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eMRCS questions > Anatomy Abdomen Book > Flashcards

Anatomy Abdomen Book Flashcards

1
Q

Spermatic cord contents

A

Arteries- cremastvtic, testicular, artery of ductus deferens
Veins- pampiniform
Nerves- genitofemoral (supplies cremastvtic muscle and symp/para for DD and arteries
Lymph
Ductus deferens

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2
Q

Layers of scrotum and there corresponding abdo origin

A

Tunica vaginalis- peritoneum

Internal spermatic fascia- trasversali fascia

Cremastatic fascia- Internal oblique

External fascia- external oblique

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3
Q

Borders of inguinal canal

A

Posterior- transversals fascia
Medially- conjoint ligament -IO+TA
Anteriorly- aponeurosis of external oblique - medially, internal oblique laterally
Laterally- internal oblique

Floor- inguinal ligament
Roof- TA, IO

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4
Q

Venous systems affected by liver cirrhosis

A

Rectal- inferior rectal and anal canal

Oesophageal - inferior

Caput medusa-from paraumbilical veins of hepatic portal to superior/inferior epigastric

Bare area of liver

Retroperitoneal

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5
Q

Artery commonly affected in bleeding duodenal ulcers

A

Gastroduodenal- if ulcer posterior

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6
Q

What is Pringles manoeuvre

A

Grasping free edges of lesser momentum
Control bleeding of liver laceration
Compressing hepatic artery, portal vein and cystic duct

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7
Q

Points at transpyloric plane

A

Inferior part of L1
Pylorus of stomach/first part of duodenum
Hila of kidneys
Duodenaljujenal junction
Neck of pancreas
9th CC
Fundus of gallbladder

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8
Q

Calots triangle borders

A

Superior- inferior border of the liver
Lateral inferior- cystic duct
Medial- Common hepatic duct

Cystic artery within

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9
Q

Which branch does cystic artery come from

A

Right hepatic

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10
Q

Blood supply of fundus of stomach

A

Short gastric arteries
From splenic

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11
Q

Location of stoma in Hartmanns

A

LLQ

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12
Q

What stomas are in RLQ

A

Ileostomy

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13
Q

Stoma in RUQ

A

Defunctioning transverse colostomy

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14
Q

What divides superficial and deep femoral branches

A

Lateral femoral circumflex artery

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15
Q

Sx of femoral nerve damage

A

Trouble standing and walking

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16
Q

Varicocele is ?

A

Due to compression or valvular disorder- pampiniform plexus

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17
Q

Billroth procedure

A

Removal of distal third of stomach and end to end anastomosis of stomach to duodenum
Used for malignancy

I- if distal third
II- if 2/3 and anastomosis to jejunum leaving blind end duodenal loop

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18
Q

Define AAA

A

> 3cm dilation or >50% than Normal

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19
Q

Gerotas fasciae

A

Covers perinephric fat of kidneys

Deficient inferiorly

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20
Q

Order of hilum of kidney

A

Ant->post
Renal vein, artery post sup, ureter

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21
Q

Ureter course

A

Retroperitoneal entire course

Descend on psoas major

Over genitofemoral nerve
Under gonadal vessel

Narrow at pelviureter junction

Run over external iliac artery/vein and under vas deferens

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22
Q

Points of narrowing of ureter

A

Uteropelvic junction
Crossing iliac vessels
Uterovesicle junciton

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23
Q

Borders of femoral triangle

A

Lateral- sartorius
Medial- adducts longus
Superior- inguinal ligament
Floor- illopsoas, pectinous, adductor longus
Roof- fascia lata

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24
Q

Mid inguinal vs midpoint of inguinal ligament

A

Mid inguinal- Pubic lymph and ASIS- femoral artery

Midpoint of IL- pubic tubercle and ASIS - deep inguinal ring

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25
Q

Femoral canal borders

A

Anterior- inguinal ligament
Posterior- pectineal ligament
Medial- lacunar
Lateral femoral vein

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26
Q

Function of femoral canal

A

Lymph drainage of lower limb
Room for vein to expand

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27
Q

Branches of renal, adrenal, gonadal and iliac arteries

A

Renal- L2

Adrenal- T12

Gonadal- L2

Illiac- L4

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28
Q

Jejenuc vs ileum

A

Jejenum- lies more at umbilicus
Redder
Valvulae conniventes
Fewer arcades
Longer vasa recta
Mesentary- lies superiorly and attached left to aorta
Villi- tall

Ileum
Suprapubic
Pinker
More arcades and shorter vasa recta
Peyers patches
Mesentary- inferior, attaches to right aorta
Villia- short

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29
Q

What is the median umbilical fold and lateral structures

A

Contains median umbilical ligament- remnants of urachus (previous connection of bladder and umbilicus)

Lateral- medial umbilical ligaments-remnants of umbilical artery

More lateral- lateral umbilical folds- inferiors epigastric vessels

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30
Q

Nerve found in inguinal canal but not spermatic cord

A

Ilioinguinal nerve

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31
Q

Anatomical relation of renal veins

A

Behind pancreases
Infront of renal arteries

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32
Q

Level renal vein joins IVC

A

L!

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33
Q

Difference in drainage of renal veins

A

Left 3x as long- crosses aorta

Left- recieves left suprarenal and gonadal

Right and above go direct to IVC

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34
Q

What is Meckel diverticulum ?
How common, size?
Where is it found?
Blood supply

A

Remnant of Vitello-intestinal duct (connects yolk sac and intestine in fetus)
Found in 2%, 2in long
Found on antimesenteric border of ileum
Ileal branch of SMA

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35
Q

Borders of epiploic foramen

A

Superior- caudate process of liver
Inferior- first part of duodenum
Anterior- Free edge of lesser omentum containing bile duct, hepatic artery, portal vein
Posteriorly- IVC

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36
Q

Difference between cell lining, arterial supply, venous drainage, nerve supply, lymphatic drainage above and below dentate line

A

Above
Columnar
Arterial- superior rectal (IMA)
Venous- IMV
Nerve- autonomic - symp pelvic plexus, para- pelvic splanchnic
Lymph- inferior mesenteric lymph node

Below
Squamous
Arterial-middle (internal iliac) and inferior rectal arteries (internal pudendal)
Venous- internal pudendal
Somatic- inferior rectal branch of pudendal
Lymph- superficial inguinal

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37
Q

Where is the portal vein formed and what from

A

Transpyloric plane behind neck of pancreas

SMV and splenic (IMC drains into splenic)

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38
Q

What structures are lateral to the bladder

A

Levator ani
Obturator internus

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39
Q

Origin of 2 heads of rectus abdominis

A

Medial - pubic symphysis
Lateral upper boarder of pubic crest- larger

40
Q

Where does the rectus abdo insert

A

Insert into 5-7th CC and xiphi

41
Q

Blood supply of rectus abdo

A

Sup and inf epigastric

42
Q

Embryo origins of urethra and bladder

A

Proximal urethra and bladder- mesopnephric ducts

Distal- urogenital sinus

43
Q

Where is urethra narrowest and widest

A

Narrowest- membranous, external meatus, bladder neck and entrance to navicular fossa ( near end of urethra)

Widest- prostatic, bulb and navilcular fossa

44
Q

Cell lining of urethra

A

Transitional - rest
Stratified squamous - spongy

45
Q

Origin of inferior epigastric

A

External iliac

Anastomoses with superifical epigastric which comes from femoral below ignuinal

And superior epigastric which origiantes from internal thoracic

46
Q

Layers of rectus sheath at different points

A

Above costal margin- just consists of external oblique ap anteriorly -no others

Above arcuate line- ext and half of int anterior
TA- post

Below- all anterior

47
Q

Spigelian hernia location, tx and complications

A

Between RA medially and semilunar line laterally (formed by EA, IA,TA) usually below arcuate line

Open or lapro

Small and high risk of strangulation

48
Q

Most common visceral artery aneurysm

A

Splenic

49
Q

Artery supply of adrenals

A

Sup- inferior phrenic
Mid- aorta
Inf- renal

50
Q

Tributes for portal vein

A

IMV drains into splenic

Splenic and SMV form Portal

Short gastric, left gastroepiloic drain into splenic
Right gastroepiploic- SMC

Cystic and left and right gastric straight into portal

51
Q

IVC relation to portal and number of valves

A

IVC posterior
0

52
Q

What ligament contain that portal triad

A

Hepatoduodenal ligament

53
Q

Relation of hepatoduodenal ligament to epiploic foramen

A

HP lig is anterior

54
Q

Borders of epiploic foramen

A

Ant- triad
Post- IVC, right crus of diaphragm
Sup- caudate lobe
Inf- first part of duo

55
Q

Uterine artery relation to ureter

A

Anterior and superior

56
Q

Nerve supply of ureter

A

Has internal pacemaker for peristalsis

Symp- thoracolumbar pre ganglionic- aorticorenal and inf/sup hypogastric

Para- S2-4

Cutaneous pain- referred to T11-L2

57
Q

Ureter relation to internal iliac and testicular artery

A

Anterior to internal iliac
Post to test

58
Q

Venous drainage of ureter and muscle

A

Inf end of ureter covered in venous plexus- drain via renal and gonadal vein
Has 2 layers of spiral muscle

59
Q

Where does testicular development begin

A

At mesodermal ridge

60
Q

Prostate gland location, number of lobes and the female equivalent

A

Between bladder and urogenital ridge

5

Skene gland

61
Q

Layers of teste capsule

A

Tunica vasculosa- innermost vascular
Tunica albuginea- tough fibrous
Tunica vaginalis- closed peritoneal sac
Visceral- close to testes
Parietal- adherent to internal spermatic cord and separated to visceral by fluid

62
Q

Layers closest to skin of scrotum

A

Dartos fascia and muscle

63
Q

Nerve innervating cremastvtic reflex

A

Genital branch of gentiofemoral

64
Q

Permanent folds of GI tract

A

Plicae circularis
Spiral valve of Heister- cystic valve
Villae
Trasverse rectal

65
Q

Lymph node drainage pathway of colon

A

Epicolic- serial wall
Paracolic- medial side of ascending/descending or mesenteric border of transverse
Intermediate- named branches of colonic vessels
Pre aortic (IM, SM)

66
Q

What can be incised to give greater mobility of 12th rib

A

Costovertebral ligament

Attach between 12th rib and 1+2nd transverse processes of lumbar

67
Q

Posterior gastric ulcer bleed affects which artery?

A

Splenic

68
Q

Male vs female pelvis

A

Female is wider, shallower

Ischial tuberosities are further apart in females
Obturator foramina- oval in females, round in males

Pelvic cavity is deeper in males
Inlet round in females and heart in males

Pubic arch wider in females - 80-90 vs 60-70

69
Q

Sites of portosystemic anastomosis

A

Collaterals between portal and systemic

Gastrooesophageal - around cardia - left gastric vein anastomose with azygous

Anus- superior rectal vein of portal with middle and inferior of systemic

Anterior abdo wall around umbilicus- para umbilical anastomose with veins

70
Q

Location of deep inguinal ring

A

Midpoint of inguinal ligament
1.5cm above

71
Q

Which hernia is more likely to extend into scrotum

A

Indirect
Potential patent processus vaginalis

72
Q

Level of pancreatic body

A

L1/2

73
Q

Anatomy of uncinate process of pancreas

A

Extends medially from left of pancreatic head
Posterior to SMA

74
Q

Blood supply of pancreas

A

From branches of splenic artery for body and tail

Head- gasproduodenal and SMA

75
Q

Where ducts of pancreas drain

A

Main- from tail and body- joins bile duct in duodenum
5% separate

Accessory- drains uncinate and inferior head opening into duodenum at minor duodenal papilla

76
Q

What is pancreas formed from and what is found behind it

A

Foregut

Portal vein formation behind neck

77
Q

Which parts of pancreas and duodenum are intraperitoneal

A

Pancreas- tail

Duodenum- 1st part

78
Q

Hilum of kidney relative to duodenum

A

Posterior

79
Q

Anatomical positions relative to third part of duodenum

A

Ant- SMA and vein

Post- psoas, ICV, aorta and right ureter

Big of treitz hold DJ flexure at 3/4th part of duodenum

80
Q

Which artery supplies distal third of oesophagus

A

Left gastric

81
Q

Why are intraoperative cholangiograms used

A

After dissected calots triangle
Small incision in cystic duct- dye inserted

Useful to identify bile leak, distal occlusions and correct identification of cystic duct

82
Q

What does the artery of Drummond supply

A

Is the anastomosis of left and middle colic artery

83
Q

Most common positioning of appendix

A

Retrocaecal then pelvic

84
Q

RF of transverse incision for appendectomy

A

Damage to iliohypogastric nerve
Could cause direct inguinal hernia due to weakness in muscles

85
Q

Peritoneal covering of rectum

A

Upper - anterior and lateral
Middle - anterior
Lower- none

86
Q

Where does rectum start relative to sacrum

A

S3

87
Q

Number of transverse folds in rectum

A

3

Called Houston’s valves

88
Q

Arterial supply of rectum

A

Superior rectal- from IMA

Middle rectal from internal iliac

Inferior rectal from internal pudendal

89
Q

What does obturator interns pass through

A

Lesser sciatic foramen

90
Q

Muscles attaching to perineal body

A

Bulbospongiosum
Levator Ani
External anal sphincter

91
Q

Testicular anastomoses with ?

A

Artery of vas
Hence why testicles do not atrophy if testicular artery is cut

92
Q

Composition of anal sphincter

A

Internal- circular muscle
External- surrounds and more distally - 3 parts, deep, superficial and subcutaneous

Deep blends with puborectalis

93
Q

Borders of quadrate and caudate lobes

A

Quadrate- right gallbladder, left round ligament (prev umbilical vein), post hepata portis

Caudare- ant hepata portis, right IVC, left ductus venosum shunt to IVC

94
Q

Quadratus lumborum attachment, innervation and action

A

Origin: Medial aspect of iliac crest and iliolumbar ligament
Insertion: 12th rib
Action: Pulls the rib cage inferiorly. Lateral flexion.
Nerve supply: Anterior primary rami of T12 and L1-3

95
Q
A

eMRCS questions (45 decks)

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