Abdomen & Pelvis Flashcards
MRCS
List the contents of the spermatic cord (3 arteries, 3 nerves, 3 other structures)
Arteries - testicular, cremasteric, artery to vas
Nerves - genital branch of genitofemoral, sympathetic nerves, ilioinguinal nerve (on it)
Other - vas deferens, pampiform plexus, lymphatics
Where is the deep inguinal ring?
1cm above the midpoint of the inguinal ligament, lateral to inferior epigastric vessels
Where is the superficial ring?
Above and medial to the pubic tubercle
Where do the inferior epigastric vessels enter the abdominal wall?
Arcuate line - halfway between the umbilicus and pubic symphysis
Where does the root of the penis attach proximally?
Perineal membrane, pubic rami via the crura, pubic symphysis via the suspensory ligament
Which testicle lies lower in the scrotum?
Left
Name the tissue layer that encapsulates the testicles
Tunica albuginea
Name the tissue layer that forms a sac around the testicles
Tunica vaginalis (parietal)
Where do the testicular veins drain?
Right - IVC
Left - left renal vein
Name the muscle that encapsulates the testicles
Cremaster muscle
What is the gubernaculum?
A fibrous cord that connects the fetal testis with the bottom of the scrotum
Where are the ejaculatory ducts found?
Lateral aspect of prostate gland
Where do the common ejaculatory ducts open?
Verumontanum either side of the urticle
Name the fascia that surround the corpora in the penis and what is it a continuation of?
Buck’s fascia
Scarpa’s fascia
Name the superficial fasica surrounding the penis
Colles fascia
Which kidney lies lower in the abdomen and why?
Right - displaced by the liver
Name the fascia that surrounds the kidney and adrenal gland
Gerota’s fascia
How long is the ureter?
25-30cm
What spinal level do parasympathetic fibres to the bladder originate?
S2-4
Which nerve supplies the external urethral sphincter?
Pudendal nerve
Describe the mechanism of a direct inguinal hernia
Bowel enters the inguinal canal directly through a weakness in the posterior wall of the canal
Describe the mechanism of an indirect inguinal hernia
Bowel enters the inguinal canal via the deep inguinal ring
Occur due to a patent processus vaginalis
What are the borders of Hesselbach’s triangle?
Medial - lateral border of rectus abdominis
Superior - inferior epigastric vessels
Inferior - inguinal ligament
Where is the femoral artery palpated?
Mid-inguinal point - midpoint between pubic symphysis and ASIS
What type of cancer is associated with Barrett’s oesophagus?
Oesophageal adenocarcinoma
What level is the oesophageal hiatus?
T10
What level is the inferior oesophageal sphincter?
T11
Which arteries anastomose to supply the stomach?
Gastric and gastro-omental
What is a sliding hiatus hernia?
The lower oesophageal sphincter slides superiorly
What is a rolling hiatus hernia?
Part of the stomach herniates into the thorax next to the lower oesophageal sphincter
What is the most common site of duodenal ulceration?
Hepatoduodenal ligament
What is the major duodenal papilla?
The site in the descending duodenum (D2) where the ampulla of Vater opens to secrete bile and pancreatic fluids
Which part of the duodenum transverses the IVC and aorta?
Inferior (D3)
Which artery is at risk of erosion from a duodenal ulcer?
Gastroduodenal
What is the arterial supply to the duodenum?
Gastroduodenal artery - before major duodenal papilla
Pancreaticoduodenal artery - after major duodenal papilla
What artery supplies the caecum?
Ileocolic artery from SMA
What is the name of the ligament which attaches the colon to the diaphragm?
Phrenicocolic ligament
Why the sigmoid colon prone to volvulus?
The sigmoid mesocolon that is attached to the posterior pelvic wall making it a long mesentery
Name 4 features of the colon that distinguishes it from the small intestine
Omental appendices
Teniae coli
Haustra
Wider diameter
Name the 3 teniae coli
Mesocolic
Free
Omental
What is the arterial supply to the ascending colon?
Ileocolic (colic, anterior caecal, posterior caecal branches) and right colic arteries from the SMA
What is the arterial supply to the transverse colon?
Right colic artery (SMA)
Middle colic artery (SMA)
Left colic artery (IMA)
What is the arterial supply to the descending colon?
Left colic artery from the IMA
Name the artery that provides collateral blood supply to the colon
Marginal artery of Drummond
What spinal level does the rectum begin?
S3
How can the rectum be distinguished from the colon?
Absence of taenia colic, haustra and omental appendices