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Catch Up > 5/23 > Flashcards

5/23 Flashcards

1
Q

Inguinal Rings

A
  • Superficial inguinal ring is formed by the aponeurosis of the external oblique
  • Internal inguinal ring is the aponeurosis of the transversalis fascia
  • Cremaster muscle is from the internal oblique
  • Common site of hernia, hernia that is strangulated will cause hematochezia, pain, fever, NH3 accumulatio etc. Keep in differential
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2
Q

Median Umbilical

A

Urachus that is obliterated. Communication between bladder and yolk sac
-Remnants can lead to adenocarcinoma of the bladder or urachal cysts

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3
Q

Medial Umbilical

A

Umbilical Arteries

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4
Q

Lateral Umbilial

A

Folds covering the inferior epigastric arteries

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5
Q

Falciform

A

-Contains ligament teres hepatis which is the remnant of the umbilical vein in the liver

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6
Q

Anterior wall nodes

A

Including penis, scrotum and anus drain to superficial inguinal and then to lumbar

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7
Q

Lesser sac

A

Behind stomach, formed by lesser omentum which connects from lesser curvature to liver

  • May be accessed through the epiploic foramen near the pylorus of the stomach
  • Free edge contains the portal vein, hepatic artery, and bile duct
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8
Q

Greater omentum

A

attaches from greater curvature to transverse colon

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9
Q

Rectouterine pouch

A

peritoneal and perineal mesentery merge leading to the lowest place and common place for blood and fluid to collect

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10
Q

First part of duodenum (Bulb)

A
  • Peritoneal structure of the foregut that lies in the ligament of the lver
  • Collects fromt pyloris, often called duodenal bulb
  • Gastroduodenal artery runs behind, duodenal uler may lead to bleed
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11
Q

Second Part of Duodeum (Descending)

A
  • Is the transition from perotneal and foregut to midgut and retroperioneal.
  • Contains the ampulalla of vater and the accessory pancreatic duct
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12
Q

Third Part of Duodenum (Transverse)

A
  • Crosses in front of aorta and IVC, midgut derived

- SMA runs over the top, can compress and lead to SMA syndrome

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13
Q

Fourth Part of Duodenum (Ascending)

A
  • Ends at the ligament of trietz (connects bowel to posterior wall)
  • Marks the transition from upper to lower GI
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14
Q

Jejunum

A

Minimal Peyers Patches

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15
Q

Ileum

A

Many peyers patches

  • Contains the ileocecal valve which is a possible site for gallstone ileus.
  • Also contains meckesl diverticulum (vitellin duct)
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16
Q

Large Intestine

A

Cecum (Peritoneal), with appendix

  • Asceinding is secondarily retroperitoneal as is descending
  • Sigmoid (peritoneal) with redundant mesentery leads to common site of volvulus
  • Transverse
  • Splenic flexure is common site of ischemia (watershed with SMA/IMA)
17
Q

Pancreas

A
  • Secondarily retroperitoneal (Except tail)
  • Main duct is from ventral and accesory is from dorsal
  • Tail is near the spleen and is peritoneal
  • Lies in the floor of the lesser sac
18
Q

Spleen

A

Mesodermally derived from dorsal mesentery of foregut

-Splenorenal ligament and splenogastric ligament

19
Q

Celiac Artery

A

Supplies foregut and resides at T12. Three main branches

-Left Gastric, Common Hepatic, and Splenic

20
Q

Left Gastric

A

-Small branch of celiac trunk, supplies lesser curvature and also gives off esophageal branches. Anastamoses with right gastric off common hepatic

21
Q

Splenic

A
  • Large branch that runs along the superior aspect of the pancreas and supplies the pancreas
  • Short gastric branches supply the fundus of the stomach and are end branches. Most likely occluded space
  • Runs in splenogastic ligament to reach spleen
  • Gives off left gastroepiploic which supplies the greater curvature and anastamoses with the Right gastroepiploic off common hepatic
22
Q

Common Hepatic

A
  • Runs in free edge of lesser omentum with the bile duct and the portal vein
  • Right Gastic runs along lesser curvature and anastamoses with left gastric
  • Gives off gastroduodenal which gives off a superior pancreatic duodenal (SMA anastamoses) and then continues as the right gastroepiploic supplying the greater curvature and anastamosing with the L Gastroepiloic
  • Hepatic proper and cystic supply liver and gallbladder
23
Q

SMA

A

Runs over the third part of the duodenum and can compress (SMA syndrome)

  • L1
  • Inferior pancreaticoduodenal anastamoses with celiac (Common hepatic)
  • Middle Colic supplies transverse colin
  • Right Colic Supplies Ascending Colon
  • Iliocecal supplies the ileum and secum
  • Marginal artery supplies the anastamoses between territiories
24
Q

IMA

A

Supplies Hindgut

  • Left Colic artery
  • Sigmoid artery
  • Superior rectal artery

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