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MRCS part A > Abdomen Anatomy > Flashcards

Abdomen Anatomy Flashcards

1
Q

What are the boundaries of the Femoral Triangle?

A

Superiorly: - Inguinal ligament
Laterally: - Sartorius
Medially: - Adductor longus

Floor: - Iliopsoas
- Adductor longus
- Pectineus

Roof: - Fascia lata
- Superficial inguinal lymph nodes
- Long Saphenous vein

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2
Q

Where do the Deep and Superficial Circumflex Iliac arteries in relation to the inguinal ligament, arise?

A

Deep circumflex iliac artery: arises above the inguinal ligament

Superficial circumflex iliac artery: arises below the inguinal ligament

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3
Q

What are the contents of the Femoral Triangle ( from medial to lateral)

A
  • Femoral vein
  • Femoral artery (pulse at mid inguinal point)
  • Femoral nerve
  • Deep and Superficial inguinal lymphs
  • Lateral Cutaneous Nerve
  • Great saphenous vein
  • Femoral branch of the Genitofemoral nerve
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4
Q

What makes up the posterior wall of the inguinal canal?

A

Transversalis Fascia

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5
Q

What structure makes up the anterior wall of the inguinal ligament and also the lateral edge of the superficial inguinal ring?

A

External oblique aponeurosis

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6
Q

What makes up the floor and roof of the inguinal canal?

A

Floor: inguinal ligament, thickened medially by the lacunae ligament

Roof: Transversalis fascia, Internal Oblique

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7
Q

What are the contents of the inguinal canal in male and females?

A

Males: Spermatic cord and Ilioinguinal nerve

Females: Round ligament of uterus and ilioinguinal nerve

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8
Q

What are the venous drainages of the left and right adrenal glands?

A

Right: directly into IVC
Left: into left renal vein and then into IVC

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9
Q

What is the arterial supply of the adrenal glands?

A

Superior adrenal: - inferior phrenic artery
Middle adrenal: - aorta
Inferior adrenal: - renal arteries

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10
Q

What are the relationships of the left and right adrenal glands?

A

Right Adrenal:
- Posteriorly: Diaphragm
- Inferiorly: Kidney
- Medially: IVC
- Anteriorly: Hepato-renal pouch

Left Adrenal:
- Posteriorly: Crus of the diaphragm
- Inferiorly: Pancreas and splenic vessels
- Anteriorly: Lesser sac and stomach

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11
Q

What is the arterial supply of the Transverse colon

A

Middle colic artery (branch of SMA)

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12
Q

What is the arterial supply of the Descending and Sigmoid colon?

A

Inferior mesenteric artery (IMA which originates at L3)

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13
Q

What organs are retro peritoneal?

SAD PUCKER

A
  • Suprarenal glands (adrenals)
  • Aorta and IVC
  • Duodenum (2nd and 4th part)
  • Pancreas (except for portion of the tail)
  • Ureters
  • Colon (Descending and Ascending colon)
  • Kidneys
  • Esophagus (lower 2/3rds)
  • Rectum
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14
Q

What is the blood supply of the rectum?

A

Superior rectal artery (from IMA)
Middle rectal artery (from Int. iliac)
Inferior rectal artery (from pudendal vessels)

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15
Q

What marks the transition between the sigmoid colon and the rectum?

A

Marked by the disappearance of the Tenia coli

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16
Q

What is the posterior fascia of the rectum?

A

Waldeyers Fascia

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17
Q

What is contained within the deep perineal pouch?

A
  • Urethral sphincter
  • Transversus perinei
  • Dorsal nerve of penis
  • Deep and Dorsal arteries of the penis
  • Urethral artery
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18
Q

What is the lymphatic drainage of the FEMALE urethra?

A

Internal iliac nodes

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19
Q

What is the name of the narrowest part of the male urethra?

A

Membranous Urethra (surrounded by external sphincter)

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20
Q

What artery is found near the point of entry of the long saphenous vein to the femoral vein?

A

Deep external pudendal artery

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21
Q

What is the nerve roots of the external urethral sphincter and what is the name of the nerve that innervates it?

A

Branches of the pudendal nerve (S2, S3, S4)

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22
Q

What is the most posterior structure at the hilum of the right kidney?

A

Ureter

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23
Q

What structures lie Anteriorly to the right kidney?

A
  • IVC
  • Right renal vein
  • Head of pancreas
  • Descending part of duodenum
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24
Q

What lies Anteriorly to the left kidney?

A
  • left renal vein
  • tail of the pancreas
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25
What is the arterial supply of the prostate gland?
Inferior vesical artery (from Int. Iliac)
26
What is the lymphatic drainage of the prostate?
Internal Iliac Nodes
27
What does the genital branch of the genitofemoral nerve supply?
Skin and fascia of the scrotum
28
What are the borders of the Greater Sciatic Foramen?
- Anterolaterally: Greater sciatic notch of the ilium - Posteromedially: Sacrotuberous ligament - Inferior: Sacrospinous ligament and ischial spine - Superior: Anterior sacroiliac ligament
29
What vessel travels above the piriformis after exiting the sciatic notch?
Superior Gluteal vessels (art + vein)
30
What structures travel below the piriformis after exiting the sciatic notch?
- Inferior gluteal vessels (art + vein) - Sciatic nerve - Posterior cutaneous nerve of the thigh
31
What nerve transmit through the sciatic Foramen?
- Sciatic - Superior and Inferior gluteal nerves - Pudendal - Posterior cutaneous nerve of thigh - Nerve to Quadratus femoris - Nerve to Obturator internus
32
What are the 3 layers of the spermatic cord and what are their origins?
- Internal spermatic fascia (Transversalis fascia) - Cremasteric fascia (internal oblique) - External spermatic fascia (External oblique aponeurosis)
33
What is the lymphatic drainage of the spermatic cord?
Lumbar and Para-aortic nodes
34
What are the arteries present in the spermatic cord and where do they arise from?
- Testicular artery (arises from AA. Supplies testis and epididymis) - Artery of Vas Deferans (arises from Inferior vesical artery) - Cremasteric artery (arises from Inferior Epigastric artery)
35
What are the testis surrounded by and from which structure are they derived from?
Testes are surrounded by the TUNICA VAGINALIS. This is derived from the peritoneum
36
What organ lies most superficially at the level of L1?
The fundus of the gallbladder
37
What are the borders of the Epiploic Foramen?
Anterior: - Bile duct (right) - Portal vein (behind) - Hepatic artery (left) Posteriorly: IVC Inferiorly: 1st part of duodenum Superiorly: Caudate process of liver
38
What is the Pringles Manoeuvre and what 3 structures does this occlude?
Placing vascular clamp across the anterior aspect of the Epiploic Foramen - done to control bleeding during liver surgery Occludes: - CBD - Hepatic artery - Portal vein
39
What is the blood supply to the proximal part of the ureter?
Branches of the renal artery
40
What forms the lateral edge of the superficial inguinal ring?
External oblique aponeurosis
41
Where is the porta hepatis and what does it transmit?
Postero-infero surface of liver and separates the caudate lobe behind the quadrate lobe in front Transmits (anterior to posterior): - Common hepatic duct - Hepatic artery - Portal vein - Lymph drainage - Sympa and parasympa fibres
42
What is the supply to the quadrate and caudate lobes and what are their relations?
Quadrate lobe: - right hepatic artery - gallbladder fossa lies on the right - fossa for umbilical vein lies on the left Caudate lobe: - supplied by right + left hepatic arteries - anterior and medial to IVC
43
Bleeding in the left paracolic gutter upon traction of the left colon is due to what source?
Spleen
44
Which embryological structure is the ureter derived from?
Mesonephric duct
45
What ligament provides the main structural support to the uterus?
Central perineal tendon
46
During a right adrenalectomy, what is the most likely source of brisk bleeding and how is this injury best managed?
Source: IVC Best managed using a Satinsky clamp and 6/0 prolene suture
47
What is the primary site of venous drainage of the urinary bladder?
Vesicoprostatic venous plexus (may be a site of significant bleeding during a cystectomy) This then drains into the Internal iliac vein
48
What is arterial supply of the urinary bladder?
Superior and Inferior VESICAL arteries (Branches of the internal iliac artery)
49
What is the positioning of the bladder in the body?
- empty bladder is contained within the pelvic cavity - usually a 3 sided pyramid - apex of the bladder points forwards towards the pubis symphysis - base lies anterior to the rectum/vagina - inferior aspect is retroperitoneal and superior aspect is covered by peritoneum
50
What are the lymphatic drainage of the Superior and Inferior vagina?
Superior vagina: Int and Ext Iliac nodes Inferior vagina: Superficial inguinal nodes
51
What are the 3 main branches of the Coeliac axis and their sub branches?
- Left gastric - Hepatic: - Right gastric - Gastroduodenal artery - Superior Pancreaticoduodenal - Cystic - Splenic: - Pancreatic - Short gastric - Left gastroepiploic
52
At what level does the coeliac axis branch off the AA?
T12
53
What are the relations of the coeliac axis?
Anterior: Lesser omentum Right: right coeliac ganglion and caudate process of liver Left: Left coeliac ganglion and gastric cardia Inferiorly: upper border of pancreas and renal vein
54
What is the arterial supply of the rectum?
Superior rectal artery Middle rectal artery (from Int. iliac) Inferior rectal artery (from Pudendal vessels)
55
What is the lymphatic drainage of the rectum?
- Mesorectal lymph nodes (Superior to dentate line) - Inguinal nodes (inferior to dentate line)
56
What are the borders of the Hesselbach’s triangle and what is it’s clinical significance?
- Superolaterally: Epigastric vessels - Medially: Lateral edge of Rectus muscle - Inferiorly: Inguinal ligament Direct hernias pass through here
57
What incision would be done for a Whipple’s procedure?
Rooftop incision (Gable)
58
What is the lymphatic drainage of the ovaries?
Para aortic nodes
59
What does the inferior mesenteric vein usually drain into?
Splenic vein
60
What is the best incision for an appendectomy?
Lanz incision
61
What structures lie anterior to the rectum?
Males: - Rectovesical pouch - Bladder - Prostate - Seminal vesicles Females: - Recto-uterine pouch (pouch of Douglas) - Cervix - Vaginal wall
62
At what level does the IVC enter the thorax?
T8 - passes through the diaphragm
63
What is the lymphatic drainage of the scrotum?
Inguinal nodes
64
What is the arterial and venous supply to the pancreas?
Arterial: - Head: pancreaticoduodenal artery - Rest: splenic artery Venous: - Head: Superior mesenteric vein - Body and tail: splenic vein
65
What are the posterior relations of the anatomical segments of the pancreas?
Head: IVC, CBD, Right and Left Renal veins, SMA and SMV Neck: SMV, Portal vein Body: - Left renal vein - Psoas muscle - Adrenal gland - Kidney - Aorta Tail: Left kidney
66
Which lobes is the Quadrate lobe functionally and anatomically part of?
Functionally: left lobe of the liver Anatomically: right lobe of the liver
67
What are the relations of the quadrate lobe?
- Porta hepatis lies behind - Gallbladder fossa lies on the right - Fossa for the umbilical vein lies on the left
68
What is the name of the fascia that surrounds the kidney?
Gerotas fascia

MRCS part A (9 decks)

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