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11. GastroIntestinal Exam 1 > 1. Anterior Abdominal Wall > Flashcards

1. Anterior Abdominal Wall Flashcards

1
Q

The abdomen can be split into 9 regions. Vertically divided via the midclavicular line and horizontally divided via the transtubercular plane and the ?

A

transpyloric plane

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2
Q

What are the upper 3 quadrants from left to right?

A 
left hypochondrium (LH)
Epigastric (E)
right hypochondrium (RH)
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3
Q

What are the 3 middle quadrants from left to right?

A 
Left flank (LL)
Umbilical (U)
Right flank (RL)
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4
Q

What are the 3 lower quadrants from left to right?

A 
Left inguinal (LI)
Pubic (P) (aka hypogastric)
Right inguinal (RI)
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5
Q

What are the four quadrants and how are they divided (2) ?

A 
RUQ: right upper quadrant
LUQ: left upper quadrant
RLQ: right lower quadrant
LLQ: left lower quadrant
Divided vertically by the median plane and horizontally via the transumbilical plane
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6
Q

Along with the gallbladder, right kidney and right suprarenal gland, what else is in the RUQ? (7)

A 
right lobe of liver
pylorus of stomach
Duodenum parts 1-3
Head of the pancreas
Right colic (hepatic) flexure
Ascending colon: superior part
Transverse colon: right half
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7
Q

Along with the spleen, stomach, left kidney, and left suprarenal gland, what else is in the LUQ? (6)

A 
Left lobe of liver
jejunum and proximal ileum
body and tail of pancreas
left colic (splenic) flexure
transverse colon: left half
Descending colon: superior part
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8
Q

Along with the cecum, appendix, ileum and right ovary, what else is in the RLQ? (6)

A 
Ascending colon: inferior part
right uterine tube
right ureter: abdominal part
right spermatic cord: abdominal part
Uterus (if enlarged)
Urinary bladder (if very full)
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9
Q

Along with the sigmoid colon, left ovary, left uterine tube and left ureter, what else is in the LLQ? (4)

A

Descending colonL inferior part
Left spermatic cord abdominal part
Uterus if enlarged
Urinary bladder if very full

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10
Q

The xiphisternal plane is at the 7th rib and goes to?

A

T9

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11
Q

The transpyloric plane at the costal margin, which has many organs at this level, goes from 9th rib to?

A

L1

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12
Q

The subcostal plane is under the ribs and goes from what to what?

A

10th rib to L3

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13
Q

There is a plane at L4 which is called?

A

the Supracristal plane which lies on the iliac crests

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14
Q

From superficial to deep in the anterior abdominal wall, the first layer is skin followed by a superficial fatty layer of tissue known as?

A

Campers fascia

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15
Q

Deep to the campers fascia, one will find deep membranous layer of subcutaneous tissue also known as?

A

Scarpas Fascia, which is white looking and becomes the scrotum

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16
Q

After Scarpa’s fascia, comes the external oblique M, then internal oblique M, and transversus abdominis. What are the final three layers?

A

transversalis fascia
extraperitoneal fat
parietal peritoneum

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17
Q

Liposuction takes the fat from which layer of the abdomem?

A

Campers fascia, or the superficial fatty layer

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18
Q

How does liposuction become bothced?

A

The device goes into the membranous layer, scarpo’s fascia and causes adhesions

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19
Q

The external oblique muscle becomes aponeurotic at the linea semilunares (mid clavicular line). Originates from 5th-12th ribs and inserts on the linea alba, pubic tubercle and anterior iliac crest. What are the actions and innvervation?

A

Compress/Support abdominal viscera and rotate trunk

Thoracoabdominal and subcostal N.

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20
Q

The internal oblique muscles becomes aponeurotic at the linea semilunares. From the anterior iliac crest and lateral inguinal ligament to the 10-12th ribs and linea alba. What are the actions and innervation?

A

Abdominal compression/ Rotate

Ilioinguinal, thoracoabdominal, subcostal, and iliohypogastric N.

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21
Q

The transversus abdominus M. becomes aponeurotic at linea semilunares. Orginiates at internal 7-10 costal cartilages and inserts on linea alba. What are its actions and innervation?

A

Compress and support abdominal viscera

ilioinguinal, thoracoabdominal, subcostal and iliohypogastric Ns.

22
Q

Rectus abdominis M is anchored to the rectus sheath and has 3 tendinous intersections (forms 6 pack). Origin at pubic symphysis and crest, inserts on xiphoid process and 5-7th costal cartilages. What are its action and innervation?

A

Flex trunk and compress viscera

Thoracoabdominal and subcostal Ns.

23
Q

Which of the abdominal muscles does not take part in forming the linea alba in the median of the abdomen?

A

rectus abdominis

24
Q

The pyramidalis M is absent in about 20% of people. What is its function?

A

it is insignificant!

25
Q

The arcuate line which can be found 1/3 of the way between the umbilicus and the pubic tubercle is made up of different fascias. What is the rectus sheath above the arcuate line made of anteriorly and posteriorly? (2,3)

A

Anteriorly above the arcuate line: External/Internal Oblique

Post above the arcuate line: Internal oblique, transversus abdominis, and trasnversalis fascia

26
Q

What is the anterior and posterior fascia made up of below the arcuate line? (3,1)

A

Anterior: External, internal oblique and transversus abdominis
Posterior: Transversalis fascia

27
Q

What is the highest point in the body that the abdomino-pelvic cavity stretches?

A

goes up to the 4th intercostal space

28
Q

What can be found at the transpyloric plane (L1)? (7)

A 
Level of gall bladder fundus
pylorus
pancreatic neck
 SMA origin
 hepatic portal vein
 root of transverse mesocolon
 hila of kidneys
29
Q

What can be found at the subcostal plane below the 10th costal cartilage? L3

A

Transverse colon

30
Q

What can be found at the transtubercle plane between iliac tubercles? L5

A

iliocecal junction

31
Q

What can be found at the interspinous plane between ASISs? S2

A

Appendix and sigmoid colon

32
Q

What are the boundaries to the anterior abdominal wall? (5)

A 
Xiphisternum/Costal margin (7-10)
Erector Spinae 
Iliac crest, tuburcle and spine
Inguinal Ligament
Pubic tuburcle and crest
33
Q

Where does the Neurovasculature of the abdomen lie?

A

between the internal oblique muscle and the transversus abdominis

34
Q

Thoracoabdominal nerves innervate T7-T11 which is a continuation of intercostal N., while subcostal N is under rib 12. What is another name for these nerves?

A

Anterior rami

35
Q

L1 is split into two different nerves. The first is iliohypogastric N and the second is?

A

Ilioinguinal N which goes into the inguinal canal to scrotum/labia and medial thigh for cutaneous innervation

36
Q

From the internal thoracic A, splits into two which are?

A

the musculophrenic and superior epigastric As.

37
Q

The superior epigastric which is posterior to rectus abdominis, will anastamose with what at the belly button?

A

inferior epigastric A which is a branch off of the external iliac A.

38
Q

What are the two abdominal wall arteries that come off the femoral A?

A

Superficial epigastric and superficial circumflex iliac A

39
Q

Above the arcuate line is whiter while below the arcuate line is considered?

A

transparent

40
Q

A midline incision from the xiphoid process to the pubic symphysis is good or bad?

A

Okay, there are no nerves or blood supply, however will take a long time to heal

41
Q

Subcostal incision is made 2.5cm inferior of the costal margin to access gall bladder/spleen. Suprapubic incision is at pubic hair line. Are these incisions good or bad?

A

Subcostal: not bad but near superior epigastric
Suprapubic: Okay but near inferior epigastric

42
Q

What is an incision that you should never use unless you have to save someones life?

A

Paramedian from costal margin to iliac crest along linea semilunaris

43
Q

What are the ventral hernias? (3)

A

umbilical, epigastric, and spigelian

44
Q

In the groin, there can be femoral or inguinal. What are the other two types of hernias?

A

Pelvic through the sciatic foramen and flank hernias through back muscles

45
Q

For lymph above the transumbilical plane, what are the two main places the lymph will drain to?

A 
Axillary LN
Parasternal LN (more to axillary)
46
Q

The deep lymphatics includ external iliac, common iliac, and lumbar (caval/aortic) nodes. Where would superficial lymph under the umbilicus drain to?

A

Superficial inguinal LN

47
Q

The median umbilical fold is made via obliterated urachus. On either side are the?

A

supravesical fossa

48
Q

The medial umbilcal fold is derived from obliterated umbilical arteries. On either side of these folds are?

A

Medial inguinal fossa

49
Q

The lateral umbilical fold is a fold due to inferior epigastric A which run anterior to posterior layer of rectus sheath. What is on either side (laterally) of the lateral umbilical folds?

A

lateral inguinal fossa

50
Q

What can cause prune belly?

A

Failure of hypomere to migrate and form the abdominal muscles OR a paramedial incision which cuts nevers

11. GastroIntestinal Exam 1 (10 decks)

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