Chapter 16: Surgical Anatomy Pearls

Question 1

What is the drainage of the left testicular vein?

Answer 1

Left renal vein

Question 2

What is the drainage of the right testicular vein?

Answer 2

IVC

Question 3

Which artery bleeds in bleeding duodenal ulcers?

Answer 3

Gastroduodenal artery

Question 4

What is Morrison’s pouch?

Answer 4

Hepatorenal recess; the most posterior cavity within the peritoneal cavity

Question 5

Where are the blood vessels on a rib?

Answer 5

Vein, Artery, and Nerve (VAN) are underneath the rib (thus, place chest tubes and thoracentesis needles above the rib!)

Question 6

What is the order of the femoral vessels?

Answer 6

Femoral vein is medial to the femoral artery

(Think: “NAVEL” for the order ofthe right femoral vessels—Nerve, Artery, Vein, Empty space, Lymphatics)

Question 7

What is Hesselbach’s triangle?

Answer 7

The area bordered by:

• Inguinal ligament
• Epigastric vessels
• Lateral border of the rectus sheath

Question 8

What nerve is located on top of the spermatic cord?

Answer 8

Ilioinguinal nerve

Question 9

What is Calot’s triangle?

Answer 9

bordered by:

• hepatic duct medially
• cystic duct laterally
• inferior edge of the liver superiorly

Question 10

What is Calot’s node?

Answer 10

Lymph node found in Calot’s triangle

Question 11

What separates the right and left lobes of the liver?

Answer 11

Cantle’s line—a line drawn from the IVC to just left of the gallbladder fossa

Question 12

What is the gastrinoma triangle?

Answer 12

Triangle where >90% of gastrinomas are located, bordered by:

1. Junction of the second and third portions of the duodenum
2. Cystic duct
3. Pancreatic neck

Question 13

Which artery is responsible for anterior spinal syndrome?

Answer 13

Artery of Adamkiewicz (pronounced “ah-dahm’kē-ā’vich”)

Question 14

Where is McBurney’s point?

Answer 14

One third the distance from the anterior superior iliac spine to the umbilicus (estimate of the position of the appendix)

Question 15

How can you find the appendix after you find the cecum?

Answer 15

Trace the taeniae back as they converge on the origin of the appendix

Question 16

What are the white lines of Toldt?

Answer 16

Lateral peritoneal reflections of the ascending and descending colon

Question 17

What is the strongest layer of the small bowel?

Answer 17

Submucosa (not the serosa, think: SUbmucosa = SUperior)

Question 18

Which parts of the GI tract do not have a serosa?

Answer 18

1. Esophagus
2. Middle and distal rectum

Question 19

What are the plicae circulares?

Answer 19

Plicae = folds, circulares = circular; thus, the circular folds of mucosa of the small bowel

Question 20

What are the major structural differences between the jejunum andileum?

Answer 20

Jejunum—

• long vasa rectae
• large plicae circulares
• thicker wall

Ileum—

• shorter vasa rectae
• smaller plicae circulares
• thinner wall (Think: Ileum= Inferior vasa rectae, Inferior plicae circulares, and Inferior wall)

Question 21

What are the major anatomic differences between the colon and the small bowel?

Answer 21

Colon has taeniae coli, haustra, and appendices epiploicae (fat appendages),whereas the small intestine is smooth

Question 22

How far up does the diaphragm extend?

Answer 22

To the nipples in men (fourth intercostal space; thus, the abdomen extends to the level of the nipples)

Question 23

Which dermatome is at the umbilicus?

Answer 23

T10

Question 24

What are the major layers of an artery?

Answer 24