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165 Cards in this Set
- Front
- Back
- 3rd side (hint)
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The costal margin extends from the xiphoid process to the ____ rib.
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10th
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D7 p1
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Where is the linea alba?
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Extends from the xiphoid proccess to the pubic crest and passes through the umbilicus.
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D7 p1
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What is the "six-pack"
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tendinous intersections of the rectus abdominis muscle
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D7 p1
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Where is the semi-lunar line?
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from the tip of the 9th rib at the costal margein to the pubic tubercle.
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D7 p1
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When dividing the surface of the abdomen into 9 regions, what are the 2 vertical lines called?
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Right and left midinguinal lines
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D7 p2
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When dividing the surface of the abdomen into 9 regions, what are the 2 horizontal lines called?
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subcostal (or transpyloric) and transtubercular
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D7 p2
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What do you call the upper right 1/9th of the abd?
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R hypochondriac
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D7 p2
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What do you call the upper middle 1/9th of the abd?
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epigastric
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D7 p2
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What do you call the upper left 1/9th of the abd?
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L hypochondriac
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D7 p2
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What do you call the middle right 1/9th of the abd?
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R lumbar (flank)
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D7 p2
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What do you call the middle middle 1/9th of the abd?
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umbilical
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D7 p2
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What do you cal the middle left 1/9th of the abd?
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L lumbar (flank)
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D7 p2
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What do you call the lower right 1/9th of the abd?
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R inguinal (iliac)
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D7 p2
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What do you call the lower middle 1/9th of the abd?
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hypogastric
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D7 p2
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What do you call the lower left 1/9th of the abd?
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L inguinal (iliac)
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D7 p2
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The inginal ligament spans which two bony landmarks?
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The ASIS and pubic tubercle
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D7 p3
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The numerous superficial veins within the superfascial fascial layer of the abdomen have connections with _______ veins which course internally from the _______ to the _________
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paraumbilical; umbilicus; liver
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D7 p3
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What must anterior cutanaeous branches pierce to get to the superficial facia of the abdomen?
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the rectus sheath
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D7 p3
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What is the fatty layer of superficial fascia in the abd called?
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Camper's fascia
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D7 p3
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What is the membranous layer of superficial fascia in the abd called?
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Scarpa's fascia
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D7 p3
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If the male urethra ruptures, where can urine and blood accumulate?
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Deep to Scarp's fascia
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D7 p4
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Which spinal nerves supply the anterior and lateral cutaneous nerves which supply the skin of the abd wall?
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thoracic spinal nerves T-7 to T-11 and the iliohypogastric nerve
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D7 p4
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What are the branches from T-7 to T-11 collectively referred to as?
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Thoracoabdominal nerves
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D7 p4
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What is the dermatome at the level of the level of the xiphisternal junction?
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T6
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D7 p4
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What is the dermatome at the level of the umbilicus?
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T10
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D7 p4
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What is the dermatome at the level of the pubic crest?
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L1
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D7 p4
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Which obliques are hands-in-pockets?
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External abdominal obliques
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D7 p4
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Which obliques are NOT hands-in-pockets?
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Internal abdominal obliques
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D7 p4
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What makes up the rectus sheath anterior to the rectus abdominus?
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External oblique aponeurosis, internal oblique aponeurosis, and transversus abdominis aponeurosis inferior to arcuate line
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D7 p4
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What makes up the rectus sheath deep to the rectus abdominus?
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Transversis abdominus aponeurosis superior to arcuate line
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D7 p4
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What is the ultimate attachment of the EAO and IAO aponeuroses?
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linea alba
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D7 p5
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Where do the thoracoabdominal nerves course obliquely?
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Between the transversus abdominus and internal abdominal oblique
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D7 p5
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What binds the rectus muscle to its anterior sheath?
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Tendinous intersections
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D7 p5
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Where does the superior epigastric artery arise?
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Thoracic aorta->brachiocephalic trunk->subclavian artery->internal thoracic artery
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SGp10
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Where does the inferior epigastric artery arise?
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Abdominal aorta->common iliac artery->external iliac artery->inferior epigastric artery?
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SGp14
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What tissues does a paramedian incision cut through?
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Paramedian incision (vertical incision to the left or right of the linea alba) cuts through
skin->superficial fascia->anterior rectus sheath (rectus abdominis muscle reflected)->posterior retus sheath->parietal peritoneum->peritoneal cavity |
D7 p7
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What incision is commonly used for an appendectomy and why?
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Muscle-splitting incision: splitting each muscle in a direction that parallels its muscle fascicles has the advantage of not cutting muscle fibers, thus leading to better healing and a stronger abdominal wall.
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D7 p7
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What layers of tissue does a suprapubic incision cut through?
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horizontal incision made at pubic hairline incises skin->both layers of superficial fascia->linea alba->anterior rectus sheaths. Then rectus muscles are retracted laterally
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D7 p7
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Why might one use a subcostal incision?
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Usually used to remove a gallbladder or spleen.
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D7 p7
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Where do you make a subcostal incision and why this location specifically?
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Incision parallels the costal margin about 2.5 cm inferior to the costal margin to avoid the upper thoracoabdominal nerves.
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D7 p7
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What surgical incision is increasingly utilized due to the greatly reduced time required for healing and risks of contamination?
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Endoscopic incisions
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D7 p7
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What two muscles are involved in rotating and bending when you touch your right hand to your left foot?
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Left IAO and right EAO
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D7 p9
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The anterior scrotal or labial nerve is a continuation of what nerve?
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The ilioinguinal nerve becomes the anterior scrotal or labial nerve when it exits the superficial ring.
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D8 p12
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Near the superficial ring, the inguinal ligament folds under the spermatic cord such that the cord rests on the portion of the inguinal ligament. What is this portion called?
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lacunar ligament
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D8 p12
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What nerve courses on the surface of the IAO witin the inguinal canal?
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ilioinguinal nerve
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D8 p12
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What does the ilioinguinal nerve innervate?
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scrotum/labia, upper medial thigh
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D8 p12
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The cremaster muscle exteds from which abdominal muscle?
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The lowermost fibers of the internal abdominal oblique.
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D8 p13
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What muscle covers the spermartic cord/round ligament of the uterus?
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Cremaster muscle
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D8 p13
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When upper medial skin of the thigh is lightly stroked in a male, what happens? What part of the physical exam is this?
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testis on that side is elevated via contraction of the cremaster muscle. This tests the cremasteric reflex.
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D8 p13
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Why do we learn about the conjoined tendon?
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The size of the weak area is inversely proportional to the size of the conjoined tendon. In other words, a larger conjoined tendon protects against direct inguinal hernia.
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D8 p14
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What abdominal muscles contribute aponeuroti fibers to the conjoined tendon (falx inguinalis)?
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IAO and TA
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D8 p13
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What makes up the floor of the "weak area"?
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Transversalis fascia
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D8 p14
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What two layers occupy the plane between the parietal peritoneum and transversus abdominis or retus sheath?
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1) extraperitoneal fat/connective tissue
2) transversalis fascia |
D8 p14
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Which is closest to the peritoneum, extraperitoneal fat/connective tissue or transversalis fascia?
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extraperitoneal fat/connective tissue
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D8 p14
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What artery branches into the inferior epigastric artery then becomes the femoral artery?
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The external iliac artery.
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D8 p15
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Which ring is lateral to the inferior epigastric artery?
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Deep inguinal ring
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D8 p15
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Which artery and vein pass through the deep inguinal ring?
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Testicular artery and vein.
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D8 p15
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At what level does the testicular artery arise?
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L2
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D8 p15
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Why are there no ovarian vessels traversing the deep inguinal ring in females?
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I don't know, email me if you do.
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D8 p15
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What nerve is parallel and just lateral to the external iliac artery?
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Genitofemoral nerve.
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D8 p15
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What does the genital nerve innervate in males?
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cremaster and skin of scrotum
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D8 p15
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What does the genital nerve innervate in females?
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mons pubis and labia
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D8 p15
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What does the femoral nerve innervate?
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Skin of upper medial thigh.
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D8 p15
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What two ligaments is the lacunar ligament continuous with?
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Inguinal ligament and pectineal (Cooper's) ligament
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D8 p15
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What is the clinical significance of the pectineal ligament?
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It can be used as an anchor for sutures during surgical reinforcement of the inguinal region floowing certain types of hernias.
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D8 p15
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What borders the inguinal (Hesselbach's) triangle?
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inferior epigastric artery, lateral border of the rectus abdominus, and inguinal ligament
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D8 p15
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What is contained in the femoral canal?
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Naught but a few lymph nodes.
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D8 p16
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What borders the femoral ring?
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Lacunar ligament, inguinal ligament, pectineal ligament, external iliac vein.
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D8 p16
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How do you differentiate between a direct and indirect inguinal hernia?
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The site through which they begin to protrude.
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D8 p16
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Where does an indirect inguinal hernia begin its protrusion?
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deep inguinal ring just lateral to the inferior epigastric artery.
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D8 p16
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Where does a direct inguinal hernia begin its protrusion?
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the "weak area" just lateral to the conjoined tendon and medial to the inferior epigastric artery.
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D8 p16
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What attaches the inferior pole of the testis to the base of the scrotum?
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scrotal ligament
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D8 p17
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The scrotal ligament represents the remains of the what embryonic structure in the male?
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gubernaculum
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D8 p17
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What are the constituents of the spermatic cord?
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ductus (vas) deferens
testicular artery pampiniform plexus of veins remnant of processus vaginalis lymphatics autonomic nerves |
D8 p17
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What is the serous sac associated with the testis called and what is it derived from embryonically?
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tunica vaginalis; processus vaginalis
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D8 p17
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What do you call a pathologic increase in serous fluid within the tunica vaginalis surrounding the testes, typically caused by injury or inflammation of the epididymis?
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hydrocele
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D8 p17
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What do you call the smooth muscle fibers located in the superficial fascia of the scrotum?
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dartos muscle
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D8 p17
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What kind of nerve component innervates the dartos muscle?
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symp/post
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D8 p17
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What does the ejaculate of a man who has had a vasectomy contain?
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Seminal and prostatic fluids (no sperm).
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D8 p17
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What is the comma-shaped structure on top of the testis?
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epididymis
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D8 p17
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What is another name for the transpyloric plane?
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subcostal plane
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D7
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At what level does the transpyloric plane intersect the vertebrae?
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L-1
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D9 p20
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What abdominal structures are related to the transpyloric plane?
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fundus of gallbladder, neck of pancreas, origin of superior mesenteric artery, duodenojejunal junction, hila of kidneys.
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D9 p20
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How does one approximate the transpyloric plane?
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Half-way between the jugular notch and pubic symphisis
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D9 p20
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What's another name for hip bones?
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os coxae, coxal bones
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D9 p20
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Name the three components of the bony pelvis from anterior to posterior.
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Pubis, ischium, ilium
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D9 p20
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Do you see the iliac fossa when the skeleton is supine or prone?
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Supine
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D9 p20
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Which is more superior: wing of the ilium or body of the ilium
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wing of the ilium
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D9 p20
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What are the anterior and posterior boundaries of the pelvic inlet?
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anteriorly by pubi crest and posteriorly by the sacral promontory.
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D9 p20
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What separates the false pelvis from the true pelvis?
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pelvic inlet (superior pelvic aperture or pelvic brim)
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D9 p20
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What do you call the lower circumference of the lesser pelvis?
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pelvic outlet (inferior pelvic aperture)
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D9 p20
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Where is McBurney's point?
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2/3 up from ASIS to umbilicus
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D9 p20
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What is the thin, sheet-like serous membrane structure that spans from umbilicus to liver?
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Falciform ligament
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D9 p20
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What is the thickened, cord-like connective tissue within the serous layers of the falciform that also attaches the umbilicus to the liver?
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Ligamentum teres
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D9 p20
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What two structures does the greater omentum hang inferiorly from?
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greater curvature of the stomach and transverse colon
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D9 p20
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Why might adhesions be present from the greater omentum?
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During healing process following incision, greater omentum may migrate to incision site to provide blood supply to aid healing, and greater omentum remains attached to incision site as adhesion.
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D9 p20
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What ligament runs from celiac trunk to duodenojejunal junction? (2 names)
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suspensory ligament of the duodenum; ligament of Treitz
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Which parts of the colon are retroperitoneal?
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ascending colon, descending coln
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Which parts of the colon have a mesentary?
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transverse mesocolon, signmoid colon
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What are 3 distinguishing surface features (other than size) seen on large intestine and not on small intestine?
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1) presence of fatty appendages
2) taenia coli 3) haustra |
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What is the most common part of the colon to find diverticula?
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sigmoid colon
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What is another name for the right colic flexure?
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hepatic flexure
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What is another name for the left colic flexure?
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splenic flexure
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What ligament is associated with the epiploic foramen?
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hepatoduodenal ligament
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This opening is the only communication between the greater sac and the lesser sac.
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What is the significance of the epiploic foramen?
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Is the spleen intra- or retro-peritoneal?
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intraperitoneal
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Is the pancreas intra- or retro-peritoneal?
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retroperitoneal
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What is the relationship between the SMA and SMV?
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SMA lies to the left of the SMV
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What are the components of the superior mesenteric plexus?
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symp/post, para/pre, viscerosensory
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Which arteries course within THE mesentary?
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intestinal arteries (supply jejunum and ileum)
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What other names do we give archades and vasa recta?
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vascular arches and straight arteries
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What key branches of the SMA do we know? (superior to inferior)
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middle colic artery, right colic arter, iliocolic artery
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What do we call the bloodless planes located posterior to those organs that became secondarily retroperitoneal during development?
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Fusion fascia
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What gross structure gives jejunum more surface area than ileum in the same length of intestine?
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plicae circulares
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What key branhes of the IMA do we know?
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left colic artery, superior rectal artery, sigmoid arteries
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What is unique about the relationship between IMA and IMV?
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IMV lies to the left of the IMA
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What vein does the IMV terminate in?
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splenic vein
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What are the 3 components of the portal triad?
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common bile duct, proper hepatic artery, and portal vein
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What are the tributaries leading to the common bile duct?
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Cystic duct and common hepatic duct
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What are the 3 branches of the proper hepatic artery?
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Cystic artery, right hepatic artery, left hepatic artery
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Which branch of the common hepatic artery passes vertically posterior to the pylorus of the stomach?
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Gastroduodenal artery
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What branches off the common hepatic artery after the gastroduodenal before it becomes the proper hepatic artery?
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Right gastric artery
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What arteries supply the lesser curvature of the stomach?
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right and left gastric arteries
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What arteries supply the greater curvature of the stomach?
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right and left gastroepiploic arteries
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What is the left gastric artery a branch off of?
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The celiac trunk.
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Where do you find the cystic artery?
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In the cystic triangle (triangle of Calot) formed by the cystic duct, the common hepatic duct, and the surface of the liver in 90% of cases
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Where does the left gastric vein terminate?
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Portal vein
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What are the 2 terminal branches of the gastroduodenal artery (they can be seen just inferior to the pylorus of the stomach)?
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right gastroepiploic artery and pancreaticoduodenal artery
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The area of vascular anastomosis supplying the pancreas and duodenum come from what 2 branches (this area of anastomosis represents the area of transition from the embryonic foregut to the embryonic midgut).
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celiac artery and SMA
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What branch of the splenic artery supplies the fundus of the stomach after coursing through the gastrosplenic ligament?
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short gastric arteries
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What are rugae?
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gastric folds
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Are there circular folds lining the first part of the duodenum?
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no
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What kind of peritoneum covers the anterior surface of the pancreas?
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parietal peritoneum (hey this has pain viscerosensory components=pancreatitis HURTS)
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What artery courses through the splenorenal ligament?
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splenic artery
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which is more superior: the head or the tail of the pancreas?
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the tail is more superior than the head.
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The splenic vein, inferior mesentaric vein, and superior mesentaric vein are all tributaries of what?
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portal vein
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What surface anatomy landmarks does the diagonal limit of the liver connect?
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6th rib left midclavicular to 10th rib right midaxillary
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What is the classic description of the location of the fundus of the gall bladder?
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intersection of the right semilunar line and right costal margin near the tip of the 9th costal cartilage
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What rib does the long axis of the spleen parallel?
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10th
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What is the anterior limit of the location of the spleen?
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axillary line
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What artery courses within the transverse mesocolon?
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middle colic artery
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What "divides" the gastrosplenic ligament from the splenorenal ligament?
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The hilus of the spleen.
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What artery courses through the gastrocolic ligament?
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gastroepiploic arteries
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The hepatogastric and hepatoduodenal ligaments are two parts of what?
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lesser omentum
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What part of the duodenum is horizontally positioned in line with the pylorus, is intraperitoneal, and usually stained green by the gallbladder?
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1st part
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What part of the duodenum descends vertically, is retroperitoneal, receives bile and pancreatic ducts, and is anterior to the hilus of the right kidney?
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2nd part
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What part of the duodenum crosses horizontally from right to left between the superior meseneric vessels anteriorly and the aorta and inferior vena cava posteriorly?
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3rd part
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Which part of the duodenum ascends to become intraperitoneal by entering the mesentary to become the jejunum?
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4th part
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What marks the ommon opening of the common bile duct and the pancreatic duct in the second part of the duodenum?
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the major duoenal papilla
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Near what should we find the main pancreatic duct: the head or tail of the pancreas?
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head
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What is the name of the channel formed by the confluence of the bile and pancreatic ducts?
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hepatopancreatic ampulla
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What controls the flow and backflow of digestive secretions into the duodenum?
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the sphincter of the ampulla
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Is the falciform ligament derived from the ventral or dorsal mesentery of the embryo?
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ventral (according to google)
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What ganglia are involved in referred gallbladder pain?
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C3 and C4 dorsal root ganglion house sensory fibers from the shoulder area and the diaphragm (part next to the gallbladder)
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The coronary ligament is continuos with the left or right triangular ligament?
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right
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The gallbladder separates the ___ lobe from the __ lobe.
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Right, quadrate
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The inferior vena cava separates the ___ lobe from the ___ lobe
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Right, caudate
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The falciform ligament separates the ___ from the ___ lobe.
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Left, quadrate
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The lesser omentum separates the ___ lobe from the ___ lobe.
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Left caudate
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Functionally, the quadrate and caudate lobes are part of the ___ lobe.
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Left
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Where does the aorta bifurcate?
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L4
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The left gonadal vein is a tributary of what?
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left renal vein
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what is the embryonic origin of medullary cells of the suprarenal glands?
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neural crest cells
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Are the sympathetic nerves serving the suprarenal medulla pre or post?
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pre
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The greater thoracic splanchnic nerve pierces the right crus of the diaphragm and makes a 90 degree turn toward what?
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celiac trunk
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