Abdo Flashcards
Borders of the femoral canal Medial Lateral Anterior Posterior
Medial: lacunar ligament
Lateral: femoral vein
Anterior: inguinal ligament
Posterior: pectineal ligament of cooper
Content of the femoral canal
Fat
Cloquets nodes
Contents of the male Inguinal canal
Spermatic cord
Ilioinguinal nerve
Contents of the female inguinal canal
️round ligament
Ilioinguinal nerve
Geniculate branch of genfem nerve
Content of spermatic cord
3 layers of fascia
3 ateries
3 veins
2 nerves
Hesselbachs triangle
Medial: ️rectus abdominis
Lateral: inferior epigastric artery
Inferior: inguinal ligament
Border of the inguinal canal
- anterior
- posterior
- floor
- roof
Anterior: external oblique and internal oblique for lateral third
Posterior: transversalis fascia and conjoint tendon for medial third
Floor: inguinal ligament
Roof: arching fibres of transversus and internal oblique
4 parts of dueodenum
D1: dueodenul cap - commonest place for dueodenul ulcers, overlapped by gall bladder
D2 : descending part, contains major dueodenul papilla
D3: inferior part - can be compressed by SMA anneryseum
D4: ascending part, end at dj flexure/ligament of trietz
Denate line
Sqaumomucosal junction
White line
Where anal canal becomes true skin
Calot triangle margins
Superior- inferior edge of ️liver
Medial : common hepatic duct and right hepatic duct
Inferior - cystic ducts
Contents of calot triangle
Cystic atery
Also - calots/Lund node, abberent hepatic artery
Innervation of the abdominal wall
Intercostal nerves T7-T11
Subcostal nerve - T12
Ilio-inguinal and ilio-hypo gastric nerves - l1
Blood supply to the abdominal wall
Superior: superficial - musculophrenic artery, Deep - superficial epigastric
Inferior: superficial - 2 branches of the femorals, deep- branches of the external iliac
Where is the arcuate line of Douglas
Midway between the umbilicus and the pubic symphysis
Above the arcuate line the rectus sheath complelty encloses the rectus muscle, this allows expansion of the pelvic content into the abdomen
Position of the gallbladder
Where the midclavicular line meets the right costal margin in 9th costal cartilidge
Position of the appendix
Base is consistently found at confluence of the caecal taeni coli however the rest of the position is very variable
- retroceaceal - 75%
- sub-caecal and pelvic - 20%
- retro or pre-Illeal - 5%,
Why do you initially have central abdominal pain in appendicitis
Visceral pain is carried by the lesser splanchic nerve which refers to the t10 dermatome
What is the ano rectal ring
Deep segment of external sphincter which is continuous with puboretalis muscle which is part of levator Ani
About 5cm away from the anal canal and demarcates the junction between the anal canal and the rectum
Must be preserved to maintain conintence
Common areas for collection
Subphrenic recess Hepatorenal recess - Morrison's pouch Lesser sac Paracolic gutters Small bowel - interloop spaces Pelvis: pouch of Douglas
Branches of Coeliac trunk
Left gastric
Common hepatic
Splenic
Branches of the super mesenteric artery
Inferior pancreaticodueodenal Ileal mans jejunal vessels Middle colic Right colic Ileocolic
Branches of the inferior mesenteric artery
Left colic
Sigmoidal branches
Superior rectal artery
Marginal artery of Drummond
Anastomotic artery between middle colic and ascending branch of left colic which may maintian hind gut blood supply even when IMA is stenosed
Splanchnic nerve - innervation and root
Greater Splanchnic nerve (T5-T10) = foregut
Lesser Splanchnic nerve (T10-T11) = midgut
Least Splanchnic nerve (T12) = kidney
Lumbar Splanchnic nerves (L1-L2) = hindgut
Two layers of enteric nervous system
Myenteric plexus of Auerbach
Submucosal plexus of Meisner
Places of ureteric narrowing
Pelviureteric junction
Crossing the iliac vessels at the brim
Vesicoureteric junction
Retroperitoneal organs
SAD PUCKER Suprenal - adrenal glands Aorta/IVC Dueodenum - 2nd and 3rd parts Pancreas - except tail Ureters Colon - ascending and descending Kidney Esophegous Rectum
