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MRCS Other > Doctors Academy - Abdomen and Pelvis COPY > Flashcards

Doctors Academy - Abdomen and Pelvis COPY Flashcards

1
Q

What structures are found in the transpyloric plane?

A
  1. end of spinal cord
  2. L1 vertebral body
  3. origin of SMA (superior mesenteric artery)
  4. origin of portal vein
  5. neck of pancreas
  6. pylorus of stomach
  7. 2nd part of duodenum
  8. sphincter of oddi
  9. hylum of each kidney
  10. DJ flexure
  11. splenic flexure
  12. route of the transverse mesentery
  13. fundus of the gall bladder
  14. tips of 9th costal cartilages
  15. hilum of spleen
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2
Q

What structures are found in the Obturator Foreman?

A
  1. Obturator vein
  2. obturator artery
  3. obturator nerve
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3
Q

What structure divides the greater sciatic foremen in to two?

A

The Piriformis muscle

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4
Q

What structures pass through the greater sciatic foraman

A

Suprapiriform foramen:

  • Superior gluteal artery, vein & nerve

Infrapiriform foramen: (PPIINNS)

  • Pudendal nerve
  • Posterior femoral cutaneous nerve
  • Inferior gluteal vessels (artery and vein) and nerve
  • Internal pudendal vessels (artery and vein)
  • Nerve to obturator internus
  • Nerve to quadratus femoris
  • Sciatic nerve
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5
Q

What structures pass through the lesser sciatic foraman?

A
  • Pudendal nerve
  • Internal Pudendal Artery and Vein
  • Nerve to obturator internus
  • Tendon of the Obturator Inernus

PINT

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6
Q

Which structures pass through both the greater and lesser sciatic foraman?

A
  1. Pudendal nerve
  2. Internal pudendal artery
  3. Nerve to obturator internus
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7
Q

What structures are found within the pudendal canal?

A
  1. Inferior rectal nerve
  2. Perineal nerve
  3. dorsal nerve of the penis / clitoris
  4. pudendal artery

NB: these are all branches of the pudendal nerve

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8
Q

Diaphragm Openings

What structures pass through the diaphragm at T8

A
  • IVC
  • Right phrenic Nerve
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9
Q

Diaphragm Openings

What structures pass through the diaphragm at T10

A
  1. Oesophagus
  2. Posterior vagal trunk
  3. hemiazygous vein
  4. Lesser Splenic Artery
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10
Q

Diaphragm Openings

What structures pass through the diaphragm at T12

A
  • Aorta
  • Thoracic Duct
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11
Q

What is the blood supply to the diaphragm

A
  1. superior phrenic artery
  2. inferior phrenic artery
  3. pericardiophernic artery
  4. musculophernic artery
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12
Q

Where in the diaphragm are Bochdalek and Morgagni hernias found

A

Bochdalek:

  • Left posterior diaphragm

Morgangni:

  • Right anterior diaphragm
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13
Q

Hernia’s

Descibe the following hernias:

  • Littres
  • Spigelian
  • Richters
  • Panaloon
  • Maydls
A

Littres - Contains a meckles diverticulum

Spigelian - found at the junction of the semilunaris

Richters - protrusion of the anti mesenteric small bowel

Pantaloon - both a direct and an indirect hernia on the same side

Maydls - Contains two loops of bowl and another loop of bowel on the inside

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14
Q

What abdominal layers would you go through in a pfannenstiel incision

A
  1. Skin
  2. subcutaneous fascia
  3. anterior rectus sheath
  4. rectus abdominis
  5. pyramidalis
  6. transversalis fascia
  7. pre and para vesical spaces
  8. peritoneum
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15
Q

what abdominal layers would you go through in a lanz incision

A

Skin, SC Fascia, external oblique, internal oblique, transverse abdominus, transversalis fascia, pre preitoneal fat, perioneum

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16
Q

where is the location of the deep inguinal ring

A

1.5cm above the mid point of the inguinal ligament

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17
Q

what is the hasslebachs triangle and what are its boarders

A

it is the weakest part of the abdominal wall as there is no rectus sheath.

Boarders:

Medially: Rectus abdominus

Laterally: Inferior epigastric vessels

Inferiorally: Inguinal Ligament

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18
Q

What are the boarders of the inguinal canal

A

The borders of the inguinal canal can be recalled using the mnemonic MALT:2

Roof (Muscles): Transversus abdominis muscle, internal oblique muscle

Anterior wall (Apeunerosis): Aponeurosis of the internal and external oblique muscle

Floor (Ligaments): Inguinal ligament, lacunar ligament

Postior wall (T’s): Conjoint tendon, transversalis fascia

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19
Q

What is the contents of the inguinal canal

A
  • Ilioinguinal nerve
  • Genital branch of the genitofemoral nerve
  • The round ligament of the uterus (Females)
  • Spermatic cord (Males)

Extra:

Spermatic Cord contents:

3 fascial layers: external spermatic fascia, cremasteric fascia/ muscle, internal spermatic fascia

3 arteries: artery to vas (ductus) deferens, cremasteric artery, testicular artery

3 nerves: ilioinguinal nerve, genital branch of genitofemoral, sympathetic and visceral afferent nerve fibres

3 other: pampiniform plexus, vas deferens, testicular lymphatics

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20
Q

which ligament supplies the most support to the uterus

A

Transverse Ligament

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21
Q

what is the innervation of the scrotal skin?

A

Anterior:

  • Ilioinguinal Nerve
  • Genital nerve or the genitofemoral nerve

Posterior:

  • Pudendal
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22
Q

which nerves are responsible for the cremasteric reflex (L1)

A
  • Ilioinguinal Nerve
  • Genital branch of the genitofemoral
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23
Q

list the retroperitoneal structures

A

SAD PUCKER

  • Suprarenal (Adrenal) Glands
  • Aorta
  • Duodenum (parts 2/3)
  • Pancreas (Appart from the tail, thats intraoperitoneal)
  • Ureters
  • Colon (Assecnding and descending)
  • Kidneys
  • Esophagus
  • Rectum (Lower part)
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24
Q

what are the boarders of callots triangle and what does it contain

A

Boarders:

Superior: Livery

Medial: Common hepatic Duct

Lateral: Cystic Duct

Contents:

  • Cystic Artery
  • Right hepatic artery
  • Sentinile lymph node
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25
Q

what is the blood supply of the CBD

A
  • Gastroduodenal artery
  • retroduodenal artery
  • right hepatic artery
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26
Q

what are the layers of the scrotum? Also, these layers are continuation of abdominal fascia, for each name the abdominal fascia they are a continuation of.

A

Scrotal Layers (Abominal layers are in brackets):

Some Damn Englishman Called It the Testes

  • Skin (N/A)
  • Dartos (scarpas fascia)
  • External Spermatic fascia (External Oblique)
  • Cremastieric Spermatic Fascia (Internal Oblique)
  • Internal Spermatic Fascia (Transversalis fascia )
  • Tunica Vaginalis (Peritoneum)
  • Tunica Alberginea
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27
Q

what nerves control acid secreition of the stomach

A

vagus nerve - causes acid secreion

Greater / lesser spanchlic nerves + hypogastric plexus - decrease acid secretion

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28
Q

What are some of the classic complications of a whipples?

A
  • Delayed gastric emptying
  • dumping syndrome
  • brittle diabetes
  • pancreatic fistula
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29
Q

Which part of the pancreas has the highest concentration of langerhans cells

A

The tail of the pancreas

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30
Q

which genetic mutation is associated with hereditory pancreatitis

A

SPINK1

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31
Q

which part of the gastrointestinal tract contains brunners glands

A

Duodenum

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32
Q

what types of mucosa are the most common in meckles diverticulum

A

Meckles are most commonly lined with ideal mucosa

they can also contain gastric and pancreatic mucosa

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33
Q

what cells line the epithelium of the majority of the GI tract and what are the exceptions

A

Most of the GI tract is columnar appart from Oesophagus and anal canal which is squamous

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34
Q

What are the branches of the SMA

A
  • Iliocolic artery
  • right colic
  • middle colic artery
  • inferior pancreatodudenum
  • jejunal
  • ileal
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35
Q

what are the branches of the IMA

A
  • Left colic
  • Sigmoid
  • Superior rectal artery
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36
Q

What is the only structure the ureters cross?

A

RULE: the ureters are always crossed by other structures, appart from when it crosses the common ileac

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37
Q

what is the order of structures in the hilum of the kidney (anterior to postior)

A

Renal vein, renal artery, ureter

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38
Q

what structures join the IVC directly and what structures join the portal system

A

Join IVC:

  • Renals (including suprarenals)
  • gonadals
  • Lumbar
  • Left hepatic
  • Right Hepatic

Join Portal System:

  • SMV
  • IMV
  • Splenic Vein
  • Gastric veins
  • Hepatic portal vein (formed from Splenic, IMV, SMV and Gastric veins)
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39
Q

What is the blood supply and venous drainage of the adrenal glands?

A

Blood Supply:

  1. Superior suprarenal (inferior phrenic)
  2. middle suprarenal (aorta)
  3. inferior suprarenal (renal artery)

Venous drainage:

Right: Right adrenal vein (IVC)

Left: Left adrenal vein (left renal vein)

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40
Q

what is the blood suppply and venous drainage of the rectum?

A

Arterial Supply:

  • Superior rectal (IMA)
  • Middle rectal (Internal Ileac)
  • Inferior rectal (Internal pudendal, branch of the internal ileac)

Venous Supply:

  • IMV
  • Internal Ileac
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41
Q

what is the site of absorbtion of vitamin B12 and Folate in the GI tract

A

distal ileum

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42
Q

What do the following facia cover:

  • Gerotas Fascia
  • Waldeyers fascia
  • colles fascia
  • gallaudets fascia
  • denovillers fascia
  • sibsons fascia
  • bucks fascia
A
  • Gerotas = kidneys
  • Waldeyers = pre sacral fascia (behind rectum - stopes infection spreading from the rectum to the spine)
  • Colles = superficial fascia of the perineum
  • Galleudets = deep peroneal fascia
  • denovilliers - fascia between prostate and rectum
  • sibsons - apex of lung
  • bucks - deep fascia of the penis
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43
Q

at what anatomical location do the ureters enter the urinary bladder

A

posterolateral angles of the trigone of the bladder

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44
Q

which colonic polyps have the greatest malignant risk?

A

villous

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45
Q

What are the branches of the internal ileac?

A
  • Inferior and superior vesical arteries (these give rise to artery to vas)
  • Middle Rectal Artery
  • Uterine artery
  • Internal pudendal artery
  • Obturator artery
  • superior and inferior gluteal artery
  • ileolumbar
  • lateral sacral

Regions: buttock, inner leg, peroneum, bladder, uterus and rectum

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46
Q

What would be the cause of neurological signs + abdominal pain

A

Acute intermittent perforia or Lead poisoning

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47
Q

What is the urinary diagnostic marker for carcinoid syndrome?

A

5 hydroxidendolaecitic (5-HIAA)

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48
Q

What is SMA syndrome and what are the common symptoms?

A

This is where the 3rd part of the duodenum gets caught under the SMA

Symptoms:

  • post prandial abdominal pain
  • nausea and vommiting of partially digested food
  • weight loss
  • often relieved by lying prone or to the left
  • high pitched bowel sounds
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49
Q

what is SMA stenosis and what are the common symptoms?

A

this is where you get calcification of the SMA.

Symptoms:

  • hx of other vascular disease
  • abdo pain about 1 hour after eating
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50
Q

What is the contents of the spermatic cord?

A

Spermatic Cord contents:

3 fascial layers: external spermatic fascia, cremasteric fascia/ muscle, internal spermatic fascia

3 arteries: artery to vas (ductus) deferens, cremasteric artery, testicular artery

3 nerves: ilioinguinal nerve, genital branch of genitofemoral, sympathetic and visceral afferent nerve fibres

3 other: pampiniform plexus, vas deferens, testicular lymphatics

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51
Q

What are the boarders of the femoral Triangle and what does it contain?

A

Boarders:

Roof: Fascia Lata

Floor: Pectineus, ileopsoas, adductor longus

Lateral: Sartorius

Medial: Adductor Longus

Superior: Inguinal Ligament

Contents:

  • Femoral branch of the genitofemoral nerve
  • femoral artery
  • femoral vein
  • femoral canal
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52
Q

What are the contents of the femoral canal?

A

lymphatics

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53
Q

What are the boarders of the Adductor canal?

A

Anteromedial: Sartorius.

Lateral: Vastus medialis.

Posterior: Adductor longus and adductor magnus.

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54
Q

What are the contents of the adductor canal?

A
  • femoral artery
  • femoral vein (posterior to the artery)
  • nerve to the vastus medialis
  • saphenous nerve
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55
Q

What are the boarders of the femoral canal?

A

Laterally: Femoral vein

Medially: Lacunar ligament

Anteriorly: Inguinal ligament

Posteriorly: Pectineal ligament

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56
Q

What is the gene associated with FAP Syndrome? and what are the symptoms?

A

Gene: APC gene

Features:

  • Multiple Colonic polyps (adenoma)
  • age of onset about 30 years old
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57
Q

What is the gene associated with Peuz-Jager syndrome? and what are the features?

A

Gene: STK11 gene

Features:

  • Multiple benign harmatomas
  • episodic obstruction and intersuseption
  • increased risk of breast, ovarian, cervical,pancreatic and testicular cancer
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58
Q

What is the gene associated with Cowdan sydnrome? and what are the common features?

A

Gene: PTEN

Features:

  • Multiple harmatomas + Trichlemmones (benign tumour from the outer root of the hair folicule)
  • associated with breast and thryoid cancer.
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59
Q

What is the gene associated with Lynch syndrome? and what are the common features?

A

Gene: MMR / MSH2

Features:

  • Fewer polyps
  • Right sided colonic tumours
  • Microsatallite instabilities

Associated with Endometrial, Gastric and pancreatic tumours

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60
Q

What is the gene associated with Li Fraumeni syndrome? and what are the common features?

A

Gene: P53

Features:

  • asscoiated with sarcomas and leukemias + adrenal tumours
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61
Q

What are the features of gardeners sydnrome?

A
  • Epidermoid cysts
  • papillary thyroid cancers
  • desmoid tumours
  • osteomas and fibromas
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62
Q

A 34 year old lady undergoes an elective cholecystectomy for attacks of recurrent cholecystitis due to gallstones. Microscopic assessment of the gallbladder is most likely to show what?

A

Aschoff-Rokitansky sinuses

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63
Q

What symptoms do you get in plummer vincent syndrome?

A
  • Iron deficient anemia
  • Oesophageal webs
  • dysphasia
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64
Q

From what cells do almost all pancreatic cancers arise?

A

Ductal epithelium

65
Q

what is the blood supply of the pancreas

A

Head is supplied by the Pancreatoduodenal artery

Tail is supplied by the splenic artery

66
Q

If you are presented with a child with abdominal pain, who has a high pitched screem and is drawing their legs up, what is your main differential?

A

Intersusseption

67
Q

what are the two main differential diagnosis for painful PR Bleeding?

A

Anal fissure and rectal ulcer syndrome (here you will have an abraision)

68
Q

if the question mentions Melanosis coli is present, what is this a sign of?

A

Laxitive abuse

69
Q

What are some of the histological features of UC?

A
  • Crypt Abcesses
  • Pseudopolps
  • mucosal islands
    *
70
Q

What is the surgical treatment for UC?

A

Panproctocolectomy + Ileostomy

71
Q

where do the majority of gall bladder cancers arise?

A

in the fundus

72
Q

what is the most common type of pancreatic cancer?

A

adenocarcinoma

73
Q

what vaccinations are reuired post splenctomy?

A
  1. Haemopholis Influenza type B
  2. Menigiococal B
  3. Pneumococcal
  4. Influenza
74
Q

what strucutres are at risk during caecal mobilisation?

A

gonadal vessels and ureters are most at risk of damge

75
Q

What is the blood supply and venous drainage of the pancreas?

A

Arterial supply

Head: pancreaticoduodenal artery

Rest: splenic artery

Venous drainage

Head: superior mesenteric vein

Body and tail: splenic vein

76
Q

What are the structures of the porta hepatis?

A

Portal vein

Hepatic artery

Common hepatic duct

77
Q

what are the constrictions of the oesophagus?

A

Constrictions of the oesophagus : ABCD
A- Arch of the Aorta
B- Left main Bronchus
C- Cricoid Cartilage
D- Diaphragmatic Hiatus

78
Q

What is the first line treatment for a muconium ileus?

A

The first line treatment for uncomplicated cases is enemas of either dilute gastrograffin or N-acetyl cysteine.

79
Q

what is the lymphatic drainage of the prostate?

A

internal ileac nodes

80
Q

what is the blood supply to the prostate?

A

inferior vesical

81
Q

What are the common features of carcinoid syndrome?

A

CARCinoid:

  • Cutaneous flushing
  • Asthmatic wheezing
  • Right sided valvular heart lesions
  • Cramping and diarhorrea
82
Q

in a male Where is the first site of resistance to be encountered on inserting the catheter?

A

The membrenous urethra

83
Q

What is the longest part of the male urethra?

A

Spongy urethra

84
Q

What composition of renal stone is most common in staghorn calculi

A

Stuvate

85
Q

What composition of renal stone is most common in malignancy

A

uric acid

86
Q

What is the most common composition of renal stone

A

Calcium oxalate

87
Q

What composition renal stones are radio-opaque

A

Calcium Oxalate
Calcium Pyrophosphate
Cystine

88
Q

What composition of renal stone is most common in renal tubular acidosis

A

Calcium pyrophosphate

89
Q

What tumour markers are raised in seminomas and non seminomatous testicular cancers?

A

Seminomas = HCG raised in 10%. AFP normal

Non seminometous = AFP raised. HCG raised in 40%

90
Q

what is the treatment of testicular cancer?

A

Inguinal orchidectomy + post operative chemotherapy

91
Q

What is the treatment of adrenal adnenomas?

A
  • <2-4cm and non functioning: dishcarge
  • 4-6cm and non functioning: discuss possible removal
  • 4-6cm and functioning: laparoscopic removal
  • If >6cm: remove open
92
Q

What are the histological features / endoscopic feature of Crohns?

A
  • Non caseating granulomas
  • Goblet cells
  • transmural inflamation
  • cobblestone appearence
93
Q

What is the main blood supply to the omentum?

A

Gastroepiploic artery

94
Q

Which vessels provides the greatest contribution to the arterial supply of the breast?

A

Internal Mammary Artery

95
Q

Which nerve is the primary source of innervation to the scrotal skin?

A
  • Anterior skin: Illioinguinal nerve + small contribution from genital branch of the genitofemoral nerve
  • Posterior Skin: Pudendal nerve
96
Q
A
97
Q

What type of liver pathology is common in patients who have worked in a PVC factory?

A

Angiosarcoma (or Hepatocellular carcinoma)

98
Q

What cancers is BRACA1 gene associated with?

A

Breast and ovarian cancer

99
Q

A 46 year old lady presents with symptoms of diarrhoea, weight loss of 10 Kg and a skin rash of erythematous blisters involving the abdomen and buttocks. The blisters have an irregular border and both intact and ruptured vesicles. What is the most likely diagnosis?

A

glucagonoma - these are associated with necrolytic erythema

100
Q

Which organ is affected by a Klatskin tumour

A

bile ducts

101
Q

at what anatomical site does anatomical sites does dormant tuberculosis most frequently reactivate?

A

apex of the lung

102
Q

If a patient has portal hypertension or varices what can be given to reduce the portal pressure?

A

Turlopressin

103
Q

What can increase gastric emptying post vagotomy

A

Erythromycin (Metoclopermides effects are decreased)

104
Q

What is goodsals rule with regards to fistula in ano?

A

Anterior fistulae will tend to have an internal opening opposite the external opening.

Posterior fistulae will tend to have a curved track that passes towards the midline.

105
Q

what is the normal size of the CBD?

A

less than 6mm

106
Q

where in the body is the most water reabsorbed?

A

Jejunum

107
Q

what agent can increase the rate of empyting in a vagotamised stomach

A

erythromycin

108
Q

what are the branches of the external iliac artery

A

inferior epigastric, deep circumflex iliac and femoral arteries (profunda femoris is a branch of the femoral)

109
Q

what structures are contained within the hepatoduodenal ligament

A
  • bile duct
  • portal vein
  • hepatic artery
    *
110
Q

what is the blood supply of the omentum

A

gastroepiploic artery

111
Q

Which sign is commonly present in a patient with retroperitoneal haemorrage?

A

grey turners sign

112
Q

which sign would you commonly see in a patient with an intraperitoneal haemorrage or pancreatitis?

A

cullens sign

113
Q

where are gastrinomas most commonly found

A

duodenum (50%)

Pancreas (20%) - these are commonly solitary and display malignant behaviour

114
Q

what is zollinger elison syndrome composed of

A
  1. Non beta islet cell tumours of the pancreas
  2. Hypergastrinaemia
  3. Severe ulcer disease
115
Q

what percentage of patients with colorectal cancer have a synchronus cancer?

A

5%

116
Q

what are the Extraintestinal manifestation of inflammatory bowel disease?

A
  • Aphthous ulcers
  • Pyoderma gangrenosum
  • Iritis
  • Erythema nodosum
  • Sclerosing cholangitis
  • Arthritis
  • Clubbing
117
Q

what hepatobiliary disorders are most classically associated with ulcerative colitis?

A

Primary sclerosing cholangiits

118
Q

which portion of the pancreas lies between the aorta and the SMA

A

uncinate process

119
Q

what are the most common benign tumour of the oesophagus

A

leiomyoma’s

120
Q

where are peyers patches most commonly found?

A

ileum

121
Q

how common are parastomal hernias

A

they occur in 10% of colostomies

122
Q

what is the common position of the inferior epigastric vessels to direct hernias

A

direct hernias are most common in hasslebachs triangle. Here the epigastric vessels would be lateal to the hernia

123
Q

what is a krunkenburg tumour

A

A Krukenberg tumor refers to a malignancy in the ovary that metastasized from a primary site, classically the gastrointestinal tract

124
Q

what is the order of structures from anterior to posterior in the porta hepatis

A

common hepatic duct, hepatic artery and the portal vein (most posterior)

125
Q

At what anatomical level does the aorta bifurcate?

A

L4

126
Q

what is the most common cause of intersusception in children?

A
  1. Hypertrophic Peyers patches (80%)
  2. Meckles diverticulum (10%)
127
Q

what are peyers patches and where are they found

A

these are aggregates of lymphoid tissue found in the small bowel

128
Q

Which hernias are found in the following positions:

  1. below and lateral to the pubic tubercle
  2. above and medial to pubic tubercle
A
  1. below and lateral to the pubic tubercle - femoral hernia
  2. above and medial to pubic tubercle - inguinal hernia
129
Q

Splenectomy increases your risk of infection to which organisms?

A
  1. Pneumococcus
  2. Meningococcus
  3. H. Influenza
130
Q

What is the most common composition of gallstones in a patient with crohns

A

Cholesterol

131
Q

descibribe the differences between the ileum and the jejunan in terms of:

  1. Site
  2. Lumen
  3. Arcades
  4. Vasa recta
A

Jejunum:

  1. Site - Left
  2. Lumen - wide lumen and thick walled
  3. Arcades: Less Arcades
  4. Vasa recta: Long vasa recta

Ileum:

  1. Site - Right
  2. Lumen - Narrow and thin walled
  3. Arcades: more arcades
  4. Vasa recta: short vasa recta
132
Q

If there was a tumour in the transverse colon, which structure should be ligated close to its origin to maximise clearance of the tumour

A

Middle colic artery

133
Q

What is the treatment of a carcinoid tumour

A
  • Smaller than 1 cm and asymptomatic – local excision
  • Bigger than 2 cm – small-bowel resection and lymphatic clearance
  • Carcinoid syndrome (by definition metastatic) and other advanced disease – palliative
134
Q

Where does fluid from a perforated peptic ulcer normally collect

A

Right paracollic gutter

135
Q

Stimulation from which nerve causes gall bladder contraction

A

Vagus nerve

136
Q

What is the blood supply of the gall bladder

A

Cystic artery (from the right hepatic artery)

137
Q

What is the management of splenic lacerations

A

Grade 1 - laceration <1cm + <10% haematoma. Treatment = Conservative

Grade 2 - Laceration 1-2cm + 10-80% haematoma. Treatment = Conservative

Grade 3 - Grade 2 + intraparencymal bleed. Treatemnt if stable = observe. If undsatble = IR or pack

Grade 4 - Grade 3 + hilar injury. Treatment = IR

Grade 5 - shattered spleen. Treatment = Splenectomy

138
Q
A
139
Q

What is the blood supply to the omentum

A

Gastroepiploic arteries

140
Q

What is the treatment of NEC?

A

Most are treated conservatively. If they dont settle conservatively you may have to undertake a laparotomy

141
Q

What is the most common viral infection a patient gets following a solid organ transplant

A

Cytomegalovirus

142
Q

What is the treatment for anal cancer

A
  1. Chemoradiotherapy
  2. APER
143
Q

What is the treatment for a toxic mega colon

A

Subtotal collectomy + end ileostomy

144
Q

What is an annular pancreas

A

This is a pancreas that wraps round the second part of the duodenum

145
Q

From which muscle does the conjoint tendon arise

A

the internal oblique

146
Q

which portion of the ascending and descending colon is retroperitoneal

A

the posterior surface

147
Q

what macroscopic change is noted at the transition point of the sigmoid colon and the upper rectum?

A

at this point the teniae fuse

148
Q

Where does the Foregut, Midgut and Hindgut begin / end

A

Foregut: Stomach and 1st part of the duodenum

Midgut: 2nd part of the duodenum to ⅔ the way along the transverse colon

Hindgut: distal ⅓ of the transverse colon to the anus

149
Q

Where does the middle colic vein and the inferior mesenteric vein drain to

A

Middle colic drains to the Superior Mesenteric vein → Portal vein →SVC

Inferior mesenteric vein drains to the Splenic vein → portal vein → SVC

150
Q

what two arteries does the marginal artery connect

A

the SMA and the IMA

151
Q

What is the nervous innervation of the internal and external anal sphincter

A

internal sphincter → Sympathetic nerves

external sphincter → S2,3,4

152
Q

Where do the testicular arteries arise from and where do the testicular veins drain to

A

Arteries: Arise from the aorta

Veins:

  • Left drains in to the left renal veins
    • right drains to the IVC
153
Q

What is found in the red and white pulp of the spleen?

A

White pulp - contains immune cells + Central trabecular artery.

red pulp - contains vessels

154
Q

What is the blood supply of the right and left lobe of the liver

A

Right → Right hepatic artery

Left → left hepatic artery

155
Q

How many liver lobes are there?

A

Right lobe (Segments 5,6,7,8)

Left Lobe (2, 3)

Quadrate lobe (segment 4 - anatomically part of the right lobe but functionally part of the left lobe)

Caudate Lobe (segment 1 - part of the left lobe)

156
Q

how many liver segments are there and in which lobe are these segments found?

A

There are 8 segments of the liver

Right lobe: 5-8 +/- segment 1

Left Lobe: 2-4 +/- Segment 1

Segment 1 is the Caudate Lobe

Segment 4 includes the quadrate lobe

157
Q

How many ligaments are there in the liver?

A

5 ligmaments:

Falciform Ligment - divides left and right lobes

Round ligament - fibrous cord at the free edge of the falciform ligament

Coronary Ligament - connects liver to the diaphragm superiorly

Left Triangular ligament - connects left corner of the liver ot the diaphragm

Right triangular ligament - connects the right corner of the liver to the diaphragm

158
Q

What is the ligament teres in the liver?

A

This is a cord like ligmaent found in the falciform ligament that is a remnant of the umbilical vein

159
Q

what is the ligament venous

A

a remnant of the ductus venosus

MRCS Other (19 decks)

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