Anatomy - Week 7 - Anatomy Of Foregut

Question 1

Where is the inguinal canal located?

Answer 1

It is located between the deep inguinal ring and superficial inguinal ring

Question 2

What is the inguinal canal?

Answer 2

It is a slit like passage that extends in a downward and medial direction, just above and parallel to the inguinal ligament which runs from anterior superior iliac spine to the pubic tubercle

Question 3

What are the contents of the inguinal canal?

Answer 3

Ilioinguinal nerve, spermatic cord in male or round ligament of the uterus in female

Question 4

What is deep inguinal ring?

Answer 4

Opening in fascia transversalis. Located 1/2 inch above the mid-inguinal point - midway between the anterior superior iliac spine and symphysis pubis

Question 5

What are the structure passing through the deep inguinal ring?

Answer 5

Spermatic cord in males

Round ligament of the uterus in females

Question 6

What is the superficial inguinal ring?

Answer 6

It is an opening in the external oblique aponeurosis. The superficial inguinal ring is located above and lateral to the pubic tubercle.

Question 7

What are the structures passing through the superficial inguinal ring?

Answer 7

Spermatic cord in male or round ligament in female and ilioinguinal nerve.

Question 8

What is the conjoint tendon formed from?

Answer 8

The lower part of the common aponeurosis of the internal abdominal oblique and the transverses abdominis as it inserts into the crest of the pubis and pectineal line

Question 9

What is the anterior wall of the inguinal canal?

Answer 9

External oblique aponeurosis, reinforced laterally by internal oblique. This wall is therefore strongest where it lies opposite the deep inguinal ring

Question 10

What is the posterior wall in the inguinal canal?

Answer 10

Conjoint tendon medially and fascia transversalis laterally. This wall is therefore strongest where it lies opposite the superficial inguinal ring.

Question 11

What is the roof wall of the inguinal canal?

Answer 11

Arching lowest fibres of the internal oblique and transversus abdominis muscles

Question 12

What is the floor wall of the inguinal canal?

Answer 12

Inguinal ligament and, at its medial end the lacunar ligament.

Question 13

What is the inguinal ligament?

Answer 13

It is a fibrous band formed by the lower border of the aponeurosis of the external oblique muscle that extends from the anterior superior illiac spine to the pubic tubercle.

Question 14

What it is the descent of the testis?

Answer 14

Gonads develop within extraperitoneal layer of abdomen
Gubernaculum extends from here to Strotum or labia major a and makes a path for descent of testes
Processus vaginalis (portion of peritoneum) pouches out through the inguinal canal guided by previous descent of gubernaculum
Testes follow processus vaginalis to scrotum.

Question 15

What is a hernia?

Answer 15

A hernia is an abnormal weakness in the abdominal wall which allows something inside (peritoneal sac or intestine) to protrude.

Question 16

What is an inguinal hernia?

Answer 16

Protrusion or passage of a peritoneal sac, with or without abdominal contents through a weakened part of the abdominal wall in the groin.
It occurs because part of the peritoneal sac enters the inguinal canal either indirectly (through the deep inguinal ring) or directly (through the posterior wall of the inguinal canal)

Question 17

What is an indirect inguinal hernia?

Answer 17

Most common, more in males.

The peritoneal sac may traverse the length of the canal and continue to the scrotum or labia majus

Question 18

What is a direct inguinal hernia?

Answer 18

A direct inguinal hernia arises from protrusion of abdominal viscera through a weakness of the posterior wall of inguinal canal medial to the inferior epigastric vessels

Question 19

Where is the venal caval hiatus aperture through the diaphragm?

Answer 19

Lies in the central tendon of the diaphragm at the level of T8 and transmits the IVC and right phrenic nerve.

Question 20

Where is the esophageal hiatus aperarture through the diaphragm?

Answer 20

Lies in the muscular part of the diaphragm (right crus) at the level of T10 and transmits the esophagus and anterior and posterior trunks of the vagus nerves.

Question 21

Where is the aortic hiatus aperture through the diaphragm?

Answer 21

Lies between two crura of diaphragm at level of T12 and transmits the aorta, thoracic duct and azygous vein.

Question 22

What is the position of the liver in the body?

Answer 22

It lies deep to ribs 7-11
It occupies the right hypochondrium, epigastric regions and extends into the left hypochondrium. It is separated into two lobes, right and left by falciform ligament.

Question 23

What is the anatomy of the liver?

Answer 23

It’s diaphragmatic surface is convex. This surface is covered by visceral peritoneum. It reflects back onto the diaphragmatic peritoneum. This reflection is known as the coronary ligament. An area on the posterior surface of the liver is in direct contact with the diaphragm, is devoid of visceral peritoneum and referred to as the bare area. Inferior vena cava traverses a deep groove within the bare area of the liver. On this posterior surface, the falciform ligament can be seen and at its free edge give rise to ligamemtum teres remnants of umbilical.

Question 24

What are the two accessory lobes of the right lobe on the posterior surface of the liver?

Answer 24

The quadrate lobe

The caudate lobe

Question 25

What is the porta hepatis?

Answer 25

(Gateway to the liver) is where the hepatic arteries and portal vein enter and the right and left hepatic ducts leave the liver.

Question 26

What is the position of the lobes on the liver?

Answer 26

The left lobe of the liver lies to the left of the ligamentum teres.
The quadrate lobe lies between the ligamnetum teres, porta hepatis and the gall bladder
The caudate lobe lies between the ivc, ligamnetum venosum and porta hepatis

Question 27

What is the blood supply of the liver?

Answer 27

From the celiac trunk, blood to liver travels in the common hepatic artery. After the origin of gastroduodenal artery, the artery is referred to as hepatic artery proper where it split into right and left hepatic arteries at porta hepatis to supply the right and left lobes

Question 28

What does the portal vein do?

Answer 28

Drains blood from the digestive tract and spleen, and transports products of the digestion to the liver for processing.

Question 29

What is the portal vein formed by?

Answer 29

It’s is formed by union of splenic vein and superior mesentric vein

Question 30

Where does the vein leave the liver?

Answer 30

Inferior vena cava

Question 31

What is the Porto-systemic anastomosis?

Answer 31

The hepatic portal system drains blood from the visceral organs of the abdomen to the liver. In Normal individuals, 100% of the portal venous flow can be recovered from the hepatic veins, whereas in patients with elevated portal vein pressure (eg. Due to cirrhosis), there is significantly less blood flow to the liver. The rest of the blood enters collateral channels, which drain into the systemic circulation.

Question 32

Where do the largest of the Porto systemic collaterals occur at?

Answer 32

The gastroesophageal junction around the cardia of the stomach where the left gastric vein form a portosystemic anastomosis with tributaries to the azygous system of veins of the caval system.
The anus - the superior rectal vein of the portal system anastomoses with the middle and inferior rectal veins of systemic venous system
Anterior abdominal wall around umbilicus para umbilical veins of porta system anastomose with veins on anterior abdominal wall of cava system