GI

Question 1

What is the anteriolateral abdominal wall bound by?

Answer 1

Costal cartilages of 7th to 10th rib and xiphoid sternum

Question 2

Where is the arcuate line and what does it signify?

Answer 2

1/3 of way from umbillicus to public crest

Where reclusive fibrous sheath stops forming posteriorly

Question 3

Name the 3 flat and 2 vertical muscles of the abdomen.

Answer 3

Trans versus abdominis, external oblique, internal oblique

Rectus abdominis and pyramidalis

Question 4

What do all aponeuroses fuse to form?

Answer 4

Rectus sheath of rectus abdominis

Question 5

What are the superior and inferior borders of the lines alba?

Answer 5

Xiphoid process and pubic symphysis

Question 6

Name the part that forms the middle of the rectus abdominis and the bits inbetween the muscles

Answer 6

Linea alba and tendinous intersections

Question 7

Where is an appendicectomy formed and what do you call this point?

Answer 7

2/3 of the distance between the umbillicus and ASIS

McBurney’s point

Question 8

Describe a gridiron incision. Give an example when it is used

Answer 8

Open and closing scissors to separate out muscle rather than cutting through things
Appendecectomy

Question 9

Give two times when a patent urachus forms.

Answer 9

At birth

Later in life when men develop benign prostatic hypertrophy

Question 10

Give me three features of meckels diverticulum. What can be caused when the diverticulum contains ectopic gastric tissue?

Answer 10

2% affected
2 feet from ileocecal valve
2 inches long
Detected in under 2s
2:1 ratio male:female 

Ulceration

Question 11

What causes faecal matter to come out of the umbillicus?

Answer 11

Vitelline fistula

Question 12

What is it called when abdominal contents are left outside the body, uncovered?

Answer 12

Gastroschisis

Question 13

What are the abdominal contents covered by in omphalocele?

Answer 13

Reflection of the amnion

Question 14

Where does pain begin in early appendicitis? At what spinal level?

Answer 14

Umbillicus T10

Question 15

Give three reasons for referred diaphragmatic pain. Which shoulder affected and why?

Answer 15

Ruptured spleen
Ectopic pregnancy
Perforated ulcer

Left as right is covered by liver

Question 16

Where does the greater omentum attach from, to?

Answer 16

From greater curve of stomach to anterior surface of transverse colon

Question 17

Where does the lesser omentum attach from, to?

Answer 17

Lesser curve of stomach and proximal duodenum to liver

Also connects stomach to portal triad

Question 18

What does the falciparum ligament do?

Answer 18

Connects liver to anterior abdominal wall

Question 19

What is the whole connecting the two omentums called?

Answer 19

Omental foramen, foreamen of Winslow

Question 20

Name the 9 surface regions of the abdomen and show them on yourself.

Answer 20

epigastric, umbilical, hypogastric/suprapubic, left/right hypochondriac, left/right lumbar, left/right iliac

Question 21

where do you find free communication between the supra and infra colic compartments?

Answer 21

paracolic gutters (lateral edge of colon)

Question 22

what sac are the supra and infra colic compartments part of?

Answer 22

greater sac

Question 23

The cavity in the abdomen formed by the lesser and greater omentum is called what?

Answer 23

lesser sac

Question 24

What is the internal epithelial lining of the gut derived from?

Answer 24

endoderm

Question 25

What is the external lining of the gut derived from?

Answer 25

splanchnic mesoderm-future musculature, visceral peritoneum

Question 26

what borders the foregut and midgut?

Answer 26

between the proximal and distal duodenum

Question 27

what borders the midgut and hindgut?

Answer 27

from proximal 2/3 of transverse to distal 1/3 of transverse colon

Question 28

what arteries supply the fore, mid and hindgut? One for each

Answer 28

for-celiac trunk mid-SMA hind-IMA

Question 29

which 2 organs have mixed blood supply in the GI tract? what 2 arteries is it?

Answer 29

duodenum and pancreas (celiac trunk and SMA)

Question 30

what mesentry is the greater omentum formed from?

Answer 30

dorsal

Question 31

what mesentry is the lesser omentum formed from?

Answer 31

ventral

Question 32

what 2 directions does the stomach rotate in?

Answer 32

longitudinal | anteroposterior axis

Question 33

Where does the vagus nerve lie after stomach rotation?

Answer 33

Anterior and posterior to stomach

Question 34

what is the name of the wedge of tissue that separates the trachea and oesophagus during embryologicial development?

Answer 34

tracheoesophageal septum

Question 35

what causes the liver to have a bare area on the superiror part?

Answer 35

grows at same time as diaphragm and doesn't have visceral covering

Question 36

Name 2 organs that are secondarily retroperitoneal.

Answer 36

duodenum and pancreas

Question 37

What is a hernia?

Answer 37

Protrusion of part of the abdominal contents beyond the normal confines of the abdominal wall

Question 38

What are the three parts of a hernia?

Answer 38

The sac Contents of the sac Coverings of the sac

Question 39

What is the sac of a hernia made up of?

Answer 39

A pouch of peritoneum

Question 40

Name 4 places you could get a weakness in the abdominal wall predisposing you to a hernia?

Answer 40

Inguinal canal Femoral canal Umbilicus Previous incisions

Question 41

What is the inguinal canal?

Answer 41

Oblique passage through lower part of abdominal wall

Question 42

What is the Gubernaculum and what does it link?

Answer 42

Condensed band of mesenchyme | Links go ad to labioscrotal dwelling

Question 43

Name the ant, post, roof and floor of the inguinal canal

Answer 43

Aponeurosis of ext oblique reinforced by int oblique laterally Tranversalis fascia, conjoint tendon medially Transversalis fascia, internal oblique and trans versus abdominis Inguinal ligament, thickened medially by lacunae ligament

Question 44

Name the two types of inguinal hernias. Which is most common?

Answer 44

Direct and indirect | Indirect is most common

Question 45

Are indirect hernia more common in men or women? Which side?

Answer 45

Men | Right sided

Question 46

Describe the relationship of the epigastric vessels to indirect and direct hernias

Answer 46

Indirect- lies lateral to inferior epigastric vessel | Direct- lies medial

Question 47

What is difference between mid inguinal point and mid point of the inguinal ligament?

Answer 47

Mid inguinal point- ASIS to pubic symphysis- finds femoral artery Mid point of inguinal ligament- midway ASIS to pubic tubercle- finds deep inguinal ring

Question 48

What are the boarders of Hesselbachs triangle? (Base, lat, med)

Answer 48

Base- inguinal ligament Lateral- inf epigastric vessels Medial- lateral boarder of rectus abdominis

Question 49

What are the boarders of the femoral triangle?

Answer 49

Sup- inguinal ligament Lat- med boarder of sartorius Med- med boarder of adductor longus

Question 50

What does and indirect inguinal hernia pass through? | Under what conditions can this pass into the scrotum?

Answer 50

Deep inguinal ring Inguinal canal Sup ring Enters scrotum if processes vaginalis is not obliterated

Question 51

Which hernia bulges through Hesselbach's triangle?

Answer 51

Direct, in the vicinity of the sup inguinal ring

Question 52

Why are femoral hernia more common in women?

Answer 52

Due to pelvic anatomy- wider so can get stuck more easily.

Question 53

What is the name of the entrance to the femoral canal?

Answer 53

Femoral ring

Question 54

What are the boarders of the femoral canal?

Answer 54

Med- lacunae ligament Lat- femoral vein Ant- inguinal ligament Post- pectineal ligament, sup ramus of pubic bone, pectineus muscle

Question 55

Where does a femoral hernia normally exit?

Answer 55

Saphenous opening

Question 56

What is the difference between and incarcerated and stangulated hernia?

Answer 56

Incarcerated is stuck and irreducible (can't be pushed back in) Strangulated- blood supply is disrupted and can lead to tissue necrosis