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Fundamentals of clinical anatomy and imaging > Conferences > Flashcards

Conferences Flashcards

Flashcards pulled from conference 15 forward

1
Q

What 3 structures are located in superficial fascia of anterior abdominal wall?

A
  1. Superficial veins
  2. Superficial lymphatics
  3. Cutaneous nerves
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2
Q

Into what 3 venous systems do superficial and deep anterior abdominal wall veins drain?

A
  1. Superior to umbilicus: superior vena cava
  2. Inferior to umbilicus: inferior vena cava
  3. Paraumbilical veins: portal venous system
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3
Q

What are the 2 drainage pathways for lymphatic vessels found in anterior abdominal wall?

A
  1. Superior to umbilicus: axillary lymph nodes

2. Inferior to umbilicus: inguinal lymph nodes

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4
Q

What 4 nerves innervate the skin of anterolateral abdominal wall via their cutaneous branches?

A
  1. Thoracoabdominal intercostals
  2. Subcostal
  3. Iliohypogastric
  4. Ilioinguinal
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5
Q

What spinal segments supply thoracoabdominal intercostals?

A

T7-11

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6
Q

What spinal segments supply subcostal?

A

T12

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7
Q

What spinal segments supply iliohypogastric?

A

L1

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8
Q

What spinal segments supply ilioinguinal?

A

L1

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9
Q

What are 3 dermatomal landmarks on anterior abdomen?

A
  1. Xiphoid process: T7
  2. Umbilicus: T10
  3. Inguinal region: L1
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10
Q

Branches of what spinal nerves innervate the muscles of anterior abdominal wall?

A

T7-L1

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11
Q

What innervates parietal peritoneum?

A

T7-L1 spinal nerves

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12
Q

What are the 4 muscles of anterior abdominal wall?

A
  1. External oblique
  2. Internal oblique
  3. Transversus abdominus
  4. Rectus abdominus
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13
Q

What are the functions of the muscles of anterior abdominal wall?

A
  1. Flexion, lateral bending, rotation of trunk
  2. Increase intraabdominal pressure by contraction against closed glottis to facilitate coughing, defecation, urination, and childbirth
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14
Q

What makes up inguinal ligament?

A

External abdominal oblique aponeurosis

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15
Q

What is inguinal canal?

A
  1. Begins laterally as evagination of transversalis fascia (deep inguinal ring)
  2. Runs oblique and emerges through external oblique aponeurosis (superficial inguinal ring)
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16
Q

What forms deep inguinal ring?

A

Transversalis fascia

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17
Q

What forms superficial inguinal ring?

A

External oblique aponeurosis

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18
Q

What are the layers of spermatic cord?

A
  1. Internal spermatic fascia
  2. Cremasteric fascia and muscle
  3. External spermatic fascia
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19
Q

What creates internal spermatic fascia?

A

Transversalis fascia

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20
Q

What creates cremasteric muscle and fascia?

A

Internal oblique

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21
Q

What creates external spermatic fascia?

A

External oblique

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22
Q

What are the 7 contents of inguinal canal (males)?

A

(I like girls that play cards drunk)

  1. Ductus deferens
  2. Testicular artery
  3. Testicular vein (pampiniform venous plexus)
  4. Ilioinguinal nerve
  5. Genital branch of genitofemoral nerve
  6. Sympathetics
  7. Lymphatics
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23
Q

What are the 4 contents of inguinal canal (females)?

A

(GIRL)

  1. Round ligament of uterus
  2. Ilioinguinal nerve
  3. Genital branch of genitoemoral nerve
  4. Lymphatics
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24
Q

What is an indirect inguinal hernia?

A

Bowel surrounded by parietal peritoneum protrudes through deep inguinal ring and may transverse entire inguinal canal and exit superficial inguinal ring into scrotum

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25
Q

What is a direct inguinal hernia?

A

Bowel surrounded by parietal peritoneum rips through transversalis fascia and may transverse the entire inguinal canal and exit superficial inguinal ring into scrotum

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26
Q

How can direct and indirect inguinal hernias be differentiated?

A

Indirect: lateral to inferior epigastric vessels
Direct: medial to inferior epigastric vessels (found in Hesselbach’s triangle)

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27
Q

What 2 vessels supply blood and remove to anterior abdominal wall?

A
  1. Superior epigastric (terminal branches of internal thoracic )
  2. Inferior epigastric (branches of external iliacs)
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28
Q

What is significant about inferior and superior epigastric vessels?

A

(Form anastomoses)
Arteries: bypass blocked descending aorta
Veins: Bypass blocked vena cava

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29
Q

What 8 structures lie on transpyloric plane?

A
  1. 9th costal cartilage
  2. L1 vertebra
  3. 1st part duodenum
  4. Pylorus of stomach
  5. Pancreatic neck
  6. Hilus of kidney
  7. Neck of pancreas
  8. Fundus of gallbladder
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30
Q

What 5 structures lie on subcostal plane?

A
  1. L3 vertebra
  2. 3rd part duodenum
  3. 10th costal cartilage
  4. Pancreatic head
  5. Inferior mesenteric artery
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31
Q

What 2 structures lie on interiliac plane?

A
  1. L4 vertebra

2. Bifurcation of aorta

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32
Q

Where is liver located?

A
  1. Right side to left mid clavicular

2. Extends from top of diaphragm to costal margin (on right)

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33
Q

Where is gall bladder located?

A
  1. On right, inferior margin of liver

2. Fundus located at tip of right 9th costal cartilage on transpyloric plane

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34
Q

Where is spleen located?

A
  1. Posterolateral left side
  2. Between ribs 9 and 11
  3. Parallel to 10th rib (superior to inferior: runs medial to lateral)
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35
Q

Where are kidneys located?

A
  1. Left superior pole: 10th intercostal space
  2. Right superior pole: 11th intercostal space
  3. Hilus: L1 (transpyloric plane)
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36
Q

Where is stomach located?

A
  1. Esophageal hiatus: T10 along midline

2. Pylorus: transpyloric plane (L1)

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37
Q

Where is duodenum located?

A
  1. 1st part: L1 (transpyloric plane)
  2. 2nd part: L2
  3. 3rd part: L3 (subcostal plane)
  4. 4th part: L2
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38
Q

Where is pancreas located?

A
  1. Head: right of midline between transpyloric and subcostal lines
  2. Neck: on midline on transpyloric plane
  3. Tail: extends superolateral (left) toward spleen
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39
Q

Where are intestinal landmarks?

A
  1. Hepatic flexure: below liver lying along costal margin
  2. Splenic flexure: deep to rib cage; below spleen
  3. Ileocecal junction: along right iliac fossa (along iliac crest)
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40
Q

Where is appendix located?

A

(McBurney’s point)

  1. Draw line between right ASIS and umbilicus
  2. 1/3 of way from ASIS to umbilicus
41
Q

What two structures serve as abdominal liners? What do they line?

A
  1. Parietal peritoneum: lines interior abdominal wall (except for unperitonealized posterior region)
  2. Visceral peritoneum: lines some abdominal viscera
42
Q

What supports some abdominal viscera? How is it composed?

A

Mesentery: visceral peritoneum surrounds organ and mounts it via a stem to parietal peritoneum

43
Q

What type of sensory nerve fibers innervate the abdominal liners?

A
  1. Parietal: somatic afferent (sharp, localized pain)

2. Visceral: visceral afferent (dull, unlocalized pain)

44
Q

What 3 types of pain do abdominal organs experience?

A
  1. Completely peritonealized: VA
  2. Partially peritonealized: VA and SA (maybe)
  3. Retroperitonealized: SA
45
Q

What are the 3 peritoneal folds and their contents?

A
  1. Median: urachus
  2. Medial: obliterated umbilical artery
  3. Lateral: inferior epigastric vessels
46
Q

Where are obliterated umbilical vessels found?

A

Arteries: medial peritoneal folds
Veins: round ligament of liver

47
Q

What 2 ligaments compose the lesser omentum?

A
  1. Hepatoduodenal ligament

2. Hepatogastric ligament

48
Q

What is the entrance to the omental bursa?

A

Epiploic foramen (posterior to hepatoduodenal ligament and associated hepatic triad)

49
Q

What is the orientation of the stomach? How is this orientation significant?

A
  1. Superior to inferior: runs posterior to anterior

2. Location of air bubble during diagnostic imaging hints patient’s position during time of imaging

50
Q

What are the rugged folds of the lower portion of stomach?

51
Q

What is the location of jejunum?

A

Upper left quadrant

52
Q

What is the location of ileum?

A

Lower right quadrant

53
Q

How can jejunum and ileum be differentiated?

A
  1. Abdominal location
  2. Diameter (jejunum is wider)
  3. Circular folds (more abundant in jejunum: appears “feathery” upon imaging)
  4. Vasculature: (jejunum has more)
54
Q

Where does the diaphragm attach to spine?

A

Left and right crus

55
Q

What 2 structures are relevant to anterior stomach?

A
  1. Left leaf of diaphragm

2. Liver

56
Q

What 2 structures are relevant to posterior stomach?

A
  1. Left crus of diaphragm

2. Spleen

57
Q

What 4 structures are relevant to pancreas?

A
  1. Stomach
  2. Spleen
  3. Left adrenal gland
  4. Left kidney
58
Q

What 3 structures are relevant to posterior superior duodenum?

A
  1. Gastroduodenal artery
  2. Common bile duct
  3. Portal vein
59
Q

What 3 structures are relevant to descending duodenum?

A
  1. Gall bladder
  2. Head of pancreas
  3. Right kidney
60
Q

What is superior duodenum at risk for? Why?

A

Ulcers (stomach acid enters duodenum and must be neutralized by pancreatic carbonate)

61
Q

What are 4 parts of biliary system?

A
  1. Common hepatic
  2. Cystic duct
  3. Gall bladder
  4. Common bile duct
62
Q

How is signal acquired in ultrasound?

A

(Reflected ultrasound is captured)
Dark: low signal (air or fluid filled)
Bright: high signal

63
Q

How are ultrasound images described?

A

(relative to surroundings)
Hyperechoic: bright signal
Hypoechoic: low signal

64
Q

What features of portal venous system permit ready establishment of collateral flow around portal vein obstruction?

A
  1. Valveless

2. Many potential anastomoses

65
Q

What are the 4 major tributaries to portal vein?

A
  1. Left gastric
  2. Splenic
  3. Inferior mesenteric
  4. Superior mesenteric
66
Q

What single organ does portal vein form posterior to?

A

Neck of pancreas

67
Q

What are the 4 major collateral pathways that permit blood flow around portal vein obstruction?

A
  1. Left gastric to esophageal (Produces esophageal varices, can rupture during food swallowing and cause life-threatening hemorrhage)
  2. Paraumbilical to superficial epigastric (caput medusa)
  3. Superior rectal to middle and inferior rectal (hemorrhoids)
  4. Colics to retroperitoneal (enlarged renal and lumbar branches of inferior vena cava)
68
Q

What are the 3 natural constriction of ureters? What is their clinical significance?

A

(Regions where kidney stones can be caught)

  1. Where renal pelvis becomes ureter2. Where ureter crosses pelvic inlet at bifurcation of common iliac vessels
  2. Where ureter enters urinary bladder
69
Q

What is the developmental kidney disease described in conference?

A

Horseshoe kidney: inferior poles of left and right kidneys fuse at midline and get caught on inferior mesenteric artery during developmental ascension

70
Q

Which nerves provide sympathetic input to celiac plexus?

A

Thoracic splanchnics (preganglionic)

71
Q

Where do thoracic splanchnics synapse?

A
  1. Celiac ganglia

2. Superior mesenteric ganglia

72
Q

Which nerves provide parasympathetic input to celiac plexus?

A

Posterior vagal trunk (preganglionic)

73
Q

Where do parasympathetic, preganglionic neurons synapse?

A

In walls of target organ

74
Q

Where does superior mesenteric artery branch from aorta?

A
  1. L1

2. Posterior to neck of pancreas

75
Q

What does superior mesenteric artery supply?

A

Major duodenal papilla to 2/3 along transverse colon

76
Q

Which nerves provide sympathetic input to the superior mesenteric plexus?

A

Thoracic splanchnics (preganglionic)

77
Q

Which nerves provide parasympathetic input to superior mesenteric plexus?

A

Posterior vagal trunk (preganglionic)

78
Q

At what level does inferior mesenteric artery branch from aorta?

79
Q

What does inferior mesenteric artery supply?

A

Hindgut (2/3 along transverse colon to upper 1/3 rectum)

80
Q

What nerves provide sympathetic input to inferior mesenteric plexus?

A

Lumbar splanchnics (preganglionics)

81
Q

Where do sympathetic, lumbar splanchnics synapse?

A

Inferior mesenteric ganglia

82
Q

Which nerves provide parasympathetic input to the viscera supplied by inferior mesenteric artery (hindgut)

A

Pelvic splanchnics S2-S4 (preganglionic)

83
Q

What is the origin of the thoracic duct? What feeds into it?

A

(Cisterna chyli)

  1. Lumbar trunks
  2. Intestinal trunk
84
Q

What are the boundaries of the pelvic region?

A
  1. Pelvic inlet

2. Pelvic diaphragm

85
Q

What are the boundaries of the pelvic inlet?

A
  1. Sacral promontory
  2. Sacral ala
  3. Arcuate line
  4. Pecten pubis
  5. Pubic tubercle
  6. Pubic crest
  7. Pubic symphysis
86
Q

What are the boundaries of the pelvic outlet?

A
  1. Pubic symphysis
  2. Ischiopubic ramus
  3. Ischial tuberosity
  4. Sacrotuberous ligament
  5. Coccyx
87
Q

What fascia keeps urine of ruptured urethra around lower abdomen?

A
  1. Scarpa’s fascia of abdomen is continuous with fascia lata of thigh
  2. Colle’s fascia and perineal membrane
88
Q

What neurovascular structures pass through the ischioanal fossa?

A

Pudendal neurovascular bundle (inferior rectal nerve - branch of pudendal)

89
Q

Where do perianal abscesses typically originate?

A

Anal sinus

90
Q

What can be palpated during a digital rectal exam (male)? (* what is normally palpable)

A
  1. Prostate
  2. Seminal vesicle, ductus deferens, ureter
  3. Distended bladder
  4. Rectovesical pouch (bowel)
  5. Sacrum*
  6. Coccyx*
91
Q

What can be palpated during a digital rectal exam (female)? (* what is normally palpable)

A
  1. Vagina
  2. Distended bladder
  3. Cervix
  4. Rectouterine pouch (bowel)
  5. Sacrum*
  6. Coccyx*
92
Q

What does the female ureter pass beneath?

A

Uterine vessels

93
Q

What does the male ureter pass beneath?

A

Ductus deferens

94
Q

How is the plane of the pelvic inlet defined?

A

Line through superior pubic symphysis and sacral promontory

95
Q

How is the plane of the midpelvis defined?

A

Inferior pubic symphysis through ischial spine

96
Q

What is the pelvic outlet defined?

A

Inferior pubic symphysis through coccyx

97
Q

What are the smallest dimensions of the pubic planes?

A

Inlet: AP
Midpelvis: transverse
Outlet: transverse

98
Q

What recess runs into the rectouterine pouch?

A

Pararectal

99
Q

What are the two components of the prostate? What are their clinical differences?

A

Central: site of benign prostatic hyperplasia

Peripheral (of posterior): prostate cancer

Fundamentals of clinical anatomy and imaging (10 decks)

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