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Part 1 MFSRH 2024 > Abdominal & Pelvic Anatomy > Flashcards

Abdominal & Pelvic Anatomy Flashcards

1
Q

What structures form the boundary of the femoral triangle?

A

1) Sartorius (laterally); 2) Adductor longus (medially); 3) Inguinal Ligament (superiorly); 4) Iliopsoas (lateral floor); 5) Pectineus (medial floor)

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2
Q

What is the mnemonic for the borders of the femoral triangle?

A

SAIL:
S - sartorius
A - adductor longus
I - inguinal…
L - ligament

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3
Q

What forms the lateral border of the femoral triangle?

A

Sartorius

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4
Q

What forms the medial border of the femoral triangle?

A

Adductor longus

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5
Q

What forms the superior border of the femoral triangle?

A

Inguinal ligament

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6
Q

What structures form the floor of the femoral triangle?

A

Pectineus and iliopsoas

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7
Q

What structures pass through the femoral triangle?

A

Femoral nerve, artery and vein

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8
Q

Which nerve supplies gluteus maximus?

A

Inferior gluteal nerve

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9
Q

What is the blood supply of gluteus maximus?

A

Superior and inferior gluteal artery

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10
Q

What is the action of gluteus maximus?

A

Extension and external rotation of the hip

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11
Q

What is the insertion of gluteus maximus?

A

Ischial tuberosity

Iliotibial band

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12
Q

What is the origin of gluteus maximus?

A

Posterior gluteal line of inner upper ilium
Posterior surface of lower sacrum
Lumbodorsal fascia
Sacrotuberous ligament

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13
Q

What structures form the rectus sheath?

A

Aponeurosis’s of transversus abdominis, external oblique and internal oblique

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14
Q

Which is deeper, scarpa’s or camper’s fascia?

A

Scarpa’s

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15
Q

What is the anatomy of rectus sheath above the arcuate line?

A

Aponeurosis’s of external oblique and the anterior lamellae of the aponeurosis of internal oblique pass anterior
The posterior lamellae of the aponeurosis of internal oblique and aponeurosis of transversalis fascia pass posterior

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16
Q

What is the anatomy of the rectus sheath below the arcuate line?

A

Aponeurosis of external oblique and internal oblique pass anterior
Aponeurosis of transversalis fascia pass posterior

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17
Q

What does the right ovarian vein empty into?

A

IVC

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18
Q

What does the left ovarian vein empty into?

A

Left renal vein

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19
Q

Which artery supplies the foregut?

A

Coeliac trunk

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20
Q

Which artery supplies the midgut?

A

Superior mesenteric

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21
Q

Which artery supplies the hindgut?

A

Inferior mesenteric

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22
Q

What are the branches of the coeliac trunk?

A

1) L gastric artery
2) Splenic artery
3) Common hepatic artery

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23
Q

What structures does the foregut form?

A

Mouth to the duodenum

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24
Q

At what level does the abdominal aorta bifurcate into the common iliac vessels?

A

L4

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25
Q

What are the terminal branches of the abdominal aorta?

A

Right common iliac
Left common iliac
Median sacral artery

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26
Q

What structures form the perineal body?

A

External anal sphincter
Transverse perineal muscles
Bulbocavernosus muscle
Levator ani muscle

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27
Q

What is the anatomical location of the deep inguinal ring?

A

Midpoint of the inguinal ligament

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28
Q

How is the midpoint of the inguinal ligament found?

A

Midpoint between ASIS and the pubic tubercle

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29
Q

What is the anatomical location of the superficial inguinal ring?

A

Just above and just lateral to the pubic tubercle

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30
Q

What passes through the inguinal canal in females?

A

Round ligament

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31
Q

What passes through the inguinal canal in males?

A

Spermatic cord

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32
Q

What structure passes through the superficial inguinal ring only, NOT the deep inguinal ring?

A

Ilioinguinal nerve

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33
Q

What are the boundaries of the inguinal canal?

A

Anterior - aponeurosis of external oblique
Posterior - transversalis fascia
Superior - internal oblique
Inferior - inguinal ligament

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34
Q

What is the anterior boundary of the inguinal canal?

A

Aponeurosis of external oblique

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35
Q

What is the posterior boundary of the inguinal canal?

A

Transversalis fascia

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36
Q

What is the superior boundary of the inguinal canal?

A

Internal oblique

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37
Q

What is the inferior boundary of the inguinal canal?

A

Inguinal ligament

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38
Q

What is the lymphatic drainage of the vagina?

A

Superior - internal iliac LNs

Inferior = superficial inguinal LNs

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39
Q

What is the transverse diameter of the pelvis?

A

13cm

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40
Q

Which arteries supply the ovary?

A

Ovarian and uterine arteries

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41
Q

What is the mediAL umbilical ligament a remnant of?

A

Remnant of fetal umbilical arteries

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42
Q

What is the mediAN umbilical ligament a remnant of?

A

Remnant of urachus

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43
Q

What innervates the testes?

A

T10 and spermatic plexus

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44
Q

What is the inferior border of the deep perineal pouch?

A

Perineal membrane

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45
Q

What is the superior border of the deep perineal pouch?

A

Superior fascia of the urogenital diaphragm

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46
Q

What separates the deep and superficial pouches?

A

Perineal membrane

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47
Q

What is the contents of the deep perineal pouch?

A

Deep transverse perineal muscle
External sphincter muscle of urethra
Compressor Urethrae Muscle (female)
Urethrovaginal Sphincter (female)
Membranous portion of the urethra (males)
Proximal portion of urethra (females)
Bulbourethral gland (males)

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48
Q

Where in the brain is the hypothalamus located?

A

Diencephalon

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49
Q

What is meralgia paraesthetica?

A

Entrapment of the lateral cutaneous nerve of the thigh

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50
Q

How does the round ligament leave the pelvis?

A

Deep inguinal ring

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51
Q

What reinforces the inguinal canal posteriorly?

A

Conjoint tendon

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52
Q

Which vessels exit the pelvis via the greater sciatic foramen?

A

Superior gluteal artery
Inferior gluteal artery
Internal pudendal artery

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53
Q

Which vessel exits the pelvis via the greater foramen and then re-enters through the lesser sciatic foramen?

A

Internal pudendal artery

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54
Q

What causes entrapment of the femoral nerve in pregnancy?

A

Fetal pressure in a difficult birth

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55
Q

What are the consequences of femoral nerve entrapment?

A

Sensory loss to the anterior thigh and knee

Quariceps weakness, loss of knee jerk

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56
Q

What causes entrapment of the lateral femoral cutaneous in pregnancy?

A

Pregnancy (in general)

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57
Q

What are the consequences of lateral femoral cutaneous nerve entrapment?

A

Sensory loss to the lateral thigh

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58
Q

What causes entrapment of the common peroneal nerve nerve in pregnancy?

A

Due to compression to the lateral head of fibula - occurs in leg bars

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59
Q

What are the consequences of common peroneal nerve nerve entrapment?

A

Sensory loss to the foot and anterolateral leg

Foot-drop

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60
Q

What causes entrapment of the obturator nerve in pregnancy?

A

Compression between the head of the fetus and the bony structures of the pelvis

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61
Q

What are the consequences of obturator nerve entrapment?

A

Sensory loss to the upper medial thigh

Weakness to leg adduction

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62
Q

What is the True (lesser) pelvis?

A

Inferior to the pelvic brim, contains the bladder, colon and reproductive organs

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63
Q

What is the False (greater) pelvis?

A

Superior to the pelvic brim, supports organs of the lower abdomen and the gravid uterus

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64
Q

What separates the true and false pelvis?

A

Pelvic brim

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65
Q

What divides the pelvis into anterior and posterior compartments?

A

Vagina

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66
Q

How many lobules in each testes?

A

250-400

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67
Q

How many seminiferous tubules are found in each testis lobule?

A

1-3

68
Q

Which ligaments attach the vagina and cervix to the pelvic wall?

A

Cardinal and uterosacral ligaments

69
Q

What is the contents of the superficial perineal pouch?

A

Ischiocavernosus muscle
Bulbospongiosus muscle
Superficial transverse perineal muscle
Crura of penis (males) / Crura of clitoris (females)
Bulb of penis (males) / Vestibular bulbs (females)
Greater vestibular glands (female)

70
Q

What in another name for the conjoint tendon which reinforces the superficial inguinal ring posteriorly?

A

Falx inguinalis

71
Q

What are the 3 important branches of the pudendal nerve?

A

Perineal nerve
Dorsal clitoral nerve
Inferior rectal nerve

72
Q

What are the superficial muscles of the perineum?

A

Bulbospongiosus
Superficial transverse perineal muscle
Ischiocavernous

73
Q

What type of cells are Sertoli cells?

A

Tall columnar

74
Q

What is the size of a resting follicle?

A

0.02mm

75
Q

What is the size of a follicle ready to ovulate?

A

20mm

76
Q

Which type of injury is reduced in frequency by open (Hasson) technique compared to closed (Verress needle) technique in laparoscopic surgery?

A

Major vessel injury

77
Q

The inferior epigastric artery is a branch of what artery?

A

External iliac artery

78
Q

What artery is contained within the infundibulopelvic ligament?

A

Ovarian artery (as well as the vein; nerve plexus; lymphatics)

79
Q

What is another name for the infundibulopelvic ligament?

A

Also known as the suspensory ligament

80
Q

What type of joint is the symphysis pubis?

A

Cartilagenous

81
Q

What is the arrangement of axial filaments in a sperm?

A

9+2

82
Q

What is the contents of the femoral triangle?

A

Femoral nerve
Femoral sheath
Femoral artery
Femoral vein and sapheno-femoral junction
Deep inguinal lymph nodes and lymphatic vessels

83
Q

What makes up the roof of the femoral triangle?

A

Fascia lata

84
Q

How much cooler is the scrotum compared to core body temperature?

A

2-2.5 degrees cooler

85
Q

What is the nerve root of the ilioinguinal nerve?

A

L1

86
Q

Describe an anthropoid pelvis:

A

Ape like, AP diameter long, transverse diameter short

87
Q

Describe a platypelloid pelvis:

A

Flat female type

88
Q

Describe an android pelvis:

A

Male type, pelvic inlet triangular or heart shaped

89
Q

Describe a gynaecoid pelvis:

A

Normal female type. Suprapubic angle 90-100 degrees

90
Q

What is the suprapubic angle of a normal gynaecoid pelvis?

A

90-100 degrees

91
Q

Which muscles forms part of the inguinal ligament?

A

External oblique

92
Q

What are the three branches of the posterior division of the internal iliac artery?

A
  1. Superior gluteal artery
  2. Lateral sacral artery
  3. Iliolumbar artery
93
Q

What are the nerve root/s of the lateral cutaneous nerve of the thigh (entrapment of which causes meralgia parasthetica)?

A

L2-L3

94
Q

What is the contents of the ischiorectal fossa?

A
  1. Inferior rectal nerve and vessels
  2. Pudendal canal and its contents
  3. Fat pad
  4. Perforating cutaneous branch of S2 and S3
  5. Perineal branch of S4
  6. Labial nerve and vein
95
Q

What is the contents of the pudendal canal?

A
  1. Internal pudendal artery
  2. Internal pudendal veins
  3. Pudendal nerve
96
Q

What is another name for the pudendal canal?

A

Alcock’s canal

97
Q

What does the pectinate line embryologically represent?

A

The junction between the hindgut and the protodeum

98
Q

Where would you find the pudendal canal (for the sake of delivering a pudendal block)?

A

Lateral wall of the ischiorectal fossa, above the sacrotuberous ligament

99
Q

What is the nerve supply of rectus abdominus?

A

Inferior epigastric artery, T7-T12

100
Q

In the perineum what dose the deep scarpa’s fascia become?

A

Colles’ fascia

101
Q

What is the origin and insertion of rectus abdominis?

A

Origin - 5th-7th costal cartilages

Insertion - pubic crest

102
Q

What is the origin and insertion of external oblique?

A

Origin - Lower 8 ribs

Insertion - pubic crest, xiphoid, linea alba, pubic tubercle, iliac crest

103
Q

What is the origin, insertion and innervation of the internal oblique?

A

Origin - lumbar fasciae, iliac crest, inguinal ligament

Insertion - lower 6 costal cartilages, linea alba, pubic crest

Innervation - T7-T12

104
Q

What is the origin, insertion and innervation of transversus abdominis?

A

Origin - lower 6 costal cartilages, lumbar fasciae, iliac crest, inguinal ligament

Insertion - lina alba, pubic crest

Innervation - T7-T12

105
Q

How long is the inguinal canal?

A

3.8cm

106
Q

What are the characteristics of the internal and external inguinal ring?

A

Internal ring = lies in the transversalis fascia

External ring = in external oblique aponeurosis, v-shaped

107
Q

What makes up the conjoint tendon?

A

Internal oblique and transversus abdominis

Inserts into the pubic crest and pectineal line

108
Q

What is the contents of the spermatic cord?

A

Arteries - testicular, vas, cremasteric
Nerves - ilioinguinal, cremasteric, sympathetic
Other - vas deferens, lymphatics, pampiniform plexus of veins

109
Q

What does adductor canal contain?

A

Femoral vessels

Saphenous nerve

110
Q

What is the usual site of a direct inguinal hernia?

A

Hasselbach’s triangle

111
Q

What is the epiploic foramen/foramen of Winslow?

A

Entrance to the lesser omental sac

112
Q

What are the boundaries of the pelvic outlet?

A

Pubic arch
x2 sciatic notch
Coccyx

113
Q

What are the boundaries of the greater sciatic foramen?

A

SUPERIOR - sacroiliac ligament
POSTEROMEDIAL - sacrotuberous ligament
INFERIOR - sacrospinous ligament
ANTEROLATERAL = greater sciatic notch

114
Q

What are the boundaries of the lesser sciatic foramen?

A

ANTERIOR - ischial tuberosity
LATERAL - lesser sciatic notch
POSTERIOR - sacrotuberous ligament
SUPERIOR - sacrospinous ligament

115
Q

What are the measurements of the pelvic inlet?

A

Transverse - 12.7
Oblique - 11.5
Anteroposterior - 10

116
Q

What are the measurements of the pelvic outlet?

A

Transverse - 10
Oblique - 11.5
Anteroposterior - 12.7

117
Q

What are the branches of the coeliac trunk?

A

Left gastric artery
Splenic artery - short gastric artery, left gastroepiploic artery
Hepatic artery - right gastric artery, cystic artery, gastroduodenal artery

118
Q

What is appendix testes a remnant of?

A

The paramesonephric duct

119
Q

What is the appendix epididymis a remnant of?

A

The mesonephric duct

120
Q

What are arbour vitae?

A

Folds of endothelium in the vagina

121
Q

Where are Doderlein’s bacilli found?

A

The vagina, converting glycogen to lactic acid

122
Q

How long are the fallopian tubes?

A

10cm

123
Q

What type of epithelium line the fallopian tubes?

A

Secretory cells (most abundant)
Ciliated simple columnar epithelium
Peg cells (least abundant)

124
Q

What is the blood flow through a non-parous uterus?

A

45ml/min

125
Q

What are the uterine ligaments?

A

Broad ligament
Round ligament - cornua to labia majora
Cardinal ligament - cervix to lateral wall of pelvis
Uterosacral ligament - cervic to sacrum
Pubocervical ligament - cervix to pubic bone

126
Q

What are the layers of the ovary?

A

Germinal epithelium
Tunica albuginia
Cortex - containing ovarian follicles
Medulla - containing ovarian vessels

127
Q

What are the ovarian support ligaments?

A

Infundibulopelvic ligament
Broad ligament
Ovarian ligament

128
Q

What is the nerve supply of the ovary?

A

T10

129
Q

What is another name for the ovarian fossa?

A

Waldeyer’s fossa

130
Q

What are the boundaries of the ovarian fossa?

A

Superior - External iliac vessel
Posterior - Internal iliac vessels, ureter
Anterior - Obliterated umbilical artery

131
Q

Which two nerves provide the primary cutaneous sensory innervation to the labia majora?

A

Ilioinguinal and pudendal

132
Q

Where are the proximal and distal centriole located in a spermatozoa?

A

Neck

133
Q

What is the contents of the femoral ring?

A

Cloquet’s node and lymphatics

134
Q

What are the boundaries of the femoral ring?

A

ANTERIOR - inguinal ligament
MEDIAL - lacunar ligament
LATERAL - medial border of femoral vein
POSTERIOR - pectineal ligament and pectineus muscle

135
Q

What nerve root mediates the cremasteric reflex?

A

L1

136
Q

What nerve root mediates the abdominal reflex?

A

T7-T12

137
Q

What are the branches of the superior mesenteric artery?

A

Intestinal arteries
Middle colic and
Right colic

138
Q

What is the umbilical artery a branch of?

A

Internal iliac artery

139
Q

What does the inguinal canal contain in women?

A

Round ligament

Ilioinguinal nerve

140
Q

What is the position of the deep inguinal ring?

A

Midway between the ASIS and the symphysis pubis, and about 1.25 cm superior to the midpoint of the inguinal ligament

141
Q

What is the position of the superficial inguinal ring?

A

Just above lateral to the pubic tubercle

142
Q

What are the nerve roots of obturator nerve?

A

L2-L4

143
Q

Which paired structures contain the uterine arteries and veins?

A

Cardinal ligaments

144
Q

Where is the muscular layer found in the fallopian tube?

A

Isthmus

145
Q

What is the blood supply to the fallopian tubes?

A

Uterine and ovarian arteries

146
Q

What is the venous drainage from the fallopian tubes?

A

Uterine and ovarian veins

147
Q

What is the lymphatic drainage from the fallopian tubes?

A

Iliac, sacral and aortic lymph nodes

148
Q

What is the lymphatic drainage of the cervix?

A

Internal iliac, external iliac, obturator AND para-aortic nodes

149
Q

Are the ovary and fallopian tube covered by peritoneum?

A

Ovary ISN’T

Fallopian tube IS covered by peritoneum (mostly)

150
Q

What is the spinal level of the umbilicus, and then what is its dermatomal level

A

Spinal level = L3-L5 (varies)

Dermatomal level = T10

151
Q

What are the branches of the anterior trunk of the internal iliac artery?

A

Obturator artery
Superior vesicle (umbilical) artery
Uterine artery
Vaginal artery
Inferior vesical artery
Middle rectal artery
(Internal) pudendal artery - Inferior rectal artery

152
Q

What are the branches of the posterior trunk of the internal iliac artery?

A

Iliolumbar artery
Lateral sacral arteries
Superior gluteal artery

153
Q

What is the cervix made up of?

A

Fibrous and elastic tissue

154
Q

Where may pain from an ovarian tumour be referred to and why?

A

The ureter descends in the posterior boundary of the fossa while the obturator nerve and vessels cross its floor. Therefore, ovarian disease which involves the parietal peritoneum at this site may produce pain referred via the nerve to the medial side of the thigh

155
Q

What are the branches of the femoral artery?

A
  1. Descending genicular artery
  2. Profunda femoris
  3. Superficial and deep external pudendal artery
  4. Superficial epigastric
  5. Superficial circumflex iliac arteries
156
Q

In terms of its peritoneal covering, what does the POD represent?

A

It represents the caudal most part of the parietal peritoneum

157
Q

What is the biologic homologue of the fallopian tubes in the male?

A

Appendix of the testis

158
Q

What are the 4 layers of the vagina?

A

Stratified squamous epithelium
Elastic lamina propria
Fibromuscular layer ( 2 layers of smooth muscle - inner circular and outer longitudinal)
Adventitia

159
Q

What is the arterial supply to the vagina?

A

Uterine and vaginal arteries

160
Q

What is the lymphatic drainage of the vagina?

A

Upper 1/3rd - external iliac
Middle 1/3rd - common and internal iliac
Lower 1/3rd - superficial inguinal and peri-rectal lymph nodes

161
Q

How is the vagina innervated?

A

Parasympathetic and sympathetic = uterovaginal nerve plexus (of the inferior hypogastric plexus) - suplying smooth muscle and vessels
Somatic innervation = the deep perineal nerve (from the pudendal nerve) - supplies inferior 1/5th, i.e. lowest 2-3cm

162
Q

Where do the lymph nodes of the vulva drain?

A

Superficial inguinal nodes

163
Q

What is the blood supply to the vulva?

A

Internal pudendal artery (supplies majority)
External pudendal artery = perineal and labial skin

164
Q

What is the venous drainage of the vulva?

A

Pudendal veins

165
Q

What is the nerve supply to the vulva?

A

Anterior = ilioinguinal and genital branch of genitofemoral nerve

Posterior = pudendal nerve and posterior cutaneous nerve of the thigh

Part 1 MFSRH 2024 (20 decks)

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