28/09/20 Flashcards
1
Q
what sensations are visceral organs sensitive to?
A
stretch, inflammation and hypoxia
2
Q
What level is the subcostal plane?
A
L3
3
Q
What level is the supracristal plane?
A
L4
4
Q
What level is the transtubercular plane?
A
L5
5
Q
What nerves innervate the foregut?
A
T5-T9
6
Q
What nerves innervate the midgut
A
T10-T11
7
Q
What nerves innervate the hindgut?
A
T12-L1
8
Q
What nerves do visceral sensory nerves travel alongside?
A
sympathetic nerves
9
Q
How long is the length from the incisors to the gastro-oesophageal junction?
A
40cm
10
Q
At what vertebral level is the upper oesophageal sphincter?
A
C6/7
11
Q
Are the left and right vagal trunks anterior or posterior to the oesophagus?
A
Left vagal trunk is anterior
Right vagal trunk is posterior
12
Q
Which parts of the GI tract have dorsal/ventral mesentery?
A
Foregut has both dorsal and ventral mesentery
Midgut and hindgut have only a dorsal mesentery
13
Q
Is the caecum intraperitoneal or retroperitoneal?
A
Mostly intraperitoneal
14
Q
Where does the ascending colon refer pain to?
A
Umbilical region
15
Q
Where does the descending colon refer pain to?
A
Pubic region
16
Q
Are ascending colon and descending colon intraperitoneal or retroperitoneal?
A
Secondary retroperitoneal
17
Q
What causes apple core sign?
A
Colorectal adenocarcinoma
18
Q
What causes diverticulitis?
A
Low fibre diet causes outpouching in colon - diverticulitis. Diverticula become infected.
19
Q
In what position are the transverse rectal folds?
A
2 on the left
1 on the right
20
Q
What is the origin point for classic haemorrhoids?
A
Internal venous plexus
21
Q
What is the origin point for external haemorrhoids?
A
External venous plexus
22
Q
On what day does a morula form?
A
~Day 3
23
Q
On what day does a blastocyst form?
A
~Day 5
24
Q
On what day does implantation occur?
A
~Day 6
And zona pellucida disappears
25
On what day does bilaminar disc appear?
~Day 8
| And amniotic cavity opens up
26
What cells form the yolk sac?
Hypoblast
27
What cells form the amniotic cavity?
Epiblast
28
What forms skin and neural tissue?
Ectoderm
29
What can happen if the primitive node and streak do not disappear?
Can lead to teratoma formation at the distal end of the vertebral column. Sacrococcygeal teratoma.
30
What does paraxial mesoderm form?
Heart, skull, skeletal muscles of head and neck. And somites
31
What does intermediate mesoderm form?
Urogenital system, kidneys and gonads
32
What does lateral plate mesoderm form?
Viscera and heart
33
What do somites form?
Axial skeleton, associated musculature and dermis of skin
34
What are the two types of embryonic disc folding?
Longitudinal Folding
The head & tail ends of the embryonic disc fold toward each other. Important for reversal.
Lateral Folding
The lateral sides of the embryonic disc fold toward each other. Meet in the anterior midline
35
Why does stenosis of the gut tube occur?
Due to partial recanalisation
36
Why does atresia of the gut tube occur?
Due to no recanalisation
37
What's the difference between omphalocele and gastroschisis?
Gut tube does not fully return to the abdomen or herniates through the abdominal wall
In omphalocele, organs are still in amniotic sac
In gastroschisis, organs are not in a membrane.
38
What happens in imperforate anus?
Abnormal urorectal septum formation
39
What cranial nerve, muscles and bones are associated with pharyngeal arch 1?
1st Arch
Nerve supply: CNV (Trigeminal nerve)
Muscles: e.g. Mastication and tensor tympani
Bones: e.g. malleus, incus, maxilla, zygoma & mandible
40
How does the stomach rotate in the embryo?
The stomach rotates 90° to the right & 90° clockwise to form the lesser sac
41
Are the pancreas and duodenum intraperitoneal or retroperitoneal?
Secondary retroperitoneal
42
What is the surface anatomy of the liver?
Triangle between:
- R 5th ICS MCL
- L 5th ICS MCL
- R just above subcostal plane
43
What does the falciform ligament contain?
Ligamentum teres (remnant of umbilical vein)
44
What is the ligamentum venosum an embryological remnant of?
Ductus venosus
45
What is the porta hepatis?
Entry/exit point for portal vein, hepatic artery, bile duct, and autonomic nerves
46
How many functionally independent segments can the liver be separated into?
8
47
Where is the gallbladder fundus found?
Tip of 9th costal cartilage
48
What guards the entrance of the major duodenal papilla?
Hepato-pancreatic sphincter
49
What is the lymphatic drainage of the pancreas and duodenum?
Coeliac nodes --> thoracic duct --> left supraclavicular nodes (Virchow's node)
50
What ribs does the spleen sit under?
9-11 or 10-12
51
Is the spleen intraperitoneal or retroperitoneal?
The spleen is intraperitoneal and of mesenchymal origin
52
What nerve exits the spinal nerves and into the sympathetic chain?
And what nerve exits the sympathetic chain to go into the spinal nerves?
White ramus communicans
spinal nerve --> sympathetic chain
Only T1-L2 will have a white ramus communicans?
Grey ramus communicans
sympathetic chain --> spinal nerve
53
Where is the superior cervical ganglion?
Near skull base
54
Where is the stellate ganglion?
Near lung apex
55
Which cells of the adrenal medulla release adrenaline into the blood?
Chromaffin cells
56
What does the kidney develop from?
metanephros (intermediate mesoderm) & the ureteric bud
57
What is an aberrant renal artery?
Blocks ureter
58
What nerves do visceral sensory nerves from the ureter travel alongside?
Sympathetic nerves
59
What dermatomes is loin to groin pain?
T12-L1
60
What ligaments support the bladder in females and in males?
Females - Pubo vesical ligament
| Males - Pubo prostatic ligament
61
What is the innervation above the pelvic pain line?
T12-L2 alongside sympathetic nerves
62
What is the innervation below the pelvic pain line?
S2-S4 alongside the parasympathetic nerves
63
What is the allantois?
Passes from bladder region of cloaca to umbilicus; involved in formation of blood cells in utero.
Remnants of the allantois can cause clinical problems eg. cysts, sinus or fistula.
64
What are the parts of the male urethra?
1. Preprostatic
2. Prostatic
3. Membranous
4. Spongy (penile)
5. Navicular fossa
65
What are the male sphincters?
1. Internal urethral sphincter
2. External urethral sphincter
3. Compressor urethrae
66
What are the female sphincters?
Internal urethral sphincter?
External urethral sphincter
Compressor urethrae
Sphincter urethrovaginalis
67
What are the stages in the micturition reflex?
Stretch of bladder wall (visceral afferents)
Contraction of detrusor (parasympathetic)
Relaxation of internal urethral sphincter (parasympathetic)
Relaxation of external urethral sphincter (somatic)
68
What is a Rigler sign? (on X-ray)
double wall sign, gas is present on both sides, not good
69
What is a coffee bean sign? (on X-ray)
Sigmoid volvulus
70
What is emphysematous pyelonephritis?
Gas in renal parenchyma, retroperitoneal and pararenal tissues
71
Where is the deep inguinal ring?
Located between the midpoint of inguinal ligament & the midinguinal point (~1cm above the inguinal ligament)
72
Where is the superficial inguinal ring?
Located within the external oblique aponeurosis; Located supero-lateral to the pubic tubercle
73
What muscle/fat layer is the deep inguinal ring in?
Transversalis fascia
74
What muscle/fat layer is the superficial inguinal ring in?
External oblique aponeurosis
75
What type of hernia can result from a weakness in the conjoint tendon?
Direct inguinal hernia
76
What are the borders of Hesselbach's triangle and what type of hernia is found in this region?
- Rectus abdominis
- Inferior epigastric artery
- Inguinal ligament
Direct hernia is found within Hesselbach's triangle
77
What nerves are at risk during inguinal canal region surgery?
Ilioinguinal and iliohypogastric nerves
78
What are the borders of an inferior lumbar (Petit's) triangle hernia?
- External oblique
- Latissimus dorsi
- Iliac crest
Patient presents with persistent back pain.
79
What are the borders of a superior lumbar (Grynfeltt/Lesshaft) triangle hernia?
- Rib 12
- Quadratus lumborum
- Internal oblique
80
At what level does the spinal cord terminate?
L1
81
At what level does the subarachnoid space end?
lower S1 to S2
82
What type of urinary stone is not visible on X-ray?
Urate
