Surgical Anatomy Pearls Flashcards
What is the drainage of the left testicular vein?
Left renal vein
What is the drainage of the right testicular vein?
IVC
What is Gerota’s fascia?
Fascia surrounding the kidney
What are the prominent collateral circulations seen in portal hypertension?
- ) Esophageal varices
- ) Hemorrhoids (Inferior hemorrhoidal vein to internal iliac vein)
- ) Patent umbilical vein (caput medusa)
- ) Retroperitoneal vein via lumbar tributaries
What parts of the GI tract are retroperitoneal?
- ) most of the Duodenum
- ) Ascending colon
- ) Descending colon
- ) Pancreas
The embryologic structure that adheres the testes to the scrotal sac; used to help manipulate the testes during indirect hernia repair.
Gubernaculum
Which artery bleeds in bleeding duodenal ulcers?
Gastroduodenal artery
What is the name of the lymph nodes between the pectoralis minor and major muscles?
Rotter’s lymph nodes
Is the left vagus nerve anterior or posterior?
Anterior; remember that the esophagus rotates clockwise during development
What is Morrison’s puch?
Hepatorenal recess; the most posterior cavity within the peritoneal cavity
Give the locations of the following structures:
Foregut
Midgut
Hindgut
Foregut - Mouth to ampulla of vater
Midgut - Ampulla of vater to distal third of transverse colon
Hindgut - distal third of transverse colon to anus
Where are the blood vessels on a rib?
Vein, Artery, and Nerve (VAN) are UNDERNEATH the rib
What is the order of the femoral vessels?
Think: “NAVEL” for the order of the right femoral vessels - Nerve, Artert, Vein, Empty space, Lymphatics
What is Hesselbach’s triangle?
The area bordered by:
- Inguinal ligament
- Epigastric vessels
- Lateral border of the rectus sheath
What nerve is located on top of the spermatic cord?
Ilioinguinal nerve
What is Calot’s triangle?
The area bordered by:
- Cystic duct
- Common hepatic duct
- Liver margin
The cystic artery is seen in this triangle
What separates the right and left lobes of the liver?
Cantile’s line - a line drawn from the IVC to just left of the gallbladder fossa
- Junction of the second and third portion of the duodenum
- Cystic duct
- Pancreatic neck
Gastrinoma triangle
Triangle where >90% of gastrinomas are located
Which artery is responsible for anterior spinal syndrome?
Artery of Adamkiewics
Where is McBurney’s point?
One third the distance from the anterior superior iliac spine to the umbilicus (estimate of 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 (Think: SUbmucosa = SUperior)
Which parts of the GI tract do not have a 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 or uterus
What does the thoracic duct empty into?
Left subclavian vein; Left internal jugular vein junction
What is the coronary vein?
Left gastric vein
What is the hypogastric artery?
Internal iliac artery
Which is longer, the left or right renal vein?
Left
What are the layers of the abdominal wall?
- Skin
- Camper’s fascia
- Scarpa’s fascia
- External oblique
- Internal oblique
- Transversus abdominis
- Transversalis fascia
- Preperitoneal fat
- Peritoneum
What are the plicae circulares?
Plicae = folds, circulares = circular; thus,
The circular folds of mucosa of the small bowel
What is another name for the plicae circulares?
Valvulae conniventes
What are the major structural differences between the jejunum and ileum?
Jejunum - long vasa rectae; large plicae circulares; thicker wall
Ileum - Shorter vasa rectae; smaller plicae circulares; thinner wall
(Think: Ileum = Inferior vasa rectae, Inferior plicae circulares, and inferior wall)
What are the major anatomic differences between the colon and the small bowel?
Colon has taeniae coli, haustra, and appendices epiploicae (fat appendages), whereas the small intestine is smooth
How far up does the diaphragm extend?
To the nipples in men (4th ICS)
Which dermatome is the umbilicus?
T10
What are the major layers of an artery?
Adventitia
Media
Intima
