Abdominal anatomy

Question 1

Embryology: where are the renal tubules derived from?

Answer 1

intermediate cell mass caudal to the metanephros

Question 2

the ureter, the pelvis, calyces and the collecting tubules of the kidney are formed from what embryologically?

Answer 2

Metanephros.
The renal tubules arise from the metanephric cap.

Question 3

How is the ureteric bud formed?

Answer 3

The ureteric bud arises as a tubular diverticulum from the mesonephric duct close to the point where it joins the cloaca.

Question 4

When does the diverticulum appear?

Answer 4

The fifth week of gestation

Question 5

What causes a pelvic kidney?

Answer 5

The ureteric bud and metanephric duct - when they fail to ascend cranially.

Question 6

At what level does the IVC pass through the diaphragm?

Answer 6

T8

Question 7

What is the first branch of the abdominal aorta?

Answer 7

Inferior phrenic arteries

Question 8

Where is the superior adrenal artery derived/what is it a branch of?

Answer 8

The inferior phrenic artery

Question 9

Embryology: from where is the spleen derived?

Answer 9

mesenchymal tissue

Question 10

Embryology: from where is the gut derived other than the spleen?

Answer 10

Endoderm

Question 11

What are the function of the following fascia?
Waldeyers fascia
Sibsons fascia
Bucks fasci
Gerotas fascia
Denonvilliers fascia

Answer 11

Waldeyers fascia- Posterior ano-rectum
Sibsons fascia- Lung apex
Bucks fascia- Base of penis
Gerotas fascia- Surrounding kidney
Denonvilliers fascia- Between rectum and prostate

Question 12

What is the venous drainage of oesophageal varices?

Answer 12

hemiazygos veins

Question 13

From where does the adrenal artery originate?

Answer 13

The abdominal aorta

Question 14

What runs through the epiploic foramen?

Answer 14

The portal vein, hepatic artery and common bile ducts

Question 15

Blood supply to the bile duct?

Answer 15

The hepatic artery

Question 16

At what level does the abdominal aorta originate from and terminate?

Answer 16

From T12 to L4

Question 17

What are the branches of the abdominal aorta?

Answer 17

Inferior phrenic
Coeliac
Superior mesenteric
Middle suprarenal
Renal
Gonadal
Lumbar
Inferior mesenteric
Median sacral
Common iliac

Question 18

What are the borders of the right adrenal gland?

Answer 18

Posteriorly: diaphragm
Anteriorly: hepatorenal pouch and bare area of the liver
Inferiorly: kidney
Vena cava: medially

Question 19

What are the borders of the left adrenal gland?

Answer 19

Postero-medially: diaphragm
Inferiorly: pancreatic and splenic vessels
Anteriorly: lesser sac and stomach

Question 20

What is the blood supply to the adrenal glands?

Answer 20

The superior adrenal arteries that are derived from the inferior phrenic arteries
The middle adrenal arteries that are derived from the abdominal aorta
The inferior adrenal arteries from the renal arteries

Question 21

What is the venous drainage of the right adrenal?

Answer 21

The central vein that drains directly into the IVC

Question 22

What is the venous drainage of the left adrenal?

Answer 22

Central vein that drains directly into the left renal vein

Question 23

What is the embryological origin of the adrenal gland?

Answer 23

The mesoderm of the posterior abdominal wall

Question 24

Nerve supply of the internal anal sphincter?

Answer 24

The sympathetic nerve supply

Question 25

Nerve supply to the external anal sphincter?

Answer 25

Inferior rectal branch of the pudendal nerve (S2, S3) Perineal branch of S4 nerve roots

Question 26

What is the anatomical location of Mcburneys point?

Answer 26

1/3 of the way along the line drawn from the anterior superior iliac spine to the umbilicus

Question 27

What are the different positions of the appendix?

Answer 27

Retrocaecal - 74% Pelvic - 21% Postileal Subcaecal Paracaecal Preileal

Question 28

What is the blood supply of the bladder and from where are these vessels derived?

Answer 28

Superior and inferior vesical arteries branches of the internal iliac arteries

Question 29

What is the venous drainage of the bladder?

Answer 29

Vesicoprostatic venous plexus Vesicouterine benous plexus Both drain into the internal iliac veins in both sexes

Question 30

lymphatic drainage of the bladder?

Answer 30

Mostly on the internal iiac nodes, some external iliac nodes and obturator nodes

Question 31

What nerves result in bladder voiding?

Answer 31

The parasymphathetics

Question 32

What are the three main branches of the coeliac axis?

Answer 32

Left gastric Hepatic Splenic

Question 33

What are the branches of the hepatic artery?

Answer 33

right gastric gastroduodenal superior pancreatoduodenal cystic

Question 34

What are the branches of the splenic artery

Answer 34

Pancreatic Short gastric Left gastroepiploic

Question 35

What are the borders of the coeliac axis?

Answer 35

Anteriorly: lesser omentum Right: right coeliac ganglion and caudate process of the liver Left: left coeliac ganglion and gastric cardia Inferiorly: upper bordre of the pancreas and renal vein

Question 36

What is the location of the coeliac plexus?

Answer 36

It surrounds the coeliac axis on the level of T12 and L1. Lies posteriorly to the stomach and lesser sac

Question 37

What structure attaches to the greater omentum?

Answer 37

The superior aspect of the transverse colon

Question 38

How would you take a surgical approach to get into the lesser sac?

Answer 38

You would divide the greater omentum from the superior aspect of the transverse colon

Question 39

Where is the descending colon positioned in relation to the peritoneum?

Answer 39

The posterior aspect of the descending colon is retroperitoneal until the level of L4 where the colon becomes wholly intraperitoneal and becomes the sigmoid colon

Question 40

Arterial supply of the ascending colon?

Answer 40

ileocolic and right colic arteries

Question 41

Arterial supply of the transverse colon?

Answer 41

Middle colic artery

Question 42

Arterial supply of the descending colon and sigmoid colon?

Answer 42

Inferior mesenteric artery

Question 43

Lymphatic drainage of the bowels?

Answer 43

Into the para-aortic nodes

Question 44

Embryological origin of the bowel?

Answer 44

Ascending colon and proximal 2/3 of the transverse colon - midgut distal 2/3 of the transverse colon and descending colon - hindgut

Question 45

Diaphragm aperture levels?

Answer 45

Vena cava - T8 Oesophagus - T10 Aortic hiatus - T12

Question 46

What is formed from the first and second pharyngeal arches?

Answer 46

The maxillary artery is formed from the first arch The external carotid buds are formed from the remnants of the first and second arch

Question 47

What is formed from the third pharyngeal arch?

Answer 47

common carotid artery and the proximal portion of the internal carotid artery

Question 48

What is formed from the fourth pharyngeal arch?

Answer 48

The arch of the aorta from the left side and the right subclavian vein and internal mammary artery from the right side

Question 49

What is formed from the fifth pharyngeal arch?

Answer 49

Nothing it regresses completely

Question 50

What is formed from the sixth pharyngeal arch?

Answer 50

The right pulmonary artery and left pulmonary artery and ductus arteriosus

Question 51

Origin of the inferior epigastric artery?

Answer 51

external iliac artery

Question 52

most appropriate incision for a whipples?

Answer 52

Rooftop incision

Question 53

What nerves are at risk in an anterior resection of the rectum?

Answer 53

The hypogastric autonomic nerves

Question 54

What nerves are at risk in an inguinal hernia surgery?

Answer 54

The ilioinguinal nerve

Question 55

What structures run through the porta hepatis?

Answer 55

The portal vein, hepatic artery and bile duct

Question 56

From where does the gastro-epiploic artery originate?

Answer 56

The gastroduodenal artery

Question 57

What level does the inferior mesenteric artery leave the abdominal aorta?

Answer 57

L3

Question 58

At what spinal level does the common iliac vein fuse with the IVC

Answer 58

L5