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MRCS > Abdomen: Viscera > Flashcards

Abdomen: Viscera Flashcards

1
Q

Innervation of peritoneum

A

Parietal: spinal somatic fibres: localised pain

Visceral: visceral afferents: referred pain

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2
Q

Greater sac and lesser sac (omental bursa)

A

Greater sac contains most of the abdomen

Lesser sac: posterior to stomach and liver

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3
Q

Omental epiploic foramen

A

Joins lesser sac to greater sac

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4
Q

Structures anterior to omental (epiploic) foramen

A

Portal vein

Hepatic artery proper

Bile duct

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5
Q

Structures posterior to epiploic foramen

A

inferior vena cava

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6
Q

Structures inferior to epiploic foraman

A

1st part of duodenum

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7
Q

Structures superior to epiploic foraman

A

caudate lobe of liver

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8
Q

Greater omentum

A

Greater curvature of stomach

Drapes down anterior to transverse colon, ileum and jejunum

Loops back up and joins transverse colon peritoneum

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9
Q

Lesser omentum

A

Lesser curvature of stomach to inferior liver

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10
Q

Mesenteries

A

Mesentery

Transverse mesocolon

Sigmoid mesocolon

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11
Q

Mesentery

A

The only double layered fold of peritoneum

connects jejunum and ileum to posterior wall

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12
Q

Structures entering through the diaphragm

A

Vena cava + right phrenic T8

Oesophagus + vagus T10

Aorta + thoracic duct T12

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13
Q

Blood supply to abdominal oesophagus

A

Left gastric artery

Inferior phrenic artery

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14
Q

Different parts of stomach

A

Note: cardial notch: superior angle where oesophagus enters stomach

Angular incisure: bend on lesser curvature

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15
Q

Arterial supply of stomach

A

Left gastric

Short gastric

Gastro-epiploic arcade

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16
Q

Parts of duodenum

A

Superior

Descending

Inferior

Ascending

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17
Q

Duodenum intra or extraperitoneal

A

First part: extra peritoneal

Rest: intra peritoneal

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18
Q

Blood supply to duodenum

A

Superior and inferior pancreatoduodenal arteries

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19
Q

Difference between the appearance of ileum and jejunum

A

Jejunum:

  • longer vasa recta, smaller arcade
  • Larger calibre.
  • Darker
  • less mesenteric fat
  • Deeper valvulae conniventes

Ilieum:

  • smaller vasa recta, more developed arcade.
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20
Q

Source of bleeding from a deudonal ulcer

A

Posterior wall

Pancreatodeudonal artery

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21
Q

Different positions of appendix

A

Retrocaecal 74%

Pelvic 21%

Postileal

Subcaecal

Paracaecal

Preileal

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22
Q

Identification of appendix during surgery

A

Caecal taenia coli converge at base of appendix and form a longitudinal muscle cover over the appendix.

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23
Q

Blood supply to appendix

A

Appendicular artery (branch of ileo-colic artery)

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24
Q

Colon, intra or retroperitoneal

A

Appendix and caecum: intra

Ascending: retro

Transverse: intra

Descending: retro

Sigmoid: intra

Rectum: (distally) retro

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25
Q

Arterial supply of colon

A

Ascending: ilio-colic and right colic (joined by marginal artery)

Transverse: middle colic

Descending: Inferior mesenteric artery (left colic)

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26
Q

Arterial supply of rectum

A

Superior rectal artery (IMA)

Middle rectal artery (internal iliac)

Inferior rectal artery (internal pudendal, from internal iliac)

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27
Q

Recesses around liver

A

Hepatorenal recess

Subphrenic recess

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28
Q

What space does the hepatorenal recess communicate with

A

Right paracolic gutter and lesser sac

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29
Q

Is liver intra or retroperitoneal

A

Intra (mostly)

30
Q

Porta hepatis content

A

Hepatic artery

Portal vein

Common hepatic bile duct

31
Q

Blood supply to liver

A

Right lobe: right hepatic artery

Left lobe: left hepatic artery

Quadrate lobe: Left hepatic artery (anatomically part of right)

Caudate: both hepatic arteries

32
Q

Ligaments of inferior aspect of liver

A

Falciform ligament

Left triangular ligament

Right triangular ligament

Anterior and posterior coronary ligaments

33
Q

Falciform ligament

A

Connects umbilicus to liver

Contains ligamentum teres (remnant of umbilical vein)

Splits into coronary and left triangular ligaments

34
Q

Ligamentum venosum

A

Remnant of ductus venosus

35
Q

Parts of gallbladder

A

Fundus

Body

Neck

36
Q

Blood supply to gall bladder

A

Cystic artery (branch of right hepatc artery)

37
Q

Pancreas parts

A
38
Q

Pancreas ducts

A

Accessory -superior

Hepatopancreatic- inferior

39
Q

Pancreatic blood supply

A

Head: Inferior/superior pancreatoduodenal artery

Rest: splenic artery

40
Q

Biliary tree anatomy

A
41
Q

Where does the common bile duct enter the duodenum

A

Posteromedial wall of the second part of the duodenum

42
Q

Position of spleen (ribcage)

A

Ribs 9 -12

43
Q

Branches of abdominal aorta

A
44
Q

Coeliac axis branches

A

Left gastric

Hepatic

Splenic: branches- Pancreatic, Short Gastric, Left Gastroepiploic

45
Q

Superior and inferior mesenteric artery branches

A
46
Q

Branches of common hepatic artery

A

Right Gastric

Gastroduodenal

Superior Pancreaticoduodenal

Cystic (occasionally).

47
Q

Branches of splenic artery

A

Pancreatic

Short Gastric

Left Gastroepiploic

48
Q

GI venous system

A

IMV, Short gastric and left gastro-epiploic → splenic v

R gastroepiploic → SMV

SMV + splenic → portal v

R gastric → portal v

49
Q

Renal anatomy

A

Outer cortex

Inner medulla: including pyramids

Papilla: apex of pyramids

50
Q

Lymph drainage of kidneys

A
51
Q

Structures in renal hilum

A

Anteriro to posterior

  • renal vein
  • renal artery
  • ureter
52
Q

Fascia surrounding kidneys

A

Gerota’s fascia

53
Q

Anatomical course of ureters

A

Starts in renal pelvis

Descends anterior to psoas major/lateral to transverse process

Crossed by gonadal vessels anteriorly, genitofemoral n posteriorly (testicular pain with ureteric stones)

Crossed by vas (male) and uterine artery anteriorly just before entering posterolateral aspect of the bladder

54
Q

Sites of constriction of ureters

A

Ureteropelvic junction

Crossing common iliac at pelvic brim

Entering the wall of the bladder

55
Q

Blood supply to ureters

A

Upper 1/3: Renal artery

Middle 1/3: testicular/ovarian/common iliac

Lower 1/3: Superior vesical (internal iliac)

56
Q

Lymph drainage of ureter

A

Upper- lateral aortic

Middle- common iliac

Lower- External and internal iliac

57
Q

Adenal gland arterial supply

A

Superior suprarenal artery (inferior phrenic)

Middle suprarenal artery

Inferior suprarenal artery

58
Q

Venous drainage of adrenal gland

A

Suprarenal vein

59
Q

Lumbar plexus nerves

A

Exit in relation to psoas major:

Lateral:

  • Ilioinguinal (L1)
  • Iliohypogastric (L1)
  • Femoral (L2,3,4)
  • Lateral cutaneous nerve of thigh (L2,3)

Medial:

  • obturator (L2,3,4)
  • Lumbosacral trunk (L4,5)

Anterior:

  • Genitofemoral (L1,2)
60
Q

Ilio-hypogastric innervates

A

Internal oblique and transvesus abdominis

61
Q

Ilio-inguinal innervates

A

Internal oblique

Transversus abdominis

62
Q

Genitofemoral innervates

A

Genital branch: cremester reflex

63
Q

Obturator innervates

A

Obturator externus

Pectineus

medial compartment

64
Q

Femoral innervates

A

iliacus

pectineus

anterior compartment

65
Q

Retroperitoneal viscera

A

SAD PUCKER

Suprarenal (adrenal glands)

Aorta & IVC

Duodenum (2-4th parts)

Pancreas

Ureters

Colon (descending and ascending)

Kidneys

Esophagus

Rectum

66
Q

Calot’s triangle borders

A

Inferior edge of liver

Common bile duct

Cystic duct

67
Q

Calot’s triangle content

A

Cystic artery

Right hepatic artery

Right branch of portal vein

68
Q

Lymph drainage of rectum

A

Above dentate line: mesorectal node

Below dentate line: Inguinal node

69
Q

Structures within gastro splenic ligament

A

short gastric arteries

70
Q

Which structure is anterior to portal vein

A

Pancreatic neck

71
Q

What anatomical structure controls the flow of the bile into the duodenum

A

Sphincter of oddi (controlled through hormonal and neural innervation)

MRCS (29 decks)

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