USMLE Road Map - Abdomen Flashcards Preview

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Flashcards in USMLE Road Map - Abdomen Deck (93):
1

The L3 marks the ...?

Inferior extent of the 3rd part of the duodenum and the origin of the IMA from the abdominal aorta.

2

The epigastric and the umbilical region are found ...?

Above and below the subcostal plane, respectively.

3

The transtubercular plane intersects the ...?

Iliac tubercles and the body of the L5 vertebra.
--> The umbilical and the hypogastric region are found above and below the transtubercular plane respectively.

4

The transpyloric plane that ...?

Intersects the L1 is an important level for imaging.

5

The transpyloric plane contains ...?

1. The pyloric part of the stomach (variable).
2. The 1st part of the duodenum.
3. Fundus of gallbladder.
4. Neck of pancreas.
5. SMA origin.
6. Hepatic portal vein.
7. Splenic vein.

6

The abdominal wall consists of ... tissue layers.

8.

7

The 8 layers of the anterior abdominal wall include:

1. Skin.
2. Several layers of fascia.
3. 3 layers of muscle.
4. Peritoneum.

8

The superficial fascia ...?

Deep to the skin, consists of an outer layer of Camper's fascia that contains fat and is continuous with superficial fascia everywhere and an inner layer of Scarpa's fascia that LACKS FAT.

9

Scarpa's fascia is ...?

Continuous with superficial perineal fascia (Colles' fascia) covering the perineum.
--> Continuous with superficial penile fascia covering the penis and clitoris.
--> Continuous with dartos fascia of the scrotum, which contains the dartos muscle, a smooth muscle that functions to help regulate the thermal environment of the testis.

10

The superficial epigastric veins of the ...?

Superficial fascia drain into the femoral vein and communicate with small paraumbilical veins at the umbilicus.

11

The external oblique consists of ...?

Fibers that run medially and inferiorly.

12

The external oblique becomes the ...?

External aponeurosis at the midclavicular line.

13

The aponeurosis of external oblique attaches ...?

Inferiorly and medially to the pubic tubercle and inferiorly and laterally to the anterior superior iliac spine (ASIS).

14

The aponeurosis of external oblique muscle is folded ...?

Posteriorly between the pubic tubercle and the ASIS and forms the inguinal ligament.
--> Marks the inferior border of the anterior abdominal wall.

15

The aponeuroses of external oblique muscles contribute to the ...?

Rectus sheath and interdigitate in the anterior midline at the linea alba.

16

The internal oblique muscle attaches ...?

To the lateral 2/3 of the inguinal ligament - Its fibers run superiorly and medially, perpendicular to those of the external oblique.

17

Internal oblique muscle becomes the ...?

Internal oblique aponeurosis at the midclavicular line --> The aponeuroses of the internal oblique muscles contribute to the rectus sheath and interdigitate in the midline at the linea alba.

18

The internal oblique muscle give rise to the ... muscle.

Cremaster muscle, which covers the testis and the spermatic cord.

19

The transversus abdominis muscle consists of fibers that run ...?

HORIZONTALLY.

20

The aponeuroses of the transversus abdominis muscles ...?

Contribute to the rectus sheath and interdigitate in the midline at the linea alba.

21

Transversalis fascia is ...?

Deep to the transversus abdominis muscle and in contact with the rectus abdominis muscle below the arcuate line.

22

Transversalis fascia gives rise to ...?

Internal spermatic fascia, which covers the testis and the spermatic cord.

23

Extraperitoneal fat is the ...?

Tissue layer in which the ovaries and the testes develop.

24

In males the peritoneal cavity is ...?

COMPLETELY CLOSED.

25

In females the uterine tubes ...?

OPEN INTO THE PERITONEAL CAVITY.

26

The dorsal mesentery ...?

Reflects off of the midline of the dorsal body wall. During fetal life, the dorsal mesentery suspends GI structures below the diaphragm.

27

The ventral mesentery ...?

Reflects off of the midline of the ventral body wall. During fetal life, the ventral mesentery suspends GI structures, derived from the fetal foregut and the spleen.

28

A mesentery contains ...?

1. Blood vessels.
2. Lymphatics.
3. Nerves.
that supply structures suspended by the mesentery.

29

Parietal peritoneum forms ... folds on the anterior abdominal wall that contain remnants of fetal structures and ... folds that contain patent structures in postnatal life.

3 folds, 2 folds.

30

The median umbilical fold ...?

Contains the urachus, a remnant of the allantois, which connected the fetal bladder to the umbilicus.

31

2 median umbilical folds ...?

Contain medial umbilical ligaments, the obliterated remnants of the fetal umbilical arteries that returned fetal blood to the placenta.

32

2 lateral umbilical folds contain the ...?

Inferior epigastric vessels; these vessels enter the rectus sheath and supply the rectus abdominis muscle.

33

Innervation of the anterolateral abdominal wall:

1. Lower intercostal nerves (T7-T11).
2. Subcostal nerve (T12).
3. Iliohypogastric + Ilioinguinal nerves (L1).
innervate skin, fascia, and muscles of the anterolateral abdominal wall.

34

The subcostal plane passes ...?

Just inferior to the costal margin and intersects the L3 vertebra.

35

The rectus sheath is formed by the ...?

Aponeuroses of the 3 muscles of the anterolateral abdominal wall and contains the rectus abdominis muscle.

36

Which aponeurosis forms the external wall of the rectus muscle sheath?

The aponeurosis of the external oblique muscle.

37

In the superior 3/4 of the rectus sheath ...?

The internal oblique aponeurosis splits to form part of BOTH the anterior and the posterior walls.

38

The transversus abdominis aponeurosis forms ...?

Part of the posterior wall in the superior 2/3 of the rectus sheath.

39

At the arcuate line ...?

The aponeuroses of the internal oblique and the transversus abdominis muscles pass anterior to the rectus abdominis muscle, leaving the posterior wall of the rectus in contact with the transversalis fascia.

40

The arcuate line is located between the ...?

Umbilicus and the pubic symphysis.

41

Blood supply of the rectus abdominis?

Inferior epigastric (external iliac artery) + Superior epigastric (internal thoracic).

42

Action of rectus abdominis muscle:

Flexes the lumbar vertebrae, and, with the other muscles of the abdominal wall, compresses the abdomen, thereby increasing intra-abdominal pressure.

43

The inguinal canal is formed by ... of ... tissue layers of the anterior abdominal wall.

4 of 8.

44

Outpocketings of ... of these tissue layers giive rise to spermatic fasciae, which cover the testis and structures in the spermatic cord.

3.

45

The inguinal canal - Posterior wall formed by ...?

Transversalis fascia.

46

1st tissue layer that covers the testis as it enters the inguinal canal.

Transversalis fascia.

47

The posterior wall of the inguinal canal contains ...?

The deep inguinal ring.

48

The deep inguinal ring is ...?

A fault in the transversalis fascia, which forms the posterior opening of the inguinal canal.

49

Which structures are medial to the deep inguinal ring?

The inferior epigastric artery and vein.

50

The posterior wall of the inguinal canal give rise to ...?

The internal spermatic fascia - an outpocketing of transversalis fascia at the deep inguinal ring.

51

The anterior wall of the inguinal ring is formed by ...?

The aponeurosis of the external oblique muscle and is the traversed by the testis at it exits the inguinal canal.

52

The anterior wall of the inguinal canal contains ...?

The superficial inguinal ring.

53

What is the superficial inguinal ring?

A fault in the external oblique aponeurosis that forms the anterior opening of the inguinal canal.

54

Which structures are lateral to the superficial inguinal ring?

The inferior epigastric artery and vein.

55

The anterior wall of the inguinal canal gives rise to ...?

External spermatic fascia - an outpocketing of the external oblique fascia at the superficial inguinal ring.

56

The floor of the inguinal canal is formed by the ...?

Inguinal ligament.

57

The roof of the inguinal canal is formed by the ...?

Arched muscle fibers of the transversus abdominis and internal oblique muscles.

58

The aponeuroses of transversus abdominis and internal oblique muscles fuse to form the ... that attaches to the pubic bone posterior to the superficial inguinal ring.

Conjoined tendon.

59

The cremasteric fascia is derived from the ...?

Fascia of the internal oblique muscle that extend along the spermatic cord.

60

Contraction of the cremasteric muscle ...?

Elevates the testis and helps regulate the thermal environment of the testis.

61

Does the transversus abdominis muscle contribute to the spermatic fasciae?

NO - The testis passes under the transversus abdominis muscle.

62

The cremasteric reflex utilizes sensory + motor fibers in the ventral ramus of the ... spinal nerve.

L1.

63

Stroking the skin of the superior and medial thigh stimulates sensory fibers of the ...?

Ilioinguinal nerve.

64

Motor branches from the genital branch of the ... nerve cause the cremaster muscle to contract, elevating the testis.

Genitofemoral.

65

The inguinal canal in males contains the ...?

Spermatic cord, which contains a number of structures.

66

The ductus deferens ...?

Conveys sperm from the epididymis to the ejaculatory duct in the male pelvis.

67

The testicular artery arises from ...?

The abdominal aorta between the L2 and L3 vertebrae.

68

The artery to the ductus deferens arises from ...?

A branch of the internal iliac artery.

69

The spermatic cord also contains the ...

Pampiniform plexus of the testicular vein.

70

Which structures of the spermatic cord provide thermoregulatory control for the testis so that spermatogenesis occurs at a constant temperature?

1. Pampiniform plexus.
2. Cremaster muscle.
3. Dartos muscle.

71

Sympathetic nerves from the ... to ... spinal cord segments innervate smooth muscle in the ductus deferens.

T11 to L1.

72

The spermatic cord contains a remnant of ...?

Processus vaginalis.

73

The processus vaginalis is an ...?

Evagination of parietal peritoneum that descends through the inguinal canal during fetal life.

74

The tunica vaginalis is a ...?

Patent remnant of the processus vaginalis that covers the anterior and lateral parts of the testis.

75

A hydrocele is ...?

An accumulation of serous fluid in the tunica vaginalis or in a persistent part of the processus vaginalis in the cord.

76

A hematocele is ...?

An accumulation of blood in the tunica vaginalis and results from rupture of testicular blood vessels after trauma to the spermatic cord or testis.

77

Pain associated with trauma to the testis may be referred over the ...-... dermatomes.

T11-L1 dermatomes.

78

A spermatocele is ...?

A cyst containing sperm that develops in the epididymis just above the testis.

79

A spermatocele is ...?

A cyst containing sperm that develops in the epididymis just above the testis.

80

Varicosities in the pampiniform plexus are observed when the patient is ...?

Standing - Disappear when the patient is lying down.

81

Painless testicular mass:

Malignancy.

82

MC location of a cryptorchid testis is ...?

The inguinal canal.

83

The inguinal canal in females contains ...?

The round ligament of the uterus + a remnant of the processus vaginalis.

84

The round ligament is the remnant of the ...?

Gubernaculum, which passes through the inguinal canal during fetal life and ends in the labium majus.

85

A persistent processus vaginalis in females forms ...?

The canal of Nuck.

86

Carcinoma of the fundus of the uterus may metastasize ...?

To superficial inguinal lymph nodes along lymphatic vessels that course with the round ligament.

87

After passing deep to the inguinal ligament, femoral hernias may ...?

Protrude anteriorly through the saphenous hiatus, a fault in the fascia lata that transmits the saphenous vein.

88

Peritoneal refers to structures that ...?

Are suspended by a derivative of a dorsal or ventral mesentery in postnatal life.

89

Secondarily retroperitoneal refers to structures ...?

That are NO LONGER suspended by a mesentery in postnatal life, are only partially covered by peritoneum, and lie on the posterior wall of the abdominopelvic cavity.

90

Primarily retroperitoneal refers to structures that ...?

Were never suspended by a mesentery, are partially covered by peritoneum, and lie mainly on the posterior wall of the abdominopelvic cavity.

91

A postnatal derivative of a mesentery may be called ...?

1. An omentum (eg greater or lesser omentum).
2. A ligament (eg the gastrosplenic ligament).
3. Named for the GI structure it suspends (eg mesocolon).

92

Sensory neurons that respond to pain and innervate GI structures course back to the CNS with SNS nerves and enter the spinal cord from ... through ... .

T5-L2.

93

Parietal peritoneum is sensitive to pain and is innervated by ...?

1. Lower intercostal nerves (T7-T11).
2. Subcostal nerve (T12).
3. Iliohypogastric and ilioinguinal nerves (L1).
4. Branches of phrenic nerve (C3-C5).