PTM - 1 Flashcards
Surface anatomy of pancreas
Neck lies at L1
Surface anatomy of spleen
9-12th rib
Liver surface anatomy
5th costal cartilage superiorly
Left midclavicular line to right midclavicular line
10th rib inferiorly
Gallbladder surface anatomy
9th costal cartilage to lateral edge of rectus abdominus
Surface anatomy of kidney
Superior pole at 12th rib
Left hilum at L1
What lies anterior to aorta at L1
Neck of pancreas
Second part of duedenum
Sites of intra-abdo collection
Hepatorenal pouch
Pelvis
Right and left subphrenic
Right and left paracolic gutters
Sites of intra-abdo collection
Hepatorenal pouch
Pelvis
Right and left subphrenic
Right and left paracolic gutters
What is meckels diverticulum
Remnant of vitello-intestinal duct
Connecting midgut to yolk sac through umbilicus
Rule of 2s for Meckels
2 % population
2inches long
Within 2 ft of ileo-caecal valve
Twice as likely in men
Hernia containing Meckles diverticulum name
Littles hernia
Potential complications of meckels diverticulum
Perforation
Obstruction
Intussuception
Herniation
Posterior relations of kidneys
Diaphragm
Psoas
Quadratus lumborum
Anterior relations of kidneys
Right:
- Liver
- Colon
- small intestine
Left:
- Stomach
- Pancreas
- small intestine
Anterior relations of kidneys
Right:
- Liver
- Colon
- small intestine
Left:
- Stomach
- Pancreas
- small intestine
Male bladder relations
Anterior to posterior
Pubic symphysis
Bladder
Retrovesical pouch
Rectum
Female bladder relations
Pubic symphysis
Bladder
Retrouterine pouch
Uterus
Pouch of douglas
Rectum
Vas deferens course
Starts from epididymis, through inguinal canal, to ejaculatory ducts
What glands form semen
Seminal vesicles
Prostate gland
Bulbourethral gland
Vas from ejaculatory ducts
Seminal vesicles role
produce seminal fluid for sperm
(outpocket in the ampulla of vas)
Role of vas
transfers sperm from epididymous to urethra
What is responsible for peau dorange appearance of breast skin
Tumour causes of oedema by obstructing lymphatic drainage
Cooper ligament fibres pulling on s/c tissue to fascia
Gives it orange peel appearance
Large bowel vs small bowel obstruction presentation
Large:
- gradual
- vomiting less prominent
- abdo distension
Small:
- acute
- early vomiting
- constipation delayed
Which organs does SMA go anterior to
Uncinate process of pancreas
3rd part of duodenum
Which organs does SMA go anterior to
Uncinate process of pancreas
3rd part of duodenum
Most likely responsible artery for diverticular bleed
Sigmoidal branches of IMA
Sensation to rectum
PSN: nervi erigentes
- sensation of fullness
- contraction
- relaxation of internal sphincter
SNS: superior hypogastric plexus
- contraction of internal sphincter
- pain
Sensation to rectum
PSN: nervi erigentes
- sensation of fullness
- contraction
- relaxation of internal sphincter
SNS: superior hypogastric plexus
- contraction of internal sphincter
- pain
What is floor of ACF
Brachialis
Supinator
How many compartments in forearm
3
- Mobile wad
- anterior
- posterior
Muscles in mobile wad compartment
Brachioradialis
Extensor carpi radialis longus and brevis
Muscles in the posterior compartment of forearm
Superficial (2): anconeus and extensor carpi ulnaris
Intermediate (2) : extensor digitorum communis and digiti minimi
Deep (5): abductor pollicis longus, extensor pollicis longus and brevis, extensor indicis, supinator
Incisions for compartment syndrome in forearm
Anterior: along ulnar border
Dorsal: lateral epicondyle to mid-wrist
Incisions for compartment syndrome in forearm
Anterior: along ulnar border
Dorsal: lateral epicondyle to mid-wrist
Nerve supply to external oblique
Lower 6 intercostal nerves
Subcostal nerve
Nerve supply to external oblique
Lower 6 intercostal nerves
Subcostal nerve
Nerve supply to testes and its implications
T10 sympathetic nerve
Ureters supplied by the same nerve: pain from renal calculus may be referred to testes
Pain from testes may be referred to umbilicus (T10)
Surface marking of heart
Superior border:
- 3rd costal cartilage on right to 2nd interccostal space left of the sternum
Inferior border:
- 6th costal cartilage on the right to 5th intercostal space left midclavicular line
Surface marking of heart
Superior border:
- 3rd costal cartilage on right to 2nd interccostal space left of the sternum
Inferior border:
- 6th costal cartilage on the right to 5th intercostal space left midclavicular line
Where is sinoatrial node found
Crista terminalis of right atrium
Blood supply to SA node
RCA (in 60% of people)
LCA (in 40% of people)
Venous drainage of heart
2/3
Coronary sinus (Great, middle and small cardiac veins, posterior vein, oblique vein)
1/3
Directly into chambers via cordis minimae
Venous drainage of heart
2/3
Coronary sinus (Great, middle and small cardiac veins, posterior vein, oblique vein)
1/3
Directly into chambers via cordis minimae
Where does coronary sinus terminate
Inferior aspect of Right atrium between IVC and tricuspid
Blood supply of knee joint
Medial, lateral superior genicular -> femoral condyle
Medial, lateral inferior genicular -> tibial condyles
Middle gennicualr -> ACL/PCL
What is iliotibial band
Thickening of fascia lata
Extends from iliac tubercle to lateral tibial condyle
Boas sign
Hypersensitivity (hyperaesthesia) of skin inferior to the right scapula
Boas sign
Hypersensitivity (hyperaesthesia) of skin inferior to the right scapula
Kehr’s sign
Pain in the shoulder tip in presence of peritoneal irritants such as blood when raising the foot of the bed
(caused by splenic rupture or biliary/hepatic pathology, causing irritation of phrenic nerve -> same roots (C3,4,5) as supraclavicular nerve supplying the skin over scapula)
Surface marking of lung/pleura
Parietal pleura: 2.5 cm above clavicle
Midclavicular: 8th rib
Midaxillary: 10th rib
Posterior: 12th rib
Lung:
Midclavicular: 6th rib
Midaxillary: 8th rib
Posterior: 10th rib
