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ANATOMY > 07-05 GIT Gx Abdominal Wall, Inguinal Canal and the Peritoneal > Flashcards

07-05 GIT Gx Abdominal Wall, Inguinal Canal and the Peritoneal Flashcards

1
Q

boundaries of the abdominal wall

A
  • costal margins & xiphoid process,
  • diaphragm,
  • plane of the pelvic inlet,
  • inguinal ligament and bones of the pelvis (iliac crest, pubic crest, and pubic syphysis)
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2
Q

surface anatomy

A
  • umbilicus
  • linea alba
  • linea transversae
  • linea semilunaris
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3
Q

!!! transpyloric plane traverses the…

A
  • pylorus (in recumbent position)
  • fundus of the gallbladder
  • neck of the pancreas
  • origins of SMA and hepatic portal vein
  • root of the transverse mesocolon
  • duodenojejunal junction
  • hila of the kidneys
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4
Q

plane that passes through the easily palpated ASIS on each side

A

interspinous plane

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5
Q

plane that passes through the iliac tubercles and the body of the L5 vertebra

A

transtubercular plane

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6
Q

plane that passes through the inferior border of the 10th costal cartilage on each side

A

subcostal plane

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7
Q

planes that pass from the midpoint of the clavicles to the midinguinal points

A

midclavicular planes

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8
Q

abdominal regions

A

(left to right/up to down)

right hypochondrium
epigastric
left hypochondrium
right flank (lateral region)
umbilical
left flank (lateral region)
right inguinal (groin)
pubic
left inguinal (groin)
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9
Q

cleavage lines of the skin

used in surgical incisions

A

Langer Lines

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10
Q

inferior to the umbilicus. 2 layers of subcutaneous tissue

A

1) superficial fatty layer (Camper fascia)

2) deep membranous layer (Scarpa fascia)

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11
Q

superficial fatty layer

A

Camper fascia

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12
Q

deep membranous layer

A

Scarpa fascia

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13
Q

membranous layer continues inferiorly into the perineal region as the ____, but nor into the thighs

A

superficial perineal fascia (Colles fascia)

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14
Q

the glistening lining of the abdominal cavity that is formed by a single layer of epithelial cells and supporting connective tissue

A

parietal peritoneum

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15
Q

parietal peritoneum is separated to the transversalis fascia by…

A

extraperitoneal fat

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16
Q

layers of the anteroabdominal wall

A
  1. skin
  2. camper fascia (superficial fatty layer of subcutaneous tissue)
  3. Scarpa fascia (deep membraneous layer of subcutaneous tissue
  4. superficial investing fascia
  5. external oblique
  6. intermediate investing fascia
  7. internal oblique
  8. deep investing fascia
  9. transversus abdominis
  10. transversalis (endoabdominal) fascia
  11. extraperitoneal fat
  12. parietal peritoneum (the glistening lining)
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17
Q

derivatives of External Oblique

A

inguinal ligament, superficial inguinal ring,

lacunar ligament

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18
Q

derivatives of Internal Oblique

A

conjoint tendon, cremasteric muscle

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19
Q

derivatives of Transversus Abdominis

A

conjoint tendon

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20
Q

largest among the 3 flat anterolateral abdominal muscles

A

external oblique

also the most superficial

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21
Q

muscle - same direction as the fingers do when the hands are in one’s side pockets

(with the most anterior and superior approaching a horizontal course

A

external oblique

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22
Q

the contralateral external and internal oblique form a two-bellied muscle sharing a common central tendon. what is this called?

A

digastric muscle

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23
Q

origin of external oblique

A

external surfaces of 5th-12th ribs

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24
Q

insertion of external oblique

A

linea alba, pubic tubercle, and anterior half of iliac crest

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25
Q

innervation of external oblique

A

thoraco-abdominal nerves (T7-T11 spinal nerves) and subcostal nerves

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26
Q

main action of external oblique & internal oblique

A

compresses and supports abdominal viscera; flexes and rotates trunk

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27
Q

muscle - like your fingers when the hand is placed over your chest

A

internal oblique

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28
Q

2 flat abdominal muscle that originates from thoracolumbar fascia

A

internal oblique, and

transversus abdominis

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29
Q

origin of internal oblique

A

thoracolumbar fascia,
anterior 2/3 of iliac crest,
connective tissue deep to lateral third of inguinal ligament

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30
Q

insertion of internal oblique

A

inferior borders of 10th-12th ribs,
linea alba, and
pecten pubis via conjoint tendon

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31
Q

innervation of internal oblique

A

(same with transversus abdominis)

thoraco-abdominal nerves (anterior rami of T6-T12 spinal nerves) and
first lumbar nerves

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32
Q

main action of internal oblique

A

same with external oblique.

compresses and supports abdominal viscera;
flexes and rotates trunk

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33
Q

transversus abdominis run more or less transverssally, except for inferior part which runs parallel to those of the

A

internal oblique

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34
Q

origin of the transversus abdominis

A

thoracolumbar fascia,
internal surfaces of 7th-12th costal cartilages,
iliac crest,
connective tissue deep to lateral third of inguinal ligament

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35
Q

insertion of transversus abdominis

A

linea alba with aponeurosis of internal oblique,
pubic crest,
pecten pubis via conjoint tendon

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36
Q

innervation of transversus abdominis

A

same with internal oblique.

thoraco-abdominal nerves (anterior rami of T6-T12 spinal nerves) and
first lumbar nerves

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37
Q

main action of transversus abdominis

A

compresses and supports abdominal viscera;

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38
Q

principal vertical muscle of the abdominal wall; long, broad, and strap-like

A

rectus abdominis

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39
Q

paried rectus abdominis is, separated by _____, lie close together inferiorly .

A

linea alba

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40
Q

rectus abdominis enclosed in the

A

rectus sheath

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41
Q

the rectus muscle is anchored transversely by attachment to the anterior layer of the rectus sheath at 3 or more ___

A

tendinous intersections

bulge outward when tensed

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42
Q

origin of rectus abdominis

A

pubic symphysis and

pubic crest

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43
Q

insertion of rectus abdominis

A

xiphoid process and

5th-7th costal cartilages

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44
Q

innervation of rectus abdominis

A

thoraco-abdominal nerves (anterior rami of T6-T12 spinal nerves)

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45
Q

small, insignificant triangular muscle that is absent in app. 20% of people. lies anteriorly to the inferior part of the rectus abdominis.

A

pyramidalis

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46
Q

when present, it is used as a landmark for median abdominal incision

A

pyramidalis

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47
Q

formed by the weaving of the aponeuroses of the flat abdominal muscles

A

rectus sheath

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48
Q

inside the rectus sheath:

A

rectus abdominis,
pyramidalis,

also:
superior and inferior epigastric arteries and veins,
lymphatic vessels,
distal portions of the thoraco-abdominal nerves (abdominal portions of the anterior rami of spinal nerves T7-T12)

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49
Q

demarcates the transition between the aponeurotic posterior wall of rectus sheath covering the superior 3/4 of the rectus, and the
transversalis fascia covering the inferior quarter

A

arcuate line

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50
Q

a defect in the linea alba through which the fetal umbilical vessels passed to and from the umbilical cord and placenta.

A

umbilical ring

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51
Q

All layers of the anterolateral abdominal wall fuse here

A

umbilicus

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52
Q

dermatome L1 includes

A

inguinal fold

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53
Q

dermatome T10 includes

A

umbilicus

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54
Q

blood supply of rectus abdominis

A

superior and inferior epigastric arteries

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55
Q

superior epigastric arteries anastomose with the inferior epigatric arteries app. at the level of

A

the umbilical region

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56
Q

origin of superior epigastric artery

A

internal thoracic artery

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57
Q

origin of inferior epigastric artery

A

external iliac artery

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58
Q

other arteries of anterolateral abdominal wall - refer to Moore’s page 196

A

memorize next time

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59
Q

superior epigatric vessels and branches of the musculophrenic vessels are from

A

internal thoracic vessels

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60
Q

inferior epigastric and deep circumflex iliac vessels are from

A

external iliac vessels

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61
Q

superficial circumflex and superficial epigastric vessels are from…

A

femoral artery and
greater saphenous vein,
respectively

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62
Q

lymphatic drainage of those above the umbilicus

A

anterior axillary lymph

nodes

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63
Q

lymphatic drainage of those below the umbilicus

A

superficial inguinal lymph nodes

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64
Q

this umbilical fold extends from tha apex of the urinary bladder to the umbilicus and covers the “median umbilical ligament”, a fibrous remnant of the URACHUS that joined the apex of the fetal bladder to the umbilicus

A

median umbilical fold

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65
Q

these umbilical fold (paired) are lateral to the median umbilical folds. these cover the “medial umbilical ligaments”, formed by OCCLUDED PARTS OF THE UMBILICAL ARTERIES (OBLITERATED UMBILICAL ARTERIES)

A

medial umbilical folds

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66
Q

these umbilical folds are lateral to the medial umbilical folds. these cover the INFERIOR EPIGASTRIC ARTERIES (vessels) and therefore bleed if cut

A

lateral umbilical folds

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67
Q

depressions lateral to the umbilical folds; potential sires for hernia

A

peritoneal fossae

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68
Q

the depression between the median and the medial umbilical cords; rises and falls with filling and emptying of the bladder

A

supravesical fossae

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69
Q

depressions between the medial and the lateral umbilical folds are commonly known as _____. these are potential sites for the less common direct inguinal hernias

A

medial inguinal fossae – inguinal triangles (Hesselbach triangles)

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70
Q

depressions lateral to the lateral umbilical folds, include the ______ and are potential sites for the most common type of hernia in the lower abdominal wall, the indirect inguinal hernia

A

lateral inguinal fossae – deep inguinal ring

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71
Q

fibrous remnant of the umbilical vein which is passed from the umbilicus to the liver prenatally

A

round ligament

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72
Q

encloses the round ligament of the liver (L. ligamentum teres hepatis) and para-umbilical veins in the inferior free edge

A

falciform ligament

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73
Q

oblique passageway through the anterior abdominal wall for the spermatic cord/ round ligament & ilioinguinal nerve

A

INGUINAL CANAL

74
Q

region where structures enter/exit the abdominal cavity

A

INGUINAL CANAL

75
Q

dense ligament consisting the inferiormost part of the external oblique

A

inguinal ligament

76
Q

thickened inferior margin of the transversalis fascia

A

iliopubic tract

77
Q

site of direct and indirect inguinal and femoral hernias; weakness in the body wall in the inguinal canal

A

myopectineal orifice

78
Q

entrance to the inguinal canal; where extraperitoneal ductus (vas deferens) and testicular vessels in males (or round ligament of the uterus in females) pass to enter the inguinal canal

A

deep (internal) inguinal ring

79
Q

ext by which the spermatic cord in males, or the round ligament in females, emerges from the inguinal canal

A

superficial (external) inguinal ring

80
Q

Anterior wall of the inguinal canal

A

External oblique aponeurosis

81
Q

Posterior wall of the inguinal canal

A

Transversalis fascia & the conjoint tendon

82
Q

Roof of the inguinal canal

A

Internal oblique & transversus abdominis muscle

83
Q

Floor of the inguinal canal

A

Inguinal & lacunar ligament

84
Q

a fibrous tract connecting the primordial testis to the anterolateral abdominal wall

A

male gubernaculum

85
Q

a fibrous cord connecting the ovary and primordial uterus to the developing labium majus - represented postnatally by the ovarian ligament (between the ovary and uterus) and round ligament (between the uterus and labia majus

A

female gubernaculum

86
Q

(surface anatomy) pit of the stomach; slight depression in the epigastric region, just inferior to the xiphoid process

A

epigastric fossa

87
Q

serous membrane that lines the abdominal wall

A

PARIETAL peritoneum

88
Q

serous membrane that covers the organs

A

VISCERAL peritoneum

89
Q

both parietal and visceral peritoneum consist of

A

mesothelium and connective tissue

90
Q

Loss of mesothelial layer in peritoneum leads to

A

adherence of underlying tissues & interferes with visceral function

91
Q

organs completely covered with VISCERAL peritoneum (e.g. stomach and spleen)

A

INTRAPERITONEAL organs

92
Q

organs external to the PARIETAL peritoneum

e.g. kidneys - retroperitoneal, urinary bladder - subperitoneal

A

EXTRAPERITONEAL organs

93
Q

potential space between the parietal and visceral layers of peritoneum

A

peritoneal cavity

94
Q

peritoneal cavity contains no organs, but only

A

peritoneal fluid (app. 100mL of fluid, but can hold up to 5 liters)

95
Q

blood & nerve supply of the PARIETAL peritoneum comes from

A

the region of the wall it

lines

96
Q

blood & nerve supply of the VISCERAL peritoneum comes from

A

the organ it covers

97
Q

cavity is completely CLOSED in males. in females,

A

there is communication to the exterior by way of uterine tubes, uterine cavity and vagina

98
Q

peritoneal reflection from the BODY WALL to the small intestine

A

Mesentery

99
Q

peritoneal reflection from the STOMACH to other abdominal organs

A

Omenta/ Omentum

100
Q

double layer of peritoneum that connects an ORGAN TO ANOTHER ORGAN or to the abdominal wall

A

Peritoneal ligament

101
Q

the LIVER is connected to the ANTERIOR ABDOMINAL WALL by the

A

falciform ligament

102
Q

the LIVER is connected to the STOMACH by the

A

hepatogastric ligament

103
Q

the LIVER is connected to the DUODENUM by the

A

hepatoduodenal ligament

104
Q

the STOMACH is connected to the INFERIOR SURFACE OF THE DIAPHRAGM by the

A

gastrophrenic ligament

105
Q

the STOMACH is connected to the SPLEEN by the

A

gastrosplenic ligament

106
Q

the STOMACH is connected to the TRANSVERSE COLON by the

A

gastrocolic ligament

107
Q

(Subdivisions of the Peritoneal Cavity)

the main and larger part of the peritoneal cavity

A

greater sac

108
Q

(Subdivisions of the Peritoneal Cavity)

lies posterior to the stomach and lesser omentum

A

omental bursa (lesser sac)

109
Q

(Subdivisions of the Peritoneal Cavity)

contains the stomach liver and spleen

A

Supracolic compartment

110
Q

(Subdivisions of the Peritoneal Cavity)

contains the small intestine and ascending and descending colon

A

Infracolic compartment

111
Q

the ____ divides the abdominal cavity into ___ and ___

A

Supracolic compartment and

Infracolic compartment

112
Q

free communication occurs between the Supracolic compartment and
Infracolic compartment through the

A

paracolic gutters

113
Q

omental bursa communicates with the greater sac through

A

omental foramen

114
Q

ANTERIOR boundary of Foramen of Winslow (Epiploic/Omental foramen)

A

Portal vein, hepatic artery, bile duct

115
Q

POSTERIOR boundary of Foramen of Winslow (Epiploic/Omental foramen)

A

IVC, right crus of diaphragm

116
Q

SUPERIOR boundary of Foramen of Winslow (Epiploic/Omental foramen)

A

Caudate lobe of liver

117
Q

INFERIOR boundary of Foramen of Winslow (Epiploic/Omental foramen)

A

1st part of duodenum

118
Q

main paired muscles of the posterior abdominal wall

A
  • psoas major
  • iliacus
  • quadratus lumborum
119
Q

psoas etymology

A

psoas = Greek = muscle of the loin

120
Q

superior attachment of psoas major

A

T12-L5

121
Q

inferior attachment of psoas major

A

lesser trochanter of femur

merges inferiorly with iliacus

122
Q

main action of iliopsoas muscle

A

flexes the thigh at hip joint

123
Q

only ___ can produce movement (flexion or lateral bending) of the lumbar vertebrae

A

psoas major

124
Q

psoas major and ilacus muscle merge inferiorly forming the

A

iliopsoas muscle

125
Q

superior attachment of ilacus

A

iliac fossa;
sacroiliac/iliolumbar ligaments;
sacrum

126
Q

inferior attachment of iliacus

A

lesser trochanter

127
Q

innervation of psoas major

A

anterior rami of lumbar nerves (L1, L2, L3)

128
Q

innervation of iliacus

A

femoral nerve (L2-L4)

129
Q

superior attachment of quadratus lumborum

A

12th rib;

L1-L5

130
Q

inferior attachment of quadratus lumborum

A

L1-L5;
iliolumbar ligament;
iliac crest

131
Q

innervation of quadratus lumborum

A

anterior rami of T12 and L1-L4 nerves

132
Q

main action of quadratus lumborum

A

lateral bending of the trunk

133
Q

abdominal aorta begins at __ and ends at ___

A

begins at the aortic hiatus in the diaphragm at the level of the T12 vertebra

and ends at the level of the L4 vertebra by dividing into the right and left common iliac arteries

134
Q

terminal brand of the abdominal aorta

A

common iliac arteries

135
Q

common iliac arteries divide into __ And ___

A

internal and external iliac arteries

136
Q

internal iliac artery enters the

A

pelvis

137
Q

external iliac artery follows the

A

iliopsoas muscle

138
Q

just before leaving the abdomen, the external iliac artery gives rise to the ___ and ___ , which will supply the anterolateral abdominal wall

A

inferir epigastric and

deep circumflex iliac arteries

139
Q

paired parietal branches of the aorta serve the ___ and ___

A

diaphragm and posterior abdominal wall

140
Q

anterior branches of the abdominal aorta and the parts they supply

A
  • Celiac trunk (abdominal foregut)
  • Superior mesenteric (abdominal midgut)
  • Inferior mesenteric (abdominal hindgut)
141
Q

lateral branches of the aorta and the parts they supply

A
  • Middle suprarenal (suprarenal glands)

- Renal arteries (kidneys)

142
Q

paired branches of the abdominal aorta

A
  • Testicular/ ovarian (Testes (male); ovaries (female))

- Inferior phrenic (diaphragm)

143
Q

posterior branches of the abdominal aorta

A
  • lumbar arteries (Posterior abdominal wall & spinal cord)

- median sacral

144
Q

left testicular or ovarian veins will enter the ____ instead of entering the IVC

A

left renal vein

145
Q

inferior vena cava (IVC) begins at ___

A

anterior to the L5 vertebra by the union of the common iliac veins

146
Q

the IVC leaves the abdomen by ___ and enters the thorax at the ___

A

leaves the abdomen by passing through the “caval opening” in the diaphragm and

enters the thorax at the T8 vertebral level

147
Q

tributaries to the inferior vena cava

A
  • external iliac veins
  • lumbar veins
  • right testicular/ovarian vein
  • renal veins
  • right suprarenal vein
  • inferior phrenic veins
  • hepatic veins
148
Q

blood from the abdominal viscera passes through the “portal venous system” and the liver before entering the IVC via the __-

A

hepatic veins

149
Q

Which of the following structures are found on the same plane as the transplyloric plane?
A. Tail of the pancreas
B. Upper pole of the left kidney C. Inferior mesenteric artery
D. 9th costal cartilage

A

D. 9th costal cartilage

150
Q

Visceral pain located in the umbilical region may emanate from which of the following abdominal viscera?

A

Ileum

151
Q

The transpyloric plane is the horizontal plane between which of the following landmarks

A

Jugular notch and pubic symphysis

152
Q

derivative of the internal oblique muscle

A

Cremasteric muscle

153
Q

derivative of the Scarpa’s fascia

A

Superficial fascia/ Dartos muscle

154
Q

derivative of the External Oblique

A

External spermatic fascia

155
Q

derivative of the Transversalis fascia

A

Internal Spermatic fascia

156
Q

derivative of the Peritoneum

A

Tunica vaginalis

157
Q

signify the transition of the rectus sheath’s position exclusively anterior to the rectus abdominis muscle

A

Arcuate line

158
Q

Which of the following zones of the anterior abdominal wall is supplied by the deep inferior epigastric artery?

A

Zone II

159
Q

The lymphatic drainage of the anterior abdominal wall structures is dependent on their position relative to which of the following structures?

A

Umbilicus

160
Q

Which of the following spinal nerves is being assessed when one strokes the area of the skin in the area just below the xiphoid process with light touch using the blunt end of a neurologic hammer?

A

T 7

161
Q

Hesselbach’s triangle is located in which peritoneal fossae

A

Medial inguinal

162
Q

located lateral to the inferior epigastric vessels

A

deep inguinal ring

163
Q

A swollen gall bladder that stretches its visceral peritoneum shall manifest as a vague, waxing and waning pain in which of the following regions of the abdomen?

A

Epigastric

164
Q

divide the peritoneal cavity into supracolic and infracolic compartments?

A

Transverse mesocolon

165
Q

peritoneal fossae where direct inguinal hernias herniate

A

Medial inguinal

166
Q

peritoneal fossa where indirect inguinal hernias herniate

A

Lateral inguinal

167
Q

In a case of a ruptured urethra, urine is prevented from leaking into the thigh because of the attachment of which of the following structures?

A

Scarpa’s fascia

168
Q

The origin of the renal artery is approximately at the level of which of the following vertebra?

A

L 2

169
Q

In the ligation of which of the following arteries should you be wary about the ureter in respect to its relationship?

A

Testicular/Ovarian

170
Q

transpyloric plane hits what vertebral level

A

L 1

171
Q

this structure extends from Anterior Superior Iliac Spine to the pubic tubercle

A

inguinal ligament

172
Q

above or below arcuate line?

rectus abdominis is covered directly by leaves of internal oblique aponeurosis

A

above

173
Q

above or below arcuate line?

aponeuroses of external oblique runs anterior to rectus abdominis

A

both above and below

174
Q

above or below arcuate line?

rectus abdominis is directly covered by transversalis fascia

A

below

175
Q

dermatome of the pubis, just above the inguinal ligament and symphysis pubis

A

L1

176
Q

dermatome of xiphoid process

A

T7

177
Q

dermatome of the umbilicus

A

T10

178
Q

dermatome of most parts of the epigastrium

A

T8

179
Q

dermatome of most parts of hypogastric area

A

T12

180
Q

origin of external oblique muscle

A

lower 8th ribs

181
Q

fundus of the gallbladder lies opposite of what anatomical structure

A

tip of right 9th costal cartilage

ANATOMY (23 decks)

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