Anatomy Clinical Correlates

Question 1

Orientation of surgical incisions

Answer 1

Parallel to cleavage (Langer’s) lines to produce very little scarring

Question 2

Collateral venous circulation in IVC blockage

Answer 2

Thoracoepigastic veins between axillary and femoral vv.

Question 3

Caput medusa

Answer 3

Peri-umbilical vv. become distended d/t portal HTN

Anastamose with inferior epigastric a.

Question 4

Ruptured membranous urethra in males

Answer 4

Urine gets sequestered between Scarpa’s fascia and abdominal wall

Question 5

Direct inguinal hernia

Answer 5

Medial to inferior epigastric artery through just superficial inguinal ring

Question 6

Indirect inguinal hernia

Answer 6

Lateral to inferior epigastric artery through deep > canal > superficial

Question 7

Laceration of liver or spleen

Answer 7

• Splenectomy

- Hold off porta hepatis through omental foramen with fingers

Question 8

GERD

Answer 8

Heartburn caused by stomach acid into esophagus > Barrett Esophagus is complication that involves metaplasia of the epithelium > adenocarcinoma of esophagus

Question 9

Perforated gastric ulcer

Answer 9

• Coffee grounds vomit caused by mixing of acid and blood

- Posterior = into lesser sac > diaphragm and pancreas > referred pain to L shoulder and/or back

Question 10

Visceral manipulation

Answer 10

• Pyloric = superior to umbilicus in mid-epigastric region
• Hepatopancreatic = superior and right of umbilicus
• Duodenal/jejunal valves = above and left of umbilicus (mid-clavicular line)
• Ileocecal valve = inferior to McBurney’s

Question 11

Umbilical vein

Answer 11

Round ligament remnant

Question 12

Foregut supplied by

Answer 12

Celiac trunk

Question 13

Midgut supplied by

Answer 13

Superior mesenteric

Question 14

Hindgut supplied by

Answer 14

Inferior mesenteric

Question 15

Portal and caval anastamoses

Answer 15

• Left gastric and esophageal veins
• Umbilical veins and epigastric veins
• Superior rectal and middle rectal
• Veins draining an organ that lies against body wall and veins of body wall

Question 16

Esophageal varices in portal blockage

Answer 16

Esophageal branches of L gastric v. have connections to esophageal branches of azygos-hemiazygos vv. that enlarge during portal HTN and can burst and quickly cause death

Question 17

Arterial anastamoses of colon

Answer 17

Colic branches from R, L, and middle and ileocolic form an anastamotic vessel called the marginal a.

Question 18

Identification of intestinal regions

Answer 18

• Jejunum vasa recta are long and only one level of arcades exist
• Ileum vasa recta are short and several levels of arcades are seen

Question 19

Last portion of anal canal

Answer 19

Formed from ectoderm and invaginates

Question 20

Kidney stones

Answer 20

1. junction of renal pelvis and ureter
2. where ureter crosses pelvic brim/common iliac vessels
3. at wall of bladder

Question 21

Hiatal hernia

Answer 21

-Stomach can go through esophageal hiatus and acidic chyme can cause reflux

Question 22

OPP Pressure gradients

Answer 22

Diaphragm creates thoracic and abdominal pressure gradients so if the diaphragm is restricted > can alter movement of venous and lymph movement > tissue congestion > MFR and ME can restore diaphragm function

Question 23

Development of urinary system

Answer 23

Kidneys and ureters develop in pelvis and rise and lose connections from aorta

Question 24

Development of thoracic diaphragm

Answer 24

Begins as mesoderm > acquires innervation from C3-5

Question 25

Medial folds embryologic remnants from

Answer 25

Umbilical aa.

Question 26

Lateral folds contain...

Answer 26

Epigastric aa

Question 27

Median fold embryologic remnants from...

Answer 27

Urachus