100 Concepts Set 1

Question 1

Where are the liver and bladder located in the abdominal wall?

Answer 1

the right upper quadrant

Question 2

Where are the stomach and spleen located in the anterior abdominal wall?

Answer 2

the left upper quadrant

Question 3

Where are the cecum and appendix located?

Answer 3

In the right lower quadrant

Question 4

Where are the ends of the sigmoid colon and descending colon located?

Answer 4

Left lower quadrant

Question 5

Where is pain arising from foregut derived structures referred to?

Answer 5

The epigastric region

Question 6

Where is pain arising from midgut derived structures referred to?

Answer 6

The umbilical region

Question 7

Where is pain arising from hindgut derived structures referred to?

Answer 7

The hypogastric region

Question 8

How many nerves make up the nerve supply of the anterior abdominal wall?

Answer 8

7

Question 9

What nerves supply the anterior abdominal wall?

Answer 9

Lower 5 intercostals
1 subcostal
L1- (iliohypogastric and ilioinguinal)

Question 10

L1 can be anesthesized by injecting in which location?

Answer 10

1 inch superior to ASIS

Question 11

Where do all the nerves and deep blood vessels of the anterior abdominal wall lie?

Answer 11

Neurovascular Plane- between internal oblique and transversus muscles

Question 12

What are the important superficial (supplying skin) arteries of the anterior abdominal wall?

Answer 12

Superficial epigastric

Superficial Circumflex Iliac

Question 13

What are the important deep arteries of the anterior abdominal wall?

Answer 13

Superior Epigastric
Inferior Epigastric
Posterior Intercostal Arteries
Lumbar Arteries
Deep Circumflex Iliac arteries

Question 14

What is an omphalocele?

Answer 14

herniation of abdominal viscera through an enlarged umbilical ring

VISCERA are covered by AMNION

Question 15

What is gastroschisis?

Answer 15

Herniation of abdominal contents through the body wall directly into the amniotic cavity

Viscera ARE NOT covered by peritoneum or amnion

Question 16

What are the 3 parts of a hernia?

Answer 16

1. Hernial Sac
2. Hernial Contents
3. Hernial Coverings

Question 17

What is a hernial sac?

Answer 17

pouch (diverticulum) of peritoneum and has a neck and body

Question 18

What is included in the hernial contents?

Answer 18

May consist of any structure found in the abdominal cavity

more often- loops of small intestine and piece of omentum major

Question 19

What are hernial coverings formed from?

Answer 19

The layers of abdominal wall through which the hernia sac passes

Question 20

What is the first structure crossed by any abdominal hernia?

Answer 20

Transversalis Fascia

Question 21

What does an indirect inguinal hernia lie in between?

Answer 21

Tunica Vaginalis and Internal Spermatic Fascia

Question 22

What is the most common form of hernia?

Answer 22

Indirect Inguinal Hernia
Believed to be congenital in origin
Common in boys 0-3 years

Question 23

Where does the Indirect Inguinal Hernia pass through?

Answer 23

The Deep Inguinal Ring lateral to the inferior epigastric vessels, inguinal canal, superficial inguinal ring, and descends into the scrotum.

Question 24

Is an indirect inguinal hernia more common in males or females?

Answer 24

20 times more common in males

1/3 of them are bilateral

Question 25

Which side is an indirect inguinal hernia more common in and why?

Answer 25

More common on the right

Normally the right proccessus vaginalis becomes obliterated after the left; the right testes descends later than the left

Question 26

Where does a direct inguinal hernia protrude through?

Answer 26

The weak area of the posterior wall of the inguinal canal, medial to the inferior epigastric vessels in the inguinal (Hesselbach’s Triangle).

After that, it runs through the superficial inguinal ring

Never descends into the scrotum

Question 27

What demographic are direct inguinal hernias common in?

Answer 27

old men- after 60 years old, with weak abdominal muscles

Direct inguinal hernias are rare in women and most are bilateral

Question 28

What 2 ligaments compose the Lesser Omentum?

Answer 28

Hepatogastric l.

Hepatoduodenal l.

Question 29

What are the contents of the Lesser Omentum?

Answer 29

Right and Left gastric vessels
Connective and fatty tissue

PORTAL TRIAD:

1. Bile Duct
2. Portal Vein
3. Proper Hepatic Artery

Question 30

What are the boundaries of the Epiploic (Winslow’s) Foramen?

Answer 30

Anteriorly: free border of hepatoduodenal ligament, containing the portal triad

Posteriorly: IVC

Superiorly: Caudate Lobe of the Liver

Inferiorly: The first part of the duodenum