MISCELLANEOUS

How can diameter in mm be determined from a French measurement?

How can needle-gauge size be determined?

What is a Tenckhoff catheter?

Divide the French size by or 3.14 (e.g., a 15 French tube has a diameter of 5 mm)

14-gauge needle is 1/14 of an inch (Thus, a 14-gauge needle is larger than a 21-gauge needle)

Catheter placed into the peritoneal cavity for peritoneal dialysis

C h a p t e r 17

What is the drainage of the left testicular vein?

What is the drainage of the right testicular vein?

What is Gerota’s fascia?

What are the prominent collateral circulations seen in portal hypertension?

What parts of the GI tract are retroperitoneal?

What is the gubernaculum?

Surgical Anatomy

Pearls

Left renal vein

IVC

Fascia surrounding the kidney

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

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

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

Is the left vagus nerve anterior or posterior?

What is Morrison’s pouch?

Give the locations of the following structures:

Foregut

Midgut

Hindgut

Where are the blood vessels on a rib?

What is the order of the femoral vessels?

Anterior; remember that the esophagus rotates during development

Hepatorenal recess; the most posterior cavity within the peritoneal cavity

Mouth to ampulla of Vater

Ampulla of Vater to distal third of transverse colon

Distal third of transverse colon to the anus

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

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 Calot’s node?

What separates the right and left lobes of the liver?

What is the gastrinoma triangle?

Which artery is responsible for anterior spinal syndrome?

Where is McBurney’s point?

How can you find the appendix after you find the cecum?

Where is the space of Retzius?

What are the white lines of Toldt?

What is the strongest layer of the small bowel?

Which parts of the GI tract do not have a serosa?

What is the vein that overlies the pylorus?

What is the pouch of

Douglas?

What does the thoracic duct empty into?

Chapter 17 / Surgical Anatomy Pearls 105

Lymph node found in Calot’s triangle

Cantle’s line—a line drawn from the IVC to just left of the gallbladder fossa

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

Artery of Adamkiewicz

One third the distance from the anterior superior iliac spine to the umbilicus (estimate of the position of the appendix)

Trace the taeniae back as they converge on the origin of the appendix

Preperitoneal space anterior to the bladder

Lateral peritoneal reflections of the ascending and descending colon

Submucosa (not the serosa, think: SUbmucosa SUperior)

Esophagus

Middle and distal rectum

Vein of Mayo

Pouch between the rectum and bladder or uterus

Left subclavian vein; left internal jugular vein junction

What are the plicae circulares?

What is another name for the plicae circulares?

What are the major structural differences between the jejunum and ileum?

What are the major anatomic differences between the colon and the small bowel?

How far up does the diaphragm extend?

What dermatome is at the umbilicus?

Plicae folds, circulares circular; thus, the circular folds of mucosa of the small bowel

Valvulae conniventes

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)

Colon has taeniae coli, haustra, and appendices epiploicae (fat appendages), whereas the small intestine is smooth

To the nipples in men (fourth intercostal space; thus, the abdomen extends to the level of the nipples)

T10

What are the major layers of an artery?

Chapter 18 / Fluids and Electrolytes 107

Adventitia

Media

Intima

C h a p t e r 18

What are the two major body fluid compartments?

What are the two subcompartments of extracellular fluid?

What percentage of body weight is in fluid?

Fluids and

Electrolytes

1.Intracellular

2.Extracellular

1.Interstitial fluid (in between cells)

2.Intravascular fluid (plasma)

60%

60%

What percentage of body fluid is intracellular?

What percentage of body fluid is extracellular?

What is the composition of body fluid?

66%

33%

Fluids 60% total body weight: Intracellular 40% total body weight Extracellular 20% total body weight

(Think: 60, 40, 20)

How can body fluid distribution by weight be remembered?

“TIE”:

T Total body fluid 60% of body weight

I Intracellular 40% of body weight E Extracellular 20% of body

weight

What are the levels and sources of normal daily water loss?

What are the levels and sources of normal daily electrolyte loss?

Urine—1200 to 1500 mL (25–30 mL/kg) Sweat—200 to 400 mL

Respiratory losses—500 to 700 mL Feces—100 to 200 mL

Sodium and potassium 100 mEq Chloride 150 mEq