anatomy - abdo

Question 1

branches of coeliac artery - T12

Answer 1

1. left gastric - supplying the lesser curvature or the lower part of the oesophagus

2. splenic artery (runs behing stomach and in the splenoRENAL ligament)–> left gastroepiploic, short gastric and pancreatic branches
3. common hepatic –> a. gastroduodenal (right gastroepiploic and superior pancreaticoduodenal) b. hepatic proper(right gastric, right and left hepatic and cystic (branch of right hepatic))

Question 2

arterial supply to thoracic oesophagus

venous supply?

Answer 2

1. inferior thyroid artery
2. thoracic aorta
3. inferior thyroids vein
4. azygous veins

Question 3

bloods supply to abdominal oesophagus?

Answer 3

arterial -left gastric artery

left inferior phrenic artery

left inferior phrenic vein –>systemic

left gastric vein –> portal system

Question 4

sma suuplies the mid gut which ends?

Answer 4

2/3 along the transverse colon

Question 5

the ascending colon is supplied by?

Answer 5

ileocolic artery –> anterior and posterior caecal arteries and

right colic artery

Question 6

transverse colon is supplied by?

descending colon supplied by?

Answer 6

SMA- right and middle colics

IMA - left colic

IMA - left colic

Question 7

sigmoid colon is supplied by?

Answer 7

IMA -sigmoid arteries

Question 8

venous drainage of the colon?

Answer 8

ascending-ileo and right colic vein –> smv

transverse -middle colic–> smv

descending –> left colic –> imv

sigmoid -sigmoid veins –>imv

all draining into the portal vein

Question 9

duodenum

which parts of the duodenum are intra and retro peritoneal?

Answer 9

1st part (superior) is intra

the other 3 parts are retro periotoneal

Question 10

what are the 4 part of the duodenum?

Answer 10

1. superior (L1) - connect to the liver by hepatoduodenal ligament and is most common site of perforation
2. descending (L1-3) - site of ampulla of vater. behind the transverse colon but in front of the right kidney
3. infeiror - under the pancreas. passes over ivc and aortsa but posterior to sma and smv
4. ascending -joins jejunum at sharp flexure called dj flexure.

Question 11

differences between jejunum and ileum?

Answer 11

jej=in the LUQ red, thicker wall, less arcades and straigter vasa recta

ileum - RLQ

Question 12

What is the arterial blood supply to the rectum?

Answer 12

superior rectal artery -terminal continuation of the IMA

middle rectal artery - branch of the internal iliac artery

inferior rectal artery - from the internal pudendal artery

Question 13

venous blood supply to rectum?

Answer 13

superior rectal vein-draining to the portal system

middle and inferior rectal veins draining into the systemic system

anastomoses of these systems are in the ANAL wall therefore creating a portocaval anastomoses.

Question 14

innervation to the rectum?

Answer 14

sesnory and autonomic

1. sympathetic- lumbar sphlancnic nerves and superior and inferior hypogastric plexus
2. parasympthetic - pelvic splanchnic nerve - S2-4
3. sensory - same as parasympathetic

Question 15

lympathic drainage of the rectum?

Answer 15

drain into the pararectal nodes–>inferior mesenteric nodes

the inferior aspect drains directly inot the internal iliac nodes

Question 16

above the pectineal line …

Answer 16

artery - superior rectal artery (IMA)

vein -superior rectal vein(IMV) to portal venous system

nerves - visceral from inferior hypogastric plexus

lymph - internal iliac lymph nodes

Question 17

below the pectineal line ….

Answer 17

artery - inferior rectal artery - from internal pudenal artery

vein - inferior rectal vein –> internal pudendal vein –>systemic ciculation

nerves - via inferior anal nerves–> pudendal nerve

lymphatics - superificial INGUINAL lymph nodes

Question 18

4 posterolateral abdo muscles?

Answer 18

Quadratus lumborum

psoas major

psoas minor

iliacus

ps and iliacus make iliopsoas and flex the hip. iliacus is innervated by L2-4.

positive psoas sign when flexing the hip causes lower abdo pain due to inflamed appendix.

Question 19

borders of hesselbach’s triangle?

Answer 19

medial - lateral border of rectus abdominis

Lateral - inferior epigastric vessels

inferior - inguinal ligament

Question 20

borders of the inguinal canal?

Answer 20

anterior - external oblique aponeurosis

roof - internal oblique and transversus abdominis

posterior - tranversalis fascia

floor - inguinal ligament

Question 21

midpoint of the inguinal ligament?

mid inguinal point?

Answer 21

• site of hernia and just above it is the deep ring. between the asis and pubic tubercle
• site of the femoral pulse

between the asis and pubic symphisis

Question 22

indirect hernias in relation to inferior epigastrics?

Answer 22

lateral