SURGICAL ANATOMY PEARLS

Question 1

Drainage of Left Testicular Vein

Answer 1

Left Renal Vein

Question 2

Drainage of Right Testicular Vein

Answer 2

IVC

Question 3

Gerota Fascia

Answer 3

Fascia surrounding the kidney

Question 4

Prominent COLLATERAL circulations seen in PORTAL CIRCULATION

Answer 4

Esophageal varices
hemorrhoids (inferior hemorrhoidal vein to internal iliac vein)
patent umbilical vein (caput medusa)
retroperitoneal vein via lumbar tributaries

Question 5

Retroperitoneal Organs (GIT)

Answer 5

duodenum (majority)
ascending colon
descending colon
pancreas

Question 6

Gubernaculum

Answer 6

Embryologic structure that adheres the testes to the scrotal sac

Used to help manipulate the testes during indirect
hernia repair

Question 7

Artery that bleeds in bleeding duodenal ulcers

Answer 7

Gastroduodenal artery

Question 8

Lymph nodes between the pectoralis minor and major

muscles

Answer 8

Rotter’s lymph nodes

Question 9

Left Vagus Nerve

Answer 9

Anterior

Question 10

Morrison Pouch

Answer 10

Hepatorenal recess

The most posterior cavity within the peritoneal cavity

Question 11

Foregut

Answer 11

Mouth to ampulla of Vater

Question 12

Midgut

Answer 12

Ampulla of Vater to distal third of

transverse colon

Question 13

Hindgut

Answer 13

Distal third of transverse colon to the

anus

Question 14

Blood vessels on a rib

Answer 14

Vein, Artery, and Nerve (VAN) are underneath the rib (thus, place chest tubes and thoracentesis needles above the rib!)

Question 15

Order of the femoral vessels

Answer 15

Femoral vein is medial to the femoral artery (Think: “NAVEL” for the order of the right femoral vessels—Nerve, Artery, Vein, Empty space, Lymphatics)

Question 16

Hesselbach’s Triangle

Answer 16

Inguinal ligament - Inferior
Epigastric vessels - Lateral
Lateral border of the rectus sheath - Medial

Question 17

Nerve located on top of the spermatic cord

Answer 17

Ilioinguinal Nerve

Question 18

Triangle of Calot

Answer 18

Cystic duct
Common hepatic duct
Cystic artery

Question 19

Cantle’s line

Answer 19

Separates the right and left lobes of the liver

Line drawn from the IVC to just left of the gallbladder fossa

Question 20

Gastrinoma Triangle

Answer 20

Junction of the second and third portions of the duodenum
Cystic duct
Pancreatic neck

Question 21

Artery is responsible for anterior spinal syndrome

Answer 21

Artery of Adamkiewicz

Question 22

McBurney’s point

Answer 22

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

Question 23

Space of Retzius

Answer 23

Preperitoneal space anterior to the

bladder

Question 24

White lines of Toldt

Answer 24

Lateral peritoneal reflections of the ascending and descending colon

Question 25

The strongest layer of the small bowel

Answer 25

Submucosa

Question 26

Parts of the GI tract do not have a serosa

Answer 26

Esophagus

Middle and distal rectum

Question 27

Vein of Mayo

Answer 27

Vein that overlies the pylorus

Question 28

Pouch of Douglas

Answer 28

Pouch between the rectum and bladder or uterus

Question 29

Thoracic duct empty into

Answer 29

Left subclavian vein; left internal jugular

vein junction

Question 30

Layers of Abdominal Wall and Scrotum

Answer 30

Skin
Superficial Fatty (Camper’s) – Dartos muscle
Deep Membranous (Scarpa) – Colles fascia
External Oblique Fascia and aponeurosis (Gallaudet fascia) – External Spermatic fascia
Internal Oblique fascia and aponeurosis – Cremasteric fascia
Transversus abdominis – does NOT reach the scrotum
Transversalis fascia - Internal Spermatic Fascia
Properitoneal space and fat
Parietal Peritoneum – Tunica Vaginalis

Question 31

Plicae circulares

Answer 31

Plicae = folds, circulares = circular;
circular folds of mucosa of the SMALL BOWEL

Valvulae conniventes

Question 32

Major structural differences between the jejunum and

ileum

Answer 32

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)

Question 33

Dermatome of umbilicus

Answer 33

T10

Question 34

Major layers of artery

Answer 34

adventitia
media
intima