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MRCS part B anatomy > Abdomen anatomy > Flashcards

Abdomen anatomy Flashcards

1
Q

Blood supply to ureter

A

Segmental supply

Abdominal supply
1. Renal arteries
2. Gonadal arteries
3. Ureteric branches from aorta

Pelvic supply
-Superior and inferior vesical arteries (from internal iliac anterior division)

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2
Q

Borders of lesser sac

A

Anterior: quadrate lobe of liver, lesser omentum, stomach, gastrocolic ligament

Posterior: Pancreas, left kidney, left adrenal gland

Superior: Superior recess lesser sac lies behind caudate lobe of liver

Inferior: Inferior recess of lesser sac lies between layers of greater omentum (superior part)

To the left: gastrosplenic, lienorenal ligament

To the right: Epiploic foramen (of wilmslow)

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3
Q

Boundaries of epiploic foramen

A

Superior: caudate lobe of liver
Anterior: common hepatic artery, portal vein and common bile duct in free edge of lesser omentum
Posterior: IVC and crus of right diaphragm
Inferior: 1st part of duodenum

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4
Q

What are the differences between the ileum and the jejunum?

A

jejunum: redder in colour, more prominent vasa recta, located in LUQ, thicker intestinal wall, less arcades
Ileum: pink, more arterial arcades and shorter vasa recta, located in RLQ

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5
Q

Borders of inguinal canal

A

Roof: arching fibres of internal oblique and transversus abdominis
Anterior: aponeurosis of external oblique reinforced in lateral 1/3rd by fibres of internal oblique
Posterior: transversalis fascia, conjoint tendon medial 1/3rd
Floor: inguinal ligament reinforced in medial 1/3rd by lacunar ligament

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6
Q

What is the conjoint tendon?

A

–> sheath of connective tissue
–> formed by lower part of common aponeurosis of internal oblique/transversus abdominis
–> forms posterior wall of inguinal canal medially

The conjoint tendon (previously known as the inguinal aponeurotic falx) is a sheath of connective tissue formed from the lower part of the common aponeurosis of the abdominal internal oblique muscle and the transversus abdominis muscle

Forms posterior wall inguinal canal medially

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7
Q

Borders femoral ring

A

Anterior: inguinal ligament
Medial: lacunar ligament
Lateral: femoral vein
Posterior: pectineal ligament overlying superior ramus of pubis

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8
Q

Blood supply to pancreas:

A

Neck, body and tail:
-Splenic artery- runs along superior margin and supplies neck, body and tail via its pancreatic branches

Head:
-Superior pancreaticoduodenal artery from gastroduodenal
-Inferior pancreaticoduodenal from SMA

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9
Q

At what vertebral level does sma arise?

A

Lower border L1

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10
Q

Name branches of SMA

A

Inferior pancreaticoduodenal
ileal and jejunal branches
middle colic
right colic
ileocolic

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11
Q

Name branches of IMA

A

Left colic
Sigmoidal
Superior rectal

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12
Q

Name the boundaries of hasselbach’s triangle

A

Medial: lateral border rectus abdominis
Lateral: inferior epigastric artery
Inferior: inguinal ligament

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13
Q

Describe blood supply of rectum

A

Superior 1/3rd: superior rectal artery (IMA)
Middle 1/3rd: middle rectal artery (internal iliac anterior division)
Bottom 1/3rd: inferior rectal artery (from internal pudendal from internal iliac)

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14
Q

Paired branches abdominal aorta

A

Inferior phrenic (T12)
Middle suprarenal (T12)
Lumbar arteries (L1-L4)
Renal (L1-L2)
Gonadal (L2)

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15
Q

Name some anatomical sites of porto-systemic anastomoses, state the vessels

A

Rectal
–> Portal: superior rectal vein –> IMV
–> Systemic: Middle and inferior rectal veins

Oesophageal
-Portal: Oesophageal branches left gastric vein –> splenic vein
-Systemic: Oesophageal branches left azygous

Retroperitoneal:
–> Portal: colic veins
–> Systemic: retroperitoneal veins

Paraumbilical
–> Portal: portal veins of liver
–> Systemic: Veins of anterior abdominal wall

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16
Q

Branches anterior division of internal iliac

A

3 urinary (umbilical, superior vesical, inferior vesical)
3 parietal (obturator, internal pudendal, inferior gluteal)
3 visceral (middle rectal, uterine, vaginal)

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17
Q

Branches posterior division internal iliac

A

PILS
-Iliolumbar
-Lateral sacral
-Superior gluteal

18
Q

Where is superficial ring located?

A

Superior to pubic tubercle. V shaped defect in external oblique

19
Q

Where is deep ring located? What forms it?

A

-Above mid point of inguinal ligament (lateral to inferior epigastric vessels)
-Formed by transversalis fascia which invaginates to cover contents of inguinal canal.

20
Q

Where is the mid-inguinal point and what is the clinical significance?

A

Midway between pubic symphysis and asis. Femoral pulse palpated here

21
Q

What are the retroperitoneal organs?

A

Primarily:
-Kidneys
-Adrenal glands
-Rectum
-IVC
-Aorta
-Oesophagus

Secondarily
-2nd and 3rd parts duodenum
-Ascending and descending colon
-Pancreas (exceept tail)

22
Q

Which muscles form pelvic floor?

A

2 pubes + the others

Iliococcygeus, pubococcygeus, puborectalis (levator ani)
Coccygeus

23
Q

Innvervation to the pevlic floor

A

-Levator ani + coccygeus: S3 and S4 nerve roots
-Perianal muscles, external urethral sphincter + external anal sphincter: pudendal nerve
-Anal canal inferior to dentate line: inferior rectal nerves + pudendal nerve

24
Q

Layers abdominal wall midline laparotomy

A

Skin
Subcut fat
camper’s fascia
Scarpa’s fasica
linea alba
preperitoneal fat
parietal peritoneum

25
Q

Describe arterial supply to anterolateral abdominal wall

A
  1. internal thoracic—> superior epigastric
  2. External iliac —> inferior epigastric, deep circuflex iliac
  3. Femoral
    —> superficial circumflex iliac
    —> superficial epigastric
26
Q

At what vertebral level does abdominal aorta bifurcate?

A

Lower border L4

27
Q

Name anterior unpaired branches of abdominal aorta

A

Coeliac trunk
sma
ima

28
Q

At what vertebral level does coeliac trunk arise?

A

Lower border T12

29
Q

Name branches of coeliac trunk

A

Left gastric artery
–> oesophageal branches

Common hepatic
–> Gastroduodenal (right gastroepiploic, superior pancreaticoduodenal)
–> Hepatic artery proper (right gastric, right–>cystic and left hepatic)

Splenic
–> Left gastroepiploic (greater curvature of stomach)
–> Short + posterior gastrics (Fundus and posterior stomach)
–> Pancreatic branches (body and tail of pancreas)

30
Q

Where to left and right testicular veins drain?

A

Left: left renal vein
right: directly into IVC

Therefore left sided varicoceles are more common

31
Q

Constrictions of the ureter

A

Pelviureteric junction
As it crosses iliac vessels at pelvic brim
Vesicoureteric junction

32
Q

Describe blood supply to the stomach

A

Lesser curvature: left (coeliac trunk) and right gastric (hepatic artery proper)
Greater curvature: left (splenic) and right (gastroduodenal) gastro-epiploic
fundus and posterior: posterior and short gastric

33
Q

Structures at the transpyloric plane

A

Upper pole right kidney
Right and left colic flexures
Fundus of gallbladder
Head of pancreas
Pylorus of stomach
2nd Part of duodenum
Formation of portal vein (joining smv and sv)
D-J flexure
SMA origin from aorta
End of spinal cord in adults
Hilum of spleen
Hilum of kidney

34
Q

What are conents of spermatic cord?

A

Fascial coverings: External spermatic fascia, internal spermatic fascia, cremasteric fascia
Arteries: Testicular artery, artery to vas deferens, cremasteric artery
Nerves: Genital branch genitofemoral nerve, sympathetic nerve fibres, ilioinguinal nerve (lies outside spermatic cord)
Other structures: pampiniform plexus, ductus deferens, lymphatics

35
Q

Abdominal wall layers: appendicectomy

A

Skin
Subcut fat
Campers
Scarpas
External oblique
Internal oblique
Transversus abdominis
Transversalis fascia
Preperitoneal fat
Peritoneum

36
Q

Contents of inguinal canal in males and females

A

Round ligament in females
Spermatic cord in males
Ilioinguinal nerve both sexes

37
Q

What is the conjoint tendon?

A

-Formed from aponeurosis of internal oblique and transversus abdominis.
-Forms medial part posterior wall inguinal canal

The conjoint tendon (previously known as the inguinal aponeurotic falx) is a sheath of connective tissue formed from the lower part of the common aponeurosis of the abdominal internal oblique muscle and the transversus abdominis muscle

38
Q

What do the branches of proper hepatic artery supply??

A

Right gastric: supplies the pylorus and lesser curvature of the stomach.
Right and left hepatic: divide inferior to the porta hepatis and supply their respective lobes of the liver.
Cystic: branch of the right hepatic artery – supplies the gall bladder

39
Q

What do branches of gastroduodenal supply?

A

Right gastroepiploic: supplies the greater curvature of the stomach. Found between the layers of the greater omentum, which it also supplies.
Superior pancreaticoduodenal: divides into an anterior and posterior branch, which supplies the head of the pancreas.

40
Q

Describe blood supply to adrenal gland

A

Superior adrenal artery – arises from the inferior phrenic artery
Middle adrenal artery – arises from the abdominal aorta.
Inferior adrenal artery – arises from the renal arteries.

MRCS part B anatomy (16 decks)

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