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Surgical Recall Chapter 17 - Surgical Anatomy Pearls

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1.

Foregut

Mouth to ampulla of Vader

2.

Hindgut

Distal third of transverse colon to the


anus

How can you find


the appendix after
you find the
cecum?

Trace the taeniae back as they converge


on the origin of the appendix

How far up does


the diaphragm
extend?

To the nipples in men

Is the left vagus


nerve anterior or
posterior?

Anterior; remember that the esophagus


rotates during development

Midgut

Ampulla of Vader to distal third of


transverse colon

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

What are the


layers of the
abdominal wall?

14.

15.

16.

17.

1. skin, then fat


2. Scarpa's fascia
3. External oblique
4. Internal oblique
5. Transversus abdominus
6. Transversalis fascia
7. Preperitoneal fat
8. Peritoneum

18.

19.

20.

21.

What are the


major anatomic
differences
between the colon
and the small
bowel?

Colon has taeniae coli, haustra, and


appendices epiploicae (fat
appendages), whereas the small
intestine is smooth

What are the


major layer of an
artery?

Adventitia --> Media --> Intima

24.

What are the


major structural
differences
between the
jejunum and
ileum?

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)

25.

What are the


plicae circulares?

Plicae = folds, circulares = circular;


thus, the circular folds of mucosa of the
small bowel

What are the


prominent
collateral
circulations seen
in portal
hypertension?

Esophageal varices, hemorrhoids


(inferior hemorrhoidal vein to internal
iliac vein), patent umbilical vein (caput
medusa), and retroperitoneal vein via
lumbar tributaries

What are the white


lines of Toldt?

Lateral peritoneal reflections of the


ascending and descending colon

22.

23.

26.

27.

28.

What artery is
responsible for
anterior spinal
syndrome?

Artery of Adamkiewicz

What dermatome is at
the umbilicus?

T10

What does the thoracic


duct empty into?

Left subclavian vein; left internal


jugular vein junction

What is Calot's node?

Lymph node found in Calot's


triangle

What is Calot's
triangle?

The area bordered by:


1. Cystic duct
2. Common hepatic duct
3. Cystic artery

What is Gerota's
fascia?

Fascia surrounding the kidney

What is Hesselbach's
triangle?

The area bordered by:


1. Inguinal ligament
2. Epigastric vessels
3. Lateral border of the rectus
sheath

What is Morrison's
pouch?

Hepatorenal recess; the most


posterior cavity within the
peritoneal cavity

What is the coronary


vein?

Left gastric vein

What is the drainage of


the left testicular vein?

left renal vein

What is the drainage of


the right testicular
vein?

IVC

What is the gastrinoma


triangle?

Triangle where > 90% of


gastrinomas are located, bordered
by:
1. Junction of the second and
third portions of the duodenum
2. Cystic duct
3. Pancreatic neck

What is the
gubernaculum?

Embryologic structure that


adheres the testes to the scrotal
sac; used to help manipulate the
testes during indirect hernia
repair

What is the hypogastric


artery?

Internal iliac artery

What is the name of the


lymph nodes between
the pectoralis minor
and major muscles?

Rotter's lymph nodes

29.

30.
31.

32.

33.

34.

35.

36.

37.
38.

39.

40.

What is the order of the femoral


vessels?

Femoral vein is medial to the femoral artery (think NAVEL) for the order of the right femoral
vessels - Nerve, Artery, Vein, Empty space, Lymphatics

What is the pouch of Douglas?

Pouch between the rectum and bladder or uterus

What is the strongest layer of the


small bowel?

Submucosa (NOT the serosa, think: SUbmucosa is SUperior)

What is the vein that overlies the


pylorus?

Vein of Mayo

What nerve is located on top of


the spermatic cord?

Ilioinguinal nerve

What parts of the GI tract are


retroperitoneal?

Most of the duodenum, the ascending colon, the descending colon, and the pancreas

What separates the right and left


lobes of the liver?

Cantlie's line - a line drawn from the IVC to just left of the gallbladder fossa

Where are the blood vessels on a


rib?

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

Where is the space of Retzius?

Preperitoneal space anterior to the bladder

Which artery bleeds in bleeding


duodenal ulcers?

Gastroduodenal artery

Which is longer, the left or right


renal vein?

Left

Which parts of the GI tract do not


have a serosa?

Esophagus, middle and distal rectum

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