Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

90 Cards in this Set

  • Front
  • Back
abdominal wall area
spans between the xiphoid process/costal margin and the pelvis
pelvic bones
formed by the fusion of 3 bones: ilium, ischium, pubis
landmarks on the ilium related to the abdominal wall
iliac crest, anterior superior iliac spine (ASIS)
landmarks on the pubis related to the abdominal wall
pubic symphysis at midline (where two pubic bones meet), pubic tubercles (prominence lateral to pubic symphysis)
former site of attachment of umbilical cord, location varies with age and body contours, lies at L4 vertebral level in physically fit person (midway between xiphoid process and pubic symphysis)
inguinal ligament
spans the distance between the ASIS and pubic tubercle; inferior part of external oblique aponeurosis
abdominal planes and quadrants
median plane and transumbilical plane form four abdominal quadrants (right upper, left upper, right lower, left lower), transpyloric plane
median plane
passes vertically through the body midline, from the xyphoid process to the pubic symphysis
transumbilical plane
passes horizontally through the umbilicus at the L4 vertebral level (corresponding to the level of the iliac crests)
transpyloric plane
passes through the L1 vertebral level (midway between the manubrium and pubic symphysis)
abdominal fascia
superficial fascia (camper fascia, scarpa fascia), deep (investing) fascia, transversalis fascia
superficial fascia (relative to umbilicus)
Inferior to umbilicus, two superficial fascia layers: superficial fatty layer (Camper fascia), Deep membranous layer (Scarpa fascia)
scarpa fascia
deep membranous layer of superficial fascia, limits the spread of abdominal wall infections inferiorly into the thigh as it is firmly attached to the iliac crest, inguinal ligament, and pubic symphysis
deep (investing) fascia
surrounds the muscles of the abdominal wall; deep to the superficial fascia and superficial to transversalis fascia
functions of abdominal muscles
Maintain posture and control movements of the torso; accessory muscles of respiration (forced expiration); Protect abdominal organs; Decrease volume of abdominal cavity, thus increasing intra-abdominal pressure (necessary for defecation, micturition / urination, and parturition / childbirth
external oblique and aponeurosis
superficial muscle of anterolateral abdominal wall; fier direction: hands in pockets
internal oblique and aponeurosis
fiber direction: right angle to external oblique
transversus abdominus and aponeurosis
fiber direction: horizontal; posterior to internal obliques, continuation of innermost intercostals
abdominal muscles
external obliques, internal obliques, transversus abdominus, rectus abdominus
rectus abdominus
fiber direction: vertical, lies on either side of the midline; interrupted by tendinous intersections; enclosed by rectus sheath
rectus sheath
formed by aponeuroses of external and interal obliques and transversus abdominus; linea alba runs verically in midline; arcuate line marks transition in composition of rectus sheath
linea alba
runs vertically in midline and is formed by fibers of the rectus sheath fusing in the midline
arcuate line
approximately 1/3 the distance between the umbilicus and pubis, marks a transition in the composition of the rectus sheath
superior to arcuate line
aponeurosis of internal oblique splits to enclose the rectus abdominis; posterior sheath contains 1/2 aponeurosis of internal oblique, aponeurosis of tranversus abdominus; with transversalis fascia posterior to that
inferior to arcuate line
all three aponeurotic layers (external, internal, transversalis) pass anterior to the rectus abdominis, leaving only the transversalis fascia posterior to rectus
located posterior to penis; pouch/extension of abdominal wall; superficial layer is skin, deep layer is dartos facia and muscle; contains spermatic cord, testes, and epididymis
dartos fascia
Contains no fat; continuous with the membranous (Scarpa) layer of superficial fascia of the abdominal wall; due to this connection, infections/fluid from the abdominal wall can collect in the scrotum
dartos muscle
(smooth muscle fibers); contracts in response to cold, giving the skin of the scrotum a wrinkled appearance and helping reduce heat loss by reducing surface area
labia majora
homologous to the male scrotum; Also form as an outgrowth of the anterior abdominal wall; Each labium majus is filled with fat, smooth muscle fibers, and contains the round ligament of the uterus
skin and muscle innervation of abdominal wall
innervated by ventral rami of T7-T11 (continuation of intercostal nerves); T12 (subcostal nerve); L1 (iliohypogastric and ilioinguinal nerves
nerves of abdominal wall
Emerge from the intercostal spaces and pass anteriorly between internal oblique and transversus abdominis layers; Innervate muscle layers segmentally as they pass through them to reach the skin.
dermatomes of abdominal wall
o Superior to umbilicus: T7-T9
o At umbilicus: T10
o Inferior to umbilicus: T11-L1
injury to single nerve of abdominal wall
because nerves innervate muscle layers segmentally, injury would not paralyze an entire muscle, only a segment of it. The paralyzed portion could create a weakened area in the abdominal wall that could allow abdominal contents to protrude or herniate
arteries of abdominal wall
posterior intercostal arteries, subcostal artery, superior epigastric arteries, inferior epigastric arteries, superficial epigastric arteries
posterior intercostal arteries, subcostal artery
posterior intercostal arteries are 10th and 11th; descend between internal oblique and transversus abdominis layers
superior epigastric arteries
Branches of internal thoracic arteries; Located within rectus sheath
inferior epigastric arteries
Branches of external iliac arteries; Anastomose with superior epigastric arteries within rectus sheath
superficial epigastric arteries
Branches of femoral artery;
Located in superficial fascia, course vertically towards the umbilicus
veins of abdominal wall
accompany arteries and share same names; Form extensive venous plexuses with many anastomoses; anastomoses are clinically significant as they provide alternative routes for venous return to the heart when normal venous channels are blocked
abdominal wall venous anaStomoses
superior and inferior epigastric veins (Caval-caval anastomosis), paraumbilical and superficial epigastric veins (portal-caval anastomosis)
caval-caval anastomosis
If blood flow through the IVC is blocked, venous blood within the inferior epigastric veins can be shunted to the superior epigastric veins, and from there to the SVC (via numerous tributaries)
portal-caval anastomosis
If blood flow through the liver is blocked (portal system blockage), venous blood within the paraumbilical veins (part of the portal system) can be shunted to the superficial epigastric veins; the veins radiating from the umbilicus dilate, creating a caput medusae
lymphatic drainage of abdominal wall
Superior to the umbilicus, lymph drains to the axillary lymph nodes; Inferior to the umbilicus, lymph drains to the superficial inguinal lymph nodes
inguinal canal
oblique canal (appx 4cm) within the anterior abdominal wall, just superior to inguinal ligament; potential site of weakness in the anterior abdominal wall; however, deep and superficial inguinal rings do not overlap , so increases in intra-abdominal pressure force the walls of the canal to tightly oppose, closing this potential passageway
borders of inguinal canal
Anterior wall: aponeurosis of external oblique; floor: inguinal ligament, reinforced medially by its extension, the lacunar ligament; posterior wall: Transversalis fascia; roof: internal oblique and transversus abdominis muscles
deep inguinal ring
Internal "entrance" where structures enter the canal;
located just superior to the midpoint of the inguinal ligament and lateral to inferior epigastric vessels
superficial inguinal ring
External "exit", where structures leave the canal; Slit-like opening within the external oblique aponeurosis, located superolateral to the pubic tubercle
ontogeny of inguinal canal in males
Testes initially develop in the posterior abdominal wall. The gubernaculum, a ligamentous cord, attaches the inferior pole of the testis to the developing scrotum. The testes descend and enter the inguinal canal via the deep ring, traverse the canal, exit the superficial ring, and enter the scrotum. As they descend, the testes drag associated vasculature, nerves, lymphatics and the ductus deferens through the canal. These structures form the spermatic cord.
fascial coverings of spermatic cord and testis
derived from layers of the anterior abdominal wall; External spermatic fascia (from external oblique aponeurosis); Cremaster muscle and fascia (from internal oblique muscle; when muscle contracts, testes are raised); internal spermatic fascia (from transversalis fascia)
spermatic cord
includes associated vasculature, nerves, lymphatics, and ducts deferens that is dragged through the inguinal canal by the testis
ontogeny of inguinal canal in females
ovaries develop in the posterior abdominal wall and descend; the gubernaculum connects the ovary and uterus to the developing labium majus. As the ovary never traverses the inguinal canal, the canal is narrower in females compared to males
adult derivatives of the gubernaculum in the female
Ovarian ligament between ovary and uterus; Round ligament of the uterus between uterus and labium majus
contents of the Inguinal Canal
Spermatic cord (in male) or round ligament of the uterus (in female); Ilioinguinal nerve (L1); Genital branch of the genitofemoral nerve (L1, L2)
ilioinguinal nerve
L1; provide sensory innervation to the inguinal region and labia majora/scrotum
genital branch of genitofemoral nerve
L1, L2; provide sensory innervation to the inguinal region and labia majora/scrotum; provides motor innervation to cremaster muscle in the male
inguinal hernias
protusion of abdominal viscera through abdominal wall; more frequent in males; indirect (congenital) and direct (acquired)
indirect (congenital)inguinal hernia
Most common type; Herniating mass enters the deep inguinal ring, lateral to the inferior epigastric vessels, and traverses the inguinal canal. As it traverses the canal, it becomes enclosed in the fascial coverings of the spermatic cord; may exit through the superficial inguinal ring and enter the scrotum (or labium majus)
direct (acquired) inguinal hernia
Involves area of weakness (inguinal triangle) bounded by the rectus abdominis, inferior epigastric vessels, and inguinal ligament; Herniating mass pushes through peritoneum and transversalis fascia, medial to the inferior epigastric vessels; Enters inguinal canal through its posterior wall; rarely enters the scrotum. If it does, the mass lies lateral to the spermatic cord, not covered by its fascial layers.
inguinal triangle
area of weakness bounded by rectus adominis, inferior epigastric vessels, and inguinal ligament; associated with direct (acquired) inguinal hernia
primarily retroperitoneal; surrounded by layers of fat and fascia; located at T12-L3 vertebral levels; right kidney sits slightly lower than left kidney; lie in the right or left upper quadrant
layers around kidney
listed from SF to deep: paranephric (pararenal) fat; renal fascia; perinephric (pararenal) fat
features of kidney
superior pole, inferior pole, lateral border, medial border, renal hilum, renal capsule, renal cortex, renal medulla, renal papillae, minor/major calyx, renal pelvis
renal fascia
prolonged inferiorly along ureters; helps prevent the spread of pus/blood, but can act as a conduit for the spread of these fluids to the pelvis
superior pole
adjacent to suprarenal gland
renal capsule and cortex
capsule is very thin outer layer of kidney; cortex is deep to capsule
renal hilum
Vertical cleft on medial border; arteries enter, veins and renal pelvis exit
relationships of hilum structures
Anterior: renal vein; middle: renal artery; posterior: renal pelvis
lateral / medial border of kidney
lateral is convex, medial is concave and contains renal hilum
renal medulla
include renal pyramids and renal columns
pathway of urine towards the ureter
renal papillae are the apices of the renal pyramids; each minor calyx collects urine from a renal papilla; each major calyx collects urine from 2-3 minor calices; renal pelvis receives urine from the 2-3 major calices and delivers it to the ureter
anomalous kidneys
pelvic kidney: failure of kidney to ascend during development; horseshoe kidney: right and left kidneys united at inferior poles; ascent stopped by IMA
primarily retroperitoneal; fibromuscular tubes extending from renal pelvis to bladder; transport urine via peristaltic contractions
suprarenal (adrenal) glands
primarily retroperitoneal; located on superomedial aspect of kidneys; enclosed in renal fascia; located in the right or left upper quadrant; right is pyramidal shaped; left is crescent shaped
lymphatics of kidneys / suprarenal glands
lymph drains to lumbar lymph nodes (along aorta); lumbar nodes drain to chyle cistern > thoracic duct
parasympathetic innervation of kidneys
preganglionic CB: brain (CN X); preganglionic fibers: vagus nn.; postganglionic cell bodies and fibers: wall of kidney
sympathetic innervation of kidneys
preganglionic CB: lateral horn of the thoracolumbar spinal cord; preganglionic fibers travel from ventral root > spinal nerve > white ramus communicans > sympathetic trunk > thoracic and lumbar splanchnic nn.; postganglionic CB: renal ganglion; pstganglionic fibers: follow arterial branches to target organ
sympathetic innervation of suprarenal glands
preganglionic CB: lateral horn of the thoracolumbar spinal cord; preganglionic fibers travel from ventral root > spinal nerve > white ramus communicans > sympathetic trunk > thoracic and lumbar splanchnic nn.; postganglionic CB: secretory cells of suprarenal glands
vessels of posterior abdominal wall
abdominal aorta (unpaired, paired branches), IVC
abdominal aorta (description)
begins at aortic hiatus of diaphragm (T12); located to left of midline; bifurcates into common iliac arteries (L4)
abdominal aorta unpaired branches
unpaired branches to abdominal organs: celiac trunk, SMA, IMA
paired branches of abdominal aorta to primarily retroperitoneal organs
renal arteries (can have accessory renal arteries from failure of embryonic arteries to degenerate) branch into inferior suprarenal arteries; middle suprarenal arteries; gonadal (testicular or ovarian) arteries
paired branches of abdominal aorta to posterior abdominal wall
inferior phrenic arteries: supply inferior surface of diaphragm, suprarenal glands (via superior suprarenal arteries); subcostal arteries; lumbar arteries
inferior vena cava
o Formed by union of common iliac veins at L5 vertebral level
o Located to right of midline
o Exits abdomen through the caval opening (T8) of the diaphragm
o Tributaries of the IVC parallel the paired branches of the aorta
exceptions to IVC tributaries parallel to paired branches of aorta
• Left gonadal vein drains to left renal vein
• Hepatic veins have no arterial complement
posterior abdominal wall muscles
iliopsoas (psoas major, ilacus), quadratus lumborum
psoas major (origin: anterior aspects of lumbar vertebrae) and iliacus (origin: iliac fossa)fuse to form the iliopsoas, which inserts on the lesser trochanter of the femur
quadratus lumborum
o Origin: 12th rib and lumbar vertebrae
o Insertion: iliac crest
subcostal nerves (T12)
o Travel laterally across quadratus lumborum
o Pierce transversus abdominis to enter abdominal wall
o Sensory innervation (T12 dermatome)
o Motor innervation to external & internal obliques, transversus abdominis
lumbar plexus
Ventral rami of lumbar spinal nerves (L1-L5) form lumbar plexus
• Ilioinguinal & iliohypogastric nerves (L1)
• Genitofemoral nerve (L1, L2)
• Femoral nerve (L2-L4)
• Obturator nerve (L2-L4)
sympathetic trunks in diaphragm
continues from thorax; located just lateral to lumbar vertebral bodies and anterior surface of sacrum; greater, lesser, least splanchnic nerves pass through diaphragm