Abdomen 1 Flashcards
What is the abdominal cavity bounded by?
It is bounded by
abdominal walls,
diaphragm, &
pelvis
What is the abdominal cavity enclosed by?
It is enclosed by
1) anterolaterally- muscular abdominal walls
2) superiorly- diaphragm
3) within the thoracic cage to level of 4th intercostal space continuous
4) inferiorly to pelvic cavity
What is the abdominal cavity lined by?
lined with peritoneum
What are the 9 regions to locate organs or pain sites?
right & left hypochondriac right & left lateral (lumbar) right & left inguinal epigastric umbilical pubic (hypogastric) 4
What are the 4 planes of the abdominal region?
2 horizontal: ( 1 subcostal & 1 transtubercular)
2 vertical: ( 2 midclavicular)
What are the clinical regions of the abdominal region?
right & left upper quadrants
right & left lower quadrants
What are the 2 planes that are found in the clinical region?
1 vertical (median) 1 horizontal (transumbilical)
What is the Anterolateral Abdominal Wall divided into?
anterior
right & left lateral (flanks)
posterior walls
Is the boundary between the anterior & lateral of the Anterolateral Abdominal Wall definite?
No the boundary between anterior & lateral is indefinite
What is the the Anterolateral Abdominal Wall bounded by superiorly and inferiorly?
It is bounded by:
superiorly- 7-10th ribs & xiphoid
inferiorly- inguinal ligaments & pelvis
What are the three layers of fascia of anterolateral wall and what do they cover?
Three layers: superficial, intermediate and deep
These layers cover external aspects of the 3 muscles
How many muscles does the Anterolateral Abdominal Wall have?
5 paired muscles: 3 flat & 2 vertical
Name the muscles of the Anterolateral Abdominal Wall?
Internal oblique External oblique Transverse abdominal (deep) Rectus Abdominis Pyramidalis Muscle
What are the characteristics of the External oblique muscle?
1) It is superficial
2) fibers run inferomedially
3) inferior margin thickens because it forms the inguinal ligament
What are the characteristics of the Internal oblique muscle?
1) It is an intermediate muscle
2) some fibers are parallel & some perpendicular to ext. oblique
What are the characteristics of the Transverse abdominal muscle?
1) It is the innermost muscle
2) fibers run mostly horizontally
What are the characteristics of the rectus abdominis muscle?
1) It is a long, broad strap-like muscle enclosed in rectus sheath
2) the muscle fibers run in 3 groups between tendinous intersections (level of xiphoid, umbilicus, & point halfway between)
What are the characteristics of the Pyramidalis muscle?
1) it is a small, triangular shaped muscle in rectus sheath anterior to inferior part of rectus abdominis
2) It ends in linea alba which it tenses
3) it is absent in 20% of people
What is the rectus sheath between midclavicular lines & midline made up of and what is it called?
It is made up of aponeurosis
Forms: linea alba
Why is the linea alba of clinical significance?
You can make an incision here b/c the muscles aren’t in the way and it’s avascular
What are the functions of Anterolateral Abdominal muscles?
- Form strong expandable support for anterolateral wall
- Protect abdominal viscera
- Compress abdominal viscera to maintain intra-abdominal pressure (elevates diaphragm during respiration, eructation (belching), yelling etc)
- Produce force for defecation, micturition, parturition
- Produce anterior/lateral flexion of trunk
What is parturition?
When pregnant woman are in LABOR
What to consider when abdominal surgical incisions made?
They are made depending on:
1) type of operation
2) location of organs
3) avoidance of nerves/vessels
What is the Internal Surface of Anterolateral Abd. Wall covered with?
It is covered with:
1) transversalis fascia
2) extraperitoneal fat
3) parietal peritoneum
What do some infraumbilical folds of the Internal Surface of Anterolateral Abd. Wall contain?
They contain remnants of vessels supplying the fetus.
Where is the Median Umbilical Fold located and where does it cover?
Location: urinary bladder to umbilicus
Covers: median umbilical ligament
What is the difference between the medial, median, and lateral umbilical folds?
Median Umbilical Fold: from urinary bladder to umbilicus & covers median umbilical ligament
Medial Umbilical Folds: lateral to median fold & cover medial umbilical ligaments (occluded parts of umbilical arteries)
Lateral Umbilical Folds: lateral to medial folds & cover inferior epigastric vessels SO DON”T CUT THEM!
Where is the inguinal area located?
between anterior superior iliac spine and the pubic tubercle
Why is the inguinal area clinically important? *
1) It is clinically important as sites for herniation
2) mostly males (86%) because of passage of spermatic cord
3) testes migrate from abdomen
Where is the Inguinal Ligament located?
It is most inferior part of external oblique aponeurosis
Where do the inguinal ligament fibers attach?
most fibers attach to pubic tubercle
But some form lacunar ligament, pectineal ligament (of Cooper) & reflected inguinal ligament.
What is the inguinal canal related to?
it is related to descent of testes or ovaries
How long is the inguinal canal?
4 cm long
Where is the inguinal canal located and what is occupied by?
parallel & superior to inguinal ligament, has openings at each end
occupied by spermatic cord or round ligament of uterus
Describe the deep (Internal) Ring.
Lateral, enter canal from lateral
It is an evagination of transversalis fascia & is lateral to inferior epigastric vessels
Describe the Superficial (External) Ring.
slit-like ring between fibers of external oblique aponeurosis
What is the inguinal canal made up of (4) parts?
Anterior wall
Posterior wall
Roof
Floor
How is the Anterior wall of inguinal canal formed and reinforced?
formed by ext. oblique aponeurosis
reinforced by fibers of internal oblique
How is the posterior wall of inguinal canal formed and reinforced?
formed by transversalis fascia
reinforced by merger of int. oblique & transverse abdominis fibers (conjoint tendon)
How is the roof of inguinal canal formed?
formed by transversalis fascia & arches of abdominal wall muscles
Where does the spermatic cord begin and end?
begins at deep inguinal ring, exits at superficial ring
ends in scrotum at posterior border of testes
What is the the spermatic cord covered in and what does the covering contain?
covered in fascia including cremasteric fascia which contains cremaster & dartos muscles
List all the contents of the spermatic cord.
ductus deferens, testicular artery, cremasteric artery, pampiniform venous plexus, sympathetic nerve fibers, genital branch of genitofemoral nerve, lymphatic vessels
What is a scrotum?
It cutaneous sac with 2 layers (pigmented skin & dartos fascia)
What is the role of the fascia in the scrotum?
the fascia elevates the scrotum preventing heat loss in cold weather
Where are the testes located?
they are suspended in scrotum by spermatic cord
What do testes produce?
produce sperm & hormones (principally testosterone)
Where does sperm production occur?
sperm forms in seminiferous tubules that are joined by straight tubules to the rete testis
Where are the tunica albuginea and tunica vaginalis located?
outer surface is tunica albuginea
tunica vaginalis is a closed peritoneal sac surrounding testes
Where are the Testicular Arteries located and run?
arise from aorta just distal to renal arteries & run retroperitoneally and crossing over ureters
What do the Testicular Arteries cross and what do they become?
cross the inguinal canal
become part of spermatic cord
What is an Epididymus?
it is an elongated structure on posterior surface of testis
What structure transports sperm and where does sperm mature?
efferent ductules transport sperm from rete testis to epididymus where they mature
Describe a sperm cell.
It has a head, body & tail
whats the most common incision for C-sections?
low transverse incision
name the umbilical folds
median umbilical
medial
lateral
In women what is similar to the spermatic cord?
round ligament
