transitional zone: transition betwen simple columnar and and stratified squamous epi
squamous zone: stratified squamous

Question 10

which part of muscaluris muscosa

1. becomes internal anal sphincter?
   2 extends over sphincter & attaches to CT?
2. becomes external anal sphincter?

Answer 10

which part of muscaluris muscosa:

circ muscle: becomes internal anal sphincter
long muscle: extends over sphincter & attaches to CT
skeletal muscle: external anal sphincter

Question 11

which hormone is released when have hypocalcemia?

what is it effects? (3)

what is 1. inhibited by?

Answer 11

fall in calcium: PTH (parathryoid hormone) rises - restores calcium back to normal by:

• Increased renal Ca++ reabsorption.
• Increased bone Ca++ release.
• Increased gut absorption via release of vitamin D (1,25vitD).

The release if PTH is inhibited by raised Ca++ levels.

Question 12

what is the differnece in the role of the intrisic and extrinsic muscles of mouth?

Answer 12

intrinsic muscle: change shape
extrinsic muscle: change position

Question 13

orbicularis oris and buccinator are both innnervated by which nerve? [1]

Answer 13

orbicularis oris and buccinator are both innnervated by facial nerve [1]

Question 14

Q

which antibody is commonly (1/200) deficient?
why is this very often not recognised?

Answer 14

A

IgA deficiency is quite common, yet no one knows they have it.

This is because IgM has a J chain so IgM undergoes a compensatory response and does the same job IgA would

Question 15

what are two seperate roles of aldosterone? [2]

Answer 15

1. restores BP, reabsorbed salt & water lvls (not excrete as much)
2. restores K loss !

(two totally differnet systems! )

Question 16

which muscles of mastiication are involved in:

a) elevation and retraction?
b) elevation and protrusion?
c) depression and protrusion?
d) elevation and protrusion?

Answer 16

a) elevation and retraction: temporalis
b) elevation and protrusion: masseter
c) depression & protrusion: lateral pterygoid
d) elevation and protrusion: medial pterygoid

Question 17

Q

what is the special and general sensory innervation for the a) anterior 2/3 tongue? b) posterior 1/3 tongue

Answer 17

• *a) anterior 2/3 tongue**
• special: facial -> chorda tympani
• general: lingual nerve (V3)
• *b) posterior 1/3 tongue**
• special: glossopharyngeal
• general: glossopharyngeal

Question 18

what are the two groups of muscles in the tongue?
how do they move the tongue?
innervated by?

Answer 18

• two groups: intrinsic (superficial) & extrinsic (deep)
• *- intrinsic** changes shape
• extrinsic changes position
• both innervated by hypoglossal nerve (CN XII)

Question 19

IgD

• role?
• shape??
• how common?
• contains?

Answer 19

IgD

• role: antigen receptor on B cells that have not been exposed to antigens.
• activates basophils and mast cells = make antimicrobrial factors
• *- activates B cells**
• how common: very low levels

Question 20

describe the structure of IgA and IgM - how many binding sites do they have?

what do they both contain?

Answer 20

IgA: dimer !! (know this) - can form 4 binding sites

IgM: pentamer - can form 10 bindings sites

= form multimers

• both have J chain: (The joining (J) chain is a small polypeptide, expressed by mucosal and glandular plasma cells)

Question 21

submanidublar gland recieves parasympathetic innervation from which nerve?

Answer 21

• submanidublar gland recieves parasympathetic innervation from facial nerve (CN VII) nerve

Question 22

how does pit. gland control FSH & LH hormone release?

why is it more complex in women then men?

Answer 22

hypothalamic hormones: GnRH + kisspeptin

regulate release of: FSH and LH from pituitary.

FSH & LH cause sex steroid release (testosterone / oestrogen) , ovulation, spermatogenesis.

in women: estradiol +ve and -ve feedback depends on stage of menstruation

Question 23

name for the muscle that causes upper oesphapgeal sphincter? [1]

Answer 23

• is produced by which skeletal muscle: cricopharyngeus muscle

Question 24

1. in the small intestine, enzymes are secreted by small intestinal cells called?
2. what are the folds called in the small intestine?
3. what are the main histological feature of small intestine? (2)
4. what are the lieberkuhns crpyts?

Answer 24

1. in the small intestine, enzymes are secreted by small intestinal cells called enterocytes
2. what are the folds called in the small intestine: plicae circularis
3. what are the main histological feature of small intestine: villi (projections of the mucosa) & microvilli

4. lieberkuhns crpyts: gland found in between villi

Question 25

which nerve provides sensory innervation for the entire face? - how is it split up? (3) - which of ^ supply superior teeth? - which of ^ supply inferior teeth?

Answer 25

* *trigeminal nerve (CN V):** - ophthalamic (V1) - maxillary (V2) - mandibular (V3) - maxillary V2 ---\> **superior alveolar nerve:** supplies superior teeth - mandible V3 ---\> **inferior alveolar nerve (** --\> mental nerve) supplies inferior teeth

Question 26

how do u tell the difference between paneth and endocrine cells?

Answer 26

**Paneth** granules are above nucleus (supranuclear) & **appear pink = P4P** **endocrine** granules are beneath the nucleus (**subnuclear**)

Question 27

what type of hormones are thyroid hormones? produced from what? what is active / inactive names? how does it circulate around body?

Answer 27

biological amines - produced from tyrosine T4 (inactive) is produced by thyroid gland -\> converted to T3 to be active (via deiodinise enzyme) circulates as T3, but attached to thryoid binding globulin

Question 28

Q how does peristalsis occur in oesophagius ? (primary / secondary waves?)

Answer 28

**peristalsis:** - bolus enters **striated muscle**, initiates **primary peristaltic wave.** pressures changes / waves of contraction push bolus down. - this stimulates s**tretch receptors** = **secondary peristaltic wave of smooth muscl**e (back up secondary wave) pushes the bolus into the stomach

Question 29

what is the ileal brake caused by? [1] what does cause secretion of ? [2]

Answer 29

- **fats** reach the ileum (even tho theyre meant to have been absorbed in duodenum) - causes release of **peptide YY & glucagon-like peptide-1 (GLP-1)** by enteroendocrine cells = slows gastric emptying

Question 30

parotid gland recieves parasympathetic innervation from which nerve?

Answer 30

parotid gland recieves parasympathetic innervation from **glossopharyngeal nerve**

Question 31

Q how do u tell histoligcally if you have significant oesophagitis? (2) how do u tell histoligcally if you have barret oesph? (1) how do u tell histoligcally if you have CD? (3)

Answer 31

**significant oesophagitis:** eosinophils in squamous mucosa & neutrophils **barret oesophagus:** complication of chronic gastro reflux disease (GERD). characterised by change of squamous mucosa in oesph to simple columnar epithelim **CD**: atrophy of villi (1), hyperplasia of intestinal crypts, more lymphocytes

Question 32

whats the role of the soft palate?

Answer 32

soft palate: elevates during swallowing to prevent food moving into nasal cavity

Question 33

muscles of mastication are supplied by which nerve?

Answer 33

manidublar nerve V3

Question 34

for anterior 2/3 tongue: which nerve supplies the a) special sensory (taste) b) general sensory (pressure etc) c) motor sensory?

Answer 34

**anterior 2/3 tongue:** nerve supplies the a) special sensory (taste): _CN VII - facial nerve - **chorda tympani**_ b) general sensory (pressure etc): _CN V - trigeminal nerve (V3, mandibular nerve)_ c) motor sensory: _hypoglossal nerve - CN XII_ **for posterior 1/3 tongue:** nerve supplies the a) special sensory (taste): _glossopharnyngeal nerve (CN IX)_ b) general sensory (pressure etc): _glossopharnyngeal nerve (CN IX)_ c) motor sensory: _hypoglossal nerve - CN XII_

Question 35

describe how movement of stomach smooth muscle is initated? at which cells?

Answer 35

human stomach movement: - random depolarisation of interstitial cells of cajal is communicated to smooth muscle cells, via gap junctions - slow waves of electrical activity propagte from dominant pacemake in corpus (see photo)

Question 36

eustachian tube is made from what?

Answer 36

fibrocartliage !

Question 37

name the three papillae in the tongue which have taste buds (2)

Answer 37

- fungiform papillae: located anteriorly - filiform papillae: loacted centrally - circumvallate papillae: located posteriorly fungiform and circumvallate = taste buds

Question 38

what are the main histological differences between the duodenum, jejunum and ileum?

Answer 38

_duodenum_: - have **brunner's glands i**n submucosa: produce secretion that neutralises acidic chyme from stomach - villi are shorter _jejunum:_ - no brunners glands - long, finger like villi with well developed **lacteal** (lympathic vessel) in the core _ileum_: * *- peyers patches** (lymphoid aggregations / nodules in the mucosa. form part of **GALT** - shorter villi - most goblet cells - prominant fat in submucosa

Question 39

where is endocrine fucntion of pancreas located?

Answer 39

islets of langerhans

Question 40

what normally prevents defecation? (2)

Answer 40

* *defecation prevented by:** - Tone of internal anal sphincter & puborectalis - Mechanical effects of acute anorectal angle. The pubic symphysis and angle act as a mechanical obstruction to defecate moving to the anus.

Question 41

why is the gut vulnerable to infections? (2)

Answer 41

- has only a **single layer of epithelium (**not much of distance between BV and lumen: blood in stools) [1] * *- lumen = essentially outside the tissues** [1]

Question 42

what are the 3 paired salivary glands? what are they innervated by? where do each of them drain into?

Answer 42

* *- parotid glands** = glossspharyngeal nerve = drain into upper 2nd molar * *- sublingual glands =** facial nerve = drain into either side of frenulum of the tongue * *- submandibular gland**s = facial nerve = drain into either side of frenulum of the tongue

Question 43

which Ig is the only antibody capable of crossing the placenta to give passive immunity to the fetus? a) IgG b) IgM c) IgA d) IgE e) IgD

Answer 43

which Ig is the only antibody capable of crossing the placenta to give passive immunity to the fetus? * *a) IgG** b) IgM c) IgA d) IgE e) IgD

Question 44

what are the dudenal and jejunal brakes?

Answer 44

**dudenal and jejunal brakes:** 1. food goes into the duodenum, might be too big - like long chain fatty acids / amino acids. causes the release of **CCK** 2. release of CCK activates **vagal efferents** 3. as a result of vagal efferents: * *- reduces opening of pyloric sphincter - reductions contractions in corpus - enhances relaxation of fundus**

Question 45

within the GI: where are the CD4 T cells usually found? where are the CD8 T cells usually found? what do each do there?

Answer 45

_CD4 T cells usually found:_ cells sit in the **lamina propria t**o produce lots of cytokines (primarily Th1 cells) _CD8 T cells usually found:_ **epithelium**, kill virally infected cells​

Question 46

out of submanidublar and sublingual duct orifaces - which is more medial to the frenelum?

Answer 46

**submandibular**

Question 47

the hard palatine is composed of which bones (2) where is the soft palate in relation to the hard palate? what does soft palate do when eating? soft palate is innervated by?

Answer 47

hard palate: **maxilla & palatine** soft palate: composed of muscles posterior to the hard palate **- elevates during swallowing to prevent food entering nasal cavity** soft palate is innervated by **vagus nerve**

Question 48

main role of thryoid hormones? (1) how controlled? - negative feedback - how? (1) - how else (4)

Answer 48

**- increases metabolic rate** - negative feedback control: T3 inhibits pituitary release of TSH _- local control mechanism:_ i) deiodinase expression ii) thyroid hormone uptake transporter expression iii) thyroid hormone receptor expression iv) release from thyroid binding globulin

Question 49

what is the correct label for this strucutre? a) rotundudm foramen b) manibular foramen c) mental foramen d) ovale foramen e) hypoglossal foramen

Answer 49

what is the correct label for this strucutre? a) rotundudm foramen b) manibular foramen * *c) mental foramen** d) ovale foramen e) hypoglossal foramen

Question 51

how does hypothalamus communicate with the anterior pit. gland? and posterior pit gland?

Answer 51

- hypothalamic **hormone** binds to **anterior pituitary cell target** (all are stimulatory except Dopamine which is inhibitory) **_via portal system_** - causes release of anterior pituitary hormone - releaed into blood - hypothalamus have **long axons** that cause release of **posterior pituitary hormone**s (ADH and oxytocin)

Question 52

Adrenal gland has different cells: ZG, ZF and ZR that all secrete different hormones how do u produce many different hormones from same organ?

Answer 52

- **different enzymes expressed in the different zones** (e.g. ZG/ ZF/ ZR will express different horomones) - **causes cholerestrol to be turned into different things**

Question 53

what is the squamocolumnar junction?

Answer 53

squamocolumnar junction: abrupt change in the mucosa from s**tratified squamous (oesphagus) to columnar cells (stomach) (and glands)**

Question 54

Q what two things specifically make u hungry?

Answer 54

- release of hormone **ghrelin** * *- phase three of migrating motor complex**

Question 55

draw basic structure of IgA, IgM, IgG, IgD, IgE

Answer 55

IgA = dimer ! = 4 binding sites IgM = pentamer = 10 binding sites IgG, IgD, IgE = monomers = 2 binding sites