GI , Snell Flashcards

1
Q

Cutaneous supply to the anterior abdominal wall is derived from (2)

A

1) Anterior rami of lower six thoracic nerves (lower 5 intercostals and subcostal)
2) Anterior rami of first lumbar nerve

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2
Q

First lumbar nerve is represented by (2)

A

1) Iliohypogastric nerve

2) Ilioinguinal nerve

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3
Q

Dermatome of T7

A

Xiphoid process

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4
Q

Dermatome of T10

A

Umbilicus

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5
Q

Dermatome of L1

A

Just above the inguinal ligament and symphysis pubis

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6
Q

Arterial supply of abdominal skin: Midline

A

Superior and inferior epigastric

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7
Q

Arterial supply of abdominal skin: Flanks (3)

A

1) Intercostal
2) Lumbar
3) Deep circumflex iliac

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8
Q

Venous drainage of abdominal skin (2)

A

1) Axillary vein via lateral thoracic vein

2) Femoral vein via superficial epigastric and greater saphenous veins

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9
Q

Lymphatic drainage of abdominal skin: Above umbilicus

A

Anterior axillary LN

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10
Q

Lymphatic drainage of abdominal skin: Below umbilicus

A

Superficial inguinal LN

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11
Q

Superficial fascia of abdomen is divided into

A

1) Camper fascia (fatty)

2) Scarpa fascia (membranous)

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12
Q

Camper fascia is continuous with

A

Superficial fascia of the rest of the body

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13
Q

Scarpa fascia fades at

A

1) Lateral

2) Superior

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14
Q

Scarpa fascia continues inferiorly over the inguinal ligament to fuse with

A

Deep fascia of the thigh (fascia kata) ~1 finger breadth below the inguinal ligament

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15
Q

Scarpa fascia continues in the midline to form

A

A tubular sheath for the penis/clitoris

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16
Q

Scarpa fascia continues in the perineum to attach at the

A

Margins of the pubic arch to form the Colles’ fascia

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17
Q

Strongest layer of the anterior abdominal wall

A

Deep fascia

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18
Q

The cremaster muscle is derived from

A

Lower fibers of the internal oblique

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19
Q

The rectus sheath is formed by

A

Aponeurosis of the 3 lateral abdominal muscles

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20
Q

Arrangement of abdominal aponeurosis at the level of the ASIS

A

All 3 aponeuroses pass anteriorly to the rectus muscle, leaving the sheath deficient posteriorly

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21
Q

All 3 aponeuroses fuse with each other and with their fellows of the opposite side in the midline between the recti muscles to form the

A

Linea alba

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22
Q

Linea alba extends from

A

Xiphoid process above to symphysis pubis below

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23
Q

The transverse tendinous intersections that divide the rectus abdomens into segments are usually ___ in number

A

3

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24
Q

Abdominal tendinous intersections levels

A

1) Level of the xiphoid
2) Level of the umbilicus
3) Between the the xiphoid and umbilicus

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25
Q

Muscle fibers that form the conjoint tendon

A

Internal oblique and transversus abdominis

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26
Q

The lower free border of the internal oblique arches over the spermatic cord/round ligament of uterus, descends behind and attaches to

A

Pubic crest and pectineal line

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27
Q

Role of the conjoint tendon

A

Strengthens the medial half of the posterior wall of the inguinal canal

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28
Q

The inguinal ligament is formed by

A

Lower border of the aponeurosis of external oblique

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29
Q

Lower border of the inguinal ligament is attached to

A

Deep fascia of thigh (fascia lata)

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30
Q

The fascia transversalis lines the

A

Transversus abdominis

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31
Q

The fascia transversalis is continuous with (2)

A

1) Lining of the diaphragm

2) Lining of the iliacus

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32
Q

Fascia transversalis forms part of what sheath

A

Femoral sheath

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33
Q

Femoral sheath is formed by (2)

A

1) Fascia transversalis

2) Fascia iliaca

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34
Q

Content of inguinal canal in females

A

Round ligament

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35
Q

Content of inguinal canal in males

A

Spermatic cord

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36
Q

Inguinal canal leads to ___ in males

A

Testis

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37
Q

Inguinal canal leads to ___ in females

A

Labium majus

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38
Q

Inguinal canal: Length

A

4 cm

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39
Q

Inguinal canal: Extends from

A

Deep/internal inguinal ring laterally to superficial/external inguinal ring obliquely and medially

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40
Q

Inguinal canal: Lies parallel and immediately above the

A

Inguinal ligament

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41
Q

Deep inguinal ring: Oval opening in the

A

Fascia transversalis

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42
Q

Deep inguinal ring: Lies approximately ___ above the inguinal ligament

A

1.3 cm

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43
Q

Deep inguinal ring: Margins give attachment to

A

Internal spermatic fascia

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44
Q

Superficial inguinal ring: Shape

A

Triangular

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45
Q

Superficial inguinal ring: Aponeurosis of

A

External oblique

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46
Q

Superficial inguinal ring: Lies immediately above and medial to

A

Pubic tubercle

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47
Q

Superficial inguinal ring: Margins give attachment to

A

External spermatic fascia

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48
Q

Inguinal canal walls: Anterior

A

EOM aponeurosis

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49
Q

Inguinal canal walls: Posterior

A

Conjoint tendon medially, fascia transversalis laterally

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50
Q

Inguinal canal walls: Superior wall (roof)

A

IO and TA

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51
Q

Inguinal canal walls: Inferior wall (floor)

A

Inguinal and lacunar ligaments

52
Q

Inguinal ligament is aka

A

Poupart’s ligament

53
Q

Structure that passes through the inguinal canal in both males and females

A

Ilioinguinal nerve

54
Q

Hernia that occurs above the inguinal ligament

A

Inguinal hernia

55
Q

Hernia that occurs below the inguinal ligament

A

Femoral hernia

56
Q

Hernial sac of an indirect inguinal hernia

A

Processus vaginalis

57
Q

More common: Indirect vs direct inguinal hernia

A

Indirect

58
Q

Indirect inguinal hernia: More common in the left vs right

A

Right

59
Q

Indirect inguinal hernia: Neck of sac, wide vs narrow

A

Narrow

60
Q

Femoral vs inguinal hernia: Sac above and medial to the pubic tubercle

A

Inguinal

61
Q

Femoral vs inguinal hernia: Sac below and lateral to the pubic tubercle

A

Femoral

62
Q

Direct inguinal hernia: Males vs females

A

Males

63
Q

Direct inguinal hernia: Neck of hernial sac, wide vs narrow

A

Wide

64
Q

Contents of spermatic cord (7)

A

1) Vas deferens
2) Artery of vas deferens
3) Remains of processes vaginalis
4) Testicular artery, vein (pampiniform plexus), and lymph vessels
5) Cremasteric artery
6) Genital branch of genitofemoral nerve, which supplies the cremaster muscle)
7) Autonomic nerves

65
Q

External spermatic fascia is derived from

A

External oblique muscle

66
Q

Internal spermatic fascia is derived from

A

Fascia transversalis

67
Q

Cremasteric fascia is derived from

A

Internal oblique muscle

68
Q

Lower expanded part of the processes vaginalis

A

Tunica vaginalis

69
Q

T/F Direct inguinal hernia never enters the scrotum

A

T

70
Q

Indirect inguinal hernia is covered by

A

1) Peritoneum

2) 3 layers of spermatic cord

71
Q

Musculoligamentous cord that connects the fetal testis with the floor of the developing scrotum

A

Gubernaculum testis

72
Q

Gubernaculum testis is homologous with

A

Female round ligament of the ovary and round ligament of the uterus

73
Q

Layers of the scrotum

A

1) Skin
2) Superficial fascia (Dartos muscle)
3) External spermatic fascia
4) Cremasteric fascia
5) Internal spermatic fascia
6) Tunica vaginalis

74
Q

Derivatives: Superficial fascia of the abdomen

A

Dartos muscle

75
Q

Derivatives: External oblique muscle

A

External spermatic fascia

76
Q

Derivatives: Internal oblique muscle

A

Cremaster muscle

77
Q

Derivatives: Fascia transversalis

A

Internal spermatic fascia

78
Q

Derivatives: Peritoneum

A

Tunica vaginalis

79
Q

Outer fibrous capsule of the testes

A

Tunica albuginea

80
Q

Structure that lies posterior to the testis that has a head, body, and tail

A

Epididymis

81
Q

Epididymis: Length

A

6m

82
Q

Emerges from the tail of the epididymis

A

Vas deferens

83
Q

Arterial supply to the testis

A

Testicular artery from the abdominal aorta

84
Q

Venous drainage of the testis (2)

A

1) IVC via the right testicular vein

2) Left renal vein via the left testicular vein

85
Q

Varicocele: Left vs right

A

Left

86
Q

Why varicocele more commonly forms on the left testicle

A

Drains into the renal vein where the pressure is higher

87
Q

Lymph drainage of the testis

A

Paraaortic LN at the level of L1

88
Q

Nerves of the anterior abdominal wall run downward and forward between

A

Internal oblique and transversus abdominis

89
Q

Nerve/s that enter the rectus sheath

A

Lower 6 thoracic nerves

90
Q

Nerve/s that does/do NOT enter the rectus sheath

A

L1

91
Q

Inguinal triangle is aka

A

Hesselbach’s triangle

92
Q

Boundaries of the inguinal triangle: Superior and lateral

A

Inferior epigastric artery

93
Q

Boundaries of the inguinal triangle: Inferior and lateral

A

Inguinal ligament

94
Q

Boundaries of the inguinal triangle: Medial

A

Rectus abdominis

95
Q

Reflex elicited by stroking the skin of the superior and medial thigh

A

Cremasteric reflex

96
Q

Cremasteric reflex: Utilizes sensory and motor fibers in the

A

Ventral rams of L1

97
Q

Cremasteric reflex: Sensory arm

A

Ilioinguinal nerve

98
Q

Cremasteric reflex: Motor arm

A

Genital branch of the genitofemoral nerve

99
Q

Superior epigastric artery arises from

A

Internal thoracic artery

100
Q

Inferior epigastric artery arises from

A

External iliac artery

101
Q

Deep circumflex iliac artery is a branch of

A

External iliac artery

102
Q

Blood supply of the anterior abdominal wall

A

1) Superior epigastric
2) Inferior epogastric
3) Deep circumflex iliac
4) Lower 2 posterior intercostal (descending thoracic aorta)
5) Four lumbar (abdominal aorta)
6) Superficial epigastric, Superficial circumflex iliac, Superficial external pudendal (femoral artery)

103
Q

T/F The peritoneal cavity in males is a closed cavity

A

T

104
Q

T/F The peritoneal cavity in females is a closed cavity

A

F, communicates with exterior through uterine tubes, uterus, and vagina

105
Q

Main compartment of the peritoneal cavity that extends from the diaphragm to the pelvis

A

Greater sac

106
Q

Compartment of the peritoneal cavity that lies behind the stomach

A

Lesser sac

107
Q

Greater and lesser sac of peritoneum are in free communication with each other at the

A

Epiploic foramen

108
Q

The liver is connected to the diaphragm by (4)

A

1) Falciform ligament
2) Coronary ligament
3) Right triangular ligament
4) Left triangular ligament

109
Q

Two-layered ford of peritoneum that connect the stomach with another viscus

A

Omenta

110
Q

Connects the greater curvature of stomach with transverse colon

A

Greater omentum

111
Q

Suspends the lesser curvature of the stomach to the fissure for the ligemantum venosum and port hepatic of the liver

A

Lesser omentum

112
Q

Connects the stomach to the hilus of the spleen

A

Gastrosplenic omentum/ligament

113
Q

Two-layered folds of peritoneum connecting parts of the intestines with the posterior abdominal wall

A

Mesenteries

114
Q

Boundaries of the epiploic foramen: Anterior (2)

A

1) Lesser omentum

2) Portal triad

115
Q

Boundaries of the epiploic foramen: Posterior

A

IVC

116
Q

Boundaries of the epiploic foramen: Superior

A

Caudate lobe of liver

117
Q

Boundaries of the epiploic foramen: Inferiorly

A

First part of duodenum

118
Q

Parietal peritoneum in the pelvis is mainly supplied by

A

Obturator nerve

119
Q

Somatic vs autonomic: Parietal peritoneum

A

Somatic

120
Q

Somatic vs autonomic: Visceral peritoneum

A

Autonomic

121
Q

Somatic vs autonomic: Pain precisely localized

A

Somatic

122
Q

Somatic vs autonomic: Pain poorly localized

A

Autonomic

123
Q

Stimulus for visceral/autonomic pain

A

Stretching or pulling

124
Q

Visceral vs parietal peritoneum: Sensitive to pressure, pain, heat and cold

A

Parietal

125
Q

Visceral vs parietal peritoneum: Insensitive to touch heat and cold

A

Visceral

126
Q

Sac of peritoneum that lies posterior to the stomach and lesser omentum

A

Lesser sac

127
Q

2 recesses of lesser sac

A

Superior recess and inferior recess