What are the walls of the inguinal canal?
• Roof: Arching fibers of the transversus abdominus reinforced by the internal oblique
• Anterior: aponeurosis of the external oblique reinforced by the internal oblique
• Floor: inguinal ligament• Posterior: conjoint tendon & transversalis fascia
Remember – M
A T
L
What is the biopsychosocial model?
The biological, psychological and social aspects influencing an individuals health
What are the 4 P’s for increasing intra-abdominal pressure?
• Peeing• Passing stool• Parturition • Puking
Give the definition of prevalence
The number of people with a disease of interest in a defined population at a defined
point in time
What are the the body points of attachment of the inguinal ligament?
• ASIS (anterior superior iliac spine) • Public tubercle
What is an aponeurosis?
A sheet of connective tissue (rather than a cord) connecting muscles to the parts they
move
Give three reasons why doctors should take account of patient’s perspectives
• Better medical outcomes• Aids diagnosis• Increased patient satisfaction
What are the arteries supplying the foregut, midgut and hindgut?
• Foregut: coeliac • Midgut: superior mesenteric• Hindgut: inferior mesenteric
What are the five Mendelian patterns of inheritance?
• Autosomal dominant• Autosomal recessive• X-linked dominant• X-linked recessive• Y-linked
Give the definition of incidence
The number of new cases of a disease of interest in a defined population in a defined
period of time
Remember – prevalence considers both old and new cases
What is the dermatome supply of the following regions – epigastric, umbilicus and suprapubic?
• Epigastric: T7• Umbilicus: T10• Suprapubic: L1
Name the only monosomy disorder that is not lethal
Turners syndrome 45XO
Monosomy is a chromosomal disorder where one chromosome of the pair is missing
Clinical decisions include what three considerations?
• Clinical state and circumstances (of the patient)
• Patient preferences• Research evidence
From how many layers is the greater omentum formed?
Four
Remember – the four layers fuse to form a two layered greater omentum
What is the function of the greater omentum?
The “policeman of the abdomen” – contains collections of macrophages, walls off areas of
infection e.g. in appendicitis
What are the five factors required for the Hardy-Weinberg equilibrium ?
• A large population• No migration in or out of the population• Random mating• No allele selection• Constant mutation rate
Define confidence intervals
A measure of certainty which can be attached to the results
With a 95% CI you are 95% sure the actual result is contained within the range of values calculated
Between which two muscle layers of the anterior abdominal wall do nerves run?
The internal oblique and the transversus abdominus
What bases are in DNA and RNA?
DNAA (adenine)C (cytosine)G (guanine)T (thymine)
RNAA (adenine)C (cytosine)G (guanine)U (uracil)
What are the coding and non-coding regions of genes?
• Coding: extons• Non-coding: introns
Introns are removed by splicing
The lesser sac is found between which two organs?
The inferior border of the liver and the lesser curvature of the stomach
What do patients want from the consultation?
• Doctors to listen and take account of their views, perspectives and expectations
• Active involvement in decisions about their care
Is mitochondrial inheritance maternal or paternal?
Maternal
Remember – mitochondria in sperm are destroyed by the egg after fertilization so mitochondria are inherited from the mother
What is the rule of twos for the Meckel’s diverticulum
• 2% are symptomatic • 2:1 males:females• 2 feets from the ileocaecal valve• 2 inches in length • 2 years is the most common age of
presentation
What is contained in the inguinal canal in males and in females?
• Males: spermatic cord• Females: round ligament
Does the rectus sheath split above or below the umbilicus?
Above
Remember – it is easier to get a ‘six pack’ above the umbilicus because there are fewer layers of muscles lying over the rectus abdominus (the six pack muscle)
Describe the rotation of the stomach during embryonic development
90° to the right
Remember – ‘I am right behind you’
Name the nine regions of the abdomen and the four planes
Regions• L & R hypochondrium • Epigastric • L & R lumbar• Umbilicus• L & R iliac fossa• Suprapubic
Planes• L & R midclavicular• Transpyloric• Transtubercular
What are the boundaries of the foregut, midgut and hindgut?
• Foregut: oesophagus – proximal ½ duodenum
• Midgut: distal ½ duodenum – proximal ⅔ transverse colon
• Hindgut: distal ⅓ transverse colon – proximal ½ rectum
State if the following structures are formed from ventral or dorsal mesentery – liver, spleen, pancreas
State if the following structures are formed from ventral or dorsal mesentery – liver, spleen, pancreas
• Liver: ventral mesentery• Spleen: dorsal mesentery• Pancreas: dorsal mesentery
What is a mosaicism?
The presence of two or more populations of cells in an individual who developed from a
single fertilized egg
List four agents that cause DNA damage
• Ionizing radiation and UV light• Chemical• Viral• Spontaneous deamination
List the organs that are intraperitoneal and retroperitoneal
Intraperitoneal• Stomach• 1st part of duodenum• Ileum• Jejenum• Caecum • Appendix• Transverse colon• Sigmoid colon• Upper ⅓ rectum
Retroperitoneal• 2nd, 3rd, 4th part of duodenum• Ascending colon• Descending colon• Pancreas
List the layers of the abdominal wall
• Skin• Camper’s fascia (fatty)• Scarper’s fascia (membranous)• External oblique• Internal oblique• Transversus abdominus• Transversalis fascia • Extraperitoneal fascia• Parietal peritoneum
• Skin• Fascia
• Muscle
• Peritoneum