5- radiological anatomy

Question 1

which radiological technique is readily available so often 1st line?

Answer 1

x-ray

Question 2

what is good & bad about ultrasound

Answer 2

good = - harmless & well tolerated & good for solid organs, biliary tree, urinary tract & free fluid
bad = bad for gas

Question 3

what is good and bad about CT scan?

Answer 3

good = see lots of structures at same time
bad = high dose ionising radiation

Question 4

what is good and bad about MRI?

Answer 4

good = for soft tissue contrast and no ionising radiation
bad = expensive & time consuming and some patients can’t tolerate

Question 5

what are the indents in oesophagus that can be seen on CT scan?

Answer 5

3 indents

1st = aortic arch
2nd = left main bronchus
3rd = left atrium

Question 6

what is route of oesophagus?

Answer 6

starts in neck and goes into thorax, lies posterior to trachea & great vessels - then descends adjacent to aorta and passes posterior to left main bronchus then passes posteriorly to left atrium

Question 7

what organs are in right upper quadrant?

Answer 7

• liver, gallbladder & biliary tree
• duodenum (1st, 2nd, 3rd part)
• pancreatic head
• colon (hepatic flexure, ascending colon, transverse colon)
• right kidney & adrenal gland

Question 8

what organs are in left upper quadrant?

Answer 8

• spleen
• stomach
• small bowel
• pancreatic tail
• colon (splenic flexure, descending colon, transverse colon)
• left kidney & adrenal gland

Question 9

what organs are in right lower quadrant?

Answer 9

• caecum
• terminal ileum
• appendix
• right ureter (ovary, fallopian tube, uterus)
• bladder

Question 10

what organs are in left lower quadrant?

Answer 10

• sigmoid colon
• left ureter (ovary, fallopian tube, uterus)
• bladder

Question 11

what is blood supply to liver?

Answer 11

portal vein (80%) & hepatic arteries (20%)

Question 12

what is the components of biliary tree?

Answer 12

• R&L hepatic ducts form common hepatic ducts
• cystic duct from gallbladder then joins CHD making common bile duct (CBD)
• pancreatic duct joins the common bile duct
• CBD then drains into duodenum via ampulla of vater

Question 13

where in duodenum is ampulla of vater located?

Answer 13

medial wall of 2nd part of duodenum

Question 14

what other organ does duodenum loop around?

Answer 14

forms C shape around pancreatic head (the pancreatic tail touches the spleen on left)

Question 15

what are the 4 parts of duodenum? (don’t have names, just like where they are)

Answer 15

• 1st part = starts at pylorus, runs up & back (INTRAPERITONEAL)
• 2nd part = descends vertically, right of L2/3 (RETROPERITONEAL)
• 3rd part = horizontally inferior to pancreas
• 4th part = upwards towards ligament of treitz

Question 16

is pancreas retroperitoneal or intraperitoneal?

Answer 16

retroperitoneal

Question 17

what is structure of pancreas?

Answer 17

uncinate process, head, neck, body, tail

Question 18

what is stomach shape?

Answer 18

J shape with 4 parts (antrum, pylorus, fundus, body) and 2 curvatures (lesser omentum attached to lesser curve and greater curve attaching to greater omentum)

Question 19

what is the point where ileum turns to caecum?

Answer 19

ileocaecal valve

Question 20

what is location of jejunum vs ileum?

Answer 20

jejunum more in LUQ and ileum more in RUQ

Question 21

what is arterial & venous supply for spleen?

Answer 21

• arterial supply = splenic artery from coeliac artery
• venous drainage = via splenic vein to portal vein

Question 22

what are the colonic flexures and their positions?

Answer 22

hepatic & splenic flexures

hepatic = lower down due to liver, on right

Question 23

what is position of rectum? (what is anterior & posterior to it)

Answer 23

posterior = sacrum/coccyx

anterior = vagina in females and prostate in males

Question 24

what are organs that are only just wrapped?

Answer 24

retroperiotoneal

Question 25

what are organs that are completely wrapped?

Answer 25

intraperitoneal

Question 26

what allows some intraperitoneal organs to move?

Answer 26

being attached to mesentery

Question 27

what parts of colon are intraperitoneal?

Answer 27

• caecum
• transverse colon (also suspended on mesentery)
• sigmoid colon (also suspended on mesentery)

Question 28

what parts of colon retroperitoneal?

Answer 28

ascending & descending

Question 29

is rectum intraperitoneal or retroperitoneal?

Answer 29

upper 2/3 covered by peritoneum, lower 1/3 below peritoneal reflection

Question 30

what is blood supply to colon?

Answer 30

both superior & inferior mesenteric arteries supply bit

• SMA branches to middle colic, right colic & ileocolic arteries = supplying caecum, ascending & proximal transverse colon
• IMA branches to left colic, sigmoid and superior rectal arteries = supplying distal transverse colon, descending colon, sigmoid colon & upper rectum