Abdomen

Question 1

Duodenal ulcer perforation, rupture of gallbladder and perforated appendix will lead to abscess in

Answer 1

Subphrenic recess

Question 2

Retroperitoneal organs

Answer 2

SAD PUCKER

Question 3

Portal triad
a) what ligament?
b) what structures

Answer 3

a) hepatoduodenal ligament
b) portal vein, hepatic artery, and bile duct
Portal: Posterior and hepatic as Liver Artery (Left and Anterior), bile as right

Question 4

Maneuver to compressed the portal triad to control bleeding of luver

Answer 4

Pringle maneuver

Question 5

Placing finger on what foramen that you can palpate the IVC and portal vein

Answer 5

Foramen of winslow / epiploic foramen

Question 6

Neurovascular communication of the visceral organ

Answer 6

Mesentery

Question 7

Connection of stomach to other parts

Answer 7

Omentum

Question 8

What are the two omentum of stomach? And its ligament?

Answer 8

Greater omentum ( greater curvature of stomach)
Lesser omentum (the lesser curvature of stomach)

Greater momentum: Gastro phrenic ligament, gastrospleenic ligament and gastrocolic ligament (dorsal)

Lesser omentum: hepato-Duodenal ligament and hepatoGastric ligament
(Ventral)

Question 9

What arteries are in the gastrospleenic ligament?

Answer 9

Short gastric artery and left gastroepiploic arteries

Question 10

Artery in the gastrocolic ligament

Answer 10

Gastroepiploic arteries

Question 11

Heaptogadtric artery?

Answer 11

Gastric vessel

Question 12

Splenorenal ligament artery

Answer 12

Splenic vessel and tail of pancreas

Question 13

Midline approach paracentesis
And what traverses

Answer 13

2cm above umbilicus
From skin to deep fascia then directly to linea alba (no muscles) extraperitoneal fat then peritoneum

Question 14

Lateral approach paracentesis

Answer 14

5 cm superior to ASIS and medial (updated is 3cm)

Traverses the external internal transversus abdominis muscles before peritoneum

Question 15

What arteries can be damaged in lateral approach?

Answer 15

Inferior epigastric artery and deep circumflex artery

Question 17

Lower part of anal canal

Endoderm, ectoderm or mesoderm

Answer 17

Ectoderm

Question 18

Marginal artery of drummond

Answer 18

Marginal anastomosis (arch along the margin of the colon) of superior and inferior mesenteric artert

Question 19

Borders of abdominal aorta

Answer 19

Right Lateral: IVC and cisterna chyli

Left Lateral: sympathetic chain

Both lateral: azygos, para aortic nodes and celiac ganglia

Anterior: M2M

Posterior: T12-L4 ver and Left lumbar veins

Question 19

Common site of AAA?

Answer 19

Proximal to the bi4cation of aorta at L4

(+) pulsating mass at the midline

Question 20

Celiac artery occlusion where is the site of collateral circulation

a) Gastroduodenal artery?
b) pancreaticoduodenal artery?
c) splenic artery?

Answer 20

Pancreaticoduodenal branches of SMA (inferior PD artery)

Kasi Superior PD artery is from celiac which is occluded

Question 21

3 branches of celiac circulation may be eroded by stomach ulcer?

Answer 21

1) Splenic artery (posterior to the stomach)

2) left gastric artery (lesser curvature of left stomach)

3) gastroduodenal artery (posterior to duodenal ulcer)

Question 22

2 common iliac veins united behind the right common iliac artery at the level of

Answer 22

L5

Question 23

Suprarenal, renal and gonadal drains to _______?

Answer 23

Inferior vena cava

Question 24

Left suprarenal and left gonadal drain to

Answer 24

Left renal vein to IVC

Question 25

Superior suprarenal artery branch of

Answer 25

Inferior phrenic artery Middle and inferior suprarenal artery comes directly from aorta

Question 26

Right renal artery goes behind the

Answer 26

IVC

Question 27

Left renal vein goes in front of

Answer 27

Aorta

Question 28

Three veins that drains anterior to IVC

Answer 28

Hepatic veins

Question 29

Superior mesentric vein passes in front of ____ and behind the ____?

Answer 29

3rd part of duodenum Neck of pancreas

Question 32

Special mention of borders of abdominal aorta Duodenum Intestine Renal left vs right, art vs vein Lesser or greater sac

Answer 32

3rd part of duodenum Small intestine Left renal vein Lesser sac

Question 33

Lymphatic drainage of small intestine that can absorb fat

Answer 33

Lacteals of jejunum and ileum

Question 34

Group of LN within mesentery

Answer 34

Juxta-intestinal Ln (close to intestinal wall) drain to Mesenteric Mesenteric LN (scattered at arterial arcades) to Superior central nodes Superior central nodes at SMA

Question 35

Innervation of jeju and ileum

Answer 35

PNS: posterior vagal trunks synapse to myenteric and submucosal plexuses (peristalsis and secretion) SNS: T8-T10 to greater, lesser and least splanchnic going to superior mesenteric nerve plexus (vasoconstrictor and opposite of PNS) Visceral afferent (sensory): no pain stimuli but DISTENSION as colic (spasm)

Question 38

Jejunum vs ileum 1) location? 2) thicker wall vs thin wall? 3) plicae circularis? 4) vascular 5) vasa recta and arcades? 6) fat 7) lymphoid tissues

Answer 38

1) LUQ jejunum; RLQ ileum 2) thick J while thin I 3) large and tall J; less and small for I 4) great vascularity hence reddish J 5) few and large arcades with long vasa recta while ileum many vasa but shorter 6) more fat sa ileum and Peyers patches

Question 40

Buzzword: Currant jelly stool

Answer 40

Intussusception

Question 41

Radiographic features of intussusception (UTZ and CT)

Answer 41

Colied spring appearance (contrast enema) Ta et sign, pseudokidney sign crescent in a doughnut sign (UTZ)

Question 42

Common extrahepatic cause of obstructive jaundice

Answer 42

Cancer in the head of the pancreas

Question 44

Where do you do liver biopsy?

Answer 44

At the right 10th ICS in MAL during full exhalation

Question 45

What maneuver to stop liver hemorrhage and what ligament is clamped?

Answer 45

Pringle maneuver at the hepatoduodenal ligament (site of portal triad

Question 46

Triangle of calot

Answer 46

Liver (S) Cystic duct (L) Common Hepatic duct (M)

Question 48

What are the two ligaments of spleen?

Answer 48

Gastrosplenic ligament and lienorenal ligament

Question 49

What ligaments carries the short gastric and left gastroepiploic artery

Answer 49

Gastrosplenic ligament

Question 50

What ligament carries the tail of pancreas and splenic vessels

Answer 50

Lienorenal / splenorenal ligament

Question 51

Cancer of neck and body of pancreas may causr

Answer 51

Portal or IVC obstruction