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134 Cards in this Set
- Front
- Back
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What are the abdominal cavity Boundaries?
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Abdominal walls, Diaphragm and Pelvis
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Name the Nine Regions of the Abdomen.
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Rt Hypochondriac; Epigastric; Lt Hypochondriac; Rt Lateral (Lumbar); Umbilical; Lt Lateral (Lumbar); Rt Inguinal; Pubic (Hypogastric); Lt Inguinal
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Name the Planes that divide the abdomen into 9 regions. (vertically and horizontally)
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Vertically: Midclavicular plane (goes to midinguinal point)
Horizontally: Subcostal Plane(2nd lumbar vertebra) and Transtubercular Plane (Tubercles of L5) |
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Name the Planes that divide the abdomen into 4 quadrants. (vertical and horizontal)
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Vertical: Median Plane
Horizontal: Transumbilical (L3-L4) |
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What are the contents of the Right Upper Quadrant?
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RUQ: Rt lobe of the liver, gall bladder, superior part of the ascending colon, Head of Pancrease, pyloric of the stomach, right kidney, right superrenal gland
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What is contained in the Right Lower Quadrant?
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Right ovary, Cecum, Ileum, Appendix, Right Uriter, Inferior part of hte Ascending colon
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What is contained in the Left Upper Quadrant?
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Left lobe of the liver, Spleen, Stomach, Left kidney, Body/Tail of Pancrease, Left colic flexure, Left superrenal gland
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What is contained in the Left Lower Quadrant?
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Sigmoid colon, Left ovary, Left Uriter, Inferior part of the descending colon, Left Uterine tube
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Layers in the Abdomen (10)
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Skin
Superficial Fascia Deep Fascia External Oblique Muscle Internal Oblique Muscle Transversus Abdominus Muscle Fascia Transversalis Extra Peritoneal Fat Peritoneum Organs |
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External Oblique Muscle
Origin, Insterion, Innervation and Function |
Origin: 5th - 12th ribs
Insertion: Linea alba, anterior 1/2 of iliac crest Innervation: T7 - T11 and subcostal nerve Function:Compress the abdomen and give the vertibral column lateral bend. |
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Internal Oblique Muscle Origin, Insertion, Innervation, Function
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Origin: Thoracolumbar Fascia, Anterior 2/3 iliac crest, Lateral 1/2 of inguinal lig.
Insertion: Inferior border of ribs 10-12, linea alba, pubis Innervation: Thoacoabdominal rami of inferior 6 thoracis nerves (T8-T11), Ln1 Function:Assist external oblique |
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Transverse Abdominal Muscle
Origin, Insertion, Innervation, Function |
Origin: Internal surface of costal cartilages 7-12, thoracolumbar fascia, iliac crest and lateral 1/3 of inguinal ligament
Insertion: Linea alba, aponeurosis of internal oblique, pubic crest and pectin via conjoined tendon Innervation: Thoracoabdominal anterior rami of inferior six thoracic nerves, Ln1 Function: Compress the abdomen |
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Rectus Abdominis Muscle
Origin, Insertion, innervation, Function |
Origin: Pubic symphysis and pubic crest
Insertion: Xiphoid process and Costal cartilage 5-7 Innrvation: Thoracoabdominal nerves and anterior rami of inferior thoracic nerves Function:Compress abdomen, aid in defication, urination and respiration |
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What forms the conjoined tendon?
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The conjoined tendon is formed by the aponeurosis of the internal oblique and transverse abdominal as they insert on the pubic symphysis
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What is the Rectus Sheath? (in terms of relationships)
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It is the relationship of the aponeurosis of the external oblique, internal oblique, and transverse abdominis to the rectus abdomins as they insert into the linea alba
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Nerves of the Anterolateral Abdominal Wall (3)
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Thoracoabdominal Nerves Tn7-Tn11
Subcostal Nerve Tn12 Iliohypogastric and ilioinguinal nerves (L1) |
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Vessels of Anterolateral Abdominal Wall (3)
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Superior epigastric vessels
Inferior epigastric and deep circumflex iliac vessels Posterior intercostal vessels |
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What are the 5 folds on the Posterior surface of the Anterior Abdominal Wall? (and what do they contain)
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(1) Median Umbilical Fold: contains remnants of the urachus "fetal bladder'
(2) Medial Umbilical Folds: Contrains obliterated umbilical artery (2) Lateral Umbilical Folds: Contains inferior epigastric arteries |
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Inguinal Triangle
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Rectus
Inferior epigastric vessels Pectinial Ligament |
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What are the Contents of the Inguinal Canal?
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Spermatic Cord (males)
Round Ligament (females) Ilioinguinal nerve |
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Inguinal Canal (defined)
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An oblique passage 3-5cm long between deep and superficial inguinal rings
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Inguinal Calan Relationships (anterior, medially, posterior, Above, Below)
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Anterior: wall formed laterally by the internal oblique muscle
Medially: external oblique aponeurosis Posterior: fascia transversalis and transverses abdominus aponeurosis Above: Internal oblique and transverses abdominus Floor: Inguinal and Lacunar Ligaments |
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What is the Deep Inguinal Ring and where is it located
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It is an opening in the fascia transversalis
Located above the inguinal ligament midway between the ASIS and the pubic symphysis The spermatic cord is also formed at this level |
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What is the Superficial Inguinal Ring and where is it located?
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It is a triangular opening in the external oblique aponeurosis where the spermatic cord leaves the inguinal canal
Located 1cm above and lateral to the pubic tubercle |
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Mechanics of the Inguinal Canal (5)
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a)Weak structure
b)Has adaptations to make it stronger c)Anterior wall reinforced by conjoined tendon behind the superficial ring d)Coughing and straining, ect, muscle contract and canal closes e)Defecation- sqatting postion, abdominal wall is protected by thigh |
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Name the different types of hernias
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Iguinal (indirect and direct)
Femoral Umbilical |
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Indirect Inguinal Hernia
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Most frequent of all hernias
More frequent in men than women Occurs by forced opening of passage, or patent opening Located lateral to the inferior epigastric artery(lateral inguinal fossa) Can extend al lthe way to the scrotum |
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Direct Inguinal Hernia
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Occur in Inguinal Triangle (Hesselbach triangle)
Doesn't descend into scrotum Know boundaries lateral, medial and inferior |
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Femoral Hernia
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Inferior to inginal ligament
Lateral to indirect inguinal hernia More common in female than male |
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Umbilical Hernia
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Failure of midgut to return to the abdomen early in fetal life
Weak area in women due to pregnancy, obesity, ect. |
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Where does the spermatic cord begin and end?
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It begins at the deep inguinal ring and ends in the scrotum at the posterior border of the testis
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Stuctures of the Spermatic Cord
(know what each is) |
Vans Deferens
Testicular Artery and Vein Lymph Vessels Autonomic Sympathetic Nerves Remnant of processus vaginalis Cremasteric artery Genitofemoral nerve (genital branch) Artery to vans deferens from inferior vesical artery |
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Testicular Veins begin on testis as "pampiniform plexus"
Where to these drain? |
Right drains into IVC at L1
Left drains into left renal vein at L1 |
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Spermatic Cord Coverings (3)
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Internal Spermatic Fascia
Cremasteric Fascia External Oblique Fascia |
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Where does the inguinal nerve pass through, exit and supply?
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It passes through the inguinal canal and exits the superficial linguinal ring to supply the skin of the penis, groin, anterior part of the scrotum or labia majora, and root of the clitoris
(note that this is a content of the inguinal canal NOT the spermatic cord) |
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What is the Scrotal Blood Supply? (3)
And what muscle causes it to wrinkle? |
Posterior scrotal branches of the perineal artery
Anterior scrotal branches of the deep external pudendal artery Cremasteric artery (from inferior epigastric) (The Dartos muscle and fascia cause scrotum to wrinkle) |
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Nerve supply of the Scrotum
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Genital branch of the genitofemoral nerve (L1-L2)
Anterior Scrotal nerves (L1) Posterior Scrotal nerves (S2-S4) Perineal branches of the posterior femoral cutaneous nerve (S2,S3) |
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Function of the Epididymis and what it consists of?
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Stores sperm and allows them to mature
Consists of Head, Body and Tail (tail transports sperm to ejaculatory duct) |
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intraperitoneal organs
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spleen
stomach sm intestines |
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retroperitoneal organs
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kidneys
supra renal glands peritoneum in anterior part |
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true or false
the peritoneal cavity contains organs? |
false
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functions of the peritoneum
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reduces friction btw organs
stores fat (protection) helps with infections |
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what layers will you have to go througth when performing a paracenthesis abdominis
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skin-camper's fascia-scarpa's fascia-external oblique-internal oblique-transversus abdominis-transversalis fascia-fat-parietal peritoneum
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T/F
This procedure (paracentesis) is done from a median (always safe) plane or lateral |
true
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peritoneum nerve supply
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Subdiaphragmatic part by the phrenic nerve C3-C5
Thoracoabominal Segmental Subcostal T12 Lumbosacral plexus |
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T/F
the peritoneum is sensitivy to pain? |
false
sensitive to stretch no pain |
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peritoneal formation
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mesentery
folds ligaments omentum recesses |
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mesentery
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continuation of visceral and parietal peritoneum
connects the intestines to the body wall is a neuroascular communication btw the organs and body wall |
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stomach relation to other organs
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Anterior – diaphragm, left lobe of the liver & anterior abdominal wall
Posterior – omental bursa, pancreas Stomach bed – SUPINE POSITION – left dome of the diaphragm, spleen, left kidney, suprarenal gland, splenic artery, pancreas, trasverse mesocolon and colon. |
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greater omentum
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Hangs like an apron from the stomach over the transverse colon.
It is mobile Helps to isolate infectionis invested in affected organ when it is infected to protect the body from infection and inflammation |
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lesser omentum
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Lies between the liver, stomach and duodenum. The lesser omentum forms the anterior boundary of the lesser sac.
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hepato duodenum ligament
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the thick and free end of lesser omentum has the portal triad, portal vein, bile duct and hepatic artery
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hepato gastric ligament
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more membranous than hepato duodenal ligament
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falciform ligament
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attaches the liver to the anterior abdominal wall
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gastrophrenic ligament
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attaches the stomach to the diaphragm
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gastrosplenic ligament
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attaches the stomach to the spleen
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gastrocolic ligament
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greater curvature of stomach descends w visceral peritoneoum of transverse colon
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the 3 gastro ligaments contribute to form?
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greater omentum
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peritoneal folds
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Rectouterine pouch peritoneum passing btw rectum and uterus
Uterovesical pouch from bladder to uterus Rectovesical pouch males only (covers the sup part of the rectum |
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dividions of the peritoneal cavity
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greater and lesser sac
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greater sac is divided into
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supracolic compartment
infracolic compartment |
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what is the function of the epiploic or omental foramen
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allows communication btw lesser and greater omentum
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boundaries of the epiploic foramen
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anterior portal triad
superior liver inferior first part of the duodenum posterior IVC and parietal peritoneum |
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supracolic compartments clinical importance
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help to isolate infections
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supracolic compartments
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RT/LT Subphrenic Space
RT/LT Subhepatic space |
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infracolic compartments
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RT/LT paracolic gutters
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infracolic compartments clonical importance
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helps to drain fluid
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esophagus
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cervical
thoracic abdominal |
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T/F
the esophagus passes through the esophageal hiatus at the level of T12 |
False
T10 |
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blood supply to the esophagus
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esophageal artery branch of the thoracic aorta
LT gastric artery a branch of the abdominal aorta and celiac trunk |
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the esophageal branch of the LT gastric vein drains into?
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portal system
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the esophageal vein drains into
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azygos system
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esophageal nerve supply
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vagus
greater splanchnic (T5-T9) |
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the stomach is divided into what 4 regions?
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cardia
fundus pylorus body |
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cardia
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cardial orifice
where esophagus enters the stomach |
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fundus
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LT 5th intercostal space and is related to the LT dome of the diaphragm
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body
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is btw the fundus and pyloric antrum
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pylorus is divided into
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antrum
canal opening sphincter |
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pyloric antrum
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widest part
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pyloric canal
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narrowest part
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pyloric opening
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btw first part of the duodenum and stomach allows passage btw stomach and duodenum
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pyloric sphincter
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formed by circular muscular layer helps to discharge contents form the stomach into dudodenum
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gastric ruggae
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around greater curvature of the stomach
forms during contraction |
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gastric canal
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around lesser curvature
forms during swallowing |
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What is the arterial supply to the stomach
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branches from the celiac trunk
gastric splenic common hepatic lt gastric RT gastric from the common hepatic RT epiploic from the common hepatic LT epiploic form the splenic short gastric also from the splenic |
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Veinous grainage of the stomach
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RT/LT gastric drain into the portal vein
short gastric veins drain into the splenic or one of its tributaries |
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gastric lyphatic vessels
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gastroomental
gastric lymph nodes pancreaticoodudodenal pancreaticosplenic pyloric lymph nodes |
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sympathetic nerve supply to the stomach
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greater splanchnic T5-T9
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parasypathetic nerve supply to the stomach
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Vagus
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What are the components of the small intestines
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duodenum
jejunum ileum |
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duodenum
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divided into 4 parts
superior descending horizontal or inferior ascending |
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superior part of the duodenum
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also called duodenal cap or ampulla
anterolateral to L1 liver and gallbladder anterior portal vein and bile duct are pposterior |
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descending part of the duodenum
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inferior along the side of L2/L3
lies parallel to IVC entrance of main pancreatic and bile duct anterior to renal vessels |
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horizontal or inferior part of the duodenum
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at the level L3
Anterior to Inferior Vena Cava, Aorta, Right ureter, Right Gonadal Artery Superior mesenteric artery and vein are anterior to the third part |
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ascending part of the duodenum
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begins at L3 and ends at L2
distal end covered with peritoneum contains the ligament of treitz |
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parasympathetic innervation to duodenum
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vagus
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sympathetic innervation to duodenum
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celiac plexus-->T5-T9
lesser splanchnic-->T10-T11 |
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blood supply to the duodenum
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gastroduodenal artery a branch of common hepatic
has 3 branches superior pancreaticoduodenal retroduodenal supraduodenal |
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plicae circularis
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anatomical landmark to differentiate btw ileum (not present) and jejunum
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jejunum and ileum
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both have mesentery that attaches them to the posterior abdominal wall
jejunum mesentery has more fat |
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parasympathetic supply to the ileum and jejunum
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Vagus
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Sympathetic supply to the ileum and jejunum
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superior mesenteric nerve plexus
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ileum and jejunum blood supply
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superior mesenteric jejunum and ilium branches
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jejunum and ileum venous drainage
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superior mesenteric vein
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large intestine
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cecum
colon rectum anal canal |
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taenia coli
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longitudinal bands of muscle fibers
NOT present in the appendix or rectum |
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haustra
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sacculations or pouches of the colon btw taenia
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omental appendixes
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small fatty appendixes of the colon
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cecum
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lies in the iliac fossa
enveloped by peritoneum NO mesentery |
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blood supply to the cecum
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anterior and posterior cecal arteries which are branches from ileocolic artery
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appendix
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lymphatic organ
messoappendix->attaches to the cecum and posterior part of the appendix Extends from the posteromedial aspect of the cecum inferior to the ileocecal junction |
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location of Mc Burney's point
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1 ½ - 2 inches along the oblique line joining the right anterior superior iliac spine to the umbilicus
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ascending colon
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RT side of the abdominal cavity
extends from the cecum to the liver where it forms the RT colic flexure covered by peritoneum on the anterior and on its side |
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transverse colon
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crosses the abdomen from the RT to LT colic flexure
attaches to the diaphragm through the phrenicocolic ligament |
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descending colon
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retroperitoneal
from the LT colic flexure to the LT iliac fossa where it is continuous with the sigmoid colon creates LT median and lateral paracolic gutters |
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sigmoid colon
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links the descending colon and the rectum
has sigmoid mesocolon-->long mesentery |
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rectum and anal canal
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continous with the sigmoid colon at S3
continuous with the anal canal |
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blood supply to the ascending and transverse up to the LT colic flexure
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Branches from the superior mesenteric
RT and middle colic artery |
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blood supply to the descending and sigmoid colon
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branches from the inferior mesenteric
Left colic artery Branches to descending colon Sigmoid artery |
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colon venous drainage
superior mesenteric |
lt and middle colic vein
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colon venous drainage
inferior mesenteric |
lt colic vein
sigmoid veins veins from the descending colon |
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inferior messentery vein
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Does NOT contribute to forming the splenic vein
drains blood from the descending and sigmoid colon |
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Portal Vein
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located behind the head of the pancreas
formed by the splenic vein superior mesentery vein drains into the liver |
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parasympathetic innervation to the colon
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vagus ends at LT colic flexure
Descending colon, sigmoid colon, rectum, anal canal, Pelvic Splanchnic S2, S3, S4 |
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sympathetic innervation to the colon
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Greater splanchnic – to celiac ganglion – T5–T9
Lower splanchnic – Superior mesenteric ganglion – T10 – T11 Lumbar splanchnic nerves – inferior mesenteric ganglion – L1 – L2 |
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the foregut
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forms the stomach and part of the duodenum
ends at 2nd part of the duodenum where the bile duct enters |
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foregut sympathetic suppy
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Splanchnic T5-T9
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foregut parasymp supply
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Vagus
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midgut
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begins at the 2nd part of the duodenum and ends at the LT colic flexure
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midgut sympathetic supply
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vagus (ends here)
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parasympathetic supply
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lesser splanchnic T10-T11
superior mesenteric ganglion from the 2nd part of the duodenum to lt colic flexure |
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hindgut
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from the lf colic flexure to the upper part of the rectum
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sympathetic supply to the hindgut
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lumbar splanchnic nerves L1,L2
supply descending, sigmoid colon and rectum |
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parasympathetic supply to the hindgut
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pelvic splanchnic nerves S2-S4
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