Xx - Uw Anatomy

Front 1

Duodenal Ulcers, ANTERIOR to duodenal bulb is prone to?

Back 1

- Perforations

Front 2

Duodenal Ulcers, POSTERIOR to duodenal bulb is prone to?

Back 2

- Hemorrhage

Front 3

Peptic Ulcer POSTERIOR to the duodenal bulb will likely erode what artery?

Back 3

- Gastroduodenal artery

Front 4

What type of Duodenal Ulcer can cause Life threatening Hemorrhage?

What manifesting Sx do you see?

Back 4

- Duodenal Ulcers, POSTERIOR to duodenal bulb, eroding gastroduodenal artery

- Coffee Ground Emesis

Front 5

Gallstone Ileus

- Gallstones does what?
- thus causing?

Back 5

- Passages thru fistula into intestines

- Blockage at Ileocecal Valve

Front 6

Gallstone Ileus

- Symptoms?

Back 6

- Symptoms of Intestinal Obstruction
(bilous vomiting, abd pain, distention)

Front 7

Gallstone Ileus?

- Diagnostic Test & results?

Back 7

Abd X-ray

- Air seen in GB & Biliary tree
(due to fistula)

Front 8

The most posterior part of the heart is?

Back 8

- Left Atria

Front 9

Left Atrial Enlargement can cause what 2 unique symptoms and why?

Back 9

1.) Dysphagia
(compression of esophageal nerve)

2.) Hoarseness
(compression of recurrent laryngeal)

Front 10

Left Atrial Enlargement can occur with what 2 conditions?

Back 10

1.) Mitral Stenosis

2.) LVF

Front 11

Normally, the SMA branches off of the Aorta at:

- what level?
- what angle?

Back 11

- L1

- 45 degrees with aorta

Front 12

Diminished angle btw Aorta & SMA causes what Dz?

Diminished angle can be caused by what conditions?

Back 12

Superior Mesenteric Artery Dz

- Rapid loss of Mesenteric Fat
- Profound Lordosis

Front 13

Diminished angle btw Aorta & SMA causes what resulting effect anatomically?

Causing what Sx?

Back 13

- Traps the Transverse Duodenum

- thus Sx of intestinal obstruction
(billous vomiting, abd pain, distension post meal, etc.)

Front 14

After a MVA, even Stable patients should receive what test?

Why?

Back 14

- Abdominal CT

- R/O Pancreatic Injury

Front 15

Retroperitoneal Hemorrhage seen in ASx & Stable patients after blunt trauma is usually due to?

Treat how?

Back 15

Pancreatic Injury

Conservatively

Front 16

Esophagus is between what anatomical parts?

Back 16

- Vertebra (posteriorly)

- Trachea (anteriorly)
(air filled lumen on X-ray)

Front 17

Gastric Ulcers

- MC anatomical location?
- more specifically between what 2 types of tissue?

Back 17

- Lesser Curvature of stomach

1.) Acid secreting mucosa
2.) Gastrin secreting mucosa

Front 18

Gastric Ulcers

- MC anatomical location?
- this location is supplied by?

Back 18

- Lesser Curvature of stomach

- Left & Right Gastric Arteries

Front 19

In Gastric Ulcers, GI bleed is usually due to what?

Back 19

Perforations of the
Left & Right Gastric Arteries.

Front 20

Which part of the duodenum is NOT part of the retroperitoneum?

Back 20

- 1st part

Front 21

1st part of duodenum overlies what in horizontal orientation?

Back 21

- L1 vertebrae

Front 22

3rd part of duodenum overlies what in horizontal orientation?

Back 22

- L3 vertebrae
- Abdominal aorta
- IVC

Front 23

2nd part of duodenum is closely associated with?

Back 23

- Pancreatic HEAD
(ampulla of vater)

Front 24

3rd part of duodenum is closely associated with?

Back 24

- UNCINATE Process of Pancreas

- Superior Mesenteric Artery & Vein

Front 25

Hindgut derivative?

Hindgut supply?

Back 25

- Distal 1/3rd Transverse Colon to Rectum

- IMA

Front 26

Which part of the Pancreas is NOT Retroperitoneal

Back 26

- TAIL of pancreas

Front 27

EXOCRINE PANCREATIC INSUFFICIENCY
- Sx?
- Hx?
- Labs?

Back 27

- Weight Loss & vague Abd Pain

- Alcohol Drinking

- Excess Neutral Fats in Stool

Front 28

Pancreatic HEAD has close associations with?

Back 28

- 2nd part of duodenum

Front 29

Pancreatic UNCINATE Process is associated with?

Back 29

3rd part of Duodenum

Front 30

Pancreatic BODY has close associations with?

Back 30

- LEFT Kidney
- IVC
- SMA
- Aorta

Front 31

Pancreatic TAIL has close association with?

Back 31

- Splenorenal ligament

Front 32

What NON-Foregut derived structure receives blood supply from Celiac Trunk?

Back 32

- Spleen

Front 33

Spleen is derived from what structure?

Back 33

- Dorsal mesentery

Front 34

GERM LAYER of:

- Spleen

Back 34

Mesoderm

Front 35

GERM LAYER of:

- Pancreas

Back 35

- Endoderm

(of Foregut & Midgut)

Front 36

GERM LAYER of:

- Liver

Back 36

- Endoderm

(of Foregut)

Front 37

"Water under the Bridge" implies?

Back 37

Ureter courses below Gonadal vessels

Front 38

When ureter enters the True Pelvis, it runs:

- Anterior to (Over) :
- Lateral to:
- Medial to:

Back 38

- External Iliac vessels
- Internal Iliac vessels
- Gonadal vessels

Front 39

DIRECT HERNIA

- Protrusion through?

Back 39

- Hesselbach's Triangle

Front 40

INDIRECT HERNIA

- Protrusion through?

Back 40

- Deep Inguinal Ring

Front 41

Hesselbach's Triangle

- Protrusion occurs in?
- Inferior border
- Medial border
- Lateral border

Back 41

- Direct Hernia

- Inguinal Ligament
- Rectus Abdominus
- Inferior Epigastric vessels

Front 42

Deep Inguinal Ring

- Protrusion occurs in?
- Inferior border
- Medial border
- Lateral border

Back 42

- Indirect Hernia

- Inguinal Ligament
- Inferior Epigastric vessels
- N/A

Front 43

Which hernia is medial to the Inferior epigastrics?

Back 43

Direct Hernia

Front 44

Which hernia is lateral to the Inferior epigastrics?

Back 44

Indirect Hernia

Front 45

Which hernia herniates into the Scrotum?

Back 45

- Indirect hernia

Front 46

Direct Hernia is covered with?

Back 46

External Spermatic Fascia

Front 47

Indirect Hernia is covered with ?

Back 47

All 3 layers of spermatic fascia

Front 48

Ovaries receive Parasympathetic innervation from?

Back 48

- Vagus nerve

Front 49

Right Ovarian Vein drains into?

Back 49

IVC

Front 50

Left Ovarian Vein drains into?

Back 50

Left Renal Vein

Front 51

Which ovarian ligament caries all the Ovarian nerve, artery, veins, and lymphatics?

Back 51

- Suspensory Ligament

Front 52

Which ovarian ligament carries the Uterine artery?

Back 52

- Transverse Cervical artery

Front 53

Which ovarian ligament carries no arteries?

Back 53

- Ovarian ligament

- Mesovarium

Front 54

Which ovarian ligament is AKA Cardinal Ligament?

What does this ovarian ligament carry?

Back 54

- Transverse Cervical Ligament

- Uterine artery

Front 55

Which ovarian ligament courses thru the Inguinal Canal

Back 55

- Round Ligament

Front 56

Which ovarian ligament carries the Sampson Artery?

Back 56

- Round Ligament

Front 57

During Ovarian Mass removal, what vessels must be ligated? (why?)

Vessels in what ligament?

Back 57

- Ovarian vessels
(to prevent massive bleed)

- Suspensory Ligament

Front 58

During Radical Hysterectomy, what vessels must be ligated?

Vessels in what ligament?

Back 58

- Uterine artery

- Transverse Cervical Ligament
(aka - Cardinal Ligament)

Front 59

SUPERFICIAL INGUINAL LN

- drains all of what?
- including?
- excluding?

Back 59

- ALL Skin (Cutaneous) Lymph below Umbilicus

- Anus (up to the Pectinate Line)

- Posterior Calf
(which is drained by Popliteal LN)

Front 60

SUPERFICIAL INGUINAL LN

- are found where?

Back 60

- Femoral Triangle

Front 61

Painless groin mass shows palpable hard LN in Right Inguinal Area. LN biopsy of malignant cells come from what origin?

Back 61

- Anal Canal origin

Front 62

Superior Bladder lymph drains into?

Inferior Bladder lymph drains into?

Back 62

- External Iliac LN

- Internal Iliac LN

Front 63

Prostate lymph drains into?

Back 63

- Internal Iliac LN

Front 64

Testes lymph drains into?

Back 64

- Abdominal Aortic LN

Front 65

Proximal 1/3 of Ureter is supplied with blood by what artery?

Back 65

- Renal Artery

Front 66

Basic Drugs used to Treat BPH

Back 66

- Alpha adrenergic Blockers

- 5-alpha-reductase inhibitors

Front 67

In BPH, why do you use Alpha-adrenergic blockers?

Back 67

- Relaxation of SM in Bladder Neck

Front 68

In BPH, why do you use 5-alpha-Reductase Inhibitors?

Back 68

- Prevent conversion of Testosterone to Dihydrotesterone

Front 69

Doxyzocin

- MOA?
- Used to Treat what conditions?

Back 69

- Alpha adrenergic blocker

- BPH (& HTN)

Front 70

"Bag of Worms" Texture on affected side of scrotum.

Back 70

- Varicocoele

Front 71

VARICOCOELE

- what are the PE signs? x2

- commonly on what side?

Back 71

- "Bag of Worms" texture on scrotum
- Testicular Enlargement

- Left side

Front 72

VARICOCOELE

- obstruction of what vessel is commonly associated?

Back 72

- Left renal vein

(thus Left sided varicocoele is MC)

Front 73

Right Testicular Vein drains into?

Left Testicular Vein drains into?

Back 73

- IVC

- Left Renal Vein

Front 74

Right Suprarenal Vein drains into?

Left Suprarenal Vein drains into?

Back 74

- IVC

- Left Renal Vein

Front 75

Right Renal Vein drains what ?

Right Renal Veins drains into?
(@ what level?)

Back 75

- ONLY the Right Kidney

- IVC
(@ L1/L2)

Front 76

Acne

Back 76

1) androgens increasing sebum production
2) Keratin plugging forming comadone
3) Sebum and cellular debris causes proliferation by P.acnes - lipases form pro-inflammatory fatty acids
4) Inflammatory acne: Inflammation and rupture of comadone wall, infiltration by neutrophils

Front 77

T/F : Renal Veins are part of the Portal System.

Back 77

False

Front 78

Primary Sx for both Anterior & Posterior Urethral Trauma

Back 78

Inability to Void
despite
Sensation of Fullness

Front 79

URETHRAL TRAUMA

- which one is above UG Diaphragm?
- which one is below UG Diaphragm?

Back 79

- Posterior Urethral Trauma

- Anterior Urethral Trauma

Front 80

URETHRAL TRAUMA

- Anterior Urethral Trauma involves what hematoma character?

Back 80

"Butterfly" pattern of blood & urine

(no extension to thighs & anal canal)

Front 81

URETHRAL TRAUMA

- Posterior Urethral Trauma involves what hematoma character?

Back 81

Hematoma below Prostate
causing
Upward displacement of Prostate

Front 82

Associated with Saddle injury?

Back 82

- Anterior Urethral Trauma

Front 83

Associated with Pelvic Fracture?

Back 83

- Posterior Urethral Trauma

Front 84

In what condition, is a Foley catheter Contraindicated?

Back 84

- Posterior Urethral Trauma

Front 85

Enlarged Testicle with Translumination of Scrotal Fluid accumulation

Back 85

- Hydorcoele

Front 86

HYDROCOELE

- Scrotal Fluid accumulation has what property?

Back 86

- Transilluminated

Front 87

HYDROCOELE

- Scrotal Fluid Accumulation is where?

Back 87

- Confined to the Tunica Vaginalis

Front 88

HYDROCOELE

- Congenital Hydrocoele etiology

Back 88

- Patency of Processes Vaginalis

Front 89

Tunica Vaginalis/Processes Vaginalis is derived from what tissue?

Back 89

- Peritoneum

Front 90

PROCESSES VAGINALIS

- Failure to Obliterate causes?

- Patency causes?

Back 90

- Indirect Hernia

- Congenital Hydrocoele

Front 91

Which hernia(s) are above Inguinal Ligament?

Which hernia(s) are below Inguinal Ligament?

Back 91

- Direct Hernia
- Indirect Hernia

- Femoral Hernia

Front 92

FEMORAL HERNIA

- Protrusion thru?

Back 92

- Femoral canal

Front 93

FEMORAL CANAL

- Protrusion causes what Dz?
- Name the borders of Femoral Canal

Back 93

- Femoral Hernia

Superior Border: Inguinal Ligament
Medial Border: Pubic Tubercle
(& Lacunar Ligament)
Lateral Border: Femoral Vessels

Front 94

FEMORAL HERNIA

- what complications can arise?

Back 94

- Incarceration

- Strangulation

Front 95

FEMORAL HERNIA

- complication of Incarceration occurs with what event?

- can this be reduced?

Back 95

- Bowels get trapped in the Femoral Hernia

- NO. can not be reduced

Front 96

FEMORAL HERNIA

- what complication follows Incarceration?

- how does this occur?

- what happens to tissues?

Back 96

- Strangulation

- Impaired blood flow b/c of trapped contents in sac after incarceration

- Ischemic & Necrotic