Anat: Abdomen And Pelvis Flashcards
Which layer of the abdominal wall gives rise to
- Dartos muscle
- Cremaster muscle
- Tunics vaginalis
- Superficial fascia
- Internal oblique
- Peritoneum
What are the borders of the inguinal canal?
Ant EOM aponeurosis
Post transversalis fascia and conjoint tendon
Superior IO and transversus abdominis
Inferior inguinal ligament
Give the boundaries of the foramen of Winslow.
Ant hepatoduodenal ligament
Post IVC
Superiority caudate liver
Inferior duodenum
What vertebral level do most aneurysms occur?
L4 where the bifurcation of the aorta is located.
What part of the primitive gut are the ff organs from?
- Urinary bladder
- Urethra
- Bile duct
- Hepatic duct
- Appendix
- Hindgut
- Hind
- Fore
- Fore
- Mid
Which among these has to cross midline to get to the IVC? Left renal v Right renal v Right suprarenal v L suprarenal b L gonadal v R gonadal v
Left renal vein
In addition it also crosses over the aorta and may be compressed by aneurysms of re SMA causing renal hypertension and varicocoele
To which side of the liver will intestinal carcinoma metastasize to?
Right lobe due to its increased drainage/supply from the portal vein.
To what side do the quadrate and caudate liver belong to, functionally?
Functionally they belong to the left love since they are supplied by the left hepatic artery. Anatomically, they are of the right lobe.
What vessels supply and drain the upper third of the esophagus? How about the lower third?
Upper third: inferior thyroid a and v
Lower third: left gastric a and v
The left gastroepiploic vein drains into?
The superior mesenteric vein into the portal vein
The sympathetic supply of the stomach is from?
T6 to T9 segments of the spinal cord
Where do gastric ulcers commonly occur?
Along the lesser curvature above the incisura angularis
Carcinomas of the stomach commonly arise from the?
Pyloric region
What are the boundaries of the inferior thoracic aperture?
T12, rib 11 & 12, costal margin, xiphisternal joints
Most duodenal ulcers occur where? Most perforations occur where?
Both on the anterior wall of the first part of the duodenum. But posterior wall is more dangerous because of the presence of the gastroduodenal artery.
What is the measurement from the nostril to the cardiac orifice of the stomach?
17.2 inches/ 44 cm
Gastric or duodenal ulcer?
- BT O
- Px awakes at night because of pain
- 75% of all ulcers
- Bleeding from left gastric artery
- Pain decreases with food intake
All duodenal except for number 4
Everything is bigger, longer, redder in the jejunum compared to the ileum EXCEPT FOR 3 key features. What are these?
Ileum has more arcades, fat and lymphoid nodules (Peyer’s patches)
What is the most common form of intussuception and in what population does is occur in?
Ileocecal in the pediatric population
What vessels may be obstructed by a mass in the neck or body of the pancreas?
Portal vein or IVC
What vessels are responsible for the formation of the esophageal varices in a patient with liver cirrhosis?
Esophageal branch of the left gastric vein and esophageal branch of the Azygos system
How long is the transverse colon?
38cm or 15 inches
How long is the appendix?
1 inch 2.5 cm
Snell: 3-5 inches (6-10 cm)
What supplies the rectum
1st part
2nd
3rd
1st inferior mesenteric a
2nd internal iliac a
3rd internal pudendal a
In a renal transplant what vessels are connected to each other?
Renal artery to? Renal vein to?
In portocaval shunts:
Portal vein to? Splenic vein to?
Renal artery to internal iliac a
Renal vein to external iliac v
Portal vein to IVC
Splenic vein to Left renal vein
Anal canal proper begins at what level?
At the level of the puborectalis
Common cause of appendicitis in children
Hyperplasia of lymphatic tissue
In males the ureter is crossed by the? How about in women?
Vas deferens in males
Uterine artery in females
Common cause of appendicitis in adults
Fecalith
Most common position of the appendix
Retrocecal
Pelvic, also according to Snell
Presentation of retrocecal appendicitis
Psoas pain - patient keeps hip flexed
Presentation of a pelvic appendicitis
May have absent abdominal tenderness on the right. Deep tenderness over the symphysis pubis. DRE: pelvic pain on the right side
Nerve commonly damaged during appendectomy
Iliohypogastric nerve - weakening of anterior abdominal wall.
Anal canal begins with a u-shaped sling formed by which muscle?
Puborectalis
Disease due to occlusion of hepatic veins
Budd-Chiari syndrome
Caput medusae result from the portal-caval anastomoses of which particular vein
Para umbilical veins -> superficial and inferior epigastric
Where is the porta hepatis?
Postero-inferior surface, between the caudate and quadrate lobes
Parasympathetic fibers of the ascending colon comes from? How about the stomach?
Both Vagus nerve
Rate of bile production (Snell)
40mL/hour
Length of the common bile duct?
3 inches / 8cm
Folding in the mucosa of the cystic duct preventing the lumen of the GB from collapsing
Spiral valve of Heister
Clinical significance of supernumerary spleens
May hypertrophy after major splenectomy and cause recurrence of symptoms for which the initial splenectomy was for.
What type of kidney develops when lower poles are fused?
Horseshoe kidney - may impinge the ureters
A fused solid pelvic kidney
Cake kidney / lump kidney
Condition when a kidney is displaced downward due to loss of supporting fat.
Nephroptosis
Cells seen in the parietal layer of Bowman’s capsule?
Podocytes
Renal arterial blood flow:
Renal artery - segmental - lobar - interlobular - arcuate - interlobular - afferent art - bowman - efferent art - peritubular capillaries OR vasa recta
Inferolateral surface of the bladder
Space of Retzius
Separates the bladder from the rectum in males
Denonvilier’s fascia
Mesonephros contributions to the male and female genital tract?
Efferent ductules of the testis
Ductus epididymis, ductus deferens, seminal vesicles, ejaculatory duct.
What nodes drain the prostate?
How about the vagina?
How about uterus?
Internal iliac nodes for ALL THREE but the fundus of the uterus drained by para aortic nodes and the lower third of the vagina drained by superficial inguinal nodes
What are the secretions of the seminal vesicles?
Fluid Ascorbic acid Prostaglandins Amino acids Fructose
All primary oocytes are formed at what lint of fetal life?
5th month
Primary oocytes arrested at what stage until puberty?
Prophase of meiosis 1
Secondary oocytes arrested at what stage until fertilization?
Metaphase of meiosis 2
Who starts dividing earlier? Egg or sperm?
Egg. Starts at fetal life. Sperm starts at puberty
Name all the posterior branches of the sciatic nerve.
Superior gluteal Inferior gluteal Nerve to piriformis Common peroneal nerve Posterior femoral cutaneous (mixed)
What hormone induces the development of the mesonephric duct into epididymis, vas deferens, ejaculatory duct?
Testosterone
Most common site for the formation of an AAA.
Proximal to the bifurcation of the aorta at L4.
Left shoulder pain due to splenic rupture
Kehr’s sign
Causes the bag of worm-like appearance in varicocoele
Varicose veins of the pampineform plexus
Fascia continuous with the external spermatic fascia over the penis
Buck’s fascia
What lobes of the prostate are palpable during DRE?
Posterior and lateral lobes.
Ligament originating from the base of the broad ligament containing the uterine artery and vein
Cardinal ligament (Ligament of Mackenrodt)
From which artery does the dorsal artery of the penis arise?
Internal pudendal artery
Indication for the repair of AAA?
Diameter > 5.5 cm, rapid growth, embolization of the clot
External anatomic landmark coinciding with the bifurcation of the aorta.
Umbilicus
Widest part of the large intestine
Cecum (7-9 cm in diameter)
The superior fascia of the urogenital diaphragm is continuous with which fascial layer?
The obturator internus fascia
Which rectal vein belongs to the portal circulation?
Superior rectal vein.
Aside from storage what is the other major function of the epididymis?
Capacitation
What allows more blood to enter the corpus cavernosum during erection?
Relaxation of the smooth muscle in the helicane arteries
