Abdomen Flashcards
Pass the Boards! (210 cards)
1
Q
Pain from the 3 segments of the ureter is referred to which areas?
A
Upper - back behind kidney
Middle - inguinal region
Lower - Penis or clitoris
2
Q
Branches of the celiac artery
A
Left Gastric Artery
Splenic Artery
Hepatic Artery
3
Q
Branches of the splenic artery
A
Pancreatic branches
Left Gastroepiploic Artery
Short Gastric Artery
4
Q
Branches of the hepatic artery
A
Right Gastric Artery
Gastroduodenal Artery
Right Hepatic Artery - Cystic Artery
Left Hepatic Artery
5
Q
Branches of the gastroduodenal artery
A
Right Gastroepiploic Artery
Superior Pancreaticoduodenal Artery
6
Q
Branches of the superior mesenteric artery
A
Inferior Pancreaticoduodenal Artery Middle Colic Artery Inferior Colic Artery Ileocolic Artery Jejunal Branches Ileal Branches
7
Q
Branches of the inferior mesenteric artery
A
Left Colic artery
Sigmoid Artery
Superior Rectal Artery
8
Q
Three main openings of the diaphragm, vertical location, and their contents
A
Aortic Opening (T12) - aorta, azygos vein, thoracic duct Esophageal Opening (T10) - Esophagus, right and left vagus nerve, esophageal vessels, lymphatics Caval Opening (T8) - inferior vena cava, right phrenic nerve
9
Q
Shape of the adrenal glands?
A
Right - pyramid
Left - crescent
10
Q
Blood supply of adrenal gland
A
Aorta, Inferior phrenic artery, renal artery
11
Q
Venous drainage of adrenal gland
A
Right - IVC
Left - renal vein
12
Q
The aorta bifurcates to the common iliac arteries at what level?
A
L4
13
Q
Campers and Scarpa’s fascia - which is fatty layer which is membranous? which is deep which is superficial
A
Camper - superficial, fatty later
Scarpa’s - deep membranous
14
Q
Anterior abdominal wall fascia continuous with the superficial fascia of the back and thorax?
A
Scarpa’s fascia
15
Q
Membranous fascia in the scrotum
A
Colles’ Fascia
16
Q
Thin layer of smooth muscle in the scrotum, which is analogue of the Camper’s fascia
A
Dartos muscle
17
Q
Rupture of penile urethra may be followed by extravasation of urine into which structures?
A
Scrotum, perineum, penis, lower part of anterior abdominal wall deep to Scarpa’s fascia
18
Q
Triangular shaped defect in the external oblique aponeurosis immediately above and medial to pubic tubercle
A
Superficial inguinal ring
19
Q
Structure passing through the superficial inguinal ring?
A
Spermatic cord - male
Round ligament of the uterus - female
20
Q
Between the ASIS and the pubic tubercle, the lower border of the external oblique aponeurosis folds backward on itself, forming what?
A
Inguinal ligament
21
Q
Ligament extending backward and upward from medial end of inguinal ligament to the pectineal line?
A
Lacunar ligament
22
Q
The free crescentic edge of the lacunar ligament forms the medial margin of which structure?
A
Femoral ring
23
Q
The fascia lata is attached to the inferior border of which structure?
A
Inguinal Ligament
24
Q
Which side of the conjoint tendon is a free border?
A
Lateral
25
Muscle found in the spermatic cord
Cremaster
26
Posterior border of which of the following is attached to the lumbar vertebrae by the lumbar fascia?
A. External Oblique
B. Internal Oblique
C. Transversus
B and C.
| A has a free posterior border
27
Curved ridge seen when the rectus abdominis contracts
Linea semilunaris
28
Three tendinous intersections of the rectus sheath?
1. Level of xiphoid process
2. Level of umbilicus
3. Halfway between 1 and 2
29
Small muscle in the lower part of the rectus abdominis which is often absent
Pyramidalis
30
Anterior and posterior wall of the rectus sheath above the costal margin
Anterior - External oblique aponeurosis
| Posterior - 5th - 7th costal cartilage and intercostal space
31
Anterior and posterior wall of the rectus sheath between costal margin and ASIS
Anterior - External + Internal oblique aponeuroisis
| Posterior - Internal oblique + Transversus aponeurosis
32
Anterior and posterior wall of the rectus sheath below the ASIS
Anterior - Aponeurosis of all 3 muscles
| Posterior - free. connected with fascia transversalis
33
Free curved lower border of the posterior wall of the rectus sheath?
Arcuate Line
34
What vessels enter the rectussheath at the arcuate line?
Inferior epigastric vessels
35
The rectus abdominis is wider above or below the umbilicus?
Above
36
Blunt trauma to the abdominal wall may cause midline abdominal pain associated with an acutely tender mass confined to one rectus sheath may cause rectus sheath hematoma. Which structure is the source of bleeding?
Inferior epigastric vein (more common)
| artery, rarely
37
The femoral sheath is formed from which fascia?
Fascia transversalis
38
A middle aged woman with poor abdominal muscles from multiple pregnancies is often incapable of supporting her abdominal viscera. The lower part of the wall protrudes forward. What condition is this?
Visceroptosis
39
Innervation of the skin, musclks, and parietal peritoneum of anterior abdominal wall
Anterior rami of T7-T12
| Iliohypogastric + Ilioinguinal nerve (L1)
40
Dermatome over the xiphoid process?
T7
41
Dermatome over the pubis
L1
42
Main arteries of anterior abdominal wall
```
Superior Epigastric
Inferior Epigastric
Deep Circumflex Iliac
Lower two posterior intercostal artery
branches of aorta
```
43
The superior epigastric artery is a terminal branch of which artery?
Internal thoracic artery
44
The inferior epigastric artery and deep circumflex artery are branches of which larger artery?
External iliac
45
Paraumbilical veins connect the veins of the anterior abdominal wall to which major vein
Portal vein
46
If the vena cava is blocked, trace the collateral pathway passing through the abdominal wall
Axillary vein - lateral thoracic vein - superficial epigastric vein - great saphenous vein - femoral vein
47
Lymph drainage of anterior abdominal wall
Above umbilicus, front - anterior axillary lymph nodes
Above umbilicus, back - posterior axillary lymph nodes
Below umbilicus - Superficial inguinal nodes
48
Length of inguinal canal in the adult
1.5 in (4 cm)
49
Margins of the deep inguinal ring provide attachment for this fascia
Internal Spermatic Fascia
50
The crura, or margin of the superficial inguinal ring provide attachment for this fascia
External Spermatic Fascia
51
Vessels located medial to the deep inguinal ring?
Inferior epigastric vessels
52
Weakest part of the inguinal canal?
Superficial and Deep Inguinal Ring
53
Contents of the spermatic cord?
```
Vas deferens
Testicular artery
Testicular veins
Testicular lymph vessels
Autonomic Nerves
Remains of processus vaginalis
Genital branch of genitofemoral nerve
```
54
Venous plexus draining the testis
Pampiniform plexus
55
The testicular veins drain differently on the left and right side. What are they?
Left - left renal vein
| Right - IVC
56
Lymphatic drainage of testis meet at what nodes?
Para-aortic lymph nodes
57
Innervation of cremaster
Genital Branch of Genitofemoral nerve
58
Coverings of the Spermatic Cord are derived from layers of the abdominal wall. Match them
External spermatic fascia - External oblique aponeurosis
Cremasteric fascia - internal oblique muscle fascia
Internal spermatic fascia - fascia transversalis
59
Afferent fibers of the cremasteric reflex
L1 and L2 (medial thigh)
60
Innermost wall of the scrotum directly covering the testes
Tunica Vaginalis
61
Which testes is lower, left or right?
Left
62
Tough fibrous capsule surrounding testis
Tunica Albuginea
63
Trace path of sperm from lobule to epididymis
Lobule - Seminiferous tubule - rete testis - efferent ductules - epididymis
64
The epididymis is located ___ to the testis
Posterior
65
A tuberculous disease from the vertebrae may spread to the upper thigh by passing under the fascia of this muscle?
Psoas Major
66
A patient was stabbed lateral to the rectus sheath. What structures in the anterior abdominal wall are hit by the knife?
```
Skin,
Campers Fascia,
Scarpa's Fascia,
Deep fascia,
external oblique
internal oblique
transversus abdominis
fascia transversalis
extraperitoneal connective tissue,
parietal peritoneum
```
67
A patient was stabbed anterior to the rectus sheath. What structures in the anterior abdominal wall are hit by the knife?
```
Skin,
Campers Fascia,
Scarpa's Fascia,
Deep fascia,
Anterior rectus sheath
Rectus abdominis
posterior rectus sheath
fascia transversalis
extraperitoneal connective tissue,
parietal peritoneum
```
68
A patient was stabbed in the midline. What structures in the anterior abdominal wall are hit by the knife?
```
Skin,
Campers Fascia,
Scarpa's Fascia,
Deep fascia,
Linea alba
fascia transversalis
extraperitoneal connective tissue,
parietal peritoneum
```
69
The peritoneal cavity is divided into two, greater sac and lesser sac. The two sacs communicate with each other through what structure?
Epiploic foramen (Foramen of Winslow)
70
TRUE OR FALSE. Intraperitoneal organs are those found inside the peritoneal cavity
FALSE. There is no organ inside the peritoneal cavity. Intraperitoneal means it is covered by visceral peritoneum on all sides.
71
Fold of peritoneum connecting the greater curvature of the stomach to the transverse colon?
Greater Omentum
72
Fold of peritoneum connecting the stomach to the hilum of the spleen
Gastrosplenic Omentum
73
Fold of peritoneum suspending the lesser curvature of stomach from the fissure of the ligamentum venosum and porta hepatis on the undersurface of the liver?
Lesser omentum
74
Borders of the epiploic foramen (A, P, S, I)
Anterior - free border of lesser omentum, bile duct, hepatic artery, portal vein
Posterior - IVC
Superior -Caudate lobe of liver
Inferior - D1
75
Parietal and Visceral peritoneum are sensitive to which sensations?
Parietal - pain, temperature, touch, pressure
| Visceral - stretch and tearing only
76
Lowest areas of the peritoneal cavity on the supine position
Right subphrenic peritoneal space and pelvic cavity
77
Volume of ascites required for it to be recognized clinically?
1500 mL
78
Anterior and posterior relations of the abdominal esophagus
Anterior - Left lobe of liver
| Posterior - Left crus of diaphragm
79
Arterial Supply of Esophagus
Left gastric artery
80
Lymph Drainage of Esophagus
Left gastric nodes
81
The gastroesophageal sphincter is
A. Anatomic
B. Physiologic
C. Both
B. Physiologic only
82
Parasympathic plexus in the wall of the esophagus
Auerbach's plexus
83
Portal-systemic venous anastomosis in the esophagus is between which two vessels
Left gastric vein and azygos vein
84
Capacity of the adult stomach in mL
1500 mL
85
Part of stomach usually full of gas
Fundus
86
Constant notch in the lower part of the lesser curvature of stomach which marks boundary between body and antrum
Incisura Angularis
87
Blood supply of the fundus of the stomac
Short gastric arteries
88
Left gastric artery comes from which artery? What does it supply
Celiac artery
| Lower 3rd of esophagus and Upper right stomach
89
Right gastric artery comes from which artery? What does it supply
Hepatic artery
| Lower right stomach
90
Left gastroepiploic artery comes from which artery? What does it supply
Splenic artery
| Upper greater curvature
91
Right gastroepiploic artery comes from which artery? What does it supply
Gastroduodenal artery
| Lower greater curvature
92
Drainage of left and right gastric vein
Portal vein directly
93
Drainage of short gastric vein and left gastroepiploic vein
Splenic Vein
94
Drainage of the right gastroepiploic vein
Superior Mesenteric Vein
95
Lymphatic Drainage of stomach?
Left and right gastric nodes, left and right gastroepiploic nodes, short gastric nodes. All converge to the celiac nodes
96
The anterior and posterior vagal trunks supply the stomach. They come from which nerves?
Anterior - left vagus
| Posterior - right vagus
97
Length of the duodenum
10 in (25 cm)
98
Is the duodenum intraperitoneal or retroperitoneal?
First inch intraperitoneal, rest is retroperitoneal
99
Part of the duodenum which runs upward and backward on the transpyloric plane
D1
100
Part of the duodenum in front of the hilum of the right kidney
D2
101
Part of the duodenum where the ampulla is located?
D2
102
Part of the duodenum running horizontally
D3
103
Part of the duodenum running vertically downward
D2
104
Part of the duodenum held by the ligament of Treitz
D4
105
The ligament of Treitz attaches which two structures?
Right crus of diaphragm and Duodenojejunal flexure
106
Circular folds found in the duodenum. (3 names)
Plicae circulares, Valves of Kerkcring, or Valvulae Conniventes
107
Part of the duodenum with no circular folds
D1
108
Blood supply of duodenum
Superior and Inferior pancreaticoduodenal artery and vein
109
Lymph drainage of duodenum
Pancreaticoduodenal node -- gastroduodenal node -- celiac nodes
or
pancreaticoduodenal node -- superior mesenteric nodes
110
Which part of the duodenum is most susceptible to tear in crush injuries
D3 - related to third lumbar vertebra
111
Perforated ulcer of the anterior wall of the intraperitoneal duodenum will affect what structures
Greater sac, right paracolic gutter, right iliac fossa
112
Perforated ulcer of the posterior wall of the intraperitoneal duodenum will affect what structures
Gastroduodenal artery, causing severe hemorrhage
113
Jejunum versus ileum (in terms of viscus wall)
Jejunum - thicker,wider, redder. More and larger plicae circulares
Ileum - smaller, fewer plicae circulares, none at the lower part
114
Jejunum vs ileum (in terms of blood vessels)
Jejunum - one or two arcades with long infrequentbranches
| Ileum - numerous arcades >3, and numerous short terminal vessels
115
Peyers patches can be found in which part of the small intestine?
Mucous membrane of lower ileum along antimesenteric border
116
Blood supply of jejunum and ileum
Superior Mesenteric aretry/vein
| Lower ileum - ileocolic artery/vein
117
Lymphatic drainage of jejunum and ileum
Superior mesenteric nodes
118
The appendix is attached to which surface of the cecum?
Posteromedial
119
Which of the following structures is present in the cecum?
1. Peritoneal covering
2. Mesentery
3. Teniae Coli
1 and 3
120
Blood supply of the cecum
Anterior and posterior cecal artery/vein, from the ileocolic artery/vein
121
Lymph drainage of the cecum
Superior mesenteric nodes
122
Ileocecal Valve vs Ileocecal Sphincter?
Valve - folds of mucous membrane. No function
| Sphincter - circular muscle at lower end of ileum, controls flow
123
TRUE OR FALSE: The appendix is completely covered with peritoneum and has a mesentery
TRUE. Mesoappendix is the mesentery
124
What is McBurney's point?
One third the way up line joining right ASIS and umbilicus
125
How do surgeons locate the base of the appendix?
Identify teniae coli of cecum and trace to base, where they converge to form continuous longitudinal muscle coat
126
The appendicular artery is a branch of which larger artery?
Posterior cecal artery
127
Lymph drainage of appendix?
Nodes of mesoappendix - superior mesenteric nodes
128
The hepatic flexure of the colon touches which lobeo f the liver?
Right lobe
129
Blood supply of ascending colon?
Ileocolic and right colic artery/vein
130
Lymph drainage of ascending colon?
Nodes along colic blood vessels -- Superior mesenteric nodes
131
The transverse colon is suspended by the _____ from the pancreas,
Transverse mesocolon
132
The transverse colon is suspended from the diaphragm by which structure?
Phrenicocolic ligament
133
Blood supply of the transverse colon
Proximal 2/3 - middle colic artery/vein
| Distal 1/3 - left colic artery/vein
134
Lymph drainage of the transverse colon?
Proximal 2/3 - colic nodes - superior mesenteric nodes
| Distal 1/3 - colic nodes - inferior mesenteric nodes
135
The descending colon becomes continuous with the sigmoid colon at which landmark
Pelvic brim
136
Blood supply of the descending colon
Left colic artery/vein and sigmoid branches of inferior mesenteric artery/vein
137
Lymphatic drainage of the descending colon
Colic lymph nodes -- inferior mesenteric lymph nodes
138
Anastomosis of colic arteries around concave margin of the large intestine forms this arterial trunk?
Marginal artery
139
The portal vein is formed behind the neck of the pancreas by the union of which two veins?
Splenic Vein and Superior Mesenteric Vein
140
Tributaries of the portal vein?
```
Splenic Vein
Inferior Mesenteric Vein
Superior Mesenteric Vein
Left Gastric Vein
RIght Gastric Vein
Cystic Veins
```
141
Tributaries of the splenic vein?
Short gastric vein,
Left gastroepiploic vein
Inferior Mesenteric Vein
Pancreatic Vein
142
Tributaries of the inferior mesenteric veins
Superior rectal vein
Sigmoid vein
left colic vein
143
Tributaries of the superior mesenteric vein
```
Jejunal vein
Ileal vein
ileocolic vein
right colic vein
middle colic vein
inferior pancreaticoduodenal vein
right gastroepiploic vein
```
144
Difference in arrangement of longitudinal muscles in small and large intestine?
Small - forms continuous layer around gut
| Large - Collected into three bands - the teniae coli
145
Fatty tags attached to the wall of the large intestine, not present in small intestine
Appendices epiploicae
146
Largest gland in the body
Liver
147
Anticoagulant synthesizedin the liver
Heparin
148
Lobes of the liver
Right - quadrade, caudate
| Left
149
The quadrate and caudate lobe are part of the left or right?
Anatomically, right
| Functionally (blood supply) - left
150
Contents of the porta hepatis
Right and left hepatic ducts
Right and left hepatic artery
Portal vein
Sympathetic and parasympathetic
151
The porta hepatis is found on which surface of the liver? (anatomic direction)
Posteroinferior
152
TRUE or FALSE: The liver is completely covered with peritoneum?
FALSE. An area devoid of peritoneum exists, called the "bare area of the liver"
153
Two layered fold of peritoneum extending from the umbilicus to the liver, splitting right and left lobes
Falciform ligament
154
The falciform ligament passes on to the anterior and superior surfaces of the liver and splits into two layers, the ____
Right - coronary ligament -- right triangular ligament
| Left left trianguular ligament
155
Remnant of the umbilical vein
Ligamentum Teres
156
The ligamentum teres is found on which surface of the liver?
Visceral surface
157
Remnant oif the ductus venosus
Ligamentum venosum
158
Blood supply of the liver
```
Hepatic artery (30%)
Portal Vein (70%)
Hepatic vein - drainage
```
159
Lymph drainage of the liver
Lymph nodes in porta hepatis - celiac nodes
160
Rate of bile production in the liver
40mL/hr
161
Which bile ducts emerge from the liver in the porta hepatis
Right and left hepatic duct
162
The ampulla of Vater is located in which wall of the duodenum?
Medial wall of D2
163
Circular muscle at the terminal of the common bile duct and pancreatic duct
Sphincter of Oddi
164
The gallbladder fundus comes into contact with the anterior abdominal wall at the tip of which costal cartilage?
9th
165
Capacity of the gallbladder
30-50mL
166
Blood supply of gallbladder
Cystic artery/vein
167
Lymph drainage of gallbladder
Cystic node -- hepatic nodes -- celiac nodes
168
The mucous membrane of the cystic duct is raised to form a spiral fold that is continuous with a similar fold in the neck of the gallbladder. This fold is called?
Spiral valve
169
Part of the head of the pancreas which extends to the left behind the superior mesenteric vessels
Uncinate process
170
The neck of the pancreas is located in front of the beginnings of two vessels. What are they?
Superior mesenteric artery
| Portal Vein
171
The accesoory duct of the pancreas, when present drains which part?
Upper part of head
172
Major duodenal papilla vs Minor duodenal papilla
Major - main duct
| Minor- accessory duct
173
Duct of Wirsung vs Duct of Santorini
Wirsung - Main duct
| Santorini - Accessory duct
174
Blood supply of pancreas
Superior and inferior pancreaticoduodenal artery/vein
175
Lymph drainage of pancreas
Pancreaticoduodenal nodes -- Celiac and superior mesenteric nodes
176
Largest single mass of lymphoid tissue in the body
Spleen
177
The spleen lies close towhich ribs
9th, 10th, and 11th
178
Contents of the splenicorenal ligament
Splenic Vessels, Tail of pancreas
179
Blood supply of spleen
Splenic Artery/Vein
180
Lymph drainage of spleen
Nodes along splenicartery -- Celiac Nodes
181
Floor ofthe retroperitoneal space is formed by which muscles
Psoas and Quadratus lumborum
182
Which kidney is higher?
left
183
The hilum of thekidney extends to a large sinus called
Renal Sinus
184
Connective tissue outside the perirenal fat and encloses anterior part of kidneys and adrenals
Gerota's Fascia (Anterior Renal Fascia)
185
Connective tissue outside the perirenal fat and encloses posterior part of kidneys and adrenals
Zuckercandl's Fascia (Posterior Renal Fascia)
186
Coverings of kidney, from posterior abdominal wall to parenchyma
Pararenal fat, Renal Fascia (Gerota if anterior, Zuckercandl if Posterior), Perirenal Fat, Fibrous Capsule
187
Divisions of the renal arteryfrom large to small
Renal Artery - Segmental Artery - Lobar Artery - Interlobar Artery - Arcuate Artery - Interlobular Artery - Afferent Glomerular Arteriole
188
Each renal pyramid has a blood supply of one ____ artery
Lobar
189
Lymph drainage of kidney
Lateral aortic lymph nodes
190
How many percent of cardiac outflow passes through the kidneys?
25%
191
Length of the ureter
10 in (25 cm)
192
Three constrictions along the course of the ureter?
Junction with renal pelvis
Junction with pelvic brim
Junctionwith bladder wall
193
Blood supply of the ureter
Upper 1/3 - Renal artery/vein
Middle 1/3 - Testicular/Ovarian artery/vein
Lower 1/3 - Superior vesical artery/vein
194
Lymph drainage of ureter
Lateral aortic nodes and iliac nodes
195
What separates the adrenal glands from the kidneys?
Perirenal fat
196
Main branches of abdominal aorta
3 anterior visceral: Celiac artery, SMA, IMA
3 lateral visceral: suprarenal artery, renal artery, testicular/ovarian artery
5 lateral abdominal wall:inferior phrenic, 4 lumbar arteries
3 terminal branches - left and right common iliac artery, median sacral artery
197
What structure crosses anteriorly at the bifurcation of the common iliac artery
Ureter
198
The common iliac arteries end in front of which structure
Sacroiliac joint
199
Tributaries of the inferior vena cava
2 anterior visceral: hepatic veins
3 lateral visceral: right suprarenal, renal veins, right testicular/ovarian vein
5 lateral abdominal wall: inferior phrenic and 4 lumbar
3 origins: 2 common iliac and median sacral vein
200
Blunt trauma to the aorta will cause rupture of which layer last?
Tunica adventitia.
| Intima and Media rupture first
201
Pre-aortic lymph nodes drain which structures
GI tract, HBT, spleen, pancreas
202
Para-aortic lymph nodes, also called lateral aortic or lumbar lymph nodes drain which structures
Urinary and reproductive structures
203
The thoracic duct commences in the abdomen as the elongated lymph sac called?
Cisterna Chyli
204
Lumbar plexus nerves from L1
Iliohypogastric nerve, ilioinguinal nerve, genitofemoral nerve
205
Lumbar plexus nerves from L2
Genitofemoral nerve, lateral cutaneous nerve of thigh, obturator nerve, femoral nerve
206
Lumbar plexus nerves from L3
lateral cutaneous nerve of thigh, obturator nerve, femoral nerve
207
Lumbar plexus nerves from L4
Obturator nerve, nerve to lumbosacral trunk and sacral plexus
208
Lumbar plexus nerves emerging from the lateral border of the psoas
Iliohypogastric, ilioinguinal, lateral cutaneous nerve of thigh, femoral nerve
209
Lumbar plexus nerve emerging from the medial border of the psoas
Obturator nerve
210
Lumbar plexus nerve emerging from the anterior surface of the psoas.
Genitofemoral nerve
