Tongue anterior 2/3 - embrionary structure [ 1st branchial arch

Tongue anterior 2/3 - sensation nerves [ mandibular branch of trigeminal nerve (

v3)
Tongue anterior 2/3 - taste nerve [ facial nerve (VII)
Tongue posterior 1/3 - embrionary structure [ 3rd and 4th branchial arch
Tongue posterior 1/3 - sensation nerves [ glossopharyngeal nerve (IX)
Tongue posterior 1/3 - taste nerve [ IX and X (very back area)
Tongue motor function nerve [ hypoglossal nerve (XII)
beefy red tongue. cause? [ Vitamin B and Fe deficiency "B-Fe"
oral herpes viruses [ HSV 1 and 2
oral thrush. cause? [ candida albicans in immunocomprmise
sympathetic stimulation to saliva nerve [ superior cervical ganglion (thick secr
etion)
parasympathetic stimulation to saliva nerve [ CN VII and IX (watery secretion)
surgery near parothid gland - risk of lesion [CN VII (runs through it)
infection on salivary glands - pathogens [ S aureus; Viridans Strep
epithelial and mesenchymal cells - salivary gland tumor. Risk? [ pleomorphic ade
noma, most common, benign, can lead to facial nerve injury
Salivary gland tumor, looks like lymphoid tissue - warthin tumor (second most co
mmon benign)
most common malignant salivary gland tumor [ mucoepidermoid carcinoma
tumors located in parotid gland are more likely benign or malignant? [ benign >
70% (most common tumors overall)
tumors located in sublingual gland are more likely benign or malignant? [ malign
ant > 70%
cleft lip - failure of which structures to fuse? [ maxillary and medial nasal pr
ocesses
cleft palate - failure of which structures to fuse? [ lateral palatine processes
, and median palatine processes, nasal septum
infectious rhinitis common patogens [ adeno, corona, echo, rhino -virus
cocaine effect in nose [ vasoconstrictor: ischemia and perforation of nasal muco
sa
REV: gram + rods? [ BaCCiLii (Bacillus, Corynebacterium, Clostridium, Listeria)
REV: gram + branching filaments [ nocardia (aerobe, acid fast) and actinomyces (
anaerobe not acid fast)
REV: Gama hemolitic strep? [ Enterococcus
REV: Gram + Cocci, Cat+, Coag- ? [ S. epidermidis (novobiocin S) and S. saprophy
ticus (novobiocin R)F
Foregut structures [ esophagus, stomach, duodenal, liver, pancreas and proximal
duodenum
Foregut blood supply [ celiac trunk
Foregut innervation [vaugs (parasympathetic), splanchnic (sympathetic)
Midgut structures [ distal duodenum to proximal 2/3 of transverse colon
Midgut blood supply [ superior mesenteric artery
Midgut innervation [ vagus (parasympathetic), splancnic (sympathetic)
Hindgut structures [ 1/3 of transverse colon to upper reectum
Hindgut bood supply [ inferior mesenteric
Hindgut innervation [ pelvic splancnic (parasympathetic), lumbar splancnic (symp
athetic)
Layers of the gut inner to outer [ mucosa (with lamina propria and muscularis mu
cosa), submucosa, muscularis externa (inner circular, outer longitudinal) and se
rosa.
Nerve plexus within gut layers [ submucosal nerve plexus (Meissner - under mucos
a) and Myoenteric nerve plexus (Auerbach - between ic and ol, within muscularis
externa)
infant (2-6 weeks) with non bilious projectile vomiting and palpable knot/ "oliv
e" in upper abdomen. Dx? Possible drug cause and complications [ Hypertrophic py
loric stenosis, can be caused by macrolide exposure. Can lead to hypocloremic, h
ypokalemic metabolic alkalosis
Infant with bilious vomitting shortly after birth. Dx? [ annular pancreas (const

ricting duodenum)
infant with cholestasis (jaundice, clay colored stools, dark urine) seen after b
irth. Dx? [ Extrahepatic biliary atresia
Meckel diverticulum - persistence of which structure? [ vitelline duct (most com
mon congenital GI anomaly)
Meckel diverticulim - ectopic epithelia? [ gastric and/or pancreatic
cecum and appendix in upper abdomen. Dx? Risk? [ malrotation of midgut (incomple
te 270 rotation) risk of volvulus
infant with no meconeoum and no peristalsis. Bowel movement precipitaded only by
digital rectal exam. Dx? Failure of which process? [ Hirschsprung disease. Fail
ure of neural crest cells to migrate to the colon
anal agenesis. Failure of formation of? [urorectal septum (can also lead to fist
ula to nearby structures)
Differences between omphalocele and gastroschisis [ omphalocele has extruding vi
scera covered by a sac, with liver often protruding and commonly associated with
other systems anomalies
Infant presenting with cyanosis,choking and vomiting with first feeding. Faillur
e to pass nasogastric tube. CXR shows esophagus filled with air. Dx? [ Tracheoes
ophageal fistula
Esophagus muscle type [ first third - skeletal muscle; Middle third - mixed; Las
t third - smooth muscle
Progressive dysphagia to solids and liquids. Dx? Mechanism? [ Achalasia - failur
e of LES relaxation due to loss of Auerbach (mioenteric) plexus (between inner a
nd outer muscular layer)
Calcinosis, Raynauds phenomenon, Sclerodactily and Telangiectasia. LES pressure?
[ low pressure
Diverticulum right above upper esophageal sphincter [ Zenker diverticulum
Diverticulum near midpoint of esophagus [ Traction diverticulum
Diverticulum above lower esophageal sphincter [Epiphrenic diverticulum (above di
afragm)
Esophageal variceal bleeding treatment [urgent endoscopy/ vasopressin
Severe retching with rupture of esophagus and pneumomediastinum. Dx? [ Boerhaave
syndrome (surgical emergency)
Alcoholic with retching and hematemesis . Dx? [ Mallory-Weiss tear
GERD treatment [ Proton pump and H2 inhibitors.
GERD associated disease [ asthma
What is Barret esophagus? disease associated? [ metaplasia in the cells of lower
esophagus (squamous -> columnar with goblet cells). Associated with esophageal
adenocarcinoma
"Hourglass" like image on CXR. Dx? Types? [ Hiatal hernia (sliding and paraesoph
ageal)
white pseudomembrane in esophagus of immunocompromise patient. PAS stain reveals
hyphate organisms. Dx? [ Esophagitis (candida)
Biopsy of esophagus with enlarged cells, intranuclear and cytoplasmatic inclusio
ns, clear perinuclear halo. Dx? [ CMV esophagitis.
Biopsy of esophagus with large pink intranuclear inclusions and host cell cromat
in that is pushed to the edge of the nucleus. Dx? [ HSV esophagitis
Patient swallows caustic substance and is now with dysphagia. Dx? Treatment? [ E
sophageal strictures. Dilation through endoscopy
*Dysphagia*, Glossitis and Iron deficiency anemia. Dx? Explain bold [ Plummer-Vi
nson syndrome; dysphagia due to esophageal webs
Esophageal adenocarcinoma - risk factors [ GERD, Barret, Smoking, Obesity, Nitro
samines; (most common in US and whites)
Esophageal squamous cell carcinoma - risk factors [ Alcohol and Tobacco; (most c
ommon worldwide and in blacks)