Abdomen Flashcards
1
Q
Where is the abdomen located?
A
Between thorax and pelvis
2
Q
What separates the thoracic cavity?
A
Thoracic diaphragm
3
Q
Why is the abdomen divided into regions?
A
Descriptive purposes
4
Q
What may abdomen regions assist with?
A
Identifying source of pain
5
Q
What are the two abdomen regions?
A
Quadrants or 9 regions
6
Q
What are the two planes in the quadrant region?
A
- Horizontal = transumbilical
- Vertical = median
7
Q
What are the planes that make up the 9 regions of the abdomen?
A
Subcostal: passes through inferior borders of 10th costal cartilages
Transtubercular: passes through iliac tubercles located approx. 5cm posterior to ASIS, at lvl of L5
Midclavicular (2): Mid point of clavicles to midinguinal points (1/2 way between the ADID and the pubic symphysis)
8
Q
How to remember subcostal plane?
A
sub = under
costal = ribs
under ribs
9
Q
How to remember transtubercular plae?
A
trans = across
tubercular = tubercles
across (iliac) tubercles
10
Q
How to remember mid clavicular?
A
mid = middle
calvicular = clavicle
mid clavicle
11
Q
What does the anterolateral abdominal wall consist of?
A
Skin, subcutaneous tissue, muscles, deep fascia, extraperitoneal fat, parietal peritoneum
12
Q
What are the aterior abdominal wall muscles from superficial to deep?
A
- External oblique
- Internal oblique
- Transverse abdominal muscle
13
Q
What is another name for extraperitoneal fat?
A
Endoabdominal fat
14
Q
What are the flat anterior abdominal muscles?
A
Exteral oblique (superficial)
Internal oblique (intermediate)
Transverse abdominal (innermost)
15
Q
What are the vertical anterior abdominal muscles?
A
Rectus abdominis
Pyramidalis
16
Q
External oblique origin and insertion
A
O: Ext. surface of ribs 5-12
I: Linea alba, pubic tubercle, ant. 1/2 iliac crest
17
Q
External oblique nerve supply and actions
A
N: Thoracoabdominal nn (vetral rami inf. 6 thoracic nn) and subcostal n
A: Flexion and contralateral rotation of trunk
18
Q
What direction do the fibres of external oblique run?
A
Inferomedially
19
Q
What does the inferior margin of the external oblique aponeurosis form?
A
Inguinal ligament
20
Q
Internal Oblique origin and insertion
A
O: Thoracolumbar fascia, ant. 2/3 iliac crest, lat 1/2 inguinal lig
I: Inferior borders of ribs 10-12, pectineal line via conjoint tendon
21
Q
Internal Oblique nerve supply and actions
A
N: Thoracoabdomial nn (ventral rami inf. 6 thoracic nns) and first lumbar n
A: Flexion and ipsilateral rotation of trunk, compression and support of abdominal viscera
22
Q
What direction do the internal oblique fibres run?
A
Horizontally: at level of ASIS
Obliquely upward: superior to ASIS
Obliquely downward: inferior to ASIS
23
Q
Tranverse abdominal origin and insertions
A
O: Inf. surfaces of costal cartilages 7-12, thoracolumbar fascia, iliac crest, lateral 1/3 of inguinal lig.
I: Linea alba with aponeurosis of internal oblique, pubic crest and pectineal line via conjoint tendon
24
Q
Transverse abdominal nerve supply and actions
A
N: AThoracoabdominal nn (ventral rami inf. 6 thoracic nn) and first lumbar n
A: Compression ad support of abdominal viscera
25
What direction do the fibres of traverse abdominal travel?
Transversomedially
Inferior fibres run parallel to fibres of IO
26
What do all the flat muscles end in?
Sheet-like aponeurosis
27
Where do the aponeurosis interlace and what do they form?
Linea alba and form the tough, tendinous rectus sheath
28
What is intramuscular exchange?
Aponeurosis of the left external oblique will cross at the linea alba and communicate with the fibres of the right external oblique
29
What is intermuscular exchange?
Right INTERAL oblique fibres will intercept with the fibres of the left EXTERNAL oblique at the midclavicular line
30
What does the interlacing of fibres cause?
Rectus sheath
31
What muscle runs in the rectus sheath?
Rectus abdominis
32
Rectus abdominis origin and insertions
O/Distal: pubic symphysis ad pubic crest
I/Proximal: Xiphoid process and costal cartilages 5-7
33
Rectus abdominis nerve supply and actions
N: Thoracoabdominal nn (ventral rami of inf. 6 thoracic nn)
A: Flexes trunk; compression and support of abdominal viscera
34
Where is most of the rectus abdominis found?
Mostly in rectus sheath
35
Where is the rectus abdominis anchored?
Transversely to ant. layer of rectus sheath at tendinous intersections
36
What forms the openings of each end of the inguinal canal?
Lateral end: deep inguinal ring
Medial end: superficial inguinal ring
37
What is the deep inguinal ring?
Opening in the transversalis fascia
38
What is the superficial inguinal ring?
Opening in exteral oblique aponeurosis
39
What is the inguinal canal?
Anatomical passageway - 4cm in length (adults)
Runs in oblique, inferomedial direction across the anterolateral abdominal wall
40
What is the anterior wall of the inguinal canal?
Aponeurosis of external oblique
41
What is the posterior wall of the inguinal canal?
Transversalis fascia
Conjoint tendon of internal oblique and transverse abdominal mm
42
What is the floor of the inguinal canal?
Inguinal ligament
- Folds back on itself to form a trough
43
What is the roof of the inguinal canal?
Fibres of internal oblique and transverse abdominal mm
44
What is the contents of the inguinal canal?
Males: Spermatic cord
Females: Round ligament of uterus, nerves, vessels ad lymphatics
45
Where is the parietal peritoneum and what separates it?
Deep to transversalis fascia
Separated by variable amount of extraperitoneal (endoabdominal fat)
46
What are the two layers of peritoneum?
Parietal peritoneum
Visceral peritoneum
47
What is the parietal peritoneum?
Line internal surface of abdominal and pelvis walls
Sensitive to pain, temp, pressure and touch
48
What is the blood and nerve supply of the parietal peritoneum?
Same as the reegion of the wall it lies on
- Cutaneous nerve: sensitive to pain, temp, pressure and touch
49
What is the visceral peritoneum?
Covers abdominal viscera
Sensitive to stretch and tearing
50
What is the blood and nerve supply of the visceral peritoneum?
Same as organs it covers
- Visceral afferent fibres not sensitive
51
What is the peritoneal cavity?
Potential space between parietal and visceral layers
Normally empty except for thin layer of fluid that keeps the peritoneal surfaces moist
52
What is peritoneal fluid?
Allows viscera to move without friction
Pale yellow and viscid
Contains leukocytes and antibodies that resist infection
53
What disease processes involve the peritoneal cavity?
Peritonitis: associated with fibrinous exudate that causes peritoneal layers to adhere (useful for infections, but can cause pain and dysfunction if excessive)
Ascites: accumulation of fluid in peritoneal cavity
54
Are there organs in the peritoneal cavity?
NO
55
What are intraperitoneal organs?
Almost completely covered with visceral peritoneum
Most are attached to the post abdominal wall by mesenteries
- Stomach, spleen
56
What are extraperitoneal or retroperitoneal organs?
Are external or posterior to the parietal peritoneum
Only partially covered with peritoneum, usually just one surface
- Kidneys
57
What are all the intraperitoneal organs?
Stomach, duodenum, jejunum and ileum, transverse colon, sigmoid colon, rectum (superior), liver, spleen, tail of the pancreas
58
What are all the extraperitoneal or retroperitoneal organs?
Kidneys, adrenal glands, pacreas, ureters, aorta, parts of the intestines (ascending and descending) oesophagus, rectum
58
What are the three descriptive terms for peritoneum?
Mesenteries, omenta, peritoneal ligaments
59
What do the parts of the peritoneum do?
Permit blood vessels, lymph vessels and nerves to reach viscera
60
What are the mesenteries?
Coect organs to the posterior abdominal wall
Are named for the organs that it ivests e.g. mesogastrium, mesoappendix, mesocolon
61
What are the lesser omenta attachments?
Lesser curvature of the stomach, proximal duodeum
Proximal duodenum
Liver
62
What are the greater omenta attachments?
Attached to greater curvature of stamach and proximal duodenum
After descending it folds back, attaching to anterior surface of transverse colon and mesentery
63
What are the peritoneal ligaments?
Double layered aspects of peritoneum
Connect organ with another organ or to the abdominal wall
64
What are the peritoneal ligaments of the liver?
Falciform (attaches liver to anteroabdominal wall), gastrohepatic, heptaoduodenal ligaments
65
What are the posterior abdominal wall muscles?
Psoas major, iliacus and quadratus lumborum
66
Psoas major O, I, N and A
O: TPs of L1-5, vertebral bodies and IVDs or T12-L5
I: Lesser trochanter of femur
N: Ventral rami of L1-3
A: Flexes thigh; flexion and lateral flexion of the trunk
67
Iliacus O, I, N and A
O: Iliac fossa, ant. sacrum, sacroiliac ligaments
I: Lesser trochanter of femur
N: Femoral nerve L2-4
A: Flexes thigh and stabilises hip joint (acts with psoas major)
68
Quadratus lumborum O, I, N and A
O: Inf border of rib 12 and TPs of L1-5
I: Iliolumbar ligament and iliac crest
N: Ventral rami of T12-L4
A: extends and laterally flexes vertebral column, fixes rib 12 during inspiration
69
What is the somatic nervous system?
The somatic nervous system is responsible for voluntary control over skeletal muscles and enables conscious movement and sensory perception
Sense touch, temp, pain
70
What are the somatic motor neurons?
Nerves that supply skeletal muscle
71
What is the autonomic nervous system?
Operating as automatic machine
The autonomic nervous system is responsible for involuntary control over internal organs and bodily functions, regulating processes like heart rate, digestion, and respiratory rate.
72
What are the nerves that supply the anterolateral wall?
Thoracoabdominal nn (T7-11)
- Continuation of ventral rami of thoracic spinal nerves
- Cutaneous nerve distribution similar to dermatomes
Subcostal nn (T12)
Iliohypogastric nn (L1)
Ilioinguinal nn (L1)
73
Which aspect of the nervous system is specific to the GIT?
Enteric nervous system
74
Thoracolumbar outflow
Division: SNS
Origin: T1-L2/3
Neurons: Adrenergic (noadrenaline/adrenaline)
Functions: Fight/flight
75
Craniosacral outflow
Division: PNS
Origin: CN S2-4
Neurons: Cholinergic - muscarinic
Functions: Rest/digest
76
Which cranial nerves have parasympathetic function?
3, 7, 9 and 10
77
Paravertebral ganglia
Sympathetic trunks on each side of the vertebral column
78
Prevertebral (preaortic) ganglia
Celiac ganglion
Superior mesenteric ganglion
Inferior mesenteric ganglion
79
What are the cardiopulmonary splanchnic nerves formed by?
Post-synaptic neurons located within cardiac, pulmonary, oesophageal plexuses
80
What do the cardiopulmonary splanchnic nerves supply?
Heart, lungs, oesophagus
81
What are the abdominopelvic splanchnic nerves formed by?
Pre-synaptic neurons
82
Where do the abdominopelvic splanchnic nerves pass synapse?
Prevertebral ganglia (exception: adrenal gland)
83
What do the abdominopelvic splanchnic nerves supply?
Abdominopelvic viscera
84
What do the abdominopelvic splanchnic nerves cosist of?
Greater splanchnic (T5-T9/10)
Lesser splanchnic (T9-T10/11)
Least splanchnic (T12)
Lumbar splanchnic (L1-3)
85
Where do pre and post synaptic nerves meet?
Terminal ganglia located near or within the target organ
86
Where is the nerve cell body for a pre-synaptic neuron of the vagus nerve found?
Dorsal motor nucleus of the medulla
87
What does the vagus nerve supply?
All cardiothoracic viscera as well as abdominal visceral up until the left colic (splenic) flexure
- Junction of transverse and descending colon
88
What do the pelvic splanchnic nerves supply
Remaining abdominal viscera (not supplied by CNX)
Also supplies pelvic viscera
89
What aspect of the nervous system is the pelvic splachnic nerves?
PNS
90
What aspect of the nervous system are the abdominopelvic nerves?
SNS
91
What levels are the abdominopelvic nerves?
T5-L2/3
92
What are the parasympathetic plexuses?
Cranial nerve 10 (X)
Pelvic splanchnic nerves
93
What are the sympathetic plexuses?
Cardiopuolmonary splanchnic nerves
Abdominopelvic splanchnic nerves
94
How do visceral afferet fibres anatomically travel?
Accompany either sympathetic or parasympathetic fibres (impulses travel in the opposite direction)
95
How do visceral afferent fibres function?
Provide information about the body's internal environment (integrated by CNS and triggers visceral and/or somatic reflexes)
96
Does normal visceral activity cause sensation?
NO
97
Where is visceral pain located?
It is poorly localised
98
What might cause visceral pain?
Sudden distension, spasms or strong contractions, chemical irritants, mechanical stimulation
99
What can lower the threshold to visceral pain?
Pathological conditions (esp.ischaemia)
100
What are the unpaired visceral branches of the abdominal aorta?
Celiac trunk (T12)
Sup. mesenteric artery (L1)
Inf. mesenteric artery (L3)
101
What are the paired visceral branches of the abdominal aorta?
Suprarenal artery (L1)
Renal artery (L1/2)
Gonadal artery (ovarian or testicular) (L2)
102
What is the primary drainage of the abdomen?
Inferior vena cava
103
Where does the inferior vena cava begin?
L5 vertebra (union of common iliac vein) and returns poorly oxygenated blood to rt. atrium
104
What is the region of drainage of the inferior vena cava?
Lower limbs, most of post. abdominal wall and abdominopelvic viscera
105
What do the tributaries of the inferior vea cava correspond with?
Branches of the abdominal aorta
106
How do the left and right sides of the inferior vea cava differ?
On the left side the left gonadal vein and left suprarenal vein drain into the left renal veing before entering the inferior vena cava
On the right side they all drain directly into the inferior vena cava
107
Where is almost all the blood collected in the GIT?
Portal system and passes through hepatic veins into IVC
108
Where does the IVC leave the abdomen?
THrough caval foramen in the diaphragm and enters thorax
109
What process of embryology is the primitive gut formed in?
Lateral folding
110
What is formed by the heads and tails folding?
Caudal and cephalic regions
111
What structures come from the ectoderm?
Epidermis, hair, nails, glands of skin
Brain and spinal cord
112
What is the notochord?
Specialised structure that gives signals off to establish nervous structures and neural tube
- Exists as nucleus pulposis in spinal cord
113
What part of embryology does most of the abdomen come from?
Splanchnic mesoderm
