16. Introduction to Abdomen Flashcards
Identify the different part of the surface anatomy of the abdominen.
A. Rectus abdominis m
B. abdominal oblique muscles: external oblique, internal oblique, transversus oblique
upper black line: costal margin
lower black line: inguinal ligaments
blue: semilunar lines
white: linea alba
orange: transverse intersection
Identify the quadrants of the abdominal surface.
defined by umbilicus, costal margin and inguinal ligaments:
upper right quadrant
upper left quadrant
lower right quadrant
lower left quadrant
Identify the various regions of the abdominal surface.
defined by: costal margins, inguinal ligaments
- midclavicular line (vertical)
- 2 horizontal lines: subcostal (transpyloric) plane L1 and transtubercular plane L5 (between tubercles of ilium)
12 regions:
Bottom: left & right inguinal region, pubic region
Middle row: umbilica region, left & right lumbar region
Upper row: epigastric region, left & right hypochondriac region (hypochondriac: below cartilage or ribs)
What muscle is this? What is its function? What sheat does it contribute to?
EXTERNAL oblique: does ipsilateral hip rotation, contralateral trunk rotation
- attaches onto linea alba
- contributes ONLY to anterior rectus sheat (external oblique aponeurosis)
Identify the various strucutres.
- upper arrow: rectus abdominis: what atenrios and posterior rectus sheat surround
- lower arrow: transversus abdominis: contributes to posterior rectus sheat until arcuate line
- red: tendinous intersections
- green: arcuate line: where everything dumps into anterior rectus sheat
Which rectus sheat does the internal oblique muscle contribute to?
both anterior and posterior rectus sheat (anterior through the internal oblique aponeurosis)
Identify the structures and their function.
A. transversalis fascia (sticks fat to peritoneum)
B. extraperitoneal fat
C. peritoneum (parietal layer): encases abdominal organ and allows abdominen to expand without friction
Identify the various structures.
- blue: parietal peritoneum (layer against abdominal wall)
- purple: visceral peritoneum (against gut)
- green: messentary: double layer of peritoneum and fat in which vessels travel through
- upper arrow: intraperitoneal
- lower arrow: retroperitonealposterior to parietal peritoneum
Where do gonads start from? What do they start as?
start in upper abdominen and start as retroperitoneal organs anchored to skin (that will become scrotum or labia major) via gubernaculum
In people with testes, what does the gubernaculum become?
ligament of the scrotum
Identify tghe various structures (male).
A. ductus deferens (roadmap for inguinal canal)
B. gubernaculum (that becomes ligament of scrotum that attaches into inside of scrotum)
C. scrotum
D. spermatic cord
In GENERAL, explain the growth of the scrotum
as fetus grows, abdominen grows but gubernaculum doesn’t => pulls testes down
-the gubernaculum will shrink to become the ligament of the scrotum which further pulls down the testes and out of the body
Identify the various structures (female).
upper arrow: gubernaculum
2nd arrow: ligament of ovary (attaches ovary to uterus)
3rd arrow: round ligament of uterus (roadmap to inguinal canal)
4th arrow: labia major
How does the growth of the ovaries differ from the testes?
unlike the testes, when signalling occurs, everything stays in place and the gubernculum becomes the ligament of ovary and round ligament of the uterus.
What are the layers that surround the testes? What forms the inguinal canal?Explain.
The testes drag layers of the anterolateral wall which forms the inguinal canal and coverings of spermatic cord.
- Layers: (from sueperficial to deep):
- skin
- subcutaneous tissue
- external oblique
- internal oblique
- transversalis fascia
- peritoneum
- deep inguinal ring: where everything funnels in
- superficial inguinal ring (at pubic bone): where evrything drops into scrotum
- space between 2 rings: INGUINAL CANAL = space in abdominal wall where testes travels through
What travels through the spermatic cord?
arteris, veins and ductus deferens
What forms the inguinal ligament?
(inguinal ligament is only tendon that attaches from asis to pubic tubercle) formed by external oblique
What travels through the inguinal canal?
spermatic cord
What is found under the inguinal ligament (what travels deep to it)?
femoral artery, vein and nerve
Where does the inguinal canal situate itself?
halfway between anterior iliac spine and pubic tubercle
What are the borders of the inguinal canal? (posterior wall, roof, floor, anterior wall)
- posterior wall: transversalis fascia
- roof: transversus abdominis and internal oblique m
- floor: inguinal ligament
- anterior wall: external oblique aponeurosis
T/F: the transversus abdominis contributes to spermatic cord.
F: it does not
What does the transversalis fascia become?
it becomes the internal spermatic fascia once it goes on spermatic chord
What muscle is found on the spermatic chord? What is its function?
cremaster muscle: retracts scrotum for thermoregulation
What does skin become in the formation of the spermatic chord?
skin of scrotum
What does the subcutaneous tissue become in spermatic cord formation?
Dartos muscle and fascial: wrinkler of scrotum for thermoregulation (works with cremaster m)
What does the external oblique become in the spermatic cord formation?
external spermatic fascia
What does the internal oblique become in the spermatic cord formation?
cremaster muscle and fascia
What does the transversus abdominis become in teh spermatic chord formation?
it does not contribute!
What does the transversalis fascia become in the spermatic chord formation?
internal spermatic fascia
What does the parietal peritoneum become in the spermatic cord formation?
tunical vaginalis (has its own visceral and parietal layers): product of processus vaginalis (when testes evaginates)
Identify the various layers.
a. skin of scrotum
b. dartos muscle and fascia
c. external spermatic fascia
d. cremaster muscle and fascia
e. internal spermatic fascia
tunical vaginalis
f. parietal layer
g. visceral layer
Why do inguinal hernias occur?
(hernia: abnormal exit of tissue, organ)
they occur bc due to punching out of the testes makes the abdominen weak
What strucutre is in green?
inguinal triange: between pelvis and rectus
What is the difference between direct and indirect inguinal hernia? Which is more common?
direct or indirect depends where hernia exits
- Direct inguinal hernia (25%):
exits medial to inferior epigastric vessels through the inguinal triangle and travels outside of the spermatic cord coverins
- indirect hernaia (75%):
exits lateral to the inferior epigastric vessels and travels within the spermatic cord coverings
c (bc inguinal canal is still developping and not fully closed)
What covers the intraperitoneal organs? retroperitoneal organs?
visceral peritoneum covers infraperiotneal organ
retroperitoneal organ covered by peritoneum only on anterior surface
What is shown in red?
peritoneum that encases organs
Identify the various structures.
a. liver
b. stomach
c. duodenum
d. transverse colon
e. (green line) lesser curvature of stomach
f. (green) lesser omentum (from stomach to liver): formed by two ligaments: (g) hepatogastric ligament + (h) hepatoduodenal ligament
i. (blue line) greater curvature of stomach
j. greater omentum (stomach to transver colon) (filled with fat)
How many layers of peritoneum have in the lesser and greater omentum? If you cut the omentums open what do you find.
lesser has 2 layers pf peritoneum, cut open: lesser sac
greater has 4 layers of peritoneum, cut open: greater sac
Identify the structure in pink and burgundy. What is the function of the structure in pink?
pink: lesser sac: allows for stomach to expand (space found behind the stomach)
burgundy: greater sac (sticking your hand into the abdominen, you’re in the greater sac)
Identify the structure in blue.
Epiploic foramen: entrance into lesser sac: can be found under the hepatoduodenal ligament at edge of the lesser omentum
What can be found when you reflect the stomach superiorly?
the lesser sac (Blue arrow=epiploic foramen)
identify the structure in light green, dark green and blue.
dark green: lesser sac
dark green: greater sac
blue: epiploic foramen
What is the danger of a splenic artery bleed?
If there is a splenic artery bleed, blood can pool into the lesser sac and exit through the epiploic foramen and pool into the lower abdominen
Draw the sagital left view of the abdominen. Where does the peritoneum get its blood supply from?
How does the lesser sac form?
