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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
Q

What is in the medial umbilical lig

A

Obliterated urachus

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26
Q

What is in the lateral umbilical folds

A

Inferior epigastric vessels

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27
Q

What is in the medial umbilical folds

A

Obliterated umbilical A

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28
Q

What are the coverings of the spermatic cord

A

Internal spermatic fascia
Cremasteric fascia
External spermatic fascia

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29
Q

Where does internal spermatic fascia arise

A

Transversalis fascia

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30
Q

Where does cremasteric fascia arise

A

Lateral part of inguinal lig, internal oblique & transversus abdominis

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31
Q

Where does external spermatic fascia originate

A

From external oblique aponeurosis

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32
Q

What are the contents of spermatic cord

A

Ductus deferens
testicular A, artery to ductus deferens, cremasteric A
Pampiniform plexus
LNs
Genital branch of genitofemoral N
Processus vaginalis

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33
Q

Blood supply of artery

A

Testicular A from aorta

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34
Q

Drainage of testis

A

Via pampiniform plexus
L = L renal V
R. = IVC

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35
Q

Lymph drainage of testis

A

Para-aortic nodes @ L2

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36
Q

Nerve supply of testis

A

Sympathetic (t10 mainly) via greater/lesser splanchni nerves

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37
Q

Sertoli cells

A

Secrete androgen binding protein

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38
Q

Leydig cells

A

Secrete testosterone

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39
Q

What do seminiferous tubucles open into

A

Rete testis

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40
Q

What is the mesonephros in males

A

Other than kidneys, mainly regresses
Remaining features - canal of epididymis, ductus deferens, ejaculatory duct, epididymal appendix

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41
Q

Epithelium of ductus deferens

A

Columnar with stereocilia

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42
Q

What does the paramesonephric duct form in women

A

Uterine tube & uterus

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43
Q

What are the remaining features of paramesonephric ducts in males

A

Appendix testis
Prostatic utricle

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44
Q

What passes through transpyloric plan

A

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

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45
Q

Falciform ligament fx and content

A

Connect liver to supraumbilical & inferior surface of diaphragm
Contains ligamentum teres

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46
Q

What is ligamentum teres

A

Obliterated L umbi V

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47
Q

What connects greater & lesser sac

A

Epiploic foamen

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48
Q

What forms the greater omentum

A

Gastrocolic (bw stomach & transverse colon)
Gastrosplenic Lig
Lienorenal lig

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49
Q

What is the attachments of lesser omentum

A

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

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50
Q

Boundaries of epiploic foramen

A

Upper = caudate process of liver
Lower = first part of duodenum
Post = IVC with parietal peritoneum on top
ant = R free margin of lesser omentum

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51
Q

What lies in the R free margin of lesser omentum

A

Hepatic portal V
Hepatic A
CBD (to the R of A)

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52
Q

What divides the supra & infracolic compartments

A

Transverse mesocolon

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53
Q

What further divides the infracolic compartment

A

Root of mesentry of Small Intestine *L to R at 45 degrees

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54
Q

What does the root of mesentry cross

A

aorta
IVC
R psoas
Ureter to the R iliac fossa

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55
Q

What does the sigmoid colon lie over

A

L ureter
Bifurcation of common iliac A
Inferior mesenteric vessels
Vein b/w ureter & artery

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56
Q

What supplies (nerve) parietal peritoneum

A

Spinal nerves
Intercostal
Lumbar nerves

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57
Q

Visceral peritoneum nerve supply

A

Afferent nerves which travel with autonomic nerves

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58
Q

What exists in the retroperitoneal space

A

Aorta
Ivc
Cisterna chyli
LN + vessels
Nerves (lymbar plexus, symp plexus)
Kidneys
Ureter
Pancreas
Asc & desc colon
Most of duodenum
Adrenal glands

59
Q

Coeliac trunk branches

A

L gastric
Splenic
Common Hepatic A

60
Q

L gastric A supplies

A

Lesser omentum to lesser curvature

61
Q

Splenic A supply

A

Pancreas & spleen

62
Q

What branches does the splenic A give rise to

A

Short gastric A
L gastroepiploic A

63
Q

Branches of CHA

A

Hepatic A proper
Gastroduodenal A
R gastric A

64
Q

Branches of gastroduodenal A

A

R gastroepiploic
Superior pancreaticoduodenal A

65
Q

What makes the portal V

A

SMV & Splenic V behind neck of pancreas

66
Q

SMA origin level

A

L1

67
Q

Origin level coeliac trunk

A

T12

68
Q

Branches of SMA

A

Inferior pancreaticoduodenal A
Jejunal & ileal branches
Ileocolic A
R colic A
Middle colic A

69
Q

Ileocolic supplies

A

Anterior and posterior branches
Ascending colon, caecum, appendicular A, and terminal ileum

70
Q

Venous drainage of midgut

A

SMV

71
Q

Where does IMA start

A

L3

72
Q

What are the significant branches of IMA

A

L colic
Sigmoidal A’s
Sup rectal A

73
Q

What drains to the IMV

A

Superior rectal V
L colic
Sigmoidal V

74
Q

Where does the iMV drain

A

Joins splenic V mainly

75
Q

What makes up the enteric nervous system

A

Myenteric (auerbacher) b/w muscle layers
Submucosal (Meissner) in submucosa

76
Q

What are the 3 main aperatures of the diaphragm and where do they pass

A

Aortic T12
Oesophageal T10
IVC T8

77
Q

How does the oesophagus enter the abdomen

A

T10, with fibres of R crus opening to form a sling

78
Q

What are the parts of the stomach

A

Cardiac notch
Fundus
Body
Greater, lesser curvatures
Pyloric part

79
Q

What makes up the stomach bed

A

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
Q

Blood supply to stomach

A

(From coeliac trunk)
L + R gastric A = lesser
Short gastric A
L+R gastroepiploic A = greater

81
Q

Stomach lymph drainage

A

Coeliac nodes

82
Q

Nerve supply to stomach

A

Sympathetic (Vasomotor)
Afferent (pain)
PSNS from vagi = anterior and posterior vagal trunks

83
Q

Where does the anterior and posterior vagal trunks arise

A

Anterior = L vagus
Post = R bagus

84
Q

What does a vagotomy due to the stomach

A

Decrease gastric secretion
Cause gastric stasis

85
Q

What are the parts of the duodenum

A

1st part = L1, superior
2nd = L2, desc
3rd = L3, horizontal
4th = L2, ascending

86
Q

How is the fourth part fixed to the L psoas

A

Via a fibrous tissue & suspensory muscle of duodenum (lig of treitz)

87
Q

Blood supply to duodenum

A

Superior and inferior pancreaticoduodenal A
In the first 2cm = hepatic, gastroduodeeal, supraduodenal, R gastric & r gastroepiploic

88
Q

Features that differentiate jejunum, ileum

A

Jejunum = wider bore, thicker walled, arterial arcades are visible as the mesenteric fat does not stretch that far

I = peyers patches

89
Q

Nerve supply to small intestines (jejunum, ileum)

A

PSNS = peristaliss
Symp vasoconstriction from lateral horns of T9, T10

90
Q

Blood supply to jejunum

A

Arterial arcades from SMA
Occlusion may cause infarction, as they are end arteries

91
Q

Ileum blood supply

A

SMA, arcades

92
Q

Lymph drainage of Small intestine

A

Sup mesenteric nodes

93
Q

Caecum blood supply

A

Ileocolic A => Ant, post caecal A

94
Q

Appendix - how to find

A

Convergence of 3 taeniae coli

95
Q

Where is appendix located

A

Posteromedial wall of caecum 2cm below Ileocolic valve

96
Q

Most common position of appendix at appendectomy OT

A

Retrocaecal
(In the absence of pathology = retroileal)

97
Q

What is the blood supply of appendix

A

Appendicular A, off post caecal A (from ileocolic A)

98
Q

Which aspects of the colon are retro/intraperitoneal

A

Ascending/descending colon = retroperitoneal
Sigmoid, transverse colon = has mesentry

99
Q

Blood supply of colon

A

SMA to asc + prox 2/3rd of transverse colon
- ileocolic, R colic, middle colic

IMA to rest
- L colic & sigmoid branches

100
Q

Watershed areas of the colon

A

L colic flexure, b/w midgut & hindgut vessels, b/w middle colic & L colic

101
Q

Lymph drainage of colon

A

Sup, inf mesenteric nodes

102
Q

Nerve supply to colon

A

PSNS from vagi, pelvic splanchnics
SNS from T10-12

103
Q

Where does ligamentum teres lie

A

In free lower margin of falciform ligament, notched on inferior border of ligament

104
Q

What are the lobes of the liver

A

L, r, caudate (upper), quadrate

105
Q

Aspects & location of gallbladder

A

Cystic duct - close to the.R end of porta hepatis
Neck is highest
Fundus is lowest

106
Q

What lies b/w GB and fissure for lig teres

A

Quadrate lobe

107
Q

What is in contact with bare area of liver

A

IVC, diaphragm

108
Q

What is the falciform ligament

A

Remnant of ventral mesentery of fetus

109
Q

What does the falciform lig contain

A

Lig teres

110
Q

What is the lig teres

A

Obliterated L umbi V

111
Q

What is the lig venosum

A

Obliterated ductus venosus

112
Q

What borders the caudate lobe

A

IVC, lig venosum, porta hepatis

113
Q

What borders the quadrate lobe

A

GB, lig teres, porta hepatis

114
Q

What is the blood supply to the liver

A

2 sources
- hepatic A (from coeliac trunk)
- portal V

115
Q

How does the liver drain into the IVC

A

Three main hepatic V

116
Q

Nerve supply of the liver

A

Sns + vagal fibres from hepatic branch of anterior vagal trunk reach the porta hepatis via lesser omentum

117
Q

What forms the CHD

A

R+L hepatic ducts

118
Q

What forms the CBD

A

CHD + Cystic duct

119
Q

What is the capacity of GB

A

50ml

120
Q

Where is the fundus of GB found (surface)

A

9th CC tip, transpyloric plane

121
Q

Blood supply to GB

A

Via cystic A from R hepatic A

122
Q

What makes up calots triangle

A

Liver, CHD, cystic duct

123
Q

What passes through calot’s triangle

A

Cystic A

124
Q

Length and size of cystic duct

A

2-3cm in length, 2-3mm in diameter

125
Q

CBD length and diameter

A

6-8cm , <8mm

126
Q

What are the three parts of the CBD

A

Supra, retro and paraduodenal

127
Q

Where does the CBD end

A

With the pancreatic duct at an angle of 60 degrees at ampulla of vater, into 2nd part of duodenum into major duodenal papilla

128
Q

Where does the major duodenal papilla lie

A

2nd part of duodenum, 10cm from pylorus

129
Q

What is the blood supply of biliary tract

A

Cystic A
R hepatic A
Post branch of sup pancreaticoduodenal A

130
Q

Nerve supply to biliary tract

A

Hepatic branch of anterior vagal trunk
SNS (coeliac ganglia)
CCK (hormonal)
Afferent from t7-8

131
Q

What is the role of PSNS in biliary tract

A

Stimulate contraction of GB & relax sphincter of oddi

132
Q

How does the portal V divide in the porta hepatis

A

Into R+L branches in T shape

133
Q

What are the sites of porto-systemic anastomosis

A

Periumbilical region
Lower end of oesophagus
Bare area of liver
Upper end of anal canal
Retroperitoneal areas

134
Q

Areas of the pancreas

A

head, neck, body, tail, uncinate process

135
Q

What is the fx of pancreas

A

Exocrine, endocrine

136
Q

Blood supply to the pancreas

A

Splenic A
Superior, inferior pancreaticoduodenalA

137
Q

Nerve supply of pancreas

A

Posterior vagal trunk
Coeliac plexus
SNS vasoconstrictors (via splanchnics)

138
Q

Spleen ligaments

A

Gastrosplenic lig
Lienorenal lig

139
Q

Where does the tail of pancreas lie

A

In lienorenal lig

140
Q

Blood supply of spleen

A

Splenic A

141
Q

Lymph drainage of spleen

A

Coeliac nodes

142
Q

Nerve supply to spleen

A

Coeliac plexus from SNS only

143
Q
A

GSSE anatomy (8 decks)

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