Stuff Flashcards
Referred pain
- Mid gut structures → periumbilical pain
- Hind gut → lower abdominal pain
- Obstruction → colicky pain in area according to embryological origin
- Foregut structures → epigastric region
Extent of ANT abdominal wall
- Superiorly → costal margin, xiphoid process
- Inferiorly→ iliac crest, pubis, pubic symphysis
Muscles of the ANT abdominal wall
- External oblique
- Internal oblique
- Transversus abdominis
- Rectus abdominis
- Pyrimidalis
Inguinal canal
- ANT wall = EO aponeurosis + IO
- POST wall = transversalis fascia, conjoin tendon, IO
- Roof = IO + transversus abdominis
- Floor = lacunar ligament + inguinal ligament
Rectus Sheath encloses
- Rectus abdominis muscle
- Pyramidalis
- Epigastric vessels
- ANT lower 6 thoracic nerves
- Lymphatics
Contents of inguinal canal
Male:
1. Spermatic Cord
2. Ilioinguinal nerve
3. Genitofemoral n.
Female:
1. Round ligament
2. ‘’
3. ‘’
Spermatic cord contents
- Ductus deferens
- Testicular artery
- Artery to ductus deferens
- Cremasteric artery
- Pamponiform plexus
- Genitofemoral n.
- Sympathetic nerves
- Lymphatics
- Remnants of processus vaginalis
“Piles don’t contribute to a good sex life”
Inguinal vs Femoral hernia
Meckel’s diverticulum
- Can cause an obstruction in SI
- Represents a persistent remnant of Vitello intestinal duct
- Site for ectopic gastric mucosa
- Presents on the anti-mesenteric border of SI
- Most common congenital abnormality in the SI
Physiological herniation of gut loops
- 180° rotation of midgut loops occurs when the loop returns to abdominal cavity
- Gastroschisis occurs due to the above process
- Only midgut is involved in the process
- Occurs due to rapid growth of intestinal loops
- Commences @ 6th week of IUL
Clara cells
- Found in respiratory + terminal bronchioles
- Detoxify substances
- Have no cilia
- Have ability to replace damaged cells
- Secretes a component surfactant
Circumvallate papillae
- Lined by stratified squamous epithelium
- Supplied by glossopharyngeal nerve
- Contains numerous taste buds
- Has von Ebner’s glands
- Filiform papillae is the most common papillae type of tongue
Bronchioles
- Simple columnar ciliated
- Have Clara cells
- No cartilage
- Rings of smooth muscle
- Diameter > 1mm
- Maintains airway resistance
Inguinal hernia
- Most common in old age (direct) + males
- Weakness of conjoint tendon is reason
- Above and medial to pubic tubercle
- Direct = med. to INF epigastric vessels + through inguinal triangle
- Indirect = lat. to INF epigastric vessels + through deep inguinal ring
Liver
- Incomplete peritoneum (bear area)
- Lobular structure (histologically)
- Hepatocytes are hexagonal
- Developed from foregut
- Caudate lobe has 1st segment
- Right lobe @ seventh rib level
- Hepatocytes from liver bud
- Bile canaliculi from disse
Pancreas
- From foregut + midgut
- Direct contact w/ lesser sac
- Crosses transpyloric plane: neck @ L1 + head @ L2
- From endoderm
- Tail is b/w splenorenal ligament
Acyanotic anomalies
- Aortic stenosis
- Pulmonary stenosis
- ASD-VSD
- AV septal defect
- Bicuspid aortic valve
- Coarction of aorta
- Patent ductus arteriosus
- Fallots Tetralogy
Immunity
Innate immunity:
1. No ability to learn
2. Common for pathogens (not specific)
3. Macrophage is main cell (+ neutrophils, basophils, eosinophils)
4. Complement system; acute phase; cytokines
5. Not lifelong
Adaptive immunity:
1. Has ability to learn
2. Lifelong
SI vs LI
SI:
1. Plicae circularis
2. Peyer’s patches
3. Villi
4. Diameter < 3cm
5. Lymphoid follicles
6. Centrally positioned
LI:
1. Haustrations
2. Semilunar folds
3. No villi
4. Appendices epiploicae
5. Taeniae coli (wider in sigmoid colon)
6. Fecal shadow in x-ray
Esophagus
- Begins @ cricopharyngeous
- Stratified squamous non-keratinizing
- Thin adventitia
- Upper: skeletal muscle (in muscularis propria)
Lower: smooth muscle
Esophageal constrictions
- Narrowest @ origin = cricopharyngeous
- Crossed by aortic arch
- Left main bronchus
- As it enters abdomen
- Right crus of diaphragm loops around it
Psoas + psoas fascia
Psoas:
1. POST to ureter
2. Attached to T12
3. Beneath Inguinal lig.
4. Lateral flexor
5. Extends to thorax under med. arcuate lig.
Psoas Fascia:
1. Extends up to abdomen
2. Ends @ pelvic brim (no thigh)
3. Attached to thoraco-lumbar fascia
4. Thickening to form med. arcuate lig.
Heart sinuses
- Transverse sinus =
ANT - aorta
POST- SVC
INF - LA - Oblique sinus =
ANT - LA
POST - pericardium
