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Anatomy MRCS Part B > Abdomen MRCS part B > Flashcards

Abdomen MRCS part B Flashcards

1
Q

which parts of the duodenum are retroperitoneal?

A

2nd, 3rd, 4th parts

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2
Q

the duodenum forms a C shape around what part of the pancreas?

A

Head of pancreas

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3
Q

What lies in the free edge of the lesser omentum?

A

Hepatic Artery, portal vein

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4
Q

what are the 5 sites of porto-systemic anastomoses?

A 
Retroperitoneum
Upper anal canal
Bare area of liver
Oesophagus
Periumbilical area
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5
Q

what are the 4 functions of the spleen?

A

F - filtration of encapsulated organisms + blood cells
I - immunological function
S - Storage of platelets
H - haematopoiesis in the fetus

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6
Q

what is the surface anatomy of the spleen?

A

LUQ 9-12th ribs

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7
Q

what is the most common place of intra abdominal fluid collection?

A

Rutherford Morrison pouch (R subhepatic space)

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8
Q

which part of the duodenum is related to the head of the pancreas?

A

2nd part

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9
Q

peyers patches are present in which part of the intestine?

A

ileum

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10
Q

which parts of the pancreas perform the exocrine function of the pancreas?

A

Pancreatic Acini

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11
Q

which cells produce insulin?

A

Beta cells of islets of langerhans

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12
Q

which cells produce glucagon?

A

Alpha cells of islets of langerhans

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13
Q

which cells produce somatostatin?

A

Delta cells of islets of langerhans

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14
Q

which arteries supply the head of the pancreas?

A

Superior and inferior pancreaticoduodenal arteries

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15
Q

Meckel’s diverticulum is a remnant of which embryological structure?

A

Vitellointestinal duct (connects midgut to yolk sac)

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16
Q

what is the blood supply to the upper 1/3 of the oesophagus?

A

Inferior thyroid artery

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17
Q

what is the blood supply to the middle 1/3 of the oesophagus?

A

Descending thoracic aorta

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18
Q

what is the blood supply to the lower 1/3 of the oesophagus?

A

Left Gastric artery

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19
Q

what is the lymphatic drainage of the upper 1/3 of the oesophagus?

A

Deep cervical nodes

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20
Q

what is the lymphatic drainage of the middle 1/3 of the oesophagus?

A

Superior and posterior mediastinal nodes

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21
Q

what is the lymphatic drainage of the lower 1/3 of the oesophagus?

A

Left gastric + coeliac nodes

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22
Q

which veins are involved in oesophageal varices?

A

Portal contribution = oesophageal branch of LEFT GASTRIC Vein
Systemic contribution = oesophageal branch of AZYGOUS vein

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23
Q

what are the sites of porto-systemic anastomoses?

A 
Oesophagus
Rectum
Umbilicus
Liver 
Retroperitoneum
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24
Q

what veins are involved in rectal varices?

A

Portal contribution = superior rectal vein

Systemic contribution = middle/inferior rectal vein

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25
Q

what 3 main mechanisms exist at the lower oesophageal sphincter to prevent gastro-oesophageal reflux?

A
  1. Acute angle of entry at diaphragm- angle of His
  2. phreno-oesophageal ligament
  3. prominent mucosal folds
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26
Q

which is more common - sliding hiatus hernia or rolling hiatus hernia?

A

Sliding hiatus hernia >80%

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27
Q

in barrets oesophagus what histological change occurs?

A

Metaplasia from stratified squamous epithelium to columnar epithelium

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28
Q

is metaplasia reversible?

A

Yes

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29
Q

what are the 3 physiological narrowings of the oesophagus?

A
  1. Cervical Constriction - Cricoid cartilage (C5/6)
  2. Thoracic Constriction - Aortic Arch (T4/5)
  3. Abdominal Construction - Oesophageal Hiatus (T10)
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30
Q

what vertebral levels does the oesophagus lie?

A

C6 (inferior border of cricoid cartilage) to T11 (cardiac orifice of stomach)

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31
Q

what is achalasia?

A

Oesophageal dysmotility caused by disordered coordination of the peristaltic action of the smooth muscle and non relaxation of the oesophageal sphincter (due to loss of the myenteric plexus)

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32
Q

what are the findings for achalasia on manometry?

A

High pressure/hypertension in the LES at rest + failure to relax the LES on swallowing as well as aperistalsis

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33
Q

the ureters are crossed by what structures anteriorly?

A

Gonadal artery and vein

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34
Q

the R ureter is crossed by what structures anteriorly?

A

Ileocolic vessels

R colic vessels

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35
Q

the L ureter is crossed by what structures anteriorly?

A

L colic vessels

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36
Q

what is the blood supply to the upper ureter?

A

Renal artery (+gonadal a + aorta)

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37
Q

what it the blood supply to the middle ureter?

A

Gonadal A + common iliac

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38
Q

what is the blood supply to the distal ureter?

A

Common iliac + internal iliac branches - superior vesical + uterine arteries

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39
Q

what are the anterior relations of the R kidney?

A 
R adrenal
R lobe of liver
Gallbladder
2nd part of duodenum
Hepatic flexure of colon
Small intestine
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40
Q

at what level does the IVC form?

A

L5 - common iliac veins converge

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41
Q

what structure lies anteriorly to the IVC at its origin?

A

Right common iliac artery

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42
Q

the common iliac veins pass anterior or posterior to the common iliac arteries?

A

Posterior

IVC moves posterior to aorta distally

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43
Q

does the ureter lie anterior or posterior to the bifurcation of iliac vessels?

A

anterior

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44
Q

does the ureter lie in front of or beneath the uterine artery?

A

Beneath

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45
Q

what are the anterior relations of the left kidney?

A

Stomach, pancreatic tail

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46
Q

what are the superior relations of the left kidney?

A

Spleen, adrenal gland

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47
Q

what are the posterior relations of both kidneys?

A

Quadratus lumborum, diaphragm, psoas major, transversus abdominis

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48
Q

is gerotas fascia surrounding or beneath the perirenal fat?

A

Surrounds perinephric fat

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49
Q

what parts of the colon are retroperitoneal?

A

Splenic + hepatic flexures

Ascending + descending colon

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50
Q

which part of the duodenum is intraperitoneal?

A

1st part

51
Q

is the spleen an intraperitoneal or retroperitoneal structure?

A

intraperitoneal

52
Q

does the SMA travel anterior or posterior to the duodenem?

A

Anterior to 3rd part

53
Q

which part of the pancreas does the SMA travel anterior to?

A

Uncinate process

54
Q

what part of the pancreas lies immeadiately anterior to the origin of the SMA?

A

Body of pancreas

55
Q

the middle colic artery is a branch of what artery?

A

SMA

56
Q

the SMA and IMA form an anastomoses called what?

A

Marginal artery of drummond

57
Q

what is the surface markings for the oblique border of the liver?

A

Diagonal line from 4th IC space MCL on left to 8-10th Rib on right mid-clavicular line

58
Q

what is the surface markings for the superior border of the liver?

A

5th IC space MCL on Right to 4th IC space MCL on Left

59
Q

what is the surface marking for the lateral border of the liver?

A

5th IC space MCL on right downwards to between 8-10th ribs

60
Q

which lobe of the liver is anatomically part of the right lobe but functionally a part of the left?

A

Quadrate lobe

61
Q

the hepatic artery divides into 3 which main branches?

A

Hepatic artery proper
Gastroduodenal
Right gastric artery

62
Q

which artery gives off the cystic artery which supplies the gallbladder?

A

Right hepatic artery

63
Q

from what structures is the portal vein formed and where?

A

SMV + splenic vein

Posterior to the pancreas neck at L2

64
Q

what is the surface marking for the gallbladder?

A

Angle between 9th costal cartilage + lateral margin of rectus muscle

65
Q

what are the 3 main functions of the gallbladder?

A

Storing Bile
Concentrating Bile
Adding mucus to bile produced by the liver

66
Q

how much bile is stored in the gallbladder?

A

50ml

67
Q

which arteries supply collateral supply to the gallbladder?

A

Perforating branches from the liver bed (supplies lateral body + fundus)

68
Q

what are the 3 borders of Calot’s triange?

A

Superior - inferior edge of liver
Lateral - cystic duct
Medical - hepatic duct

69
Q

what structures are found in calot’s triangle?

A

Cystic Artery

Lymph node of Lund

70
Q

what does courvoisiers law state?

A

Presence of a palpable gallbladder in a patient with painless jaundice is unlikely to be gallstones

71
Q

what does Bsoas sign refer to?

A

Area of hyperaesthesia of skin just below the right scapula in acute cholecystitis

72
Q

what does Kehr sign refer to?

A

Referral of abdominal pain to the shoulder tip

73
Q

the superior rectal artery is a branch of what artery?

A

inferior mesenteric artery

74
Q

into which vein does the inferior mesenteric vein drain?

A

Splenic vein

75
Q

initially visceral pain from the appendix is conveyed via what spinal nerve roots?

A

T10

76
Q

which of campers or scarpas fascia is the outer fatty subcutaneous fascia?

A

Campers fascia

77
Q

where do the 3 taenia coli converge to help identify the appendix?

A

Caecum

78
Q

the inferior rectal artery is a branch of what artery?

A

Internal pudendal

79
Q

the middle rectal artery is a branch of what artery?

A

Middle rectal

80
Q

the upper 1/3 of the rectum has peritoneum over which areas?

A

Front and sides

81
Q

the middle 1/3 of the rectum has peritoneum over which areas?

A

Front only

82
Q

the lower 1/3 of the rectum has peritoneum over which areas?

A

None - lies beneath the peritoneal reflection

83
Q

the ejaculatory duct drains in to what?

A

The prostatic urethra

84
Q

the seminal vesicles lie between what 2 structures?

A

Bladder and Rectum

85
Q

where in the bladder wall do the ureters open?

A

Posteriorly in trigone region

86
Q

what are the 3 constrictions of the ureter?

A
  1. Uretopelvic junction
  2. Pelvic brim, at bifurcation of common iliac
  3. Vesicoureteric junction
87
Q

what organism causes chronic inflammation predisposing to SCC of the bladder?

A

Schistosoma haematobium

88
Q

which arteries supply blood to the bladder?

A

Superior and inferior vesical arteries (branches of internal iliac)

89
Q

what is the venous drainage of the bladder?

A

External Iliac Nodes

+internal iliac, obturator nodes

90
Q

which nerves provide parasympathetic supply to the bladder?

A

Pelvic sphlanchnic nerves

91
Q

what is the nerve supply to the external uretheral sphincter?

A

Pudendal nerve S2,3,4

92
Q

what supplies sympathetic supply to the bladder?

A

Hypogastric plexuses

93
Q

what is the nerve supply to external oblique?

A

T7-T12 thoracoabdominal nerves + Subcostal nerve (T12)

94
Q

what is the roof of the inguinal canal?

A

Internal oblique

transversus abdominis

95
Q

what is the floor of the inguinal canal?

A

inguinal ligament

lacunar ligament

96
Q

what is the anterior wall of the inguinal canal?

A

Aponeurosis of external oblique

Internal oblique

97
Q

what is the posterior wall of the inguinal canal?

A

Transervaslis fascia

Conjoint tendon

98
Q

where does the conjoint tendon attach?

A

Pectineal line

Pubic crest

99
Q

which ligament of the uterus passes through the inguinal canal?

A

round ligament of the uterus

100
Q

what are the 3 arteries in the spermatic cord?

A

Artery to vas
Cremasteric artery
testicular artery

101
Q

what are the 3 nerves in the spermatic cord?

A

Genital branch genitofemoral n
Autonomic nerves
Ilioingional nerve (not within cord but in canal)

102
Q

what are the 3 ‘others’ in the spermatic cord?

A

Vas deferens
Lymphatics
Pampinoform plexus

103
Q

what are the 3 coverings of the spermatic cord?

A

External spermatic fascia
Cremasteric Muscle
Internal spermatic fascia

104
Q

what is the external spermatic fascia derived from?

A

External oblique

105
Q

what is the cremasteric muscle derived from?

A

Internal oblique + transervsus abdominis

106
Q

what is the internal spermatic fascia derived from?

A

transversalis fascia

107
Q

what is the nerve supply to the testes?

A

T10 sympathetic nerve

108
Q

the superior epigastric artery is a branch of what artery?

A

INternal thoracic (subclavian)

109
Q

the inferior epigastric artery is a branch of what artery?

A

External iliac

110
Q

what is the medial border of Hesselbach’s triange?

A

Rectus sheath (lateral border)

111
Q

what is the superolateral border of Hesselbachs triange?

A

Inferior epigastric vessels

112
Q

what is the inferior border of Hesselbach’s triangle?

A

Inguinal ligament

113
Q

what does the genital branch of the genitofemoral nerve innervate?

A

Cremaster muscle

Skin of scrotum (posterior)

114
Q

what does the ilioinguinal nerve supply?

A

upper and medial parts of thigh
anterior scrotum
base of penis

115
Q

what does the iliohypogastric nerve supply?

A

Skin above pubis

116
Q

where are femoral hernias found in relation to the pubic tubercle?

A

Below and lateral to pubic tubercle

117
Q

where are inguinal hernias found in relation to the pubic tubercle?

A

Above and medial to pubic tubercle

118
Q

what are the contents of the femoral canal?

A

Fat

Lymph node of Cloquet

119
Q

what is the function of the femoral canal?

A

Allows expansion of femoral vessels

Potential space

120
Q

what is the posterior border of the femoral canal?

A

Pectineal ligament

121
Q

what is the medial border of the femoral canal?

A

Lacunar ligament

122
Q

where does hunters canal run?

A

From base of the femoral triangle to popliteal fossa

123
Q

what are the boundaries of hunters canal?

A

Anterolaterally - vastus medialis
Anteromedially/Roof - sartorius
Posteriorly - adductor longus + magnus

124
Q

what are the contents of hunters canal?

A

Femoral artery
Femoral Vein
Saphenous nerve
nerve to vastus medialis

Anatomy MRCS Part B (3 decks)

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