Tusom Anatomy Shelf: Abdomen 2012 (Alixdixon)

Front 1

External oblique

Back 1

I: Intercostal (T7-T11); subcostal
A: Compresses abdomen; flexes trunk; active in forced expiration

Front 2

Internal oblique

Back 2

I: Intercostal (T7-T11); subcostal; iliohypogastric and ilioinguinal (L1)
A: Compresses abdomen; depresses ribs

Front 3

Rectus abdominis

Back 3

I: Intercostal, subcostal
A: Depresses ribs; flexes trunk

Front 4

Cremaster

Back 4

I: Genitofemoral
A: Retracts testis

Front 5

Pyramidal

Back 5

I: Subcostal
A: Tenses linea alba

Front 6

Arcuate line

Back 6

A crescent-shaped line marking the inferior limit of the posterior layer of the rectus sheath just below the level of the iliac crest

Front 7

Hesselbach's Triangle

Back 7

Aka inguinal triangle. Bounded medially by linea semilunaris, laterally by the inferior epigastric vessels, and interiorly by the inguinal ligament. Area of potential weakness and hence is a common site of a direct inguinal hernia

Front 8

Superficial inguinal ring

Back 8

Triangular opening in the aponeurosis of the external oblique muscle that lies just lateral to the pubic tubercle.

Front 9

Deep inguinal ring

Back 9

Lies in the transversalis fascia, just lateral to the inferior epigastric vessels

Front 10

Contents of the spermatic cord

Back 10

ductus deferens; testicular, cremasteric and deferential arteries; pampiniform plexus of testicular veins; genital branch of genitofemoral and cremasteric nerves and the testicular sympatetic plexus; and lymph vessels.

Front 11

Dartos fascia

Back 11

A layer of smooth muscle fibers; when contracted, it wrinkles to regulate temperature. Innervated by genital branch of genitofemoral

Front 12

Median umbilical ligament or fold

Back 12

A fibrous cord that is a remnant of the obliterated urachus

Front 13

Cremasteric reflex

Back 13

Efferent limb is genital branch of the genitofemoral nerve; afferent limb is femoral branch of the genitofemoral nerve and also of the ilioinguinal nerve

Front 14

Lymphatics in region above umbilicus

Back 14

Drain into axillary lymph nodes

Front 15

Lymphatics in the region below the umbilicus

Back 15

Drain into the superficial inguinal nerves

Front 16

Superficial inguinal lymph nodes

Back 16

Receive lymph from the lower abdominal wall, buttocks, penis, scrotum, labium majus, and the lower parts of the vagina and anal canal. Their efferent vessels primarily enter the extenal iliac nodes and, ultimately, the lumbar nodes

Front 17

Lesser omentum

Back 17

Double layer of peritoneum extending from the porta hepatis of the liver to the lesser curvature of the stomach and beginning of duodenum. Consists of hepatogastric and hepatoduodenal ligaments. Has right free margin that contains proper hepatic artery, bile duct and portal vein

Front 18

Greater omentum

Back 18

Transmits right and left gastroepiploic vessels along greater curvature. Contains gastrosplenic, splenorenal, gastrophrenic and gastrocolic ligaments.

Front 19

Falciform ligament

Back 19

Sickle-shaped peritoneal fold connecting the liver to the diaphragm and the anterior abdominal wall. Contains the ligamentum teres hepatis and paraumbilical vein.

Front 20

Ligamentum teres hepatis

Back 20

Formed after birth from the remnant of the L umbilical vein.

Front 21

Ligamentum venosum

Back 21

Fibrous remnant of the ductus venosus. Lies in fissure on the inferior surface of the liver, forming the left boundary of the caudate lobe of the liver.

Front 22

Peritonitis

Back 22

Inflammation and infection of the peritoneum and commonly results from a burst appendix that leaks feces into the peritoneal cavity, from a penetrating wound to the abdomen, from a perforating ulcer that leaks stomach contents into peritoneal cavity, or from poor sterile technique during surgery

Front 23

Paracentesis location

Back 23

Midline at approximately 2 cm below the umbilicus or lateral to McBurney's point, avoiding inferior epigastric vessels.

Front 24

Epiploic or Omental Foramen

Back 24

Natural opening between the lesser and greater sacs. Bounded superiorly by peritoneum on the caudate lobe of the liver, inferiorly by peritoneum on the first part of the duodenum, anteriorly by the free edge of the lesser omentum, and posteriorly by peritoneum covering the IVC.

Front 25

GERD

Back 25

Digestive disorder caused by a lower esophageal sphincter dysfunction and hiatal hernia, causing reflux of stomach contents

Front 26

Hiatal or esophageal hernia

Back 26

Herniation of a part of the stomach through the esophageal hiatus of the diaphragm into the thoracic cavity. The hernia is caused by an abnormally large esophageal hiatus, by relaxed and weakened lower esophageal sphincter, or by an increased pressure in the abdomen.

Front 27

Peptic ulcer

Back 27

Erosion in the lining of the stomach or duodenum. Most commonly caused by an infection w/ H. pylori, but is also caused by stress, acid and pepsin. Occurs most often in pyloric region of stomach (gastric ulcer) or first part of duodenum (duodenal ulcer) and less frequently n distal esophagus

Front 28

Gastric ulcer

Back 28

May perforate into the lesser sac and erode the pancreas and splenic artery

Front 29

Duodenal ulcer

Back 29

May erode the pancreas of gastroduodenal artery, causing burning and cramping epigastric pain. 3x more common than gastric ulcers.

Front 30

Small bowel obstruction

Back 30

Caused by postop adhesions, tumors, Crohn's disease, hernias, peritonitis, gallstones, volvulus, congenital malrotation, stricture and intussusception. Strangulated obstructions are surgical emergencies. Sxs include colicky abdominal pain and cramping, NV, constipation, dizziness, abdominal distension and high-pitched bowel sounds

Front 31

Inflammatory bowel disease

Back 31

Involves small or large intestine or both and also includes Crohn's and ulceritive colitis as the best known forms.

Front 32

Crohn's disease

Back 32

An inflammatory bowel disease and usually occurs in the ileum, but it can affect any part of the digestive tract. Sxs include diarrhea, rectal bleeding, anemia, weight loss and fever

Front 33

Ulcerative colitis

Back 33

Involves colon and virtually always involves the rectum. It is characterized by a shallow inflammation of the large intestinal mucosa, mainly in the rectum, and pt's w/ prolonged ulcerative colitis are at increased risk for developing colon cancer.

Front 34

Jejunum vs ileum

Back 34

Jejunum is emptier, larger in diameter and thicker walled than ileum. Has circular folds and less prominent arterial arcades w/ longer vasa recta.
Ileum is longer than jejunum. It is characterized by presence of Peyer's patches, shorter circular folds and vasa recta, and more mesenteric fat and arterial arcades.

Front 35

Meckel's diverticulum

Back 35

Outpouching of the ileum, derived from an unobliterated yolk stalk and is located 2 ft proximal to ileocecal junction on antimesenteric side. Approx 2 inches long, occurs in approx 2% of population, may ontain 2 types of ectopic tissues (gastric and pancreatic), presents in first 2 decades of life and more often in first 2 years, and is found 2 times more freq in boys as in girls. Represents persistent portions of the embryonic yolk sac. Sxs frequently mimic appy

Front 36

Sigmoid volvulus

Back 36

A twisting of the sigmoid colon around its mesentery creating a colonic obstruction and may cause intestinal ischemia that may progress to infarction and necrosis, peritonitis and abdominal distension.

Front 37

Hirschsprung's

Back 37

Caused by absence of enteric ganglia in the lower part of the colon, which leads to dilation of the colon proximal to the inactive segment. Results from failure of NCC to form myenteric plexus.

Front 38

Appendicitis

Back 38

Sxs include rebound tenderness, periumbilical pain which may move to the R iliac fossa on McBurney's point, accompanied by loss of appetite, NVD, fever and constipation.

Front 39

Blood supply of quadrate lobe

Back 39

Receives blood fro the left hepatic artery and drains bile into the left hepatic duct

Front 40

Blood supply of caudate lobe

Back 40

Receives blood from the right and left hepatic arteries and drains bile into both right and left hepatic ducts.

Front 41

Sxs of liver cirrhosis

Back 41

Portal HTN, resulting in esophageal verices, hemorrhoids, caput medusa, spider angioma, ascites, peripheral edema, jaundice, hepatic encephalopathy, splenomegaly, hepatomegaly, palmar erythema, testicular atrophy, gynecomastia and pectoral alopecia.

Front 42

Liver biopsy

Back 42

Performed percutaneously by needle puncture, which commonly goes through the right 8th or 9th intercostal space in the R midaxillary line under US or CT. Pt is asked to hold their breath in full expiration to reduce costodiaphragmatic recess.

Front 43

What is the gallbladder in contact with?

Back 43

Duodenum and transverse colon

Front 44

Gallstones

Back 44

Present commonly in Fat, Fertile, Females over Forty. Stones may become lodged in fundus of gallbladder, bile duct, and hepatopancreatic ampulla

Front 45

What occurs when a stone is lodged in fundus of gallbladder?

Back 45

May ulcerate through wall of the fundus of the gallbladder into the transverse colon or through the wall of the body of the gallbladder into the duodenum.

Front 46

What occurs when a stone is lodged in the bile duct?

Back 46

Obstruct bile flow to the duodenum, leading to jaundice.

Front 47

What occurs wen a stone is lodged in the hepatopancreatic ampulla?

Back 47

It will block both the biliary and the pancreatic duct systems. In this case bile may enter the pancreatic duct system, causing aseptic or noninfectious pancreatitis

Front 48

Cholecystitis

Back 48

Inflammation of the gallbladder, caused by obstruction of the cystic duct by gallstones. Acute cholecystitis is a sudden inflammation of the gallbladder caused by impacted gallstones in the gallbladder, which obstruct the cystic duct. The trapped bile causes irritation and pressure buildup in the gallbladder, leading to bacterial infection and perforation and causing pain in RUQ and epigastric region. Pain may radiate to back or R shoulder

Front 49

Pancreatic head tumor

Back 49

Bile flow is obstructed, resulting in jaundice

Front 50

Pancreatitis

Back 50

Inflammation of the pancreas caused by gallstones and alcohol consumption. Sxs include upper abdominal pain, NV, weight loss, fatty stools, mild jaundice, DM, low blood pressure, heart and kidney failure

Front 51

Pancreatic cancer

Back 51

Frequently causes severe back pain, has potential to invade into adjacent organs, and is extremely difficult to treat but may be treated by surgical resection called Whipple's procedure. Obstructive jaundice may be present.

Front 52

Cancer of pancreatic neck and body

Back 52

May cause portal or IVC obstruction because the pancreas overlies these large veins

Front 53

Location of spleen

Back 53

Lies against diaphragm and ribs 9-11 in L hypochondriac region.

Front 54

Splenomegaly

Back 54

Caused by venous congestion resulting from thrombosis of the splenic vein or portal HTN, which causes sequestration of blood cells, leading to thrombocytopenia and easy bruising. Sxs include fever, diarrhea, bone pain, weight loss and night sweats

Front 55

Rupture of spleen

Back 55

Occurs frequently by fractured ribs or severe blows to L hypochondrium and causes profuse bleeding.

Front 56

Hodgkin's disease

Back 56

A malignant lymphoma characterized by painless progressive enlargement of the lymph nodes, spleen and other lymphoid tissue, accompanied by night sweats, fever and weight loss.

Front 57

Annular pancreas

Back 57

Occurs when the ventral and dorsal pancreatic buds form a ring around the duodenum, thereby obstructing it

Front 58

Anorectal agenesis

Back 58

Occurs when the rectum ends as a blind sac above the puborectalis muscle

Front 59

Anal agenesis

Back 59

Occurs when the anal canal ends as a blind sac because of abnormal formation of the urorectal septum

Front 60

Pringle's maneuver

Back 60

Temporary cross-clamping of the hepatoduodenal ligament containing portal triads at the foramen of Winslow for control of hepatic bleeding during liver surgery or donor hepatectomy for living liver transplantation.

Front 61

Superior mesenteric artery obstruction

Back 61

Caused by thrombus, an embolus, artherosclerosis, and aortic aneurysm, a tumor in the uncinate process of the pancreas, compression by the third part of the duodenum, or surgical scar tissue. The obstruction leads to small and large intestinal ischemia, resulting in necrosis of all or part of the involved intestinal segment. Sxs are abdominal pain, NVD, and electrolyte imbalance.

Front 62

Portal vein

Back 62

Formed by union of the splenic vein and superior mesenteric vein posterior to the neck of the pancreas. The inferior mesenteric vein joins either the splenic or superior mesenteric vein, or junciton of these two veins. Also receives the l gastric vein.