Abdomen Flashcards by Lucy Lee-Smith

Contents of inguinal canal

men: ilioinguinal nerve and spermatic cord
women: ilioinguinal nerve and round ligament of uterus

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Relations of hasselbach triangle

lateral: inferior epigastric vessels
inferior: inguinal ligament
medial: rectus

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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)

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Contents of femoral canal

Lymphatics
Cloquet’s node
Fat

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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

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Relation of inferior epigastric vessels direct vs indirect hernia

indirect = lateral to inferior epigastric vessels
direct = medial to inferir epigastric vessels

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Relation of pubic tubercle inguinal vs femoral hernia

inguinal = above and medial to pubic tubercle
femoral = below and lateral to pubic tubercle

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Kocher’s incision location and layers

Subcostal

skin
subcut
campers
scarpas
external oblique
internal oblique

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Giridion incision location and layers

mcburney’s
Skin, campers, scarpers lower end, ext oblique aponeurosis, int oblique muscle, transversus muscle, extraperitoneal fat, peritoneum

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Midline incision location and layers

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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

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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

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Layers of spermatic cord

external oblique forms external spermatic fascia
internal oblique forms cremaster fascia
transversalis fascia forms internal spermatic fascia

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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

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Contents of epiploic foramen

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Borders of epiploic foramen

freemargin lesser ommentum - hepatic artery, bile duct, portal vein
first part duodenum
IVC
caudate process liver

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What is the epiploic foramen

communication between greater and lesser sac
at T12

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What is the lesser sac

smaller part of the abdominal cavity, behind the stomach and lesser ommentum
Allows expansion of the stomach

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Retroperitoneal organs

SAD PUCKER
Suprarenal gland
Aorta and IVC
Duodenum - second part
Pancreas
Ureters
Colon - ascending and descending
Kidneys
Esophagus
Rectum

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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

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Rutherford Morrison Incision

Above the inguinal ligament

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Gallbladder blood supply

cystic artery (branch of right hepatic, branch of common hepatic, branch of coeliac axis)

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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?

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

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