Anatomy (Abdomen,Pelvis & Perineum) Flashcards
(235 cards)
1
Q
Anterior rectus sheath above costal margin
A
Devoid of internal oblique aponurosis
2
Q
Beginning of veins of testes
A
At septa
3
Q
Formation of pampiniform plexus
A
Veins from
Septa and Tunica vasculosa
4
Q
Drainage of pampiniform plexus
A
Into testicular vein
5
Q
Covering of spermatic cord
A
External
Cremasteric
Internal spermatic fascia
6
Q
Supply of testicular artery other than testes
A
Epididymis
7
Q
Origin of Artery to vas
A
Inferior vesical artery
8
Q
Origin of cremasteric artery
A
Inferior epigastric
9
Q
Relation of sympathetic and parasympathetic fibers of testes
A
Sympathetic with artery
Parasympathetic with vas
10
Q
Innervation of genital branch of genitofemoral nerve
A
Cremaster
11
Q
Drainage site of lymphatics in the spermatic cord
A
Lumbar
Para aortic
12
Q
Innermost layer of scrotum
A
Parietal later of tunica vaginalis
13
Q
Blood supply is scrotum
A
The scrotum receives blood from the anterior and posterior scrotal arteries, which branch off from the internal and external pudendal arteries, respectively:
Anterior scrotal artery
A branch of the deep external pudendal artery, which comes from the external iliac artery
Posterior scrotal artery
A branch of the internal pudendal artery, which comes from the internal iliac artery
14
Q
Origin and supply of internal spermatic artery
A
The testicular artery, also known as the internal spermatic artery, is the main source of blood for the testes. It usually originates from the abdominal aorta, BELOW the renal arteries, and at the level of the SECOND lumbar vertebra.
15
Q
Location of tunica vaginalis
A
Testes are surrounded by it.
It is a closed peritoneal sac. The PARIETAL later of of tunica vaginalis is adjacent to the INTERNAL spermatic fascia.
16
Q
Insertion of ureter
A
Upper and lateral aspect of Base
Internally called Trigone
17
Q
What is happened to ureter after crossing bony pelvis
A
Wall muscular coat becomes 3 layers
18
Q
Relation of transverse processes with ureter
A
Tip of L2-L5
—
19
Q
Blood supply of ureter
A
Abdominal aorta
Renal artery
Gonadal artery
Common iliac artery
Internal iliac artery
20
Q
What is gubernaculum
A
A ridge of mesenchymal tissue that connects the testes to inferior aspect of scrotum
21
Q
Mechanism of descent of testes
A
During foetal growth the body grows relative to gubernaculum
22
Q
Initial level of testes
A
L2
23
Q
Age of testes at iliac fossa
A
3rd intrauterine month
24
Q
Age of testes at deep inguinal ring
A
7th intrauterine month
25
Cause of cyst in spermatic cord
Part closure of processus vaginalis
—
26
Main structural support of uterus
Central perineal tendon
27
Origin of uterine artery
Internal iliac
28
Utero additional support derived from endopelvic fascia
Lateral cervical
Round
Uterosacral ligaments
29
Offline
*Lymphatic drainage of male urethra
Prostatic & membranous into internal iliac
Spongy with glans into deep inguinal
*Abnormality of which bladder part may lead to stress incontinence
Weakness of bladder neck cause this part is subjected to raised intra abdominal pressure
*Location of external sphincter of female urethra
Between layers of urogenital diaphragm
*Innervation of preprostatic urethra
Sympathetic noradrenergic
*Muscular layer of preprostatic urethra
Skeletal
*Importance of preprostatic urethra
Prevents retrograde ejaculation & has sterile lumen
*Narrowest part of male urethra
Membranous
*Which part of male urethra has external sphincter
Membranous
*Longest part of male urethra
Penile
*Name of dilations of penile urethra
At origin infundibular fossa
At termination navicular fossa
*Opening of bulbs glands
Into membranous part 2.5cm below perineal membrane
*Nature of urethral urothelium
Transitional near bladder and squamous distally
*First site of urethral resistance during catheter insertion and reason
Membranous because surrounded by external sphincter
*Relation of urethra with pubic symphysis
Membranous part traverses perineal membrane 2.5cm posteroinferior to pubic dumpy
*What forms the lateral edge of superficial inguinal ring
External oblique aponurosis
*Relation of rectus abdominis to superficial inguinal ring
Posteromedially
*Relation of pubic tubercle with superficial inguinal ring
Ring is anterior to tubercle
*Points needed to locate deep inguinal ring
ASIS & pubic tubercle
*Contribute of lacunar ligament to inguinal canal
Floor
*Passages of left Phrenic nerve through diaphragm
Muscular part anterior to central tendon
*Origin and Posterior relation of abdominal aorta
Origin T12
Posterior relation L1-4
—
*Which mesenteric vein is related to abdominal aorta
IMV anteriorly
*Relation between abdominal aorta and cisterna chyli
Right lateral to aorta
*Relation of sympathetic trunk to ABDOMINAL aorta
Left one
*Blood supply of bile duct
Hepatic
Retrodudenal part(as CBD itself is a retroduodenal structure)of gastroduodenal
*Resultant of bile duct after injury to hepatis artery
Stricture
*Gall bladder lining
Columnar
*Which part of duodenum lies posterior to gall bladder
1st
*Between which lobes does gall bladder lie
Right and quadrate
*Nerve supply of gall bladder
Sympathetic-mid thoracic spinal nerves
Parasympathetic-anterior vagal
*Origin of CBD
cystic and CHD
*Posterior relation of CBD
Proximally portal vein
Distally right renal vein
*Another name of Calot's triangle
Hepatobiliary triangle
*What marks externally the transition between sigmoid colon and rectum
Disappearance of tinea coli
*Indication of total mesorectum excision
Rectal carcinoma
*Anorectal lymphatic drainage
Above dentate mesorectal nodes
Below dentate inguinal
*Longitudinal muscle of appendix is derived from
Caecal taenia coli
*Site to insert needle into femoral artery
1-2cm BELOW midinguinal point
Midinguinal is mid of ASIS & symphySIS
*For of femoral triangle
Iliopsoas, adductor longus, pectineus
*Nervous content of femoral triangle
Femoral
Femoral branch of genitofemoral
Lateral cuteneous
*Does 11&12 ribs give origin to ex.oblique?
It says lower 8 ribs
But nerves from lower 6 thoracic
30
Beach of abdominal aorta at level of left renal vein
SMA
31
Branch of abdominal aorta at T12
Inferior Phrenic
Coeliac
32
Abdominal aortic branch at L1
Superior mesenteric
Middle suprarenal
33
Level is transpyloric plane
BODY of L1
34
Comparison of hilums of kidneys
Right one is 1.5cm lower
35
Level of spleen
Transpyloric
36
Relation of PUDENDAL canal with obturator internus
Canal lies along inferior border of muscle
37
Fossa for pudendal canal
Ischioanal
38
Extension of PUDENDAL canal
From lesser sciatic foramen to posterior margin of urogenital diaphragm
39
Lymphatic drainage of ureter
Upper para aortic
Lower common iliac
40
Hepatic relation to Coeliac axis
Caudate lobe on right side
41
Gastric relation with Coeliac axis
Cardia on left side
42
Why mesenteric adenitis may mimic appendicitis
Appendix is mainly lymphoid tissue
43
How does gastroduodenal artery supply head of pancreas
By anterior and posterior—
superior pancreaticoduodenal arteries
44
Nerve for cremasteric reflex
Genital of genitofemoral-within cord
Ilioinguinal-along cord
45
Another name of PERINEAL MEMBRANE
Inferior fascia is urogenital diaphragm
46
What is in the urogenital diaphragm?
sphincter urethrae and deep transverse perinei with perineal membrane together are known as the urogenital diaphragm.
47
Boundary of deep perineal pouch
Superior and inferior fascia of urogenital diaphragm
48
Contents of deep perineal pouch
Transverse perineal muscle
Muscular branches of perineal nerve
Urethral sphincter
Urethral artery
Deep ava dorsal arteries of penis
Stem of origin of artery to the bulb of penis
49
Proximal communication of IMA and via what artery
Middle colic via marginal
50
Part of pancreas at transpyloric plane
Neck
51
Identifying point of transpyloric plane
Meeting point of lateral border of rectus abdominis with costal margin
52
Lowest border of 10th costal cartilage defines what
Subcostal plane
53
Level of L4 body defines which plane
Intercristal plane
54
At which vertebral level the highest point of iliac crest is
Body of L4
55
Vertebral level of intertubercular plane
Body of L5
56
Most dilated part of colon
Caecum
57
Mark of base of caecum
Convergence of taenia coli
58
Peritoneal relation of base of caecum
Intraperitoneal
59
Point of demarcation between intra and retro peritoneal right/ascending colon and its importance
A white line
It's the line of incision for colonic resection
60
Attachment sure of greater omentum with transverse colon air its importance
Along superior border
Division of this attachment permits entry into lesser sac
And
Separation of transverse colon from greater omentum is a routine operation step in both gastric and colonic resection
61
Relation of L4 with descending colon
Colon becomes intraperitoneal and becomes sigmoid
62
Relation of sacral promontory with sigmoid colon
Becomes rectum
63
Macroscopically visible mark of sigmoid to rectal transition
Fusion of taenia
64
Importance of peritoneal relation of colon
Generalized peritonitis in case of whole intraperitoneal segments
65
Relation of gall bladder with hepatic flexure
Bladder is medial
66
Structure to get surgical assessment of pancreas
Attachment of greater omentum with transverse colon
67
Pancreatic relation of renal vein
Both veins lie posterior to head
68
Relation of pancreas with SMA&V
They are BEHIND head
BUT
FRONT of uncinate process
by passing
UNDER neck
69
Posterior relation of neck of pancreas
SMV & portal vein
70
Renal relation with pancreas
Body of pancreas is in direct contact with left kidney along with renal vein & adrenal
71
Structure behind pancreatic tail
Kidney
72
Structure anterior to pancreatic tail
Splenic hilum
73
Structure anterior to body of pancreas
Stomach and DJ flexure
74
Relation between head of pancreas with 1st part of duodenum
1st part is anterior to head
75
Gastric relation of head of pancreas
Pylorus is anterior to head
76
Superior relation of pancreas
Coeliac trunk (cause at L12) with branches obviously
77
What the groove of pancreatic head for
For 2nd and 3rd part of duodenum
78
Trunk of pancreatic blood supply
Coeliac
79
Venous drainage is pancreatic head
SMV
80
Importance of ampulla of vater
Transition from foregut to midgut
with their different blood supply
81
Similarity between hepatic artery and portal vein
Their blood flows at same direction
82
Occlusion of which structure will result in greater reduction of hepatic blood flow
Portal vein
83
Percentage of blood flow to liver by portal vein
70%
84
Blood flow track of liver
Portal+hepatic>sinusoid>central veins of lobules>hepatic veins>IVC
85
Peculiarity of couinaud segment l
It can be a part of either anatomical segment right or left
86
Peculiarity of quadrate lobe
Anatomically right
Functionally left
&
Couinaud lV
87
Fossa related to quadratus lobe of liver
On Right side is fossa for gall bladder
On Left side is fossa for umbilical vein
88
Arterial supply of CAUDATE lobe of liver
From both right and left hepatic artery
89
Name of couinaud segment l
CAUDATE lobe
90
Biliary drainage of segment l
Into both right and left hepatic duct
91
Location and content of portal canal
Between liver lobules
Contain portal triad(hepatic artery, portal vein, tributary of bike duct)
92
Lobes separated by porta hepatis
Caudate behind from Quadrate in front
93
Biliary portion of porta hepatis
Common hepatic duct
94
Nerve in porta hepatis
Sympathetic and parasympathetic of Coeliac plexus
95
Branch of Falciform ligament
Coronary
Left triangular
96
Joining of umbilical vein
Left branch of portal vein in porta hepatis
97
Connection of ductus VENOSUS
Umbilical vein to IVC
98
What forms lacunar ligament
Triangular expansion of inguinal ligament
99
Thoracic relation of external oblique
Origins from outer aspect of ribs 5-12
100
Thoracic relation of internal oblique
Inserts into cartilages of lower 3 ribs
101
Direction of transversus abdominis
From lumbodorsal fascia to linea alba
102
Offline
*Relation of transversus abdominis with rectus abdominis
Upper part lies posterior to rectus abdominis but lower to arcuate line,fibers run anteriorly only
103
*Direction of rectus abdominis
From pubis to xiphoid
104
Termination of iliohypogastric nerve
Pierces the external oblique aponurosis above the superficial inguinal ring
(That's why it is outside the inguinal canal)
105
Why ilioinguinal nerve is within inguinal canal
Cause it pierces only internal oblique muscle she lies deep to external oblique aponurosis
106
Innervation of ilioinguinal nerve
Muscles passing through
Superomedial skin of femoral triangle
Scrotal skin
Skin of root and doreum of penis
Skin of labia majora
107
Structures separated by Waldeyer's fascia
Mesorectum from Sacrum
108
Relation of rectal lymphatic drainage with dentate line of anal canal
Above line into mesorectum
Below line into inguinal
109
First branch of SMA
Inferior pancreaticoduodenal artery
110
Why lodgement of emboli is common in SMA
Because it takes more oblique angle from aorta
111
Vein between aorta and SMA
Left renal
112
Relation between SMA & SMV
Vein on right side as IVC is on right
113
extension of spermatic cord
The spermatic cord extends from the DEEP inguinal ring in the inferior abdomen to the scrotum, where it ends at the POSTERIOR border of the testes
114
*Is testicular vein outside of cord???
No
The pampiniform plexus of veins (Figure 1) which drains the testis and epididymis, become the testicular vein at the level of the internal inguinal ring.
And the cord srarts from deep inguinal ring
115
Importance of scrotal lymphatic drainage
Inguinal
As testes drains in para aortic, so take ABDOMINAL approach in surgery for tricksy cancer not scrotal to avoid desimination into inguinal nodes
116
*Origin of cremasteric artery
from inferior epigastric
(as continuation of abdominal wall
117
*Origin of artery to VAS
from inferior VESical artery
118
*From where does fluid of hydrocele come
Peritoneal secretion
119
*Inguinal surgery for metastasis lesion from anal canal
Block dissection
120
*Apex of lesser sac with apical content
Hilum of spleen with short gastric vessels
121
*Renal relation of spleen
Kidney retro so retro
122
*Draining point of IMV
splenic vein
123
*Peritoneal relation of spleen
Intra
124
*Largest lymphatic organ of body
Spleen
125
*Biochemical test to detect pancreatic injury
Peritoneal fluid for amylase
(As tail is intraperitoneal)
126
*Color of pancreas secretion
Clear
127
*Innervation of perianal skin
Pudendal
128
*Nerve to be anesthetized for episiotomy
PUDENDAL because it innervates posterior vulval area
129
*Anterior relation of adrenal gland
Bare area is anterior to right adrenal
Stomach and lesser sac to left adrenal
130
*Management of injury to IVC
By Satinsky champ and a 6-0 prolene
131
*Venous drainage of adrenal gland with importance
By ONE very SHORT vein to IVC from RIGHT
& to left RENAL from LEFT
So handle the glad carefully but to injure IVC or LEFT renal
132
*Extension of internal and external anal sphincter
Internal upper 2/3 of anal canal
External whole length
133
*Supply of external anal sphincter with root
INFERIOR rectal branch of pudendal S234
& Perineal branch of S4
134
*Type of renal artery
End
135
*Contents of renal sinus
Branches of renal arteries
Tributaries of renal vein
Major and minor calyces
Fat
136
*Marking of innermost apex of renal pyramid
Papilla
137
Number of pyramids of kidney
6-10
138
*Origin of common renal and adrenal fascia
Fascia transversalis
139
*Hilum of right kidney
L2-3
140
*Level of upper and lower pole of left kidney
Upper 11th rib
Lower L3
141
*Dimensions of kidney
11×5×3cm
142
*Relation between IMA and aortic bifurcation
3-4cm above bifurcation
143
Arterial supply of embryonic hindgut
IMA
144
Level of dermatome blockage for local inguinal hernia surgery
T12
145
Drainage part of bulbourethral glands
Into spongy
146
Fascia embedding female urethra
Endopelvic
147
Another name of penile urethra
Spongy
148
Relation of ureter with major vessels
Posterior to gonadal
Anterior to common iliac
149
Relation of cysterna chyli with aorta
Chyli lies right laterally
150
Relation of aorta with duodenum
3rd part anteriorly,
4th with DJ flexure left laterally
151
Connection between SMA and small gut
Jejunal and ileal arcades
152
Pancreatic relation with hilum of both kidneys
Head lies anterior to right hilum
Tail lies anterior to left hilum
153
Requirement of division of IMA
During surgery of AAA
During Anterior resection of rectum
154
Relation of gallbladder with hepatic flexure
Gall lies MEDIALLY
155
Types of joints
Fibrous
Cartilaginous
Synovial
156
Types of fibrous joint and unity
Suture -skull
Gomphosis -teeth
Syndesmosis -inferior tibiofibular
Tight connective tissue unites the joint
157
Types of cartilaginous joint and unity
Epiphyseal growth plate
Symphysis pubis
United by layer of hyaline cartilage
158
Character sheet example of synovial joint
Both ends permit free movement
Both ends are covered by cartilage
Both ends are surrounded by fluid
Hip/knee joint
159
Innervation and function of quadratus lumborum
Anterior primary Rami of T12-L3
Causes lateral flexion of trunk
160
Most notable malignant involvement of omentum
Ovarian cancer
161
Major arterial relation of IVC
Right renal posterior
Right gonadal anterior
Right common iliac anterior
162
Tributary of IVC before leaving abdomen
At T8
Hepatic veins
Inferior phrenic veins
163
Largest autonomic plexus
Coeliac
164
Vessels covered by Coeliac plexus
Coeliac trunk
SMA
165
Which nerves join the plexus and ganglia of Coeliac Plex
Greater splanchnic
Lesser splanchnic
Phrenic branches
Vagus branches
166
Valve of IVC
A NONfunctional valve between RA and IVC
167
Which nerve provides aotnomic control of urinary bladder
Hypogastric plexus
168
Division of which structure is a must for splenectomy
Short gastric vessels
169
Arterial supply of prostate
Inferior vesical artery (as inferior to vesical) which is as branch of internal iliac artery
170
Venous drainage of prostate
Via prostatic venous plexus into paravertebral veins
171
Innervation of prostate
Inferior hypogastric plexus
172
Lobes of prostate
Posterior
Median
Lateral 2
Isthmus
173
Zones of prostate
Peripheral -most cancers
Central
Transitional
Stroma
174
Location of prostatic venous plexus
Anterolateral
175
Prostatic dimensions
2×3×4cm
AP×SI×L
176
Surgery for Conn's syndrome
Adrenalectomy
177
Another name of perineal membrane
inferior fascia of the urogenital diaphragm.
178
urogenital diaphragm
The urogenital diaphragm is a triangle shaped muscle layer created by sphincter urethrae along with deep transverse perineal muscles. They are confined among a superior as well as an inferior layer of fascia of the urogenital diaphragm.The inferior layer of fascia is often called as the perineal membrane.
179
Muscles of superficial perineal pouch
Superficial transverse perineal muscles
Bulbospongiosus
Ischiocavernosus
180
Location of SUPERFICIAL perineal pouch
Below perineal membrane aka inferior fascia of urogenital diaphragm
181
Difference between urogenital diaphragm & deep Perineal pouch
All of urogenital diaphragm is part of deep Perineal pouch but the other way around
The deep pouch is the region between the perineal membrane (inferior fascia of urogenital diaphragm) and the pelvic diaphragm (formed by the levator ani & coccygeus).
182
Triad of bulbar rupture
Urinary retention
Perineal hematoma
Blood in the meatus
183
Peritoneal relation of membranous rupture
Can be intra or extra
184
Peritoneal relation of urinary bladder injury with effect on management
Can be intra (laparotomy) or
extra (conservative)
185
Which nerve injury will cause inguinal ligament pain with lower abdominal radiation after caesarean section
Ilioinguinal
186
Which nerve is at risk in the anterior resection of rectum
Hypogastric plexus
187
Branches of Coeliac trunk
LHS
188
Vertebral level of CAUDATE process of liver
T12
189
Surrounding of Coeliac trunk
Caudate lobe
Gastric cardia
Pancreatic superior border
Left renal vein
190
Which structure must be mobilize fire anterior approach of right adrenal gland
Hepatic flexure
191
Most likely site of perforation in case of complete large bowel obstruction
Caecum
192
SEGMENTAL arterial supply of URETER
Renal
Gonadal
Aortic
Common iliac
Internal iliac
Superior vesical
Uterine
Middle rectal
Vaginal
Inferior vesical
193
Nerve in porta hepatis
Parasympathetic
194
Caution for midline incision
Avoid Falciform Liga above umbilicus
195
Peculiarity of battle incision
A paramedian incision but
Rectus muscle is displaced medially thus denervated
196
Difference between Lanz and Gridiron
Lanz horizontal so cosmetic,2/3 medially
— —
Gridiron vertical on McBurney's line
2/3 above
197
Use of McEvedy's incision
A groin incision used for emergency repair of strangulated femoral hernia
198
lymphatic drainage of male urethra
Preprostatic urethra: This region drains to the external iliac, hypogastric, and obturator lymph nodes.
Prostatic and membranous urethra: These regions drain to the obturator and internal iliac lymph nodes.
Penile urethra: This region drains to the deep and superficial inguinal lymph nodes.
199
Lymphatic drainage of female urethra
Entire part to internal iliac
200
Nerve supply of liver
Coeliac plexus
201
Branches of PUDENDAL nerve
Rectal
Perineal
Dorsal nerve of penis/clitoris
202
Between which muscles does PUDENDAL nerve pass after origin
Piriformis & coccygeus
203
Lobar relation of gallbladder
Between quadrate lobe and right lobe
204
Nerve supply of gallbladder
Sympathetic from mid thoracic spinal
Parasympathetic from anterior vagal
205
Vessel in superficial perineal pouch
Posterior scripts arteries/
Posterior labial arteries
206
Root of genitofemoral nerve
L1,2
207
PUDENDAL nerve lies in which perineal space
Deep
208
Structures passing through both greater and lesser sciatic foamina
PUDENDAL nerve
Internal PUDENDAL artery
Nerve to obturator internus
209
Which muscle pass through lesser sciatic foramen
Tendon of obturator internus
210
Structure to divide to get access a retrocaecal appendix
Lateral peritoneal attachment of caecum
211
Lymphatic drainage of prostate
Internal iliac
Sacral
212
Artery to cervical oesophagus
Inferior thyroid
213
Walls of inguinal canal
MALT×2
214
Structure at more risk during anterior resection of (UPPER) rectum
Left ureter
215
Lateral Wall is deep inguinal ring
Transversalis fascia
216
Cause of neuropathic pain after hernia surgery
Injury to ilioinguinal nerve
217
Mechanism of splenic injury during colonic surgery
Pulling
218
Medial boundary of deep inguinal ring
Inferior epigastric artery
219
Primary site of venous drainage of urinary bladder
Vesicoprostatic venous plexus then internal iliac
220
Blood supply of urinary bladder
Superior and inferior vesical arteries from internal iliac artery
221
Lymphatic drainage of urinary bladder
Mainly external iliac but also internal iliac and obturator
222
Innervation of urinary bladder
Sympathetic from L1-2 via hypogastric plexus
Parasympathetic from pelvic splanchnic
Muscles of trigone by sympathetic
External sphincter by voluntary control
223
Which splenic structure lies most posteriorly
Linorenal LIGAMENT
224
Development of spleen
Upper dorsal mesogastrium
225
Causes of massive splenomegaly
Myelofibrosis
Chronic myeloid leukemia
Malaria
Kala Azar
226
Location of accessory spleen
Hilum of spleen
Tail of pancreas
Along splenic vessels
Gastrosplenic ligament
Linorenal ligament
Walls of stomach & intestine
Greater omentum
Mesentery
Gonads
227
Effect of cholecystokinin on gall bladder
Contraction
228
Peritoneal relation of gallbladder fundus
Usually intraperitoneal
229
Origin and function of internal spermatic fascia
From fascia transversalis
It invests
Ductus deferens
Testicular vessels
230
Pathological coecal diameter
>9cm
231
Extension of lesser omentum
Arises from porta hepatis and passes the lesser curvature of the stomach
232
Renal hilum content from superior to inferior
A
V
P
233
Other names for SMA syndrome and compressed part
Other names for SMA syndrome have included chronic duodenal ileus, Wilkie syndrome, arterio-mesenteric duodenal compression syndrome and cast syndrome
3rd part of duodenum
234
Compression in Median arcuate ligament syndrome
Coeliac trunk
235
Origin of dartos fascia
Continuation of scarpa's fascia
