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91 Cards in this Set
- Front
- Back
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Superficial fascia
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1) Campers
2) Scarpa's - upper thigh (fascia lata), penis and scrotum (labia majora), perineum (colles fascia) |
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External oblique
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O: outer surface of lower 8 ribs
I: xiphoid, linea alba, pubic tubercle, pubic crest, half of iliac crest -forms inguinal ligament N: thoracoabdominal nerves A: compress & support viscera, flex and rotate trunk |
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Internal oblique
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O: thoracolumbar fascia, iliac crest, inguinal ligament
I: border 10-12th ribs, linea alba, pectin pubis N: thoracoabdominal nerves A: compress & support viscera |
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Rectus abdominus
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O: pubic symphysis and crest
I: xiphoid process, costal cartilage N: thoracoabdominal nerves A: flexes trunk & compress viscera |
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Transversus abdominus
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O: costal cartilage, thoracolumbar fascia, iliac crest, inguinal ligament
I: linea alba, pubic crest, pectin pubis N: thoracoabdominal nerves A: compress & support viscera |
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Arcuate line of Douglas
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lower border of rectus sheath,
inferior epigastric A & V (branches of external iliac A) anastomose with superior epigastric vessels (branches of internal thoracic A & V) |
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Thoracoabdominal N
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T7 to T11
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Subcostal N
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T12
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Iliohypogastric N
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L1
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Ilioinguinal N
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L1
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Contents of Inguinal Canal
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Males: 3 Fascia, 3 Arteries, 3 Nerves, 3 Other Structures
Females: round ligament of uterus |
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Inguinal Hernia
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Indirect - hernial sac LATERAL to inferior epigastric A, through deep ring
Direct - medial to inferior epigastric A |
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Dartos muscle
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Enclosed w/i superficial fascia of testis
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Tunica vaginalis
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parietal + visceral separated by serous fluid
tunica vaginalis fused with tunica albuginea |
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Hydrocele
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accumulation of serous fluid between parietal and visceral layer
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Inguinal Hernia
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intestinal loops may herniate into scrotal sac
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Peritoneal Cavity
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greater + lesser sac
communicate via winslow |
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Retroperitoneal structures
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partially covered by peritoneum - kidneys, ascending colon, descending colon, pancreas, duodenum
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Omentum
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double layered extension or fold that passes from stomach to organs in abdomen
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greater omentum
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hangs like apron from greater curvature of stomach to transverse colon
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lesser omentum
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lesser curvature of stomach and proximal part of duodenum to liver
(two ligaments - hepatogastric + hepatoduodenal) |
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Falsiform ligament
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connects liver to abdominal wall
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Ligamentum teres hepatis
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remnant of left umbilical vein
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Hepatogastric ligament
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connects stomach to liver
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Hepatoduodenal
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connects liver to first part of duodenum
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Mesentery
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provides means for neurovascular communication between organ + body wall
i.e. MESOCOLON of large intestine |
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Stomach
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cardia - fundus - body - pyloric (antrum + canal + sphincter - to duodenum)
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Small Intestine
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Duodenum
D1 - superior - intraperitoneal D2 - descending - retroperitoneal D3 - transverse - retroperitoneal D4 - ascending - retroperitoneal Jejunum Ileum |
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Large Intestine
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Cecum, appendix, (ascending + transverse + descending + sigmoid) colon, rectum and anal canal
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Haustra
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Sacculations of colon between Teniae (large intestine)
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Epiploic appendages
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small fatty aggregations on large intestine
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McBurneys point
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one third way down oblique line (right ASIS and umbilicus), location of base of appendix
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Liver
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falciform ligament, subphrenic spaces, hepatorenal pouch/morrison pouch, costodiaphragmatic recess/morrison pouch
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Liver biopsy
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between 9th and 10th rib
liver enlarged and palpable |
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Porta hepatis
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gateway to the liver (portal vein, hepatic artery, right & left hepatic ducts, hepatic autonomic nerves, lymphatics)
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Infection of liver
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rupture into diaphragm/chest cavity
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Blood vessels of liver do not significantly communicate with each other
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Particular segment can be removed from liver wo much bleeding
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Gall bladder pain
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fundus right 9th costal cartilage at lateral border of rectus abdominus
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Cholecystitis
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Inflammation of gallbladder - most often cholesterol stones
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Jaundice
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Bile duct obstruction
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Ampulla of Vater
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common bile duct + pancreatic duct
thickening --> sphincter of oddi |
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Peptic Ulcers
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common in lesser curvature/first part of duodenum
brunt of gastric contents hit gastric canal/first part of duodenum |
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Congenital Pyloric Stenosis
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abnormal thickening in newborn causes projectile vomiting
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Celiac Trunk
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from Abdominal aorta, T12 vertebra
3 branches - left gastric, splenic, common hepatic |
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Left gastric (branch of celiac trunk)
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passes between lesser omentum
supplies lesser curvature of stomach + esophagous |
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Splenic artery (branch of celiac trunk)
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passes behind stomach
supplies hilum of spleen + fundus of stomach (branches) + greater curvature of stomach (left gastro-omental) |
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Common hepatic artery (branch of celiac trunk)
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becomes hepatic artery proper
supplies liver right hepatic - cystic artery right gastric (lesser curvature) + gastroduodenal (pancreas/duodenum and greater curvature) from common hepatic |
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Spleen
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largest hematopoetic organ
separated from stomach by greater sac/gastrosplenic ligament separated from left kidney by splenorenal/lienorenal ligament |
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Stab wounds near 9th, 10th, 11th ribs
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rupture spleen, bleed into abdomen and injure lung and pleura
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Hilum of spleen
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splenic artery + vein + autonomic nerves + lymphatics
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Pancreas
-exocrine -endocrine |
exo: digestive juices to duodenum
endo: insulin and glucagon from islets of langerhans |
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Pancreatitis
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blockage in pancreatic duct (maybe from bile stones)
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Annular pancreas
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ventral bud of pancreas surrounds & constricts duodenum - obstructive jaundice
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What separates supracolic and infracolic regoin?
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Transverse colon!
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How do supracolic and infracolic regoins communicate?
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Paracolic gutters!
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Small intestine
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Jujunem + ileum + cecum
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Suspensory ligament of Trietz
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supports duodeno-jejunal flexure/dj flexure
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Jejunum & Ileum
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Jejunum 2/5 length of small intestine
both anchored to posterior abdominal wall by mesentery |
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Blood supply of the duodenum
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Proximal - gastroduodenal + superior pancreatico-duodenal arteries
Distal: pancreaticoduodenal |
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SMA
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-midgut
-jejunum, ileum, caecum, appendix, ascending colon, 2/3 transverse colon |
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Branches of SMA
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right colic
middle colic ileocolic inf pancreaticoduodenal artery jujunal and ileal branches |
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IMA
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-hindgut
-1/3 transverse colon, descending, sigmoid colon, rectum, 2/3 anal canal |
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Branches of IMA
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left colic
sigmoidal superior rectal artery |
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Marginal Arteries of Drummond
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Anasomosis of colic branches of SMA and left colic and sigmoidal branches of IMA
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Porto-systemic anastomoses
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Inferior esophagus
Anal canal Paraumbilical regoin Retroperitoneal |
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Taenia coli
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smooth muscle fibers
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Haustra
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pouches in colon between taenia
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Epiploic appendages
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small fatty projections of fat on surface of colon
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caliber
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diameter larger than small intestine
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Caecum
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freely mobile, no mesentery
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McBurneys Point
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1/3 way up right ASIS to umbilicus
usually RETROCAECAL/RETROCOLIC |
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Appendix
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appendicular artery
from ileocolic artery from SMA |
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Celiac plexus
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Greater, lesser splanchnic
Right, left vagus FOREGUT - liver, gall bladder, bile duct system, stomach, 1st and 2nd part of duodenum, pancreas, spleen |
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Superior Mesenteric Plexus
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Celiac plexus, greater, lesser, least splanchnic
Right, left vagus MIDGUT - duodenum, pancreas, jejunum, appenxix, ascending colon, transverse colon |
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Inferior Mesenteric Plexus
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Lesser, least, lumbar splanchnic
S2,3,4 HINDGUT - 1/3 transverse colon, descending colon, sigmoid colon, rectum, proximal 2/3 anal canal, urinary bladder, urethra, prostate, uterus, vagina |
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Referred pain
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Liver/gall bladder - right shoulder
Appendix - umbilicus Kidney/ureter - groin/genetalia |
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Innervation of Stomach
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Greater splanchnic from celiac
-constrict pyloric sphincter, relaxes stomach muscles Left and right vagus -relaxes pyloric sphincter, contracts muscle wall, increase secretions of glands (PEPTIC ULCERS IF TOO MUCH) |
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Innervation of Liver & Biliary Tract
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Greater splanchnic
Anterior and Posterior Vagal Trunks (Liver)/Vagus nerve (Gall bladder) |
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Innervation of Duodenum & Pancreas
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Greater and Lesser Splanchnic
Anterior and Posterior Vagal |
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Innervation of Kidney, Suprarenal, Gonads
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Lesser, least, lumbar splanchnic
Greater splanchnic Paraaortic |
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Lumbar plexus
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Anterior primary rami of L1-L4 nerves
GRAY COMMUNICANS sympathetic |
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Nutcracker syndrome
(hematuria, proteinuria, flank pain, testicular pain, nausea and vomiting) |
Left renal vein longer than right
Can compress abdominal aorta OR SMA |
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Renal Angle
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Erector spinae and 12th rib
Biopsy, lithotripsy, nephrectomy |
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Renal Hilum
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VADA (vein, anterior branch of artery, duct of ureter, posterior branch of artery)
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Stone Obstruction
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Junction w renal pelvis
Crossing pelvic brim Crossing bladder wall |
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Water under the bridge
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Ureter passing underneath uterine artery
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Lumbar triangle of Petit
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iliac crease, external oblique abdominus, latissimus dorsi - site of potential herniation (due to weakness)
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Gluteus maximus
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inferior gluteal nerve
inferior gluteal artery |
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Lithotomy
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Medical examination or childbirth
back, knees bent, legs wide apart stirrups support feet |
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Episiotomy
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Surgical incision of perineum and lower vaginal wall
Mediolateral incisions so as not to damage perineal body |
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Superficial fascia of urogenital triangle
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fatty layer - campers fascia (ishiorectal + superficial fascia of thigh)
scrotum - smooth muscle - dartos (reacts to temperature changes) Membranous layer - scarpas fascia - becomes colles fascia in perineum - continues over penis/clitoris |
