Abdomen Flashcards
Contents of inguinal canal
men: ilioinguinal nerve and spermatic cord
women: ilioinguinal nerve and round ligament of uterus
Relations of hasselbach triangle
lateral: inferior epigastric vessels
inferior: inguinal ligament
medial: rectus
Relations of femoral canal
anterior: inguinal ligament
posterior: pectineal ligament
medial: lacunar ligament (beware abnormaml obturator artery)
lateral: femoral vein (purpose is to allow expansion of femoral vein)
Contents of femoral canal
Lymphatics
Cloquet’s node
Fat
Contents of femoral sheath
and what it is made of
Femoral artery (and genitofemoral branch of femoral nerve)
Femoral vei
Femoral canal
anteriorly it is an extension of transversalis fascia and iliacus fascia posteriorly
Relation of inferior epigastric vessels direct vs indirect hernia
indirect = lateral to inferior epigastric vessels
direct = medial to inferir epigastric vessels
Relation of pubic tubercle inguinal vs femoral hernia
inguinal = above and medial to pubic tubercle
femoral = below and lateral to pubic tubercle
Kocher’s incision location and layers
Subcostal
skin
subcut
campers
scarpas
external oblique
internal oblique
Giridion incision location and layers
mcburney’s
Skin, campers, scarpers lower end, ext oblique aponeurosis, int oblique muscle, transversus muscle, extraperitoneal fat, peritoneum
Midline incision location and layers
Paramedian incision location and layers
2.5cm lateral to the midline
skin
superficial fascia
anterior rectus sheath and intersecting tendons, segmental vessels
rectus muscle
posterior rectus sheath ( only transversalis fascia below arcuate line)
extraperitoneal fat
peritoneum
Battle incision location and layers
pararectus
lateral border rectus umbilical level
skin
campers fascia
scarpas fascia
anterior rectus sheath
rectus
posterior rectus sheath
extraperitoneal fat
peritoneum
Layers of spermatic cord
external oblique forms external spermatic fascia
internal oblique forms cremaster fascia
transversalis fascia forms internal spermatic fascia
Where does the fluid go when bulbous urethra ruptures and why
scrotum, perineum, penis, abdominal wall deep to scarpa’s fascia because of the attachment of scarpas fascia to the deep thigh 2.5cm below inguinal ligament
Contents of epiploic foramen
Borders of epiploic foramen
freemargin lesser ommentum - hepatic artery, bile duct, portal vein
first part duodenum
IVC
caudate process liver
What is the epiploic foramen
communication between greater and lesser sac
at T12
What is the lesser sac
smaller part of the abdominal cavity, behind the stomach and lesser ommentum
Allows expansion of the stomach
Retroperitoneal organs
SAD PUCKER
Suprarenal gland
Aorta and IVC
Duodenum - second part
Pancreas
Ureters
Colon - ascending and descending
Kidneys
Esophagus
Rectum
Structures along transpyloric plane
Level of L1
Pylorus
Hilum of kidney
Pancreas - neck
Fundus of gallbladder
Hilum of spleen
Second part duodenum
DJ flexure
SMA origin
12th costal cartilage
Termination of cord
Portal vein origin
Rutherford Morrison Incision
Above the inguinal ligament
Gallbladder blood supply
cystic artery (branch of right hepatic, branch of common hepatic, branch of coeliac axis)
Branches of coeliac axis
left gastric
splenic
common hepatic
Branches of SMA
ileocolic
right colic
middle colic
Branches of IMA
left colic
sigmoid
superior rectal
Hepatobiliary triangle borders and contents
liver, common hepatic duct, cystic duct
contains cystic artery
Rectum blood supply
superior rectal (IMA)
middle rectal (internal iliac)
inferior rectal (internal pudendal)
Rectal fascia
anterior - demonvilliers
posterior - waldeyers
Lymphatic drainage rectum
above dentate line = mesorectal
below dentate line = inguinal
Where does the inferior mesenteric vein drain into
splenic vein
what is each half of the circle of willis made up of?
anterior cerebellar
anterior communicating
internal carotid
posterior communicating
posterior cerebellar
Branches of the basillar arter
posterior cerebellar
superior cerebellar
pontine
labrynthine
anterior inferior cerebellar
vertebrals
Internal carotid branches
anterior cerebral
middle cerebral
anterior choroidal
anterior posterior communicating
Signs of middle cerebral artery occlusion
contralateral face and arm weakness. motor and sensory
Layers of meninges
bone
dura
arachnoid
pia
Do dural venous sinuses have valves?
no
Where do dural venous sinuses drain into and which one does this directly?
IJV
sigmoid sinus
Which cranial nerve is most t risk of raised ICH and why?
abduces
long path
What causes a cavernous sinus thrombosis?
infection
superficial - facial or ophthalmic veins
deep - pterygoid plexus
cavernous sinus tumour
Constrictions of the oesophagus
A. aortic arch
B. bronchus - left main
C. cricoid cartilage
D. Diaphragmatic hiatus - T10
Innervation oesophagus
upper 1/2 recurrent laryngeal
lower 1/2 - oesophageal plexus - vagus
Epithelium oesophagus
non-kertinised squamous
epithelium gallbladder
collumnar
muscle oesophagus
striated to smooth
Which parts of the liver are extraperitoneal?
bare area (marked by coronal ligaments)
porta hepatis
gallbladder fossa
what is the liver capsule called and what is it innervated by?
glissons
lower intrcostals
lobes of the liver
technically 2, really 4
right and left
right is bigger, also contains caudate and quadrate
caudate - venous ligament and IVC groove
quadrate - roud ligament to gallbladder fossa
what is morsions pouch
recess between liver and right kidney. deepest art of peritoneaum.
fluid collection lying down for a lng time
arrangement of liver lobules
hexagon
central vein
portal triad
central vein > colelcting veins > hepatic veins > IVC
portal triad
- bile duct
- arteriole from hepatic artery
- venule from portal vein
what demarcates the rigt and left lobes of the liver
falciform ligament
what is ligament teres
remnant of umbilical vein
and hip
how many fucntional lobes of the liver
8
how many hepatic veins
3
central right and lift
which segments removed in a right hemihepatectomy
V VI VII VIII
anatomically which lobe is the fourth segment part of and what section is it part of functinally
anatomically right lobe
functionally left
fucntional division made by line between gallbladder and IVC
how are structures arranged at the free edge of lesser ommentum?
bile duct aterior and right
hepatic artery anterior and left
portal vein posterior
IVC posterior, searated by epiploic foramen
what is pringles manaeurver
compressing portal vein and hepatic artery if bleeding occurs during cholecystectomy by pressing on free edge lesser ommentum
