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MSc Human Anatomy and Education trunk and limbs > abdomen > Flashcards

abdomen Flashcards

1
Q

how is the abdomen divided into quadrants

A

line horizontally and vertically through umbilicus

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2
Q

what are the borders of the abdomen ?

A

superior: costal margin
inferior: pubic symphysis and inguinal ligaments
lateral: iliac crests and skin

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3
Q

what planes divide the abdomen into 9 regions

A

transpyloric plane - level with where 9th costal cartilage and midclavicular line meet
intertubecular plane - line between superior aspects of iliac crests (where the iliac tubercles lie)
mid clavicular lines

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4
Q

where is the subcostal plane and what vertebral level is it level with?

A

inferior border of costal margin and L3 (quite low down!)

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5
Q

what spinal level is the intertubercular plane level with?

A

L5 (and iliac tubercles)

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6
Q

what are the 2 superficial layers of the anterior abdominal wall

A
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7
Q

what is the significance of the arcuate line?

A

above this - the rectus sheath is anterior and posterior to the rectus abdominis
below, all anterior

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8
Q

what is the rectus sheath?

A

aponeurosis of the flat muscles of the anterior abdominal wall

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9
Q

what is the linea alba ?

A

aponeurosis of flat muscles intertwined in midline - attaches from xiphisternum to PS

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10
Q

what are the attachments of rectus abdominis?

A

xiphisternum, costal cartilage 5-7, pubic crest and symphysis

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11
Q

what innervates rectus abdominis?

A

thoracabdominal neves T7-11

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12
Q

where does EO attach?

A

5th-12th rib
linea alba
iliac crest
pubic tubercle

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13
Q

what are the actions of EO and IO ?

A

rotation of trunk - contralateral to each other

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14
Q

what are the attachments of IO ?

A 
10-12 rib 
thoracolumbar fascia 
Linea alba 
iliac crest 
pubic symphysis via conjoint tendon
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15
Q

what are the attachments of transversus abdominis ?

A 
rib 7-12
linea alba 
thoracolumbar fascia 
iliac crest 
pubic crest and conjoint tendon
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16
Q

what innervates IO and TA

A

iliohypogastric and ilioinguinal nerves

thoracoabdominal nerves T7-12

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17
Q

above the acruate line, what aponeurosis can be found anterior/posterior to rectus abdominis?

A

TA posterior
IO - posterior and anterior (splits)
EO - anterior

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18
Q

below the arcuate line, what aponeurosis can be found anterior/posterior to the rectus abdominis?

A

all anterior

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19
Q

what is the deepest layer of the anterior abdo wall?

A

parietal peritoneum

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20
Q

where is the inguinal canal?

A

canal through the anterior abdominal wall parallel and superior to inguinal ligament

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21
Q

what are the borders of the inguinal canal?

A

superior: IO and TA
posterior: transversalis fascia
inferior: inguinal ligament
anterior: EO

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22
Q

identify the superficial inguinal ring

A
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23
Q

where is the deep inguinal ring?

A

transversalis fascia at midpoint of inguinal ligament lateral to inferior epigastric vessels

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24
Q

compare the formation of the inguinal canal in males and females

A

both formed due to the presence of the gubernaculum attaching the gonad to the genital swellings

in females, the ovaries are pulled down into the pelvis then stop hence the remnant of the gubernaculum, the round ligament, passes through the inguinal canal

in males, the teste is pulled all the way through the inguinal canal to the scrotum so the spermatic cord (attaches to the teste) passes through the inguinal canal

in both the male and female, the genital branch of the genitofemoral passes through the canal, and the ilioinguinal nerve enters the canal through the posterior wall/roof and exist via the superficial inguinal ring (doesn’t pass through the deep ring)

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25
Q

what is hesselbachs triangle?

A

triangle where direct inguinal hernias pass through

image is a view from internally

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26
Q

describe the peritoneum

A

continues membrane
divided into two layers based on what the membrane is in contact with
parietal - on inner surface of anterior abdominal wall
visceral - in contact with the intraperitoneal abdominal organs

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27
Q

describe the nerve supply of the peritoneum

A

takes nerve supply of what it is in contact with

visceral - splanchnics
parietal - somatic

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28
Q

what is a mesentery

A

double fold of visceral peritoneum connecting intra-abdominal organ to posterior abdo wall

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29
Q

what is a difference in the structure of the greater and lesser omenta?

A

greater - 4 layers of visceral peritoneum

lesser - 2 layers of visceral peritoneum

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30
Q

what layer of peritoneum covers the retroperitoneum organs?

A

parietal

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31
Q

what is the lesser omentum also known as?

A

hepatogastric and hepatoduodenal ligament

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32
Q

where is the epiploic foramen (aka foramen of windslow)

A

foramen between the lesser and greater sac - hepatoduodenal ligament formes opening of this

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33
Q

where is the greater omentum attached to?

A

greater curve of stomach, proximal duodenum and transverse colon

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34
Q

where does the portal triad run within the lesser omentum

A

free edge of hepatoduodenal ligament

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35
Q

where would the pancreas be on this image?

A

pancreas tail is within the splenorenal ligament which is formed from dorsal mesentery of the foregut

we can see how the pancreas is secondarily retroperitoneal here

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36
Q

where doe the liver and spleen develop in relation to the stomach?

A

liver - ventral mesentry

spleen - dorsal

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37
Q

what is the falciform ligament a remnant of?

A

anterior attachment of ventral mesentry of stomach

double fold of parietal peritoneum

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38
Q

what organs are intraperitoneal?

A

stomach, liver, spleen, gall bladder, jejunum, ileum, caecum, transverse colon, sigmoid colon

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39
Q

what organs are secondarily retroperitoneal?

A

duodenum, pancreas, ascending and descending colon

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40
Q

what structures and organs are primarily retroperitoneal?

A

oesophagus, kidneys, ureters, rectum adrenal glands, aorta, IVC

41
Q

what are the boundaries of the foregut?

A

oesophagus to 2nd part (descending part) of duodenum

42
Q

what are the boundaries of the midgut?

A

2nd part of duodenum to 2/3rds legnth of transverse colon

43
Q

what are the boundaries of the hindgut?

A

distal 1/3rd of transverse colon to anal canal

44
Q

describe the attachment of the small bowel mesentery to the posterior abdominal wall

A

from left hypochondrium to right iliac fossa

45
Q

what arteries supply the foregut, midgut and hindgut?

A

CT, SMA, IMA

46
Q

where does the coeliac trunk branch from the abdominal aorta ?

A

T12 - immediately after aortic hiatus

47
Q

what are the branches of the CT?

A

left gastric, common hepatic and splenic

48
Q

what does the common hepatic artery branch into?

A

proper hepatic - liver

gastroduodenal

49
Q

what does the left gastric artery supply?

A

lesser curve stomach and abdominal oesophagus

50
Q

what does the splenic artery supply?

A

spleen, pancreas, fundus of stomach, greater omentum

51
Q

what are the branches of the SMA ?

A

jejunal, ileal, ileocolic, right colic, middle colic

52
Q

compare the mesentery of the ilium and jejunum

A

jejunum: less fat, longer vasa recta, fewer arterial arcades
ileum: more fat, more arterial arcades, shorter vasa recta

53
Q

what are the branches of the IMA

A

left colic, sigmoid and superior rectal

54
Q

where does the SMA branch

A

L1 - transpyloric plane

branches and over the left renal vein

55
Q

where does the IMA branch

A

subcostal plane - L3

56
Q

what is the missing label?

A

major duodenal papilla - where ampulla of vater drains into duodenum - controlled by sphincter of oddi

57
Q

where does the SMA pass in relation to the duodenum?

A

SMA anterior to inferior part of duodenum

58
Q

what ligament marks the duodenal-jejunal junction?

A

ligament of treitz

59
Q

how can you differentiate the jejunum from the duodenum?

A

mesentery

60
Q

describe the blood supply to the duodenum. why is this significant?

A

Proximal to the major duodenal papilla – supplied by the gastroduodenal artery (branch of the common hepatic artery from the coeliac trunk).
Distal to the major duodenal papilla – supplied by the inferior pancreaticoduodenal artery (branch of superior mesenteric artery).

marks the junction between foregut and midgut derivatives

61
Q

describe the wall of the jejunum and ileum

A

plicae circularis (circular bands of muscle)

more in the jejunum and less in ileum

62
Q

what is a unique feature of large bowel?

A

appendicies epiploicae

teniae coli - these 3 longitudinal bands of muscle contract forming sacculations known as haustra

63
Q

where are payers patches found

A

wall of terminal ileum

64
Q

where do the 3 bands of taenia coalesce

A

appendix

65
Q

label the stomach

A
66
Q

describe the right and left gastric artery

A

right - from proper hepatic
left - from CT
anastamose to form an arcade running on the lesser curve

67
Q

describe the left and right gastroepiploic artery

A

left branches from the splenic
right branches from the gastroduodenal artery

anastomose forming arcade on greater curve

68
Q

what are the 3 layers of muscle in the stomach?

A

longitudinal
circular
oblique

69
Q

describe the venous drainage of the stomach

A

left and right gastric vein into hepatic portal vein

left and right gastroepiploic into SMV/splenic vein

70
Q

where does the IMV drain into?

A

splenic vein

71
Q

describe the anatomical location of the spleen

A

anterior to ribs 9-11
posterior to stomach and splenic flexure of colon
lateral and superior to kidney

72
Q

how can you orientate a spleen?

A

notch on superior border

73
Q

describe the impressions of the spleen

A

renal, gastric, colic

74
Q

describe the anatomy of the pancreas

A 
head 
neck
uncinate process 
body 
tail
75
Q

what 2 arteries supply branches to the pancreas?

A

gastroduodenal and splenic (see workbook)

76
Q

what separates the pancreas from the stomach?

A

lesser sac

77
Q

where is the transverse mesocolon on relation to the pancreas?

A

attaches to the anterior pancreas as this is secondarily retroperitoneal

78
Q

where does the sma emerge relative to the pancreas?

A

posterior/inferior to the neck of the pancreas

anterior to uncinate process

79
Q

descrive the venous drainage of the pancreas?

A

pancreatic veins drain neck, body and tail of pancreas into splenic vein

head drained by SMV/portal vein

80
Q

where is the liver?

A

right hypochondrium mainly

partly left hypochondrium

81
Q

what are the 2 surfaces of the liver?

A

diaphragmatic (superior anterior) and visceral (posterior-inferior)

82
Q

what holds the liver in place?

A

IVC (via hepatic veins and connective tissue)
Falciform ligament
coronary and triangular ligaments
hepatoduodenal and hepatogastric ligaments (lesser omentum)

83
Q

Where are the coronary and triangular ligaments found

A

superior surface of liver (part of diaphramatic surface)

84
Q

label this diagram

A
85
Q

locate the lobes of the liver, as well as the ligamentum venosum and ligamentum teres

A

ligamentum venosum and teres are continuous

86
Q

where is glissons capsule ? describe its innervation

A

deep to visceral peritoneum covering the liver
extends into the liver over the vasculature

innervated by intercostal nerves (somatic) so when stretched - sharp and localised pain

87
Q

describe the blood supply of the liver

A

CT -> common hepatic -> proper hepatic -> left and right hepatic
hepatic portal vein

88
Q

describe the pathway for bile from the liver

A

bile duct joins with cystic duct to form common bile duct, with drains into the duodenum via the ampulla of vata (never acctually joins with pancreatic duct as the enzymes in the pancreatic duct would erode the CBD)

89
Q

where does the cystic artery arise from?

A

right hepatic artery

90
Q

describe a liver lobule

A

central vein
arteriole (from proper hepatic artery)
venule (from portal vein)
bile ductule (drains to bile duct)

91
Q

describe the areas of the gall bladder

A
92
Q

where do the cystic veins drain into?

A

portal vein

93
Q

describe the location of the gall bladder

A

lies on inferior border
fundus is most anterior lateral
neck more medial and posterior

94
Q

where do the kidneys sit?

A 
T11 left 
T12 right (lower due to liver)

inferior pole - L3/L4

95
Q

what level is the renal hilum at?

A

L1 ish - left renal vein passes over the aorta just inferior to where the SMA branches

gonadal branch distal to this from aorta

96
Q

describe the flow of urine out of the kidney

A

tubules (within medullary pyraminds), papilla, minor calyx, major calyx, renal pelvis, ureter, bladder, urethra

97
Q

label the kidney

A

renal column is where the vessels run between the pyramids

98
Q

what 2 large muscles overly the posterior kidney

A

quadratus lumborum and psoas major

99
Q

describe how the renal artery branches in the kidney

A

anterior/posterior, each give 5 segmental branches, interlobar arteries, arcuate arteries which then give of interlobular (tiny) arteries

MSc Human Anatomy and Education trunk and limbs (8 decks)

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