Abdomen Flashcards
There are five
lumbar vertebrae out of which first ___ is typical and ___ is atypical
four (L1 to L4) are typical
and fifth (L5) is atypical.
Difference between typical and atypical luber vertebrae
Atypical
The transverse processes are thick, short, and pyramidal
in shape.
The body is largest of all lumbar vertebrae
The spine is small, short, least substantial, and rounded
at the tip
A lumbar vertebra ossifies from
three primary centres and
five secondary centres.
What’s Sacralization of the fifth lumbar vertebra:
It is the
fusion of the fifth lumbar vertebra with the sacrum. The
fusion may be complete or incomplete
Which may lead to the compression of the L5 spinal nerve
What’s Spondylolisthesis
In normal conditions, which parts of the fifth lumbar vertebra and sacrum interlock with each
other.
Spondylolisthesis: It is the forward slipping of the fifth
lumbar vertebra over the sacrum
Normally inferior articular processes of L5 vertebra interlock with the articular processes of the sacrum.
What’s Spina bifida
Spina bifida: It occurs due to non fusion of two halves of
the vertebral arch. In this condition the meninges and
spinal cord are exposed and may herniate out in the
midline through the gap
Structures Emerging through Sacral Hiatus
- Fifth sacral (S5) nerves.
- Coccygeal (C×1) nerves.
- Filum terminale.
What are the structures that relates with the ala of sacrom, medial to laterally
Sympathetic chain
Lumbersacral trunk
Iliolumber Artery
Obturator nerve
Each hip bone consists of three parts:
And sre fused together and forms
ilium, ischium, and pubis
Acetabulum
Sympathies pubies consists of
L&R pubic bone
Acetabulum is a fusion of ___’ bone
Obturator foraman is the fusion of ____ bine
Iliac, pubic & ishium
Obturator–pubic & ishium
Most prominent feature on the dorsal surface of
the sacrum
Presence of five vertical crests
The ant. Wall of the abdomen is bonded by?
Above by xiphoid process
R&L by costal margin
Below by pubic symphasis, pubic crest, pubic tubercle, iliac crest
Seperated from pst. By mid axillary line
McBurney’s line is also called___&
It runs from ___ to____
McBurney’s line
(spino-umbilical line)
Umbilicus to Right Ant. Superior Iliac Crest
Where’s the McBurney’s point
And it’s relevance
It is a point at the junction of medial 2/3rd and lateral 1/3rd
of the line
Appendix lies deep in there
What’s Murphy’s point and it’s relevance
It’s a point that corresponds to the tip of the 9th costal cartilage. The fundus of gall bladder lies deep to
this point.
What are the layers of the abdominal wall
- Skin.
- Superficial fascia.
- External oblique muscle.
- Internal oblique muscle.
- Transversus abdominis muscle.
- Fascia transversalis.
- Extraperitoneal tissue.
- Parietal layer of peritoneum.
NB: deep fascia is absent
Umbilicus lies in the same line as?
In adults L3 to L4
In infant and old people it’s lower
The skin around the umbilicus is supplied by T10 spinal segment. Therefore, visceral pain of appendicitis is referred to the umbilicus (note the appendix is supplied by T10 spinal segment
T
Campers fascia
Campers fascia is the superficial fascia of the abdomen is continuous with the superficial fascia of the adjoining areas of the body. Over the penis, it is devoid of fat, and in the scrotum, it is replaced by an involuntary dartos
muscle.
Most common vertical incision given in the anterior abdominal wall
Paramedian incision
___ incision is used to work on the gallbladder?
Kocher’s incision (Right subcostal incision): It is given 2
to 5cm below and parallel to the right costal margin
- What is umbilical hernia?
What are the various types of umbilical hernias?
Any hernia which is closely related to the umbilicus is called umbilical hernia.
Congenital, Acquired and paraumblical hernia
What’s congenital umbilical hernia
Congenital umbilical hernia is the protrusion of bowel through the weak scar of the umbilicus just after the fall of the atrophied umbilical cord or few months later
Acquired umbilical hernia is the protrusion of abdominal contents through the umbilical scar in the adults due to raised intra-abdominal
pressure.
Paraumbilical hernia is the common acquired hernia. It appears through a defect, which is close to the umbilical scar
Content of the pelvic cavity
- Loops of the small intestine.
- Sigmoid colon, rectum, and anal canal.
- Urinary bladder, lower part of the ureters, and urethra.
What organ secrets intrinsic factors needed for absorption of vital. B12
Stomach
Among the extensions of the inguinal ligament where does femoral hernia take place?
This ligament is triangularin shape with apex attached to the pubic tubercle– Lacunar lig.
Others–pectineal, reflected part & ilioinguinal lig.
The inferior part of the femoral sheath is divided into ___
By 2 anteroposterior fibrous septa.
compartments and contains?
- Lateral compartment lodges the femoral artery and genital branch of the genitofemoral nerve.
- Middle compartment contains the femoral vein.
- Medial compartment is relatively empty and called femoral canal. It contains lymph node
Boundaries of the femoral canal
Anterior: Inguinal ligament
Medial: Sharp edge of the lacunar ligament
Posterior: Pecten pubis
Lateral: Femoral vein
Inguinal canal lies @ lateral or medial half of the inguinal ligament?
Medial 1/2
Deep inguinal ring is_____ while superficial is ______ in shape
Oval
Triangular gap in external oblique @pubic crest
Contents of the deep inguinal ring in male & female
Male
Ductus deferens and its artery
• Testicular artery and the
accompanying veins
• Obliterated remains of
processus vaginalis
• Genital branch of
genitofemoral nerve
• Autonomic nerves and
lymphatics
Female
• Round ligament of uterus
• Obliterated remains of
processus vaginalis
• Lymphatics from the
uterus
Content of superficial inguinal ring
Male
• Spermatic cord
• Ilioinguinal nerve*
Female
• Round ligament of uterus
• Ilioinguinal nerve*
___ doesn’t enter the deep inguinal ring but Peirces through the canaland passes through the superficial inguinal ring
Ilioinguinal Nerve
INGUINAL TRIANGLE (HESSELBACH’S TRIANGLE) boundaries
Medal– lower lateral border of rectus abdomimus
Lat. Inferior epigastric artery
Inf. Medial half of inguinal ligament
All the contents of inguinal canal lie within the
spermatic cord except
Ilioinguinal nerve
The superior horizontal plane lies @
The inferior horizontal plane lies @
L1
L5
Contents of L&R hypochondric region
Right hypochondrium • Liver
• Gallbladder
Epigastric region • Stomach
• Pancreas
• Duodenum
Left hypochondrium • Spleen
• Left colic flexure
Contents of the L&R luber region and umbilical region
Right lumbar region • Right kidney
• Right ureter
• Ascending colon
Umbilical region • Loops of small intestine
• Aorta
• Inferior vena cava
Left lumbar region • Left kidney
• Left ureter
• Descending colon
Contents of the L&R iliac fossa and hypo gastric region
Right iliac fossa • Caecum
• Appendix
Hypogastric region • Coils of small intestine
• Urinary bladder (if distended)
• Uterus (if enlarged)
Left iliac fossa • Sigmoid colon
the abdominal cavity
is divided into four quadrants by
a horizontal transumbilical
plane passing through the umbilicus and a vertical median
plane intersecting the horizontal plane at the umbilicus
The largest serous sac of the body is made by?
Peritoneum
Peritoneal is lined with simple squamous
The peritoneum covering the uterus is lined by?
Cuboidal Excited
Difference between parietal and viseral peritoneum
Arrangement of the parietal layer of the peritoneum is simple Arrangement of the visceral layer of peritoneum is complex
Embryologically it is derived from the somatopleuric layer of the
lateral plate mesoderm
Embryologically it is derived from the splanchnopleuric layer of
the lateral plate mesoderm
Retroperitoneal organs are classified into
Primarily retroperitoneal
• Kidneys
• Suprarenal glands
• Ureters
Secondarily
retroperitoneal
(mesentery lost during
development by zygosis)
• Pancreas (except tail)
• Duodenum (except initial 2 cm)
• Ascending colon
• Descending colon
• Caecum
• Rectum (upper two-third)
Some organs are initially suspended by the peritoneal folds, i.e., they possess mesenteries but later on lose their mesenteries by a process called
zygosis and become retroperitoneal.
What’s zygosis?
The zygosis is a process of absorption of the mesentery. One layer of the mesentery fuses with the parietal peritoneum and then fused portions of visceral and parietal peritoneum are absorbed and organ become retroperitonealized
The functions of peritoneal folds are
- To provide mobility to the viscera.
- To provide passage to vessels and nerves
The peritoneal folds are classified into.
mesentery/mesocolon, omenta, and ligaments
The fold suspending the small
intestine is called mesentery and the fold suspending
the colon is called mesocolon.
