Abdomen Flashcards
(17 cards)
What are the attachments of the umbilical ligaments?
Median - fundus of bladder to umbilicus
Medial - internal iliac artery to umbilicus
Lateral - passes superomedially from external iliac to enter rectus sheath
Describe the sections of the duodenum.
Superior - L1, 2cm
Descending - L2, 8cm, ampulla of vater
Horizontal - L3, 8cm
Ascending - L2, 4cm, ligament of Treitz
Compare the jejunum with ileum.
Jejunum - wider, thicker wall, more prominent valvula conniventes, fewer and bigger Peyers patches
Ileum - opposite
Describe the arterial supply to the colon.
SMA - ileocolic artery, right colic artery, middle colic artery
IMA - left colic, sigmoid, superior rectal
Divide the liver as per Couinaud classification.
Caudate 1
Left lobe lateral superior 2
Left lobe lateral inferior 3
Left lobe medial superior 4a
Left lobe medial inferior 4b
Right lobe anterior inferior 5
Right love posterior inferior 6
Right lobe posterior superior 7
Right lobe anterior superior 8
What is the location of the hepatic veins?
Middle - between right and left lobes
Left - between medial and lateral segments of left lobe.
Right - between anterior and posterior segments of right lobe.
Describe normal variants of gallbladder.
Septum
Phrygian cap
Diverticula
Retrohepatic or suprehepatic or intrahepatic
Left sided
Absent
Double
Describe variations in the bile duct.
RPD drain into LHD before confluence of RAD.
Rad, rpd, LHD may triple confluence.
RPD may drain into right RAD and not pass posterior to it.
Accessory hepatic ducts
Rhd and LHD may fail to unite - double hepatic duct
Cystic ducts:
Low insertion with distal CHD
Medial insertion to CHD
Adheres closely to CHD for 2cm
What are the normal measurements of the biliary system in ultrasound?
Intrahepatic ducts - Less than 2mm
Hepatic duct - 3mm at 20 and 6.5mm over 75. 10mm post chole.
Gallbladder - 10cm long and 3cm wide
Describe variations in pancreatic anatomy
Pancreatic divisum
Annular pancreas
Agenesis of dorsal pancreatic moiety
Ectopic pancreas
Describe the portal venous system.
Portal vein formed by:
Superior mesenteric vein - similar to artery including right gastroepiploic and inferior pancreaticoduodenal, jejunal and ileal branches, ileocolic/right colic/mid colic branches.
Inferior mesenteric artery - left colic, sigmoid, superior rectal veins and some pancreatic branches.
Splenic vein - receives short gastric and left gastroepiploic vein from stomach. Multiple pancreatic branches. Joins with IMV posterior to tail of pancreas. Joins SMC behind neck of pancreas.
Where are the 4 sites of portosystemic anastomoses?
GEJ
Rectum
Retroperitoneum
Umbilicus
Describe the anatomical variants of kidneys.
System duplication
Fetal lobulation
Retain accessory artery supply
Horseshoe kidney
Pelvic kidney
Crossed fused ectopia
Pancake kidney
Thoracic kidney
What are the branches of the abdominal aorta?
Unpaired:
Coeliac trunk
SMA
IMA
3 paired visceral:
Adrenal
Renal
Gonadal
5 paired parietal:
Inferior phrenic
Four lumbar
Terminal:
Common iliac
Median sacral
What are the tributaries of the IVC?
3rd and 4th lumbar
Right gonadal
Right renal
Right adrenal
Small veins from right and caudate lobes of liver
Hepatic veins
Right inferior phrenic vein
Left renal vein
Describe the lymphatic drainage of the abdomen.
Preaortic - passes in right and left intestinal trunks to CC. Drains GIT, liver, GB, pancreas and spleen.
Coeliac - receive gastric, hepatic and pancreaticosplenic nodes.
Gastric nodes divided into left gastric, gastroepiploic, pyloric.
Superior and inferior mesenteric nodes.
Para aortic nodes
Retroaortic
What are the 8 groups of the abdomen?
Left para aortic
Pre aortic
Retro aortic
Aortocaval
Right paracaval
Precaval
Retrocaval
Coeliac axis
