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Flashcards in GI , Snell Deck (127):
1

Cutaneous supply to the anterior abdominal wall is derived from (2)

1) Anterior rami of lower six thoracic nerves (lower 5 intercostals and subcostal)
2) Anterior rami of first lumbar nerve

2

First lumbar nerve is represented by (2)

1) Iliohypogastric nerve
2) Ilioinguinal nerve

3

Dermatome of T7

Xiphoid process

4

Dermatome of T10

Umbilicus

5

Dermatome of L1

Just above the inguinal ligament and symphysis pubis

6

Arterial supply of abdominal skin: Midline

Superior and inferior epigastric

7

Arterial supply of abdominal skin: Flanks (3)

1) Intercostal
2) Lumbar
3) Deep circumflex iliac

8

Venous drainage of abdominal skin (2)

1) Axillary vein via lateral thoracic vein
2) Femoral vein via superficial epigastric and greater saphenous veins

9

Lymphatic drainage of abdominal skin: Above umbilicus

Anterior axillary LN

10

Lymphatic drainage of abdominal skin: Below umbilicus

Superficial inguinal LN

11

Superficial fascia of abdomen is divided into

1) Camper fascia (fatty)
2) Scarpa fascia (membranous)

12

Camper fascia is continuous with

Superficial fascia of the rest of the body

13

Scarpa fascia fades at

1) Lateral
2) Superior

14

Scarpa fascia continues inferiorly over the inguinal ligament to fuse with

Deep fascia of the thigh (fascia kata) ~1 finger breadth below the inguinal ligament

15

Scarpa fascia continues in the midline to form

A tubular sheath for the penis/clitoris

16

Scarpa fascia continues in the perineum to attach at the

Margins of the pubic arch to form the Colles' fascia

17

Strongest layer of the anterior abdominal wall

Deep fascia

18

The cremaster muscle is derived from

Lower fibers of the internal oblique

19

The rectus sheath is formed by

Aponeurosis of the 3 lateral abdominal muscles

20

Arrangement of abdominal aponeurosis at the level of the ASIS

All 3 aponeuroses pass anteriorly to the rectus muscle, leaving the sheath deficient posteriorly

21

All 3 aponeuroses fuse with each other and with their fellows of the opposite side in the midline between the recti muscles to form the

Linea alba

22

Linea alba extends from

Xiphoid process above to symphysis pubis below

23

The transverse tendinous intersections that divide the rectus abdomens into segments are usually ___ in number

3

24

Abdominal tendinous intersections levels

1) Level of the xiphoid
2) Level of the umbilicus
3) Between the the xiphoid and umbilicus

25

Muscle fibers that form the conjoint tendon

Internal oblique and transversus abdominis

26

The lower free border of the internal oblique arches over the spermatic cord/round ligament of uterus, descends behind and attaches to

Pubic crest and pectineal line

27

Role of the conjoint tendon

Strengthens the medial half of the posterior wall of the inguinal canal

28

The inguinal ligament is formed by

Lower border of the aponeurosis of external oblique

29

Lower border of the inguinal ligament is attached to

Deep fascia of thigh (fascia lata)

30

The fascia transversalis lines the

Transversus abdominis

31

The fascia transversalis is continuous with (2)

1) Lining of the diaphragm
2) Lining of the iliacus

32

Fascia transversalis forms part of what sheath

Femoral sheath

33

Femoral sheath is formed by (2)

1) Fascia transversalis
2) Fascia iliaca

34

Content of inguinal canal in females

Round ligament

35

Content of inguinal canal in males

Spermatic cord

36

Inguinal canal leads to ___ in males

Testis

37

Inguinal canal leads to ___ in females

Labium majus

38

Inguinal canal: Length

4 cm

39

Inguinal canal: Extends from

Deep/internal inguinal ring laterally to superficial/external inguinal ring obliquely and medially

40

Inguinal canal: Lies parallel and immediately above the

Inguinal ligament

41

Deep inguinal ring: Oval opening in the

Fascia transversalis

42

Deep inguinal ring: Lies approximately ___ above the inguinal ligament

1.3 cm

43

Deep inguinal ring: Margins give attachment to

Internal spermatic fascia

44

Superficial inguinal ring: Shape

Triangular

45

Superficial inguinal ring: Aponeurosis of

External oblique

46

Superficial inguinal ring: Lies immediately above and medial to

Pubic tubercle

47

Superficial inguinal ring: Margins give attachment to

External spermatic fascia

48

Inguinal canal walls: Anterior

EOM aponeurosis

49

Inguinal canal walls: Posterior

Conjoint tendon medially, fascia transversalis laterally

50

Inguinal canal walls: Superior wall (roof)

IO and TA

51

Inguinal canal walls: Inferior wall (floor)

Inguinal and lacunar ligaments

52

Inguinal ligament is aka

Poupart's ligament

53

Structure that passes through the inguinal canal in both males and females

Ilioinguinal nerve

54

Hernia that occurs above the inguinal ligament

Inguinal hernia

55

Hernia that occurs below the inguinal ligament

Femoral hernia

56

Hernial sac of an indirect inguinal hernia

Processus vaginalis

57

More common: Indirect vs direct inguinal hernia

Indirect

58

Indirect inguinal hernia: More common in the left vs right

Right

59

Indirect inguinal hernia: Neck of sac, wide vs narrow

Narrow

60

Femoral vs inguinal hernia: Sac above and medial to the pubic tubercle

Inguinal

61

Femoral vs inguinal hernia: Sac below and lateral to the pubic tubercle

Femoral

62

Direct inguinal hernia: Males vs females

Males

63

Direct inguinal hernia: Neck of hernial sac, wide vs narrow

Wide

64

Contents of spermatic cord (7)

1) Vas deferens
2) Artery of vas deferens
3) Remains of processes vaginalis
4) Testicular artery, vein (pampiniform plexus), and lymph vessels
5) Cremasteric artery
6) Genital branch of genitofemoral nerve, which supplies the cremaster muscle)
7) Autonomic nerves

65

External spermatic fascia is derived from

External oblique muscle

66

Internal spermatic fascia is derived from

Fascia transversalis

67

Cremasteric fascia is derived from

Internal oblique muscle

68

Lower expanded part of the processes vaginalis

Tunica vaginalis

69

T/F Direct inguinal hernia never enters the scrotum

T

70

Indirect inguinal hernia is covered by

1) Peritoneum
2) 3 layers of spermatic cord

71

Musculoligamentous cord that connects the fetal testis with the floor of the developing scrotum

Gubernaculum testis

72

Gubernaculum testis is homologous with

Female round ligament of the ovary and round ligament of the uterus

73

Layers of the scrotum

1) Skin
2) Superficial fascia (Dartos muscle)
3) External spermatic fascia
4) Cremasteric fascia
5) Internal spermatic fascia
6) Tunica vaginalis

74

Derivatives: Superficial fascia of the abdomen

Dartos muscle

75

Derivatives: External oblique muscle

External spermatic fascia

76

Derivatives: Internal oblique muscle

Cremaster muscle

77

Derivatives: Fascia transversalis

Internal spermatic fascia

78

Derivatives: Peritoneum

Tunica vaginalis

79

Outer fibrous capsule of the testes

Tunica albuginea

80

Structure that lies posterior to the testis that has a head, body, and tail

Epididymis

81

Epididymis: Length

6m

82

Emerges from the tail of the epididymis

Vas deferens

83

Arterial supply to the testis

Testicular artery from the abdominal aorta

84

Venous drainage of the testis (2)

1) IVC via the right testicular vein
2) Left renal vein via the left testicular vein

85

Varicocele: Left vs right

Left

86

Why varicocele more commonly forms on the left testicle

Drains into the renal vein where the pressure is higher

87

Lymph drainage of the testis

Paraaortic LN at the level of L1

88

Nerves of the anterior abdominal wall run downward and forward between

Internal oblique and transversus abdominis

89

Nerve/s that enter the rectus sheath

Lower 6 thoracic nerves

90

Nerve/s that does/do NOT enter the rectus sheath

L1

91

Inguinal triangle is aka

Hesselbach's triangle

92

Boundaries of the inguinal triangle: Superior and lateral

Inferior epigastric artery

93

Boundaries of the inguinal triangle: Inferior and lateral

Inguinal ligament

94

Boundaries of the inguinal triangle: Medial

Rectus abdominis

95

Reflex elicited by stroking the skin of the superior and medial thigh

Cremasteric reflex

96

Cremasteric reflex: Utilizes sensory and motor fibers in the

Ventral rams of L1

97

Cremasteric reflex: Sensory arm

Ilioinguinal nerve

98

Cremasteric reflex: Motor arm

Genital branch of the genitofemoral nerve

99

Superior epigastric artery arises from

Internal thoracic artery

100

Inferior epigastric artery arises from

External iliac artery

101

Deep circumflex iliac artery is a branch of

External iliac artery

102

Blood supply of the anterior abdominal wall

1) Superior epigastric
2) Inferior epogastric
3) Deep circumflex iliac
4) Lower 2 posterior intercostal (descending thoracic aorta)
5) Four lumbar (abdominal aorta)
6) Superficial epigastric, Superficial circumflex iliac, Superficial external pudendal (femoral artery)

103

T/F The peritoneal cavity in males is a closed cavity

T

104

T/F The peritoneal cavity in females is a closed cavity

F, communicates with exterior through uterine tubes, uterus, and vagina

105

Main compartment of the peritoneal cavity that extends from the diaphragm to the pelvis

Greater sac

106

Compartment of the peritoneal cavity that lies behind the stomach

Lesser sac

107

Greater and lesser sac of peritoneum are in free communication with each other at the

Epiploic foramen

108

The liver is connected to the diaphragm by (4)

1) Falciform ligament
2) Coronary ligament
3) Right triangular ligament
4) Left triangular ligament

109

Two-layered ford of peritoneum that connect the stomach with another viscus

Omenta

110

Connects the greater curvature of stomach with transverse colon

Greater omentum

111

Suspends the lesser curvature of the stomach to the fissure for the ligemantum venosum and port hepatic of the liver

Lesser omentum

112

Connects the stomach to the hilus of the spleen

Gastrosplenic omentum/ligament

113

Two-layered folds of peritoneum connecting parts of the intestines with the posterior abdominal wall

Mesenteries

114

Boundaries of the epiploic foramen: Anterior (2)

1) Lesser omentum
2) Portal triad

115

Boundaries of the epiploic foramen: Posterior

IVC

116

Boundaries of the epiploic foramen: Superior

Caudate lobe of liver

117

Boundaries of the epiploic foramen: Inferiorly

First part of duodenum

118

Parietal peritoneum in the pelvis is mainly supplied by

Obturator nerve

119

Somatic vs autonomic: Parietal peritoneum

Somatic

120

Somatic vs autonomic: Visceral peritoneum

Autonomic

121

Somatic vs autonomic: Pain precisely localized

Somatic

122

Somatic vs autonomic: Pain poorly localized

Autonomic

123

Stimulus for visceral/autonomic pain

Stretching or pulling

124

Visceral vs parietal peritoneum: Sensitive to pressure, pain, heat and cold

Parietal

125

Visceral vs parietal peritoneum: Insensitive to touch heat and cold

Visceral

126

Sac of peritoneum that lies posterior to the stomach and lesser omentum

Lesser sac

127

2 recesses of lesser sac

Superior recess and inferior recess