Anatomy Flashcards
Tributaries to the portal vein? (5)
• Formed by splenic and superior mesenteric vein union
• right and left gastric veins
• cystic veins
• para-umbilical veins
Tributaries to the splenic vein? (4)
• Short gastric veins ( fundus of stomach )
• left gastro-omental vein (greater curvature stomach)
• pancreatic veins
• inferior mesenteric vein (rectum, sigmoid, descending colon, splenic flexure)
Tributaries to the superior mesenteric vein? (7)
• Right gastro-omental vein (greater curvature stomach)
• ant and post inferior pancreaticoduodenal veins
• jejunal vein
• ileal vein
• ileocolic vein
• right colic (asc colon)
• middle colic vein (transversecolon)
Name the 4 major sites of porto-systemic anastomosis
• oesophageal: oesophageal branch of left gastric vein and oesophageal tributaries to azygous system.
• rectal: superior and inferior rectal veins
• retroperitoneal: portal tributaries of mesentenic veins and retroperitoneal veins
• paraumbilical: portal veins of liver and veins of ant abdominal wall
(Most common sites of varices due to portal hypertension)
General Arterial supply to the colon?
Superior mesenteric artery= midgut
Inferior mesenteric artery = hindgut
Arterial supply to ascending colon? (5)
Ileocolic artery (sma)
• colic
• anterior caecal
• posterior caecal
Right colic a (sma)
Arterial supply to transverse colon?
Middle colic artery (sma)
Arterial supply to descending colon? (2)
Left colic artery (IMA)
Sigmoid aa (IMA)
Which artery provides collateral supply to colon and maintains supply in case of occlusion or stenosis of one of the major vessels?
Marginal artery of Drummond:
As terminal vessels sup and inf mesenteric a approach colon they split into many branches which anastomose with each other and form a continuous arterial channel which extends length of colon.
Vasa recta arise from marginal artery.
Lymphatic drainage colon? (5)
• Ascending and transverse → superior mesenteric nodes
• descending and sigmoid → inferior
→ intestinal lymph trunks → cisterna chyli → thoracic duct
What level does rectum begin?
S3 as continuation sigmoid
5 flexures of rectum?
• Sacral flexure: anteroposterior curve with anterior concavity
• anorectal: anteroposterior curve with anterior convexity. Formed by tone of puborectalis muscle. Contributes significantly to fecal continence.
• superior, intermediate and inferior: formed by transverse folds of internal rectum wall
Blood supply to rectum? (3)
• Superior rectal artery (terminal of ima)
• middle rectal (internal iliac)
• inferior rectal ( internal pudendal)
Venous drainage rectum? (3)
• Superior rectal vein → portal system
• middle and inferior rectal → systemic
Lymph drain rectum?
Pararectal nodes → inf mesenteric
Lower rectum directly to internal iliac nodes (nb in metastasis)
Embryological origin of the breast?
Ectoderm. Mammary ridge (groin to Axilla)
Name the 5 layers of the epidermis from superficial to deep
• Stratum corneum
• stratum lucidum
• stratum granulosum: secrete lipids and other waterproofing molecules
. Stratum spinosum:
• stratum basale
Function epidermis?
Cornification: increased keratin production and migration toward external surface
Name 3 specialised non-keratinocyte cells that inhabit the epidermis
• Melanocytes
• langer Hans cells: antigen-presenting dendritic cells
• Merkel cells: sensory mechanoreceptors
Name the 2 layers of the dermis
• Superficial papillary layer
• deep reticular layer: more collagen, more durable
Name 4 cell types and structures found in the dermis
• Fibroblasts: synthesize extra cellular matrix composed of collagen and elastin
• mast cells: histamine containing
• Blood vessels and cutaneous sensory nerves
• skin appendages: hair follicles, nails, sebaceous and sweat glands
What does the hypodermis consist of?
Stores adipose tissue
Differential diagnosis right hypochondriac pain? (7)
Biliary,
• Acute cholecystitis
• ascending cholangitis
• biliary colic cholelithiasis
Liver
• acute hepatitis
• liver abscess
Diaphragm
• subdiaphragmatic abscess
Chest
• right lower lobe pneumonia
Differential diagnosis epigastric pain? (10)
Chest
• inferior mi
Vascular
• aortic dissection
• pericarditis
Stomach !
• peptic ulcer, perforation
• gastritis
• GORD
Pancreas
• acute pancreatitis
Biliary: acute cholecystitis, acute cholangitis
Liver: acute hepatitis
Differential diagnosis left hypochondriac pain? (6)
Spleen!
• splenic infarct
• splenic abscess
Stomach
• gastritis
• gastric ulcer, perforation
Pancreas
• pancreatitis
Chest
• left lower lobe pneumonia
Differential diagnosis lumbar pain? (3)
Urinary
• pyelonephritis
• ureteric obstruction
colon!
• obstruction
Differential diagnosis peri-umbilical pain? (9)
Bowel!
• obstruction
• strangulation
• gastroenteritis
• early appendicitis
Vascular
• abdominal aortic aneurysm
• mesenteric thrombosis
Urinary
• diabetic ketoacidosis
Pancreas
• pancreatitis
Spleen
• splenic abscess
Differential diagnosis right inguinal pain? (8)
Appendix!
• late appendicitis
Bowel
• IBD
• strangulated inguinal hernia
• mesenteric adenitis
• typhilitis (caecum inflammation)
Gyaenacological
• acute salpingitis (gradual onset)
• ectopic pregnancy
Urinary
• nephrolithiasis
Differential hypogastric pain? (3)
Bowel
• IBD
Urinary
• cystitis
• pelvic inflammatory disease
• referred pain kidney
Differential left inguinal pain? (7)
Colon
• sigmoid volvulus!
• diverticulitis
• IBD
• strangulated inguinal hernia
Guynae
• ectopic pregnancy
Urinary
• salpingitis
• nephrolithiasis
