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MRCS Part A > MRCS Anatomy > Flashcards

MRCS Anatomy Flashcards

1
Q

What are the borders of the femoral triangle?

A

Lateral - sartorius
Medial - adductor longus
Superior - inguinal ligament

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2
Q

Which muscles form the floor of the femoral triangle?

A

Iliopsoas laterally and pectineus medially

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3
Q

Break down femoral triangle vs sheath vs canal?

A

Femoral triangle = contains NAVEL
Femoral sheath = artery, vein and canal
Femoral canal = lymphatic and empty space

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4
Q

What vertebral level does the IVC pierce diaphragm?

A

T8

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5
Q

What 2 things pass through caval opening of diaphragm? Orientation?

A

IVC medially and right phrenic nerve laterally

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6
Q

Where does the right phrenic nerve pierce diaphragm?

A

T8 laterally to IVC

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7
Q

What level does esophagus enter diaphragm? With what else? Orientation?

A

T10

With left and right gastric arteries and veins, (med and lat) right vagus (posterior) left vagus (anterior)

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8
Q

What level do the vagus nerves pierce diaphgram? Where?

A

T10 through split of diaphragm, left anterior to esophagus right posterior to esophagus

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9
Q

Where is the caval opening of diaphragm?

A

T8 - Central tendon

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10
Q

What level does aorta traverse diaphragm? With what? Orientation?

A

T12

With azygos vein (right anterior) and thoracic duct (right posterior)

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11
Q

Where do azygos vein and thoracic duct pass through diaphragm?

A

T12 with aorta

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12
Q

What ligament lies forms anterior of aortic opening of diaphragm?

A

Median arcuate ligament

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13
Q

Which nerves pierce the left and right crus of diaphragm? Orientation?

A

Greater (anterior) and lesser (posterior) splanchnic nerves

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14
Q

Anterior to posterior of diaphgram apertures?

A

T8 anterior caval
T10 middle esophageal
T12 posterior aortic

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15
Q

Where is the transpyloric plane? Anatomical vertebral level?

A

Horizontal line midway between suprasternal notch (T2/3) and pubic symphysis
L1 vertebral level

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16
Q

What level is suprasternal notch?

A

T2/3

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17
Q

Pretty Pretty Please Feed Him Some Love Dude, Damn of things at L1 transpyloric plane level?

A 
Pancreatic neck
Pylorus
Portal vein origin
Fundus of gb
Hila of kidneys and spleen
SMA origin
L1 and lower spinal cord
D2 of duodenum
DJ flexure
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18
Q

Which part of pancreas is at level of transpyloric plane?

A

Neck

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19
Q

Which parts of duodenum are at transpyloric plane?

A

D2 and DJ flexure

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20
Q

Which vertebral level is transpyloric plane?

A

L1

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21
Q

Which vessels are at level of transpyloric plane?

A

Portal vein origin, SMA, hila of kidneys and spleen

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22
Q

Which costal cartilage level is at transpyloric plane?

A

9th costal cartilate

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23
Q

Which part of colonic mesentery is at level of transpyloric plane?

A

Transverse mesocolon

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24
Q

What are the boundaries of the perineum?

A

Posterior - tip of coccyx
Lateral - inferior ramus of pubis, ischial tuberosity and sacrotuberous lig on each side
Anterior - pubic arch and arcuate ligament of pubis
Floor - skin and fascia
Roof - pelvic floor

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25
Q

What is the perineal body and which 6 things make it?

A

Fibromuscular mass at junction of ant and post triangles of perineum, made of:
Bulbospongiosus muscle
Superficial and deep transverse perineal muscles
Anterior fibres levator ani
Urethral sphincter fibres
External anal sphincter

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26
Q

Which 3 muscles are in the superficial perineal pouch?

A

Superficial transverse perineal muscle
Bulbospongiosius
Ischiocavernosus

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27
Q

Nerve for cutaneous innervation of thumb?

A

Palmar cutaneous branch of median nerve

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28
Q

What nerve innervates the thenar muscles?

A

Recurrent branch of median nerve

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29
Q

What nerve innervation deep muscles of anteiror forearm?

A

Anterior interosseus branch of median nerve

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30
Q

Palmar digital branch of median nerve innervates?

A

Palmar surface of index middle and 1/2 of ring finger

Fingertips of above

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31
Q

Which nerve is responsible for tingliness in carpal tunnel syndrome?

A

Palmar digital branch of median nerve

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32
Q

5 bones navicular articulates with?

A

3 cuneiforms
Cuboid
Talus

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33
Q

Calcaneus articulates with which 2 bones?

A

Cuboid and talus

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34
Q

4 bones talus articulates with?

A

Tibia
Fibula
Navicular
Calcaneus

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35
Q

Where is the cuboid bone?

A

Lateral foot - anterior to calcaneus and postterior to 4th and 5th metatarsals

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36
Q

Curtis can’t count bones, never took calculus of 7 tarsal bones?

A 
Cuneiform medial
Cuneiform intermediate
Cunieform lateral
CuBoid
Navicular
Talus
Calcaneus
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37
Q

What is the arcuate line and what is it anatomical marker for?

A

Horizontal line 3-5cm below umbilicus

Where inferior epigastric vessels pierce through rectus abdominis

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38
Q

What is the linea semilunaris and its importance?

A

Spigelian line - where hernia form- line joining tip of 9th costal cartilage to pubic tubercle

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39
Q

What is the transtubuercular plane and its clinical relevance?

A

Horizontal line passing through iliac tubercles marking location of L5 and confluence of common iliacs to form IVC

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40
Q

Blood vessels encountered directly below campers fascia?

A

Superficial inferior epigastric artery and vein

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41
Q

What is the narrowest part of the male urethra?

A

External urethral orifice

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42
Q

What are the parts of the male urethra?

A 
Preprostatic
Prostatic 
Membranous (within deep perineal pouch) - external urethral sphincter here
Spongy part
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43
Q

Where is the external urethral sphincter in men?

A

In membranous part of penis - in deep perineal pouch

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44
Q

Where is the navicular fossa?

A

Just before external urethral orifice - spongy part

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45
Q

What is the widest part of male urethra?

A

Prostatic part

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46
Q

What does ilioinguinal nerve do? 3 sensory regions and 2 motor roles

A

Supplies sensation to skin over medial aspect of thigh, upper scrotum and penile root
Inmervation to internal abdominal oblique and transversus abdominis

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47
Q

Ilioinguinal nerve is a branch of which nerve root?

A

L1

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48
Q

Cremasteric muscle is innervated by?

A

Genital branch of genitofemoral nerve

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49
Q

Lab markers suggestive of hemolytic anaemia?

A 
Low Hb
Raised MCV and reticulocytes
Unconjugated raised bilirubin
Reduced haptoglobins
Elevated urine urobilinogen
Stercobilinogen in faeces
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50
Q

Femoral nerve innervates what?

A 
Anterior compartment of thigh musculature
Anteromedial thigh (anterior cutaneous branch)
Medial leg (saphenous branch)
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51
Q

What muscles does obtruator nerve innervate?

A

Adductor muscles

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52
Q

Common peroneal nerve innervates what? Branch from?

A

Branch from sciatic
Skin to upper lateral leg (lateral sural cutaneous)
Lower posterolateral leg skin (sural nerve)
Dorsum of foot
Motor - short head biceps femoris, then superficial and deep peroneal nerve to lateral and anteiror compartments of leg

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53
Q

Injury to neck of fibula can injure what nerve? Sx?

A

Common peroneal nerve

Leads to foot drop, loss of dorsiflexion and loss of sensation to dorsum of foot and lateral leg

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54
Q

Tibial nerve supplies what? Branch from?

A

Branch from sciatic
Innervates skin to lateral leg and foot and plantar surface of foot
Muscles of posterior leg compartment and hamstring part of adductor magnus

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55
Q

What does ansa cervicalis innervate?

A

Strap muscles

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56
Q

Vocal hoarseness may be due to which nerve injury?

A

Recurrent laryngeal

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57
Q

Anterior wall of inguinal canal?

A

Aponeuroses of internal and external obliques

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58
Q

Posterior wall of inguinal canal?

A

Transversalis fascia

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59
Q

Roof of inguinal canal?

A

Arching fibres of transversalis abdominis and internal obliques

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60
Q

Autonomic supply to duodenum?

A

Sympathetic nerves from coeliac plexus

Parasympathetic from hepatic and coeliac branches

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61
Q

What is the hepatoduodenal ligament and where does it connect?

A

From D1 duodenal bulb to inferior part of liver

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62
Q

Blood supply of duodenum?

A

D1 - coeliac via right gastroepiploic and gastric

D2-4 - from SMA

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63
Q

Lengths of duodenum parts?

A

D1 - 2inch
D2 - 3inch
D3 - 4
D4 -1

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64
Q

SAD PUCKER of retroperitoneal structures?

A 
Suprarenal glands
Aorta and IVC
Duodenum (second half)
Pancreas
Ureters
Colon ascending and descending 
Kidneys
Esophagus
Rectum
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65
Q

3 parts of the spongy urethra?

A

Navicular fossa
Pendulous
Bulbous

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66
Q

MAFFIAH of muscles supplied by ulnar nerve?

A 
Median 2 lumbricals
Adductor policis
Flexor carpi ulnaris
Flexor digitorum profundis medial half
Interossei
Abductor digiti minimi
Hypothenar eminence
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67
Q

What brachial plexus does ulnar nerve arise from?

A

Medial cord - C8-T1

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68
Q

What is Froments sign?

A

Ulnar nerve entrapment causing flexion of ITP of thumb via FPL when holding piece of paper with thumb and forefinger, due to weakness of adductor policis

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69
Q

Anterior interosseus nerve - branch from what? Motor and sensory?

A

Branches from median nerve
No sensory
Motor to deep muscles of forearm except ulnar half of FDP - flexor policis longus, pronator quadratus, radial half FDP

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70
Q

Outline lower limb arterial anatomy and major nerve links?

A

Common iliac - external iliac becomes common fem
Common fem to SFA and PF
SFA becomes popliteal which splits to ant tibial and tibioperoneal trunk
Ant tibial becomes dorsalis pedis
Tibioperoneal trunk becomes post tibial and peroneal
Ant tibial art runs with deep peroneal nerve
Popliteal artery next to tibial nerve

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71
Q

Outline lower limb arterial anatomy and major nerve links?

A

Common iliac - external iliac becomes common fem
Common fem to SFA and PF
SFA becomes popliteal which splits to ant tibial and tibioperoneal trunk
Ant tibial becomes dorsalis pedis
Tibioperoneal trunk becomes post tibial and peroneal
Ant tibial art runs with deep peroneal nerve
Popliteal artery next to tibial nerve

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72
Q

Which nerve runs with anterior tibila artery?

A

Deep peroneal nerve

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73
Q

Which nerve runs with anterior tibila artery?

A

Deep peroneal nerve

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74
Q

Which nerve runs with popliteal artery?

A

Tibial nerve

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75
Q

Outline venous drainage of arm?

A

Cephalic vein starts distal, superficially and laterally
Basilic vein is medial
Two link in ACF via median cubital vein
Basilic joined by deep brachial to form axillary
Axillary joined by subscapular vein
Axillary and cephalic join to subclavian

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76
Q

What forms the subclavian vein?

A

Axillary and cephalic with subscapular

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77
Q

What forms the axillary vein?

A

Basilic and brachial veins

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78
Q

Outline arterial supply of upper limb?

A

Subclavian artery becomes axillary artery
Axillary becomes brachial
Brachial splits to radial and ulnar with interosseus branch

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79
Q

What arteries supply upper rectum? From which?

A

Superior rectal

From IMA

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80
Q

Which arteries supply lower rectum? From?

A

Inferior rectal - from internal pudendal, from internal iliac

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81
Q

Where does the inferior pudendal artery arise from?

A

Internal iliac

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82
Q

What is the venous drainage of upper rectum?

A

Superior rectal vein into IMV

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83
Q

What is the venous drainage of distal rectum?

A

Inferior rectal veins into inferior pudendal vein

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84
Q

Where does lymph from upper rectum drain?

A

Mesorectal and internal iliac nodes

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85
Q

Where does lymph from lower rectum drain?

A

Superficial inguinal nodes

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86
Q

What are the 4 muscles function and nerve of anterior lower limb compartment?

A

Extensor digitorum and hallucis longus
Tibialis anterior
Peroneus tertius
Innervated by deep peroneal - for dorsiflexion mostly

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87
Q

2 muscles and function and nerve of peroneal compartment?

A

Peroneus longus and brevis- eversion

Superficial peroneal nerve

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88
Q

3 muscles function and nerve of deep posterior compartment of lower limb?

A

Flexor digitorum and hallucis longus
Tibialis posterior
Tibial nerve
For plantarflexion

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89
Q

2 muscles nerve and function of superficial compartment lower limb?

A

Gastrocnemius and soleus
Tibial nerve
Plantarflexion

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90
Q

Nerve root of femoral nerve?

A

L2 3 4

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91
Q

3 branches of femoral nerve?

A

Saphenous nerve

Medial and intermediate cutaneous nerves of thigh

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92
Q

7 muscles innervated by femoral nerve?

A 
Quadriceps femoris
Vastus medialis, lateralis and intermedialis
Pectineus
Sartorius
Rectus femoris
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93
Q

What forms the walls and roof of adductor (subsartorial) canal?

A

Roof is sartorius
Lat wall is vastus medialis
Posterior is adductor longus and magnus

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94
Q

What 3 things are in the adductor canal?

A

Saphenous nerve
SFA
SFV

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95
Q

Outline 4 muscles and nerves of rotator cuff?

A

Supraspinatus and infraspinatus - suprascapular nerve
Subscapularis - superior and inferior subscapular nerves
Teres minor - axillary nerve

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96
Q

Where do rotator cuff muscles insert? 1 exception?

A

Greater tuberosity of humerus

Exception is subscapularis - inserts on lesser tuberosity

97
Q

Which 2 rotator cuff muscles externally rotate shoulder?

A

Infraspinatus and teres minor

98
Q

What rotator cuff muscle internally rotates shoulder? How come?

A

Subscapularis - because it attaches to lesser tuberosity

99
Q

What nerve and vessels are at posterior edge of rotator cuff?

A

Suprascapular nerve and vessels

100
Q

What nerve vessels are inferior to rotator cuff?

A

Circumflex humeral vessels

Axillary nerve

101
Q

What is anteriorly related to rotator cuff?

A

Brachial plexus

Axillary artery and vein

102
Q

Outline drainage of Parotid duct?

A

Stensons duct -crosses masseter, pierces Buccinatorr and drains adjacent to 2nd upper molar

103
Q

What 4 structures pass through the parotid gland? 2nerves 1 artery 1 vein

A

2 nerves - facial and auriculotemporal
External carotid artery
Retromandibular vein

104
Q

What lymph nodes does parotid drain to?

A

Deep cervical nodes

105
Q

Sensory innervation to parotid?

A

Greater auricular nerve

106
Q

Which cords form medial nerve? Roots?

A

C5-T1

Lateral and medial cords

107
Q

What is the relation between median nerve and axillary artery?

A

Crosses anterior to 3rd part of axillary artery

108
Q

What is the relation between median nerve and brachial artery?

A

Lateral initially, then crosses anteriorly to medial side at elbow

109
Q

What muscle heads does median nerve pass between and on deep surface of which muscle does it run?

A

Between heads of pronator teres and on deep surface of flexor digitorum superficialis

110
Q

What does median nerve damage at elbow result in?

A

Carpal tunnel plus anterior interosseus nerve palsy I.e. weakness of forearm pronation, flexion and ulnar wrist deviation

111
Q

Where does anterior interosseus nerve come from?

A

Median nerve just below elbow

112
Q

Anterior interosseus nerve innervates? 2.5 muscles

A

Pronator quadratus
Flexor pollicis longus
Half of FDP

113
Q

Action of anterior interosseus nerve?

A

Pronate forearm, flex thumb and flex index finger (+ deep muscles of forearm)

114
Q

What is the lateral most tarsal bone?

A

Cuboid

115
Q

What are the anterior most tarsal bones?

A

Cuboid laterally, cuneiforms medially

116
Q

What tarsal bone forms the heal?

A

Calcaneus

117
Q

Which is more anterior- navicilar or talus?

A

Navicular

118
Q

Carpal bones in order?

A

Scaphoid lunate triquetrum pisiform

Trapezium trapezoid capitate hamate

119
Q

Which cardiac vein drains directly into right atrium?

A

Anterior cardiac vein

120
Q

Blood supply to heart?

A

Aortic sinus - right and left coronary arteries
RCA to right marginal and posterior descending arteries
LCA to LAD, left marginal, circumflex and diagonal branches

121
Q

What does right coronary artery supply?

A

Right atrium, diaphragmatic RV, Posterior 1/3 UV septum and the nodes

122
Q

What does left coronary artery supply?

A

Left atrium and ventricle, part of right ventricle, anteiror 2/3 of IV septum and apex

123
Q

Where is foramen ovale of skull? What 5 things go through it?

A

Sphenoid bone

Emissary veins, V3, otic ganglion and accessory meningeal artery and lesser petrosal nerve

124
Q

What bone is foramen spinosum in? What 2 things go through it?

A

Sphenoid bone

MMA and meningeal branch of mandibular nerve

125
Q

Foramen rotundum is in what bone? What 1 thing goes through it?

A

Sphenoid - V2

126
Q

What 4 foramina are in sphenoid bone?

A

Ovale
Spinosum
Rotundum
Superior orbital fissure

127
Q

What goes through foramen lacerum?

A

Atery and berve of pterygoid canal

128
Q

What bone is jugular foramen in? What 6 things go through?

A 
Temporal bone
Inferior petrosal sinus anteriorly 
CN 9-11
Sigmoid sinus into IJV posteriorly 
Meningeal branches of occipital and ascending pharyngeal arteries
129
Q

What bone is foramen magnum in? What 4 things go through?

A

Anterior and posterior spinal arteries
Vertebral arteries
Medulla

130
Q

Stylomastoid foramen location and 2 things passing through?

A

Temporal bone

Facial nerve and stylomastoid artery

131
Q

What bone is superior orbital fissure in? 6 things going through?

A 
Sphenoid
CN 3 4 and 6
V1 - lacrimal frontal and nasocilisry branches
Recurrent meningeal artery
Superior ophthalmic vein
132
Q

4 things going through inferior orbital foramen?

A

Zygomatic branch of V2
Ascending branches of pharyngopalatine ganglion
Infraorbital vessels
Inferior ophthalmic vein

133
Q

Posterior interosseus nerve is a branch of? What does it do?

A

Radial

Innervates supinator, abductor policis longus, extensors

134
Q

Origin of ulnar nerve roots?

A

C8/T1

135
Q

Where in relation to flexor retinaculum does ulnar nerve run?

A

Superficial

136
Q

What nerve innervates palmaris brevis?

A

Ulnar

137
Q

What nerve innervates palmaris longus?

A

Median

138
Q

What does ulnar nerve injury at wrist cause?

A

Claw hand
Hypothenar wasting
Loss of sensation in medjal 1.5 fingers
Positive Froment sign

139
Q

Positive froment sign suggests?

A

Ulnar nerve lesion distal to elbow

140
Q

What are the 7 parts of the ICA?

A 
Cervical 
Petrous
Lacerum
Cavernous
Clinoid
Ophthalmic
Communicating
141
Q

What is the first intraDural part of the ICA?

A

Ophthalmic part

142
Q

What nerve innervates lat dorsi? Roots and job?

A

Thoracodorsal
C6 7 8
Adducts shoulder

143
Q

What nerve and roots innervate pectoral major?

A

Medial and lateral pectoral, C8 and C67

144
Q

Roots of long thoracic nerve?

A

C5 6 7

145
Q

What nerve and root innervates rhomboid? What does this do?

A

Dorsal scapular - C5

Stabilises scapula

146
Q

Where do the roots of the brachial plexus come out?

A

Between anterior and medial scalenes, in posterior triangle of neck

147
Q

What is the relationship between trunks of brachial plexus and subclavian artery and first rib?

A

Trunks run through posterior triangle of neck, over first rib, behind SCA

148
Q

What are the 5 bits of the brachial plexus?

A 
Roots
Trunks
Divisions 
Cords
Terminal branches
149
Q

How many divisions of brachial plexus are there?

A

6 - 3 anterior which flex, 3 posterior which extend

150
Q

How many divisions of brachial plexus are there?

A

6 - 3 anterior which flex, 3 posterior which extend

151
Q

What are the 3 brachial plexus cords and what do they relate to?

A

Relating to second part of SCA

Lateral, medial and posterior

152
Q

What are the 3 brachual plexus trunks?

A

Superior, middle and inferior

153
Q

Where do majority of extra nerves from brachual plexus come from?

A

Cords (7)

154
Q

Where do the terminal branches of the brachial plexus arrive in relation to SCA?

A

Around 3rd part

155
Q

Where is the transpyloric plane?

A

Horizontal plane half way between suprasternal notch (T2/3) and pubic symphysis, at L1 vertebral body

156
Q

Pretty pretty please feed him some love, damn Daniel of transpyloric plane contents?

A 
Portal vein origin
Pancreatic neck
Pylorus
Fundus of GB
Hila of kidneys and spleen
SMA origin
Lower spinal cord andL1
D2 of Duodenum
DJ flexure
9th costal cartilage
157
Q

Which costal cartilage is at transpyloric plane level?

A

9th

158
Q

Which vagus nerve is more anterior in relation to oesophagus?

A

Left

159
Q

What runs through central tendon aperture of diaphragm at T8?

A

IVC medially

Right phrenic nerve and liver lymph laterally

160
Q

Which nerves pierce the crura of the diaphgram?

A

Greater and lesser splanchnics

161
Q

What goes througg T10 of diaphgram through split of right crus?

A

Left vagus anteriorly
Oesophagus and left and right gastric vessels
Right vsgus posteriorly

162
Q

What goes through aortic aperture of diaphragm just behind median arcuate lig?

A

T12 - aorta
Azygos vein anteriorly
Thoracic duct posteriorly

163
Q

What is the apex and base of thyroid gland?

A

Apex is thyroid cartilage lamina

Base is 4th and 5th tracheal ring

164
Q

Posterolateral relations of thyroid?

A

Carotid sheath

165
Q

What nerve is next to superior thyorid artery?

A

External laryngeal

166
Q

What nevre is next to inferior thyroid artery?

A

Recurrent larngyeal

167
Q

Which artery is next to recurrent laryngeal nerve?

A

Inferiro thyroid

168
Q

Which artery is next to external laryngeal nerve?

A

Superior thyroid artery

169
Q

Outline blood supply to thyroid?

A

Superior TA - first branch of ECA
Inferior TA - from TC trunk, from SCA
Thyroid ima - from brachiocephalic artery or aorta

170
Q

Venous drainage of thyroid?

A

Sup and med thyroid veins to IJV

Inf thyroid veins to brachiocephalic

171
Q

Which ligament supports the medial longitudinal arch? How?

A

Deltoid ligament - holds talus to medial malleolus

172
Q

What forms the roof of the tarsal tunnel?

A

Flexor retinaculum of foot

173
Q

What embryologically forms parathyroids?

A

Brachial pouch - upper 4th, lower 3rd

174
Q

Floor of anatomical snuffbox?

A

Scaphoid and trapezium

175
Q

Which nerve innervates skin over femoral triangle and can be damaged within femoral sheath?

A

Femoral branch of genitofemoral nerve

176
Q

What is pectineus innervated by?

A

Femoral nerve

177
Q

Nerve supply to anal canal?

A

Above dentate line to internal sphninter is SNS vis pelvis plexus
Pelvic splanchjnjc for PNS

178
Q

Why is prostate Ca commonly metastatic via blood e.g. to bone?

A

Venous plexus extensive around prostate

179
Q

What is the floor of the inguinal canal?

A

Inguinal ligament

180
Q

Anterior wall of inguinal canal?

A

External oblique

181
Q

Posterior wall of inguinal canal? What strengthens it medially

A

Transversalis fascia

Conjoint lig medially

182
Q

Medial ceiling of the inguinal canal?

A

Conjoint tendon

183
Q

Level of trachea bifurcation?

A

T4

184
Q

Levels of insulin, proinsulin and C peptide in insulinoma?

A

All high

185
Q

Boundaries of the inguinal canal?

A

Floor is inguinal lig
Ant is external oblique aponeurosis
Post is transversalis fascia, conjoint tendon medially
Roof is transversus abdominis and internal oblique

186
Q

2 SALP MALT for inguinal canal?

A

Superior - 2 Muscles- transversus abdominis and internal oblique
Anterior - 2 aponeurosis - ext oblique, int laterally
fLoor- 2 ligs - inguinal lig and lacunar lig
Posterior - 2 Ts- transversalis fascia and conjoint Tendon

187
Q

What is the mid inguinal point? Significance?

A

Half way between ASIS and pubic symphysis

Femoral artery marking

188
Q

Whst is the midway point of the inguinal xanal? Significance?

A

Midway between ASIS and pubic tubercle

Superficial inguinal ring

189
Q

9+ 1 contents of inguinal canal/spermatic cord in males?

A

3 arteries - testicular, cremasteric, to Vas
3 fascia- ext spermatic, int spermatic, cremasteric
3 other - vas, Pampiniform plexus, lymph
1 nerve - genital branch genfem

190
Q

What nerve runs through superficial inguinal ring and with inguinal canal but not though it?

A

Ilioinguinal

191
Q

What goes through inguinal canal in women?

A

Round lig only and genital branch genfem nerve

192
Q

Difference between direct and indirect inguinal hernias? With inferior epigastrics?

A 
Direct = not through inguinal canal, medial to inf epigastrics
Indirect= through canal, lateral to inf epigastrics
193
Q

Relate the layers of abdo wall to scrotim/testicle covering?

A

Skin - scrotum
Superficial fascia- dartos fascia and muscle
Ext oblique aponeurosis- ext spermatic fascia
Int oblique muscle and fascia - cremaster
Transversalis fascia- int spermatic fascia
Peritoneum - processus/tunica vaginalis

194
Q

Layers of scrotum? She Decides Everything, Complain In Testicle

A 
Scrotum
Dartos fascia and muscle
Ext spermatic fascia
Cremaster
Int spermatic fascia
Tunica vaginalis
195
Q

Relation of inf epigastrics to inguinal canal/rings?

A

Passes anteriorly to canal, medial to deep ring, lateral to superficial ring

196
Q

What forms the deep inguinal ring?

A

Transversalis fascia

197
Q

What forms the superficial inguinal ring?

A

Evagination of external oblique

198
Q

Which nerve is most at risk in hernia repairs?

A

Ilioinguinal

199
Q

Direct vs inguinal hernia?

A

Direct goes straight through post wall i.e. through transveralis fascia
Indirect goes through deep ring of fascia and through canal

200
Q

What does the inferior epigastric artery arise from?

A

External iliac

201
Q

What does the cremasteric reflex? Sensory and motor?

A

Genfem nerve - motor bit is genital branch

Or ilioinguinal - sensory bit of medial thigh

202
Q

Usefulness of cremasteric reflex in testicular problems?

A

Absent in torsion

Exaggerated in epididimitis

203
Q

Whst does iliohypogsstric nerve do?

A

Sensory over lateral gluteal/pubis

Motor to internal oblique and transverse abdominis

204
Q

Nerves to ext oblique muscle?

A

Thoracoabdominal T7-11

Subcostal T12

205
Q

What is Hesslbachs triangle? Remember RIP

A

Lateral - inferior epigastrics
Medial - lateral rectus sheath (linea semilunaris)
Base - inguinal lig

206
Q

What is found at the sternal angle? Which level?

A

T4 (/5 IV disc)
2nd pair of CCs

Carina of trachea
Thoracic duct travels right ot left behind esophagus
Ligamentium arteriosum
Left rec laryngeal nerve around aortic arch

207
Q

What will a posterior duodenal ulcer bleed through?

A

Gastroduodenal

208
Q

What will a lesser curve ulcer bleed through?

A

Left gastric

209
Q

Which ant or post do perfed ulcers usually occur?

A

Anterior

210
Q

What are the 4 parts of the male urethra?

A

Preprostatic
Prostatic
Membranous
Spongy

211
Q

Where is the membranous part of the male urethra? Significance?

A

In deep perineal pouch

Ext urethral sphincter is here

212
Q

Where is external urethral sphincter which part of urethra?

A

Membranous

213
Q

Where is internal urethral sphincter?

A

Preprostatic part

214
Q

Where do bulbourethral glands open?

A

Proximal spongy Urethra just past membranous part

215
Q

What is the most distal part of urethra before opening? Dilated bit

A

Navicular fossa

216
Q

Sixties Teens Love Sex and Pot of branches of axillary artery? How are they divided?

A 
Superior thoracic - 1 
Thoracoacromial -2 
Lateral thoracic -2
Subscapular -3
Ant -3
Post humeral circumflex -3
Medial, deep to and lateral to pec minor
217
Q

What muscle divides up axillary artery?

A

Pec minor

218
Q

VIT C D of subclavian artery branches? How is this divided?

A 
Vertebral - 1
Internal thoracic -1
Thyrocervical trunk -1
Costocervical -2
Dorsal scapular -3
Divided by scalenus anterior
219
Q

3 borders roof and floor of anatomical snuffbox?

A 
Medial - tendon extensor pollicis longus
Lateral - tendons of ext pol brev and abductor pol long
Prox - styloid process
Floor - scaphoid and trapezium
Roof - skin
220
Q

PISS in big and POO in little holes of greater and lesser sciatic foramen?

A 
PISS greater sciatic foramen
Pudendal nerve and vessels, post cut nerve of thigh, piriformis
Inferior gluteal NAV
Sciatic nerve
Superior gluteal NAV

POO lesser
Pudendal NAV
Obturator internus muscle
Obturnator internus nerve

221
Q

Whst is the only thing going through suprapiriform notch of greater sciatic foramen?

A

Superior gluteal NAV

222
Q

What are the 3 things passing through greater into lesser sciatic notch?

A

Pudendal nerve and Art

Nerve to obturator

223
Q

Boundaries of ACF?

A

Medially - pronator teres
Laterally - brachioradialis
Floor - brachialis and supinator
Roof - bicipital aponeurosis, deep fascia and median cubital vein

224
Q

What does positive trendelenburg test indicate?

A

Hip abductor weakness on affected side (glut med and min) - may be superior inf nerve issue

225
Q

What does inferior alveolar nerve innervate? From?

A

Motor to mylohyoid and ant belly digastrics
Senskry to teeth, chin and lower lip
From V3

226
Q

What does lingual nerve innervate?

A

Sensory to ant 2 3 of tongue

227
Q

What innervates sensation to angle of jaw?

A

Greater auricular nerve

228
Q

What joins to form portal vein? What level? In relation to panc?

A

Splenic vein and SMV
At L2
Posterior to panc neck

229
Q

IMV drains into?

A

Splenic vein

230
Q

How do you enter lesser sac of abdomen?

A

Finger in epiploic foramen from peritoneal cavity

231
Q

What is the hepatoduodenal lig? Significance? Order ant to post?

A

Free edge of lesser omentum
Contains portal vein, hepatic artery, CBD
Can occlude with pringle maneuver
Duct Artery Vein

232
Q

What separates anteiror and posterior eye Chambers?

A

Iris

233
Q

Power features of bipolar diathermy?

A

Low voltage, low current, high frequency

234
Q

Red white and blue and air 2 of sternal angle?

A 
Aorta arch
Thoracic duct crossover 
Azygos into SVC
Trachea bif
2nd CC
235
Q

Which lobes of prostate enlarge in BPH vs cancer?

A

Medial in BPH

Post in cancer

236
Q

What is a littres hernia?

A

Meckel div in sac

237
Q

What is a amyand hernia?

A

Appendix through hernia sac

238
Q

Acute renal tubule dysfunction can be treated with what medication?

A

Osmotic diuretics

MRCS Part A (7 decks)

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