Abdomen 1 Flashcards

1
Q

Rectus Abdominis Origin & Insertion

A

Origin: 5, 6, 7 costal cartilage
Insertion: Pubic crest

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2
Q

Rectus Abdominis Function

A

Flexion of Lumbar Spine (acts in opposition to erector spinae)
Static function: Keeping the spine straight

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3
Q

3 Flat Muscles (from deep to superficial)

A

Transversus Abdominis, Internal Oblique, External Oblique

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4
Q

Aponeurosis

A

Tendon in the form of a sheet - flat muscle insertions have aponeuroses

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5
Q

Transversus Abdominis Origin & Insertion

A

Different parts of the muscle have different origins and insertion points
Origin: Ribs 6-12 of inner aspect of costal margin + Iliac Crest + Thickening of Iliopsoas Fascia
Insertion: Transversus Aponeurosis

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6
Q

Which flat muscle is the deepest?

A

Transversus Abdominis

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7
Q

Of which other aponeurosis of which flat muscle does the aponeurosis of the transversus abdominis fuse with?

A

Internal oblique (overlying muscle, superficial to TA)

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8
Q

Internal Oblique Origins & Insertion

A

Different parts of the muscle have different origins and insertion points
Origin: Arises from thoracolumbar fascia + Iliac Crest + Thickening of Iliopsoas Fascia (like TA)
Insertion: Lowest 3 ribs + Internal Oblique Aponeurosis

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9
Q

What type of border do all 3 flat muscles have in common?

A

Short free lower border

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10
Q

Of which other aponeurosis of which flat muscle(s) does the aponeurosis of the internal oblique fuse with?

A

Transversus Abdominis (deep) and External Oblique (superficial) on outer aspect

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11
Q

Functions of anterolateral abdominal wall

A
  • Protection of viscera within the abdomen
  • Accessory muscles for respiration
  • Compress abdominal contents to increase intra-abdominal pressure for coughing, sneezing, defecation and parturition
  • Movement of trunk
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12
Q

Which flat muscle is the outermost/superficial?

A

External Oblique

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13
Q

External Oblique Origins & Insertion

A

Origin: Ribs 5-12 on outside of rib cage, zig-zag line of origin (fits in with line origin of serratus anterior)
Insertion: Depends on which part:

Anterior: origin - ribs 6-9, insertion - external oblique aponeurosis
Posterior: origin - ribs 10-12, insertion - outer edge of anterior half of iliac crest

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14
Q

Functions of flat muscles

A
  • When 3 flat muscles on both sides contract together (as they usually do), they raise pressure inside the abdominal cavity, aiding in respiration and defecation.
  • When they contract in isolation, they play a part in producing lateral flexion of the lumbar spine and rotation of thoracic spine.
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15
Q

What do the aponeuroses of the 3 flat muscle insertions form?

A

The rectus sheath

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16
Q

Inguinal ligament origin and insertion

A

Anterior superior iliac spine –> Pubic tubercle

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17
Q

Why is there a gap between the inguinal ligament and the underlying bone?

A

Important structures pass through from abdomen –> thigh, including femoral vein, artery and nerve medially and the belly of the psoas and iliacus musles laterally

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18
Q

What is the inguinal ligament the lowest part of?

A

The external oblique aponeurosis

19
Q

What do the lowest fibres of the inguinal ligament curl around to form?

A

A triangular extension known as the Lacunar ligament

20
Q

Where does the Lacunar ligament insert?

A

Sharp upper edge of the superior pubic ramus - the pectin.

21
Q

What do the tendinous fibres of the transversus abdominis and internal oblique unite to form?

A

Conjoint tendon

22
Q

What does the Conjoint tendon attach to?

A

The pubic crest and pectin (Sharp upper edge of the superior pubic ramus)

23
Q

What is the superficial inguinal ring part of?

A

External oblique aponeurosis - it’s an opening in it

24
Q

What passes through the superficial inguinal ring?

A

Spermatic cord (men) or Round ligament of the uterus (women) - this is contained within the inguinal canal

+ ilioinguinal nerve + genital branch of genitofemoral nerve

25
Q

What are the inferior and superior crura of the superficial inguinal ring attached to respectively?

A

Pubic tubercle and pubic crest

26
Q

Where does the inguinal canal begin?

A

Deep inguinal ring - arch beneath the lower border of the transversus

27
Q

What is the deep inguinal ring part of/made from?

A

Transversus abdominis aponeurosis

28
Q

Describe the presence of an anterior/posterior rectus sheath above and below the arcuate line

A

Above/superior to arcuate line: Anterior and posterior rectus sheath
Below/inferior to arcuate line: Only a thick anterior rectus sheath

29
Q

What is the anterior rectus sheath anterior to (and vice versa)?

A

The rectus abdominis

30
Q

What 3 structures form the borders of Hesselbach’s Triangle?

A

Rectus Abdominis, inguinal ligament and inferior epigastric vessels (which supply the Rectus Abdominis)

31
Q

What does Hesselbach’s Triangle describe?

A

A potential area of weakness in the abdominal wall, through which a hernia can produce

32
Q

What are the fibrous bands in between the muscle bundles of the rectus abdominis known as?

A

Tendinous intersections

33
Q

What is the name/significance of the white fibrous structure that runs down the midline of the abdomen?

A

Linea alba, insertion of both layers of rectus sheath. Xiphoid process –> pubis

34
Q

Describe the differences between a direct and indirect inguinal hernia

A

Direct: protrude through Hesselbach’s Triangle into inguinal canal (only through superficial inguinal ring), caused by weakness in abdominal wall due to age
- medial to IEA

Indirect: protrude through both deep and superficial inguinal rings, due to incomplete closure of deep inguinal ring, most common in males (infancy/old age)
- lateral to IEA

35
Q

Position of Arcuate Line

A

1/3 of distance between umbilicus and pubis

36
Q

Abdominal GIT start and end

A

distal 3-4 cm of oesophagus –> superior rectum

37
Q

Peritoneum

A

sheet of epithelium which lines the internal abdominal walls and organs.

Serous membrane

very difficult to see with the naked eye because it is so thin, but it can be identified as shiny coating on the inside of the abdominal walls and surface of the GIT and accessory organs

38
Q

Intra vs Retroperitoneal organs

A

During development as the GIT becomes folded and as the accessory organs develop, the peritoneum wraps around different structures. Some structures become completely enveloped in peritoneum and are called intraperitoneal organs. Other structures do not become wrapped inside the peritoneum and instead sit behind the peritoneum, these are called retroperitoneal organs.

In the cadaver, it is very easy to see the intraperitoneal structures, however it is really difficult to see the retroperitoneal structures because they are hidden behind the peritoneum at the back of the abdominal cavity.

39
Q

Intraperitoneal organs

A

Abdominal oesophagus
Stomach
Jejunum
Ileum
Caecum
Appendix
Transverse colon
Sigmoid colon
Liver and gallbladder
Spleen

40
Q

Extraperitoneal organs

A

Duodenum (the very first part is intraperitoneal with the stomach)
Pancreas (apart from the tail)
Ascending colon
Descending colon
Superior rectum
Kidneys and ureters
Adrenal glands
Aorta and inferior vena cava

41
Q

Main function and origin of mesentery

A

Origin - peritoneum, function - anchor gut tube to the back of the abdominal wall

42
Q

Visceral vs parietal vs double layers of peritoneum

A

Visceral - lines intraperitoneal organs
Parietal - lines retroperitoneal organs + abdominal wall
Double layers - suspend abdominal organs from each other e.g. omentum, mesentery, mesocolon, peritoneal ligaments

43
Q

What separates transversus abdominis from parietal peritoneum?

A

Transversalis fascia