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151 Cards in this Set
- Front
- Back
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Striae |
Stretch marks, perpendicular to langer's lines. Caused by stretching of connective tissue fibers. Ex. Obesity, pregnancy |
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Top abdominal wall (after epidermis and dermis) |
Superficial Fascia: made up of superficial layer and deep (scarpa) fascia. |
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Scarpa fascia |
Deep fascia of the superficial fascia. Holds structure together and continues with fascia lata of the high. |
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Middle abdominal wall (after epidermis and dermis) |
Deep investing fascia: consists of deep perineal fascia and deep penile fascia. |
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Deepest abdominal fascia |
Transversalis fascia: wraps abdominal cavity and support peritoneum. Separate from peritoneum by a layer of fat. |
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peritoneum |
the serous membrane lining the cavity of the abdomen and covering the abdominal organs. |
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Abdominal wall anterior to posterior |
epidermis, dermis, superficial fascia (superficial and deep (scarpa) layers), deep investing fascia, 3 muscle layers, transversalis fascia, fat layer, peritoneum. Needle goes in fat layer! otherwise you puncture organ. |
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External Oblique |
-most superficial lateral muscle -from last 5-6 ribs -inserted at iliac crest, pubis, and linea alba |
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Internal Oblique |
-middle of lateral layers -right angle to external oblique -Provide cremaster muscle (spermatic cord that raises the testicle) -Anterior side interweaves with external oblique. Posterior side interweaves with transverse oblique |
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Transverse Abdominis |
Deepest of the 3 lateral muscles directed horizontally |
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Rectus Sheath |
fusion of apponeurosis of internal oblique, external oblique, and transverse abdominis muscle. |
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Crest and pubis |
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Rectus Abdominis |
Anterior muscle connecting to the sternum and the pubic bone. Innermost inserted muscle |
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ASIS and Pubic tubercle |
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Inguinal Ligament |
formed by inferior muscle between ASIS and Pubic tubercle |
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superficial inguinal ring |
Triangle defect in the aponeurosis of external oblique muscle. |
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Linea alba, linea similunaris, tendinous intersections |
Linea alba: fusion of rectus abdominis medial borders Linea similunaris: lateral margin of rectus abdominis Tendinous intersections: between rectus ab. and anterior wall of rectus sheath. Creates bulge. |
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Action of anterior abdominal wall muscles |
fixation, respiration, flexion, abduction, rotation |
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Inguinal canal Deep inguinal ring Superficial inguinal ring |
Deep inguinal ring: partial interruption of transversalis fascia Superficial inguinal ring: triangular interruption in external oblique aponeurosis -Inguinal canal transmits spermatic cord (M) or round ligament (F) |
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Direct inguinal hernia and indirect inguinal hernia |
Direct inguinal hernia: medial to the vessels via superficial ring. Doesn't descend into the canal Indirect inguinal hernia: lateral to the vessels through the deep ring. Descends into the canal. |
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Aorta supplies |
lower intercostal arteries |
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Internal mammary supplies: |
musculophrenic, and superior epigastric arteries -anastomosis between superior and inferior epigastric arteries makes a shunt (hole for fluid flow between lower limbs). |
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External iliac supplies: |
inferior epigastric arteries |
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lymphatic drainage above umbilicus |
superficial lymphatic drainage to axillary node deep lymphatic drains to parasternal node |
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lymphatic drainage below umbilicus |
superficial lymphatic drain to superficial inguinal nodes deep lymphatic drains to external iliac nodes. |
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Abdominal wall innervation |
-intercostal nerves T7-T12 -Lumbar nerves T12-L4 -Umbilicus T10 -Inguinal L1 |
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Parietal and visceral peritoneum |
Parietal peritoneum: mesothelium serous membrane covering inside wall of the abdominal cavity Visceral peritoneum: peritoneal reflection over the viscera. Peritoneal fluid: peritonitis (inflammation), ascites (accumulation), paracentesis (fluid removal with needle). |
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Contents of Abdomen |
GI tract, liver, pancreas, spleen, kidneys, suprarenal glands, abdominal aorta (and branches) -Bladder when full, uterus when pregnant, gonads when a fetus. |
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Forgut -contents -vasculated by -innervation |
-esophagus, stomach, duodenum, liver, pancreas -supplied by celiac trunk -Parasympathetic: vagus nerve, sympathetic: greater splachnic nerve T5-T9 -Digest Food |
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Midgut -contents -vasculated by -innervation |
-jejunum, ileum, ascending and transverse colon -supplied by superior mesentric artery -Parasympathetic: vagus nerve, sympathetic: lesser splachnic nerve T10-T11 -Absorb nutrients and water |
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midgut (image) |
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Hindgut -contents -vasculated by -innervation |
-descending colon, sigmoid colon, rectum -supplied by inferiror mesenteric artery -parasympathetic: pelvic splanchnic nerves S2-S4. sympathetic: lumbar splachnic nerve L1-L2 -fecal transport, storage, and evacuation |
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hindgut (image) |
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hiatus hernia |
the protrusion of the stomach, through the esophageal opening in the diaphragm (esophageal hiatus, T10)
-sometimes described as heart burn |
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Upper esophagus midesophagus lower esophagus; cardiac sphincter |
upper esophagus: skeletal muscle (swallowing) forms superior esophageal sphincter midesophagus: propels food bolus lower esophagus/cardiac sphincter: prevents regurgitation into esophagus |
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esophagus vasculature and veins |
Arteries: esophageal branches (from descending aorta), left gastric arteries (from celiac trunk) Veins: Azygous vein (systemic), left gastic vein (portal) -Anastomosis called esophageal varices |
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Lymphatics and innervation of esophagus |
-lymphatics: celiac nodes -parasympathetic: Vagus! (at mycenteric and meissner plexuses) -sympathetic: greater splanchnic nerve T5-T9 -Afferent: run along sympathetic fibers T4-T5 |
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pylorus |
opening of stomach into the duodenum, contains pyloric sphincter |
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Pyloric stenosis |
Narrowing (stenosis) of the outlet of the stomach so that food cannot pass easily from it into the duodenum. Results in vomiting. |
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Rugae vs. Gastric Canal |
Rugae is internal gastric surface of stomach that will flatten when full. Gastric Canal is the permanent furrows (grooves) in the stomach. |
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Greater vs. lesser curvature |
Greater: inferior border of the stomach Lesser: superior border -suspended my mesentries |
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Greater vs. lesser omentum |
Greater: extends inferiorly from greater curvature to cover most of abdominal organs lesser: connects lesser curvature to the liver via gastrohepatic ligament. |
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Gastrophrenic ligament and gastrosplenic ligament |
gastrophrenic ligament: between fundus and diaphragm gastrohepatic ligament: between stomach and spleen |
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Secretions of stomach |
HCl, enzymes (pepsiogen->pesin (via HCl)), factors (that help absorb Vitamin B-12) |
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Branches from celiac trunk |
1. Left gastric artery 2. Splenic artery-> short gastric arteries, left gastro-omental artery 3. Common hepatic artery -> right gastric artery, right gastro-omental artery. |
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Stomach vasculature (image) |
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Veins and lymphatics of stomach |
Veins follow arteries, drain to portal vein lymphatic drainage: follows arteries, systemic and hepatic mestasis |
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stomach innervation |
parasympathetic: vagus (stimulates acid secretion, movement, relaxes sphincter) sympathetic: greater splanchnic nerve (t5-9), stimulates constriction |
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tumor in stomach |
can go to systemic or portal circulation (lead to the liver) |
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superior portion of duodenum covered in: |
peritoneum. Supported by hepato-duodenal ligament of lesser omentum |
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descending portion of duodenum |
duodenal papilla (entry site of bile and pancreatic secretions) Hepatopancreatic ampulla (formed by union of the pancreatic duct and common bile duct) |
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Hepatopancreatic sphincter |
a muscle valve that controls the flows of digestive juices |
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Inferior portion of duodenum divides into |
transverse portion- superior mesentric vessels ascending portion- suspensory ligament; muscle connects to diaphragm |
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Duodenum vasculature |
celiac artery branches (superior pancreatic-duodenal arteries) and superior mesentric artery, inferior pancreatico-duodenal arteries. |
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venous, lympathic, and innervation of duodenum |
venous and lymphatic follow the arteries. Innervation (t5-t11 greater and lesser splanchnic) referred pain in umbilicus is possible. |
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Location of liver |
epigastric and right hypochondriac quadrant. 5th rib anteriorly, and 5th intercostal space. |
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Glisson capsule |
The liver is enclosed in a thin fibrous hepatic capsule called Glisson capsule. Sudden stretching and pain called hepatomegaly. |
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Liver lobes |
Right, left, quadrate, and caudate lobes. Quadrate and caudate lobes are on inferior surface. |
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Falciform ligament |
attaches liver to the anterior of the abdominal wall |
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Round ligament |
inferior side of liver, it is a remnant of umbilical vein |
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Coronary Ligament |
between superior pole of liver and inferior surface of diaphragm. |
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Liver and stomach are connected in the lesser omentum via: |
hepatoduodenum and hepatogastric ligaments |
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Porta Hepatis |
contains vessels (a. and v.), and ducts for the liver. |
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subphrenic recess and hepatorenal recess |
subphrenic recess: between diaphragm and liver. If infected, it can easily spread to pleural cavity Hepatorenal recess: between liver and right kidney |
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What makes up H shape of inferior liver |
venosum ligament, round ligament, porta hepatis, IVC, gall bladder. |
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Liver vasculature |
Hepatic artery (divides right and left) Hepatic portal vein -caput medusae: can see paraumbilical veins radiating from umbilicus. A result of portal hypertension |
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Bile secretion via |
hepatic ducts. Blockage leads to jaundice. bile breaks down fats for absorption |
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Gall Bladder location, parts, function |
-between right and quadrate lobes -fundus, body, and neck -collects and concentrates bile; secrete via cystic ducts |
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Biliary Tree |
R/L hepatic duct-> common hepatic duct (liver)-> + cystic duct (gallbladder) and forms common bile duct-> + pancreatic duct into duodenum at hepato-pancreatic ampulla |
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closer of hepato pancreatic duct lead to: |
build up of bile and gall stones. Surgery required but you still function normally |
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Gall Bladder -Vasculature -Innervation |
-cystic artery and vein -parasympathetic: vagus nerve sympathetic: greater splanchnic nerve (T5-9) |
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Pancreas -location -Parts (Head, body, tail, uncinate process) |
-epigastric and left hypochondriac region, mainly retroperitoneal |
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-Two lymphatic ducts of pancreas -Vasculature |
-Main pancreatic duct and accessory pancreatic duct -Supplied via celiac and superior mescentric arteries |
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Inflammation of pancreas |
pancreatitis (from blockage of ducts) |
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inflammation of gall bladder |
Cholecystitis |
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Spleen -Location -hilum |
-located at the left hypochondriac region, upper half may reach 11-12th ribs. Prone to rupture. -Hilum contains vessels, located on concave border. Next to pancreatic tail |
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Spleen function |
Immune functions, it is filled with lymphocytes. Helps in destruction of RBC's. In fetus it generates RBCs. |
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-Spleen vasculature -ligaments |
-Splenic artery, and splenic vein (leads to portal circulation and liver) -Gastro-splenic and spleno-renal ligaments |
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Abnormal enlargement of spleen called |
splenomegaly |
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Formation of Portal Vein |
-formed by union of splenic vein and superior mescentric vein |
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Portal hypertension causes: |
esophageal varices: abnormal enlarged veins in lower esophagus caput medusae: enlarged epigastric veins around umbilicus Hemorrhoids: inflamed veins in the rectus and anus causing discomfort/bleeding |
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Jejunum and Ileum location |
-Jejunum at left upper quadrant (proximal 2/5 of small intestine) -Ileum at right lower quadrant (distal 3/5) |
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Mesentery proper (and its blood vessels) |
-Runs diagonally from upper left to lower right. -Supports jejunum and ileum. Contains blood vessels; arterial arcades and vasa recta. |
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Difference between Jejunum and Ileum -lumen -vessels -fat content |
-Jejunum has wider lumen ('cuz it comes straight from duodenum) -Jejunum has larger arterial arcades and longer vasa recta -Ileum has more fat in mesentry |
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volvulus |
Excessive twisting of intestines. -Could compress mescentric blood vessels (ischemia) -could lead to vomiting |
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Plicae circularis Villi and microvilli |
Plicae circularis: circular folds in the internal structure of jejunum and ileum Villi and microvilli: microscopic finger like projections, inc absorption |
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Jejunum & Ileum -Vasculature -Lymphatics -Innervation |
-Jejunal and ileal branches of superior mesenteric arteries (arcades and vasa recta) -Venous return via superior mesentric vein -Lymphatics drain via mediastinal lymph node, and terminal lymphatic duct via thoracic duct -Para: vagu, Sym: lesser splanchnic T10-11 |
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Omental appendices or epiploic appendages |
Fat filled tags on the colon |
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Teniae Coli Haustra |
Teniae Coli: the band of longitudinal smooth muscle over large intestine Haustra: These are the rounded "bulges" that are formed due to contraction of the teniae coli |
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Ileocecal valve |
sphincter that controls the entry of materials into the large intestine |
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Cecum |
Blind sac located in lower right quadrant of abdomen |
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Intussusception |
Herniation of terminal ileum into cecum. Can lead to vomiting. |
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Vermiform appendix |
Below ileocecal valve -Appendicitis-> inflamed appendix |
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Ascending colon |
Bends at the inferior border of the liver, right colic flexure (hepatic flexure) |
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Transverse colon |
From right colic flexure and approaches the spleen. Bends downward at left colic flexure -suspended by transverse mesocolon and gastrocolic ligament. |
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Ascending and transverse colon vasculature, and innervation |
-Superior mescenteric artery and vein -innervated by vagus and lesser splanchnic nerve T10-11. Appendicitis pain could be referred to umbilical region (T10) |
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Descending colon |
-originates at left colic flexure, terminates into sigmoid colon -less diameter -prone to diverticulosis (pounches of feces) |
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Sigmoid colon |
-peritoneal suspended by the sigmoid mesentery -ends at S3 vertebra -Diverticulosis can occur |
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Descending and Sigmoid colon vasculature and innervation |
-Inferior mesenteric vessels -Innervated via pelvic splanchnic and lumbar splanchnic nerves -Afferent fibers L1-2 (injury=constipation) -L1-2 referred pain to groin and anterior thigh |
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Hirschsrung's disease |
present in newborn when there is no plexus of nerve bodies for the colon and the stool wont release |
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Rectum and anal canal |
-located in the pelvis -supplied by inf. mesenteric artery and internal iliac branches (anastomosis) -Hypertension = hemorrhoids |
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Location of left and right kidney |
-Left is above right -Left (T12-13) -Right (T12) -retroperitoneal |
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Renal Hilum |
On concave border -Vessels, nerves, and renal pelvis enters/exits |
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Renal sinus |
cavity in the kidney filled with perirenal fat. |
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peri-ureternal sheath |
The renal fascia that anchors the kidney to posterior abdominal wall. |
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Two types of fat in the renal sinus |
-Peri-nephric fat: fills space between structures within the renal sinus -Para-nephric fat: external to the fascia surrounding the kidney more posteriorly. |
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Internal Structure of Kidney -cortex -medulla -renal columns -renal pyramids -apex and renal papilla |
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What are the minor and major calyx. What is nephroliths? |
-Urine excreted thru papilla inters the minor calyx and fuses with others to form major calyx. -Nephroliths: the formation of a kidney stone. -The major calyx's with fuse to form renal pelvis |
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Renal Pelvis |
Collects the total urine output from one kidney and transports it into the ureter. |
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Ureter function |
-fibromuscular tube which serves as the excretory duct between the kidney and bladder. Starts at renal pelvis and ends at bladder |
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IVP (intravenous pyelogram) |
an x-ray exam that uses an injection of contrast material to evaluate your kidneys, ureters and bladder. |
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Kidney functions |
produce and excrete urine with other waste from the blood stream. -regulates blood hypertension (renin) |
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Three constrictions/junctions of ureter |
1. at renal pelvis and ureter junction 2. at bifurcation of common iliac vessel 3. Junction of ureter entering the bladder. |
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Arteries path in Kidney's |
Abdominal aorta-> L/R renal arteries-> 5 segmental arteries. |
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ligations of segmental arteries in kidney leads to |
segmental necrosis |
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Ureter receives blood from: |
renal, aorta, iliac, and gonadal branches. |
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kidney - venous system |
Right/Left renal vein drains right/left kidney, leads into inferior vena cava. |
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What drains into left renal vein? |
Receives blood from: -left gonadal -left suprarenal vein -left inferior phrenic vein -communicates with azygos |
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Renal innervation (afferent too) |
-renal plexus made up of lesser splanchnic and lumbar nerves. -Afferent: T12 (kidney stone pain), L1-L2 -Enters the kidney at the hilum. |
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Ureter innervation |
S2-S4 |
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Suprarenal Gland (adrenal gland) -adrenal cortex -adrenal medulla |
-Adrenal cortex: produces steroid hormones (aldosterone, cortison, sex hormones) -Adrenal medulla: gives rise to sympathetic ganglie; secretes epinephrine |
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Pheochromocytoma |
Tumor in adrenal gland, causes a lot of epinephrine and nonepinephrine to be released. Causes severe hypertension. |
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Suprarenal Gland vasculature |
-3 suprarenal arteries (branches from aorta, renal, and phrenic) - 1 suprarenal vein (R-vein into IVC, L-vein into Left renal vein) |
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What's an aneurysm? What's coarctation? |
-aneurysm: bulge or "ballooning" in arterial wall (could burts) -coarctation: narrowing of the aorta. Causes heart to pump harder |
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Cisterna Chyli |
lymphatic sac in the abdomen located at the lower end of the thoracic duct. Drains into left subclavian vein. |
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What is nephrolith? What is hydronephrosis? |
Nephrolith: kidney stone (flank pain occurs) Hydronephrosis: stone blocks ureter (kidney keeps working). Excess fluid and swelling occurs. |
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Path Of Urine |
Nephron-> Collecting duct-> papillary duct in renal pyramid-> minor calyx-> major calyx-> renal pelvis-> ureter-> bladder |
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Esophagus -Arteries |
esophageal branches of descending aorta -and left gastric artery |
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Esophagus -Vein |
Azygous (systemic) and left gastric vein (portal) |
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Stomach -Arteries |
-left gastric artery -Splenic (short gastric and left gastro-omental) -Common hepatic (right gastric and right gastro-omental) |
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Stomach -Veins |
Veins follow arteries and lead to portal vein |
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Duodenum -Arteries |
-Celiac branches and superior pancreatic duodenal arteries -Superior mesentric and inferior pancreatico-duodenal -Anastomosis |
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Duodenum -Veins |
veins follow arteries |
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Liver -Arteries |
Right and left hepatic |
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Liver -Veins |
Hepatic portal vein |
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Gallbladder -Artery |
cystic artery |
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Gallbladder -veins |
cystic vein |
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Pancreas -Artery |
Celiac and superior mesentric |
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Pancreas -Veins |
Pancreatic veins (portal circulation) |
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Spleen -Artery |
Splenic artery |
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Spleen -Vein |
Splenic vein (portal circulation) |
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Jejunum and Ileum -Artery |
Jejunal and ileal branches of superior mesentric -arterial arcades and vasa recta |
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jejunum and ileum -veins |
superior mesentric vein |
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Ascending and transverse colon -artery |
superior mesentric artery |
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Ascending and transverse colon -vein |
superior mesentric vein |
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Descending colon -Artery |
inferior mesentric artery |
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Descending colon -Vein |
Inferior mesentric vein |
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Kidney artery and vein |
renal artery and vein |
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Suprarenal artery and vein |
A: renal, aorta, and phrenic (RAP) V: R-> IVC L-> left renal vein |
