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eMRCS questions > Anatomy Abdomen Book > Flashcards

Anatomy Abdomen Book Flashcards

(95 cards)

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1
Q

Spermatic cord contents

A

Arteries- cremastvtic, testicular, artery of ductus deferens
Veins- pampiniform
Nerves- genitofemoral (supplies cremastvtic muscle and symp/para for DD and arteries
Lymph
Ductus deferens

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2
Q

Layers of scrotum and there corresponding abdo origin

A

Tunica vaginalis- peritoneum

Internal spermatic fascia- trasversali fascia

Cremastatic fascia- Internal oblique

External fascia- external oblique

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3
Q

Borders of inguinal canal

A

Posterior- transversals fascia
Medially- conjoint ligament -IO+TA
Anteriorly- aponeurosis of external oblique - medially, internal oblique laterally
Laterally- internal oblique

Floor- inguinal ligament
Roof- TA, IO

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4
Q

Venous systems affected by liver cirrhosis

A

Rectal- inferior rectal and anal canal

Oesophageal - inferior

Caput medusa-from paraumbilical veins of hepatic portal to superior/inferior epigastric

Bare area of liver

Retroperitoneal

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5
Q

Artery commonly affected in bleeding duodenal ulcers

A

Gastroduodenal- if ulcer posterior

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6
Q

What is Pringles manoeuvre

A

Grasping free edges of lesser momentum
Control bleeding of liver laceration
Compressing hepatic artery, portal vein and cystic duct

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7
Q

Points at transpyloric plane

A

Inferior part of L1
Pylorus of stomach/first part of duodenum
Hila of kidneys
Duodenaljujenal junction
Neck of pancreas
9th CC
Fundus of gallbladder

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8
Q

Calots triangle borders

A

Superior- inferior border of the liver
Lateral inferior- cystic duct
Medial- Common hepatic duct

Cystic artery within

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9
Q

Which branch does cystic artery come from

A

Right hepatic

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10
Q

Blood supply of fundus of stomach

A

Short gastric arteries
From splenic

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11
Q

Location of stoma in Hartmanns

A

LLQ

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12
Q

What stomas are in RLQ

A

Ileostomy

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13
Q

Stoma in RUQ

A

Defunctioning transverse colostomy

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14
Q

What divides superficial and deep femoral branches

A

Lateral femoral circumflex artery

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15
Q

Sx of femoral nerve damage

A

Trouble standing and walking

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16
Q

Varicocele is ?

A

Due to compression or valvular disorder- pampiniform plexus

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17
Q

Billroth procedure

A

Removal of distal third of stomach and end to end anastomosis of stomach to duodenum
Used for malignancy

I- if distal third
II- if 2/3 and anastomosis to jejunum leaving blind end duodenal loop

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18
Q

Define AAA

A

> 3cm dilation or >50% than Normal

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19
Q

Gerotas fasciae

A

Covers perinephric fat of kidneys

Deficient inferiorly

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20
Q

Order of hilum of kidney

A

Ant->post
Renal vein, artery post sup, ureter

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21
Q

Ureter course

A

Retroperitoneal entire course

Descend on psoas major

Over genitofemoral nerve
Under gonadal vessel

Narrow at pelviureter junction

Run over external iliac artery/vein and under vas deferens

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22
Q

Points of narrowing of ureter

A

Uteropelvic junction
Crossing iliac vessels
Uterovesicle junciton

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23
Q

Borders of femoral triangle

A

Lateral- sartorius
Medial- adducts longus
Superior- inguinal ligament
Floor- illopsoas, pectinous, adductor longus
Roof- fascia lata

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24
Q

Mid inguinal vs midpoint of inguinal ligament

A

Mid inguinal- Pubic lymph and ASIS- femoral artery

Midpoint of IL- pubic tubercle and ASIS - deep inguinal ring

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25
Femoral canal borders
Anterior- inguinal ligament Posterior- pectineal ligament Medial- lacunar Lateral femoral vein
26
Function of femoral canal
Lymph drainage of lower limb Room for vein to expand
27
Branches of renal, adrenal, gonadal and iliac arteries
Renal- L2 Adrenal- T12 Gonadal- L2 Illiac- L4
28
Jejenuc vs ileum
Jejenum- lies more at umbilicus Redder Valvulae conniventes Fewer arcades Longer vasa recta Mesentary- lies superiorly and attached left to aorta Villi- tall Ileum Suprapubic Pinker More arcades and shorter vasa recta Peyers patches Mesentary- inferior, attaches to right aorta Villia- short
29
What is the median umbilical fold and lateral structures
Contains median umbilical ligament- remnants of urachus (previous connection of bladder and umbilicus) Lateral- medial umbilical ligaments-remnants of umbilical artery More lateral- lateral umbilical folds- inferiors epigastric vessels
30
Nerve found in inguinal canal but not spermatic cord
Ilioinguinal nerve
31
Anatomical relation of renal veins
Behind pancreases Infront of renal arteries
32
Level renal vein joins IVC
L!
33
Difference in drainage of renal veins
Left 3x as long- crosses aorta Left- recieves left suprarenal and gonadal Right and above go direct to IVC
34
What is Meckel diverticulum ? How common, size? Where is it found? Blood supply
Remnant of Vitello-intestinal duct (connects yolk sac and intestine in fetus) Found in 2%, 2in long Found on antimesenteric border of ileum Ileal branch of SMA
35
Borders of epiploic foramen
Superior- caudate process of liver Inferior- first part of duodenum Anterior- Free edge of lesser omentum containing bile duct, hepatic artery, portal vein Posteriorly- IVC
36
Difference between cell lining, arterial supply, venous drainage, nerve supply, lymphatic drainage above and below dentate line
Above Columnar Arterial- superior rectal (IMA) Venous- IMV Nerve- autonomic - symp pelvic plexus, para- pelvic splanchnic Lymph- inferior mesenteric lymph node Below Squamous Arterial-middle (internal iliac) and inferior rectal arteries (internal pudendal) Venous- internal pudendal Somatic- inferior rectal branch of pudendal Lymph- superficial inguinal
37
Where is the portal vein formed and what from
Transpyloric plane behind neck of pancreas SMV and splenic (IMC drains into splenic)
38
What structures are lateral to the bladder
Levator ani Obturator internus
39
Origin of 2 heads of rectus abdominis
Medial - pubic symphysis Lateral upper boarder of pubic crest- larger
40
Where does the rectus abdo insert
Insert into 5-7th CC and xiphi
41
Blood supply of rectus abdo
Sup and inf epigastric
42
Embryo origins of urethra and bladder
Proximal urethra and bladder- mesopnephric ducts Distal- urogenital sinus
43
Where is urethra narrowest and widest
Narrowest- membranous, external meatus, bladder neck and entrance to navicular fossa ( near end of urethra) Widest- prostatic, bulb and navilcular fossa
44
Cell lining of urethra
Transitional - rest Stratified squamous - spongy
45
Origin of inferior epigastric
External iliac Anastomoses with superifical epigastric which comes from femoral below ignuinal And superior epigastric which origiantes from internal thoracic
46
Layers of rectus sheath at different points
Above costal margin- just consists of external oblique ap anteriorly -no others Above arcuate line- ext and half of int anterior TA- post Below- all anterior
47
Spigelian hernia location, tx and complications
Between RA medially and semilunar line laterally (formed by EA, IA,TA) usually below arcuate line Open or lapro Small and high risk of strangulation
48
Most common visceral artery aneurysm
Splenic
49
Artery supply of adrenals
Sup- inferior phrenic Mid- aorta Inf- renal
50
Tributes for portal vein
IMV drains into splenic Splenic and SMV form Portal Short gastric, left gastroepiloic drain into splenic Right gastroepiploic- SMC Cystic and left and right gastric straight into portal
51
IVC relation to portal and number of valves
IVC posterior 0
52
What ligament contain that portal triad
Hepatoduodenal ligament
53
Relation of hepatoduodenal ligament to epiploic foramen
HP lig is anterior
54
Borders of epiploic foramen
Ant- triad Post- IVC, right crus of diaphragm Sup- caudate lobe Inf- first part of duo
55
Uterine artery relation to ureter
Anterior and superior
56
Nerve supply of ureter
Has internal pacemaker for peristalsis Symp- thoracolumbar pre ganglionic- aorticorenal and inf/sup hypogastric Para- S2-4 Cutaneous pain- referred to T11-L2
57
Ureter relation to internal iliac and testicular artery
Anterior to internal iliac Post to test
58
Venous drainage of ureter and muscle
Inf end of ureter covered in venous plexus- drain via renal and gonadal vein Has 2 layers of spiral muscle
59
Where does testicular development begin
At mesodermal ridge
60
Prostate gland location, number of lobes and the female equivalent
Between bladder and urogenital ridge 5 Skene gland
61
Layers of teste capsule
Tunica vasculosa- innermost vascular Tunica albuginea- tough fibrous Tunica vaginalis- closed peritoneal sac Visceral- close to testes Parietal- adherent to internal spermatic cord and separated to visceral by fluid
62
Layers closest to skin of scrotum
Dartos fascia and muscle
63
Nerve innervating cremastvtic reflex
Genital branch of gentiofemoral
64
Permanent folds of GI tract
Plicae circularis Spiral valve of Heister- cystic valve Villae Trasverse rectal
65
Lymph node drainage pathway of colon
Epicolic- serial wall Paracolic- medial side of ascending/descending or mesenteric border of transverse Intermediate- named branches of colonic vessels Pre aortic (IM, SM)
66
What can be incised to give greater mobility of 12th rib
Costovertebral ligament Attach between 12th rib and 1+2nd transverse processes of lumbar
67
Posterior gastric ulcer bleed affects which artery?
Splenic
68
Male vs female pelvis
Female is wider, shallower Ischial tuberosities are further apart in females Obturator foramina- oval in females, round in males Pelvic cavity is deeper in males Inlet round in females and heart in males Pubic arch wider in females - 80-90 vs 60-70
69
Sites of portosystemic anastomosis
Collaterals between portal and systemic Gastrooesophageal - around cardia - left gastric vein anastomose with azygous Anus- superior rectal vein of portal with middle and inferior of systemic Anterior abdo wall around umbilicus- para umbilical anastomose with veins
70
Location of deep inguinal ring
Midpoint of inguinal ligament 1.5cm above
71
Which hernia is more likely to extend into scrotum
Indirect Potential patent processus vaginalis
72
Level of pancreatic body
L1/2
73
Anatomy of uncinate process of pancreas
Extends medially from left of pancreatic head Posterior to SMA
74
Blood supply of pancreas
From branches of splenic artery for body and tail Head- gasproduodenal and SMA
75
Where ducts of pancreas drain
Main- from tail and body- joins bile duct in duodenum 5% separate Accessory- drains uncinate and inferior head opening into duodenum at minor duodenal papilla
76
What is pancreas formed from and what is found behind it
Foregut Portal vein formation behind neck
77
Which parts of pancreas and duodenum are intraperitoneal
Pancreas- tail Duodenum- 1st part
78
Hilum of kidney relative to duodenum
Posterior
79
Anatomical positions relative to third part of duodenum
Ant- SMA and vein Post- psoas, ICV, aorta and right ureter Big of treitz hold DJ flexure at 3/4th part of duodenum
80
Which artery supplies distal third of oesophagus
Left gastric
81
Why are intraoperative cholangiograms used
After dissected calots triangle Small incision in cystic duct- dye inserted Useful to identify bile leak, distal occlusions and correct identification of cystic duct
82
What does the artery of Drummond supply
Is the anastomosis of left and middle colic artery
83
Most common positioning of appendix
Retrocaecal then pelvic
84
RF of transverse incision for appendectomy
Damage to iliohypogastric nerve Could cause direct inguinal hernia due to weakness in muscles
85
Peritoneal covering of rectum
Upper - anterior and lateral Middle - anterior Lower- none
86
Where does rectum start relative to sacrum
S3
87
Number of transverse folds in rectum
3 Called Houston's valves
88
Arterial supply of rectum
Superior rectal- from IMA Middle rectal from internal iliac Inferior rectal from internal pudendal
89
What does obturator interns pass through
Lesser sciatic foramen
90
Muscles attaching to perineal body
Bulbospongiosum Levator Ani External anal sphincter
91
Testicular anastomoses with ?
Artery of vas Hence why testicles do not atrophy if testicular artery is cut
92
Composition of anal sphincter
Internal- circular muscle External- surrounds and more distally - 3 parts, deep, superficial and subcutaneous Deep blends with puborectalis
93
Borders of quadrate and caudate lobes
Quadrate- right gallbladder, left round ligament (prev umbilical vein), post hepata portis Caudare- ant hepata portis, right IVC, left ductus venosum shunt to IVC
94
Quadratus lumborum attachment, innervation and action
Origin: Medial aspect of iliac crest and iliolumbar ligament Insertion: 12th rib Action: Pulls the rib cage inferiorly. Lateral flexion. Nerve supply: Anterior primary rami of T12 and L1-3
95

eMRCS questions (45 decks)

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