Abdomen

Question 1

Contents of Transpyloric plane

Answer 1

The transpyloric plane is the midpoint between jugular notch and pubic symphysis

it’s contents include

1. Pylorus of stomach
2. Fundus of the gallbladder
3. Front on the pancreas
4. superior mesenteric artery
5. splenic vein behind the pancreas
6. Hilum of the kidneys

Question 1

Contents of Transpyloric plane

Answer 1

The transpyloric plane is the midpoint between jugular notch and pubic symphysis

it’s contents include

1. Pylorus of stomach
2. Fundus of the gallbladder
3. Front on the pancreas
4. superior mesenteric artery
5. splenic vein behind the pancreas
6. Hilum of the kidneys

Question 2

Falciform Ligament is an anterior abdominal peritoneal structure contain

Answer 2

The ligamentum teres ( obliterated portion of the L) umbilical vein)

Question 3

Borders of the lesser sac and it’s function

Answer 3

• provides a slippery surface for the mobility of the posterior surface of the liver

ant surface: stomach and lesser omentum

Left border: hilum of the spleen

Right border: epiploic foramen

Roof: peritoneum of the caudate lobe of the liver

Floor: Transverse mesocolon

Question 4

What are the sites of origin of the greater omentum

Answer 4

The greater curvature of the stomach

Question 5

The lesser omentum covers..

Answer 5

The connection between the liver and lesser curvature of the stomach.

• originates from the R) side of the abdominal esophagus to D1 of the duodenum
• originates at the liver from fissure of ligamentum venosum and porta hepatis

this forms epiploic foramen where, portal triad exists

• portal vein(back)
• hepatic artery(front and left)
• common bile duct(front and right)

Question 6

Border of the epiploic foramen consists of:

Answer 6

Upper boundary: Caudate lobe of liver

Lower boundary

Question 7

How are the Peritoneal Compartments separated

Answer 7

There are 3 supracolic spaces and they each have their own subspace

• Supracolic
  i. Right upper
  ii. Right Lower
  iii. Left upper
  iv. Left Lower

They are separated by the Transverse Mesocolon

• Infracolic
  i. Right/ Upper
  ii. Left/ Lower

Pelvic

Question 8

How is the Infracolic Section of Peritoneum Separated

Answer 8

It is separated via the root of the mesentery which is a 40 degree angle from L-> R
- Starts at the left of the duodojejunal junction and crosses the 3rd part of the duodenum where SMA enters it’s mesentary

Question 9

What is the Right/Upper infracolic compartment and it’s borders

Answer 9

• Triangular area of peritoneum of the posterior abdominal wall

Apex: Lies in the ileocecal junction
Right side: Ascending colon
Left side: the mesentary of small intestine
Base: attachment of transverse mesocolon

Floor of the triangle consists

• Right kidney
• in the left the duodenum can also be felt

Question 10

What is the Left/Lower Infracolic Ligament and it’s borders

Answer 10

• It is a quadrilateral shaped space

borders
Sup border: Attachment of the transverse mesocolon between dudodojejunal flexture and the splenic flexure

ascending duodenum lies in this space
lateral end of upper border lies the inferior pole of the L) kidney
floor: IVC and abdominal aorta

at the lower end of infracolic compartment is the sigmoid mesocolonh is A-shaped and the two limbs diverge from each other at the bifurcation of the common iliac vessels,

Question 11

what is the embryological form of the ligamentum teres

Answer 11

the umbilical vein

Question 12

in embryology, The liver grows downwards @ the anterior abdominal wall and engulfs….

Answer 12

the ligamentum teres

Question 13

during embryology, the dorsal stomach rotates into becoming the …. curvature

Answer 13

greater curvature

Question 14

during embryology, the dorsal stomach rotates into becoming the …. curvature

Answer 14

greater curvature

Question 15

ORIGIN of the Coeliac Plexus

Answer 15

@ the level of T12 between the crura and the median arcuate ligament. It is flanked by the pre-aortic lymph nodes and surrounded by the sympathetic nerves. It will then devide above the superior border of the pancreas, behind the peritoneum of the lesser sac

Question 16

Splenic artery will pass through

Answer 16

it runs across the left crus and left psoas to the hilum of the Ieft kidney, where it runs forward in the lienorenal /ligament to the hilum of the spleen.

it gives off 3 branches

i. Arteries to the pancreas
ii. short gastric arteries
iii. left gastroepiploic artery

Question 17

The common hepatic artery supplies

Answer 17

initially in it’s course it goes downwards and backwards until the lower part of the duodenum and turns upwards into the lesser sac forming the portal triad.

It branches off and gives off the

i. The right gastric
ii. Gastroduodenal–> gastroepiploic
iii. Superior pancreaticoduodenal from branch of gastroduodenal and has posterior and anterior branches and anastomosis with Inferior pancreaticoduodenal branches.

Question 18

The portal vein has tribituaries from….

Answer 18

i. Left gastric veins
ii. Right gastric veins
iii. right gastroepiploic vein
iv. left gastroepiploic veins
v. Confluence of the superior mesenteric vein and Splenic vein

Question 19

Where and what is a meckel’s diverticulum

Answer 19

it is at the apex of the physiological hernia during embryology, this is at the vitellointestinal duct at the ileum.

Question 20

What level is the branch of superior mesenteric artery, it’s course and it’s branches

Answer 20

it’s origin is at the level of L1

It is directed steeply downwards behind the splenic vein @ the head of the pancreas, next to the superior mesenteric vein. passing in front of the L) renal vein and in between the uncinate process, and finally on the third part of the duodenum.

the branches include

i. The inferior pancreaticoduodenal arteries–> ant. and post.
ii. Jejunal branch
iii. Ileal branch
iv. Ileocolic artery- has posterior and anterior branches that communicate
v. right colic artery- ascending and descending branches
vi. middle colic artery

Question 21

What level is the branch of the inferior mesenteric artery, it’s course and branches

Answer 21

occurs at the level of L3
runs obliquely down the pelvic brim crosses the bifurcation of the iliac arteries at the SI joint

branches
i. sup. rectal artery
ii left colic artery-> ascending and descending branch
iii. sigmoid arteries

Question 22

What are the lymphatic vessels that lie in front of the aorta

Answer 22

i. Coeliac
ii. Superior mesenteric
iii. Inferior mesenteric

they travel upwards, they are the last in a series of lymph node filters between the guy and cisterna chylii.

Initially, they lie in the follicles in the mucous membrane through the muscle wall of the gut ot nearby nodes.

• juxtaintestinal nodes in the mesentary of the small intestine or paracolic nodes for the large intestine.
• the second group lie along the main blood vessels of the supply and finally to the pre-aortic roots as above

Question 23

What is the collective nerve supply of the GIT called and it’s plexus. What systems do these nerves recieve

Answer 23

that are collectively called the enteric plexus they consists of:-

• Myenteric plexus(of Auerbach)- in the muscle layers
• Submuous plexus(of Meissner)- in the submucosa

they receive

i. post-ganglionic sympathetic (inhibatory)
ii. pre-ganglionic parasympathetic fibres(excitory)

Question 24

What is the arteries that supply the stomach?

Answer 24

The coeliac plexus supplies the blood supply of the stomach; the stomach is supplied by the left and right gastric arteries(usually a branch of the gastroduodenal or the hepatic artery) this supplies the lesser curvature The left and right gastroepiploic arteries left gastroepiploic a branch of the gastroduodenal arteries right gastroepiploic artery is a branch of the splenic artery

Question 24

What is the arteries that supply the stomach?

Answer 24

The coeliac plexus supplies the blood supply of the stomach; the stomach is supplied by the left and right gastric arteries(usually a branch of the gastroduodenal or the hepatic artery) this supplies the lesser curvature The left and right gastroepiploic arteries left gastroepiploic a branch of the gastroduodenal arteries right gastroepiploic artery is a branch of the splenic artery

Question 25

What are the lymphatic drainage of the stomach

Answer 25

there are: i. Left gastric nodes--> splenic nodes--> pancreatic nodes ii. Right gastric nodes iii. The rest reach nodes along the gastroepiploic vessels of the greater curvature and in the pyloric region

Question 26

Nervous supply of the stomach consists of

Answer 26

Sympathetic fibres provide vasomotor and pain and run with the various arterious branch to the stomach The vagus nerve provides the parasympathetic innervation and this controls the secretions and motiliy. - The Anterior vagal trunk( lies in the right margin)--> runs downs the lesser omentum to the lesser curvature towards the left gastric artery giving a branch to the anterior surface of the stomach, a hepatic branch which also givens a branch to the pyloric antrum - The posterior vagi trunk(rarely double) lies in loose connective tissue to the right oesophageal margin but not in contact; it also runs in the lesser omentum BEHIND the anterior trunk. It provides a branch to the coeliac ganglion

Question 27

What cells of the stomach produce acid and gastrin

Answer 27

The parietal cells produce acid secreting and is in the body of the stomach the G cells producing gastrin are precent in the pylorus

Question 27

What cells of the stomach produce acid and gastrin

Answer 27

The parietal cells produce acid secreting and is in the body of the stomach the G cells producing gastrin are precent in the pylorus

Question 28

What are the relative positions of the duodenum to the pancreas and in the transpyloric plane

Answer 28

The duodenum makes a C shaped loop around the pancreas, D1 lies above the pancreas @ L1, D2 and the right side of the pancreas @ L2, D3 on L3, and D4 on the Left of L2 Relative to the transpyloric plane; D1 runs to the right upwards and and backward to the pylorus, the duodenal cap convexity is where the neck of the gallbladder lies. the next 3cm passes backwards and upwards to the right crus of the diaphragm & the R) psoas muscle. It's post, syrface us bare of peritoneum and to the R) of the epiploic foramen. It touches the head of the pancreas, where the inferior surface of the right lobe of the liver lies. D2, curves downwards over the hilum of the R) kidney. and crossed by the transverse mesocolon, thus the upper half lies in the supracolic comparment to the left of the hepatorenal pouch and the L) to the inf. poles of the R) kidney. it lies alongisde the head of the pancreas. D2 receives the hepatopancreatic ampula at the major duodenal papilla at the posterior-medial wall. it is guarded by a semilunar flap. above it is the accessory pancreatic duct. D3 curves forwards, from R) paravetebral gutter over R) psoas muscle and IVC and aorta, around origin of IMA. its upper border hugs the lower border of the pancreas.lies in btoh right and left infracolic compartments and is in line with the jejunum. D4 lies in the L) of aorta. and psoas muscle. and L) lumbar sympathetic trunk, reaching the lower border of the pancrease. it is covered by the peritoneal floor of the L) infracolic compartment and jejunum, and then leaves peritoneum to form duodenojejunal flexure.

Question 29

What separates the duodenum and jejunum and it's significance

Answer 29

The duodenum is retroperitoneum and the jejunum is within a mesentary, it is fixed to the L) psoas via fibrous tissue & further supported by suspensory muscle of the duodenum/ligament of Trentz(From the R) crus of the diaphgram in front of the aorta and the renal vessels but behind the pancreas.

Question 30

What are the numerous folds of the small intestine called

Answer 30

plicae circulares/ valvulae conniventes

Question 31

What is the blood supply of the duodenum

Answer 31

The dudenum is supplies by the superior and inferior pancreaticoduodenal arteries. The sup inferior pancreaticoduodenal arteries are a branch of the gastroduodenal arteries and branch into an ant. and post. branch the inferior pancreaticoduodenal arteries are a branch of the SMA of the jejunal arteries but may also recieve blood supply from i. common hepatic ii. hepatic iii. right gastric iv. gastroduodenal

Question 32

How to distinguish between the jejunum and the ilium?

Answer 32

Jejunum - Wider Bored and thicker walled - no payers patches - single arcade of arterial supply - long straight arteries Ilium - Thinner and thinner wall - presence of payers patches - double arcade of arterial supply - short straight arteries

Question 33

What is the blood supply of the appendix

Answer 33

the appendix is supplied by the appendicular artery a branch of the posterior caecal. it runs in the free edge of the mesoappendix, and is a end artery hence is at risk of infarction if obstructed

Question 34

What are the limbs of the parietal peritonuem surrounding the free sigmoid colon

Answer 34

there is a lateral and medial limb lateral limb - external iliac artery medial limb - bifurcation of the common iliac artery to the midline of the posterior pelvic wall @ S3

Question 35

what is the nerve supply of the large intestine

Answer 35

usually supplied by parasympathetic fibres from the vagi and the pelvic splanchnic nerve sympathetic supply from T10-L2

Question 36

what surfaces does the porta hepatis and the hepatic veins come from

Answer 36

porta hepatis- inferior/visceral surface hepatic veins- posterior surface

Question 37

What bounds the gallbladder in its position inferiorly to the liver

Answer 37

it is firmly bound under the surface of the liver by connective tissues and small cystic veins

Question 37

What bounds the gallbladder in its position inferiorly to the liver

Answer 37

it is firmly bound under the surface of the liver by connective tissues and small cystic veins

Question 38

What is the blood supply of the gallbladder;

Answer 38

1.The Cystic artery a branch of the R) hepatic artery that usually lies in the Calot's Triangle Sup: Lower edge of the liver Medi: Common hepatic duct Lat: cystic duct - passes behind the cystic duct into the neck of the gallbladder - multiple variations i. common hepatic ii. L) hepatic iii. gastroduodenal 2.arteries from the hepatic bed

Question 39

What is the lymphatic drainage of the gallbladder following?

Answer 39

Lymphatic channels from the gall bladder drain to nodes in the porta hepatis. - to the cystic node (in Calot's triangle at the junction of.the common hepatic and cystic ducts), - to a node situated at the anterior border of the epiploic foramen. From these nodes lymph passes in the free edge of the lesser omentum to the coeliac group of preaortic nodes.

Question 40

What are the important structures of the bile duct.

Answer 40

it is discussed in thirds... i. Supraduodenal part- lies in the free edge of the lesser omentum ii. Middle/Retroduodenal part- behind the duodenum and slopes to the right. Away from the portal vein which is with the gastroduodenal artery. IVC behind the duct iii. Lower/ Paraduodenal - behind the head of the pancreas & D2. In front of the R) renal veins iv. Lower down the bile ducts, may have retroduodenal a branch of the post. superior pancreaticoduodenal artery

Question 41

What are the blood supply of the biliary tract

Answer 41

small branches from - cystic art. - hepatic art. - gastroduodenal art.

Question 42

What nerve supplies the gallbladder`

Answer 42

the parasympathetic fibres from the hepatic branch of the anterior vagal trunk(L trunk) this stimulates secretion and peristalsis the sympathetic fibres from cell bodies of the coeliac ganglia(preganglionic lateral horn cells of T7-9) inhibit contraction. This may also provide afferent innervation but may also go to the phrenic nerve(C3,C4,C5)

Question 43

What happens to the formation of the portal vein and it's course to the porta hepatis

Answer 43

The portal vein is the formation of the superior mesenteric vein with the splenic vein behind the neck of the pancreas. It lies in front of IVC. - Passes upwards of D1 and loses contact with IVC by passing through the greater omentum. -

Question 44

What are the tribituaries of the portal vein

Answer 44

i. R) gastric vein ii. L) gastric vein iii. superior pancreaticoduodenal veins iv. cystic veins v. periumbilical vein

Question 45

What are the 5 sites of portal/systemic shunts

Answer 45

i. Easophageal arteries ii. upper end of the anal canal iii. bare area of the liver iv. periumbilical area v. retroperitoneal area

Question 45

What is anterior to the pancreas

Answer 45

The transverse mesocolon lies anterior to the pancreas,hence it mostly lies in the supracolic compartment.

Question 46

What surrounds the head of the pancreas

Answer 46

the C-shaped duodenum surrounds the pancreas. - posterior to the pancreas lies the IVC - bile duct runs behind the pancreas - L & R renal veins @ L2 anterior to it lies the SMA

Question 47

What is the blood supply of the pancreas

Answer 47

the pancreas is mostly supplied by tribitutuaries around the splenic artery. The head is also supplied by the super and inferior pancreatodudodenal arteries.

Question 48

What are the origin and insertion of the psoas muscle and it's innervation

Answer 48

origin: i. Superficial part - overlies the lumbar plexus and takes origin from the sides of the T12 and L1 to L4 ii transverse processes of lumbar vertebrae L1 to L5 insertion: into the lesser trochanter of the femur innervation: via L1-L3 but mainly L2.

Question 49

What are the relative position of nerves from the psoas muscle

Answer 49

the genitofemoral nerve passes through it laterally: i. iliohypogastric ii. ilioinguinal iii. lateral femoral cutaneous iv. femoral nerves medially: i. obturator ii. Lumbrosacral trunk

Question 50

What is the origin and the insertion of the quadratus lumborum and it's innervation

Answer 50

Origin: the transverse process of L5 and the iliolumbar ligament and the adjoining iliac crest Inserts: moves upwards and inserts into the upper transverse process of the upper four lumbar vertabrea. and inferior border of the twelfth ribs Innervation: T12- L3

Question 51

What is the origin of the iliacus and it's insertion and nerve supply

Answer 51

origin is in the inner iliac crest of the iliac fossa. insertions: The anterior SI joint and it's anterior sacroiliac ligament. Nerve supply: Femoral nerve of L2, L3

Question 51

What is the origin of the iliacus and it's insertion and nerve supply

Answer 51

origin is in the inner iliac crest of the iliac fossa. insertions: The anterior SI joint and it's anterior sacroiliac ligament. Nerve supply: Femoral nerve of L2, L3

Question 52

What are the branches of the abdominal aorta

Answer 52

- The median sacral artery- runs over the sacral promontory into the hollow of the sacrum. - Paired arteries i. Suprarenal arteries - between phrenic and renal arteries ii. Renal Arteries- large vessels @ L2 & crosses the L) crus and psoas behind and above the renal vein. R) renal vein passes passes the R) crus & psoas behind the IVC & R) renal vein iii. gonadal arteries below the arteries but sup. to IMA. -similar course into the pelvic brim @ the sacroiliac joint iv. Common Iliac artery v. Subcostal Artery(though not strictly abdominal) vi. Inferior Phrenic arteries vii. Lumbar arteries 4 pairs - Single Ventral Arteries i. Coeliac plexus ii. Sup. Mesenteric artery iii. Inf. Mesenteric artery

Question 52

What are the branches of the abdominal aorta

Answer 52

- The median sacral artery- runs over the sacral promontory into the hollow of the sacrum. - Paired arteries i. Suprarenal arteries - between phrenic and renal arteries ii. Renal Arteries- large vessels @ L2 & crosses the L) crus and psoas behind and above the renal vein. R) renal vein passes passes the R) crus & psoas behind the IVC & R) renal vein iii. gonadal arteries below the arteries but sup. to IMA. -similar course into the pelvic brim @ the sacroiliac joint iv. Common Iliac artery v. Subcostal Artery(though not strictly abdominal) vi. Inferior Phrenic arteries vii. Lumbar arteries 4 pairs - Single Ventral Arteries i. Coeliac plexus ii. Sup. Mesenteric artery iii. Inf. Mesenteric artery

Question 53

What are the tribituaries of the Inferior Vena Cava

Answer 53

i. Hepatic veins ii.2nd and 3rd lumbar veins iii. Gonadal vein iv. Renal Vein v. vi.

Question 53

What are the tribituaries of the Inferior Vena Cava

Answer 53

i. Hepatic veins ii.2nd and 3rd lumbar veins iii. Gonadal vein iv. Renal Vein v. vi.

Question 54

what is the course of the inferior vena cava

Answer 54

origin @ L5 vertabra as the formation of the common iliac veins, behind the R) common iliac artery behind it's arteries. - L) common iliac longer than the right * it receives iliolumbar and lateral sacral veins * *L) also receives median sacral vein - hepatic veins - ascending lumbar veins help to drain 1st and 2nd lumbar veins into

Question 54

what is the course of the inferior vena cava

Answer 54

origin @ L5 vertabra as the formation of the common iliac veins, behind the R) common iliac artery behind it's arteries. - L) common iliac longer than the right * it receives iliolumbar and lateral sacral veins * *L) also receives median sacral vein - hepatic veins - ascending lumbar veins help to drain 1st and 2nd lumbar veins into

Question 55

What makes the lumbar plexus

Answer 55

the anterior rami of L1-L4

Question 56

posterior relations of the kidneys include

Answer 56

1. diaphragm 2. quadratus lumborum muscles with overlap with psoas muscles and transversus abdominis 3. costodiaphragmatic recess of the pleura 4. subcostal vein, artery and nerve 5. iliohypogastric 6. ilioinguinal nerve

Question 57

what are the anatomical relations of the R) suprarenal gland

Answer 57

Inferior: upper pole of the R) kidney anterior: IVC and the bare area of the liver medial: ureters L) suprerenal gland inferior: medial border of the L) kidney anterior: post wall of the lesser sac medial: ureters

Question 57

what are the anatomical relations of the R) suprarenal gland

Answer 57

Inferior: upper pole of the R) kidney anterior: IVC and the bare area of the liver medial: ureters/ R) inferior phrenic artery L) suprerenal gland inferior: medial border of the L) kidney anterior: post wall of the lesser sac/body on pancreas/splenic artery medial: ureters/coeliac ganglion L) gastric vessels

Question 58

What are the anatomical relations of the R) kidney

Answer 58

Hilum: 2nd part of the duodenum Inferior: i. Laterally by the hepatic flexure ii. medially in contact with the peritoneum - between peritoneum and kidney lies R) colic artery Superior: coils of peritoneum where it forms the hepatorenal pouch below the liver

Question 59

What are the anatomical relations of the L) kidney

Answer 59

Hilum: Tail of the pancreas Inferiorly i. Laterally peritoneum is separated by the splenic flexure ii. medially in contact with peritoneum - left colic artery is present covered by perironeum of the lesser sac and so fonns part of the stomach bed Lateral margin contains the iliorenal ligament Superiorly:

Question 60

What is the renal blood supply

Answer 60

the renal arteries are supplied via the renal artery within the hilum of the kidney it will branch into an anterior and posterior branch 1. the anterior branch further branches off into i. apical ii. upper iii. middle iv. lower there are no colaterrals formed the venous drainage is via multiple renal segment communications that form into 5 or 6 main veins that unite at the hilum of the kidneys.

Question 61

What are the 3 contrictions of the ureter

Answer 61

1. pelvico-ureteric junction 2. and the bifurcation of the common iliac artery/ pelvic brim 3. uretero-pelvic junction

Question 62

what is the course of the ureter

Answer 62

the ureter passes downwards under cover of the peritoneum. it will the cross the genitofemoral nerve; itself crossed by the gonadal vessels. and will leave the psoas muscle at the bifurcation of the comon iliac artery @ SI joint. The R) upper part is passed by the duodenum and below if by the root of the mesentery, right colic, ileocolic and superior mesenteric vessels the L) part is lateral to the inferoir mesenteric vessels and is crossed by the left colic vessels and apex of sigmoid colon

Question 63

what is the blood supply of the ureters?

Answer 63

i. upper end from the ureteric branch of the renal artery i. middle end from branches of gonadal artery / common iliac artery ii. lower end supply from the 1. inferior vesical artery 2. superior vesical artery 3. middle rectal artery

Question 64

what is the nerve supply of the kidneys

Answer 64

the renal nerves have supply to parasympathetic: sympathetic: pre-ganglionic cells from T12-L1 to the thoracic & lumbar splachnic nerves post-ganglionic cells from coeliac, renal and superior hypogastric plexus and renal plexus

Question 64

what is the nerve supply of the kidneys

Answer 64

the renal nerves have supply to parasympathetic: sympathetic: pre-ganglionic cells from T12-L1 to the thoracic & lumbar splachnic nerves post-ganglionic cells from coeliac, renal and superior hypogastric plexus and renal plexus

Question 65

The differences between jejunum and ileum include:

Answer 65

1.Jejunum has a thick and double layer vs. Ileum with only a single layer. 2.Ileum have Payers Patches 3.Both have arterial arcades however, the ileum have 3-5 arcades and longer windows with fat in it

Question 66

What is the blood supply of the appendix and it's origin

Answer 66

The appendicular artery supplies the appendix, it is from a branch of the posterior ceacal artery itself a branch of the ilealceacal artery from the superior mesenteric artery

Question 67

What are the tributuaries of the portal vein

Answer 67

i.Superior Mesenteric Vein ii. Splenic Vein iii.L) and R) gastric veins iv.superior pancreoduodenal veins v.Cystic Vein vi.Peri-umbillical veins vii.L) umbilical vein/Ligamentum teres

Question 68

Discuss the sacroiliac joint?

Answer 68

It is a synovial joint with ligamentous bands surrounding the capsule it consists of i.anterior- flat band joins the bones above and below the pelvic brim ii.posterior- the most superficial fibres and joint with the sacrotuberous joint iii.interosseous sacroiliac ligament- mass of ligaments attaching the sacrum to the ileum coming from deep pits/ prevents forward gliding of the weight from the joint. - the joint depends on these ligaments for stabiity

Question 69

Discuss the sacrotuberous ligament?

Answer 69

Blended with the posterior sacroiliac joint, it then joins the posterior border of the ileum and the posterior superior and inferior iliac spines and to the transverse tubercles of the sacrum and the upper part of the coccyx and then attaches itself on the medial surface of the ischial tuberosity and at its lower edge includes prolongation termed the falciform ligament. It gives origin to gluteus maximus. it is pierces by the perforating cutaneous nerve and branches of the inf.

Question 70

Discuss the sacrospinous ligament

Answer 70

Lies in the pelvic side of the sacrotuberous ligament, broad origin in the sacrum in the lower part of the sacrum and coccyx and thins out further down into the spine of the ischium.

Question 71

The SMV is part of the portal vein, what are its constituents and its course before forming the portal vein?

Answer 71

prior to the joining with the splenic vein and forming the portal vein, the SMV has tribituaries from the R) colic artery, jejunal and ileal branches, iliacolic arteries and the middle colic artery. It is at the RIGHT of the artery and then, it crosses D3 and the uncinate process of the pancreas. Behind the neck of the pancreas it is joined by the splenic vein to form the portal vein. This continues upwards behind the first part of the duodenum, below this joint the vein is called SMV