Abdomen Flashcards

1
Q

What are the bony landmarks that define the borders of the abdomen?

A

xiphoid process, inferior border of costal cartilages, iliac crest, inguinal ligament, public bone

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2
Q

What rib level is the highest part of the diaphragm?

A

5th intercostal space

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3
Q

what is the subcostal plane?

A

axial line between the lowest part of the thoracic cage either ribs or costal cartilages - at level L3

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4
Q

Where is the intertubercular plane?

A

axial line between the ASIS - at level L5

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5
Q

What are the four lines that divide the abdomen into 9 sections?

A

subcostal plane, intertubercular plane and both mid-clavicular lines

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6
Q

what are the names of the 9 sections of the abdomen?

A

hypochondrium x2, epigastrium, flank x2, umbilical region, iliac x2, supra-pubic/hypogastrium,

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7
Q

Where is the transpyloric plane?

A

axial line across tips of 9th rib, the most lateral point where rectus abdominis attaches at level L1

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8
Q

Where is mc-burney’s point?

A

2/3rd of the way from the umbilicus to the ASIS

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9
Q

What are the three muscle layers of the abdomen?

A

external oblique, internal oblique, transversus abdominis

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10
Q

At which point do the 3 abdominal wall muscle layers aponeurose?

A

Mid-clavicular line

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11
Q

Where does the rectus abdominis muscle attach to?

A

O: pubic crest
I: ribs 5,6,7, xiphoid process

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12
Q

What is an aponeurosis?

A

also known as rectus sheath, a sheet of tendinous tissue

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13
Q

What is the linea alba?

A

fibrous structure down the midline of the abdomen - no structures cross

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14
Q

What are the two most superficial layers of fascia in the abdomen?

A

campers and scarpa’s fascia

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15
Q

What is campers fascia?

A

The most superficial fatty fascial layer of the abdomen

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16
Q

What is scarpa’s fascia?

A

The second-most superficial membranous fascial layer of the abdomen

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17
Q

Does the rectus sheath lie in-front of or behind rectus abdominis?

A

upper 2/3rds: surrounds muscle
lower 1/3rd: lies in-front of muscle

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18
Q

Does the internal oblique aponeurosis lie behind or in-front of rectus abdominis?

A

upper 2/3rds: half goes behind and half in front
lower 1/3rd: all in front

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19
Q

Which nerve covers the dermatome that includes the umbilicus?

A

T10

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20
Q

Which nerve covers the dermatome that includes the hair-bearing area of the pubis?

A

L1

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21
Q

What nerve roots does the greater splanchnic nerve come from? (Foregut)

A

T5-T9

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22
Q

What nerve roots does the lesser splanchnic nerve come from? (Midgut)

A

T10, T11

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23
Q

What nerve root does the least splanchnic nerve come from? (Hindgut)

A

T12

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24
Q

What are the four muscles of the abdominal wall?

A

ext oblique, int oblique, transversus abdominis, rectus abdominis

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25
Q

what is the falciform ligament?

A

carries ligamentum teres from umbilicus to left portal vein

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26
Q

At what level does the oesophagus pass through the diaphragm?

A

T10

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27
Q

What are the five parts of the stomach?

A

Fundus, cardia, body, antrum, pylorus

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28
Q

Where is the pyloric sphincter?

A

Between the stomach and the duodenum

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29
Q

At what point does the duodenum become the jejunum?

A

When it develops a mesentery

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30
Q

Which part of the large bowel comes first in the digestive tract?

A

Caecum - with appendix

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31
Q

What are the two flexures of the large bowel called?

A

Hepatic and splenic flexure

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32
Q

What divides the right and left infra-colic department?

A

Small bowel mesentery

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33
Q

Where is the greater omentum attached to?

A

The greater curve of the stomach

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34
Q

Where is the lesser omenrum attached to?

A

The lesser curve of the stomach, the duodenum and the liver

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35
Q

Where is the lesser sac?

A

Behind the lesser omentum

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36
Q

What is the foramen of winslow/epiploic foramen?

A

The opening into the lesser sac

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37
Q

what are the two arteries that supply the lesser curve of the stomach?

A

right gastric (from common hepatic), left gastric artery (from coeliac trunk)

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38
Q

What are the two arteries that supply the greater curve of the stomach?

A

left (from splenic) and right (from gastroduodenal artery) gastro-epiploic or gastro-omental arteries

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39
Q

What is the blood supply to the fundus of the stomach?

A

short and posterior gastric artery - branches of splenic artery

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40
Q

What is the blood supply to the pylorus of the stomach?

A

Gastroduodenal artery - branch of common hepatic

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41
Q

What is the omentum made up of?

A

Two double layers of peritoneum containing a neurovascular bundle and lymphatics

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42
Q

Which organ lies directly behind the lesser sac?

A

The pancreas

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43
Q

What is the name of the folds of the stomach wall?

A

Rugae

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44
Q

Where is the duodenal-jejunal flexure?

A

left upper quadrant deep to the transverse colon, where the small bowel comes through the peritoneum

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45
Q

Which areas of the large bowel are mobile?

A

Transverse and sigmoid colon - attached via mesentery

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46
Q

Name some differences between the large and small intestine

A

lg: teniae coli, epiploic appendages, haustra,
sml: peyer’s patches, smooth wall, villi inside

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47
Q

What is the difference between the jejunum and ileum blood supply?

A

J: larger vessels, Long arcades, long vasa recti
I: smaller vessels, much more smaller arcades, short vasa recti

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48
Q

What is the name of the folds in the jejunum?

A

Plicae circulares

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49
Q

What are the four things that the small bowel has to increase its surface area?

A

Length, plicae circulares, villi, microvilli

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50
Q

What is the difference between the jejunum and ileum?

A

fewer plicae circulares in the ilium. more peyers patches in ilium, more fat in mesentery of ileum

51
Q

What are haustra?

A

Small pouches in the bowel caused by sacculation

52
Q

What is the blood supply to the thoracic oesophagus?

A

inferior thyroid artery, direct from the aorta, left gastric

53
Q

What is the blood supply to the abdominal aorta?

A

oesophageal artery branches from left gastric artery

54
Q

What are the five parts of the pancreas?

A

tail, body, neck head, uncinate process

55
Q

What are the four parts of the duodenum?

A

Superior, descending, inferior, ascending

56
Q

In which part of the duodenum do the papillas exist?

A

Descending portion

57
Q

What are the attachments of the diaphragm?

A

lumbar vertebrae, costal cartilages of ribs 7-10, ribs 11-12, xiphoid process

58
Q

What are the attachments of the crura of the diaphragm?

A

right: L1-L3
Left: L1-L2

59
Q

What structures pass through the diaphragm at T8?

A

Inferior vena cava, right phrenic nerve

60
Q

What structures pass through the diaphragm at T10?

A

oesophagus, right and left vagus nerve, left gastric artery and vein

61
Q

What structures pass through the diaphragm at T12?

A

Aorta, thoracic duct, azygous vein

62
Q

At which level does the aorta bifurcate?

A

L4/L5

63
Q

What is the surface marking of the gallbladder?

A

Midclavicular line, tip of 9th costal cartilage

64
Q

Where is pain from the gallbladder felt?

A

Epigastric T5,6,7,8,9 supplies gallbladder - so those dermatomes

65
Q

Where is pain felt if the gallbladder rubs on the peritoneum?

A

Sharp pain at tip of 9th rib

66
Q

Where is pain felt if the gallbladder rubs on the diaphragm?

A

Tip of the right shoulder, C3/4/5 supplies the diaphragm

67
Q

What are the three main branches of the coeliac trunk?

A

Common hepatic artery, left gastric artery and splenic artery

68
Q

Where is bile produced?

A

The liver

69
Q

What is the portal triad made up of?

A

Hepatic artery, common bile duct and hepatic portal vein

70
Q

What separates the right and left lobe of the liver?

A

The falciform ligament

71
Q

From which area of the digestive tract does the portal vein drain blood from?

A

Lower 1/3rd of oesophagus to rectum

72
Q

Where does the IVC sit in relation to the liver?

A

Posterior to the anatomical middle of the liver

73
Q

What are the four lobes of the liver?

A

Left, right, caudate, quadrate lobe

74
Q

What structures does the caudate lobe of the liver sit between?

A

IVC and attachment to lesser omentum

75
Q

Where is the anterior coronary ligament?

A

Antero-superior aspect of the right lobe of the liver, just above the bare area of the liver. Attachment of peritoneum to liver.

76
Q

Where is the posterior coronary ligament?

A

Postero-superior aspect of the right lobe of the liver. Attachment of peritoneum to liver.

77
Q

Where is the left triangular ligament of the liver?

A

On the superior aspect of the left lobe of the liver

78
Q

Which artery do the short gastric arteries arise from?

A

Splenic artery

79
Q

Which two veins join to form the hepatic portal vein?

A

Superior mesenteric vein and splenic vein

80
Q

What is the sphincter of oddi?

A

The sphincter that controls bile release from the common bile duct and pancreatic duct into the duodenum

81
Q

What is the ampulla of vater?

A

Formed by the joining of the common bile duct and pancreatic duct at the major duodenal papilla

82
Q

Do the pancreatic and common bile duct join before or after the sphincter of oddi?

A

After - to prevent refluxing of ductal contents. The sphincter still controls outputs from both ducts

83
Q

What level is the subcostal plane?

A

L3

84
Q

What level is the intertubercular plane?

A

L5

85
Q

Name the two superficial branches of the lower intercostal nerves

A

anterior and lateral cutaneous

86
Q

What does the iliohypogastric nerve supply?

A

Transversus abdominis, internal oblique, conjoint tendon

87
Q

What is the path of the iliohypogastric nerve?

A

L1 - travels posterior to kidneys - pierces transversus abdominis - continues between trans abdo and internal oblique

88
Q

What is the conjoint tendon?

A

aponeurosis of trans abdo and internal oblique

89
Q

What are the actions of external oblique?

A

ipsilateral trunk lateral flexion, contralateral trunk rotation

90
Q

What are the actions of internal oblique?

A

ipsilateral trunk lateral flexion, ipsilateral trunk rotation

91
Q

What are the attachments of the inguinal ligament?

A

ASIS and pubic tubercle

92
Q

Which blood vessel lies posterior to the caecum?

A

Gonadal vessel

93
Q

What level do the testicular arteries come off the aorta?

A

L2

94
Q

What level is the coeliac trunk?

A

T12

95
Q

What level is the superior mesenteric artery?

A

L1

96
Q

What level is the inferior mesenteric artery?

A

L3

97
Q

At what level does the aorta bifurcate?

A

L4

98
Q

What level do the common iliac arteries bifurcate?

A

L5

99
Q

What level does the left renal artery come of the aorta?

A

L1

100
Q

What is the nerve supply to the upper half of the oesophagus?

A

Recurrent laryngeal nerve

101
Q

Where is the superficial inguinal ring?

A

1.25cm above the pubic tubercle

102
Q

Where is the deep inguinal ring?

A

At the midpoint of the inguinal ligament, 1.25cm above the ligament

103
Q

What is the deep inguinal ring?

A

An invagination of the transversalis fascia

104
Q

What is the superficial inguinal ring?

A

A triangular gap within the aponeurosis of external oblique

105
Q

What forms the anterior wall of the inguinal canal?

A

Aponeurosis of external oblique (A)

106
Q

What forms the posterior wall of the inguinal canal?

A

Transversalis fascia, conjoint tendon (T)

107
Q

What forms the roof of the inguinal canal?

A

Conjoint tendon - made up of internal oblique and transversus abdominis (M)

108
Q

What forms the floor of the inguinal canal?

A

Inguinal ligament and lacunar ligament (L)

109
Q

What are the contents of the inguinal canal?

A

Spermatic cord (m), round ligament (f), ilioinguinal nerve and genital branch of the genitofemoral nerve

110
Q

What does the lateral (inferior) crus of the superficial inguinal ring attach onto?

A

Fibres arch over the contents of the inguinal canal and attach onto the Pubic tubercle

111
Q

What does the medial (superior) crus of the superficial inguinal ring attach onto?

A

Pubic crest

112
Q

What do the intercrural fibres of the superficial inguinal ring do?

A

Stop the crura from spreading apart

113
Q

Which ring does the ilioinguinal nerve pass through?

A

Superficial inguinal ring. It enters the canal part way through the roof, and does not go through the deep ring

114
Q

Which nerve passes through both rings of the inguinal canal?

A

The genital branch of the genitofemoral nerve

115
Q

What are the attachments of the internal oblique muscle?

A

O: anterior 2/3rds of iliac crest
I: Ribs 10-12, linea alba

116
Q

What are the attachments of the external oblique muscle?

A

O: ribs 5-12
I: Linea alba, pubic tubercle

117
Q

What are the attachments of transversus abdominis muscle?

A

O: Ribs 7-12, anterior 2/3rds of iliac crest
I: linea alba, pubic crest, aponeurosis of internal oblique

118
Q

Where does the abdominal linea alba run from?

A

xiphoid process to pubic symphysis

119
Q

What are the attachments of rectus abdominis?

A

O: Pubic symphysis, pubic crest
I: Xiphoid process, costal cartilages of ribs 5-7

120
Q

What is the function of the pyramidalis muscle?

A

It tenses the linea alba, acting with abdominal wall muscles to increase intra-abdominal pressure

121
Q

What are the attachments of the pyramidalis muscle?

A

O: Pubic crest, pubic symphysis
I: Linea alba

122
Q

What artery does the inferior epigastric artery come off?

A

External Iliac artery

123
Q

Where does the inferior epigastric artery lie in relation to the inguinal canal?

A

The arteries lie just medially to the deep inguinal ring, and arise just superiorly to the inguinal ligament

124
Q
A