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Anatomy Flashcards

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1
Q

Length of colon

A

150cm

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2
Q

Which part of the colon is retroperitoneal?

A
  • ascending colon
  • descending colon
  • rectum and anal canal
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3
Q

Length of sigmoid colon

A

40cm

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4
Q

Arterial supply of ascending colon

A
  • Ileocolic (from SMA)

- Right colic arteries (from SMA)

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5
Q

Arterial supply of transverse colon

A
  • Right 2/3: right marginal branch from SMA

- Left 1/3: left marginal branch from SMA

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6
Q

Arterial supply of descending colon

A
  • Left colic artery (from IMA)
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7
Q

Arterial supply of sigmoid colon

A
  • Sigmoid arteries (from IMA)
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8
Q

What is Marginal Artery of Drummond?

A

Clinically important vessels that provide collateral supply to colon - maintaining arterial supply in case of occlusion of major vessels. Forms from terminal vessels of SMA and IMA.

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9
Q

Nerve supply of colon

A
  • Midgut-derived (ascending colon and proximal 2/3 of transverse colon) = superior mesenteric plexus
  • Hindgut-derived structures (distal 1/3 of the transverse colon, descending colon and sigmoid colon)
    = Inferior mesenteric plexus (parasympathetic: pelvic splanchnic nerve; sympathetic: lumbar splanchnic nerve)
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10
Q

How long is the oesophagus?

A

25cm

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11
Q

Where does the oesophagus start and end at?

A
  • Start at the cricoid cartilage (C6 vertebra)

- End at the stomach (T10 vertebra)

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12
Q

Upper oesophagal sphincter formed by

A

Cricopharyngeus muscle

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13
Q

Lower oesophageal sphincter formed by

A
  • Increased tone of the muscularis propria
  • Fibres of the right diaphragmatic crus
  • Angle of His
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14
Q

3 narrow points of the oesophagus

A
  • Cricopharyngeus sphincter
  • Aortic arch
  • Where the oesophagus pierces through the diaphragm
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15
Q

Layers of oesophagus

A
  • Mucosa
  • Submucosa [Meissner’s plexus]
  • Muscularis propria (Inner circular, outer longitudinal) [Auerbach Plexus in between]
  • Serosa or adventitia
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16
Q

Retroperitoneal part of duodenum

A

1st inch of the 1st part

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17
Q

Difference between jejunum and ileum

A

> Jejunum

  • Vasa recta longer
  • Arcades less
  • Has valvular conniventes

> Ileum

  • Shorter vasa recta
  • Arcades more
  • Has Peyer’s patches
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18
Q

Arterial supply of small intestine

A

> Duodenum

  • 1st and 2nd: superior pancreatoduodenal artery (branch of gastroduodenal artery)
  • 3rd and 4th: inferior pancreatoduodenal artery (branch of superior mesenteric artery)

> Jejunum & Ileum
- Jejunal and ileal branches of SMA

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19
Q

Inferior mesenteric vein drains blood from

A
  • Rectum
  • Sigmoid colon
  • Descending colon
  • Splenic flexure
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20
Q

Ureter length and diameter

A
  • 25-30cm long

- 3mm in diameter

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21
Q

Relation of inguinal canal

A

> Floor
- Inguinal ligament

> Roof

  • Formed by arching fibers of transversus abdominis and internal oblique
  • Become the conjoint tendon medially

> Anterior wall

  • External oblique aponeurosis
  • Reinforced laterally by internal oblique

> Posterior wall
- Transversalis fascia

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22
Q

Content of spermatic cord

A

> 3 arteries

  • Testicular artery
  • Artery to the Vas Deferens
  • Cremasteric artery

> 3 nerves

  • Autonomic nerve (sympathetic from T10)
  • Ilio-inguinal nerve
  • Nerve to cremaster ( from genito-femoral nerve)

> 3 important structures

  • Vas Deferens
  • Pampiniform Plexus of vein
  • Processus Vaginalis
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23
Q

Anatomy of anal sphincter

A

> Internal anal sphincter

  • Upper 2/3
  • Involuntary smooth muscle

> External anal sphincter

  • Lower 2/3
  • Voluntary muscle
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24
Q

Arterial supply of anal canal

A

> Above pectinate line
- Superior rectal artery (branch of IMA)

> Below pectinate line
- Inferior rectal artery
( branch of internal pudendal artery)

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25
Nerve supply of anal canal
> Above pectinate line - Visceral innervation via inferior hypogastric plexus > Below pectinate line - Somatic innervation via inferior rectal nerve (branches of pudendal nerve)
26
Venous drainage of anal canal
> Above pectinate line - Superior rectal vein -> inferior mesenteric vein (portal venous system) > Below pectinate line - Inferior rectal vein -> internal pudendal vein (systemic venous system) - Site of varices when portal HPT
27
Common position of appendix
- Post-ileal (1 or 2 o'clock) - Pre-ileal (1 or 2 o'clock) - Pelvic (5 o'clock) - Sub-cecal (6 o'clock) - Retrocecal (11 o'clock) [Most common]
28
Describe branches of portal venous system
- Formed by union of the splenic vein and SMV posterior to neck of pancreas - IMV join to splenic vein posterior to body of pancreas
29
Superior mesenteric vein drains blood from
- Small intestine - Cecum - Ascending colon - Transverse colon
30
Anatomy of pancreas
- Head: lie within c-shaped concavity of duodenum, uncinated process extend to left behind the superior mesenteric vessels - Neck: lie in front of portal vein - Body: run upward and left across the midline - Tail: anterior to left adrenal gland contacting hilum of spleen
31
Blood supply of pancreas
- Celiac artery -> splenic artery (tail) and superior pancreaticoduodenal artery (head) - Superior mesenteric artery -> inferior pancreaticoduodenal artery (head) - Venous drainage via pancreaticoduodenal veins -> portal vein
32
Arterial supply of breast
> Medial - Internal thoracic artery (branch of subclavian artery) > Lateral - Lateral thoracic and thoracoacromial branches (from axillary artery) - Lateral mammary branches (from posterior intercostal arteries) - Mammary branch (from anterior intercostal artery)
33
Lymphatic drainage of breast
- Axillary nodes (75%) [5 groups] - Parasternal nodes (20%) - Posterior intercostal nodes (5%)
34
Anatomical division of liver
- Separated by falciform ligament into right and left lobe - 2 accessories lobes arise from right lobe, located at visceral surface of liver: caudate (upper) and quadrate (lower) lobe - Portal hepatis separate the 2 accessory lobes
35
Arterial supply of liver
- Hepatic artery proper (25%) | - Hepatic portal vein (75%)
36
Functional division of liver
- Divide by 1 transverse plane (main branch of portal vein) and 3 sagittal plane (3 main hepatic veins) - Into 8 segments numbered in anti-clockwise manner around porta hepatis - Have own vascular inflow, outflow, and biliary drainage
37
Border of anterior triangle
- Lower border of mandible superiorly - Midline anteriorly - Anterior border of the SCM posteriorly
38
Border of posterior triangle
- Posterior border of the SCM anteriorly - Anterior border of the trapezius posteriorly - Clavicle inferiorly
39
Blood supply of thyroid glands
- Superior thyroid artery (from external carotid) - Inferior thyroid artery (from thyrocervical trunk) - Thyroid ima artery - around 10% of people
40
Symptoms of damaged recurrent laryngeal nerve
- Unilateral damage = hoarseness | - Bilateral damage = dyspnea
41
Arteries of lower limb
- External iliac artery continues as femoral artery after crossing the inguinal ligament - Superficial femoral enter the adductor canal and pass through the hiatus in the adductor magnus to reach the popliteal fossa, where it changes its name to popliteal artery - Popliteal divide at lower border of popliteus into anterior and posterior tibial artery - Anterior tibial -> dorsalis pedis - Posterior tibial -> peroneal artery + medial and lateral plantar artery
42
Course of the great saphenous vein
- Arise from medial side of dorsal venous arch of foot - Ascends immediately in front of medial malleolus (accompanied by saphenous nerve) - Ascends obliquely up the medial aspect of thigh - Pierces the cribriform fascia at the saphenofemoral junction to drain into the femoral vein
43
Course of small saphenous vein
- Arise from lateral side of the dorsal venous arch of foot - Passes posterior to the lateral malleolus - Ascends up the midline of calf - Pierces the deep fascia over popliteal fossa to drain into popliteal vein - Accompanied in course by sural nerve
44
Location of communicating veins
- Saphenofemoral junction - Hunterian perforator: mid-thigh - Dodd's perforator: distal thigh - Boyd's perforator: knee - Calf perforator: at 5, 10, 15cm above medial malleolus
45
Parts of gallbladder
- Fundus - Body - Neck
46
Describe the biliary tree
- Right and left hepatic ducts -> common hepatic duct - Joined with cystic duct when descend -> common bile duct - Joined with main pancreatic duct -> hepatopancreatic ampulla/ ampulla of Vater
47
Artery supply of gallbladder
- Cystic artery (branch of right hepatic artery)
48
Calot's triangle
- Inferior border of liver superiorly - Cystic duct laterally - Common hepatic duct medially
49
Content of inguinal canal
- Males: spermatic cord + ilioinguinal nerve | - Females: round ligament of the uterus + ilioinguinal nerve
50
Borders of Hesselbach's triangle
- Lateral: inferior epigastric artery - Medial: lateral border of rectus abdominis - Inferior: inguinal ligament
51
Anatomy of inguinal canal
- 4-6cm long oblique passage above inguinal ligament - Deep ring: 2cm above the midpoint of the inguinal ligament - Superficial ring: above and medial to the pubic tubercle
52
Langer line
- Line of skin tension - Associated with the distribution of collagen and elastic fibers in the skin - Predominantly horizontal in abdomen
53
Location of appendix
- Pre-ileal (1, 2 o'clock) - Post-ileal (1, 2 o'clock) - Sub-ileal (3 o'clock) - Pelvic (5 o'clock) - Subcecal (6 o'clock) - Paracecal (10 o'clock) - Retrocecal (11 o'clock) [Most Common]
54
Artery supply of appendix
- Appendicular artery (derived from ileocolic artery, a branch of SMA)
55
Major branches of SMA
Inferior Pancreaticoduodenal artery - Inferior region of head of pancreas - Uncinated process - Duodenum Jejunal and Ileal artery Ileocolic artery - Ileum - Cecum - Appendix - Ascending colon Right colic artery - Ascending colon Middle colic artery - Transverse colon
56
Dependent area for pelvic - Supine position
- Morison's pouch (hepato-renal fossa) - Pouch of Douglas (retro-uterine pouch) - Para-colic gutter
57
Cantlie line
- Vertical line extends from inferior vena cava posteriorly to the middle of gallbladder fossa anteriorly - Left: segment 2,3,4a,4b Right: segment 5,6,7,8
58
Anatomical vs Functional division of liver
> Anatomical division - Demarcated by falciform ligament > Functional division - Demarcated by Cantlie's line -> more important for reading CT scan and surgery - Further divide into 8 functional segment
59
9 layers of abdominal wall
- Skin - Subcutaneous tissue - Superficial fascia - External oblique muscle - Internal oblique muscle - Transversus abdominis muscle - Transversalis fascia - Preperitoneal adipose and areolar tissue - Peritoneum
60
Midline vs Paramedian incision
> Midline - Cut through skin, subcutaneous tissue, fascia, linea alba, transversalis fascia and peritoneum > Paramedian - Cut through skin, subcutaneous tissue, anterior rectus sheath, posterior rectus sheath, transversalis fascia, and peritoneum - Assess lateral viscera - kidney, spleen, and adrenal glands - Can damage blood and nerve supply, leading to atrophy of muscle medially
61
Blood supply of stomach
> Lesser curvature - Right gastric (branches of common hepatic, from coeliac trunk) - Left gastric (directly from coeliac trunk) > Greater curvature - Right gastro-omental (branches of gastroduodenal artery, from common hepatic) - Left gastro-omental (branches of splenic artery, from coeliac trunk)
62
Direct vs Indirect hernia
> Indirect - Remnants of patent processus vaginalis - Lateral to the inferior epigastric vessels - Travelling through the inguinal canal with spermatic cord - May continue through the superficial inguinal ring into the scrotum > Direct - Result of weak posterior wall - Arise medial to the inferior epigastric vessels - Not within the spermatic cord
63
Example of perforator veins
- Saphenofemoral junction - Hunter veins (at thigh level) - Dodd's perforators (inferior 1/3 of the thigh, above the knee) - Body's perforator (at or below the knee level) - Cockett's perforator (at the level of calf and inferior 2/3 of the leg) - further subdivided into superior, medium and inferior perforators
64
Mallampati classification
- Class 1: complete visualization of the soft palate - Class 2: complete visualization of the uvula - Class 3: visualization of only the base of uvula - Class 4: soft palate is not visible at all
65
Lymph nodes at inguinal region
- Divide into 2 groups by their position relative to a horizontal line drawn at the level of termination of the great saphenous veins - Above line: Superficial inguinal nodes - Below line: Sub-inguinal nodes (Superficial and Deep)

Surgery (11 decks)

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