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MRCS Anatomy by Sanjid > Abdomen > Flashcards

Abdomen Flashcards

1
Q

What is the embryological origin of the ligamentum teres hepatis?

A

Remnant of fetal left umbilical vein

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2
Q

What is the embryological origin of the ligamentum venosum?

A

Remnant of the ductus venosus separating the caudate and left lobe

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3
Q

What is the embryological origin of the falciform ligament?

A

Remnant of embryonic ventral mesentry

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4
Q

What is the arterial blood supply of the CBD?

A

1) Cystic artery
2) RIght & Left hepatic artery
3) 3 o’clock artery & 9 o’clock arteries
4) Posterior superior pancreaticoduodenal artery

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5
Q

Within the hepaticoduodenal ligament, what is the position of the CBD?

A

Right anterolateral

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6
Q

Within the hepaticoduodenal ligament, what is the position of the common hepatic artery?

A

Left anterolateral

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7
Q

Within the hepaticoduodenal ligament, what is the position of the portal vein?

A

Posterior to both CBD & common hepatic artery

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8
Q

What is the position of the IVC in relation to the porta hepatis?

A

Posterior

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9
Q

What is the porta hepatis?

A

A deep transverse fissure in the liver surface separatring the caudate and quadrate lobes

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10
Q

What structures does the porta hepatis transmit?

A

1) CBD
2) Hepatic arteries
3) Portal vein

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11
Q

Where is the bare area of the liver?

A

Non-peritoneal liver surface area which is in contact with the diaphragm

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12
Q

What is the arterial supply of the lower third of oesophagus?

A

oesophageal branches of left gastric artery

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13
Q

Which vein does the inferior mesenteric vein drain into?

A

Splenic vein

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14
Q

Which vein does the splenic vein drain into?

A

Portal vein

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15
Q

Which vein does the right gastric vein drain into?

A

Portal vein

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16
Q

Name the 5 portosystemic anastomoses

A

1) Lower end of oesophagus - left gastric & oesophageal azygous & hemiazygous
2) Upper end of anal canal - superior rectal vein & middle & inferior rectal veins
3) Bare area of liver - hepatic portal veins & inferior phrenic systemic veins
4) Peri-umbilical - ligamentum teres is the venous watershed area. Left branch of portal vein & indirectly via axillary & saphenous veins (systemic)
5) Retroperitoneal - left, right colic & splenic veins (portal) & lumbar veins (IVC & azygous veins).

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17
Q

What are the structures passing through the aortic opening?

A

1) Aorta
2) Thoracic duct
3) Azygous vein

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18
Q

At what level is the aortic opening situated?

A

T12

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19
Q

What are the structures passing through the oesophageal opening?

A

1) Oesophagus
2) Left gastric artery
3) Left gastric vein
4) L & R vagus nerves

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20
Q

At what level is the oesophageal opening situated?

A

T10

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21
Q

What are the structures passing through the vena caval opening?

A

1) IVC

2) R phrenic nerve

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22
Q

Where does the right testicular vein drain into?

A

IVC

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23
Q

Where does the left testicular vein drain into?

A

Left renal vein

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24
Q

What vertebral level is the hilum of the left kidney found?

A

L1

25
Q

What vertebral level is the hilum of the right kidney found?

A

L2

26
Q

What vertebral level does the bifurcation of the aorta occur?

A

L4

27
Q

What is the nerve supply of the liver?

A

Coeliac plexus (sympathetic & parasympathetic)

28
Q

Of the structures relating to the left kidney, which of the following is anterior and posterior?

  • renal artery
  • renal vein
  • ureter
A 
MOST ANTERIOR
- Renal vein
- Renal artery
- Ureter
MOST POSTERIOR
29
Q

Which structure is not present inferior to the arcuate line?

A

posterior rectus sheath

30
Q

In any incision of the abdomen, which 3 layers are always present?

A

transversalis fascia, pre-peritoneal fat, peritoneum

31
Q

What forms the superficial ring of the inguinal canal?

A

Aponeurosis of the external oblique muscle

32
Q

What forms the deep ring of the inguinal canal?

A

Transversalis fascia

33
Q

Which nerve is more likely to be injured in an open appendicectomy?

A

Iliohypogastric nerve

34
Q

Which nerve is more likely to be injured in a hernia repair?

A

ilioinguinal nerve

35
Q

Which artery provide arterial supply of the anterior abdominal wall superiorly?

A

Superior epigastric artery (branch of internal mammary artery).

36
Q

What vertebral level is the Xiphoid process?

A

T9

37
Q

What vertebral level is the transpyloric plane?

A

L1

38
Q

What are the 4 layers of the GI tract wall?

A

1) Mucosa
2) Submucosa
3) Muscularis externa
4) Adventitia

39
Q

What vertebral level is the supracristal plane?

A

L4

40
Q

What bony structures are found at L4?

A

Summits of iliac crests

41
Q

What vertebral level is the subcostal plane?

A

L3

42
Q

What vertebral level is the umbilicus?

A

L3/L4

43
Q

What are the 3 landmarks that would outline the position of the liver in a healthy adult?

A

1) 10th Rib midaxillary line
2) 5th R intercostal space midaxillary line
3) 5th L intercostal space midaxillary line

44
Q

Where does the spleen lie?

A

9th-11th rib posteriorly on left side

45
Q

What vertebral level does the neck of pancreas lie?

A

L1

46
Q

Above the costal margin, what does the anterior sheath only comprise of?

A

external oblique aponeurosis

47
Q

What is the purpose of a midline incision?

A

Provides a rapid bloodless access to the abdomen

48
Q

What constitutes the anterior rectus sheath between the costal margin & arcuate line?

A

Aponeurosis of muscles:

1) External Oblique
2) Internal Oblique

49
Q

What constitutes the posterior rectus sheath between the costal margin & arcuate line?

A

Aponeurosis of muscles:

1) Internal Oblique
2) Transverus abdominus

50
Q

Which structure lies posterior to the superior/inferior epigastric arteries & veins between the costal margin & arcuate line?

A

Posterior rectus sheath

51
Q

Describe a Kocher’s incision

A

From midline & extends parallel to subcostal margin inferiorly by 1 inch

52
Q

Which nerve is most likely to be damaged by a Kocher’s incision?

A

8th intercostal nerve

53
Q

Which incision would you use to gain access to the open extraperitoneal exposure of the prostate?

A

Pfannenstiel Incision

54
Q

What is the median umbilical fold?

A

obliterated fetal urachus from bladder to umbilicus

55
Q

What are the medial umbilical folds?

A

Obliterated umbilical arteries from umbilicus to internal iliac arteries

56
Q

What are the lateral umbilical folds?

A

peritoneum covering the inferior epigastric vessels

57
Q

Name the 4 intraperitoneal fossae

A

1) Lesser sac via foramen of Winslow
2) Paraduodenal fossa - between duodenojejunal flexure & inferior mesenteric vessels
3) retrocecal fossa - appendix normally found
4) intersigmoid fossa - inverted V attachment of mesosigmoid

58
Q

What anatomical relation does the supracristal plane at L4 refer to?

A

Summits of iliac crests

59
Q

What are the boundaries of the epiploic foramen?

A

1) Caudate lobe
2) Free edge of lesser omentum (bile duct, portal vein, hepatic artery)
3) IVC (peritoneum of vena cava)
4) 1st part of duodenum

MRCS Anatomy by Sanjid (11 decks)

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