Abdomen And Pelvis Flashcards

1
Q

Origin of diaphragm.

A

Sternal part - xiphoid process
Costal part - inner aspect of lower 6 ribs
Vertebral part - right and left crus.

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2
Q

Medial arcuate ligament.

A

Thickening of the psoas fascia.

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3
Q

Lateral arcuate ligament.

A

Thickening of the anterior layer of the thoraco-lumbar fascia.

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4
Q

Openings in the diaphragm.

A

T8 - IVC and right phrenic nerve.

T10 - esophagus and right and left vagus

T12 - aorta, azygos vein and thoracic duct.

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5
Q

How do the sympathetic chain and subcostal nerve and vessels enter the abdomen.

A

Sympathetic chain enters abdomen behind the medial arcuate ligament.

Subcostal nerve and vessels enter the abdomen behind lateral arcuate ligament.

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6
Q

Foramen of Morgagni.

A

Also known as space of Larry.

A small defect between sternal and costal origins of the diaphragm.

Superior epigastric vessels enter the abdomen through this opening.

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7
Q

Muscles of the posterior abdominal wall.

A

Psoas major, quadratus lumborum, transversus abdominins.

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8
Q

Where is lumbar plexus formed.

A

In the substance of psoas major.

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9
Q

Nervus furcalis.

A

Nervus furcalis is the ventral ramus of L4.
It’s takes part in the formation of the lumbar and sacral plexus.
Joins with L5 to form sacral plexus.

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10
Q

Terminal branches of abdominal aorta.

A

Common iliacs at the level of L4.

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11
Q

Ventral branches of abdominal aorta.

A

Coeliac trunk at the level of T12.

Superior mesenteric artery at the level of L1.

Inferior mesenteric artery at the level of L3.

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12
Q

Lateral branches of the abdominal aorta.

A
Inferior thoracic.
Middle suprarenal.
Renal.
Gonadal.
Dorsal branches.
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13
Q

Other branches of abdominal aorta.

A

4 pairs of lumbar arteries and 1 medial sacral artery.

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14
Q

L5 is supplied by what artery.

A

Ilio-lumbar artery branch of posterior division of internal iliac.

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15
Q

Nutcracker sign.

A

Refers to the Left renal vein when it gets obstructed between the abdominal aorta and the superior mesenteric artery.
Since the left gonadal vein drains into the left renal artery.
Decreased flow of blood causes pooling of blood in left kidney and the left testes. (Nutcracker sign)

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16
Q

Branches of the coeliac trunk.

A

3 branches - Left gastric, splenic and common hepatic.

Splenic branch gives pancreatic, short gastric and left gastroepiploic branches.

Common hepatic gives right gastric branch and divides into hepatic artery proper and gastroduodenal artery.

Gastroduodenal artery divides into right gastroepiploic and superior pancreatico-duodenal branches.

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17
Q

Parts of the portal vein.

A

Supraduodenal part.
Retroduodenal part.
Infraduodenal part.

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18
Q

Relations of the supraduodenal part of the portal vein.

A

Anterior and to the right - bile duct.

Anterior and to the left - hepatic artery

Posterior - IVC.

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19
Q

Relations of the infraduodenal part of the portal vein.

A

Anterior - neck of pancreas.

Posterior - IVC.

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20
Q

Relations of the retroduodenal part of the portal vein.

A

Anterior and to the right - bile duct

Anterior and to the left - gastroduodenal artery

Posterior - IVC.

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21
Q

Branches of the superior mesenteric artery.

A
Inferior pancreaticoduodenal.
Jejunal and ilial branches.
Middle colic.
Right colic.
Ilio-colic

Ilio-colic further divides into ascending and descending branches.

Descending branches of ilio-colic give 1. Anterior caecal 2. Posterior caecal 3. Appendicular 4. Ilial

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22
Q

Appendicular artery is a branch of.

A

Descending branch of ilio-colic.

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23
Q

Recurrent appendicular artery is a branch of.

A

Appendicular or posterior caecal.

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24
Q

Appendicular artery of Sheshachalam.

A

POSTERIOR CAECAL.

Branch of posterior caecal branch of descending branch of ilio-colic artery.

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25
Q

Branches of the inferior mesenteric.

A

Left colic.
Sigmoid branches.
Superior rectal artery (continuation of inferior mesenteric)

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26
Q

Boundaries of inguinal ligament.

A

Anterior wall - external oblique
Lateral wall - internal oblique and transverse abdominis
Posterior wall - fascia transversalis
Medial wall - conjoint tendon
Roof - conjoint tendon
Floor - external oblique and inguinal ligament.

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27
Q

Coverings of the testes.

A

External spermatic fascia - from ext. oblique aponeurosis
Cremasteric fascia - from cremaster.
Internal spermatic fascia - from fascia transversalis
Tunica vaginalis
Tunica albuginea
Tunica vasculosa

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28
Q

Median umbilical ligament.

A

Obliterated urachus/ allantois.

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29
Q

Persistence of urachus/ allantois.

A

Weeping umbilicus.

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30
Q

Medial umbilical ligament.

A

Obliterated umbilical artery

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31
Q

Lateral umbilical ligament.

A

Fold of peritoneum which covers inferior epigastric vessels.

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32
Q

Contents of the spermatic cord.

A
Vas deferens.
Artery to vas
Cremasteric artery
Testicular artery
Pampiniform plexus of veins
Genital branch of genitofemoral nerve
Lymphatics from the testes.
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33
Q

Anterior relations of the right kidney.

A
Right suprarenal gland.
Liver
2nd part of duodenum
Ascending colony and hepatic flexure.
Small intestines.
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34
Q

Anterior relations of the left kidney.

A
Left suprarenal gland.
Stomach
Splenic artery
Spleen
Pancreas
Splenic flexure and descending colon.
Small intestines.
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35
Q

Posterior relations of the stomach bed.

A
Left suprarenal gland
Left kidney
Splenic artery
Spleen
Pancreas
Transverse colon.
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36
Q

Retroperitoneal structures.

A
Kidneys
Suprarenal glands
Duodenum (except small area of 1st and 4th part)
Pancreas
Ascending and descending colons
Aorta and IVC
Ureters.
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37
Q

Root of the mesentry extends from.

A

DJ flexure to Right sacroiliac joint.

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38
Q

Structures crossed by the root of mesentry.

A
3rd part of duodenum.
Aorta
IVC
Right psoas major
R ureter
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39
Q

Boundaries of the epiploic foramen.

A

Anterior - lesser omentum containing hepatic artery, portal vein and bile duct.

Posteriorly - IVC, right suprarenal gland and T12 vertebra body

Superiorly - caudate lobe of the liver (caudate process)

Inferiorly - 1st part of duodenum

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40
Q

Obliterated left umbilical vein.

A

Ligamentum teres.

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41
Q

Ductus venosus becomes.

A

Ligamentum venosum.

42
Q

Foramen ovale becomes.

A

Fossa ovalis.

43
Q

Ductus arteriosus becomes.

A

Ligamentum arteriosum.

44
Q

Obliterated umbilical artery.

A

Medial umbilical ligament.

45
Q

Non-obliterated part of the umbilical artery.

A

Superior vesicular artery.

46
Q

Derivatives of the ventral mesogastrium.

A

Falciform ligament which contains ligamentum teres and paraumbilical veins.
Lesser omentum.
Superior and inferior layers of the coronary ligament.
Right and left triangular ligament.

47
Q

Derivatives of dorsal mesogastrium.

A

Gastrosplenic ligament.
Linorenal ligament.
Greater omentum.
Gastrophrenic ligament.

48
Q

Relations of head of pancreas.

A

Anterior - transverse colon and mesocolon/ 1st art of duodenum
Posterior - IVC/ right renal vein/ right crus of diaphragm/ bile duct

49
Q

Relations of neck of pancreas.

A

Anterior - Pylorus of stomach

Posterior - portal vein.

50
Q

Relations of the uncinate process of the pancreas.

A

Anterior - superior mesenteric vessels.

Posterior - aorta.

51
Q

Relations of body of pancreas.

A

Superior - splenic artery
Anterior - stomach and transverse colon and mesocolon
Posterior - aorta and origin of superior mesenteric artery/left renal vein/ left crus of diaphragm/ left kidney/ left suprarenal gland and splenic vein.

52
Q

Relations of the tail of pancreas.

A

Enters the hilum of the spleen.

Lies in the linorenal ligament.

53
Q

Development of pancreas.

A

Dorsal pancreatic bud forms upper part of head, neck and tail of pancreas.
Ventral pancreatic bud forms lower part of head and uncinate process.

54
Q

Annulopancreas happens due to.

A

Defective migration of ventral pancreatic bud.

55
Q

Non-union of two pancreatic buds leads to.

A

Pancreatic divisum.

56
Q

Main pancreatic duct development.

A

Duct of Wirsung

Formed by the ducts of the dorsal bud, ventral bud and the anastomoses between them.

57
Q

Where does the pancreatic duct join the duodenum.

A

Opens at major duodenal papillae.

8-10 cm from the pylorus.

58
Q

Accessory pancreatic duct.

A

Duct of Santorini.

Formed by duct of dorsal bud.

Opens at minor duodenal papillae.

6-8 cm from pylorus.

59
Q

Part of hindgut below attachment of hindgut.

A

Cloaca.

60
Q

Urorectal septum divides cloaca into.

A

Urogenital sinus anteriorly.

Rectum and anal canal posteriorly.

61
Q

Cloacal membrane is divided into.

A

Urogenital membrane anteriorly.

Inner membrane posteriorly.

62
Q

Parts of rectum above and below Houston valve.

A

Part of rectum above Houston valve is derived fro hindgut and the part below is derived from the cloaca.

63
Q

Part of anal canal above and below the dentate line is derived from.

A

Part of anal canal above the dentate line is derived from the cloaca and the part below is derived from proctoderm. (Invagination of anal membrane)

64
Q

Secretory part of kidney is formed from what and what structures do they include.

A

Secretory part of the kidney is derived from the metanephros / metanephric blastema.

It forms the Bowman’s membrane, PCT, DCT, loop of henle and the collecting ducts.

65
Q

Collecting part of the kidney is derived from what and what structures do they include.

A

Collecting part of the kidney is derived from the ureteric bud/ metanephric diverticulum.

It forms the collecting tubules, minor calyx, major calyx, pelvis and ureters.

66
Q

Failure of communication between collecting and secretory parts of the kidney result in.

A

Congenital polycystic kidney.

67
Q

Failure of ureteric bud or form results in.

A

Renal agenesis.

68
Q

Horse shaped kidney remains below what level.

A

L3.

69
Q

Which of the three germ layers is the kidney derived from.

One part of the urinary system that does not arise from the same germ layer.

A

Entire kidney is derived from the endoderm.

Except trigone of the bladder. It is derived from the mesoderm.

70
Q

Blood supply of the supra renal gland.

A

Superior suprarenal artery which is a branch of the inferior phrenic artery.

Middle suprarenal artery which is a branch of the abdominal aorta.

Lower suprarenal artery which is a branch of renal artery.

71
Q

Right renal vein is derived from.

A

Right mesonephric vein.

72
Q

Left renal vein is derived from.

A

Left mesonephric vein.
Left subcardinal vein.
Inter-subcardinal anastomoses.

73
Q

IVC is derived from.

A
Posterior cardinal vein.
Supracardinal vein.
Suprasub cardinal anastomoses.
Sub cardinal vein.
Hepato cardiac channel or right Vitelline vein.
74
Q

Branches of internal iliac artery.

A

Anterior and posterior division of internal iliac.

75
Q

Branches of anterior division of internal iliac artery.

A
Superior vesical artery
Inferior vesical artery (supplies prostate)
Middle rectal
Obturator artery
Uterine and vaginal artery
Inferior gluteal
Internal pudendal
76
Q

Branches of posterior division of internal iliac artery.

A

Superior gluteal
Lateral sacral
Ilio-lumbar artery. (5th lumbar artery).

77
Q

Inferior vesical artery in females is replaced by.

A

Uterine and vaginal arteries.

78
Q

Where does the ureter enter the bladder.

A

Superolateral part of the trigone of the bladder.

79
Q

Ureter is crossed in the pelvis by what structure in males and females.

A

Ureter is crossed by the vas deferens in males and by the round ligament of the uterus and uterine artery in females.

80
Q

What space lies behind the pubic symphysis and what structure is present in it.

A

Retropubic space of Retzius lies behind the pubic symphysis.

Contains the vesical venous plexus.

81
Q

Nerve supply of the bladder.

A

Sympathetic - T10 to L2 - contracts the sphincter and relaxes the muscle.

Parasympathetic - S2, S3, S4 - contracts the muscle and relaxes the sphincter.

82
Q

Ligaments which help support the ovary.

A

Suspended from the posterior leaflet of the round ligament by fold of peritoneum called the meso-ovarian.

Attached to the uterus by the ligament of ovary.

Attached to the lateral pelvis walls by the suspensory ligament of the ovary.

83
Q

Boundaries of the ovarian fossa.

A

Superiorly - external iliac vessels.
Posteriorly - internal iliac vessels and ureter
Lateral and the floor - obturator nerve and vessels.

84
Q

Prostatic venous plexus communicated with.

A

Vesical venous plexus.
Dorsal vein of the penis.
Vertebral venous plexus - Batson’s plexus.

85
Q

Structure formed by the mesonephric duct in females.

A

Gartner’s duct.

86
Q

Structures formed by the para-mesonephric duct.

A

Males - appendix of testes and prostatic utricle.

Females - fundus, body, cervix, upper 2/3rd of vagina, Fallopian tubes

87
Q

Structures formed by the mesonephric tubules.

A

Males - Paradidymis.

Females - epoophoron, para-oophoron

88
Q

Structures formed by the genital tubercles.

A

Males - penis

Females - clitoris.

89
Q

Structures formed by the genital swellings.

A

Males - scrotum

Females - labia majora

90
Q

Structures formed by the genital folds.

A

Males - ventral aspect of penis

Females - labia minora

91
Q

Prostatic urethra.

A

Present at the junction of anterior 1/3rd and posterior 2/3rd of the gland.

Shows convexity anteriorly.

4cm long

Membranous part - 1.5 to 2 cm

92
Q

Urethral crest.

A

Elevation in the midline of the prostatic urethra.

Due to continuation of the trigonal muscles of the bladder.

93
Q

An elevation in the middle of the urethral crest near the opening of the ejaculatory ducts.

A

Verumontanum/ Colliculus seminalis.

94
Q

Contents of the deep perineal pouch.

A

Sphincter urethrae.
Deep transverse perenei

Males - bulbourethral glands/ cowper’s glands.

95
Q

Contents of the superficial perineal pouch.

A

Muscles - ischiocavernosus
Bulbospongiosus
Superficial transverse perenei

In females - bartholin’s glands/ greater vestibular glands.

96
Q

Holden’s line

A

Line drawn laterally from pubic tubercle.

Urine does not cross this line due to firm attachment of fascia lata along this line.

97
Q

Length of urethra.

A

Male - penile urethra - 15 to 20 cm

Female - 4 cm

98
Q

Most and least dilatable part of the male urethra.

A

Most - prostatic

Least - external urethral meatus

99
Q

Dentate/ pectinate line.

A

Represents lower end of the anal column.

100
Q

White line of hilton.

A

Represents mucocutaneous junction of the anal canal.