Abdomen Flashcards
What are the following incisions? Kocher's Lanz Gridiron Pfannestie Battle's?
diagram
Composition of the anterior and posterior rectus sheath above and below the arcuate line?
above- ant- eo and io. post- io and transverse, and transversalis fascia
below- ant- eo, io, transversus post- transversalis fascia
How can you find the appendix?
where the tinae coli coalesce
Surface landmark for appendix?
mcburney’s point- third of the way between ASIS and umbilicus
Appendicitis pain?
Generalised midgut pain, when peritoneum becomes inflammed pain localises to mcburney point
Psoas sign?
one leg flexed to relax psoas msucle
Is meckel’s a true diverticulum?
yes outpouching of mucosa muscle and serosa
Rule of 2 for meckels
2% of pop <2 feet from ileoceacal junction 2 inches in length commonly presents less than 2 years old 2:1 male:females
boundaries between fore, mid and hind gut?
fore and mid- ligament of treitz just above DJ flexure
mid and hind- 2/3 along transverse colon
how can you differentiate the jejunal and ileal arteries
Jejunum- arterial arcades short, vasa recta long
Ileum- arterial arcades long, vasa recta short
Definition of a hernia?
when part of an organ is displace and protrudes through the cavity containing it
divisions of coeliac trunk?
Common hepatic- proper hepatic, left hepatic, right hepatic, cystic,,, right gastric, gastrduodenal, supraduodenal, superior pancreatoduodenal, right gastroeipoleic
Left gastric- oesophageal
Splenic- short gastric and left gastroepiploeic
what ligamen do the short gastric, portal triad run in?
gastrolineal lig
hepatoduodenal
Divisions of the SMA?
Inferior pancreatoduodenal Middle Right colic Ileocolic- colic, caecal- ant, post- appendicular,,,ileal ileal jejunal
What artery anastamosises the SMA and IMA?
Marginal artery of Drummond
IMA divisions?
Left colic- ascending and descending
Sigmoidal
Superior rectal
What is toldt’s plane?
way of accessing the retroperitoneum
between mesocolon and retroperitoneum
formed by fusing of viseral and parietal peritoneum
What is kocherisation?
mobilisation and medialising of duodenal to expose retroperitoneal structures. perforated duodenal ulcer etc.
Open Cholecysectomy set up and incision?
GA, supine, kochers
Retrograde cholecysectomy procedure
Remove gall bladder from bed
identify calot’s triangle
clip and ligate cystic duct and artery
What is callot’s triangle?
Common hepatic duct
Cystic duct
Inferior surface of the liver
contains cystic artery
Liver ligs?
coronary, triangular, falciform
How can you access the lesser sack?
Epiploeic foramen of winslow in lesser omentum
What is pringle’s manouver?
compression of portal triad by pressing on hepatoduodenal lig
What ligament is the splenic flexture?
Phrenicolineal lig??
How can determine if a structure is an ureter or not?
Vermiculation
Where does the ureter cross on entering the pelvis?
Bifurcation of common iliac- SI joint
Retropubic space?
Cave of Retzius
Retroinguinal space?
Cave of Bogros
Superficial blood supply to the abdominal wall?
Superior- musculophrenic
Inferiorly- medially- superficial epigastric artery. Lat- superficial circumflex iliac artery. Both off femoral artery
Deep blood supply of abdominal wall
Superior- medially- Superior epigastric artery. Laterally- 10th/11th IC artery
Inferiorly- Medially- inferior epigastric artery. Laterally- Deep circumflex iliac artery. Both off external iliac.
What is component separation in abdominal wall reconstruction?
Cutting of EO ApoN, pararectal
Allows midline closure, weakens wall laterally
Posterior component separation?
Take posterior rectus sheath of rectus muscle
create a pocket to protect bowel from mesh
What neurovascular structure must be identified in Posterior component separation?
inferior epigastric artery
Retroperitoneal organs?
RAPID SUCK Rectum Abdominal aorta Pancreas Inferior Vena Cava Duodenum 2/3 Supraadrenal glands Ureters Colon- ascending and descending Kidneys
Divisions of the internal iliac artery?
Anterior- Iliolumbar, lateral sacral, superior gleuteal
Posterior- Inferior gleuteal- obturator- foveal, Middle rectal, internal pudendal- inferior rectal, Inferior vesicular/vaginal, Uterine, Superior vesicular, obliterated umbilical artery
Periotoneal reflections?
Greater and lesser omentum
Mesentry
Transverse mesocolon
sigmoid mesocolon
