SR Chapter 17: Surgical 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 HTN?

Answer 4

1. Esophogeal varices
2. Hemorrhoids
3. Caput medusa (umbilical)
4. Retroperiotneal vein via lumbar tributaries

Question 5

What parts of the GI tract are retroperitoneal?

Answer 5

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

Question 6

What is the gubernaculum

Answer 6

Embryologic structure that adheres the testes to the scrotal sac; used to help maipulate the testes during indirect hernia repair

Question 7

Which artery bleeds in bleeding duodenal ulcers?

Answer 7

Gastroduodenal artery

Question 8

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

Answer 8

Rotter’s LN

Question 9

Is the left vagus nerve anterior or posterior?

Answer 9

Anterior

Question 10

What is Morrison’s pouch?

Answer 10

Hepato-renal recess; the most posterior cavity within the peritoneal cavity

Question 11

Foregut vs. Midgut vs. Hindgut

Answer 11

Mouth to ampulla of Vater

• To distal third of transverse colon
• To the anus

Question 12

Where are the blood vessels on a rib

Answer 12

VANi (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. Inferior epigastric vessels
3. Lateral border of 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

1. Cystic duct
2. Common hepatic duct
3. Border of the liver/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 – a line drawn from the IVC to just left of the gallbladder fossa

Question 18

What is the gastrinoma triangle?

Answer 18

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

1. Junction of the 2/3 portions of the duodenum
2. Cystic duct
3. Pancreatic neck

Question 19

Which artery is responsible for anterior spinal artery syndrome?

Answer 19

Artery of Adamkieqicz

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

What 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 GIT do not have serosa?

Answer 24

Esophagus

Middle & distal rectum

Question 25

What is the vein that overlies the pylorus?

Answer 25

Vein of Mayo

Question 26

What is the pouch of Douglas

Answer 26

Pouch between the rectum and bladder or uterus

Question 27

What does the thoracic duct empty into?

Answer 27

Left subclavian; left IJ

Question 28

What is the coronary vein?

Answer 28

Left gastric vein

Question 29

What is the hypogastric artery?

Answer 29

Internal iliac

Question 30

Which is longer, the left or right renal vein?

Answer 30

Left

Question 31

What are the layers of the abdominal wall?

Answer 31

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

Question 32

What is another name for plicae circulares?

Answer 32

Valvulae connivientes

Question 33

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

Answer 33

J: long vasa recta; large plicae, thicker wall I: shorter VR, thinner wall, smaller plicae

Question 34

What are the major anatomic differences b/t the SM bowel and the colon?

Answer 34

Colon: taeniae coli, haustra, appendices epiplocae (fat appendages) SM bowel: smooth

Question 35

How far up does the diaphragm extend?

Answer 35

To the nipples (4th IC space); abdomen extends to the level of the nipples

Question 36

What are the major layers of an artery?

Answer 36

Intima, media, adventitia