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Dr Bishoy Voice Shots > Anatomy (Abdomen And Pelvis) > Flashcards

Anatomy (Abdomen And Pelvis) Flashcards

1
Q

Structure divided during approach to juxtarenal aortic aneurysm

A

Left renal vein

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2
Q

First branch of abdominal aorta

A

Inferior phrenic artery

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3
Q

Tone limit for abdominal aortic clamp

A

10-15 minutes

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4
Q

Supply of median sacral artery

A

Lumbar
Sacral
Coccyx
Anorectal junction of posterior

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5
Q

Location of superior and inferior epigastric vessels

A

Within rectus sheath

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6
Q

Level of placement of mesh in hernial surgery

A

Below the cord
Below the external oblique(overlay) or below fascia traversalis (sublay)

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7
Q

Which anal is associated without incontinence

A

External

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8
Q

Drug used as a trial before lateral sphincterotomy

A

Local diltiazem

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9
Q

Valves in IVC

A

The inferior vena cava (IVC) does not have one-way valves. Instead, the IVC’s forward flow of blood to the heart is driven by the pressure difference created by respiration.

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10
Q

Median arcuate ligament compression syndrome

A

Compression of Coeliac trunk

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11
Q

Symptoms of median arcuate ligament syndrome

A

ABDOMINAL pain
Unintentional weight loss
ABDOMINAL bruits

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12
Q

Confirmatory investigation and treatment of median arcuate ligament syndrome

A

Vascular imaging
Surgically releasing ligament band

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13
Q

What is Dunbar syndrome

A

Celiac axis syndrome
Median arcuate ligament compression syndrome MALS also known as
Harjola-Marable syndrome

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14
Q

Consequence of Harjola-Marable syndrome

A

Mesenteric ischemia

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15
Q

Origin of main pancreatic duct

A

Duct of ventral rudiment

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16
Q

Origin of annular pancreas

A

Ventral bud may split and enclose the duodenum

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17
Q

Symptoms of annular pancreas

A

Fullness after eating
Nausea
Vomiting
Depending on degree of compression

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18
Q

Associated anomaly with annular pancreas

A

Down syndrome
Poly hydramnios

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19
Q

Normal site of gastrinoma

A

Duodenum

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20
Q

Type of pancreatic gastrinoma

A

Highly malignant are solitary

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21
Q

Triad of zollinger Ellison syndrome

A

Non beta cell tumor of pancreas
Hyper gastrinemia
Severe ulcer disease

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22
Q

Diagnosis criteria of peptic ulcers disease

A

Fasting hypergaetrinemia
Increased basal acid output
Secretin stimulating test positive

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23
Q

Continuation of external oblique fascia in scrotum

A

External spermatic fascia

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24
Q

Continuation of internal oblique muscle in scrotum

A

Cremasteric muscle and fascia

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25
Q

Continuation of scarpas fascia in scrotum

A

Dartos fascia and smooth muscle

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26
Q

Continuation of transversalis muscle

A

Cremasteric muscle and fascia

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27
Q

Continuation of fascia transversalis

A

Internal spermatic fascia

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28
Q

Continuation of peritontium in scrotum

A

Tunica vaginalis

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29
Q

Anterior and posterior fascia of rectum

A

Posteriorly Waldeyer
Anteriorly denovillers

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30
Q

Anterior and posterior fascia of kidney

A

Anterior Gerota
Posterior Zuckerkandl

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31
Q

Location of bucks fascia

A

Penis

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32
Q

Ribs related to kidney

A

11
12
And
10 in case of left kidney

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33
Q

Structures of renal pelvis

A

From anterior to posterior
VAP

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34
Q

Origin level of SMA

A

L1

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35
Q

Origin level of IMA

A

L3

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36
Q

Origin level is renal artery

A

L2

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37
Q

Relation of creatinine with age

A

It declines with age

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38
Q

Most accurate substance for measuring GFR

A

Inulin

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39
Q

Origin and termination of greater splanchnic nerve

A

T5-T9
After piercing the diaphragm they synapse with ciliary ganglion

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40
Q

Level of origin of portal vein

A

L1

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41
Q

Level of head of pancreas

A

L2

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42
Q

Vascular structure behind head of pancreas

A

Renal veins so L2 level

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43
Q

Vertebral level of CBD

A

L2

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44
Q

Posterior relation of femoral artery

A

Psoas tendon

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45
Q

Surface anatomy of deep inguinal ring

A

Midpoint of inguinal ligament

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46
Q

Point of palpation of femoral artery

A

Midinguinal point
Between ASIS and pubic symphysis

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47
Q

Gut related superiorly to urinary bladder

A

Small intestine
Sigmoid colon

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48
Q

Muscles related lateral to urinary bladder

A

Levator ani
Obturator internus

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49
Q

On which muscle does abdominal portion of ureter lie

A

Psoas major

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50
Q

Vertebral relation of abdominal portion of other

A

Transverse processes of L2-5

51
Q

Point of ureter becoming pelvic from abdomen

A

Anterior to sacroiliac joint

52
Q

Relation of ureter with common iliac artery

A

Ureter passes ANTERIOR to bifurcation of common iliac artery

53
Q

Reason of ischial some with ureter

A

It passes anterior to spine

54
Q

Areas to notice for ureteric stone with vertebral level

A

Pelvis (lateral to L2)
Pelvic brim (level of sacral promontory)
Vesicoureteric junction (ischial spine)

55
Q

Vertebral level of kidney

A

T12-L3

56
Q

Arterial supply of gall bladder

A

Cystic artery

57
Q

Origin of cystic artery

A

Right hepatic artery

58
Q

Ligament related to cystic artery

A

The artery is formed within Hepatoduodenal ligament

59
Q

Branches of Coeliac trunk

A

Hepatic artery
LEFT gastric artery
Splenic artery

60
Q

Overview on Coeliac trunk

A

Coeliac trunk—

*Left gastric (connects with R. Gastric)

                  proper H.—Left & Right-cystic                   *C.Hepatic- 
                Gast.duo.-su.pan.duo & R.ga.epi

                Short gastric *Splenic -
                Left gastroepiploic
61
Q

Boundary of Calot’s triangle

A

Superiorly Lower border of liver
Right lateral Cystic duct
Left lateral Common hepatic duct

62
Q

Vertebral level of Coeliac trunk

A

T12

63
Q

What structure is to be damaged for urine to collect in superficial perineal pouch and in scrotum

A

Spongy urethra

64
Q

Goodsall’s rule

A

a rule that helps determine the internal opening of an anal fistula based on the location of its external opening

Anterior external opening: The internal opening is in the same radial position.

Posterior external opening: The internal opening is in the midline posteriorly, sometimes taking a curvilinear course

65
Q

Surgical classification of

A

The Parks classification has become the most widely used surgical classification for distinguishing four types of fistula. The course of the fistula and its relationship to the anal sphincters is described in the coronal plane 1,5,6:

intersphincteric (~70%): fistula crosses the intersphincteric space and does not cross the external sphincter

transsphincteric (25%): fistula crosses from the intersphincteric space, through the external sphincter, and into the ischiorectal fossa

suprasphincteric (5%): fistula passes superiorly into the intersphincteric space, and over the top of the puborectalis muscle then descending through the iliococcygeus muscle into the ischiorectal fossa and then skin

extrasphincteric (1%): fistula crosses from the perineal skin through the ischiorectal fossa and levator ani muscle complex into the rectum (i.e. it is outside the external anal sphincter)

66
Q

Other name of exomphalos

A

Omphalocele
Cele, so containing sac

67
Q

Main difference between Gastroschisis and omphalocele

A

G - apart from umbilical cord
O - within umbilical cord

68
Q

Pathology in imperforated anus

A

Rectum

69
Q

Most common hernia irrespective of gender

A

Indirect

70
Q

Most common hernia in female

A

Femoral
4 time more than male

71
Q

Relation of kidney and pancreas

A

Body of pancreas is in direct contact with anterior surface with left kidney

72
Q

Relation of colon and kidney

A

They are in direct contact

73
Q

Posterior relation of 1st part of duodenum

A

Portal vein
CBD
Gastroduodenal artery
IVC

74
Q

Vascular relation of 3rd part of duodenum

A

ABDOMINAL aorta posteriorly
Coeliac trunk anteriorly

75
Q

Relation of duodenum with colon

A

Transverse colon passing anteriorly to 2nd part of duodenum

76
Q

Superior border of epiploic foramen

A

Caudate lobe

77
Q

Which part of foramen of Winslow is composed during Pringles maneuver

A

Anterior wall

78
Q

Gastric relation with spleen

A

Located between gastric fundus and left hemidiaphragm

79
Q

Axis of spleen related to rib

A

Along left 10th rib

80
Q

Importance of lower pole of spleen extended to mid clavicular line

A

It has become 3 times of normal size
And it is only palpable then

81
Q

Proper time of transfusion platelet during splenectomy

A

During applying vascular clamp

82
Q

Origin of longitudinal muscle layer of appendix

A

Taenia coli

83
Q

Origin of appendicular artery

A

From iliocolic artery
Iliocolic artery arises from SMA

84
Q

*Blood supply of rectum

A

Superior from IMA- just after entering sigmoid mesocolon it turns into SRA on crossing the pelvic brim
Middle R.A. small or absent
Inferior R.A. from internal pudendal artery
Median sacral from abdominal aorta

85
Q

*Location of puborectalis

A

Surrounding around anorectal junction

86
Q

*Attachment of pubococcygeus

A

To anococcygeus ligament

87
Q

*Muscular attachment of perineal body

A

External anal sphincter
Levator ani
Bulbospongiosus
Superficial and deep transverse perineal

88
Q

Formation of internal rectal plexus

A

Submucosal veins

89
Q

Formation of external rectal plexus

A

Subserosal veins

90
Q

Blood draining of rectum

A

Internal and external rectal plexuses drain into portal vein via superior rectal vein

And to internal iliac vein via middle and inferior rectal vein

91
Q

Cause of formation of deep inguinal ring

A

Defect in fascia transversalis

92
Q

Cause of formation of superficial inguinal ring

A

Defect in external oblique aponurosis

93
Q

Why not hernioplasty in children

A

Plasty is used to reinforce the posterior wall of inguinal canal
But in children pathology is not in wall, rather due to patent proceous vaginalis
ALSO the superficial and deep rings will be apart from each other during growth.

94
Q

Process of herniotomy

A

Cut the sac & retract it Back

95
Q

Reason may cause direct hernia in children

A

Collagen disease like
Ehlers-Danlos syndrome (EDS)

96
Q

Symptoms of EDS

A

Skin: Loose, velvety skin that bruises easily and can lead to wound healing problems

Joints: Joints that are excessively flexible and can dislocate

Blood vessels: Fragile blood vessels that can cause easy bruising and bleeding

Internal organs: Organs that can split open and lead to life-threatening bleeding

97
Q

Relation of LEFT phrenic nerve with left common carotid and left subclavian artery

A

Nerve descends between these arteries

98
Q

Relation of L.phrenic nerve with aortic arch

A

Nerve crosses the left surface of arch

99
Q

Sensory supply of left phrenic nerve

A

Pleura
Pericardium
Small part of peritoneum

100
Q

Relation of Phrenic nerve with IJV

A

The nerve descends parallel to the vein

101
Q

Important relation of phrenic nerve in the neck

A

Anterior to anterior scalenes lateral border
Posterior to Prevertebral fascia, transverse cervical artery and subscapular artery

102
Q

Anterior relation of right pelvis and ureter

A

Origin of right ureter is covered by descending duodenum
Right colic vessels
Iliocolic vessels
Lower part of mesentery & terminal part of ileum near superior aperture of pelvis

103
Q

Anterior relation of left ureter

A

Left colic vessels
Sigmoid colon with its mesentery near superior aperture of pelvis

104
Q

Relation of IVC with ureter

A

Right ureter lies right side of IVC

105
Q

Ureteric relation in female

A

Lies in ovarian fossa
Lateral part of lower uterus accompanied by uterine artery fir 2.5cm (water under bridge)
Upper part of vagina

106
Q

Origin of urinary bladder

A

Cloaca
Mesonephric duct

107
Q

Division of cloaca

A

By urorectal septum into urogenital sinus and rectum

108
Q

Function of mesonephric/wolffian duct in urinary bladder

A

They expand to form bladder trigone

109
Q

Origins of The epithelial tissue in the urinary bladder

A

The epithelial tissue in the urinary bladder has different origins depending on its location:

Urothelium in the bladder and proximal urethra: This tissue comes from the endoderm, the inner germ cell layer that develops during gastrulation.

Urothelium in the ureters and renal pelvis: This tissue comes from the mesoderm.

Trigone: Some studies suggest that the trigone comes from the endoderm, while others suggest it comes from the Wolffian ducts, which are derived from the mesoderm.
MESOderm from MESOnephric duct

110
Q

Structure of urothelium

A

The urothelium starts as a single layer of immature cells that divide and differentiate into three layers: basal, intermediate, and umbrella cells. The transitional epithelium tissue in the bladder is elastic, allowing the bladder to stretch and hold urine.

111
Q

Relation of levator ani with bladder

A

It lies inferolateral to bladder and prostate

112
Q

Main pathology of Femoral hernia

A

Weakness of femoral RING

113
Q

Difference between sliding hiatal hernia and paraoesophageal hernia

A

Content
H-whole stomach
P-portion of stomach (more risk of strangulation-(so then may require surgery)

114
Q

Painful scrotum without skin discoloration indicates what

A

Not surgical emergency at that time

115
Q

What to do with a child with hydrocele

A

Observe until 6 months

116
Q

Location of Spigelian hernia hernia

A

At the level of arcuate line between interval and external oblique like a mushroom

A spigelian hernia is a rare, abnormal protrusion of abdominal contents or peritoneum through a defect (spigelian fascia), which is comprised of the transversus abdominis and the internal oblique aponeuroses.

The borders of the Spigelian aponeurosis are the rectus muscle medially and the linea semilunaris laterally.

117
Q

Most common site of gall stone ileus

A

Narrowest part ileum (that’s why ileus)

118
Q

What to do with gall bladder in case of gall stone ileus

A

Nothing
Let the patient recover from acute condition after removing stone from lodgement site

119
Q

Signs of gallstone ileus

A

Features of intestinal obstruction
Pneumobilia

120
Q

Splenic artery to pancreatic supply

A

Neck,body and tail

121
Q

Blood supply of pancreatic head

A

*Superior pancreaticoduodenal from gastroduodenal from common hepatic from Coeliac trunk
*Inferior pancreaticoduodenal artery from superior mesenteric artery

122
Q

Type of gall stones

A

Pigments -dark/black (high bilirubin due to hemolysis, sickle cell, hemolytic anaemia, Crohn’s disease)
Cholesterol -green(imbalance of composition & improper emptying gall bladder)most common 80%
Mixed -brown(cholesterol+Ca+bilirubin)

123
Q

PBF features of post splenectomy

A

3H
High platelets -Following splenectomy, reactive thrombocytosis is an anticipated
Howell jolly bodies - Nuclear remnants that remain in red blood cells after they’ve matured in the bone marrowHowell-Jolly bodies are not normal, and they usually indicate a damaged or absent spleen
Heinz bodies -spleen is not there to remove Heinz bodies from the blood.
Heinz bodies are a late sign of oxidative damage and are caused by the degradation of hemoglobin

Dr Bishoy Voice Shots (10 decks)

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