Surgical Anatomy Pearls

Question 1

What are the prominent collateral ciruclations seen in portal hypertension

Answer 1

Esophageal varices
Hemorrhoids
Patent umbilical vein
retroperitoneal vein via lumbar tributaries

Question 2

What parts of the GI tract are retroperitoneal

Answer 2

Most of duodenum
Ascending colon
Head neck and body of Pancreas (tail is intra)

Question 3

What is the gubernaculum?

Answer 3

Embryologic structure that adheres testes to the scrotal sac; helps manipulate testes during indirect hernia repair

Question 4

Which artery bleeds in bleeding duodenal ulcers?

Answer 4

Gastroduodenal artery

Question 5

What is Morrisons pouch?

Answer 5

Hepatorenal recess; the most posterior cavity within the peritoneal cavity

Question 6

What is heselbach’s triangle?

Answer 6

Bordered by

1. Inguinal ligament
2. Epigastric vessels
3. Lat border of rectus sheath

Question 7

Where is mcburney’s point?

Answer 7

One third distance from anterior superior iliac spine to umbilicus (est position of appendix)

Question 8

What is the strongest layer of the small bowe?

Answer 8

Submucosa (NOT SEROSA)

think SUbmucosa=Superior

Question 9

What are the layers of the abdominal wall?

Answer 9

1. Skin, then fat
2. Scarpa’s fascia, more fat
3. External oblique
4. Interal oblique
5. Transversus abdominus
6. Transversalis fascia
7. Preperitoneal fat
8. Peritoneum

Question 10

What are the major layers of an artery

Answer 10

Adventitia (outer layer)
Media (middle layer)
Intima (inner layer)