#separator:Tab
#html:false
#tags column:5
IMF-078-02-0001-en	What keeps the gastro-oesophageal junction competent despite the absence of a discrete sphincter ring?	Intrinsic smooth-muscle tone, diaphragmatic crura, the angle of His, the phrenooesophageal membrane, and abdominal pressure together support it.	Integrated Medical Foundations; chapter 78, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cff71a4bbd650e67a6cf40df46f15da66a31e440c546b02496a0e49913ba9d15; editorial review pending	imf lang::en chapter::078 module::078-02 review::pending
IMF-078-02-0002-en	What distinguishes a sliding from a paraoesophageal hiatal hernia?	In a sliding hernia the junction itself moves upward; in a paraoesophageal hernia the stomach herniates beside a relatively fixed junction.	Integrated Medical Foundations; chapter 78, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cff71a4bbd650e67a6cf40df46f15da66a31e440c546b02496a0e49913ba9d15; editorial review pending	imf lang::en chapter::078 module::078-02 review::pending
IMF-078-02-0003-en	Why is the distal oesophagus a portosystemic site, and why can its tumours spread longitudinally?	Its veins drain both to left gastric portal tributaries and azygos systemic veins, and its lymph drains superiorly to mediastinum and inferiorly along left gastric nodes.	Integrated Medical Foundations; chapter 78, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cff71a4bbd650e67a6cf40df46f15da66a31e440c546b02496a0e49913ba9d15; editorial review pending	imf lang::en chapter::078 module::078-02 review::pending
IMF-078-02-0004-en	Why can a posterior gastric ulcer or tumour involve the pancreas or splenic vessels?	Posteriorly the stomach faces the lesser sac and the stomach bed, formed by pancreas, spleen, left kidney and adrenal, transverse mesocolon, and diaphragm.	Integrated Medical Foundations; chapter 78, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cff71a4bbd650e67a6cf40df46f15da66a31e440c546b02496a0e49913ba9d15; editorial review pending	imf lang::en chapter::078 module::078-02 review::pending
IMF-078-02-0005-en	Which artery is endangered by an ulcer of the superior part of the duodenum, and why?	The gastroduodenal artery, because it lies posterior to the superior part, where an ulcer can erode into it.	Integrated Medical Foundations; chapter 78, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cff71a4bbd650e67a6cf40df46f15da66a31e440c546b02496a0e49913ba9d15; editorial review pending	imf lang::en chapter::078 module::078-02 review::pending
IMF-078-02-0006-en	Why can the third part of the duodenum become obstructed in selected weight-loss contexts?	It crosses anterior to aorta and inferior vena cava and posterior to the superior mesenteric vessels, so it can be compressed between the superior mesenteric artery and aorta.	Integrated Medical Foundations; chapter 78, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cff71a4bbd650e67a6cf40df46f15da66a31e440c546b02496a0e49913ba9d15; editorial review pending	imf lang::en chapter::078 module::078-02 review::pending
IMF-078-02-0007-en	How does the duodenal arterial supply mark the foregut-midgut junction?	Supply shifts from coeliac-derived superior pancreaticoduodenal branches to superior mesenteric inferior pancreaticoduodenal branches, and their arcade connects the two territories.	Integrated Medical Foundations; chapter 78, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cff71a4bbd650e67a6cf40df46f15da66a31e440c546b02496a0e49913ba9d15; editorial review pending	imf lang::en chapter::078 module::078-02 review::pending
IMF-078-02-0008-en	What features generally distinguish jejunum from terminal ileum?	Jejunum has a thicker wall, larger diameter, more prominent circular folds, longer vasa recta, fewer arterial arcades, and less mesenteric fat, though the boundary is gradual.	Integrated Medical Foundations; chapter 78, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cff71a4bbd650e67a6cf40df46f15da66a31e440c546b02496a0e49913ba9d15; editorial review pending	imf lang::en chapter::078 module::078-02 review::pending
IMF-078-02-0009-en	Why do long-chain lipids bypass initial portal transport?	Lacteals absorb them as chylomicrons into lymph, which passes mesenteric nodes to the cisterna chyli and thoracic duct rather than the portal vein.	Integrated Medical Foundations; chapter 78, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cff71a4bbd650e67a6cf40df46f15da66a31e440c546b02496a0e49913ba9d15; editorial review pending	imf lang::en chapter::078 module::078-02 review::pending
IMF-078-02-0010-en	How can the appendix base be found, and why does appendiceal position alter the presentation?	It arises from the posteromedial caecum where the three taeniae coli converge; its position varies (retrocaecal, pelvic, subcaecal, pre-ileal, post-ileal), altering symptoms and examination.	Integrated Medical Foundations; chapter 78, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cff71a4bbd650e67a6cf40df46f15da66a31e440c546b02496a0e49913ba9d15; editorial review pending	imf lang::en chapter::078 module::078-02 review::pending
IMF-078-02-0011-en	Why are the splenic flexure and rectosigmoid junction vulnerable to ischaemia?	They are watershed regions where superior and inferior mesenteric territories or their branches meet, relying on marginal artery connections, so low flow or arterial interruption affects them.	Integrated Medical Foundations; chapter 78, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cff71a4bbd650e67a6cf40df46f15da66a31e440c546b02496a0e49913ba9d15; editorial review pending	imf lang::en chapter::078 module::078-02 review::pending
IMF-078-02-0012-en	How do epithelium, innervation, and lymph drainage differ above and below the pectinate line?	Above: columnar epithelium, visceral innervation, internal iliac or inferior mesenteric lymph. Below: stratified squamous epithelium, somatic inferior rectal innervation, superficial inguinal drainage.	Integrated Medical Foundations; chapter 78, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cff71a4bbd650e67a6cf40df46f15da66a31e440c546b02496a0e49913ba9d15; editorial review pending	imf lang::en chapter::078 module::078-02 review::pending
IMF-078-02-0013-en	Why are internal haemorrhoids less painful than a thrombosed external haemorrhoid?	Internal haemorrhoids arise above the pectinate line with visceral innervation unless prolapsed or thrombosed, whereas thrombosis below the line is somatically innervated and painful.	Integrated Medical Foundations; chapter 78, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cff71a4bbd650e67a6cf40df46f15da66a31e440c546b02496a0e49913ba9d15; editorial review pending	imf lang::en chapter::078 module::078-02 review::pending
IMF-078-02-0014-en	Along which pathways does gut pain travel, and why does it change character below the pectinate line?	Visceral pain afferents often travel with sympathetics, but below the pectinate line somatic pudendal pathways carry sharp localised pain.	Integrated Medical Foundations; chapter 78, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: cff71a4bbd650e67a6cf40df46f15da66a31e440c546b02496a0e49913ba9d15; editorial review pending	imf lang::en chapter::078 module::078-02 review::pending