SR 17 - Surgical Anatomy Pearls Flashcards
Drainage of the left testicular vein?
Left renal vein
Drainage of the right testicular vein?
IVC
Gerota’s fascia?
Fascia surrounding the kidney
Fascia surrounding the kidney?
Gerota’s fascia
Prominant collateral circulations in portal hypertension?
Esophageal varices (left gastric vein, esophageal veins) Hemorrhoids (superior rectal and inferior messenteric) Caput medusa (paraumbilical veins and umbilical vein) Retroperitoneal veins (clear spot of the liver)
Parts of the GIT that are retroperitoneal?
Most of the duodenum
Ascending colon
Descending colon
Pancreas
What is the gubernaculum?
Embryologic structure that adheres the testes to the scrotal sac
Use to help manipulated the testes during indirect hernia repair
Artery that bleeds in bleeding duodenal ulcers?
Gastroduodenal artery
Name of the lymph nodes between the pectoalis minor and major muscles?
Rotter’s lymph nodes
Left vagus nerve - anterior or posterior?
Anterior
Due to esophageal rotation during development
Where is Morrison’s pouch?
Hepatorenal recess
Most POSTERIOR cavity within the peritoneal cavity
Location of the foregut?
Mouth to ampulla of Vater
Location of the midgut?
Ampulla of Vater to distal third of transverse colon
Location of the hindgut?
Distal third of transverse colon to the anus
Where are the blood vessels on a rib?
Vein
Artery
Nerve
VAN runs under the rib - place things on the top of the rib
What is the order of the femoral vessels?
Femoral vein is medial to the femoral artery
NAVEL - Nerve, Artery, Vein, Empty space, Lymphatics
What are the borders of hesselbach’s triangle?
Inguinal ligament
Epigastric vessels
Lateral border of the rectus sheath
What nerve is located on top of the spermatic cord?
Ilioinguinal nerve
Borders of Calot’s triangle?
Cystic duct
Common hepatic duct
Cystic artery (inferior border of the liver - CT)
What is Calot’s node?
LN located within the triangle of Calot
What seperates the right and left lobes of the liver?
Cantle’s line - drawn from IVC to just left of the gallbladder fossa
What is the gastrinoma triangle?
Location of >90% of gastrinomas
Junction of the second and third portions of the duodenum
Cystic duct
Pancreatic neck
Which artery is responsible for anterior spinal syndrome?
Artery of Adamkiewicz
Where is McBurney’s Point?
One third of the distance from the anterior superior iliac spine to the umbilicus (estimates the position of the appendix)
How can you find the appendix after you find the cecum?
Trace the taeniae back as they converge on the origin of the appendix
Where is the space of Retzius?
Preperitoneal space anterior to the bladder
What are the white lines of Toldt?
Lateral peritoneal reflections of the ascending and descending colon
What is the strongest layer of the small bowel?
Submucosa
What parts of the GIT do not have serosa?
Esophagus
Middle and distal rectum
What is the vein that overlies the pylorus?
Vein of Mayo
What is the pouch of Douglas?
Pouch between the rectum and bladder/uterus
What does the thoracic duct empty into?
Left subclavian vein and left internal jugular vein junction
What is the coronal vein?
Left gastric vein
What is the hypogastric artery?
Internal iliac artery
Which is longer - left or right renal vein?
Left
Layers of the abdominal wall?
Skin Fat (camper's fascia) Scarpa's fascia (membranous) External oblique Internal oblique Transverse abdominal Transversalis fascia Preperitoneal fat Peritoneum
What are the plicae circulares?
Circular folds of mucosa of the small bowel
Alternative name for plicae circulares?
Valvulae conniventes
What are the major structural differences between the jejunum and ileum?
Jejunum - LONG vasa rectae; LARGE plicae circulares; thicker wall
Ilium - SHORT vasa rectae; SMALL plicae circulares; thinner wall
What are hte major anatomic differences between the colon and small bowel?
Colon has taeniae coli, haustra, and appendices epiploicae
Small intestine is smooth
How far up does the diaphragm extend?
To the nipples in men - 4th ICS
Dermatome at the umbilicus?
T10
Major layers of an artery?
Out to in:
Adventitia
Media
Intima