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Andrea > 28/09/20 > Flashcards

28/09/20 Flashcards

1
Q

what sensations are visceral organs sensitive to?

A

stretch, inflammation and hypoxia

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2
Q

What level is the subcostal plane?

A

L3

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3
Q

What level is the supracristal plane?

A

L4

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4
Q

What level is the transtubercular plane?

A

L5

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5
Q

What nerves innervate the foregut?

A

T5-T9

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6
Q

What nerves innervate the midgut

A

T10-T11

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7
Q

What nerves innervate the hindgut?

A

T12-L1

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8
Q

What nerves do visceral sensory nerves travel alongside?

A

sympathetic nerves

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9
Q

How long is the length from the incisors to the gastro-oesophageal junction?

A

40cm

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10
Q

At what vertebral level is the upper oesophageal sphincter?

A

C6/7

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11
Q

Are the left and right vagal trunks anterior or posterior to the oesophagus?

A

Left vagal trunk is anterior

Right vagal trunk is posterior

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12
Q

Which parts of the GI tract have dorsal/ventral mesentery?

A

Foregut has both dorsal and ventral mesentery

Midgut and hindgut have only a dorsal mesentery

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13
Q

Is the caecum intraperitoneal or retroperitoneal?

A

Mostly intraperitoneal

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14
Q

Where does the ascending colon refer pain to?

A

Umbilical region

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15
Q

Where does the descending colon refer pain to?

A

Pubic region

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16
Q

Are ascending colon and descending colon intraperitoneal or retroperitoneal?

A

Secondary retroperitoneal

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17
Q

What causes apple core sign?

A

Colorectal adenocarcinoma

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18
Q

What causes diverticulitis?

A

Low fibre diet causes outpouching in colon - diverticulitis. Diverticula become infected.

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19
Q

In what position are the transverse rectal folds?

A

2 on the left

1 on the right

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20
Q

What is the origin point for classic haemorrhoids?

A

Internal venous plexus

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21
Q

What is the origin point for external haemorrhoids?

A

External venous plexus

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22
Q

On what day does a morula form?

A

~Day 3

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23
Q

On what day does a blastocyst form?

A

~Day 5

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24
Q

On what day does implantation occur?

A

~Day 6

And zona pellucida disappears

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25
Q

On what day does bilaminar disc appear?

A

~Day 8

And amniotic cavity opens up

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26
Q

What cells form the yolk sac?

A

Hypoblast

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27
Q

What cells form the amniotic cavity?

A

Epiblast

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28
Q

What forms skin and neural tissue?

A

Ectoderm

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29
Q

What can happen if the primitive node and streak do not disappear?

A

Can lead to teratoma formation at the distal end of the vertebral column. Sacrococcygeal teratoma.

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30
Q

What does paraxial mesoderm form?

A

Heart, skull, skeletal muscles of head and neck. And somites

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31
Q

What does intermediate mesoderm form?

A

Urogenital system, kidneys and gonads

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32
Q

What does lateral plate mesoderm form?

A

Viscera and heart

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33
Q

What do somites form?

A

Axial skeleton, associated musculature and dermis of skin

34
Q

What are the two types of embryonic disc folding?

A

Longitudinal Folding​
The head & tail ends of the embryonic disc fold toward each other. Important for reversal.

Lateral Folding​
The lateral sides of the embryonic disc fold toward each other. Meet in the anterior midline

35
Q

Why does stenosis of the gut tube occur?

A

Due to partial recanalisation

36
Q

Why does atresia of the gut tube occur?

A

Due to no recanalisation

37
Q

What’s the difference between omphalocele and gastroschisis?

A

Gut tube does not fully return to the abdomen or herniates through the abdominal wall

In omphalocele, organs are still in amniotic sac

In gastroschisis, organs are not in a membrane.

38
Q

What happens in imperforate anus?

A

Abnormal urorectal septum formation

39
Q

What cranial nerve, muscles and bones are associated with pharyngeal arch 1?

A

1st Arch​
Nerve supply: CNV (Trigeminal nerve)​
Muscles: e.g. Mastication and tensor tympani​
Bones: e.g. malleus, incus, maxilla, zygoma & mandible

40
Q

How does the stomach rotate in the embryo?

A

The stomach rotates 90° to the right & 90° clockwise to form the lesser sac​

41
Q

Are the pancreas and duodenum intraperitoneal or retroperitoneal?

A

Secondary retroperitoneal

42
Q

What is the surface anatomy of the liver?

A

Triangle between:

  • R 5th ICS MCL
  • L 5th ICS MCL
  • R just above subcostal plane
43
Q

What does the falciform ligament contain?

A

Ligamentum teres (remnant of umbilical vein)

44
Q

What is the ligamentum venosum an embryological remnant of?

A

Ductus venosus

45
Q

What is the porta hepatis?

A

Entry/exit point for portal vein, hepatic artery, bile duct, and autonomic nerves​

46
Q

How many functionally independent segments can the liver be separated into?

A

8

47
Q

Where is the gallbladder fundus found?

A

Tip of 9th costal cartilage

48
Q

What guards the entrance of the major duodenal papilla?

A

Hepato-pancreatic sphincter

49
Q

What is the lymphatic drainage of the pancreas and duodenum?

A

Coeliac nodes –> thoracic duct –> left supraclavicular nodes (Virchow’s node)

50
Q

What ribs does the spleen sit under?

A

9-11 or 10-12

51
Q

Is the spleen intraperitoneal or retroperitoneal?

A

The spleen is intraperitoneal and of mesenchymal origin​

52
Q

What nerve exits the spinal nerves and into the sympathetic chain?

And what nerve exits the sympathetic chain to go into the spinal nerves?

A

White ramus communicans
spinal nerve –> sympathetic chain
Only T1-L2 will have a white ramus communicans?

Grey ramus communicans
sympathetic chain –> spinal nerve

53
Q

Where is the superior cervical ganglion?

A

Near skull base

54
Q

Where is the stellate ganglion?

A

Near lung apex

55
Q

Which cells of the adrenal medulla release adrenaline into the blood?

A

Chromaffin cells

56
Q

What does the kidney develop from?

A

metanephros (intermediate mesoderm) & the ureteric bud

57
Q

What is an aberrant renal artery?

A

Blocks ureter

58
Q

What nerves do visceral sensory nerves from the ureter travel alongside?

A

Sympathetic nerves

59
Q

What dermatomes is loin to groin pain?

A

T12-L1

60
Q

What ligaments support the bladder in females and in males?

A

Females - Pubo vesical ligament

Males - Pubo prostatic ligament

61
Q

What is the innervation above the pelvic pain line?

A

T12-L2 alongside sympathetic nerves

62
Q

What is the innervation below the pelvic pain line?

A

S2-S4 alongside the parasympathetic nerves

63
Q

What is the allantois?

A

Passes from bladder region of cloaca to umbilicus; involved in formation of blood cells in utero.
Remnants of the allantois can cause clinical problems eg. cysts, sinus or fistula.

64
Q

What are the parts of the male urethra?

A
  1. Preprostatic
  2. Prostatic
  3. Membranous
  4. Spongy (penile)
  5. Navicular fossa
65
Q

What are the male sphincters?

A
  1. Internal urethral sphincter
  2. External urethral sphincter
  3. Compressor urethrae
66
Q

What are the female sphincters?

A

Internal urethral sphincter?
External urethral sphincter
Compressor urethrae
Sphincter urethrovaginalis

67
Q

What are the stages in the micturition reflex?

A

Stretch of bladder wall (visceral afferents)​
​
Contraction of detrusor (parasympathetic)​
​
Relaxation of internal urethral sphincter (parasympathetic)​
​
Relaxation of external urethral sphincter (somatic)​

68
Q

What is a Rigler sign? (on X-ray)

A

double wall sign, gas is present on both sides, not good

69
Q

What is a coffee bean sign? (on X-ray)

A

Sigmoid volvulus

70
Q

What is emphysematous pyelonephritis?

A

Gas in renal parenchyma, retroperitoneal and pararenal tissues

71
Q

Where is the deep inguinal ring?

A

Located between the midpoint of inguinal ligament & the midinguinal point (~1cm above the inguinal ligament)

72
Q

Where is the superficial inguinal ring?

A

Located within the external oblique aponeurosis; Located supero-lateral to the pubic tubercle​

73
Q

What muscle/fat layer is the deep inguinal ring in?

A

Transversalis fascia

74
Q

What muscle/fat layer is the superficial inguinal ring in?

A

External oblique aponeurosis

75
Q

What type of hernia can result from a weakness in the conjoint tendon?

A

Direct inguinal hernia

76
Q

What are the borders of Hesselbach’s triangle and what type of hernia is found in this region?

A
  • Rectus abdominis
  • Inferior epigastric artery
  • Inguinal ligament

Direct hernia is found within Hesselbach’s triangle

77
Q

What nerves are at risk during inguinal canal region surgery?

A

Ilioinguinal and iliohypogastric nerves

78
Q

What are the borders of an inferior lumbar (Petit’s) triangle hernia?

A
  • External oblique
  • Latissimus dorsi
  • Iliac crest

Patient presents with persistent back pain.

79
Q

What are the borders of a superior lumbar (Grynfeltt/Lesshaft) triangle hernia?

A
  • Rib 12
  • Quadratus lumborum
  • Internal oblique
80
Q

At what level does the spinal cord terminate?

A

L1

81
Q

At what level does the subarachnoid space end?

A

lower S1 to S2

82
Q

What type of urinary stone is not visible on X-ray?

A

Urate

Andrea (10 decks)

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