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202 Cards in this Set
- Front
- Back
how many abdominal regions are there
how many quadrants are there? |
9
4 |
|
What is lining the deep surface of the transverse aponeurosis (ab muscle)
what lines interal to that? what is inbetween these two surfaces? |
transversalis fascia
parietal peritonium extraparitoneal fat |
|
How many bilaterally paired muscles in the anterolateral abdominal wall?
|
5
(3flat and 2 vertical) 3 flat: external olbiques internal oblique transverse abdominus |
|
What are the attachments of the inguinal ligament?
|
ASIS and pubic turburcle
|
|
The linea alba extends from what to what?
what forms it? |
xiphoid to pubic symph.
interweaving of the abdominal aponeursosis: ext oblique interna oblique transverse abdomin which all work togetherto compress and support abdominal viscera |
|
what ribs is the external oblique associated with
|
5-12
|
|
what forms the rectus sheath?
|
1. ext and int oblique apon
2. post lamina of int obliqu and transverse abdom aponer |
|
What AAW is inside the rectus sheath?
|
rectus abominus
|
|
List in order the layers from the SKIN to the parietal peritoneum!
|
1. skin
2. camper fascia (fat) 3. scarpa fascia (membrenous) 4. investing fascia 5. ext oblique 6. investing fascia 7. internal oblique 8. investing fascia 9. trasnverse abdom 10. investing fascia 11. transversalis fascia 12. extraperitoneal fat 13. parietal peritoneum!! |
|
triangle of petite is a site for
|
hernias
|
|
rectus abdom attachment sites
|
xiphiod process
5-7 costal cartildege |
|
What demarcates the transition between posterior rectus sheath(superior area) and the transversalis fascia covering the inf area.
|
arcuate line
|
|
Contents of the rectus sheath
|
1. rectus abdominus
2. pyramidalis muscle 3. abastimosing inferior and superior epigastric A and V 4. lymph vesseles 5. distal portions of the anterior rami of spinal nerves t7-t12 (which supply the muscle and overlying skin) |
|
What is made from reminants of the Uracus?
|
median umbilical fold ligament
|
|
what layer of the rectus sheath consists of all three aponeurotic layers?
|
anterior layer, for a couple inches above the body of the pubis
(this is because transverse ab and posterior internal oblique are posterior and then they come to join the ext oblique and the anterior internal oblique on the lanterior side) |
|
What forms the conjoint tendon?
what type of hernia can occur here? |
internal oblique and rectus abdominus
direct hernia |
|
What two nerves originate from the anterior ramus of L1 spinal nerve?
|
1. iliohypogastric L1
2. ilioinguinal L1 |
|
The skin and muscles of the anterolateral abdomincal wall are supplied mainly by the (nerve)
|
thoroacbdominal
subcostal branches of anterior L1 |
|
What is the direct continuation of the interal thoracic artery
how does it enter the rectus sheath? |
superior epigastric artery
superioly through the posterior layer |
|
the level of umbilicus indicates what?
|
- level of T10 dermatome
- 4th costal disk |
|
what vertebra level is iliac crest?
|
L4
|
|
what demarcates the lateral borders of the rectus abdom and rectus sheath?
|
semilunar lines
|
|
An incisional hernia is a protrusion of?
|
omentum or organ through a surgical incision
|
|
What lymph nodes are in the AAW?
|
NONE
|
|
what drains the posterior abdominal wall?
what drains the anterior abdominal wall |
azygos
femoral veins |
|
where is the mcburny point?
|
right by the iliac crest on the anerior side
|
|
the depressions lateral to the unbilical folds are-
|
peritoneal fossae- each of which is a potential site for hernias
|
|
inguinal triangles aka-
|
hasselbach
|
|
where is the site for the most common type of hernia?
|
lower adom wall lateral to the lateral ubbilica folds
"lateral inguinal fossa" |
|
what is the inferioror most part of the external oblique aponeurosis
|
inguinal ligament
which most of its fibers insert into the pubic tuburcle |
|
whta is the ligament of COOPER and what is another name for it
|
another name is the pectineal ligament that runs across the pectin pubius, originating from the lacunar ligament which is on of the attachment thingys for th einguinal ligament
|
|
What is it called when the inguinal ligament arches superiorly to blend with te contralateral external oblique oblique aponerosis
|
refelcted inguinal ligament
|
|
what runs parallel and deepo to the inguinal ligament
|
iliopublic tract
|
|
The iliopubic tract transverses what?
|
subinguinal space
NAVEL |
|
The inguinal canal is formed in relation to the...
|
gonads
and quick fact- the inguinal cnal has openings at each ends |
|
the main occupant of the inguinal canal is
also contains... |
spermatid cord (or the round ligament of the uterus)
- blood an dlymph, ilioinguinal NERVE |
|
internal enterence to the inguinal canal is called?
|
deep internal ring
- made by invagination of transversalis facsia - lateral to the inferior epigastric vessels |
|
the exit from the inguinal canal is called-
|
supericical (extneral) inguinal ring
- between the external oblique and pubic tuburcle - formed by the lateral and medial crura- which are prevented from spreading open by the intercural fibers |
|
indirect hernias of the scrotum happen where?
|
at the opening of the inguinal canal- called deep inguinal ring.
|
|
what innervates the cremaster?
|
genital branch of the genital femoral nerve
(this nerve also brings sensory to scrotum) |
|
what constitutes the SPERMATIC CORD
|
- ductus deferns+artery
- tresticular artery - cremaster artery - pampiniform veins - smpathetic nerve - genital branch of genitalfem nerve (motor) - lymph - vestige of the processus vanginalus |
|
cancer of the testis mestastizes initially to the
|
lumbar lymph nodes
where as scrotum cancer goes to the superficial inguinal lymph nodes |
|
what important things are in the lesser omentum?
|
- portal triad
- hepatogastric ligament |
|
what is the triad in the portal triad?
|
1. hepatic artery
2. bile duct 3. portal vein |
|
how would a bowel herniation get into the inguinal ring?
(indirect hernia) how would a direct hernia get into the inguinal canal |
- passes lateral to inferior epigastric vessels
- passes medial to the inferior epigastric through the inguinal triangle |
|
where can you palpate an inguinal hernia?
|
at the superficial inguinal ring
|
|
what organs are in the peritoneal cavity?
|
NONE
|
|
what connects the lesser curvature of the stomach and th proximal part of the duadenum to the liver
|
lesser omentum
|
|
what connects the stomach to the liver?
|
hepatogastric ligament
|
|
what conducts the portal triad?
|
hepatoduodenal ligament
|
|
are organs completely covered with visceral peritonium?
|
No- so there is room for neurovascular streuctures to come in.
|
|
what is the "police man" of the abdomen
|
greater omentum
|
|
what has the largest collection of lymph tissue?
|
spleen
|
|
ther peritoneal cavity is devided into
|
greater sac
omentum bursa |
|
how to you surgicaly enter the greater sac
|
incision through the anteriorlatreal abdom wall
|
|
what is the communication between the greater and lesser sacs?
|
foramin of winslow
aka omental foreamin aka epiploic foreamin |
|
what compartment contains the stomach liver and spleen?
|
supracolic compartment
|
|
the arterial supply to the abdominal part of the alimentary tract, spleen, pancreas, gallbladder, and liver is from...
|
abdominal aorta
|
|
3 major branches of the abdominal aorta?
|
celiak trunk
superior mesinteric A inferior mesenteric A |
|
what is the lesser sac in front of?
|
pancreas
|
|
what forms the portal vein?
|
superior mesenteric and splenic veins
|
|
what takes blood away from the liver?
|
hepatic Vein
|
|
the right gastric vein empties into?
what else drains into this? |
portal vein
- L+R gastric-omental vein |
|
after the portal vein passes the end of the stomach it is called
|
superior mestenteric vein
|
|
the inferior mesenteric vein drains into
|
splenic vein on its way to forming the portal vein
|
|
what takes 75% of blood to the liver?
what takes the rest? |
portal V
hepatic artery |
|
what regulates the bolis?
|
pyloric antrum
|
|
where does the celiac trunk come from?
and what the celiac trunk devide into? |
T12- just distal to aortic hiatus of diaphram
1. left gastric 2. splenic 3. commen hepatic |
|
Course of the left gastric artery
|
ascends retroperitoneally to esophageal hiatus, gives off a branch then runs along lesser curvature of the stomach
|
|
what gets blood from the splenic artery?
|
pancreas
spleen greater curvature of stomach fundus |
|
where does the left gastric-omental artery come from?
|
splenic artery in hilium of spleen
|
|
Course of the Celiac Trunk
|
passes retroparitoneally to reach hepadoduodenal lgament, passes passes between its layers to portal hepatis, then devides into right and left heptaic arteries
|
|
what artery acsends onthe head of pancreas?
|
artery from the superior mesenteric
|
|
posteriorly, the stomach is related to
anteriorly? |
omental bursa and pancreas
disphram, left liver lobe |
|
the fundus and upper body of stomach recieve blood from
|
short and posterior gasrtic arteries (branches of the splenic artery)
|
|
what surrounds origen of celiac artery?
|
celiac lymph nodes
|
|
what acompanies arteries along the greater and lesser ciurvature of the stomach?
|
gastric lymph
|
|
what synapses at the celiac ganglion and plexus?
what just passes through? |
splechnic sympathetic nerves
vagus Nerve |
|
WRT the vertebra- discribe the following...
1. pylorus 2. pyloric part of stomach 3. fundus 4. cardial orifice |
1. l2 or l4
2. L1 3. posterior to 5th left rib 4. T10 or 11 |
|
the transverse colon is superior to the
|
duodenum
|
|
the majority of the GI tract is innervated by
|
VAGUS
|
|
what supplies symptheit cinnervation to GI tract
|
greater thoracic splencnic nerve from t6-t9 segments
|
|
what constotues the first part of the large intestine
|
ilieum joins the cecum
|
|
what is the first and shortest part of the small intestine?
|
duodenum
|
|
Name the four parts of the Duodenum-
|
1. bulb/cap- superior (L1)
2. descending (has bile duct) 3. horizontal (anterior to IVC and aorta 4. ascending (left of aorta) |
|
what is the duodenejejunal flexure?
|
an acute angle formed when the duodenum joins the jejunem. supported by the ligaments of treitz
|
|
where would you put yoiur finger to show where the spleen is?
|
upper left quadrant between 9-11th ribs
|
|
together, the jejunum and ilium are ____long in cadavers
they are attached to the posterior abdominal wall via |
6-7m
mesentary (and gets arterial supply from the SMA) |
|
Name all of the things the root of the mesentary crosses!!
|
- acesding and horizontal dudenum
- abdominal arota - IVC - right ureter - rihgt psoas major muscle - right testicle/ovarian |
|
what part of the colon is fixed without a mesentary
what is NOT fixed, WITH a mesentary? |
left colic flexture
sigmoid colon |
|
what tyoe of stimulation reduces motitly?
how does it reach the suyperior mesenteric nerve plexus |
sympathetic
(T8-T10) through synpathetic trunk and the greater and lesser splanchnic nerves. |
|
Where does the vagus nerve terminate?
|
near distal end of transverse colon
|
|
After the vagus nerve terminates, what takes over for the parasympathetic system?
|
craniosacral pevis (s2-s4) splanchnic nerves from hypogastric nerve plexus
|
|
the large intestine can be distinguished from the snall intestine by:
|
teniae coli
haustra (cause sacculation) omental appendices caliber |
|
what makes up the longitudinal muscle fo the large inestine?
|
3 tenaie coli (except in the rectum)
|
|
common appendix postitions-
|
- retrocecal
- by pelvis |
|
SMA =
|
embryonic midgut
|
|
how many lobes does the liver have?
what about in terms of bolood supply? how many segments of the liver? |
4
-left lobe -caudal lobe -quadrate lobe -right lobe only 2 (portal lobes) (seperated by the right saggital fissue a line between the IVC and th egallbladder is the physiologiucal lobes 8 |
|
the anitomical right lobe of liver is seperated by ____ from the left lobe
|
falciform lig and left saggital fissure
|
|
the liver lies mainly in the
|
right upper quadrant (where it is hidden from the thoraic cage and disaphgram)
|
|
what developes in chronic alchoholics
|
cirrihosis of liver (the most commen cause of portal hypertension)
|
|
what forms the ampulla of vater?
aka- hepatopancreatic ampulla the distal end of the ampulla opens up to the duodenum through the |
bile duct and main pancreatic duct
major duodenal papilla |
|
the bile duct forms in the lesser omentum by the
|
cycsitc duct and commen hepatic duct
|
|
where do you feel gall stone pain?
|
epigastric pain
referred shoulder pain |
|
what side of the liver is the gallbaldder?
|
vsiceral surface
|
|
what arisses at the angle of the commen hepatic duct and the cycstic duct?
|
cystic artery (which supplies gallstone and cycti c duct
|
|
what is important inthe advent of the intraheptatic or extraheptaic portal venous block
|
the communication sbetween the portal venous system and the systemic venous sytem
they have no valvues and if there is liver disease blood can still get to thr heart through the IVC |
|
what can lead to a caput medusa?
what is often seen alonh with this? |
portal hypertension
bleeding from the esp[hageal varices at the distal end of the esophagus |
|
a commen method for reducing portal hypertension is-
|
divert blood from the portal system to the systemic venous system by creating a communication between the portal vein and the IVC
-portacacal anastinmosis -portosystemic shunt |
|
what seperates right kidney from liver?
|
morrisons pouch
|
|
postior muscles of the kidney
|
psoas maj
quad lumborum |
|
wat vertibral level are the idneys at?
which kidney is higher and why? |
T12- L3
the left kidney- becuase the right is pushed down by the liver |
|
what is the enterce to the sapce within the kidney?
|
renal hilum
but all the nerves and stuff are embedded in the renal sinus |
|
the renal pyramids drain into the _____ with drain into the____ which drain into the______ which drains into the _______
|
the top 3 minor calyx drains into the maor calyx which drains into the renal pelvis with drains into the ureter
|
|
due to distention, the ureter has refeered pain- what is carrying this
|
visceral afferent in sympathtic fibers
|
|
what places are the ureters constricted?
aka- sites of kidney stones |
1. junciton of ureter and renal pevis
2. where they ross brim of pelvic inlet 3. passage of urinary bladder wall |
|
whats the difference between the left and right suprarenal glands?
|
RIGHT
- pyramid shaped - anterior to diaphram - contacts IVC (AntMed) - conects to liver (ANTLAT) LEFT - crescent shaped - related to spleen, stomach, pancrase, and left crus of diaphram |
|
the renal arteries are at the level of
which one passes posterior to the IVC |
4th disk between L1 +L2
right(longer too) |
|
The renal veins lie anterior to _______
which renal vein passes anterior to the aorta? |
renal arteries
Left (longer too) |
|
the suprarenal arteries arise from 3 sources
|
(superior (6-8) , medial and inferior)
1. sup-from inferior phrenic 2. mid-between aorta and SMA 3. inf- from renal artery 3. |
|
discribe how the two suprarenal veins drain
|
short right-> IVC
long left -> joins the inferior phrenic vein and empties into left renal vein |
|
discribe how the gonadal veins drain
|
RT - direct to IVC
LFT- to left renal vein, then to IVC |
|
what conveys presynaptic sympathetic fibers to the abominopelvic cavity?
|
abdomino pelvic splanchnic nerves t7-L2 (from anterior roots)
- pass the synpathetic trunk without suynpasing to enter the splanichnic which take them to gnaglia of abdominal cavity) |
|
the abdominopevlic splanchinic nerves include the
which is the main source to abdominal vicsera which go to the inferior and supoerior mesenteric and superior hypogastric plexus? |
lower thoraco(greater and lesser and least) and lumbar splanchnic
- lower thoracic(SYMP) - lumbar (SYMP) btw- the superior hypogastric is symp only and the iunferior is MIXED |
|
what brings autonomicness (hehe) to the gut
|
vagal trunks
|
|
the pelvic splanchnic nerves are distant from other splanchinic nerves in that they...
|
1. have nothing to do with sympathetic trunks
2. directly from anterior rami of S2-S4 3. convey presynaptic parasympathetic fibers to the inferior hypogastric (pelvic) plexus |
|
postior venous drainage of diaphram go to
|
azygos and hemiazygos
|
|
Upon rectal examination, a firm structure, directly in front of the rectum in the midline, is palpated through the anterior wall of the rectum. This structure is the:
|
cervix
|
|
The most inferior extent of the peritoneal cavity in the female is the:
|
rectouniterin pouch
|
|
The terminal ends of the ilioinguinal nerves in the female are referred to as:
|
anteriolabial
|
|
The usual location for an appendectomy incision is the:
|
right lower quadrant
|
|
what happens to the iolioinguinal N after is passes through the superior inguinal ring
|
However, the ilioinguinal nerve does not pass through the deep ring - it enters the inguinal canal on the side.
|
|
, you would indicate the position of the deep inguinal ring to be:
|
Above the midpoint of the inguinal ligament
|
|
An elderly patient with a large indirect inguinal hernia came to your clinic complaining of pain in the scrotum. You conclude that the hernial sac is compressing the following nerve:
|
The ilioinguinal nerve runs in the inguinal canal, so this nerve could easily be compressed by an inguinal hernia. The ilioinguinal nerve also gives off the anterior scrotal nerve, which is the nerve responsible for sensory innervation to the anterior scrotum. The location of this hernia and the scrotal pain both fit with an injury to the ilioinguinal nerve
|
|
what abdominal wall layers surround the superficial inguinal ring?
|
External spermatic fascia
Peritoneum and extraperitoneal connective tissue Weak fascia of the transversus abdominis muscle lateral to the falx |
|
15-year-old boy was admitted to the emergency room for having large bowel obstruction resulting from a left-sided indirect inguinal hernia. The most likely intestinal segment involved in this obstruction is the:
|
The sigmoid colon is the most likely intestinal segment to be involved in a left-sided indirect inguinal hernia. Although the descending colon is also on the left side of the abdomen, it is a bit superior to be herniating through the deep inguinal ring.
|
|
The boundaries of the inguinal triangle include
|
Inferior epigastric vessels
Inguinal ligament Lateral border of rectus abdominus muscle |
|
The superficial inguinal ring is an opening in which structure?
|
External abdominal oblique aponeurosis
|
|
If a hernia enters into the scrotum, it is most likely a(n):
|
Indirect inguinal hernias cross through the deep inguinal ring, passing deep to the internal spermatic fascia. This means that they can enter the scrotum fairly easily, and indirect inguinal hernias are often found in the scrotum. Direct inguinal hernias are not covered by the internal spermatic fascia; they enter the inguinal canal next to the spermatic cord, and rarely enter the scrotum
|
|
herniation of bowel between the lateral edge of the rectus abdominis muscle, the inguinal ligament and the inferior epigastric vessels. These boundaries defined the hernia as a(n):
|
direct inguinal hernia
|
|
Which of the following veins does not run a course parallel to the artery of the same name?
|
inferior mesenteric
|
|
The presence of which feature (also obvious on a radiograph with barium contrast) distinguishes small from large bowel?
|
circular folds of the mucosa
|
|
Occlusion of the inferior mesenteric artery is seldom symptomatic because its territory may be supplied by branches of the
|
middle colic
|
|
male complaining of right lower quadrant pain, the surgeon initially sees no appendix but knows that he can quickly locate it by
|
looking at the confluence of the teniae coli
The teniae coli are three bands of longitudinal muscle on the surface of the large intestine. Remember, the large intestine does not have a continuous layer of longitudinal muscle--instead, it has teniae coli. These three bands meet at the appendix. which is the terminal portion of the cecum. |
|
Meckel's diverticulum
|
is a site of ectopic pancreatic tissue
|
|
Pain of appendicitis is often first felt around the umbilicus, indicating that the appendix receives its sympathetic (and thus visceral afferents) from which spinal cord segment
|
Sensation from around the umbilicus is mediated by T10
|
|
The spleen normally does not descend below the costal margin. However, it pushes downward and medially when pathologically enlarged. What structure limits the straight vertical downward movement?
|
The left colic flexure, also called the splenic flexure, is the point where the colon takes a sharp downward turn
|
|
what part of colon is not effected by damage to the vagus nerve?
|
Sigmoid colon
|
|
what part of colon gets blood NOT from the inferior mesenteric artery?
|
cecum--->superior mesenteric artery
|
|
This is a loop of large bowel!" Which characteristic(s) would identify it specifically as large bowel?
|
Large Inestine:
tinea coli haustra omental appendages |
|
The anastomotic artery running along the border of the large intestine is called the:
|
The marginal artery is an important anastomosis for the large intestine. It runs around the border of the large intestine, and it is formed by the anastomosis of branches of the ileocolic artery, right colic artery, middle colic artery, left colic artery, and sigmoid artery. If a small artery becomes occluded, these branches allow blood to reach all segments of the colon.
|
|
the artery of the midgut is the
|
The superior mesenteric artery is the artery of the midgut. The celiac trunk is the artery of the foregut, and the inferior mesenteric arery is the artery of the hindgut. The splenic artery is a branch of the celiac artery, and the proper hepatic artery is a branch of the common hepatic artery, which is a branch of the celiac artery.
|
|
Sympathetic fibers in the greater splanchnic nerve arise from neuron cell bodies found in the
|
spinal cord
|
|
The celiac plexus of nerves may contain fibers derived from all of the following sources
|
posterior vagal trunk
greater thoracic splanchnic nerve lumbar splanchnic nerves |
|
Cells that secrete epinephrine and norepinephrine are innervated by preganglionic fibers from
|
the greater thoracic splanchnic nerve.
|
|
The vagus nerve passes into the abdomen by passing through the
|
esophageal hiatus
|
|
The cisterna chyli accompanies which structure as it passes through the diaphragm?
|
IVC
|
|
Blood from an injured kidney will seep through the perirenal fat until it contacts the internal surface of the renal (Gerota's) fascia. Without perforating this fascia the blood could then continue to pass in what direction?
|
inferiorly towards pevlis
|
|
A 19-year-old male suffers a tear to the psoas major muscle during the course of a football game. A scar, which formed on the medial part of the belly of the muscle, involved an adjacent nerve, immediately medial to the muscle. The nerve is called the:
|
obterator!
|
|
Which of these nerves lies immediately medial to the psoas major muscle.
|
obterator
|
|
A patient was diagnosed with bleeding ulcer of the lesser curvature of the stomach. Which artery is most likely involved?
|
left gastric artery (from the celiac trunk)
|
|
the spleen developes in the
|
The spleen and pancreas develop behind the stomach in the dorsal mesogastrium; the liver develops in the ventral mesogastrium. The spleen is not a retroperitoneal organ--it is covered by visceral peritoneum on all its surfaces.
|
|
gastric nerve branches are located in great amount near what stomach area?
|
lesser curvature
|
|
Which of the following structures does not lie at least partially in the retroperitoneum?
|
spleen
|
|
if an ulcer distrypoed the posterior wall of the duodenum, what artery would be injured?
|
The gastroduodenal artery is a branch of the common hepatic artery; it descends behind the first part of the duodenum
|
|
X-rays revealed that her 9th and 10th ribs were fractured near their angles on the left side. The abdominal organ most likely to be injured by the fracture is:
|
spleeeeeeeeeeeeeeeeeeen
|
|
A patient presented with a swollen spleen, which protruded medially toward the umbilicus in the abdomen. A vertical and downward expansion of the spleen was resisted by the:
|
left colic flexure
|
|
During emergency surgery, it was found that a chronic gastric ulcer had perforated the posterior wall of the stomach and eroded a large artery running immediately posterior to the stomach. The artery is the:
|
splenic A
|
|
The spleen contacts all of the following organs
|
Kidney
Left colic flexure Tail of the pancreas Stomach |
|
what are the boundaries of the omental foramine?
|
Caudate lobe of the liver
First part of the duodenum Hepatoduodenal ligament |
|
Before incising the mesentery she was careful to find and preserve a nerve lying in the upper portion of the hepatogastric ligament, i.e., the
|
Hepatic branch of the anterior vagal trunk
|
|
Which of the following is NOT in contact with the spleen?
Colon Diaphragm Duodenum Pancreas Stomach |
duodenum
|
|
Which organ becomes retroperitoneal during rotation of the gut tube?
|
duodenum
|
|
To stop hemorrhaging from a ruptured spleen, it was necessary to temporarily ligate the splenic artery near the celiac trunk. The blood supply to which structure is least likely to be affected by the ligation?
|
duodenum
|
|
Further examination revealed that the obstruction was caused by the nutcracker-like compression of the bowel between the superior mesenteric artery and the aorta. The compressed bowel is most likely the
|
duodenum!
|
|
what is the one duodenum segment with no circular folds?
|
The superior part of the duodenum is the one segment of the duodenum that has no circular folds
|
|
"In the triangle of Calot." What stuctures form this triangle and are the keys to finding the artery?
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Common hepatic duct, liver and cystic duct
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large tumor in the quadrate lobe of the liver. During the surgical removal of the tumor, one of the vessels that needs to be clamped to effectively control bleeding is the:
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LEFT heptatic artery
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examination, it was found that the third (transverse) portion of the duodenum was compressed by a large vessel causing the obstruction. The vessel involved is most likely to be the:
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The superior mesenteric artery crosses over the third part of the duodenum, and the aorta is posterior to the third part of the duodenum
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atient was diagnosed with pancreatitis due to a reflux of bile into the pancreatic duct caused by a gallstone. The stone is likely to be lodged at the:
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Hepatopancreatic ampulla
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The blockage of a main bile duct in the quadrate lobe will likely cause reduced flow of bile secretion in the:
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left hepatic duct
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The inferior mesenteric vein usually joins which vein?
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splenic
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A surgeon needs to construct a bypass between the veins of the portal and caval systems to circumvent insufficient drainage through the natural portacaval anastomoses. Which plan is likely to be successful?
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splenic vein to left renal
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head of the pancreas. Which structure was compressed by the tumor?
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common bile duct
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The second way of dividing the abdominal surface is into 9 regions:
left hypochondriac LH left lumbar LL left iliac LI epigastric E umbilical U hypogastric H right hypochondriac RH right lumbar RL right iliac RI These regions are formed by two vertical planes and two horizontal planes. The two vertical planes are the lateral lines LLL and RLL. These lines are dropped from a point half way between the jugular notch and the acromion process. The two horizontal planes are the transpyloric plane TPP and the transtubercular plane TTP. The tubercles are the tubercles of the iliac crests. |
check it
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what does the portal hepatis transmit?
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hepatic arteries
hepatic ducts autonomic nerves from the celiac plexus portal vein |
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what nerve passes through the superficial inguinal ring?
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ilioinguinal nerve
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The posterior boundary of the epiploic foramen is the
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IVC
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whta is the floor of the inguinal canal?
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inguinal ligament
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the deep ring is located lateral to?
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located just lateral to the inferior epigastric artery
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what bounds the epiploic foramin anteriorly?
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hepatoduodenal ligament
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The common bile duct and major pancreatic duct join to form the:
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ampulla of vater
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what is located at the opening between the small and large intestines?
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ileocecal valve
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left gastroepiploic is an important branch of the
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spleenic A
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Which of the following arteries is used to characterize an inguinal hernia as direct or indirect?
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inferior epigastric
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Which nerve is identified by its position on the anterior surface of the psoas major muscle?
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genitofermoral N
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what is the female counterpart of the scrotum
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labia majora
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A
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1. The ligament that extends from the anterior superior iliac spine to the pubic tubercle and forms the lower lateral boundary of the abdominal wall, is the: lacunar
interfoveolar inguinal ilio-pectineal pectineal 2. The "porta hepatis" of the liver transmits all of the following EXCEPT the: hepatic arteries hepatic ducts autonomic nerves from the celiac plexus portal vein hepatic veins 3. Most of the small intestine receives its blood supply from branches of a single artery. The artery that supplies most of the small bowel is the: middle colic celiac gastroduodenal inferior mesenteric superior mesenteric 4. Which of the following nerves passes through the superficial inguinal ring? iliohypogastric nerve obturator nerve lateral femoral cutaneous nerve ilioinguinal nerve pudendal nerve 5. The posterior boundary of the epiploic foramen (of Monro) is the: caudate lobe of the liver first part of the duodenum portal vein common bile duct inferior vena cava 6. Regarding the anatomy of the inguinal canal, all of the following statements are true about it EXCEPT: its floor is predominately formed by the inguinal ligament its deep ring is located just lateral to the inferior epigastric artery its roof is formed by arching fibers of the internal oblique and transversus muscles its deep ring is formed by peritoneum its superficial ring is formed by the aponeurosis of the external oblique muscle 7. The abdominal aorta passes through the diaphragm at which vertebral level? T8 T10 T12 L1 L2 8. The common bile duct, hepatic artery and postal vein are found grouped together in the: gastrosplenic ligament gastrohepatic ligament hepatoduodenal ligament gastrocolic ligament falciform ligament 9. The inguinal ligament runs between the: symphysis pubis and the inferior iliac spine anterior and posterior superior iliac spines left and right iliac tubercles pubic tubercle and iliac tubercle anterior superior iliac spine and pubic tubercle 10. In the human kidney, the renal papilla projects directly into the: renal pyramid ureter major calyx renal columns minor calyx 11. The epiploic foramen is bounded anteriorly by the: hepatoduodenal ligament peritoneum over the inferior vena cava peritoneum on the caudate lobe of the liver free border of the greater omentum peritoneum at the beginning of the duodenum 11. Motor innervation to the respiratory diaphragm is the: vagus nerve thoracic splanchnic nerve 3rd, 4th and 5th thoracic nerves phrenic nerve recurrent laryngeal nerve 12. The common bile duct and major pancreatic duct join to form the: hepatic duct common hepatic duct cystic duct cisterna chyli ampulla of Vater 13. Each of the following forms a boundary of the lesser peritoneal sac EXCEPT the: gastrosplenic ligament left triangular ligament of the liver greater omentum lesser omentum splenorenal ligament 14. Which of the following is located at the opening between the small and large intestines? ligament of Treitz cardiac sphincter ileocecal valve pyloric sphincter tricuspid valve 15. When removing the spleen, a surgeon must be careful not to cut one of its branches, the: superior mesenteric left gastric left gastroepiploic superior pancreaticoduodenal left renal 16. Which of the following arteries is used to characterize an inguinal hernia as direct or indirect? obturator deep external pudendal femoral superficial circumflex iliac inferior epigastric 17. When performing surgery in the ischiorectal fossa, the internal pudendal vessels and pudendal nerve should be avoided by staying away from the: base of the fossa medial wall of the fossa lateral wall of the fossa anterior wall of the fossa posterior wall of the fossa 18. Infected glands of the anus (near the pectinate line) may erode the wall of the anal canal and rupture laterally into the: ischiorectal fossa deep perineal pouch (or space) rectovesical fossa superficial perineal pouch (or space) retropubic space 19. Which nerve is identified by its position on the anterior surface of the psoas major muscle? femoral ilioinguinal genitofemoral obturator lateral femoral cutaneous 20. The external spermatic fascia is derived from the: tunica vaginalis transversus abdominis aponeurosis external oblique aponeurosis extraperitoneal fascia internal oblique aponeurosis 21. The perineum is bounded by all of the following EXCEPT the: ischiopubic ramus pubic symphysis apex of the coccyx urogenital diaphragm sacrotuberous ligament 22. The portion of the male urethra that passes through the urogenital diaphragm is called the: penile urethra spongy urethra membranous urethra prostatic urethra external urethral sphincter 23. The scrotum has as its counterpart in the female the: bulb of the vestibule crura of the clitoris labia majora labia minora clitoris 24. When a surgeon removes the uterus and cuts the uterine artery, he must be careful not to cut the: ovarian artery ureter urethra internal pudendal artery vagina 25. The portion of the broad ligament of the uterus that attaches to the uterine tube is known as the: round ligament mesovarium mesometrium mesosalpinx parametrium In the adjacent diagram of a sagittal section through the female pelvis, select a letter that answers the question or statement: 26. A space or recess used to reach the urinary bladder without entering the peritoneal cavity: 27. A space or recess easily entered from the posterior fornix of the vagina |
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throughout most of its extent, the aponeurosis of this muscle contributes only to the posterior layer of the rectus sheath
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transverse abdominus
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contraction of this muscle stabilizes the 12th rib
independent contraction of this muscle results in trunk flexion |
quadratus lumborum
rectus abdom |
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this muscle is innervated by the femoral nerve
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iliacis!
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the tunica vaginalis is formed from the
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peritonium
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