Stop Forgetting 2

Question 1

spigelian hernia

Answer 1

lateral ventral hernia through the semilunar line (midclavicular)

Question 2

inguinal ligament formed from

Answer 2

External oblique aponeurosis.
Superficial inguinal ring = lateral crus, medial crus, intercrural fibers.
Deep inguinal ring.

Question 3

hasselback’s triangle borders

Answer 3

Inguinal ligament.
Inferior epigastric vessels.
Lateral border of rectus abdominis.

Question 4

ventral mesentery forms:

Answer 4

Liver develops inside ventral mesentery.

Ventral mesentery forms adult lesser omentum and falciform ligament.

Question 5

two ligaments of lesser sac

Answer 5

hepatogastric

hepatoduodenal

Question 6

round ligament of the liver is a remnant of

Answer 6

former umbilical vein

Question 7

L hepatic artery supplies blood to

Answer 7

Left lobe,
quadrate lobe,
1/2 of caudate lobe

Question 8

R hepatic artery supplies blood to

Answer 8

Right lobe,
1/2 caudate lobe.
Gallbladder.

Question 9

umbilical fissure

Answer 9

Consists of ligamentum venosum and round ligament.

Question 10

portocaval anastamoses (shunts if portal hypertension)

Answer 10

1) esophageal (L gastric, esophageal branches, azygos, IVC)
2) retroperitoneal (IMV, colic vs., retroperitoneal v, IVC)
3) rectal (IMV, superior rectal v, inferior rectal v, internal iliac v, common iliac v, IVC)
4) paraumbilical (smv, paraumbilical vs, superior epigastric, internal thoracic v, IVC // inferior epigastric v, external iliac v, common iliac v, IVC)

Question 11

sympathetic input to hepatobiliary system

Answer 11

Greater splanchnic nerve synapses on celiac ganglion.

Nerves follow periarterial plexus to effector organ.

Question 12

parasympathetic input to hepatobiliary system

Answer 12

Vagus nerve.

Stimulate bile production, glycogen synthesis.

Question 13

main veins of abdomen

Answer 13

IMV empties into splenic v.

Splenic vein joins SMV to form hepatic portal vein.

Question 14

ligament of treitz

Answer 14

Suspensory ligament of duodenum.
Right crus of diaphragm, continues as CT.
Divides into upper/lower GI.
Rotational point in embryological development –> landmark for malrotation.

Question 15

pancreatic blood supply

Answer 15

HEAD:
anastamoses of A/P superior pancreaticoduodenal (gastroduodenal/common hepatic/celiac trunk) and A/P inferior pancreaticoduodenal (SMA)

BODY/TAIL:
greater pancreatic a., dorsal pancreatic a (both from splenic a., celiac trunk)

Question 16

Pancreatic lymphatic drainage

Answer 16

MAJOR:
celiac LN,
superior mesenteric LN

MINOR:
superior pancreatic LN
pancreaticoduodenal LN
pyloric LN

Question 17

gold standard of Crohn’s diagnosis

Answer 17

endoscope view of ileocecal junction

Question 18

major things large intestine absorbs

Answer 18

water, electrolytes, vitamin K

Question 19

3 tests for appendicitis

Answer 19

Palpate McBurney's point.
Psoas sign.
Rebound tenderness (Blumberg sign)

Question 20

blood supply of stomach

Answer 20

R gastric (celiac trunk) anastamoses with L gastric (CHA) - lesser curvature.

R gastroepiploic (splenic a) anastamoses with L gastroepiploic (gastroduodenal a) - greater curvature

Question 21

ileocecal artery (origin, supplies)

Answer 21

Origin: SMA

Supplies:
ileum,
cecum (superior/inferior cecal aa.),
appendix (appendicular a.)

Question 22

middle colic artery (origin, supplies)

Answer 22

Origin: SMA

Supplies:
transverse colon

Question 23

right colic artery (origin, supplies)

Answer 23

Origin: SMA

Supplies: ascending colon

Question 24

ileojejunal branches (origin, supplies)

Answer 24

Origin: SMA

Supply: ileum, jejunum

Turn into vasa recta

Question 25

marginal artery (origin, supplies)

Answer 25

Connects SMA and IMA. (connects MRI colics of SMA with Left colic of IMA) provides alternative blood supply

Question 26

celiac lymph nodes drain:

Answer 26

liver, gallbladder, duodenum, pancreas

Question 27

superior mesenteric lymph nodes drain:

Answer 27

cecum, ascending colon, R 1/2 transverse colon, ileum, jejunum

Question 28

inferior mesenteric lymph nodes drain:

Answer 28

all of hindgut

Question 29

anal canal, above vs below pectinate line (derived layer, artery, vein, LN, innervation)

Answer 29

ABOVE: Endoderm. Superior rectal a./v. Internal iliac LN, inferior mesenteric LN. Autonomic and visceral hindgut innervation to internal sphincter and mucosa. ``` BELOW: Ectoderm. Inferior rectal a./v. Superficial inguinal LN. Somatic motor to external sphincter, somatic sensory to skin around anus ```

Question 30

lumbar triange (of petit) borders

Answer 30

Lat dorsi. External oblique. Iliac crest. Only transversus abdominis, internal oblique tendons are there --> lumbar hernias can occur

Question 31

arteries of posterior abdominal wall

Answer 31

``` Inferior phrenic a - ab aorta. Middle suprarenal a - ab aorta. Lumbar aa. - ab aorta Gonadal a. - ab aorta, just below SMA Median sacral a. - ab aorta at bifurcation Common iliac, internal/external iliac. ```

Question 32

posterior abdominal wall drains into which lymphatics?

Answer 32

Lateral aortic (lumbar) LNs

Question 33

origin of esophageal artery

Answer 33

Left gastric (celiac trunk)

Question 34

origin of R gastric a

Answer 34

proper hepatic a. (celiac trunk, CHA)

Question 35

origin of short gastric arteries

Answer 35

splenic artery (celiac trunk)

Question 36

origin of R gastroepiploic artery

Answer 36

gastroduodenal a (celiac trunk, CHA)

Question 37

origin of superior anerior pancreaticoduodenal a.

Answer 37

gastroduodenal a (celiac trunk, CHA)

Question 38

origin of L gastroepiploic a

Answer 38

splenic a

Question 39

branches off of posterior internal iliac a

Answer 39

1) superior gluteal 2) iliolumbar 3) lateral sacral

Question 40

branches off of anterior internal iliac a

Answer 40

1) umbilical 2) superior vesical 3) obturator 4) vaginal 5) inferior vesical 6) uterine 7) middle rectal 8) internal pudendal 9) inferior gluteal

Question 41

conjoint tendon

Answer 41

Anterior to Hesselbeck's triangle. Fusion of internal oblique/transversus abdominis muscle tendons. Resists direct hernias.

Question 42

ileum vs jejunum

Answer 42

More complex arcades in ileum, shorter vasa recta.

Question 43

parietal peritoneum feels...

Answer 43

somatic pain

Question 44

hydronephrosis

Answer 44

gross dilation of calyces and pelvis caused by kidney stones (no urine flowing, fluids back up)

Question 45

midgut rotation

Answer 45

90 deg counterclockwise 180 deg counterclockwise TOTAL: 270 deg counterclockwise

Question 46

omphalocele

Answer 46

Failure of umbilicus to close completely. GI still functions normally.

Question 47

ectopia cordis

Answer 47

Failure of abdominal wall to close more superiorly. Heart is partially/totally outside of chest. Cardiac problems.

Question 48

gastroschisis

Answer 48

Abdominal wall does not involve the umbilicus. GI does NOT function normally. Incomplete closure of lateral folds.

Question 49

external urethral sphincter controlled by which nerve?

Answer 49

pudendal nerve

Question 50

broad ligament

Answer 50

Folding of peritoneum Mesosalpinx Mesometrium Mesovarium

Question 51

suspensory ligament of ovary

Answer 51

contains ovarian a/v from ovary, to lateral side

Question 52

ligament of ovary

Answer 52

connects ovary to uterus | usually below oviduct

Question 53

what forms into the lower 1/3 of vagina and the hymen?

Answer 53

urogenital sinus