Anatomy Test 4 (Final)

Front 1

4 Features of the ilium

Back 1

-ASIS
-Iliac crest (L4)
-Iliac tubercle (L5)
-PSIS (S2)

Front 2

5 features of the pubis

Back 2

-body & sup/inf pubic rami
-pubic symphysis
-pubic tubercle
-pubic crest
-pectineal line

Front 3

superior boundries of the abdominal wall

Back 3

Xiphisternal junction (T9) & costal margin

Front 4

9 regions of exterior abdomen
&
reference planes delineating regions

Back 4

-left & right hypochondriac regions
-left and right lateral regions
-left & right inguinal regions
-epigastric
-umbilical
-hypogastric

vertical lines are midclavicular

horizontal lines
-subcostal plane passes through inferior border of costal cartilage 10
-transtubercular plane passes through the iliac tubercles at L5

Front 5

7 fascial layers in abdominal wall from superficial to deep

Back 5

-skin
-superficial fascia (2 layers)
a. Camper's fascia
b. Scarpa's fascia (inf to umb)
-Deep fascia
-transversalis fascia
-Extraperitoneal fat
-parietal pertoneum

Front 6

pyramidalis muscle

Back 6

small triangular musle that lies inferior to rectus abdominus
-spans from linea alba to pubs

Front 7

5 muscles of anterior abdominal wall

Back 7

-external oblique
-internal oblique
-transversus abdominus
-rectus abdominus
-pyramidalis

Front 8

2 ligament specializations of the external oblique

Back 8

Inguinal ligament
-from ASIS to pubic tubercle

Lacunar ligament
-extension of inguinal ligament at its medial border that reflects posteriorly (connects inguinal ligament to pectineal ligament)

Front 9

arcuate line

Back 9

-midway between umbilicus and pubic symphasis

rectus sheath above line
-anterior layer is made up of aponeurosis of external oblique mm & anterior lamina of aponeurosis of internal oblique mm
-posterior layer is made up of posterior lamina of aponeurosis of internal oblique mm & aponeurosis of transveralis fascia

rectus sheath below the line
-anterior layer made up of aponeurosis of all 3 abdominal muscles
-posterior layer made up of only transversalis fascia

Front 10

4 arteries of anterior abdominal wall

Back 10

Posterior intercostal arteries (10-11) & subcostal artery (12)
-descend along abdominal wall between transversus abdominis and internal oblique

Superior epigastric arteries
-branches of internal thoracic arteries
-located within rectus sheath posterior to rectus abdominis

Inferior epigastric arteries
-branches of ext. iliac aa
-anastomose with sup epigastric arteries

Superficial epigastric
-branches of femoral artery
-located in sup. fascia

Front 11

2 regions of lymphatic drainage of abdominal wall

Back 11

Axillary lymph nodes
-recieve lymph from vessels level of umbilicus (L4)

Superficial inguinal lymph nodes
-recieve lymph from vessels below umbilicus (L40

Front 12

boundaries of inguinal canal

Back 12

anterior wall
-aponeurosis of the external oblique mm

posterior wall
-transversalis fascia

roof
-fibers of internal oblique & transversus abdominis muscles

Floor
-inguinal ligament

Front 13

scrotal ligament

Back 13

-remnant of the gubernaculum

-anchors testes to skin of scrotum

Front 14

adult derivitives of the gubernaculum in females

Back 14

round ligament of the uterus
-between uterus & labia majora

Ovarian ligament
-between ovary & uterus

Front 15

inguinal canal contents

Back 15

spermatic cord/round ligament of uterus

ilioinguinal nerve

genital branch of genitofemoral nerve

Front 16

2 layers of scrotum

Back 16

skin

Dartos fascia
-smooth mm contracts to wrinkle skin in response to cold

Front 17

female homologous structure to mail scrotum

Back 17

labia majora
-outgrowth of anterior abdominal wall
-full of fat & smooth mm

Front 18

3 contents of scrotum

Back 18

spermatic cord
-begins at deep inguinal ring & ends at posterior border of testes

testes

Epididymis
-highly coiled tube connecting testes to ductus deferens

Front 19

3 fascial coverings of spermatic cord

Back 19

external spermatic fascia
-derived from external oblique apneurosis

cremastoric fascia (muscle)
-derived from internal oblique muscle (sk mm)

Internal spermatic fascia
-derived from transversalis fascia

Front 20

tunica vaginalis

Back 20

closed peritoneal sac full of serous fluid. surrounding the testes

Front 21

tunica albuginea

Back 21

white tough fibrous covering of testes

Front 22

path of sperm within the testes

Back 22

-seminiferous tubules
-rete testes
-efferent ductules
-epididymis for storage

Front 23

3 parts of the epididymis

Back 23

head
-attached to testes

body
-long part

tail
-continuous with ductus deferens

Front 24

cryptorchidism (clinical note)

Back 24

1 or both of testes have not completely descended

Front 25

hydrocele (clinical note)

Back 25

patency of processus vaginalis can result in an accumulation of excess serous fluid

-can be transiluminated

-can be localized to scrotum or confined to spermatic cord

Front 26

Hematocele (clinical note)

Back 26

blood within tunica vaginalis

-doens't transilluminate

Front 27

canal lf nuck cysts (clinical concern)

Back 27

persistant processus vaginalis in female can result in patent inguinal canal
-cysts can develop in canal
-can produce bulge in labium majora

Front 28

torsion of spermatic cord (clinical concern)

Back 28

-twisting of spermatic cord can lead to necrosis of testes if untreated due to compressed vessels

-usually occurs in adolescence

Front 29

cancer of testes/ scrotum / uterus (clinical concern)

Back 29

testes
-metastasizes to lumbar lymph nodes

scrotum
-metastasizes to superficial inguinal lymph nodes

Uterus
-can metastasize to either

Front 30

cremasteric reflex (clinical concern)

Back 30

-stimulation of interior thigh can raise testes
-can test L1-L2 spinal cord segments
-reflex is very active in young, hyperactivity can stimulate undescended testes

Front 31

Inguinal triangle

Back 31

area of weakness & common site for direct inguinal hernia

borders
-inferior epigastric artery/vein
-lateral border of rectus sheath
-inguinal ligament

Front 32

2 types of inguinal hernias

Back 32

indirect (congenital)
-most common 75%
-herniates through inguinal canal into scrotum
-mass will have all 3 coverings of spermatic cord

direct (acquired)
-passes through inguinal triangle
-enters inguinal canal through posterior wall
-does not typically enter scrotum
-lies parallel to spermatic cord not inside it

Front 33

4 structures associated with the parietal peritoneum and the anterior abdominal wall

Back 33

Lateral umbilical folds
-formed by peritneum covering inferior epigastric vessels

medial umbilical folds
-covering umbilical ligaments

Median umbilical fold
-covering median umbilical ligament

Round ligament of the liver (ligamentum teres)
-covering remnant of umbilical vein

Front 34

7 specific messenteries

Back 34

Mesentery proper
-small intestine

Root of the mesentery
-attaches messentery proper to posterior wall

Transverse mesocolon
-mesentery of transverse colon

Mesoappendix

Sigmoid mesocolon

Lesser omenta

Greater omenta

Front 35

peritoneal ligament of liver

Back 35

falciform ligament
-contains teres hepatis
-to ant abdominal wall

Front 36

2 ligaments of the lesser omentum

Back 36

gastro hepatic ligament

Hepatoduodenal ligament
-conducts portal triad

Front 37

4 ligaments of greater omentum

Back 37

gastrophrenic ligament

gastrosplenic ligament

gastrocolic ligament
-stomach to transverse colon

splenorenal ligament

Front 38

supracolic compartment portion of the greater sac contains all or part of the...

Back 38

stomach

spleen

liver

Front 39

infracolic compartment portion of the greater sac contains all or part of the ...

Back 39

ascending & descending colon

small intestine

Front 40

4 abdominal recesses

Back 40

hepatorenal recess
-between lobe of liver & right kidney

subphrenic recess
-between liver & diaphragm

left & right paracolic sulci (gutters)
-ascening & descending colon imprints

Front 41

spaces where peritoneal fluid can accumulate in pelvic portion of abdominal cavity

Back 41

males
-rectovesical pouch

females
-vesicouterine pouch & rectouterine pouch

Front 42

inflammatory exudate (clinical concern)

Back 42

can flow along paracolic gutters spreading infection or cancer etc

Front 43

ascites (clinical concern)

Back 43

excess fluid that builds up in perioneal cavity

-usually in response to infection

Front 44

Foregut
derivatives:
blood supply:
reffered pain:
lymphatics:

Back 44

derivatives: esophagus, stomah, proximal duodenum, liver & part of pancreas

blood supply: celiac trunk

reffered pain: epigastric region

lymphatics: celiac nodes

Front 45

midgut
derivatives:
blood supply:
reffered pain:
lymphatics:

Back 45

derivatives: part of pancreas, distal duodenum, jejunum, ileum, cecum, appendix, ascending colon, proximal 2/3 of transverse colon

blood supply: SMA

reffered pain: umbilical region

lymphatics: superior mesenteric nodes

Front 46

hindgut
derivatives:
blood supply:
reffered pain:
lymphatics:

Back 46

derivatives: distal 1/3 of transverse colon, descending colon, sigmoid colon, rectum, upper portion of anal canal

blood supply: IMA

reffered pain: hypogastric region

lymphatics: inferior mesenteric nodes

Front 47

hiatal hernias

Back 47

sliding hiatal hernia
-esophagus slides through hiatus so that esophagial junction is above the hiatus

paraesophageal hernia
-fundus of stomach herniates through hiatus side by side with esophagus

Front 48

3 parts of gall bladder

Back 48

fundus

body

neck

Front 49

hepatopancreatic ampulla of vader

Back 49

formed by the union of the pancreatic duct and the common bile duct. The ampulla is specifically located at the major duodenal papilla.

Front 50

sphincter of oddi

Back 50

collection of sphincters at ampulla of vater

Front 51

Triangle of calot

Back 51

contains cystic artery

boundaries
-common hepatic duct
-cystic duct
-liver

Front 52

biliary ducts

Back 52

sphincter of oddi is fed by
-common bile duct
-pancreatic bile duct

common bile duct is fed by
-cystic duct
-common hepatic duct

-common hepatic duct is fed by
-right & left hepatic ducts

Front 53

4 anatomical portions of the pancreas

Back 53

head
-lies in c shaped curve of duodenum

neck
-lies posterior to pylorus of stomach

body
-lies anterior to aorta

tail
-close to spleen

Front 54

3 branches of celiac trunk

Back 54

Left gastric artery
-supplies lesser curvature of stomach & esophagus

common hepatic artery
(-branches)
-gastroduodenal artery (*branches)
*right gastro-omental artery
*ant/post superior pancreatic duodenal arteries
-Proper hepatic artery (*branches)
*right gastric
*right/left hepatic arteris
*cystic artery

Splenic artery (-branches)
-left gastro-omental artery
-short gastric arteries
-pancreatic branches

Front 55

2 systems of venous drainage of the abdomen

Back 55

Caval (IVC)

Portal (liver)
-70%

Front 56

4 portal caval anastomoses

Back 56

esophageal varices
-esophageal veins drain into either left gastric vein (portal) or azyogs vein (caval)

Rectal varices or hemorrhoids
-sup rectal vein (portal)
-inf/middle rectal veins (caval)

Caput medusae
-paraumbilical veins anastomose with portal veins & epigastric veins (caval)

Hidden varices
-colic veins (portal) anastomose with retroperitoneal veins (caval)

Front 57

Hepatic portal vein collects blood from (4 veins)

Back 57

right/left gastric veins

splenic vein

superior mesenteric vein

Front 58

Celiac lymph nodes
(9) from:
to:

Back 58

from:
-R/L gastro-omental nodes
-R/L gastric nodes
-Splenic nodes
-Pyloric nodes
-Pancreatico splenic nodes
-hepatic nodes

To:
-cysternal chyli which then goes to the thoracic duct

Front 59

4 parts of duodenum

Back 59

Superior part (L1)
-mostly intraperitoneal

Descending part (L1-3)
-2ndrly retroperitoneal
-ampulla of vater

Horizontal Part (L3)
-2ndrly retroperitoneal

Ascending part (L3-2)
-2ndrly retroperitoneal
-suspensory muscle of duodenum (ligament of trietz) sk mm band coming from diaphragm

Front 60

Jejunum vs ileum
length:
location:
vascular supply:

Back 60

Jejunum
length:2/5 of total jejunal length
location: left upper quadrant
vascular supply:1-2 rows of arcades with long vasa recta

Ileum
length: 3/5 jejunoileal length
location: lower right quadrant
vascular supply: multiple rows of arcades with short vasa recta

Front 61

ileal diverticulum

Back 61

remnant of vitiline duct (connection between yolk sac and developing duct)

-may involve ileal cyst, ligament, or fistula

-can be infected and mistaken for appendicitus

Front 62

referred pain of duodenum

Back 62

midgut

Front 63

length of jejunoileal intestine and legth of colon

Back 63

jejunoileal is 6-7 m long

colon is 1.5 m long

Front 64

cecum

Back 64

round pouch like proximal end of colon
-ileocecal valve
-appendix

Front 65

teniae coli

Back 65

bands of smooth mm that course along length of colon

Front 66

epiploic appendices

Back 66

small fatty projections of omentum

Front 67

haustra

Back 67

sacculations of colon defined by semilunar folds

Front 68

vertebral level of superior colon

Back 68

S3

Front 69

Superior messenteric artery

Back 69

Inferior pancreaticoduodenal arteries

jejunal & ileal arteries
-15-20 branches from left side of SMA
-Anastomosing arcades with short vasa recta

Colic arteries (contribute to marginal artery)
-ileocolic artery (most inferior branch)
-right colic artery
-middle colic artery

Front 70

Inferior messenteric artery

Back 70

Level L3

Left colic artery

sigmoid arteries

superior rectal artery

Front 71

Greater splanchnic nerve
from:
to:

Back 71

arises from T5-9
-preganglionic sympathetic fibers
goes to celiac ganglia

Front 72

lesser splanchnic nerve
from:
to:

Back 72

from:
-T10-11

To:
- aorticorenal & superior messenteric ganglia

preganglionic sympathetic fibers

Front 73

least splanchnic nerve
from:
to:

Back 73

From:
-T12

To:
-renal & aorticorenal ganglia in renal plexus

preganglionic sympathetic fibers

Front 74

Lumbar splanchnic nerves
from:
to:

Back 74

from:
-L1-2

To:
-inferior mesenteric ganglion and superior hypogastric plexus

preganglionic sympathetic fibers

Front 75

Celiac Ganglia
from:
to:

Back 75

from:
-sympathetic gagnlia at base of celiac trunk

To:
-along periarterial plexuses of celiac branches to foregut target organs

postganglionic sympathetic fibers

Front 76

Superior mesenteric ganglia
from:
to:

Back 76

from:
-sympathetic ganglia at bases of SMA

to:
-along periarterial plexuses of SMA to target mid gut organs

postganglionic sympathetic fibers

Front 77

Inferior mesenteric ganglia
from:
to:

Back 77

from:
-sympathetic ganglia at bases of IMA

to:
course along periarterial plexuses of IMA to midgut target organs

Postganglionic sympathetic nerve fibers

Front 78

Vagus Nerve (CNX)
from: brain
to:

Back 78

carries preganglionic parasympathetic fibers to foregut & midgut viscera

Front 79

Pelvic splanchnic nerves
from:
to:

Back 79

from:
-S2-4

To:
-hindgut viscera

preganglionic parasympathetic fibers