GROSS ANATOMY VIRTUAL TABLE CONFERENCE 14

STUDENT-CENTRED INTERACTIVE STUDY ON THE DIGESTIVE

SYSTEM

Please read through these QUESTIONS carefully and write all your answers on the
worksheets. Please use your atlases, videos, text books, and lecture notes. This is
a good opportunity for interactive learning - Confer with your neighbours/colleagues! Please
maintain your small groups of 10/9/8/7/6/5. At the end of the table conference, write your
names individually and sign against your names on the last page. Please photocopy your
worksheets and submit the original copy to the Instructor/Demonstrator. Please sign the
submission book when you submit your work.

Learning objectives

At the end of your study, you should be able to:

 Understand the regions and boundaries of the oral cavity
 Know the major anatomic features of the lips, cheeks, hard and soft palate, and
gingivae
 Describe the external features of the tongue
 Outline the intrinsic and extrinsic muscles of the tongue and their movements
 Describe the parotid, submandibular, and sublingual salivary
glands
 Know the structure of the oesophagus, stomach, small intestine
and large intestine and its relations

ORAL CAVITY

1. List the boundaries of the mouth

2. What are the palatoglossal and palatopharyngeal arches?

a) Identify the two regions – vestibule and oral cavity proper.

Vestibule
1
 3. List the boundaries of the vestibule.

4. The vestibule communicates with the oral cavity proper at what space?

5. Where is the opening of the parotid duct (parotid papilla) into the oral cavity located?

Oral cavity proper

6. List the boundaries of the oral cavity proper. Note that the oropharyngeal isthmus opens
into the oropharynx

7. What structures are contained in the oral cavity proper?

b) Features of lip
8. Identify the parts in specimen A

i
ii
iii iv

Specimen A
c) Palate
9. Hard palate
i. Which bones forms the hard palate?
ii. Identify the incisive foramen and greater and lesser palatine
foramina. What structure do they transmit?
10.Soft palate
iii. What is the function of the uvula of the soft palate?
iv. List all the muscles of the soft palate
2
d) Tongue
11. Compare the anterior 2/3 and the posterior 1/3 of the tongue.
12. Compare and contrast the lingual papillae

13. What is the developmental origin of the foramen cecum?

14. Using your atlas study the sublingual space and identify the
sublingual caruncle, fimbriated folds and deep lingual veins, lingual
frenulum, the openings of the submandibular (Wharton’s) duct and
sublingual duct.

15. The submandibular duct is in close relationship with which nerve?

16. What is Ankyloglossia?

17. What are the intrinsic and extrinsic muscles of the tongue?

18.Identify the intrinsic muscles in specimen B

ii

iii

Specimen B

19.Which nerve provide motor innervation to the tongue?

3
 20. Identify the structures labelled in the specimen C
i x
ii xi
iii xii
iv xiii
v
xiv
xv
v

vi

vii

viii

ix
Specimen C
Oropharynx

21. Describe the boundaries of the oropharynx

22. Identify the parts labelled in specimen D

ii v

vi
iii vii

iv viii

Specimen D

e) Salivary glands
4
 23. Compare the major paired salivary glands.
24. Which nerve passes through the parotid gland?
25. Describe the course of the parotid (Stensen’s) duct.
26. Identify the muscle that it passes anteriorly and pierces to enter the oral
cavity.
Note that the submandibular duct lies on the sublingual gland
Remember that the minor salivary glands exist in the submucosa of the hard palate, cheeks,
tongue and lips.

Oesophagus
27. Begins at the lower border of the cricoid cartilage at what vertebral level?
28. What is the vertebral level of the oesophageal hiatus?
29. What other structures pass through this hiatus?

Abdominal oesophagus – the shortest part and is intraperitoneal.

• Has two margins; The right margin continuous with the lesser curvature of
stomach whilst the left form the uppermost part of the greater curvature of stomach
• Has anterior and posterior surfaces
30. Which nerves are related to the respective surfaces?

31. What factors contribute towards or guards against the reflux of gastric
content into the oesophagus.
Stomach
• Note that the stomach is; the most dilated part of the alimentary canal, completely
surrounded by peritoneum, has anterior and posterior surfaces, cardiac and
pyloric orifices, lesser and greater curvatures, cardia and angular notches and 4
parts (cardia, fundus, body and pylorus)

32. List the structures that form the stomach bed.

5
 33. What is the vertebral level of the cardiac (gastro-oesophageal) junction?
34. Identify the following parts in specimen E

i ii iii iv v

vi

Specimen E

Small intestine
The small intestine is made up of the duodenum, jejunum and ileum. The term small
intestine clinically excludes the duodenum.

Duodenum - is the first and widest part of the small intestine.

Is retroperitoneal except for the beginning of the 1st part, which is connected to the
liver by the hepatoduodenal ligament of the lesser omentum.

35. a) What is the normal shape of the duodenum?’

b) What structure lies in the concavity of the C-shape duodenum?

The duodenum is divided into 4 parts with approximate lengths of 2, 3, 4 and 1

(inch) respectively. Identify the parts of the duodenum: 1st (superior) part, 2nd
(descending) part, 3rd (horizontal) part and 4th (ascending) part.
6
 36. What are the relations and vertebral levels of each part of the duodenum?

37. a) What is the suspensory ligament (of Treitz)? b) What is its clinical
significance?

Jejunum and ileum - lie on the free margin of the mesentery

The root of mesentery crosses the posterior abdominal wall diagonally from upper left
(duodenojejunal junction) to lower right (ileocaecal junction).

38. Distinguish macroscopically the characteristic features of jejunum and

ileum taking note of luminal diameter, wall thickness, degree of circular
fold (or plicae circulares), presence or absence of Peyer's patches, amount of
fat in the mesentery, number of arterial arcades and length of vasa
recta/straight arteries.

39. Identify the parts labelled in specimens F - G

ii

iii

iv

Specimen F

7
 i

ii

iii

iv

Specimen G

Large intestine
38. What is the commonest position and other positions of the appendix?
39. Distinguish macroscopically the small intestine from the large
intestine.
40. Identify the structures labelled in specimens H - I

ii

iii

iv

vi

Specimen H
8
 i ii iii
Specimen I

38. How far is the cardiac of the stomach away from the incisor teeth?

39. What are the effects of total or partial gastrectomy?

40. What muscle assists in maintaining the flexure between rectum and
anal canal?

41. What is the significance of the anal columns and the pectinate line?

42. Evaluate the blood supply and venous drainage to the rectum and anal
canal.

43. Identify the following in specimens J - K

9
i iii

iv
ii
v

Specimen J

i vii

ii

iii

iv

vi

Specimen K

10
Clinical correlations
44. Briefly explain the following
 Hiatal hernia
 Barrett oesophagus
 Pyloric stenosis
 Peptic ulcer
 Meckel 's diverticulum
 Colonoscopy and Colostomy
 Sigmoid volvulus
 Diverticulosis and Diverticuliti

11