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66 Cards in this Set
- Front
- Back
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What makes up the abdomen
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-Part of the trunk, surrounded by abdominal walls
-Contains abdominal cavity-separated from thoracic cavity by respiratory diaphragm; and from pelvic cavity by an imaginary plane, the plane of the pelvic inlet |
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What does the superior boundary of the abdomen consist of
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diaphragm
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What does the inferior boundary of the abdomen consist of
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plane of pelvic inlet (pelvic brim) extends from superior border of pubic symphysis to sacral promontory)
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What does the anterior boundary of the abdomen consist of
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anterior abdominal wall
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What does the lateral boundary of the abdomen consist of
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lateral abdominal walls
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What does the posterior boundary of the abdomen consist of
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posterior abdominal wall
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What are the superior border's bony landmarks
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1. xiphoid process
2. costal margin |
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What are the inferior border's BONY landmarks
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1. iliac crests
2. ant. sup. iliac spine (ASIS) 3. pubic symphysis 4. pubic crests 5. pubic tubercle 6. pecten pubis (pectineal line) 7. arcuate line of ilium 8. Iliopectineal line: pecten pubis + arcuate line 9. linea terminalis: pubic symphysis to arcuate line 10. ala of sacrum 11. sacral promontory |
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What are the major SURFACE landmarks for the superior border
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1. xiphoid process
2. costal margin |
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What are the major SURFACE landmarks for the inferior border
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1. iliac crests - LV4
2. ant. superior iliac spines (ASIS) 3. inguinal fold/groove (inguinal lig.) 4. pubic crests 5. pubic tubercle 6. pubic symphysis |
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What are the major SURFACE landmarks for the lateral border
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ant. axillary folds (ant. axillary lines)
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What are other major SURFACE landmarks
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1. umbilicus
2. linea semilunaris-lateral border of rectus abdominis m. 3. linea alba- fibrous band extending from xiphoid process to pubic symphysis 4. tendinous intersections 5. rectus abdominis m. |
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What is the abdominal horizontal place
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Transumbilical plane: : umbilicus; IV disc between LV3-LV4
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What is the abdominal vertical plane
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Median plane: indicates the position of the linea alba
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What do the horizontal planes of the abdominal regions consist of
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1. Subcostal plane:
10th costal cartilages, body of LV3 2. Transtubercular plane iliac tubercles, body of LV5 |
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What do the vertical planes of the abdominal regions consist of
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Midclavicular planes-
L and R; midpoint of clavicle to midinguinal point |
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What are the abdominal regions (9 of them)
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1. right hypochondriac
2. left hypochondriac 3. epigastric 4. right lumbar (lateral) 5. left lumbar (lateral) 6. umbilical 7. right inguinal (or iliac) 8. left inguinal (or iliac) 9. hypogastric (or pubic) |
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What is the transpyloric plane
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imaginary plane running through the tips of 9th costal cartilages and body of LV1
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What structures are found in the transpyloric plane
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1. pylorus of stomach
2. duodenojejunal junction 3. origin of superior mesenteric artery 4. hila of the kidneys 5. neck and body of pancreas 6. 9th costal cartilages 7. body of lumbar vertebra 1 |
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What are the components of the lateral anterior abdominal wall (10 of them)
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1. Skin
2. Camper’s fascia 3. Scarpa’s fascia 4. Deep fascia 5. External abd. oblique m** 6. Internal abd. oblique m.** 7. Transversus abd. m.** 8. Transversalis fascia 9. Extraperitoneal fatty layer 10. Parietal peritoneum **differ in medial ant. ab. wall |
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What are the components of the medial anterior abdominal wall (10 of them)
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1. Skin
2. Camper’s fascia 3. Scarpa’s fascia 4. Deep fascia 5. Anterior rectus sheath** 6. Rectus abdominis m.** 7. Posterior rectus sheath** 8. Transversalis fascia 9. Extraperitoneal fatty layer 10. Parietal peritoneum **differ from lateral ant. ab. wall |
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What does the superficial fascia of the anterior abdominal wall consist of
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-subcutaneous tissue; hypodermis
-has superficial bv & cutaneous nn -extends into the perineum as Colle’s fascia (superficial perineal fascia) |
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What does the deep fascia of the ant. abdominal wall consist of
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adherent to underlying muscles
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What are Camper's and Scarp's fascia
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superficial fascia in ant. abdominal wall
1.Camper's fascia- superficial fatty layer 2.Scarpa's fascia- deep membranous layer; inserts on fascia lata of the thigh |
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What is the extravasation of urine from a ruptured urethra
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-Potential space between Scarpa’s fascia and the deep fascia.
-Extravasated urine from a ruptured urethra may travel between the superficial and deep fasciae in the anterior abdominal wall and perineum, but does not extend into the thigh! |
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What are the muscles of the anterior abdominal wall
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A.External oblique m.
-runs inferomedially (down and in) B.Internal oblique m. -runs superoanteriorly (up and in) C.Transversus abdominis m. -runs horizontally D.Rectus abdominis m. -runs vertically within rectus sheath E.Pyramidalis m. -in 80% of people; tenses linea alba |
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What are the parts of the external oblique muscle
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1. ext. oblique aponeurosis
2. anterior rectus sheath 3. linea alba 4. inguinal ligament 5. lacunar ligament 6. ext. spermatic fascia 7. lumbar triangle of petit |
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What is the inguinal ligament
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inferior border of external oblique aponeurosis; attaches to ASIS and pubic tubercle
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What is the lacunar ligament
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extension of medial fibers of inguinal ligament that attach to pecten pubis
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What is the ext. spermatic fascia
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outer covering of spermatic cord
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What is the lumbar triangle of petit
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lateral border of the triangle; a possible site of herniation.
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What is pectineal (Cooper's) ligament
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fibers from lacunar ligament along the pecten pubis; lateral extension of lacunar ligament
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What are the parts of the internal oblique muscle
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1.Int. oblique aponeurosis
2.Ant./post. rectus sheath 3.Linea alba 4.Conjoint tendon (falx inguinalis) 5.Cremaster muscle |
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What is the Conjoint tendon (falx inguinalis)
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common tendon of internal oblique and transverse abdominis muscles inserted on pecten pubis
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What is the Cremaster muscle supplied by
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supplied by genital branch of genitofemoral nerve (L1-L2)
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What are the parts of the Transversus Abdominis
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1.Transversus abdominis aponeurosis
2. Ant./post. rectus sheath 3.Linea alba 4.Conjoint tendon (falx inguinalis) *does not contribute to covering of the spermatic cord* |
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What are the derivatives of flat muscles for the external oblique muscle
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1. Inguinal ligament
2. Lacunar ligament 3. Anterior rectus sheath 4. Linea alba 5. External spermatic fascia |
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What are the derivatives of flat muscles for the internal oblique muscle
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1.Conjoint tendon (falx inguinalis)
2.Anterior/posterior rectus sheath 3. Linea alba 4. Cremaster muscle |
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What are the derivatives of flat muscles for the transversus abdominis muscle
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1.Conjoint tendon (falx inguinalis)
2.Anterior/posterior rectus sheath 3.Linea alba |
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What do the rectus abdominis and pyramidalis consist of
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1. Tendinous intersections (tendinous inscriptions)
2. Linea semilunaris - lateral border |
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What does the rectus sheath formation ABOVE the costal margin consist of
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ant: ext. oblique
post: absent (lie on costal cartilages) |
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What does the rectus sheath formation BETWEEN the costal margin and arcuate line consist of
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ant: ext. and int. obliques
post: int. oblique and transversus abdominis |
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What does the rectus sheath formation BETWEEN the arcuate line and pubic crest consist of
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ant: ext., int., obliques and transversus abdominis
post: absent (lie on transversalis fascia) |
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What are the contents of the rectus sheath
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A. rectus abdominis m. & pyramidalis m.
B. superior and inferior epigastric vessels C. lymphatic vessels D. terminal parts of ventral primary rami of T7-T12 |
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What is the transversalis fascia
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1. Continuous layer of fascia lining the abdominal cavity deep to the transversus abdominis muscle.
2. Directly in contact with the rectus abdominis below the arcuate line |
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What are the derivatives of the transversalis fascia
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1. deep inguinal ring
2. internal spermatic fascia |
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What are the different abdominal surgical incisions
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Median/midline - explore
Left paramedian - explore Gridiron - appendix Transverse - appendix Pfannenstiel- uterus Subcostal- gall bladder |
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How are abdominal surgical incisions made
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Tiny incisions allow less morbidity. The peritoneal cavity is inflated using carbon dioxide and an endoscope with camera is inserted.
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What are the superficial abdominal arteries
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A. Superficial epigastric aa.
B. Superficial circumflex aa. C. Superficial ext. pudendal aa. |
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What are the deep abdominal arteries
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A. brs. of post. intercostal aa.
B. brs. of subcostal aa. C. lumbar aa. from abd. aorta D. deep circumflex iliac aa. - ext. iliac a. E. inf. epigastric aa. F. sup. epigastric aa. A-D: are in the fascial plane between the int. abd. oblique and transverse abd. E-F: are in the rectus sheath |
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What are the superficial abdominal veins
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1. lateral thoracic vv.
2. superficial circumflex iliac vv. 3. superficial epigastic vv. 4. superficial ext. pudendal vv. 5. thoracoepigastric vv. |
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What is the thoracoepigastric vein
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connects lateral thoracic and superficial epigastric vv.;
-enlarged upon compression of IVC cava (i.e., pregnancy) |
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What is the paraumbilical vein
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drains into the portal vein; may shunt portal blood into the superficial veins around umbilicus (caput medusae) in portal HPN.
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How do the deep abdominal veins drain
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- accompany the arteries
- venae comitantes - named according to arteries they accompany |
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What do the ventral rami of T7-T12 consist of
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-Thoracoabdominal nn.
-T10 supplies skin and tissues at the level of the umbilicus -T12 (subcostal n.) |
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What do the ventral rami of L1 consist of
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1. iliohypogastric n.
2. ilioinguinal n. - sensory component of cremaster reflex; motor served by genital branch of genitofemoral n. (L1-L2); elicited by stroking medial aspect of thigh (groin) |
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What are the GSA functional components of the abdominal nerve supply
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GSA - skin/superficial fascia > anterior/lateral cutaneous branches of intercostal nerves, dorsal root, DRG, dorsal root > spinal cord
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What are the GSE functional components of the abdominal nerve supply
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ventral horn, ventral root, spinal nerve ventral ramus, intercostal nerves (T7-L1) > muscles
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What are the GVE functional components of the abdominal nerve supply
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IMLCC, ventral root, spinal nerve, ventral ramus, white ramus > paravertebral sympathetic ganglia, gray ramus intercostal nerves T7-L1 > smooth muscle of blood vessels and glands of abdominal wall
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What does the lymphatic drainage of superficial tissues (skin and fascia) consist of
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1. above the umbilicus
- axillary lymph nodes 2. below the umbilicus - superficial inguinal nodes; drain to the iliac nodes |
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What does the lymphatic drainage of deep tissues (muscles) consist of
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eventually drain to para-aortic nodes:
1. lumbar nodes 2. common iliac nodes 3. external iliac nodes |
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What does the normal folding of the abdominal ventral wall consist of (embryo)
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There initially are right and left intraembryonic cavities, one on each side of the midline; however, when the flat embryo folds cephalocaudally and laterally to form the rounded human body, the right and left intraembryonic cavities (Fig. B) merge into a single intraembryonic cavity extending from the thoracic region to pelvic region
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How does a defect in the ventral wall occur during the embryonic stage
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-In the future mid-abdominal region, a temporary defect in the body wall (primitive umbilical ring) is caused by the vitelline duct and the connecting stalk; the vitelline duct connects the midgut with the yolk stalk; above and below these connections at the future umbilicus, the body wall completely encloses the intraembryonic cavity
-May be due to a failure of body folding or to failure of fusion of lateral body wall folds in the anterior midline |
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What is an umbilical hernia (defect of ventral body wall)
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-10-20% of all infants; more common in African Americans
-protrusion of peritoneum or abdominal organ(s) around the navel (belly-button) -midgut protrudes thru the defect when crying, straining, or coughing -not covered with amnion -small hernias usually close spontaneously without treatment by age 1 or 2 -usually painless |
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What is an omphalocele (defect of ventral body wall)
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-1:5000 to 1:10000
-due to failure of the midgut to return to the body cavity following physiological herniation; viscera protruding through umbilicus are covered by amnion in the proximal part of umbilical cord -high α-fetoprotein levels present. |
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What is a gastroschisis (defect of ventral body wall)
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-incomplete closure of lateral folds allows gut to protrude into amniotic cavity.
-loops of bowel herniate through a weakness in the body wall lateral to the umbilicus; not covered by amnion -high α-fetoprotein levels present in maternal serum and amniotic fluid |
