Stop Forgetting 2 Flashcards
spigelian hernia
lateral ventral hernia through the semilunar line (midclavicular)
inguinal ligament formed from
External oblique aponeurosis.
Superficial inguinal ring = lateral crus, medial crus, intercrural fibers.
Deep inguinal ring.
hasselback’s triangle borders
Inguinal ligament.
Inferior epigastric vessels.
Lateral border of rectus abdominis.
ventral mesentery forms:
Liver develops inside ventral mesentery.
Ventral mesentery forms adult lesser omentum and falciform ligament.
two ligaments of lesser sac
hepatogastric
hepatoduodenal
round ligament of the liver is a remnant of
former umbilical vein
L hepatic artery supplies blood to
Left lobe,
quadrate lobe,
1/2 of caudate lobe
R hepatic artery supplies blood to
Right lobe,
1/2 caudate lobe.
Gallbladder.
umbilical fissure
Consists of ligamentum venosum and round ligament.
portocaval anastamoses (shunts if portal hypertension)
1) esophageal (L gastric, esophageal branches, azygos, IVC)
2) retroperitoneal (IMV, colic vs., retroperitoneal v, IVC)
3) rectal (IMV, superior rectal v, inferior rectal v, internal iliac v, common iliac v, IVC)
4) paraumbilical (smv, paraumbilical vs, superior epigastric, internal thoracic v, IVC // inferior epigastric v, external iliac v, common iliac v, IVC)
sympathetic input to hepatobiliary system
Greater splanchnic nerve synapses on celiac ganglion.
Nerves follow periarterial plexus to effector organ.
parasympathetic input to hepatobiliary system
Vagus nerve.
Stimulate bile production, glycogen synthesis.
main veins of abdomen
IMV empties into splenic v.
Splenic vein joins SMV to form hepatic portal vein.
ligament of treitz
Suspensory ligament of duodenum.
Right crus of diaphragm, continues as CT.
Divides into upper/lower GI.
Rotational point in embryological development –> landmark for malrotation.
pancreatic blood supply
HEAD:
anastamoses of A/P superior pancreaticoduodenal (gastroduodenal/common hepatic/celiac trunk) and A/P inferior pancreaticoduodenal (SMA)
BODY/TAIL:
greater pancreatic a., dorsal pancreatic a (both from splenic a., celiac trunk)
Pancreatic lymphatic drainage
MAJOR:
celiac LN,
superior mesenteric LN
MINOR:
superior pancreatic LN
pancreaticoduodenal LN
pyloric LN
gold standard of Crohn’s diagnosis
endoscope view of ileocecal junction
major things large intestine absorbs
water, electrolytes, vitamin K
3 tests for appendicitis
Palpate McBurney's point. Psoas sign. Rebound tenderness (Blumberg sign)
blood supply of stomach
R gastric (celiac trunk) anastamoses with L gastric (CHA) - lesser curvature.
R gastroepiploic (splenic a) anastamoses with L gastroepiploic (gastroduodenal a) - greater curvature
ileocecal artery (origin, supplies)
Origin: SMA
Supplies:
ileum,
cecum (superior/inferior cecal aa.),
appendix (appendicular a.)
middle colic artery (origin, supplies)
Origin: SMA
Supplies:
transverse colon
right colic artery (origin, supplies)
Origin: SMA
Supplies: ascending colon
ileojejunal branches (origin, supplies)
Origin: SMA
Supply: ileum, jejunum
Turn into vasa recta
marginal artery (origin, supplies)
Connects SMA and IMA.
(connects MRI colics of SMA with Left colic of IMA)
provides alternative blood supply
celiac lymph nodes drain:
liver, gallbladder, duodenum, pancreas
superior mesenteric lymph nodes drain:
cecum, ascending colon, R 1/2 transverse colon, ileum, jejunum
inferior mesenteric lymph nodes drain:
all of hindgut
anal canal, above vs below pectinate line (derived layer, artery, vein, LN, innervation)
ABOVE:
Endoderm.
Superior rectal a./v.
Internal iliac LN, inferior mesenteric LN.
Autonomic and visceral hindgut innervation to internal sphincter and mucosa.
BELOW: Ectoderm. Inferior rectal a./v. Superficial inguinal LN. Somatic motor to external sphincter, somatic sensory to skin around anus
lumbar triange (of petit) borders
Lat dorsi.
External oblique.
Iliac crest.
Only transversus abdominis, internal oblique tendons are there –> lumbar hernias can occur
arteries of posterior abdominal wall
Inferior phrenic a - ab aorta. Middle suprarenal a - ab aorta. Lumbar aa. - ab aorta Gonadal a. - ab aorta, just below SMA Median sacral a. - ab aorta at bifurcation Common iliac, internal/external iliac.
posterior abdominal wall drains into which lymphatics?
Lateral aortic (lumbar) LNs
origin of esophageal artery
Left gastric (celiac trunk)
origin of R gastric a
proper hepatic a. (celiac trunk, CHA)
origin of short gastric arteries
splenic artery (celiac trunk)
origin of R gastroepiploic artery
gastroduodenal a (celiac trunk, CHA)
origin of superior anerior pancreaticoduodenal a.
gastroduodenal a (celiac trunk, CHA)
origin of L gastroepiploic a
splenic a
branches off of posterior internal iliac a
1) superior gluteal
2) iliolumbar
3) lateral sacral
branches off of anterior internal iliac a
1) umbilical
2) superior vesical
3) obturator
4) vaginal
5) inferior vesical
6) uterine
7) middle rectal
8) internal pudendal
9) inferior gluteal
conjoint tendon
Anterior to Hesselbeck’s triangle.
Fusion of internal oblique/transversus abdominis muscle tendons.
Resists direct hernias.
ileum vs jejunum
More complex arcades in ileum, shorter vasa recta.
parietal peritoneum feels…
somatic pain
hydronephrosis
gross dilation of calyces and pelvis
caused by kidney stones (no urine flowing, fluids back up)
midgut rotation
90 deg counterclockwise
180 deg counterclockwise
TOTAL: 270 deg counterclockwise
omphalocele
Failure of umbilicus to close completely.
GI still functions normally.
ectopia cordis
Failure of abdominal wall to close more superiorly.
Heart is partially/totally outside of chest.
Cardiac problems.
gastroschisis
Abdominal wall does not involve the umbilicus.
GI does NOT function normally.
Incomplete closure of lateral folds.
external urethral sphincter controlled by which nerve?
pudendal nerve
broad ligament
Folding of peritoneum
Mesosalpinx
Mesometrium
Mesovarium
suspensory ligament of ovary
contains ovarian a/v
from ovary, to lateral side
ligament of ovary
connects ovary to uterus
usually below oviduct
what forms into the lower 1/3 of vagina and the hymen?
urogenital sinus
