GI Flashcards
What is the anteriolateral abdominal wall bound by?
Costal cartilages of 7th to 10th rib and xiphoid sternum
Where is the arcuate line and what does it signify?
1/3 of way from umbillicus to public crest
Where reclusive fibrous sheath stops forming posteriorly
Name the 3 flat and 2 vertical muscles of the abdomen.
Trans versus abdominis, external oblique, internal oblique
Rectus abdominis and pyramidalis
What do all aponeuroses fuse to form?
Rectus sheath of rectus abdominis
What are the superior and inferior borders of the lines alba?
Xiphoid process and pubic symphysis
Name the part that forms the middle of the rectus abdominis and the bits inbetween the muscles
Linea alba and tendinous intersections
Where is an appendicectomy formed and what do you call this point?
2/3 of the distance between the umbillicus and ASIS
McBurney’s point
Describe a gridiron incision. Give an example when it is used
Open and closing scissors to separate out muscle rather than cutting through things
Appendecectomy
Give two times when a patent urachus forms.
At birth
Later in life when men develop benign prostatic hypertrophy
Give me three features of meckels diverticulum. What can be caused when the diverticulum contains ectopic gastric tissue?
2% affected 2 feet from ileocecal valve 2 inches long Detected in under 2s 2:1 ratio male:female
Ulceration
What causes faecal matter to come out of the umbillicus?
Vitelline fistula
What is it called when abdominal contents are left outside the body, uncovered?
Gastroschisis
What are the abdominal contents covered by in omphalocele?
Reflection of the amnion
Where does pain begin in early appendicitis? At what spinal level?
Umbillicus T10
Give three reasons for referred diaphragmatic pain. Which shoulder affected and why?
Ruptured spleen
Ectopic pregnancy
Perforated ulcer
Left as right is covered by liver
Where does the greater omentum attach from, to?
From greater curve of stomach to anterior surface of transverse colon
Where does the lesser omentum attach from, to?
Lesser curve of stomach and proximal duodenum to liver
Also connects stomach to portal triad
What does the falciparum ligament do?
Connects liver to anterior abdominal wall
What is the whole connecting the two omentums called?
Omental foramen, foreamen of Winslow
Name the 9 surface regions of the abdomen and show them on yourself.
epigastric, umbilical, hypogastric/suprapubic, left/right hypochondriac, left/right lumbar, left/right iliac
where do you find free communication between the supra and infra colic compartments?
paracolic gutters (lateral edge of colon)
what sac are the supra and infra colic compartments part of?
greater sac
The cavity in the abdomen formed by the lesser and greater omentum is called what?
lesser sac
What is the internal epithelial lining of the gut derived from?
endoderm
What is the external lining of the gut derived from?
splanchnic mesoderm-future musculature, visceral peritoneum
what borders the foregut and midgut?
between the proximal and distal duodenum
what borders the midgut and hindgut?
from proximal 2/3 of transverse to distal 1/3 of transverse colon
what arteries supply the fore, mid and hindgut? One for each
for-celiac trunk
mid-SMA
hind-IMA
which 2 organs have mixed blood supply in the GI tract? what 2 arteries is it?
duodenum and pancreas (celiac trunk and SMA)
what mesentry is the greater omentum formed from?
dorsal
what mesentry is the lesser omentum formed from?
ventral
what 2 directions does the stomach rotate in?
longitudinal
anteroposterior axis
Where does the vagus nerve lie after stomach rotation?
Anterior and posterior to stomach
what is the name of the wedge of tissue that separates the trachea and oesophagus during embryologicial development?
tracheoesophageal septum
what causes the liver to have a bare area on the superiror part?
grows at same time as diaphragm and doesn’t have visceral covering
Name 2 organs that are secondarily retroperitoneal.
duodenum and pancreas
What is a hernia?
Protrusion of part of the abdominal contents beyond the normal confines of the abdominal wall
What are the three parts of a hernia?
The sac
Contents of the sac
Coverings of the sac
What is the sac of a hernia made up of?
A pouch of peritoneum
Name 4 places you could get a weakness in the abdominal wall predisposing you to a hernia?
Inguinal canal
Femoral canal
Umbilicus
Previous incisions
What is the inguinal canal?
Oblique passage through lower part of abdominal wall
What is the Gubernaculum and what does it link?
Condensed band of mesenchyme
Links go ad to labioscrotal dwelling
Name the ant, post, roof and floor of the inguinal canal
Aponeurosis of ext oblique reinforced by int oblique laterally
Tranversalis fascia, conjoint tendon medially
Transversalis fascia, internal oblique and trans versus abdominis
Inguinal ligament, thickened medially by lacunae ligament
Name the two types of inguinal hernias. Which is most common?
Direct and indirect
Indirect is most common
Are indirect hernia more common in men or women? Which side?
Men
Right sided
Describe the relationship of the epigastric vessels to indirect and direct hernias
Indirect- lies lateral to inferior epigastric vessel
Direct- lies medial
What is difference between mid inguinal point and mid point of the inguinal ligament?
Mid inguinal point- ASIS to pubic symphysis- finds femoral artery
Mid point of inguinal ligament- midway ASIS to pubic tubercle- finds deep inguinal ring
What are the boarders of Hesselbachs triangle? (Base, lat, med)
Base- inguinal ligament
Lateral- inf epigastric vessels
Medial- lateral boarder of rectus abdominis
What are the boarders of the femoral triangle?
Sup- inguinal ligament
Lat- med boarder of sartorius
Med- med boarder of adductor longus
What does and indirect inguinal hernia pass through?
Under what conditions can this pass into the scrotum?
Deep inguinal ring
Inguinal canal
Sup ring
Enters scrotum if processes vaginalis is not obliterated
Which hernia bulges through Hesselbach’s triangle?
Direct, in the vicinity of the sup inguinal ring
Why are femoral hernia more common in women?
Due to pelvic anatomy- wider so can get stuck more easily.
What is the name of the entrance to the femoral canal?
Femoral ring
What are the boarders of the femoral canal?
Med- lacunae ligament
Lat- femoral vein
Ant- inguinal ligament
Post- pectineal ligament, sup ramus of pubic bone, pectineus muscle
Where does a femoral hernia normally exit?
Saphenous opening
What is the difference between and incarcerated and stangulated hernia?
Incarcerated is stuck and irreducible (can’t be pushed back in)
Strangulated- blood supply is disrupted and can lead to tissue necrosis
