100 Concepts Set 1 Flashcards
Where are the liver and bladder located in the abdominal wall?
the right upper quadrant
Where are the stomach and spleen located in the anterior abdominal wall?
the left upper quadrant
Where are the cecum and appendix located?
In the right lower quadrant
Where are the ends of the sigmoid colon and descending colon located?
Left lower quadrant
Where is pain arising from foregut derived structures referred to?
The epigastric region
Where is pain arising from midgut derived structures referred to?
The umbilical region
Where is pain arising from hindgut derived structures referred to?
The hypogastric region
How many nerves make up the nerve supply of the anterior abdominal wall?
7
What nerves supply the anterior abdominal wall?
Lower 5 intercostals
1 subcostal
L1- (iliohypogastric and ilioinguinal)
L1 can be anesthesized by injecting in which location?
1 inch superior to ASIS
Where do all the nerves and deep blood vessels of the anterior abdominal wall lie?
Neurovascular Plane- between internal oblique and transversus muscles
What are the important superficial (supplying skin) arteries of the anterior abdominal wall?
Superficial epigastric
Superficial Circumflex Iliac
What are the important deep arteries of the anterior abdominal wall?
Superior Epigastric Inferior Epigastric Posterior Intercostal Arteries Lumbar Arteries Deep Circumflex Iliac arteries
What is an omphalocele?
herniation of abdominal viscera through an enlarged umbilical ring
VISCERA are covered by AMNION
What is gastroschisis?
Herniation of abdominal contents through the body wall directly into the amniotic cavity
Viscera ARE NOT covered by peritoneum or amnion
What are the 3 parts of a hernia?
- Hernial Sac
- Hernial Contents
- Hernial Coverings
What is a hernial sac?
pouch (diverticulum) of peritoneum and has a neck and body
What is included in the hernial contents?
May consist of any structure found in the abdominal cavity
more often- loops of small intestine and piece of omentum major
What are hernial coverings formed from?
The layers of abdominal wall through which the hernia sac passes
What is the first structure crossed by any abdominal hernia?
Transversalis Fascia
What does an indirect inguinal hernia lie in between?
Tunica Vaginalis and Internal Spermatic Fascia
What is the most common form of hernia?
Indirect Inguinal Hernia
Believed to be congenital in origin
Common in boys 0-3 years
Where does the Indirect Inguinal Hernia pass through?
The Deep Inguinal Ring lateral to the inferior epigastric vessels, inguinal canal, superficial inguinal ring, and descends into the scrotum.
Is an indirect inguinal hernia more common in males or females?
20 times more common in males
1/3 of them are bilateral
Which side is an indirect inguinal hernia more common in and why?
More common on the right
Normally the right proccessus vaginalis becomes obliterated after the left; the right testes descends later than the left
Where does a direct inguinal hernia protrude through?
The weak area of the posterior wall of the inguinal canal, medial to the inferior epigastric vessels in the inguinal (Hesselbach’s Triangle).
After that, it runs through the superficial inguinal ring
Never descends into the scrotum
What demographic are direct inguinal hernias common in?
old men- after 60 years old, with weak abdominal muscles
Direct inguinal hernias are rare in women and most are bilateral
What 2 ligaments compose the Lesser Omentum?
Hepatogastric l.
Hepatoduodenal l.
What are the contents of the Lesser Omentum?
Right and Left gastric vessels
Connective and fatty tissue
PORTAL TRIAD:
- Bile Duct
- Portal Vein
- Proper Hepatic Artery
What are the boundaries of the Epiploic (Winslow’s) Foramen?
Anteriorly: free border of hepatoduodenal ligament, containing the portal triad
Posteriorly: IVC
Superiorly: Caudate Lobe of the Liver
Inferiorly: The first part of the duodenum
