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155 Cards in this Set
- Front
- Back
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What are the 4 anterolateral abdominal muscles?
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External Oblique, Internal Oblique, Transversus abdominis, Rectus Abdominis
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What are the 3 posterior abdominal muscles?
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Quadratus Lumborum, Psoas major, iliacus
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What occurs to the linea alba in pregnant women?
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It becomes more pigmented and darkens
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The umbilicus is at which vertebral level?
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L3/L4
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The unbilicus is at which dermatome?
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T10
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What vertebral level is the transpyloric plane found?
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L1
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What does the transpyloric plane demarcate?
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Origin of superior mesenteric artery
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What vertebral level is the subcostal plane found?
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L3
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What does the subcostal plane demarcate?
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Origin of inferior mesenteric artery
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What vertebral level is the supracristal plane found?
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L4
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What does the supracristal plane demarcate?
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Bifurcation of abdominal aorta
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What vertebral level is the transtubercular plane found?
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L5
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What does the transtubercular plane demarcate?
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Formation of inferior vena cava
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The abdomen is separated into quadrants using which 2 planes?
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Transumbilical and median plane
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Pain in the right lower quadrant of the abdomen is typically what disorder?
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Appendisitis
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Under what circumstance is T10 pain never appendisitis?
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If the patients appendix has already been removed
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What is McBurney's Point?
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Area 1/3 up to AIIS that is maximum tenderness during
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Why are surgeon's discouraged to put pressure on McBurney's Point now?
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If we push an appendix that is very swollen, we may rupture it
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What planes are used to separate the abdomen into 9ths?
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Subcostal (L3), Transtubercular (L5), and 2 mid clavicular lines
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Where is gall bladder pain seen according to the referred pain hypothesis?
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Lateral neck and shoulder. (C3-C5). Enlarged gall bladder irritates diaphragm (phrenic nerve C3-C5)
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What abdominal layer is being worked on during liposuction?
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Camper's Fascia
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Why can a patient bleed out after a liposuction?
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The Camper's Fascia has a lot of vasculature
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What layer of fascia lies directly under the Camper's fascia?
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Scarpa fascia
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What is the fundiform ligament?
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Holds yo dick up. Urologists can cut it to make your dick look bigger
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If the portal veins or vena cava are blocked, what important vessels anastomose to get blood to the heart?
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The paraumbilical veins
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What is Caput Medusae?
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Blockage of the vena cava or portal vein (perhaps due to cancer) causes paraumbilical veins to distend
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Why do alcoholics have caput medusae?
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Liver cirrhosis can block portal veins. Paraumbilical anastomoses occur.
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Membranous superficial layer of the anterior abdominal wall is tight with fascia lata. Why is this clinically relevant?
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It creates a pocket where fluid can collect, but not travel into the legs.
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During urinary extravasation, between what two fascia layers does fluid accumulate
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Scarpa fascia (superficial membrane layer) and deep fascia over external oblique
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What is Caput Medusae?
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Blockage of the vena cava or portal vein (perhaps due to cancer) causes paraumbilical veins to distend
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Why do alcoholics have caput medusae?
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Liver cirrhosis can block portal veins. Paraumbilical anastomoses occur.
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Membranous superficial layer of the anterior abdominal wall is tight with fascia lata. Why is this clinically relevant?
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It creates a pocket where fluid can collect, but not travel into the legs.
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During urinary extravasation, between what two fascia layers does fluid accumulate
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Scarpa fascia (superficial membrane layer) and deep fascia over external oblique
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What are 2 ways we can have urinary extravasation?
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motorcycle accident and metal rod in urethra
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Compare the direction of fibers in external and internal oblique muscles.
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Opposite. External oblique has "hands in pocket" orientation
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The conjoint tendon is a combination of which 2 muscles?
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internal oblique and transversus abdominis
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Which anterior abdominal muscle gives rise to the cremaster muscle?
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Internal oblique
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Why does referred pain from the appendix occur in areas outside the T10 dermatome?
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Once it is enflamed enough, it will actually touch the body wall. Then is irritates whatever dermatome that is.
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What anatomical feature on the posterior surface of the anterior abdominal wall is a remnant of fetal arteries?
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Medial umbilical fold
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Why is the lateral umbilical fold an important landmark during a hernia operation?
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Lateral fold passes over epigastric arteries. Help us decide if hernia is direct or indirect
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What is the clinical significance of the inguinal triangle?
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Weak area of the abdominal wall. direct inguinal hernias occur here.
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Direct inguinal hernias occur in what area relative to the epigastric vessels?
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medially
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Indirect inguinal hernias occur in what area relative to the epigastric vessels?
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laterally
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What is interesting about the rectus abdominis muscles longitudinal fibers?
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They are segmented
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In a transverse section above the acruate line, the aponeurosis of the transverse abdominal muscle is found ____ to the rectus abdominis?
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Posterior
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In a transverse section above the acruate line, the aponeurosis of the external oblique muscle is found ____ to the rectus abdominis?
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Anterior
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In a transverse section below the acruate line, the aponeurosis of the transverse abdominal muscle is found ____ to the rectus abdominis?
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anterior
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In a transverse section below the acruate line, the aponeurosis of the external oblique muscle is found ____ to the rectus abdominis?
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anterior
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In a transverse section below the acruate line, what is the only fascia found posteriorly to the rectus abdominis?
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Transversalis fascia
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The ilioinguinal and genitofemoral nerves run between which muscle layers in the inguinal canal?
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Between the transversalis abdominal and internal oblique
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What 2 nerves are at risk for damage during an inguinal hernia repair?
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Ilioinguinal and genitofemoral
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Which is the layer just superficial to the tunica albiginia?
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Process vaginalis
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What passes through the inguinal canal in males?
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Spermatic cord
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What passes through the inguinal canal in females?
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Round ligament of uterus
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Why do testes decend into scrotum?
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They need lower temp. to function
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What nerve passes through psoas major?
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Genitofemoral nerve
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What "structure" passes through psoas major?
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Psoas minor tendon
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Why does the pampiform plexus of veins form around the cremasteric artery?
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Venous blood attempt to cool blood before getting to testes
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The ilioinguinal nerve is found between the layers of what 2 muscles?
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transverse and internal abdominal muscles
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The tranversalis fascia creates what layer of fascia of the spermatic cord?
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internal spermatic fascia
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Where does the internal spermatic fascia begin to form?
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Deep inguinal ring, midway between ASIS and pubic tubercle
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The external oblique aponeurosis creates what layer of fascia of the spermatic cord?
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external spermatic fascia
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Where does the external spermatic fascia form?
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Near pubic tubercle
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The inguinal ligament connects between what 2 structures?
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ASIS and pubic tubercle
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Why does coughing cause your abdominal muscles to contract?
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To hold the spermatic cord in place during force
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what is Processes vaginalis?
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fetal scrotum without testes in it
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What is the gubernaculum testes?
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the funniest word ever; connective tissue at the base of the testes that pulls it down into the processes vaginalis during puberty
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As the testes descend into the process vaginalis during growth, what layer (superior to the testes) also descends?
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Peritoneum
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Cremasteric fascia contains what type of muscle?
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Skeletal
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What are the 3 "landmarks" for where the spermatic cord gains a layering cover?
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Deep inguinal ring (internal spermatic), conjoint tendon (cremasteric fascia), and superficial inguinal ring (external spermatic)
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Why does the cremasteric reflex exist?
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Protective relfex
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Cremasteric reflex tests which spinal level
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L1
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Where do scrotum cancer cells collect?
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Superficial inguinal nodes
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Where do testiculuar cancer cells collect?
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Lumbar nodes
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Parasympathetic innervation of genitalia
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vagus nerve (It hurts in the abdomen when you get kicked in the balls. nausea)
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Sympathetic innervation of genitalia
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T10-T11 segments
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What is a hydrocele?
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Fluid accumulates in the remnant of the process vaginalis
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What is the easiest way to diagnose a hydrocele?
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Shine light in the scrotum, we can see through due to liquid
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What is a Varicocele
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vericose veins of the pampinoform plexus.
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What is a major side effect of a varicocele in males?
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Low sperm count. Pampinoform plexus cannot properly cool cremasteric artery blood
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Direct hernias occur medially or laterally to inferior epigastric arteries?
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Medially, within the inguinal traingle
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FUN FACT: Direct hernias do not generally enter the inguinal canal
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In the unlikely even that the hernia does enter the canal, it would go through the superficial ring
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How do you repair a direct hernia?
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Goretex patch
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What type of hernia is more common, direct or indirect?
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Indirect
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Which type of hernia is prone to strangulation?
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Indirect
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Which type of hernia can enter the inguinal canal through the superficial ring?
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Direct and Indirect, it is less common for direct though
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Why are direct hernias more common in older people?
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Their abdominal walls are generally weaker
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Why would an indirect hernia have a layer of peritoneum and spermatic cord layers over it?
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It enters the deep ring of the inguinal canal
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Which nerve is more medial? (ilioinguinal or genitofemoral)
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ilioinguinal
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If you feel a pulse superior to the testes, do you have a direct or indirect hernia? Why?
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Indirect. the hernia is in the superficial ring
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What is the most accurate way to distinguish a direct vs. indirect hernia?
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During surgery
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What are the 3 major branches of the abdominal aorta supplying the abdominal viscera?
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Celiac Trunk, Superior mesenteric artery, Inferior mesenteric artery
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At which vertebral level can we find the rectosigmoidal junction (End of colon)?
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S3
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During development, what characteristic of the growing colon causes herniation and the folding?
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It is growing way faster than the body cavity
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The gastrocolic ligament is between what 2 structures?
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Transverse colon and Greater Omentum
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The esophageal hiatus of the diaphragm is formed by what?
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Right Crus
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The esophagus terminates at the cardiac orifice at which vertebral level?
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T11
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GERD
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Gastric Reflux Disease, incompetent esophageal valve = acid in the esophagus = eroded lining
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Barrett's Esophagus
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metaplasia change when too much acid is in the esophagus. strat. squamous becomes columnar with goblet cells
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Esophageal Verices
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Portal hypertension forces anastomoses with esophageal veins. Weakened vessels can hemmorrage.
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Achalasia
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esophageal sphincter is inactive. fluids help patients swallow, ultimately cut open esophagus, have gastric reflux as side effect
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Hepatoduodenal Ligament contains what 3 important vessels?
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portal triad- hepatic proper artery, hepatic portal vein, bile duct
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Which artery lies right over the duodenum?
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Superior mesenteric artery
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What organ lies anterior to the hilum of the right kidney?
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Duodenum
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The duodenum cradles what organ?
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Head of pancreas
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Gallstones have trouble crossing what?
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Bile duct, ampulla of Vater
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What directly causes jaundice?
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Bile retention
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Why does pancreatic cancer cause jaundice?
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If pancreatic head grows, it can compress bile duct. bile is stored
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What are some common causes of jaundice?
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Pancreatic cancer, large gallstone, hepatitis c
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What is scleral icterus
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whites of the eyes turn yellow due to bile build up
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Damage to ribs 9-11 puts what organ at risk for damage?
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Spleen
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Why does portal vein obstruction cause the spleen to swell?
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splenic vein is also storing fluid. the splenic vein drains directly into the portal vein
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If a spleen is swelling, where will be able to palpate it?
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Midaxillary line and anterior mid axillary line
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Why are the liver and spleen so well vascularized?
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All gastrointestinal blood must pass through them to be filtered.
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The posterior liver articulates with what structure?
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Diaphragm
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What structure lies posterior to the superior pole of kidney?
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Diaphragm and costodiaphragmatic recess
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Ligamentum teres is a remnant of what embryological structure?
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Left Umbilical vein
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What is the coronary ligament?
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Ligament that suspends the liver from the diaphragm
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The fetal ductus venosus served what purpose?
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Bypass the liver. Maternal blood entered from umbilical vein, didn't need to be filtered by fetal liver.
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Gallbladder function
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stores bile
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Gallstones can cause pain where?
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Epigastric/right upper quadrant, or shoulder pain if hitting diaphragm
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What do Brown pigment gall stones indicate?
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Bacterial cholangitis
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Fun Fact: Cholesterol gall stones are much more likely in women
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sucks for girls
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3 branches of celiac trunk
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Left gastric, common hepatic, splenic arteries
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Left gastroepiploic artery anastomoses with what artery along the greater stomach curvature?
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right gastroepiploic artery from gastroduodenal artery
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Right gastric artery branches from what artery?
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Common hepatic - celiac trunk
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Where does the celic trunk come off the aorta?
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T12/L1, just above superior mesenteric artery
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Where do the left and right gastric arteries anastomose?
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Lesser curvature of stomach
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What arteries provide anastomoses between the celiac trunk and superior mesenteric arteries?
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Pancreaticduodenal arteries
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Foregut is innervated by what nerves?
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T6-T9, Greater splanchnic nerve
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How do we differentiate the blood supply of the jejunum from the ileum?
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Jejunum has short arcades, long vasa recta. Ileum has elaborate arcades, short vasa recta
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7 parts of colon
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Cecum, ascending, transverse, descending, sigmoid, rectum, anal canal
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Midgut Innervation
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T8-T12
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Left colic artery comes from which artery?
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Inferior mesenteric artery
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What major artery provides anastomoses between Inferior and Superior mesenteric arteries?
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Marginal artery (from superior) to left colic artery (from inferior)
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What are the 4 anastomoses in the portal-caval system?
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Esophageal veins, paraumbilical veins, anal canal veins, retroperitoneal veins
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What is the recto anal watershed?
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Area of blood supply with lymph that follows inferior mesenteric artery
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Below the pectinate line, which lymph nodes collect lymph?
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superficial inguinal nodes
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Hindgut innervation
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T12-L2
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What are 3 possible reasons for jaundice?
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Alcoholism, Pancreatic cancer, hepatitis C
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Fun Fact: Abdominal viscera are not in the peritoneal cavity
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get your sexy on
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Epithelium of parietal and visceral peritoneum of abdomen?
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mesothelium
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Blood supply of visceral peritoneum of abdomen?
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Same as the organ it surrounds
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What is the name for the single entrance into the lesser sac of the abdomen?
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Epicloic foramen of winslow
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How does posterior wall stomach ulceration damage the abdominal cavity
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Stomach acid can erode organs if it leaves
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Clinical relevance of Epiploic Foramen of Winslow?
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Bowel can enter and become strangulated and ischemic
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Describe the outer layer of "peritoneal" organs?
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Layer of visceral peritoneum
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Describe the outer layer of "retroperitoneal" organs?
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covered by peritoneum only on anterior wall
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What is Ascites
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Abnormal levels of serous fluid in the peritoneal cavity. drain with paracentesis
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Why are some drugs given intraperitoneally?
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visceral peritoneum is thin and well vascularized = rapid delivery to circulation
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Parietal and Visceral peritoneum are derived from what layer?
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Lateral mesoderm
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Fun Fact: Mesentaries are formed by 2 layers of splanchnic mesoderm sandwiching the vessels and nerves.
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yea
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What remnant of ventral mesentary is seen in adults?
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Falciform ligament and lesser omentum
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Main remnant of dorsal mesentary seen in adults?
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Greater omentum, gastrocolic, gastrorenal, ileorenal ligaments
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Omental bursa is found between which organs?
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Stomach and pancreas
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