Anatomy (Abdomen,Pelvis & Perineum) Flashcards
Anterior rectus sheath above costal margin
Devoid of internal oblique aponurosis
Beginning of veins of testes
At septa
Formation of pampiniform plexus
Veins from
Septa and Tunica vasculosa
Drainage of pampiniform plexus
Into testicular vein
Covering of spermatic cord
External
Cremasteric
Internal spermatic fascia
Supply of testicular artery other than testes
Epididymis
Origin of Artery to vas
Inferior vesical artery
Origin of cremasteric artery
Inferior epigastric
Relation of sympathetic and parasympathetic fibers of testes
Sympathetic with artery
Parasympathetic with vas
Innervation of genital branch of genitofemoral nerve
Cremaster
Drainage site of lymphatics in the spermatic cord
Lumbar
Para aortic
Innermost layer of scrotum
Parietal later of tunica vaginalis
Blood supply is scrotum
The scrotum receives blood from the anterior and posterior scrotal arteries, which branch off from the internal and external pudendal arteries, respectively:
Anterior scrotal artery
A branch of the deep external pudendal artery, which comes from the external iliac artery
Posterior scrotal artery
A branch of the internal pudendal artery, which comes from the internal iliac artery
Origin and supply of internal spermatic artery
The testicular artery, also known as the internal spermatic artery, is the main source of blood for the testes. It usually originates from the abdominal aorta, BELOW the renal arteries, and at the level of the SECOND lumbar vertebra.
Location of tunica vaginalis
Testes are surrounded by it.
It is a closed peritoneal sac. The PARIETAL later of of tunica vaginalis is adjacent to the INTERNAL spermatic fascia.
Insertion of ureter
Upper and lateral aspect of Base
Internally called Trigone
What is happened to ureter after crossing bony pelvis
Wall muscular coat becomes 3 layers
Relation of transverse processes with ureter
Tip of L2-L5
—
Blood supply of ureter
Abdominal aorta
Renal artery
Gonadal artery
Common iliac artery
Internal iliac artery
What is gubernaculum
A ridge of mesenchymal tissue that connects the testes to inferior aspect of scrotum
Mechanism of descent of testes
During foetal growth the body grows relative to gubernaculum
Initial level of testes
L2
Age of testes at iliac fossa
3rd intrauterine month
Age of testes at deep inguinal ring
7th intrauterine month
Cause of cyst in spermatic cord
Part closure of processus vaginalis
—
Main structural support of uterus
Central perineal tendon
Origin of uterine artery
Internal iliac
Utero additional support derived from endopelvic fascia
Lateral cervical
Round
Uterosacral ligaments
Offline
*Lymphatic drainage of male urethra
Prostatic & membranous into internal iliac
Spongy with glans into deep inguinal
*Abnormality of which bladder part may lead to stress incontinence
Weakness of bladder neck cause this part is subjected to raised intra abdominal pressure
*Location of external sphincter of female urethra
Between layers of urogenital diaphragm
*Innervation of preprostatic urethra
Sympathetic noradrenergic
*Muscular layer of preprostatic urethra
Skeletal
*Importance of preprostatic urethra
Prevents retrograde ejaculation & has sterile lumen
*Narrowest part of male urethra
Membranous
*Which part of male urethra has external sphincter
Membranous
*Longest part of male urethra
Penile
*Name of dilations of penile urethra
At origin infundibular fossa
At termination navicular fossa
*Opening of bulbs glands
Into membranous part 2.5cm below perineal membrane
*Nature of urethral urothelium
Transitional near bladder and squamous distally
*First site of urethral resistance during catheter insertion and reason
Membranous because surrounded by external sphincter
*Relation of urethra with pubic symphysis
Membranous part traverses perineal membrane 2.5cm posteroinferior to pubic dumpy
*What forms the lateral edge of superficial inguinal ring
External oblique aponurosis
*Relation of rectus abdominis to superficial inguinal ring
Posteromedially
*Relation of pubic tubercle with superficial inguinal ring
Ring is anterior to tubercle
*Points needed to locate deep inguinal ring
ASIS & pubic tubercle
*Contribute of lacunar ligament to inguinal canal
Floor
*Passages of left Phrenic nerve through diaphragm
Muscular part anterior to central tendon
*Origin and Posterior relation of abdominal aorta
Origin T12
Posterior relation L1-4
—
*Which mesenteric vein is related to abdominal aorta
IMV anteriorly
*Relation between abdominal aorta and cisterna chyli
Right lateral to aorta
*Relation of sympathetic trunk to ABDOMINAL aorta
Left one
*Blood supply of bile duct
Hepatic
Retrodudenal part(as CBD itself is a retroduodenal structure)of gastroduodenal
*Resultant of bile duct after injury to hepatis artery
Stricture
*Gall bladder lining
Columnar
*Which part of duodenum lies posterior to gall bladder
1st
*Between which lobes does gall bladder lie
Right and quadrate
*Nerve supply of gall bladder
Sympathetic-mid thoracic spinal nerves
Parasympathetic-anterior vagal
*Origin of CBD
cystic and CHD
*Posterior relation of CBD
Proximally portal vein
Distally right renal vein
*Another name of Calot’s triangle
Hepatobiliary triangle
*What marks externally the transition between sigmoid colon and rectum
Disappearance of tinea coli
*Indication of total mesorectum excision
Rectal carcinoma
*Anorectal lymphatic drainage
Above dentate mesorectal nodes
Below dentate inguinal
*Longitudinal muscle of appendix is derived from
Caecal taenia coli
*Site to insert needle into femoral artery
1-2cm BELOW midinguinal point
Midinguinal is mid of ASIS & symphySIS
*For of femoral triangle
Iliopsoas, adductor longus, pectineus
*Nervous content of femoral triangle
Femoral
Femoral branch of genitofemoral
Lateral cuteneous
*Does 11&12 ribs give origin to ex.oblique?
It says lower 8 ribs
But nerves from lower 6 thoracic
Beach of abdominal aorta at level of left renal vein
SMA
Branch of abdominal aorta at T12
Inferior Phrenic
Coeliac
Abdominal aortic branch at L1
Superior mesenteric
Middle suprarenal
Level is transpyloric plane
BODY of L1
Comparison of hilums of kidneys
Right one is 1.5cm lower
Level of spleen
Transpyloric
Relation of PUDENDAL canal with obturator internus
Canal lies along inferior border of muscle
Fossa for pudendal canal
Ischioanal
Extension of PUDENDAL canal
From lesser sciatic foramen to posterior margin of urogenital diaphragm
Lymphatic drainage of ureter
Upper para aortic
Lower common iliac
Hepatic relation to Coeliac axis
Caudate lobe on right side
Gastric relation with Coeliac axis
Cardia on left side
Why mesenteric adenitis may mimic appendicitis
Appendix is mainly lymphoid tissue
How does gastroduodenal artery supply head of pancreas
By anterior and posterior—
superior pancreaticoduodenal arteries
Nerve for cremasteric reflex
Genital of genitofemoral-within cord
Ilioinguinal-along cord
Another name of PERINEAL MEMBRANE
Inferior fascia is urogenital diaphragm
What is in the urogenital diaphragm?
sphincter urethrae and deep transverse perinei with perineal membrane together are known as the urogenital diaphragm.
Boundary of deep perineal pouch
Superior and inferior fascia of urogenital diaphragm
Contents of deep perineal pouch
Transverse perineal muscle
Muscular branches of perineal nerve
Urethral sphincter
Urethral artery
Deep ava dorsal arteries of penis
Stem of origin of artery to the bulb of penis
Proximal communication of IMA and via what artery
Middle colic via marginal
Part of pancreas at transpyloric plane
Neck
Identifying point of transpyloric plane
Meeting point of lateral border of rectus abdominis with costal margin
Lowest border of 10th costal cartilage defines what
Subcostal plane
Level of L4 body defines which plane
Intercristal plane
At which vertebral level the highest point of iliac crest is
Body of L4
Vertebral level of intertubercular plane
Body of L5
Most dilated part of colon
Caecum
Mark of base of caecum
Convergence of taenia coli
Peritoneal relation of base of caecum
Intraperitoneal
Point of demarcation between intra and retro peritoneal right/ascending colon and its importance
A white line
It’s the line of incision for colonic resection
Attachment sure of greater omentum with transverse colon air its importance
Along superior border
Division of this attachment permits entry into lesser sac
And
Separation of transverse colon from greater omentum is a routine operation step in both gastric and colonic resection
Relation of L4 with descending colon
Colon becomes intraperitoneal and becomes sigmoid
Relation of sacral promontory with sigmoid colon
Becomes rectum
Macroscopically visible mark of sigmoid to rectal transition
Fusion of taenia
Importance of peritoneal relation of colon
Generalized peritonitis in case of whole intraperitoneal segments
Relation of gall bladder with hepatic flexure
Bladder is medial
Structure to get surgical assessment of pancreas
Attachment of greater omentum with transverse colon
Pancreatic relation of renal vein
Both veins lie posterior to head
Relation of pancreas with SMA&V
They are BEHIND head
BUT
FRONT of uncinate process
by passing
UNDER neck
Posterior relation of neck of pancreas
SMV & portal vein
Renal relation with pancreas
Body of pancreas is in direct contact with left kidney along with renal vein & adrenal
Structure behind pancreatic tail
Kidney
Structure anterior to pancreatic tail
Splenic hilum
Structure anterior to body of pancreas
Stomach and DJ flexure
Relation between head of pancreas with 1st part of duodenum
1st part is anterior to head
Gastric relation of head of pancreas
Pylorus is anterior to head
Superior relation of pancreas
Coeliac trunk (cause at L12) with branches obviously
What the groove of pancreatic head for
For 2nd and 3rd part of duodenum
Trunk of pancreatic blood supply
Coeliac
Venous drainage is pancreatic head
SMV
Importance of ampulla of vater
Transition from foregut to midgut
with their different blood supply
Similarity between hepatic artery and portal vein
Their blood flows at same direction
Occlusion of which structure will result in greater reduction of hepatic blood flow
Portal vein
Percentage of blood flow to liver by portal vein
70%
Blood flow track of liver
Portal+hepatic>sinusoid>central veins of lobules>hepatic veins>IVC
Peculiarity of couinaud segment l
It can be a part of either anatomical segment right or left
Peculiarity of quadrate lobe
Anatomically right
Functionally left
&
Couinaud lV
Fossa related to quadratus lobe of liver
On Right side is fossa for gall bladder
On Left side is fossa for umbilical vein
Arterial supply of CAUDATE lobe of liver
From both right and left hepatic artery
Name of couinaud segment l
CAUDATE lobe
Biliary drainage of segment l
Into both right and left hepatic duct
Location and content of portal canal
Between liver lobules
Contain portal triad(hepatic artery, portal vein, tributary of bike duct)
Lobes separated by porta hepatis
Caudate behind from Quadrate in front
Biliary portion of porta hepatis
Common hepatic duct
Nerve in porta hepatis
Sympathetic and parasympathetic of Coeliac plexus