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FRCEM Primary > Anatomy - Abdomen > Flashcards

Anatomy - Abdomen Flashcards

1
Q

9 regions of the abdomen

A 
Right and left hypochondrium
Right and left lumbar
Right and left inguinal
Epigastrium
Umbilical
Hypogastrium
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2
Q

Origin of external oblique

A

Lower 8 ribs

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3
Q

Insertion of external oblique (6)

A 
Xiphoid process
Linea alba
Pubic crest
Pubic tubercle
Iliac crest
Is the origin of the inguinal ligament
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4
Q

Origin of internal oblique (3)

A

Lumbar fascia
Iliac crest
Lateral 2/3rds inguinal ligament

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5
Q

Insertion of internal oblique (4)

A

Lower 3 ribs and costal cartilage
Xiphoid process
Linea alba
Symphysis pubis

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6
Q

Innervation of external oblique (3)

A

Lower 6 thoracic nerves
Iliohypogastric nerve
Ilioinguinal nerve

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7
Q

Innervation of internal obliques (3)

A

Lower 6 thoracic nerves
Iliohypogastric nerve
Ilioinguinal nerve

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8
Q

Origin of transversus (4)

A

Lower 6 costal cartilages
Lumbar fascia
Iliac crest
Lateral third inguinal ligament

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9
Q

Insertion of transversus (3)

A

Xiphoid process
Linea alba
Symphysis pubis

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10
Q

Nerve supply of transversus (3)

A

Lower 6 thoracic nerves
Iliohypogastric nerve
Ilioinguinal nerve

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11
Q

Origin of rectus abdominis (2)

A

Symphysis pubis

Pubic crest

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12
Q

Rectus abdominis (2)

A

5th-7th costal cartilages

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13
Q

Innervation of rectus abdominis

A

Lower 6 thoracic nerves

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14
Q

The rectus sheath is formed from the aponeurosis of

A

External obliques
Internal obliques
Transversus

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15
Q

Above the level of the costal margin the anterior rectus sheath is formed by

A

The external oblique aponeurosis.

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16
Q

Above the level of the costal cartilage the posterior rectus sheath

A

doesn’t exist

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17
Q

From the costal cartilage to the anterior iliac spine the anterior rectus sheath is formed by

A

the external oblique aponeurosis and the anterior part of the split internal oblique aponeurosis

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18
Q

From the costal cartilage to the anterior iliac spine the posteior rectus sheath is formed by

A

the posterior part of the split internal oblique aponeurosis and the transversus abdominus aponeurosis

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19
Q

From the ASIS to the pubis the anterior rectus sheath is formed by

A

the combined aponeuroses of external oblique, internal oblique and transversus

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20
Q

From the ASIS to the pubis the posterior rectus sheath is

A

absent. Rectus abdominis lies on transversalis fascia, thickened to form the iliopubic tract

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21
Q

The rectus sheath contains (3)

A

Posterior intercostal nerves
Superior epigastric artery
Inferior epigastric artery

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22
Q

The actions of the abdominal muscles (3)

A

Truncal movement
Rib depression
Visceral support

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23
Q

Place and role of the inguinal canal

A

An oblique passage through the lower part of the abdominal wall. Allows passage of structures from testis to the abdomen or the round ligament of the uterus from the uterus to the labium majus. 6cm long lying parallel and above the inguinal ligament from the inguinal ring to the superficial inguinal ring

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24
Q

Roof of inguinal canal

A

Arching lower fibres of internal oblique and transversus muscles

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25
Q

Anterior wall of inguinal canal

A

Aponeurosis of external oblique

Reinforced by internal oblique in lateral third

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26
Q

Posterior wall of inguinal canal

A

Fascia transversalis

Reinforced by conjoint tendon in medial third

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27
Q

Floor of inguinal canal

A

The inguinal ligament - rolled under inferior edge of the aponeurosis of external oblique
At the medial end of the lacunar ligament

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28
Q

Superficial inguinal ring

A

Triangular shaped defect on the external oblique aponeurosis sitting above and medial to pubic tubercle

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29
Q

Deep inguinal ring

A

Oval opening int he transversalis fascia

Lies 1.3cm above the inguinal ligament midway between ASIS and symphysis pubis

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30
Q

Contents of the inguinal canal

A 
Vas deferens
Testicular artery
Artery to vas deferens
Cremasteric artery
Pampiniform plexus
Lymphatic vessels
Genital branch of genitofemoral nerve
Sympathetic nerves
ilioinguianl nerve
Processus vaginalis
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31
Q

Spermatic cord contains

A

Vas, vessels and three covering layers:
Internal spermatic fascia
Cremasteric fascia
External spermatic fascia

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32
Q

The testes is surrounded by a fibrous capsule called

A

tunica albuginea

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33
Q

The blood supply of the testes comes from

A

testicular artery from the abdominal aorta

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34
Q

Lymph drainage of the testis

A

Via the para-aortic lymph nodes

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35
Q

Lymph from the covering of the testis drains to

A

external iliac nodes

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36
Q

Lymph from the scrotum drains

A

to superficial inguinal lymph nodes

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37
Q

Innervation of testes

A

Sympathetic fibres derived from T6-T10 - pain often referred to abdomen

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38
Q

The testes begin development in the abdomen embedded in the

A

gubernaculum

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39
Q

The gubernaculum swells and draws the testis

A

down towards the scrotum along with a diverticulum of peritoneum called processus vaginalis

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40
Q

The gubernaculum becomes

A

a remnant in the scrotum and the vas passes down through the inguinal canal.

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41
Q

Vas deferens transports

A

Mature sperm from epididymis to ejaculatory duct and urethra

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42
Q

Course of the vas deferens

A

Arises from the tail of epididymis and runs up the inguinal canal , leaving through the deep inguianl ring, passes around the inferior epigastric artery. Passes along the lateral wall of the pelvis downwards and backwards, crossing the ureter at the level of the ischaial spine. Continues medially and downward along the posterior surface of the bladder, joining the seminal vesicle forming the ejaculatory duct which pierces the posterior surface of the prostate into the prostatic part of the urethra.

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43
Q

Site of parietal peritoneum

A

Lines walls of abdominal and pelvic cavities

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44
Q

Parietal peritoneum is sensitive to

A

Pain, temperature, touch and pressure

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45
Q

Site of Visceral peritoneum

A

Covers organs

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46
Q

Visceral peritoneum is sensitive to

A

Stretch and tearing

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47
Q

Parietal peritoneum is supplied by (3)

A

Abdominal section - Lower 6 thoracic and 1st lumbar nerves
Diaphragmatic section - Phrenic nerve and lower 6 thoracic nerves
Pelvic section - obturator nerve

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48
Q

Visceral peritoneum is supplied by (1)

A

Autonomic nerve fibres that supply viscera or travel in mesentery

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49
Q

3 sections of the peritoneum

A

Supracolic
Infracolic
Pelvic

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50
Q

What divides the supracolic and onfracolic compartments?

A

Transverse mesocolon

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51
Q

The infracolic compartment contains

A

Small intestine
Ascending colon
Descending colon

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52
Q

Infracolic compartment is divided into

A

Right and left infracolic compartments by the root of the mesentery which starts at the left duodenojejunal junction and runs down and right at 45 degrees to the right iliac fossa

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53
Q

The sigmoid mesocolon attachments

A

Medial side of left psoas major
Runs up and back to apex overlying bifurcation of common iliac vessels and left ureter
Bends down to end at level of 3rd sacral vertebra in median plane

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54
Q

Supracolic compartment contains (3)

A

Stomach
Liver
Spleen

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55
Q

Greater omentum connects

A

greater curve of the stomach to the transverse colon.

It hangs down in front like an apron and then folds back on itself

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56
Q

Oesophagus pierces diaphragm at level

A

T10

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57
Q

Factors guarding against reflux are (3)

A

A physiological sphincter formed by a circular layer of muscle at lower end of oesophagus. Controlled by vagus nerve, augmented by hormonal control from secretin, glucagons, cholecystokinin

Fibres of right crus of diaphragm
Muscularis mucosa has mucosal flaps

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58
Q

Posterior to oesophagus in abdomen

A

Left crus of diaphragm
Right vagus nerve
Left lobe of liver

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59
Q

Anterior to oesophagus in abdomen

A

Covered in peritoneum

Left vagus nerve

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60
Q

Oesophageal nerve supply

A

Vagus plexus

Oesophageal plexus

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61
Q

Blood supply to abdominal oesophagus

A

Branches from left gastric artery

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62
Q

Venous drainage of abdominal oesophagus

A

Left gastric vein - tributary of portal vein

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63
Q

Sections of the stomach (3)

A

Fundus
Body
Pylorus

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64
Q

Fundus of the stomach

A

Projects above the cardia and connects with the diaphragm, dome shaped and full of gas

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65
Q

Body of the stomach extends from

A

Cardiac orifice to incisura angularis.

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66
Q

Level of body of stomach when standing

A

T10

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67
Q

The pylorus of the stomach has a thick muscular wall called and does what

A

the pyloric sphincter. It controls the rate of passage of stomach contents into the duodenum

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68
Q

When recumbent the pyloric opening lies

A

Right of midline at level of L1

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69
Q

Anterior relations of the stomach left to right

A

Diaphragm
Anterior abdominal wall
Left lobe of liver

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70
Q

Posterior relations of stomach left to right

A 
Lesser sac
Diaphragm
Aorta
Pancreas
Spleen
Left kidney
Left adrenal gland
Transverse mesocolon
Transverse colon
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71
Q

Arterial supply of the stomach comes from

A

the 3 branches of the coeliac trunk

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72
Q

Nerve supply of the stomach

A

Vagus nerves
Anterior and posterior vagi enter abdomen and supply parasympathetic fibres
Sympathetic nerve supply is from coeliac plexus

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73
Q

Innervation of the stomach: Anterior nerve from left vagus supplies

A

Anterior aspect of stomach. 3 branches
Gastric
Hepatic
Branches to pyloric antrum

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74
Q

Innervation of the stomach: Posterior nerve from right vagus supplies

A

Posterior aspect. 2 branches
Coeliac branch
Numerous branches to posterior stomach

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75
Q

Blood supply of the duodenum

A

Pancreaticoduodenal arteries - upper half by superior, lower half by inferior.

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76
Q

Vertebral levels of the four parts of the duodenum

A

1: Upwards and backwards to right of L1
2: Right of L2, L3
3: Crosses L3
4: L3

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77
Q

Duodenum - intra or retroperitoneal ?

A

First 5cm intraperitoneal, rest is retroperitoneal

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78
Q

Duodenum position relative to aorta

A

Aorta is posterior to third and fourth part of duodenum

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79
Q

Duodenum position relative to pancreas

A

Pancreas sits inferior to first part
Pancreas sits medial to second part
Pancreas sits superior to third part

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80
Q

Duodenum position relative to IVC

A

IVC sits posterior to first part and third part

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81
Q

The jejunum and ileum are susceptible to injury because

A

they are freely mobile but fixed to the posterior abdominal wall by the mesentery of the small intestine

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82
Q

What is meckel’s diverticulum

A

A diverticulum in the ileum, 60cm from the caecum, 5cm long, containing all three lyers of intestinal wall. Can be attached to the umbilicus by a fibrous cord or be adhered to it. May contain ectopic gastric or pancreatic mucosa. Presents with haemorrhage or perforation, volvulus, intussusception or Meckel’s diverticulitis

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83
Q

Nerve supply of the jejunum and ileum

A

Vagal sympathetic and parasympathetic form the superior mesentericplexus.

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84
Q

Referred pain from the jejunum and ileum

A

Pain fibres pass to the spinal cord via splanchnic nerves and pain is referred to T9-T10 dermatomes. Pain is felt here first and then localises.

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85
Q

Blood supply of the jejunum and ileum comes from

A

midgut superior mesenteric artery.

The lowest part of the ileum is supplied by the ileocolic artery

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86
Q

Position of the caecum

A

Right iliac fossa
Anterior to psoas and iliacus muscle
Anterior to lateral cutaneous nerve of the thigh

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87
Q

Referred pain from caecum

A

In the leg when psoas is stretched or hip moves

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88
Q

Where is McBurney’s point

A

1/3rd way from ASIS to umbilicus

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89
Q

Common positional variants of the tip of the appendix

A

Retrocaecal - 62%
Pelvic - 34%
Pre-ileal - 1%
Post-ileal - 0.5%

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90
Q

Arterial supply of the colon

A

Hindgut inferior mesenteric artery

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91
Q

Innervation of the colon

A

Pain from sympathetic fibres to the aortic plexus T10-L2.
Motor for proximal colon to transverse colon from vagus nerve
Motor for distal colon from sacral nerves

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92
Q

Ascending colon relation to abdominal organs

A

Posterior to small intestine

Anterior to lower pole right kidney

93
Q

Transverse colon relation to abdominal organs

A

Attached to pancreas via the mesocolon

Anterior to the small intestine and 2nd part of duodenum

94
Q

Descending colon relation to abdominal organs

A

Posterior to small intestine

Anterior to lateral border left kidney

95
Q

Lobes of the liver (4)

A

Right
Left
Caudate
Quadrate

96
Q

Two surfaces of the liver

A

Diaphragmatic

Visceral

97
Q

Anterior relations of the liver (5)

A 
Diaphragm
Right and left costal margins
Right and left pleural and inferior lung margins
Xiphoid process
Anterior abdominal wall
98
Q

Posterior-inferior surface relations of the liver (8)

A 
Abdominal oesophagus
Stomach
Duodenum
Right colic flexure
Right kidney
Right adrenal gland
Gallbaldder
IVC
99
Q

Building blocks of the liver are called

A

lobules

100
Q

The space between the liver lobules is called

A

portal canal

101
Q

Inside a lobule is

A

a central vein - a tributary of the hepatic veins

102
Q

Portal canals contain

A

the portal triad - branches of the portal vein
branches of the hepatic artery
a bile duct tributary

103
Q

What are sinusoids

A

spaces where arterial and venous supply passes through between liver cells before draining into the central vein

104
Q

Stability of the liver comes from

A

the hepatic veins connecting to IVC

105
Q

30% of liver blood supply comes from

A

Hepatic artery, a branch of the coeliac artery (oxygenated blood)

106
Q

70% of the liver’s blood supply comes from

A

portal vein (deoxygenated blood, rich in digestion products)

107
Q

Pathway of blood through the liver (3)

A

Into the central veins which drain
To left and right hepatic vein which open
Directly to IVC

108
Q

Right lobe of the liver mainly receives blood from the (1)

A

Intestine

109
Q

Left, caudate and quadrate lobes receive blood mainly from the (2)

A

stomach and spleen

110
Q

Lymph leaves the liver via the

A

porta hepatis

111
Q

The liver drains lymph to

A

Coeliac and posterior medastinal lymph nodes

112
Q

The gall bladder is made of three parts

A

Fundus
Body
Neck

113
Q

In the gall bladder where is Hartmann’s pouch

A

A dilated area of the gallbladder neck just before it joins the cystic duct

114
Q

Bile journey

A

Made in the liver
Stored and concentrated in the gallbladder
Delivered in to the duodenum

115
Q

Formation of the common bile duct

A

Right and left hepatic ducts come from the right and left side of the liver and combine in the porta hepatis,
uniting to form the common hepatic duct which
unites with the cystic duct from the gall bladder to form the common bile duct

116
Q

First part of the common bile duct sits where

A

in the free margin of the lesser omentum
in front of the portal vein
to the right of the hepatic artery

117
Q

Second part of the common bile duct sits where

A

Lies behind the 1st part of the duodenum

To the right of the gastroduodenal artery

118
Q

Third part fo the common bile duct sits where

A

Lies in a groove on the posterior surface of the head of the pancreas

119
Q

How does the common bile duct open into the duodenum

A

Together with the pancreatic duct the pierce the medial wall of the second part fo the duodenum in the ampulla of vater

120
Q

Nerve supply of bile ducts

A

Sympathetic and parasympathetic vagal fibres from coeliac plexus

121
Q

Referred pain from the bile ducts is felt

A

Right upper quadrant or epigastrium T7, T8, T9

122
Q

The portal vein is a continuation of

A

the superior mesenteric and splenic vein

123
Q

5 sites of portosystemic anastamosis

A 
Lower third of the oesophagus - oesophageal varices
Paraumbilical area - caput medusa
Upper end of anal canal - haemorrhoids
Retroperitoneal
Bare area of liver
124
Q

Exocrine function of pancreas

A 
Pancreatic juice excretes into duodenum containing amylase
lipase
trypsinogen and chymotrypsinogen
Peptidases
Bicarbonate ions
Sodium ions
Water
125
Q

Endocrine function of pancreas

A

Insulin from beta cells
Glucagon from alpha cells
Somatostatin from delta cells
Pancreatic polypeptide from F cells

126
Q

Anatomical divisions of the pancreas

A

Head
Neck
Body
Tail

127
Q

Relations of the head of the pancreas

A

lies in a c shape cavity in the duodenum

128
Q

Relations of the neck of the pancreas

A

in front of the portal vein and origin of sma

129
Q

Relations of the body of the pancreas

A

passes up and left forming part of stomach bed

130
Q

Relations of the tail of the pancreas

A

in contact with hilum of spleen

131
Q

Blood supply of the pancreas

A

Splenic artery

Pancreaticoduodenal artery

132
Q

Venous drainage of the pancreas

A

to the portal vein

133
Q

Lymph drainage of the pancreas

A

Nodes along the arteries and then to coeliac and superior mesenteric lymph nodes

134
Q

Innervation of the pancreas

A

sympathetic and parasympathetic vagal nerve fibres. Pain refers to T6-T10

135
Q

Functions of the spleen

A

Filtering blood - macrophages remove cellular and non-cellular material
Haemopoiesis - in foetus and if demand exceeds marrow capacity
Immune - antigen recognition
Opsonisation
Protection from infection
Iron reutilisation

136
Q

Surface markings of spleen

A

LUQ
Under ribs 9-11
Pathologically extends down and medially

137
Q

Origin of psoas

A

Transverse processes, bodies and intervertebral discs of T12, L1-L5

138
Q

Insertion of psoas

A

Lesser trochanter of femur

139
Q

Innervation of psoas

A

Lumbar plexus

140
Q

Action of psoas

A

Flexes thigh on trunk

If thigh is fixed, flexes trunk on thigh (sitting up)

141
Q

Origin of quadratus lumborum

A

Iliolumbar ligament
Iliac crest
Transverse process of lower lumbar vertebrae

142
Q

Insertion of quadratus lumborum

A

12th rib

143
Q

Actions of quadratus lumborum

A

Fixes 12th rib during inspiration
Depresses 12th rib in forced expiration
Laterally flexes vertebral coloumn

144
Q

Innervation of quadratus lumborum

A

Lumbar plexus

145
Q

Actions of iliacus

A

Flexes thigh on trunk

If thigh is fixed, flexes trunk on thigh (sitting up)

146
Q

Innervation of iliacus

A

Femoral nerve

147
Q

Iliopsoas and quadratus lumborum is covered by a thick fascia derived from

A

lumbar fascia

148
Q

Surface markings of aorta. Bifurcates at

A

L4

149
Q

Branches of the aorta

A

Single ventral gut
Paired visceral
Paired wall

150
Q

IVC surface markings

A

Lies to the right of aorta
Formed by the union of the common iliac veins at L5
Pierces the diaphragm at T8

151
Q

Tributaries of IVC

A 
External iliac
Lumbar
Gonadal
Renal
Hepatic
152
Q

Lumbar plexus nerves - Iliohypogastric nerve

A 
L1
External oblique
Internal oblique
Transversus abdominis
Skin of lower anterior abdominal wall and buttock
153
Q

Lumbar plexus - Ilioinguinal nerve

A 
L1
External oblique
Internal oblique
Transversus abdominis
Skin of upper medial aspect of thigh
Root of penis/scrotum
Mons pubis/Labia majorum
154
Q

Lumbar plexus nerves - Lateral cutaneous nerve of the thigh

A

L2/L3

Skin of anterior and lateral thigh

155
Q

Lumbar plexus nerves - Genitofemoral nerve

A

L1/L2
Cremaster muscle
Cremasteric reflex
Skin of anterior surface of thigh

156
Q

Lumbar plexus nerves - femoral nerve

A 
L2/L3/L4
Iliacus
Pectineus
Sartorius
Quadriceps femoris
Skin of anterior surface of thigh
Skin of medial side of leg and foot
Branches to hip and knee joints
157
Q

Preaortic lymph nodes

A

Coeliac
Superior mesenteric
Inferior mesenteric

158
Q

Preaortic lymph nodes drain

A

GI tract from lower third oesophagus to halfway down anal canal
Spleen
Pancreas
Gall bladder, greater part of liver

159
Q

Para-aortic lymph nodes drain

A 
Kidneys
Adrenals
Testes/ovaries
Uterine tubes
Fundus of uterus
Deep abdominal wall
Common iliac nodes
160
Q

With normal respiration kidneys move down by

A

2.5cm

161
Q

Surface anatomy of the kidney

A

Spine of T12 to spine of L3.

Hila at L1

162
Q

The kidney relations

A

Retroperitoneal
Directly under the diaphragm
Lie on psoas, quadratus lumborum, origin of transversus abdominis

163
Q

Coverings of the kidney deep to superficial

A

Fibrous capsule
Perirenal fat
Renal fascia
Pararenal fat

164
Q

Renal fascia in disease

A

An abscess burting traps pus in the renal fascia causing a tender mass, slow in onset. The renal fascia is continuous with transversalis fascia

165
Q

Explain renal arterial blood supply

A

Renal arteries come off the aorta at L2.
Divide into Posterior and anterior branches
Branches divide into 5 segments, each supplying different segments of the kidney
Lobar arteries>interlobar aryeries> arcuate arteries which are umbrella spokes between the medulla and cortex

166
Q

Lymph drainage of the kidneys

A

follows the renal artery to drain into para-aortic and lumbar lymph nodes

167
Q

Nerve supply to the kidney

A

Coeliac plexus
Sympathetic trunk
Spinal nerves

168
Q

Renal colic pain

A

Renal pelvis and ureter have afferent nerves that run T11-L2. Pain can be felt in loin, groin, flank, scrotum, testes, labium majora, or front of thigh from genitofemoral nerve

169
Q

Kidney structure

A

Outer cortex
Inner medulla
Medulla contains 12 pyramids (base in cortex apex faces medially)
Pyramids indent to 12 minor calyces, uniting to 2-3 major calyces which form the renal pelvis
Renal pelvis is continuous with the ureter

170
Q

Structure of the nephron

A

Afferent arteriole feeds a capillary network called the glomerulus which invaginates into Bowman’s capsule. Drained by an efferent arteriole.

171
Q

Absorption in the loop of henle

A

The loop of Henle allows sodium, water and chloride to be reabsorbed in the descending limb and sodium and chloride to be reabsorbed in the ascending limb.

172
Q

Where are renin secreting cells

A

Juxtoglomerular cells in the walls of the afferent arterioles

173
Q

Course of ureters

A

Out from the kidney down psoas along the tips of the transverse processes of the lumbar vertebrae
Enters the pelvis crossing the bifurcation of the common iliac artery in front of the sacroiliac joint
Runs down the lateral wall of the pelvis to the level of the ischial spine where it turns medially to enter the bladder

174
Q

Significance of ureters in appendectomies

A

Right ureter can be adhered to the appendix if it has perforated and so is at risk in surgery.

175
Q

Bladder capacity

A

500 ml

176
Q

Bladder location when full and empty

A

Empty - behind symphysis pubis, entirely in pelvis

Full - superior border rises up tot he hypogastric region

177
Q

Structure of the bladder

A

Apex
Base - superolateral angles are joined by ureters
Inferolateral
Superior surface

178
Q

Control of micturation

A

Reflex when volume >300ml
Afferent impulses pass up pelvic splanchnic nerves S2-4 and via hypogastric plexus to L1-2 causing a desire to micturate.
Smooth muscle contracts, bladder sphincter relaxes.
Urethral sphincter receives efferent impulses from S2-4 pudendal nerve and relaxes

179
Q

Spinal injury and bladder control - Spinal shock

A 
Atonic bladder - 
wall relaxes, 
bladder sphincter contracts
urethral sphincter relaxes
bladder becomes distended and overflows
Lasts days to weeks
180
Q

Cord lesion above S2-4

A

Automatic reflex - Bladder fills and empties as a reflex every 1-4 hours

181
Q

Cord lesion destroying S2-4

A

Autonomous, no reflex control
Bladder fills to capacity and overflows
Constant dribbling

182
Q

Bones of the pelvis (3)

A

Ilium
Ischium
Pubis

183
Q

The pelvic floor can be described as

A

A muscular sheet

184
Q

The rectum arises from the…. and is a continuation of the

A

Sigmoid colon

Mesocolon

185
Q

Felt on a PR exam to the posterior

A

Coccyx

186
Q

Felt on a PR exam to the anterior

A

Prostate

Cervix

187
Q

What is the anorectal junction

A

Where muscles give way to sphincters supported by puborectalis

188
Q

What separates the prostate and the rectum and prevents local spread of carcinoma

A

The rectovesical fascia

189
Q

Sympathetic nerve supply of rectum and anus (2)

A

Branches of the hypogastric and coeliac plexus

190
Q

Parasympathetic nerve supply of rectum and anus

A

S2-4 Pelvic splanchnic nerves

191
Q

What is the anal canal

A

The last 4cm of the ailmentary tract

192
Q

Lymph drainage of rectum and anus

A

Pararectal nodes then along branches of the arteries
Upper and middle section to inferior mesenteric nodes.
Lower part and anus to internal iliac

193
Q

Anal skin sensation is supplied by

A

S5, S4, S3 in concentric circles

194
Q

Anal tone is supplied by

A

S2-4

195
Q

Size of the normal adult prostate

A

3cm

20g

196
Q

Superior relation of the prostate

A

Neck of the bladder

197
Q

Inferior relation of the prostate

A

Urogenital diaphragm

198
Q

Anterior relation of the prostate

A

Symphysis pubis

199
Q

Posterior relation of the prostate

A

Rectum

200
Q

Lobes of the prostate (5)

A 
Anterior
Middle
Posterior
Right lateral
Left lateral
201
Q

Anatomical basis of prostate hypertrophy

A

In BPH the middle lobe enlarges upwards, encroaching on the bladder sphincter because it has the most glandular tissue
Malignancy occurs in the peripheries, limited by the prostatic capsule

202
Q

Lymph drainage of prostate (4)

A

Internal/external iliac
Sacral
Vesical

203
Q

Parts of the uterus (3)

A

Fundus
Body
Cervix

204
Q

Anterior to the uterus

A

Bladder
Uterovesical pouch
Cervix

205
Q

Posterior to the uterus

A

Rectouterine pouch of douglas

206
Q

Lateral relations to the uterus

A

Broad ligament/uterine vessels
Ureter
Fallopian tubes

207
Q

Divisions of uterine tubes

A

Infundibulum
Ampulla
Isthmus

208
Q

Sites of ectopic pregnancies

A

97% uterine tunbe
75% ampulla
25% isthmus
3% intar-abdominally - ovary or cervix

209
Q

Uterus blood supply

A

Uterine artery ( a branch of the internal iliac), running in the broad ligament. Runs anterior and superior to ureter to reach the uterus at the level os the internal os. Ascends up the lateral side of the body of the uterus before turning laterally and inferiorly to anastomose with the ovarian artery

210
Q

Innervation of the uterus and fallopian tubes

A

Inferior hypogastric plexus

211
Q

Innervation of the ovary

A

Aortic plexus
T10-T11
Inferior hypogastric plexus

212
Q

Referred pain from the ovary can be felt

A

Paraumbilically or to the thigh (presses on the lateral cutaneous nerve of the thigh)

213
Q

Blood supply of the ovary

A

Ovarian artery - a branch of the aorta

214
Q

Lymph drainage of the ovary

A

Follows the ovarian artery to para-aortic nodes

215
Q

Location of ovary

A

4x2cm lying against the lateral wall of the pelvis int he ovarian fossa

216
Q

Size of the vagina

A

7-8cm long

217
Q

Anterior relations of the vagina (2)

A

Base of bladder

Urethra

218
Q

Posterior relations of vagina (4)

A

Rectouterine pouch of douglas
Anterior wall of rectum
Perineal body
Anal canal

219
Q

Superior relations of vagina (1)

A

Ureter

220
Q

Lateral relations of vagina (2)

A

Levator ani muscles

Pelvic fascia

221
Q

Structures palpable on digital vaginal examination (4)

A

Cervix
Uterus
Adnexae
Vaginal walls

222
Q

Length of the male urethra

A

20 cm

223
Q

Divisions of the male urethera

A

Prostatic - widest part
Membranous - narrows at the bladder neck
Spongy

224
Q

Innervation of the scrotum

A

L1, S2, S3

225
Q

Lymph drainage of the scrotum

A

Medial group of superficial inguinal ymph nodes

226
Q

Innervation of the penis

A

S2

227
Q

Cross section of the penis

A

2 corpus cavernosum side by side, enclosing deep arteries. Below is corpus spongiosum enclosing urethra. Above is deep dorsal vein, lateral superficial veins, superficial dorsal veins and dorsal artery and nerve.

228
Q

Branches of sciatic nerve

A

Tibial

Common peroneal

229
Q

Branches of the common peroneal nerve

A 
Genicular branch
Lateral cutaneous nerve of calf
Sural communicationg branch
Superficial peroneal nerve
Deep peroneal nerve

FRCEM Primary (32 decks)

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