Anatomy- Anterolateral Abdominal Wall

Front 1

Identify the significant abdominal structures corresponding to L1.

Back 1

transpyloric plane, hilum of kidneys, celiac trunk, body of pancreas, duodeno-jejunal flexure, hepatic portal vein, fundus of gallbladder

Front 2

Identify the significant abdominal structures corresponding to L2.

Back 2

azygos vein and thoracic duct begin, spinal cord ends, cisterna chyli

Front 3

Identify the significant abdominal structures corresponding to L3.

Back 3

subcostal plane (passes through inferior border of 10th rib)

Front 4

Identify the significant abdominal structures corresponding to L4.

Back 4

umbilical plane, bifurcation of aorta, highest point of iliac crest

Front 5

Identify the significant abdominal structures corresponding to L5.

Back 5

transtubercular plane, IVC begins, arcuate line

Front 6

What is the anterior boundary of the abdominal cavity?

Back 6

abdominal wall

Front 7

What is the posterior boundary of the abdominal cavity?

Back 7

L1-5 vertebrae, psoas major, quadratus lumborum, iliacus in false pelvis

Front 8

What is the superior boundary of the abdominal cavity?

Back 8

diaphragm

Front 9

What is the supralateral boundary of the abdominal cavity?

Back 9

costal margin

Front 10

What is the infralateral boundary of the abdominal cavity?

Back 10

inguinal ligament, pelvic inlet

Front 11

What forms the floor of the pelvic cavity?

Back 11

pelvic diaphragm

Front 12

What structures are in the right upper quadrant?

Back 12

liver, gallbladder, stomach (pylorus), duodenum, head of pancreas, right kidney and suprarenal gland, ascending and transverse colon

Front 13

What divides the abdomen into 4 quadrants?

Back 13

median plane, transumbilical plane

Front 14

What structures are located in the left upper quadrant?

Back 14

liver, spleen, stomach, jejunum, body and tail of pancreas, left kidney and suprarenal gland, descending and transverse colon

Front 15

What structures are located in the right lower quadrant?

Back 15

cecum, appendix, ileum, right ovary, uterine tube, ureter, spermatic cord, ascending colon

Front 16

What structures are located in the left lower quadrant?

Back 16

sigmoid and descending colon, left ovary, uterine tube, ureter, and spermatic cord

Front 17

What are the 2 layers of superficial fascia of the anterolateral abdominal wall?

Back 17

camper's and scarpa's fascia

Front 18

Describe Camper's fascia

Back 18

FATTY layer

Front 19

Describe Scarpa's fascia.

Back 19

deep FIBROUS layer, blends with fascia lata, extends into penis/labia and into perineum as Colle's fascia

Front 20

What is the fundiform ligament?

Back 20

thickening of Scarpa's fascia- extends from the linea alba, splits and runs laterally around sides of penis like a sling

Front 21

In rupture of a vessel or urethral bulb, where might extravasation of blood/urine extend to?

Back 21

fibrous layer of abdomen but not the lower limb because of attachment of Scarpa's fascia to deep fascia of thigh

Front 22

Name the fascia deep to the muscle layers of the abdomen.

Back 22

Transversalis fascia

Front 23

What are the two structures that the transversalis fascia lies between?

Back 23

transversus abdominus and parietal peritoneum

Front 24

What is the Potential Space of Bogros?

Back 24

area between transversalis fascia and peritoneum, used to placing prosthetics (e.g. repairing inguinal hernias)

Front 25

Name the two parts of the rectus sheath and what separates them.

Back 25

cephalic part (above arcuate line)
caudal part (below arcuate line)

Front 26

What is another name for the arcuate line?

Back 26

semicircular line of Douglas

Front 27

What are the contents of the rectus sheath?

Back 27

rectus abdominus, pyramidalis, superior and inferior epigastric vessels, terminal portions of some nerves of abdominal wall

Front 28

What defines the two ends of the linea alba?

Back 28

xiphoid process and pubic tubercles

Front 29

What are rhaphe?

Back 29

thread/suture- aponeurotic fibers from the linea alba, forms a groove on the skin

Front 30

What forms the middle and posterior layers of the thoracolumbar fascia?

Back 30

aponeuroses of transversus abdominis and internal oblique, contributions of aponeurosis of latissimus dorsi

Front 31

What forms the anterior layer of the thoracolumbar fascia?

Back 31

thin fascia of quadratus lumborum

Front 32

What forms the inguinal ligament of Poupart?

Back 32

external oblique aponeurosis

Front 33

Name the attachments of the inguinal ligament.

Back 33

ASIS and pubic tubercle

Front 34

Name the medial part of the inguinal ligament that arches posteriorly and inferiorly to attach to the superior pubic ramus.

Back 34

lacunar ligament of Gimernat

Front 35

Name the medial part of the inguinal ligament that arches posteriorly and inferior to run along the pectineal line.

Back 35

pectineal ligament of Cooper

Front 36

The superficial inguinal ring is a gap in what aponeurosis?

Back 36

external oblique

Front 37

The deep inguinal ring is an opening in what fascia?

Back 37

transversalis fascia

Front 38

Where is the deep inguinal ring located?

Back 38

midway between the pubic tubercle and ASIS

Front 39

What type of hernia exit the abdominal cavity via the deep inguinal ring?

Back 39

indirect inguinal hernias

Front 40

What are the contents of the inguinal canal?

Back 40

spermatic cord (males)
round ligament of uterus (females)
ilioinguinal nerve (L1)

Front 41

What is another name for the falx inguinalis?

Back 41

conjoint tendon

Front 42

What is the function of the conjoint tendon?

Back 42

forms a support posterior to the superficial inguinal ring

Front 43

What provides collateral circulation between the subclavian and external iliac arteries?

Back 43

superior and inferior epigastric arteries

Front 44

With what artery does the deep circumflex iliac artery anastomose?

Back 44

musculophrenic artery

Front 45

Identify the venous route above the umbilicus.

Back 45

cutaneous veins- thoracoepigastric vein- lateral thoracic vein- axillary vein- subclavian vein

Front 46

Into what do the cutaneous veins below the umbilicus eventually drain into?

Back 46

great saphenous vein

Front 47

With what do the subcutaneous veins near the umbilicus anastomose?

Back 47

portal vein

Front 48

Identify the destination of lymphatic drainage above the umbilicus.

Back 48

axillary and parasternal nodes

Front 49

Identify the destination of lymphatic drainage below the umbilicus.

Back 49

superficial inguinal lymph nodes

Front 50

Where does the deep lymphatic drainage go to?

Back 50

along blood vessels to external iliac nodes

Front 51

Name the 6 common causes of abdominal distension.

Back 51

fat, feces, fluid, flatus, fetus, food

Front 52

What factors influence position of abdominal viscera.

Back 52

stature, position, respiration, tonus of body wall, fullness of viscera, pressure of adjacent viscera, tonus of hollow viscera

Front 53

Define peritoneum.

Back 53

a continuous, thin, transparent serous membrane of simple squamous epithelium, with parietal and visceral layers

Front 54

Define peritoneal cavity.

Back 54

POTENTIAL space between visceral and parietal layers of peritoneum, contains lubricative fluid

Front 55

What is the advantage of peritoneal dialysis?

Back 55

peritoneum is a semi-permeable membrane

Front 56

Define peritonitis.

Back 56

Inflammation of the peritoneum, caused by bacteria from trauma or appendicitis, results in pus and pain

Front 57

Define ascites.

Back 57

accumulation of serous fluid in the peritoneal cavity, caused by cirrhosis, congestive heart failure, metastases, starvation

Front 58

Define adhesions.

Back 58

visceral and parietal peritoneum becomes inflammed and stick together by connective tissue scar, caused by surgery, infection, inactivity

Front 59

What are some treatments for adhesions?

Back 59

deep tissue massage, colonics, surgery

Front 60

Define paracentesis.

Back 60

Surgical puncture of the peritoneal cavity for the aspiration or drainage of fluid.

Front 61

Define thoracentesis.

Back 61

Insertion of a hollow needle into the pleural cavity of the chest to drain pleural fluid.

Front 62

What is the function of the greater omentum?

Back 62

cushions and protects abdominal organs, prevents adhesions, conducts vessels

Front 63

Name the 3 ligaments of the greater omentum.

Back 63

gastrophrenic ligament (to diaphragm)
gastrosplenic ligament (to spleen)
gastrocolic ligament (to transv. colon)

Front 64

What is the function of the lesser omentum?

Back 64

Connects the lesser curvature of the stomach to porta hepatis of the liver.

Front 65

Name the 2 ligaments of the lesser omentum.

Back 65

hepatogastric ligament
hepatoduodenal ligament (conducts portal triad)

Front 66

Name the 3 components of the portal triad.

Back 66

hepatic portal vein
hepatic artery proper
bile duct

Front 67

What is the function of the falciform ligament?

Back 67

separates right and left lobes of the liver, attaches anterior abdominal wall and liver

Front 68

Name the cord-like structure formed by the obliterated umbilical vein.

Back 68

Ligamentum teres (round ligament of the liver)

Front 69

What is the function of the lienorenal ligament?

Back 69

connects spleen and kidney on left side

Front 70

What is the function of the Ligament of Treitz?

Back 70

suspends small intestine from body wall

Front 71

What is another name for the ligament of Treitz?

Back 71

suspensory muscle of the duodenum

Front 72

Name the 3 peritoneal reflections.

Back 72

lateral umbilical folds
medial umbilical folds
median umbilical fold

Front 73

Name the 2 compartments of the greater sac.

Back 73

supracolic compartment
infracolic compartment

Front 74

What are the contents of the supracolic compartment of the greater sac?

Back 74

liver, stomach, pancreas, spleen, upper part of duodenum

Front 75

What are the contents of the infracolic compartment of the greater sac?

Back 75

small intestine, ascending and descending colons, sigmoid colon, rectum

Front 76

What communicates between the supracolic and infracolic compartments of the greater sac?

Back 76

paracolic gutters

Front 77

What is the clinical importantance of paracolic gutters?

Back 77

provide pathways for flow of ascetic fluid and spread of intraperitoneal infections, can develop fluid accumulation if lying down

Front 78

Through what does the greater sac and lesser sac communicate?

Back 78

epiploic foramen (omental foramen, foramen of Winslow)

Front 79

What is the function of the omental bursa?

Back 79

permits free movement of stomach on structure posterior and inferior to it because walls slide easily over each other

Front 80

What is an abdominal hernia?

Back 80

loop of small intestine may pass through the omental foramen into the omental bursa

Front 81

Name the pouches formed by peritoneal reflections in the pelvis in females. In males?

Back 81

uterovesical pouch (front of uterus)
rectouterine pouch (of Douglas)
males: rectovesical pouch

Front 82

Is the peritoneal cavity an open or closed cavity?

Back 82

closed in males, open in females where uterine tube enters

Front 83

What is the clinical significance of peritoneal fossae?

Back 83

may serve as potential sites of internal hernias

Front 84

Name the 6 peritoneal fossae.

Back 84

lesser sac, duodenal fossae, cecal fossa, retrocecal fossa, ileocecal fossae, intersigmoid fossa

Front 85

Name the primary retroperitoneal structures.

Back 85

abdominal aorta, IVC, adrenal glands, kidneys, ureters, gonads

Front 86

Define primary retroperitoneal.

Back 86

embryonically begins and remains retroperitoneal

Front 87

Define secondary retroperitoneal.

Back 87

was suspended by mesentery initially, but ended up behind the mesentery

Front 88

What structures are secondary retroperitoneal?

Back 88

part of duodenum, ascending and descending colons, rectum, pancreas

Front 89

Define intraperitoneal.

Back 89

organ completely invested by visceral peritoneum, connected to the abdominal wall by a mesentery

Front 90

What structures are intraperitoneal?

Back 90

stomach, most of small intestine, cecum, appendix, transverse colon, sigmoid colon, sliver, spleen, tail of pancreas