Abdomen Flashcards
what is the abdomen a part of
the trunk
the abdomen is between what two things
thorax and pelvis
what is superior to the abdomen
the inferior thoracic aperature
what is inferior to the abdomen
the pelvic gridle
what part of the vertebral column is associated with the abdomen
the lumbar column
what is the abdomen able to do while the flexibility of the thorax and pelvis continue?
it is able to enclose itself and protect itself
how many regions are there in the abdomen?
9
the nine regions are used to describe what
the location of
- organs
- pains
- pathologies
what are the four planes that line the nine regions of the abdomen
2 sagittal(vertical) 2transverse
the two sagital planes are also known as…
midclavicular planes
where do the two sagital planes pass from?
midpoint of the clavicle and the midinguinal parts
what are also known as the subcostal plane and the transtubercular plane
the transverse planes
where do the subcostal plane pass through
inferior border of the 10th costal cartilage on each side
where does the transtubercular plane pass
the illiac tubercles on the body of L5
the transpyloric plane is the midway between what?
the superior border of the manubrium and the pubic symph
L1 level
what structures is the transpyloric plane a landmark for?
- fundus of gallbladder
- neck of the pancreas
- hilia of kidney
- superior mesenteric artery and vein
- duodenum
- transverse mesocolon
the interspinous plane passes through what
easily palpated anterior spine of the illiac
the abdominal wall is musculoaponeurotic except for..
the posterior wall (includes lumbar vertebrae)
why is the term anterolateral wall used
because the boundaries between anterior and lateral are indefinite
what structures are in both the anterior and lateral walls of abd
muscles and cutaneous nerves
all skeletal origin for the anterolateral wall of abdomen is from..
the ribs and xiphoid process (cartilages 7-10)
walls of the abdomen mainly consist of
- skin
- subcutanous tissue(superficial fascia)
- muscles
- aponerosis of musckes
- deep fascia
- parietal peritoneum
the skin is loosely attached the subcutaneous tissue except where?
except at the umbilicus
skin is tightly adheres to the..
umbilicus
what kind of pressure zone is the abdomen
it is a positive pressure zone so everything is always trying to escape
where is the most common site for herniation
inguinal wall
where is the major site for fat storage
the subcutaneous tissue
some areas in the stomach have fat even durring..
starvation
what is known as the sagging folds found in morbid obese people
panniculi
single form- panniculus or apron
the subcutaneous tissue inferior to the umbilicus has two layers what are they called?
superficial fatty layer
(Camper’s fascia)
deep membranous layer Scarpa Fascia
membranous layer ( scarpa fascia) is continous with what
colles fascia ( superifical perinal fascia)
where does the Scarpa Fascia ends where
2.5cm of innguinal lig
the scarpa fascia is not continuos with what
lata fascia
what fascia is tightly structured?
lata fascia
the investing fascia covers what
external aspects of the three muscle layers of the anterolateral abdominal wall
what is the internal aspect of the abdominal wall lined with
endoabdominal fascia ( has varying thickness)
investment means?
surrounding a structure like you are giving it a hug
different parts of fascia are named based on what
the apenorosis or muscle it is lining
what is the lining of the abdominal cavity called
the parietal peritoneum
why is extraperitoneal fat annoying for a surgeon
becuase it makes surgery difficult because you have to cut through it and the arteries can slip around overall making it a difficult procedure
where can potential fluid gather?
between the membranous layer of the subcutaneous tissue and the deep fascia
why can fluids not spread inferiorly into the thigh
because of the membranous layer fuses with the deep layer of the thigh (fascia lata)
what is an
important part for surgery
fat filled space between the endoabdominal fascia
the kidney’s and the lumbar vertebrae can be reached by
cutting through the endoabdominal fascia and accessing the extraperitonel fat
by entering the fat in the abdominal wall during surgery you avoid what
contamination, because you do not enter the membranous peritoneal sac that contains the abdominal viscera
the space between the transversalis fascia and the parietal peritoneum
the space of Bogros
what is the space of Bogros used for
placing a prostheses for example when repairing inguinal hernias
what are the three flat muscles in the abdomen
- external oblique
- internal oblique
- transverse abdominal
which muscles run from the side and are the deepest ones
the transverse abdominal muscles
the three flat muscles are so strong why
because they fuse together
the three flat muscles make a sheet like aponeruoses in the anterior portion, why is this important
because it is very strong as well as LIGHT!!
what encloses the rectus abdominis muscle
the rectus sheath ( aponerous of three muscles)
where is the linea alba?
in the middle of the abdomen, extending from the midclavicular line to the pubic symphysis
the two vertical muscles un the abdomen wall that are under the rectus sheath are called?
rectus abdominis and pyramidalis
where does the spinoumbilical line run
from umbilicus to the anterior superior illiac crest
the inguinal ligament is continuos with what
the deep fascia of the thigh
the inguinal ligament serves as what
a retaining band for the structures underneath of the thigh
fixes structures where they should be
the internal oblique muscles has thoracolumbar fascia but what doesn’t
the external oblique muscles
what are the long, broad, strap-like muscles
rectus abdominis
what is the principle vertical muscle
rectus abdominis
rectus abdominis are seperated by what
linea alba
what is broad and thin superiorly and thick inferiorly
rectus abdominis
what kind of hernia can happen in the rectus abdominis muscle that are closer to the top
epigastric hernia
rectus abdomins are separated by
3 or more tendinous sheaths
when tensed in muscular people the stretches of rectus abdominis muscle between the tendons do what
bulge out
the pyramidalis is absent in how many people
20%
what is the strong compartment of the abdomen that is made up of incomplete fibers that covers the rectus abdominis
rectus sheath
external oblique contributes to what portion of the rectus sheath
the anterior wall
what splits into two laminae that go anteriorly and posteriorly to the rectus abdominis
the internal oblique
below umbilicus the rectus sheath stops making the wall what
deficient
warm hands are important when palpating the abdominal wall why
because cold hands will make the muscles tense, causing spasm to occur
intense guarding across things like the appendix when what is happening
when there is inflammation ( the aim is to isolate that portion)
involuntary muscular spasms attempt to do what
protect the viscera from pressure
what is the good postion for abdomen palpation
supine with knees and thighs semiflexed (enables relaxation)
what two things that can make palpation of the abdomen difficult ( done by patient)
placing hands behind head and lying your thighs straight, this tightens the muscle
what is the only protection that most of abdomen wall have
abdominal wall
superficial ABDOMINAL reflex is elliceted how
by horizontally stroking the abdomen wall
in what people will you might not feel contractions
obese people
you cannot dissect things in what area
umbilical area (ring) all muscles are fused here so we avoid it
why are prominent abdomen common in infants and children
because they have more air in there GI tract
liver and spleen are big in who
infants and kids, causing prominent belly
eversion of the umbilicus can be a sign of what
an accumulation of fluid in the peritoneal cavity ( pressure, can be tumor or the liver)
organomegaly
organ enlargement
ex: like splenomegaly)
- if you can palpate enlargement then it is pathological
three places hernias are likley to happen
- inguilanl (MAX) 90%
- umbilical
- epigastric
what hernias are common in kids
umbilical (umbilical ring)
due to pressure, especially in low birth babies
acquired umbilical hernias occur most in?
women and obese people
usually what do you see in umbilical hernia
extra peritoneal fat
line along which the fibers of abdomen aponeruoses is a good spot for
herniation
gaps in aponeruouis can be …
congenital
or due to the stress of obese and aging people
ALSO SURGERY
epigasttric hernia occurs where
between xiphoid and umbilicus
spigelian hernias?
this happens where the muscles become aponeurotic
spigelian hernia occur in who
people over 40 and obese people
if the hernia is small then what? if big?
small- fat
big- might have intestine
all nerves for the abdomen run how
anteriorinferiorly
injury of abdomen nerve during surgery can cause
herniation and weakness of muscles
planned incisions for abdomen should not be
vertical
it is ideal to follow what when making incisions
Langer’s Lines
high risk incisions include what
- pararectus ( along lateral border of rectus sheath) and inguinal incisions
incisions on pararectus is unadvised why
because you may cut the nerve supply
during inguinal incisions to repair hernia you may harm the
ilioinguinal nerve
incisional hernia
hernia due to incision ( protrusion or organ or omentum(fold of peritoneum)
incisional hernia can result from
muscular and aponeurotic layers not healing properly
factors that can lead to incisional hernia are
- age
- obesity
- postoperative wound infection
many abdominal procedures are performed how today?
endoscope
