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MRCS Part B > Anatomy abdomen > Flashcards

Anatomy abdomen Flashcards

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1
Q

Name the parietal branches of the aorta

A

Inferior phrenic (paired)
Lumbar (4 pairs)
Median sacral (unpaired)

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2
Q

Which arteries branch from the aorta at T12?

A

Inferior phrenic
Coeliac

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3
Q

Which arteries branch from the aorta at L1?

A

Superior mesenteric
Middle suprarenal
Renal (L1/2)

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4
Q

What level does the gonadal artery arise from the aorta?

A

L2

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5
Q

What level does the inferior mesenteric artery branch from the aorta?

A

L3

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6
Q

Name the three branches of the coeliac trunk

A

Left gastric
Common hepatic
Splenic

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7
Q

Name the 4 branches of the common hepatic artery

A

Right gastric
Gastroduodenal
Hepatic proper
Cystic

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8
Q

Name the 3 branches of the splenic artery

A

Pancreatic
Short gastric
Left gastroepiploic

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9
Q

What organs are palpable in the normal abdomen?

A

Aorta
Lower pole of right kidney

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10
Q

Describe the surface markings of the liver

A

Superior - nipple line
Inferior - right 10th rib
Left lateral - left 5th intercostal space mid clavicular line

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11
Q
A
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11
Q

Describe the surface markings of the neck of pancreas

A

L1 - transpyloric plane

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12
Q

Describe the surface markings of the gallbladder

A

9th costal cartilage, mid clavicular line

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13
Q

Describe the surface markings of the spleen

A

Behind ribs 9-11

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14
Q

Describe the surface markings of the abdominal aorta

A

T12-L4 in the retroperitoneal space

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15
Q

What lies anterior to the aorta at L1?

A

SMA
Neck of pancreas
SMV
Pylorus of stomach

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16
Q

What does the transpyloric plane represent?

A

Halfway point between the suprasternal notch and pubic symphysis

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17
Q

What is the epiploic foramen of Winslow

A

Communication between the greater and lesser sacs of the peritoneal cavity

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18
Q

What lies above the epiploic foramen of Winslow?

A

Caudate lobe of the liver

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19
Q

What lies below the epiploic foramen of Winslow?

A

1st part of duodenum

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20
Q

What lies in front of the epiploic foramen of winslow?

A

Hepatoduodenal ligament

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21
Q

Which structures lie within the hepatoduodenal ligament?

A

CBD
Hepatic portal vein
Hepatic artery proper

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22
Q

What lies behind the epiploic foramen of Winslow?

A

IVC

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23
Q

What is Pringle’s maneouvre?

A

Compression of the hepatic artery and portal vein where they lie in the free edge of the lesser omentum in the epiploic foramen of winslow to stop bleeding from the liver during laparotomy

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24
What are the functions of the spleen?
FISH F - filtration of encapsulated organisms and blood cells I - Immunological S - Storage of platelets H - haematopoiesis in the foetus
25
Which organs may be damaged during a splenectomy?
Diaphragm Left kidney Tail of pancreas Splenic flexure of colon
26
Where do porto-systemic anastomoses occur?
Retroperitoneum Upper anal canal Bare area of the liver Lower end of the oesophagus Periumbilical area of abdominal wall
27
What are the common sites for intra-abdominal collections to form?
Hepatorenal pouch of Rutherford-Morrison (right subhepatic space) Pelvis Subphrenic spaces Paracolic gutters
28
Describe the surface anatomy of the kidney
Superior pole lies at 12th rib posteriorly
29
Name the parts of the stomach
Cardia Fundus Body Pylorus - antrum and sphincter
30
Which part of the duodenum is intraperitoneal?
1st
31
Differences between the jejunum and ileum
Jejunum - greater diameter, thickener wall, larger and thicker valvulae conniventes, long vasa recta, thinner mesentry, fewer arcades Ileum - shorter vasa recta, more arcades
32
How can you tell the difference between large and small bowel on AXR?
Large bowel - haustra, peripheral Small bowel - valvulae conniventes, more central
33
How many parts does the pancreas have?
Head, uncinate process, neck, body, tail
34
What are the functions of the pancreas?
Endocrine - insulin, glucagon, somatostatin Exocrine - produce and secrete digestive enzymes
35
Describe the blood supply to the pancreas
Head - superior (coeliac via gastroduodenal) and inferior (SMA) pancreaticoduodenal arteries Other areas - pancreatic branches of splenic artery
36
What are the three main divisions of the coeliac axis?
Left gastric artery Hepatic artery proper Splenic artery
37
What is the blood supply to the lesser curve of the stomach?
Left (from coeliac axis) and right gastric (from common hepatic) arteries
38
What is the blood supply to the lesser curve of the stomach?
Left and right gastro-epiploic/omental arteries
39
Where do the gastro-epiploic arteries arise from?
Left - splenic artery Right- gastroduodenal - branch of common hepatic
40
Which artery can bleed due to erosion by a duodenal ulcer?
Gastroduodenal artery - ulcer in 1st or 2nd part Pancreaticoduodenal - ulcer in 3rd or 4th part
41
What is Meckel's diverticulum?
Remnant of the embryological vitellointestinal duct (connects mid gut to yolk sac)
42
At what level is the renal hilum found?
L1 - transpyloric plane
43
What are the posterior relations of the kidney?
Diaphragm, psoas major, quadratus lumborum, transversus abdominis, 12th rib
44
What are the layers of the adrenal glands?
Zona glomerulosa - aldosterone Zona fasciculata - glucocorticoids Zona reticularis - androgens Medulla - adrenaline, noradrenaline
45
Which part of the pancreas is intraperitoneal?
Tail
46
What is the role of the vas deferens?
Transfers sperm from the epididymis to the ejaculatory ducts During ejactulation contraction of smooth muscle in the vas propels sperm forward into the urethra
47
What are the anatomical relations of the bladder?
Anterior - pubic bone Posterior - rectum, vagina
48
What is the blood supply to the ureter?
Upper - renal, aorta, gonadal Middle - common iliac, gonadal Lower - common and internal iliac, uterine, superior vesical
49
Which blood vessels supply the bladder?
Superior and inferior vesical Vaginal Inferior gluteal Obturator
50
Which organ lies directly in front of the SMA?
Body of pancreas
51
What is the relation of the SMA to the duodenum and pancreas?
Passes in front of the third part of the duodenum and the uncinate process of the pancreas
52
Name the branches of the IMA and what they supply
Left colic - descending colon Sigmoid branches - sigmoid colon Superior rectal - rectum
53
Where does the interior mesenteric vein drain?
Splenic vein
54
How is the hepatic portal vein formed?
Superior mesenteric and splenic vein join
55
Which artery supplies the appendix?
Ileocolic
56
What positions can the appendix lie?
Retrocaecal Pre-ileal Post-ileal Pelvic Subcaecal
57
What layers are encountered when performing an open appendicectomy?
Skin Campers fascia Scarpas facia EO, IO, TA Transversalis fascia Extraperitoneal fat Parietal peritoneum
58
What anatomical feature can help you identify the base of the appendix during surgery?
Three teniae coli converge at caecum
59
What is the blood supply of the rectum?
Upper - superior rectal from IMA Middle - middle rectal from internal iliac Lower - inferior rectal from internal pudendal
60
Name the 5 branches of the SMA
Inferior pancreatoduodenal Jejunal and ileal Ileocolic Middle colic Right colic
61
Which lobe of the liver do the caudate and quadrate lobes arise from?
Right
62
Which artery is the cystic artery a branch of?
Right hepatic
63
What is the difference between the common hepatic artery and hepatic artery proper?
Common hepatic gives off right gastric and gastroduodenal arteries before becoming the hepatic artery proper which supplies 25% of blood supply to liver
64
Where is the hepatic portal vein formed?
Posterior to the neck of pancreas
65
What is the surface marking of the gallbladder?
Angle between the 9th costal cartilage and the lateral margin of the rectus muscle
66
Describe the structures that make up the biliary tree
Interlobar ducts Intrahepatic bile ducts Left and right hepatic ducts Common hepatic duct Common bile duct (common hepatic + cystic) Pancreatic duct
67
What does Courvoisier's law state?
Palpable gallbladder with painless jaundice is unlikely to be due to gallstones This points to potential malignancy
68
Describe Kehr's sign
Pain referred to shoulder tip by diaphragmatic irritation Due to phrenic nerve having the same roots as supraclavicular nerve
69
Describe Boas sign
Hyperaesthesia of the skin just below the right scapula in acute cholecystitis
70
Describe the blood supply of the oesophagus
Superior third - inferior thyroid arteries Middle third - branches of descending thoracic aorta Lower third - left gastric and inferior phrenic arteries
71
What are the veins involved in oesophageal varices?
Oesophageal branch of the left gastric vein (portal) Oesophageal branch of the azygos vein (systemic)
72
What anatomical anastomosis is associated with rectal varices?
Superior rectal vein (portal) middle and inferior rectal veins (systemic)
73
What structures are responsible for physiological narrowing of the oesophagus?
Cervical constriction - cricoid cartilage (C5/6) Thoracic constriction - aortic arch (T4/5) Abdominal constriction - oesophageal hiatus (T10/11)
74
Describe the course of the oesophagus
Begins at C6 (inferior border of cricoid) where it is continuous with laryngopharynx Descends into superior then posterior mediastinum Posterior to trachea, anterior to vertebral bodies Enters abdomen through oesophageal hiatus at T10 Terminates when it joins the cardiac orifice of the stomach at T11
75
What is achalasia?
Oesophageal dysmotility disorder caused by disordered coordination of the peristaltic action of smooth muscle and non-relaxation of the oesophageal sphincter (loss of myenteric plexus)
76
What is the typical sign of achalasia on barium swallow?
'Bird's beak' sign
77
What are the characteristic findings for achalasia on manometry?
High pressure in lower oesophagus Failure to relax LES Aperistalsis
78
What crosses the ureter anteriorly as it descends in the abdomen?
Both - gonadal vessels Right - right colic and ileocolic vessels Left - left colic vessels
79
What is the blood supply of the ureter?
Upper - branches of renal, gonadal and aorta Middle - common iliac and gonadal Lower - common iliac and internal iliac
80
What are the anterior relations of the right kidney?
Right adrenal Right lobe of liver Gallbladder 2nd part duodenum Hepatic flexure Small intestine
81

MRCS Part B (10 decks)

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