anatomy pearls

Question 1

What is the drainage of the left testicular vein?

Answer 1

Left renal vein

Question 2

What is the drainage of the right testicular vein?

Answer 2

IVC

Question 3

What is Gerota’s fascia?

Answer 3

Fascia surrounding the kidney

Question 4

What are the prominent collateral circulations seen in portal hypertension?

Answer 4

Esophageal varices, hemorrhoids (inferior hemorrhoidal vein to internal iliac vein), patent umbilical vein (caput medusa), and retroperitoneal vein via lumbar tributaries

Question 5

What parts of the GI tract are retroperitoneal?

Answer 5

Most of the duodenum, the ascending colon, the descending colon, and the pancreas

Question 6

What is the name of the lymph nodes between the pectoralis minor and major muscles?

Answer 6

Rotter’s lymph nodes

Question 7

Is the L vagus nerve anterior or posterior?

Answer 7

Anterior; remember that the esophagus rotates clockwise during development

Question 8

What is Morrison’s pouch?

Answer 8

Hepatorenal recess; the most posterior cavity within the peritoneal cavity

Question 9

Foregut location

Answer 9

Mouth to ampulla of Vater

Question 10

Midgut location

Answer 10

Ampulla of Vater to distal third of transverse colon

Question 11

Hindgut location

Answer 11

Distal third of transverse colon to the anus

Question 12

Where are the blood vessels on a rib?

Answer 12

Vein, Artery, and Nerve (VAN) are underneath the rib (thus, place chest tubes and thoracentesis needles above the rib!)

Question 13

What is Hesselbach’s triangle?

Answer 13

Area bordered by: 1. Inguinal ligament 2. Epigastric vessels 3. Lateral border of the rectus sheath

Question 14

What nerve is located on top of the spermatic cord?

Answer 14

Ilioinguinal nerve

Question 15

What is Calot’s triangle?

Answer 15

Area bordered by: 1. Cystic duct 2. Common hepatic duct 3 . Cystic artery

Question 16

What is Calot’s node?

Answer 16

Lymph node found in Calot’s triangle

Question 17

What separates the right and left lobes of the liver?

Answer 17

Cantle’s line - line drawn from IVC to just left of the gallbladder fossa

Question 18

What is the gastrinoma triangle?

Answer 18

Triangle where >90% of gastrinomas are located, bordered by:

1. Junction of the second and third portions of the duodenum
2. Cystic duct
3. Pancreatic neck

Question 19

Which artery is responsible for anterior spinal syndrome?

Answer 19

Artery of Adamkiewicz

Question 20

How can you find the appendix after you find the cecum?

Answer 20

Trace the taeniae back as they converge on the origin of the appendix

Question 21

Where is the space of Retzius?

Answer 21

Preperitoneal space anterior to the bladder

Question 22

What are the white lines of Toldt?

Answer 22

Lateral peritoneal reflections of the ascending and descending colon

Question 23

What is the strongest layer of the small bowel?

Answer 23

Submucosa

Question 24

Which parts of the GI tract do not have a serosa?

Answer 24

Esophagus

Middle and distal rectum

Question 25

What is the vein that overlies the pylorus?

Answer 25

Vein of mayo

Question 26

What does the thoracic duct empty into?

Answer 26

Left subclavian vein; left internal jugular vein junction

Question 27

What is the coronary vein?

Answer 27

Left gastric vein

Question 28

What is the hypogastric artery?

Answer 28

Internal iliac artery

Question 29

Which is longer, the left or right renal vein?

Answer 29

Left

Question 30

What are the layers of the abdominal wall? (8)

Answer 30

1. Skin, then fat 2. Scarpa’s fascia, then more fat. 3. External oblique 4. Internal oblique 5. Transversus abdominis 6. Transversalis fascia 7. Preperitoneal fat 8. Peritoneum

Question 31

What are the plicae circulares?

Answer 31

Circular folds of the mucosa of the small intestine

Question 32

What are the major structural differences between the jejunum and ileum?

Answer 32

Jejunum—long vasa rectae; large plicae circulares; thicker wall Ileum—shorter vasa rectae; smaller plicae ciruclares; thinner wall (Think: Ileum = inferior vasa rectae, inferior plicae circulares, inferior wall)

Question 33

What are the major anatomic differences between the colon and small bowel?

Answer 33

Colon has taeniae coli, haustra, and appendices epiploicae (fat appendages), whereas the small intestine is smooth

Question 34

How far up does the diaphragm extend?

Answer 34

To the nipples in men (Fourth intercostal space; thus, the abdomen extends to the level of the nipples)