# Thoracic, Abdominal & Pelvic Anatomy

> 32 regional-anatomy review cards on the heart, lungs, diaphragm, abdominal viscera, celiac/mesenteric and portal vessels, retroperitoneal kidneys and ureters, inguinal canal, and pelvic floor. Assumes basic anatomical terminology.

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- **Level:** intermediate
- **Languages:** en → en
- **Total Cards:** 32

## Flashcards (32 Cards)

| # | Front (Term / Prompt) | Back (Definition / Answer) | Example | Multiple-Choice Options |
| :--- | :--- | :--- | :--- | :--- |
| 1 | What is anterior left renal vein compression, and when is it called nutcracker syndrome? | The left renal vein is compressed between the superior mesenteric artery and aorta. Compression may raise venous pressure; it is called a syndrome when associated with symptoms such as hematuria or flank pain. Compression can also be asymptomatic. |  |  |
| 2 | What is the usual course and drainage territory of the thoracic duct? | It starts from abdominal lymphatic trunks, often through a cisterna chyli, passes through the aortic hiatus and crosses from right to left near T4–T5 before ending near the left venous angle. It drains the body except the right side of the head/neck, right upper limb and right thorax. Its course varies. |  |  |
| 3 | What are the roots, neck course and main functions of the phrenic nerve? | It arises mainly from C3–C5 and descends on the anterior surface of anterior scalene. It supplies motor fibers to the diaphragm and sensory fibers to its central region, the fibrous pericardium and mediastinal pleura. |  |  |
| 4 | What are the four main parts of the pancreas, and how does the uncinate process relate to the superior mesenteric vessels? | Head (including the uncinate process), neck, body and tail, which extends toward the spleen. The superior mesenteric artery and vein pass anterior to the uncinate process and posterior to the pancreatic neck. |  |  |
| 5 | What is the limitation of the classic list of three ureteral narrowing sites? | Traditional teaching lists the ureteropelvic junction, iliac-vessel crossing and ureterovesical junction. CT studies find stones clustered mainly in the upper ureter and at the ureterovesical junction; the iliac crossing is not consistently a narrow point or common impaction site. |  |  |
| 6 | What are the usual arterial sources and venous drainage of the adrenal glands? | Superior adrenal arteries: usually inferior phrenic arteries; middle: aorta; inferior: renal arteries. The right adrenal vein usually drains directly to the inferior vena cava. The left commonly joins the inferior phrenic vein before reaching the left renal vein. |  |  |
| 7 | Where is the transverse pericardial sinus, and what does its position allow during surgery? | It lies behind the ascending aorta and pulmonary trunk, in front of the superior vena cava and above the left atrium. This passage lets surgeons encircle the arterial outflow vessels separately from the venous inflow. |  |  |
| 8 | How are the modern hepatocystic triangle and Calot’s original triangle bounded? | The hepatocystic triangle lies between the cystic duct, common hepatic duct and inferior liver surface, and usually contains the cystic artery. Calot’s original triangle used the cystic artery as its upper boundary instead of the liver. |  |  |
| 9 | What are the usual three branches of the aortic arch, in order from right to left? | Brachiocephalic trunk, left common carotid artery and left subclavian artery. The brachiocephalic trunk divides into the right common carotid and right subclavian arteries. Branching variants occur. |  |  |
| 10 | At what approximate vertebral levels are the three major diaphragmatic openings, and what are their main contents? | T8: caval opening, transmitting the inferior vena cava. T10: esophageal hiatus, transmitting the esophagus and vagal trunks. T12: aortic hiatus behind the diaphragm, transmitting the aorta and thoracic duct. These are approximate anatomical levels. |  |  |
| 11 | Which three gross features help distinguish the colon from the small intestine? | Taeniae coli (longitudinal muscle bands), haustra (sacculations) and epiploic appendages (fat-filled pouches). This combination characterizes the colon, not every part of the large intestine: the rectum and appendix lack the typical combination. |  |  |
| 12 | What territory and major branches are associated with the superior mesenteric artery (SMA)? | The midgut territory, from the duodenum beyond the major papilla to the proximal two-thirds of the transverse colon. Usual branches include inferior pancreaticoduodenal, jejunal/ileal, ileocolic, right colic and middle colic arteries; branching varies. |  |  |
| 13 | Which veins usually form the hepatic portal vein, and where do they unite? | The superior mesenteric and splenic veins unite behind the neck of the pancreas. The inferior mesenteric vein often drains into the splenic vein, but its termination varies. |  |  |
| 14 | How do primary and secondary retroperitoneal organs differ? Give examples. | Primary retroperitoneal organs, such as kidneys, adrenal glands and ureters, develop behind the peritoneum. Secondary retroperitoneal organs initially have a mesentery that later fuses to the posterior wall: most of the duodenum, pancreas except its tail, and ascending/descending colon. |  |  |
| 15 | How are the renal cortex and medulla arranged, and where does urine go after the papillae? | Beneath the fibrous capsule, the outer cortex surrounds medullary pyramids, with cortical columns between them. Urine flows from papillae → minor calyces → major calyces → renal pelvis → ureter. |  |  |
| 16 | What is the ureter’s abdominal course, and which structures cross above it near the bladder? | It descends retroperitoneally in front of psoas major, crosses the iliac vessels near their bifurcation and enters the pelvis. Near the bladder it passes beneath the uterine artery in typical female anatomy and beneath the ductus deferens in typical male anatomy. |  |  |
| 17 | Which regions do the left anterior descending (LAD) and left circumflex (LCx) coronary arteries usually supply? | LAD: anterior left ventricular wall, apex and anterior two-thirds of the interventricular septum. LCx: mainly the lateral left ventricular wall, with variable posterior/inferior supply. Territories overlap and vary with coronary anatomy and dominance. |  |  |
| 18 | Where are the main portosystemic venous anastomoses, and what can happen in portal hypertension? | Lower esophagus: left gastric ↔ azygos system; rectum: superior ↔ middle/inferior rectal veins; umbilicus: paraumbilical ↔ abdominal-wall veins; retroperitoneum: colic ↔ systemic veins. Portal hypertension can enlarge these channels, producing varices or caput medusae. |  |  |
| 19 | How are SMA and IMA territories connected, and where are important colonic watershed regions? | The marginal artery of Drummond runs near the colon; a variable arc of Riolan can provide another connection. The splenic flexure (Griffiths’ point) and rectosigmoid junction (Sudeck’s point) are traditionally described watershed regions. Collateral continuity and strength vary. |  |  |
| 20 | Where is McBurney’s point, and how can the taeniae coli help locate the appendix? | McBurney’s point is about one-third of the way from the right anterior superior iliac spine toward the umbilicus. The three taeniae coli converge at the appendiceal base on the cecum; the position of the tip varies. |  |  |
| 21 | How do the right and left lungs usually differ in lobes, fissures and distinctive features? | The right lung has superior, middle and inferior lobes separated by horizontal and oblique fissures. The left has superior and inferior lobes separated by an oblique fissure, plus a cardiac notch and the lingula of the superior lobe. |  |  |
| 22 | Trace filtrate from Bowman’s capsular space to a collecting duct. | Capsular space → proximal tubule (convoluted then straight) → descending and ascending limbs of Henle’s loop → distal convoluted tubule → connecting tubule → collecting duct. Short loops lack a thin ascending limb. Collecting ducts receive fluid from several nephrons and are not part of the nephron proper. |  |  |
| 23 | What defines coronary dominance, and which artery usually supplies the AV node in a right-dominant heart? | Dominance is defined by the origin of the posterior interventricular (posterior descending) artery. In right dominance it arises from the right coronary artery, which usually also gives off the AV nodal artery near the crux of the heart. |  |  |
| 24 | Trace the usual extrahepatic bile duct pathway to the duodenum. | Right and left hepatic ducts → common hepatic duct; the cystic duct joins it to form the common bile duct. This usually joins the main pancreatic duct before opening at the major duodenal papilla in the second part of the duodenum. The union varies; the sphincter of Oddi regulates flow. |  |  |
| 25 | What territory and major branches are associated with the inferior mesenteric artery (IMA)? | The distal third of the transverse colon, descending and sigmoid colon, and upper rectum. Its main branches are the left colic, sigmoid and superior rectal arteries. |  |  |
| 26 | What is the anatomical basis of the eight Couinaud liver segments? | Each segment has a portal pedicle providing portal venous and hepatic arterial inflow and biliary drainage. Major hepatic veins generally run between these territories. Segment I (caudate) often drains directly to the inferior vena cava. This organization guides resection, but vascular variants must be considered. |  |  |
| 27 | How do the right and left mainstem (primary) bronchi differ in anatomical orientation, and why is this clinically relevant? | The adult right main bronchus is generally wider, shorter and more vertical than the left, favoring right-sided entry of aspirated material or a deeply advanced endotracheal tube. Aspiration distribution also depends on position: basal lower-lobe segments are often involved when upright, and posterior upper-lobe or superior lower-lobe segments when supine. These patterns are not exclusive. |  |  |
| 28 | What typical features help distinguish jejunum from ileum? | Jejunum: thicker wall, more prominent circular folds, fewer arterial arcades, longer vasa recta and less mesenteric fat. Ileum: the opposite tendencies and more prominent Peyer’s patches. These are gradual differences, not a sharp boundary. |  |  |
| 29 | What muscles constitute the Levator Ani complex of the pelvic diaphragm, and what is its role in fecal continence? | Levator ani comprises puborectalis, pubococcygeus and iliococcygeus. Together with the separate coccygeus muscle, it forms the pelvic diaphragm. Puborectalis supports continence by maintaining the anorectal angle; relaxation allows the angle to straighten during defecation. |  |  |
| 30 | What defines a bronchopulmonary segment, and how many are usually described in each lung? | A territory supplied by a segmental bronchus and a corresponding pulmonary arterial branch; pulmonary veins mainly run between segments. Usually 10 segments are described on the right and 8–10 on the left, depending on fusion and counting conventions. |  |  |
| 31 | What are the usual branches of the celiac trunk, and how does its territory differ from a purely embryological foregut list? | Left gastric, splenic and common hepatic arteries. They supply foregut derivatives, including the stomach, proximal duodenum, liver/biliary tract and part of the pancreas, plus the abdominal esophagus. The spleen also receives celiac blood but develops from mesoderm, not the foregut. |  |  |
| 32 | Trace a normal cardiac impulse from the sinoatrial node to ventricular myocardium. | Sinoatrial node near the superior vena cava–right atrial junction → atrial myocardium → atrioventricular node in the region of Koch’s triangle → AV bundle (His) → right and left bundle branches → Purkinje fibers → ventricular myocardium. |  |  |

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