tut Flashcards
1
Q
what is the level of the manubrium
A
T3-4
2
Q
what level is the clavile and jugular notch
A
T2
3
Q
what positionis the diaphrgam in expiration
A
higher
4
Q
what position is the diagphragm in inspiraiton
A
lower (lungs are bigger)
5
Q
what level is the transpyloric plane
A
lower border of L1
6
Q
what level is the subcostal plane
A
body of L3 vertebra
7
Q
what level is the transtubercular plane
A
upper part of L5 body vertebra
8
Q
what ribs do the kidneys lie deep to
A
ribs 11 +12
9
Q
what vertebral level does the transumbilical plane lie
A
btw L 3 and 4 verbra
10
Q
foregut pain refferal region?
A
epigastric region
11
Q
midgut pain referal region?
A
umbilical region
12
Q
hingut pain referal region?
A
pubic region
13
Q
what structures are included in the foregut
A
abdominal oesphagus, stomach, half of duodenum, liver, pancreas, gallbladder
14
Q
what structures make up the midgut
A
half of duodenum thorugh to prox 2/3 of colon
15
Q
what structures make up hindgut
A
just before splenic flexure to anal canal
16
Q
what vertebral level is the coeliac trunk
A
t12/l1
17
Q
what does the coelic trunk supply
A
foregut
18
Q
what vertebral level is the superior mesenteric a
A
l1
19
Q
what does the sup. mesenteric artery supply
A
midgut structures
20
Q
what vertebral level is the renal artery
A
L1/2
21
Q
what level is the gonadal a
A
L2
22
Q
what level is the inf. mesenteric artery
A
L3
23
Q
what does the inferior mesenteric artery supply
A
hingut
24
Q
what is the vertebral level of the bifurcation of the aorta into R and L common iliac arteries
A
L4
25
what vertebral level is the formation of the IVC at the union of the two common iliac veins
L5
26
characteristics of female pelvis vs male pelvis
bones are lighter and thinner, pelvic inlet is wide, wider subpubic angle (80-90d), larger sciatic notch (almost 90d)
27
characteristics of male pelvis vs female
more narrow subpubic angle (60-70d), more heart shaped, ischial spines are more prominent
28
Where is the appendix located?
right lower quadrant - in regards to GIT, the appendix arises from the poseriomedial wall of caecum
29
what is mcburneys point?
1/3 way btw the ASIS and umbilicus - exact location of the base of the appendix
30
. Explain the migration of pain towards the McBurney’s point and the right iliac fossa as the appendicitis progresses further:
pain migrates from the umbilical region towards mcburneys point due to inflammation of the parietal peritoneum - somatic sensation
31
3.1. Explain the initial pain presentation in the umbilical region
Pain intially presented in the umbilical region due to referred pain - the visceral peritoneum of the appendix is innervated by visceral afferents the belong to the T10 dermatome, corresponding with the umbilical region
32
List the layers of the body wall that a surgeon would go through accessing the appendix at McBurney’s point (superficial to deep
skin, EAO, IAO, TA, Transversalis fascia, externla fat, parietal pertioneum
33
what blood supply of appendix?
SMA
34
diaphragmatic hemiparalysis - how would each side of diaprahgm move in inspiration?
normal side moves down, paralysed side moves up
35
what else does the phrenic nerve supply?
pariteal pericardium, pariteal pleura
36
what is the most likely cause of urinary incontinence in the case study
weakening of pelvic floor muscles and urethrosphincter as a result of her vaginal births
37
in the urinary incontinence case - what organ is likely to be pushing onto the vagina?
bladder
38
what is the normal position of the vagina
anteverted adn anteflexed
39
what is the perineal body
th ecentral tendon of the perineum. a fibromuscular structure int he midline of th eperineum at the junciton of the anus and urogenital triangle
40
what does the female urogenital triangle contain?
mons pubis, labia, clitoris, vagina and urethral openings
41
what does the male urogenital triangle contain?
penis and scrotum
42
What are the two ligaments that form the lesser omentum?
hepatogastric and hepatoduodenal
43
Is the colon retro- or intra-peritoneal?
ascending and descending colon are retroperitoneal
sigmoid and transverse colon are intrapertioneal
44
What is the course of the thoracic duct?
Begins in abdomen at cisterna chyli (L2) and ascends throguh aortic hatus ad emptities into the junction of left int. jugular and left subclavian
45
What are the tributaries of SVC?
the superior vena cava is formed by a fusion of the R and L brachiocephalic veins. The SVC also receives the azygos vein, which arches over the R lung root
46
What are the origins of the superior and inferior epigastric arteries?
Superior epigastric - Internal thoracic artery
Inferior epigastric - ext. iliac artery
47
What is the difference between the R and L phrenic nerve in regards its entering the diaphragm?
R phrenic nerve enters the diaphragm via the caval opening with the IVC
L phrenic n follows the left heart boundary and pierces the muscular part of the diaphragm on the left side
48
The ovarian artery is a direct branch of:
Abdominal aorta
49
True or false: The hepatic artery is responsible for supplying the liver with oxygen deficient blood.
false
50
T / F : The parietal peritoneum is pain sensitive:
true
51
The pericardium has autonomic innervation. The parasympathetic innervation is from:
Vagus nerve
52
motor innervation of The rectus abdominis muscle?
The correct answer is: Receives motor innervation from the thoracoabdominal (T7-T12) nerves
53
What are the structures that are found in the vena caval opening?
Inferior vena cava and right phrenic nerve
54
What is the main nerve of the perineum?
pudendal nerve (S2-S4), mixed by function: supplies pelvic floor muscles and external sphincters, and also provides sensory innervation from the perineal structures
55
What is the function of the pelvic sphanchnic nerves?
provide parasympathetic innervation to pelvic viscera such as rectum and urinary bladder
56
State the formation and location of ejaculatory ducts
formed by the union of the duct of the seminal vesicle and the ampulla of the vas (ductus) deferens; travel via the prostate gland; open into the prostatic urethra
57
Contents of deep perineal pouch
bulbourethral glands in male, external urethral sphincter mechanism (note that sphincter urethrae is made of skeletal muscle), deep transverse perineal muscle
58
Contents of superficial perineal pouch
erectile tissues (bulb of vestibule in female, crura of penis, clitoris) and corresponding muscles (bulbospongiosus and ischiocavernosus)
59
What are the two parts of the pelvic diaphragm?
2 muscles are the coccygeus and levator ani;
60
What muscles line the lateral walls of the true pelvis?
piriformis + obturtator internus
61
What is the perineum?
space below the pelvic diaphragm; contains the anus and external genitalia
62
Explain the formation of the biliary tree
two hepatic (R & L) ducts emerge from the porta and form the common hepatic duct;
63
List distinguishing external features of the large intestine
epiploic appendages, haustrations, teniae coli
64
Name the two compartments of the peritoneal cavity divided by the transverse mesocolon
supracolic (above it) and infracolic (below it)
65
What is found inside the hepatoduodenal ligament?
hepatic artery, bile duct, portal vein
66
Name the GIT part suspended by the mesentery
jejunum and ilium
67
Provide examples of intraperitoneal organs
Intraperitoneal organs are those almost completely covered and carry double layers pertioneum such as mesentery. These organs include stomach, spleen, tv colon.
68
Provide examples of retroperitoneal organs
Alternatively, retropertioneal organs are those that are either partially covered by periotneum or not at all for example, pancreas, kidneys and urinary bladder.
69
Summarize innervation of the visceral peritoneum
ANS - pain is poorly localized and refer to dermatomes which are supplied by the same sensory ganglia (and sp cord segments) as the nerve fibres innervating the viscera
70
What is the difference in innervation of visceral vs parietal pleura?
Visceral pleura is innervated by pulmonary plexuses (ANS; it is not sensitive to pain); Parietal pleura - by the intercostal & phrenic nerves (sensitive to pain)
71
State the location of the lung apex
it is located above the 1st rib, approximately 2.5cm above the medial end of the clavicle
72
Name the three parts of the oesophagus
cervical, thoracic and abdominal
73
What is the location of the heart apex?
typically, in the 5th intercostal space, at the midclavicular line, directed towards the left
74
The branch of which (R or L) coronary artery runs in the anterior interventricular sulcus?
anterior interventricular artery;
75
Name the vessel receiving the lymph from the right side of the head, neck, thorax and right upper limb
right lymphatic duct; the lymph from the rest of the body drains into the thoracic duct
76
What is the location of the arch of aorta?
superior mediastinum
77
What are branches of the ascending aorta?
The branches of the ascending aorta include right and left coronary arteries.
78
