Abdominal

• Surface markings of left and right kidney

  • left t11
  • rigbt t12
• What level is the renal hila

  L1
• What lies in front of the right kidney?

  • right adrenal gland
  • second part of duodenum
  • right colic flexure
  • segment of small intestine
• What lies in front of the left kidney

  • left adrenal gland
  • spleen
  • Pancreas
  • stomach
  • left colic flexure
  • descending colon
  • duodenojenjunal flexure
  • coils of small intestine
• What is posterior to the kidneys

  • diaphragm
  • psoas major
  • QL
  • transverse abdominus
• Where does the renal artery come from

  L1/L2
• Lymphatic drainage of kidneys

  Lumbar / para aortic lymph nodes
• Innervation of kidneys

  • renal plexus
  • parasympathetic fibres from vague nerve
  • sympathetic fibres of thoracic splanchnic nerves
• Label kidney

  Label

  
• What is the uterus supplied by

  Supplied by the uterine artery which is a branch of the internal iliac artery

  also suppied by uterine branches of the ovarian artery which comes off the abdominal aorta

  uterine and ovarian artery anastamose
• Uterus nerve supply

  • sympathetic efferent: inferior hypogastric plexus
  • sympathetic afferent: T10-12 L1
  • parasympathetic: pelvis splanchnic S2-4
• Label the following

  As below

  
• What structure remains beneath the rectus muscles after the actuate line?

  Transversalis fascia
• What vessels are in the rectus sheath?

  Superior and inferior epigatric vessels
• What other muscle is in the rectus sheath?

  Pyramidalis
• What nerves are in the rectus sheath

  • termination intercostal nerves T7-12
• Layers of abdomen

  Layers

  
• Label

  Label

  
• Femiral nerve root

  L2-L4
• The ureters enter the pelvic brim where?

  at bifurcation of the common iliac arteries
• What level to the ureters turn to enter the bladder

  Ischial spines
• What causes urinary frequency in appendicitis

  Right ureter lies close
• What are the three construction points of the ureter

  1. ureteropelvic junction
  2. pelvic brim
  3. vesicoureteric junction
• ureter afferent fibres supplied by which roots? Corresponds to loin to groin pain

  T11 - L2
• Describe the aetiology of indirect and direct hernias

  • direct: acquired, through back of inguinal canal
  • indirect: congenital, patent processus vaginalis, comes through ring
• What’s more common, direct or indirect hernia?

  Direct
• Which hernia is lateral to inferior epigastric vessels?

  Indirect
• What structures are retroperitoneal?

  S suprarenal

  A aorta and ivc

  D duodenum (distal 2/3)

  P pancreas (not tail)

  U ureter and bladder

  C colon (asc and desc)

  K kidneys

  E oesophagus

  R rectum
• The diaphragmatic portion of the parietal peritoneum is supplied by the phrenic nerve c3 - c5 and the rest of it is supplied segmentally by the intercostal or lumbar nerves
• The visceral peritoneum is innervated by visceral afferents that accompany autonomic nerves. It can’t localise pain very well
• what is the livers blood supply and lymphatic drainage?

  Blood: Hepatic artery from coeliac trunk Lymphatic drainage: Hepatic lymph nodes to coeliac lymph node
• What is contained within the hexagonal shaped liver lobule? (6)

  Heptaocytes, vein, arteriole, bile duct, lymphatic vessels, vagal parasympathetic fibres
• The blood supply to the jejenum and ileum is from what?

  Superior mesenteric artery
• The tip of the appendix can have a variable position. What is the most common?

  Retrocecal (then the pelvic, then pre/post ilea)
• Where is mcburneys point?

  1/3 from ASIS and umbillicus
• What are the contents of the inguinal canal?

  Spermatic cord (males) or round ligament of the uterus (females) and ilioinguinal nerve
• What are the contents Of the spermatic cord?

  P pampiniform plexus

  D ductus deferens

  C cremasteric artery

  T testicular artery

  A artery of ductus deferens

  G genital branch of genitofemoral nerve

  L lymphatic vessels
• The greater sac is divided into supra and infracolic by what structure?

  Transverse mesocolon
• The infracolic compartment is divided into left and right by what structure?

  oblique attachment of mesentery
• What does the mesentery attach to?

  posterior abdominal wall