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Abdomen & Pelvis anatomy Flashcards

(100 cards)

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1
Q

Lymphatic drainage of abdominal wall above umbilicus

A

Anterior axillary lymph nodes

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2
Q

Lymphatic drainage of abdominal wall below umbilicus

A

Superficial inguinal lymph nodes

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3
Q

Lymphatic drainage below dentate line/scrotum/labia majora

A

Medial superficial inguinal lymph nodes

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4
Q

Level of arcuate line

A

2cm below umbilicus

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5
Q

Layers of abdominal wall medially above arcuate line

A

Skin
Campers
Scarpas
Anterior rectus sheath
Rectus Abdominis
Posterior rectus sheath
Transversalis fascia
Parietal peritoneum

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6
Q

Layers of abdominal wall laterally above arcuate line

A

Skin
Campers
Scarpas
External oblique
Internal oblique
Transversus abdominis
Transversalis fascia
Parietal peritoneum

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7
Q

Layers of abdominal wall
medially below arcuate line

A

Skin
Campers
Scarpas
Anterior abdominal aponeurosis
Rectus abdominis
Transversalis fascia
Parietal peritoneum

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8
Q

Layers of abdominal wall
laterally below arcuate line

A

Skin
Campers
Scarpas
External oblique
Internal oblique
Transversus abdominis
Transversalis fascia
Parietal peritoneum

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9
Q

Spigelian hernia

A

Weakness in semilunaris

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10
Q

L1 surface markings

A

Half way between suprasternal and symphysis pubis - 2 Ss

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11
Q

L3

A

3 things
- IMA
- 3rd pharyngeal pouch
- Inferior parathyroid

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12
Q

Surface marking of fundus of gallbladder

A

Intersection of R mid clavicular line & transpyloric plane

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13
Q

Spinal cord termination

A

Children are inferior to adults
L1 in adults
L3 in children

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14
Q

Transpyloric plane

A

Bones - L1, 9th costal cartilage
Nerve - conus medullaris
Lymph - cisterna chyli
Vessels - SMA, portal vein
Organs - fundus of gallbladder, pylorus of stomach, 2nd part of duodenum (sphincter of Oddi), colon (hepatic and splenic flexure), renal hilum, NECK of pancreas

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15
Q

Location of lumbar hernia

A

Posterior abdominal wall
IQ 12 (of examiners)
Internal oblique
Quadratus lumborum/erector spinae
Lower border of 12th rib

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16
Q

Ligaments formed by lesser omentum

A

Hepatoduodenal ligament
Hepatogastric ligament

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17
Q

Attachments of greater omentum

A

Attaches to greater curve of stomach and then transverse colon

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18
Q

Pancreatic pseudocysts

A

Smooth elevation in POSTERIOR wall of stomach

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19
Q

Portal triad

A

Portal vein
Hepatic artery proper
CBD

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20
Q

What makes a cyst a PSEUDO cyst?

A

No epithelial lining

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21
Q

Pancreatic HEAD pathology

A

Cancer

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22
Q

Location of pancreatic NECK

A

L1

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23
Q

Pancreatic BODY pathology

A

Pseudocysts

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24
Q

Pancreas TAIL pathology

A

Diabetes - 90% of islets in tail

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25
Borders of epiploic foramen
IVC - posterior D1 - inferior Caudate lobe of liver - superior Free edge of lesser omentum - anterior
26
Branches of celiac trunk
C is 3rd letter of alphabet L gastric Splenic Common hepatitic
27
Why is splenic artery tortuous?
To compensate for difference in pressure between aorta and spleen
28
Anastomosis of L gastric vein
L gastric anastomoses to azygous --> portosystemic shunt
29
Relation of splenic vein and portal vein to pancreas
POSTERIOR
30
Which parts of GI tract are intraperitoneal?
D1 and pancreatic TAIL
31
Splenic artery
Bulge in posterior stomach
32
Border of Calot's triangle
Inferior margin of liver Common hepatic duct Cystic duct
33
Contents of Calot's
R hepatic artery - supplies R lobe of lover, if damaged can result in deranged LFTs following cholecystectomy Cystic artery Lymphatics - node of Lund
34
Most common location of gallstone
Ampulla --> narrowest
35
Mirizzi syndrome
Compression of common hepatic duct leading to jaundice
36
Gallstone ileus
Within 60cm of ileocaecal valve
37
Most common causative organism for cholecystitis
E coli
38
Signs of ascending cholangitis
Gas in biliary tree Fever, pain, jaundice Unwell
39
Cancer most often caused by chronic inflammation
Squamous cell
40
Cancer caused by gallbladder inflammation & Barrett's oesophagus
Adenocarcinoma
41
Organism causing porcelain gallbladder
Salmonella Typhi Blue colour - calcification
42
Structure posterior to 1st part of duodenum
Gastroduodenal artery
43
Structures relating to 2nd part of duodenum
TRANSPYLORIC PLANE Post - right renal hilar vessels Kocker maneouvre
44
Structures relating to 3rd part of duodenum
Post - aorta and IVC Ant - SMA, SMV and ureter
45
Structures relating to 4th part of duodenum
Post - L renal hilar vessels
46
Jejunum
Long vasa rectae Less arterial arcades Thicker wall More plicae circulares
47
Ileum
THINK CROHNS --> HOLE --> NEEDS MORE VESSELS TO HEAL Short vasa rectae More arterial arcades Thinner wall Peyers patches
48
Blood supply of pancreas
Splenic artery - pancreatic branches Head also supplied by: superior pancreaticoduodenal (branch of gastroduodenal) inferior pancreaticoduodenal (branch of SMA)
49
SMA syndrome
Intermittent bowel obstruction Thin patient Post-prandial - 3rd part of duodenum
50
Which part of duodenum affected in SMA syndrome?
3rd part
51
Position of L renal vein
BEHIND SMA IN FRONT OF aorta
52
Nutcracker syndrome
Compression of L renal vein between SMA and aorta --> loin pain and haematuria
53
Surface marking of spleen
Mid axillary line 9, 10, 11th rib
54
Embryonic derivative of spleen
MESODERM
55
Location of pancreatic TAIL
Intraperitoneal
56
Drug given to treat pancreatic fistula
Ocreotide (somatostatin) stops secretions
57
Structures close to R of liver
Gallbladder IVC
58
Structures close to L of liver
2 x Ls Ligamentum venosus Round ligament
59
Watershed areas of large bowel
2/3rds of transverse colon Sigmoid colon
60
How much of transverse colon does SMA supply?
2/3rd
61
Sites of portocaval anastomoses
Gut, butt then caput L gastric - via azygous - oesophageal veins Superficial epigastric veins - umbilical vein Superior rectal - IMV Middle rectal - internal iliac Inferior rectal - internal iliac
62
Venous drainage of rectum
Superior rectal ----- Inferior mesenteric vein (PORTAL VENOUS) Middle rectal ------ Internal iliac vein Inferior rectal ------ Internal iliac vein (pudendal) (SYSTEMIC)
63
Blood supply of rectum
Superior rectal artery – terminal continuation of the inferior mesenteric artery Middle rectal artery – branch of the internal iliac artery Inferior rectal artery – branch of the internal pudendal artery
64
Submucosal wall
Weakness causes oesophageal varies and haemorrhoids
65
Embryological relevance of dentate line
Separates ectoderm and endoderm
66
Anal canal above dentate line
Endoderm Columnar epithelium Insensate Internal iliac nodes
67
Anal canal below dentate line
Ectoderm Squamous epithelium Sensate Superficial inguinal nodes
68
Lymphatic drainage of ovary, fundus and fallopian tube
Para aortic
69
Lymphatic drainage of uterine body
External iliac
70
Lymphatic drainage of cervix
Internal iliac
71
Lymphatic drainage of scrotum
Superficial inguinal
72
Lymphatic drainage of glans penis
Deep inguinal
73
Order of structures at renal hilum
A-->P VAU Renal vein Renal artery Ureter
74
Location of R adrenal gland
Posterior to IVC
75
Location of L adrenal gland
Next to aorta
76
Gold standard imaging for venous clot
MRI
77
Blood supply of ureter
Supplied by all branches it passes EXCEPT for: Inferior rectal artery Median sacral artery
78
Location of upper abdominal collection when supine
Hepatorenal pouch (Morrison)
79
Location of lower abdominal collection when supine
Rectouterine/vesicle (Douglas)
80
Most dependent part when sitting/standing
Rectouterine/vesical (Douglas)
81
Location of deep inguinal ring
Mid-point of inguinal ligament INGUINAL LIGAMENT --> THINK HERNIA
82
Location of femoral artery
Mid-inguinal point
83
Significance of mid clavicular line
Fundus of gallbladder, femoral artery, nipple
84
Inguinal canal
Muscles superior Aponeurosis anterior Muscle - TA, IO Aponeurosis - IO, EO Ligament - inguinal, lacunar Tendon - conjoint tendon, transversals fascia
85
Inguinal canal
ICE TIE Bottom line gives rise to top line Internal spermatic fascia, cremasteric fascia, external spermatic fascia Transversalis fascia, internal oblique, external oblique
86
Borders of Hesselbach's triangle
Inguinal ligament - lateral Inferior epigastric - superior Rectus abdominis - medial
87
Role of inf epigastric in inguinal hernia
Lateral to IE --> indirect Medial to IE --> direct
88
Femoral hernia
More common in females
89
Borders for femoral hernia
P for posterior - pectineal Anterior - inguinal Medial - lacunar Lateral - femoral vein
90
Which nerve pierces psoas major?
Gentiofemoral (can be mistaken for psoas minor)
91
Location of femoral nerve in relation to obturator canal
EXTERNAL to obturator canal
92
Genital regional dermatomes
THINK FIG F - anterior thigh - femoral I - thigh and scrotum - ilioinguinal G - scrotum - genitofemoral
93
Sensory part of cremasteric reflex
General somatic afferent - ilioinguinal & femoral branch of genitofemoral nerve
94
Motor part of cremasteric reflex
General somatic efferent - genital branch of genitofemoral nerve
95
Structures felt in male DRE
Anterior - prostate Posterior - coccyx Lateral - puborectalis
96
Pudendal canal syndrome - Alcocks
Perianal pain on sitting
97
Most important ligament supporting uterus
Uterosacral - pulling dog on leash
98
Sensory supply of pudendal nerve
Posterior scrotum and posterior labia majora
99
Surface landmark for pudendal nerve
Ischial spine
100
Water under the bridge
Urine goes under uterine artery

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