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GSSE anatomy > Abdomen > Flashcards

Abdomen Flashcards

1
Q

what is the transpyloric plane

A

Midway between jugular notch & Pubic symphysis
Approx L1

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2
Q

Origin & insertion external oblique M

A

Lower 8 ribs
Fleshy insertion onto outer lip of iliac crest

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3
Q

Lumbar triangle of petit borders

A

Anterior - posterior border of Ext Oblique M
Floor = internal oblique M
Inferior border = iliac crest
Posterior border = anterior border of lat dorsi

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4
Q

Where does the superficial ring lie

A

Above & lateral to pubic tubercle in aponeurosis

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5
Q

Origin & insertion internal oblique m

A

Arises
- lumbar fasica
- intermediate area of ant 2/3rd of iliac crest
- lateral 2/3rd of inguinal lig
Inserts: tip of 9th costal cartilage and rectus sheath

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6
Q

Transversus abdominis origin & insertion

A

Arises - lateral 1/3rd of inguinal lig, anterior 2/3rd of inner lip of iliac crest, lumbar fascia, 12th rib, inner aspect of 6th CC where it interdigitates with diaphragm

Fuses with internal oblique into linea alba & conjoint tendon

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7
Q

Rectus abdominis origin and insertion

A

Medial head - in front of pubic symphysis
Lat - upper border of pubic crest
Insert = in front of 5-7th CC

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8
Q

What is the arcuate line

A

Where all abdoneurosis of abdominal muscles pass anterior - there is no posterior sheath

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9
Q

Contents of the rectus sheath

A

Rectus abdominis
Pyramidalis
Lower 6 thoracic nerves
Posterior intercostal vessels
Superior & inferior epigastric A

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10
Q

Blood supply of anterolateral abdo wall

A

Intercostals
Epigastrics
Lumbar
Deep circumflex iliac A (at risk in gridiron incision)

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11
Q

Lymph drainage of anterorlat abdo wall

A

Pectoral group of axillary nodes
Superficial inguinal nodes
Mediastinal

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12
Q

Nerve supply of rectus abdominis

A

Lower intercostal & subcostal N T7-12

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13
Q

Nerve supply of external oblique m

A

Lower intercostal & subcostal N t7-12

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14
Q

Nerve supply of internal oblique m

A

Lower intercostal, subcostals, T7-12, iliohypogastric & ilioinguinal

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15
Q

Nerve supply of transversus abdominis

A

Lower intercostal, subcostal, T7-12, iliohypogastric, ilioinguinal

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16
Q

What is transmitted in the inguinal canal b/w men & women

A

M = spermatic cord, ilioinguinal N
F = round lig, ilioinguinal N

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17
Q

What is the inguinal canal

A

A oblique intermuscular slit approx 4cm long, from deep to superficial ring

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18
Q

What are the walls of inguinal canal

A

2MALT

Roof = internal oblique, transversus abdominis

Anterior wall = external oblique + internal oblique aponeurosis

Floor = inguinal & lacunar lig

Posterior wall = conjoint tendon, weak transversalis

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19
Q

Where is the deep inguinal ling

A

1.25cm above midpoint of inguinal lig

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20
Q

Does the ilioinguinal N pass in the spermatic cord

A

No passes through the inguinal canal ABOVE the cord

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21
Q

what does the ilioinguinal N supply

A

Skin of inguinal region
Upper thigh
Ant 2/3rd scrotum
Root of penis

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22
Q

Hasselbach triangle boundaries

A

Medial - lateral border of rectus
Lateral - inferior epigastric A
Inferior - inguinal lig

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23
Q

What defines indirect hernia

A

Lateral to inferior epigastric A

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24
Q

What denies direct hernia

A

Medial to inferior epigastric A

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25
What is in the medial umbilical lig
Obliterated urachus
26
What is in the lateral umbilical folds
Inferior epigastric vessels
27
What is in the medial umbilical folds
Obliterated umbilical A
28
What are the coverings of the spermatic cord
Internal spermatic fascia Cremasteric fascia External spermatic fascia
29
Where does internal spermatic fascia arise
Transversalis fascia
30
Where does cremasteric fascia arise
Lateral part of inguinal lig, internal oblique & transversus abdominis
31
Where does external spermatic fascia originate
From external oblique aponeurosis
32
What are the contents of spermatic cord
Ductus deferens testicular A, artery to ductus deferens, cremasteric A Pampiniform plexus LNs Genital branch of genitofemoral N Processus vaginalis
33
Blood supply of artery
Testicular A from aorta
34
Drainage of testis
Via pampiniform plexus L = L renal V R. = IVC
35
Lymph drainage of testis
Para-aortic nodes @ L2
36
Nerve supply of testis
Sympathetic (t10 mainly) via greater/lesser splanchni nerves
37
Sertoli cells
Secrete androgen binding protein
38
Leydig cells
Secrete testosterone
39
What do seminiferous tubucles open into
Rete testis
40
What is the mesonephros in males
Other than kidneys, mainly regresses Remaining features - canal of epididymis, ductus deferens, ejaculatory duct, epididymal appendix
41
Epithelium of ductus deferens
Columnar with stereocilia
42
What does the paramesonephric duct form in women
Uterine tube & uterus
43
What are the remaining features of paramesonephric ducts in males
Appendix testis Prostatic utricle
44
What passes through transpyloric plan
Spinal cord = conus medullaris SMA leaves aorta Pylorus of stomach Head, neck, body of pancreas Lower border of L1 vertebra Kidney hilum Fundus of GB Cuts costal margin at 9th CC
45
Falciform ligament fx and content
Connect liver to supraumbilical & inferior surface of diaphragm Contains ligamentum teres
46
What is ligamentum teres
Obliterated L umbi V
47
What connects greater & lesser sac
Epiploic foamen
48
What forms the greater omentum
Gastrocolic (bw stomach & transverse colon) Gastrosplenic Lig Lienorenal lig
49
What is the attachments of lesser omentum
R side of oesophagus along lesser curve to first 2cm of dudenum L shaped liver attachment to fissure for lig venosum & porta hepatis Right free margin
50
Boundaries of epiploic foramen
Upper = caudate process of liver Lower = first part of duodenum Post = IVC with parietal peritoneum on top ant = R free margin of lesser omentum
51
What lies in the R free margin of lesser omentum
Hepatic portal V Hepatic A CBD (to the R of A)
52
What divides the supra & infracolic compartments
Transverse mesocolon
53
What further divides the infracolic compartment
Root of mesentry of Small Intestine *L to R at 45 degrees
54
What does the root of mesentry cross
aorta IVC R psoas Ureter to the R iliac fossa
55
What does the sigmoid colon lie over
L ureter Bifurcation of common iliac A Inferior mesenteric vessels Vein b/w ureter & artery
56
What supplies (nerve) parietal peritoneum
Spinal nerves Intercostal Lumbar nerves
57
Visceral peritoneum nerve supply
Afferent nerves which travel with autonomic nerves
58
What exists in the retroperitoneal space
Aorta Ivc Cisterna chyli LN + vessels Nerves (lymbar plexus, symp plexus) Kidneys Ureter Pancreas Asc & desc colon Most of duodenum Adrenal glands
59
Coeliac trunk branches
L gastric Splenic Common Hepatic A
60
L gastric A supplies
Lesser omentum to lesser curvature
61
Splenic A supply
Pancreas & spleen
62
What branches does the splenic A give rise to
Short gastric A L gastroepiploic A
63
Branches of CHA
Hepatic A proper Gastroduodenal A R gastric A
64
Branches of gastroduodenal A
R gastroepiploic Superior pancreaticoduodenal A
65
What makes the portal V
SMV & Splenic V behind neck of pancreas
66
SMA origin level
L1
67
Origin level coeliac trunk
T12
68
Branches of SMA
Inferior pancreaticoduodenal A Jejunal & ileal branches Ileocolic A R colic A Middle colic A
69
Ileocolic supplies
Anterior and posterior branches Ascending colon, caecum, appendicular A, and terminal ileum
70
Venous drainage of midgut
SMV
71
Where does IMA start
L3
72
What are the significant branches of IMA
L colic Sigmoidal A’s Sup rectal A
73
What drains to the IMV
Superior rectal V L colic Sigmoidal V
74
Where does the iMV drain
Joins splenic V mainly
75
What makes up the enteric nervous system
Myenteric (auerbacher) b/w muscle layers Submucosal (Meissner) in submucosa
76
What are the 3 main aperatures of the diaphragm and where do they pass
Aortic T12 Oesophageal T10 IVC T8
77
How does the oesophagus enter the abdomen
T10, with fibres of R crus opening to form a sling
78
What are the parts of the stomach
Cardiac notch Fundus Body Greater, lesser curvatures Pyloric part
79
What makes up the stomach bed
Posterior wall of stomach is covered by peritoneum of the anterior wall of lesser sac Splenic A Body of pancreas Transverse mesocolon L upper part of kidey L suprarenal Spleen L colic flexure
80
Blood supply to stomach
(From coeliac trunk) L + R gastric A = lesser Short gastric A L+R gastroepiploic A = greater
81
Stomach lymph drainage
Coeliac nodes
82
Nerve supply to stomach
Sympathetic (Vasomotor) Afferent (pain) PSNS from vagi = anterior and posterior vagal trunks
83
Where does the anterior and posterior vagal trunks arise
Anterior = L vagus Post = R bagus
84
What does a vagotomy due to the stomach
Decrease gastric secretion Cause gastric stasis
85
What are the parts of the duodenum
1st part = L1, superior 2nd = L2, desc 3rd = L3, horizontal 4th = L2, ascending
86
How is the fourth part fixed to the L psoas
Via a fibrous tissue & suspensory muscle of duodenum (lig of treitz)
87
Blood supply to duodenum
Superior and inferior pancreaticoduodenal A In the first 2cm = hepatic, gastroduodeeal, supraduodenal, R gastric & r gastroepiploic
88
Features that differentiate jejunum, ileum
Jejunum = wider bore, thicker walled, arterial arcades are visible as the mesenteric fat does not stretch that far I = peyers patches
89
Nerve supply to small intestines (jejunum, ileum)
PSNS = peristaliss Symp vasoconstriction from lateral horns of T9, T10
90
Blood supply to jejunum
Arterial arcades from SMA Occlusion may cause infarction, as they are end arteries
91
Ileum blood supply
SMA, arcades
92
Lymph drainage of Small intestine
Sup mesenteric nodes
93
Caecum blood supply
Ileocolic A => Ant, post caecal A
94
Appendix - how to find
Convergence of 3 taeniae coli
95
Where is appendix located
Posteromedial wall of caecum 2cm below Ileocolic valve
96
Most common position of appendix at appendectomy OT
Retrocaecal (In the absence of pathology = retroileal)
97
What is the blood supply of appendix
Appendicular A, off post caecal A (from ileocolic A)
98
Which aspects of the colon are retro/intraperitoneal
Ascending/descending colon = retroperitoneal Sigmoid, transverse colon = has mesentry
99
Blood supply of colon
SMA to asc + prox 2/3rd of transverse colon - ileocolic, R colic, middle colic IMA to rest - L colic & sigmoid branches
100
Watershed areas of the colon
L colic flexure, b/w midgut & hindgut vessels, b/w middle colic & L colic
101
Lymph drainage of colon
Sup, inf mesenteric nodes
102
Nerve supply to colon
PSNS from vagi, pelvic splanchnics SNS from T10-12
103
Where does ligamentum teres lie
In free lower margin of falciform ligament, notched on inferior border of ligament
104
What are the lobes of the liver
L, r, caudate (upper), quadrate
105
Aspects & location of gallbladder
Cystic duct - close to the.R end of porta hepatis Neck is highest Fundus is lowest
106
What lies b/w GB and fissure for lig teres
Quadrate lobe
107
What is in contact with bare area of liver
IVC, diaphragm
108
What is the falciform ligament
Remnant of ventral mesentery of fetus
109
What does the falciform lig contain
Lig teres
110
What is the lig teres
Obliterated L umbi V
111
What is the lig venosum
Obliterated ductus venosus
112
What borders the caudate lobe
IVC, lig venosum, porta hepatis
113
What borders the quadrate lobe
GB, lig teres, porta hepatis
114
What is the blood supply to the liver
2 sources - hepatic A (from coeliac trunk) - portal V
115
How does the liver drain into the IVC
Three main hepatic V
116
Nerve supply of the liver
Sns + vagal fibres from hepatic branch of anterior vagal trunk reach the porta hepatis via lesser omentum
117
What forms the CHD
R+L hepatic ducts
118
What forms the CBD
CHD + Cystic duct
119
What is the capacity of GB
50ml
120
Where is the fundus of GB found (surface)
9th CC tip, transpyloric plane
121
Blood supply to GB
Via cystic A from R hepatic A
122
What makes up calots triangle
Liver, CHD, cystic duct
123
What passes through calot’s triangle
Cystic A
124
Length and size of cystic duct
2-3cm in length, 2-3mm in diameter
125
CBD length and diameter
6-8cm , <8mm
126
What are the three parts of the CBD
Supra, retro and paraduodenal
127
Where does the CBD end
With the pancreatic duct at an angle of 60 degrees at ampulla of vater, into 2nd part of duodenum into major duodenal papilla
128
Where does the major duodenal papilla lie
2nd part of duodenum, 10cm from pylorus
129
What is the blood supply of biliary tract
Cystic A R hepatic A Post branch of sup pancreaticoduodenal A
130
Nerve supply to biliary tract
Hepatic branch of anterior vagal trunk SNS (coeliac ganglia) CCK (hormonal) Afferent from t7-8
131
What is the role of PSNS in biliary tract
Stimulate contraction of GB & relax sphincter of oddi
132
How does the portal V divide in the porta hepatis
Into R+L branches in T shape
133
What are the sites of porto-systemic anastomosis
Periumbilical region Lower end of oesophagus Bare area of liver Upper end of anal canal Retroperitoneal areas
134
Areas of the pancreas
head, neck, body, tail, uncinate process
135
What is the fx of pancreas
Exocrine, endocrine
136
Blood supply to the pancreas
Splenic A Superior, inferior pancreaticoduodenalA
137
Nerve supply of pancreas
Posterior vagal trunk Coeliac plexus SNS vasoconstrictors (via splanchnics)
138
Spleen ligaments
Gastrosplenic lig Lienorenal lig
139
Where does the tail of pancreas lie
In lienorenal lig
140
Blood supply of spleen
Splenic A
141
Lymph drainage of spleen
Coeliac nodes
142
Nerve supply to spleen
Coeliac plexus from SNS only
143

GSSE anatomy (8 decks)

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