Abdomen Flashcards
1
Q
what is the abdomen a part of
A
the trunk
2
Q
the abdomen is between what two things
A
thorax and pelvis
3
Q
what is superior to the abdomen
A
the inferior thoracic aperature
4
Q
what is inferior to the abdomen
A
the pelvic gridle
5
Q
what part of the vertebral column is associated with the abdomen
A
the lumbar column
6
Q
what is the abdomen able to do while the flexibility of the thorax and pelvis continue?
A
it is able to enclose itself and protect itself
7
Q
how many regions are there in the abdomen?
A
9
8
Q
the nine regions are used to describe what
A
the location of
- organs
- pains
- pathologies
9
Q
what are the four planes that line the nine regions of the abdomen
A
2 sagittal(vertical) 2transverse
10
Q
the two sagital planes are also known as…
A
midclavicular planes
11
Q
where do the two sagital planes pass from?
A
midpoint of the clavicle and the midinguinal parts
12
Q
what are also known as the subcostal plane and the transtubercular plane
A
the transverse planes
13
Q
where do the subcostal plane pass through
A
inferior border of the 10th costal cartilage on each side
14
Q
where does the transtubercular plane pass
A
the illiac tubercles on the body of L5
15
Q
the transpyloric plane is the midway between what?
A
the superior border of the manubrium and the pubic symph
L1 level
16
Q
what structures is the transpyloric plane a landmark for?
A
- fundus of gallbladder
- neck of the pancreas
- hilia of kidney
- superior mesenteric artery and vein
- duodenum
- transverse mesocolon
17
Q
the interspinous plane passes through what
A
easily palpated anterior spine of the illiac
18
Q
the abdominal wall is musculoaponeurotic except for..
A
the posterior wall (includes lumbar vertebrae)
19
Q
why is the term anterolateral wall used
A
because the boundaries between anterior and lateral are indefinite
20
Q
what structures are in both the anterior and lateral walls of abd
A
muscles and cutaneous nerves
21
Q
all skeletal origin for the anterolateral wall of abdomen is from..
A
the ribs and xiphoid process (cartilages 7-10)
22
Q
walls of the abdomen mainly consist of
A
- skin
- subcutanous tissue(superficial fascia)
- muscles
- aponerosis of musckes
- deep fascia
- parietal peritoneum
23
Q
the skin is loosely attached the subcutaneous tissue except where?
A
except at the umbilicus
24
Q
skin is tightly adheres to the..
A
umbilicus
25
what kind of pressure zone is the abdomen
it is a positive pressure zone so everything is always trying to escape
26
where is the most common site for herniation
inguinal wall
27
where is the major site for fat storage
the subcutaneous tissue
28
some areas in the stomach have fat even durring..
starvation
29
what is known as the sagging folds found in morbid obese people
panniculi
| single form- panniculus or apron
30
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
31
membranous layer ( scarpa fascia) is continous with what
colles fascia ( superifical perinal fascia)
32
where does the Scarpa Fascia ends where
2.5cm of innguinal lig
33
the scarpa fascia is not continuos with what
lata fascia
34
what fascia is tightly structured?
lata fascia
35
the investing fascia covers what
external aspects of the three muscle layers of the anterolateral abdominal wall
36
what is the internal aspect of the abdominal wall lined with
endoabdominal fascia ( has varying thickness)
37
investment means?
surrounding a structure like you are giving it a hug
38
different parts of fascia are named based on what
the apenorosis or muscle it is lining
39
what is the lining of the abdominal cavity called
the parietal peritoneum
40
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
41
where can potential fluid gather?
between the membranous layer of the subcutaneous tissue and the deep fascia
42
why can fluids not spread inferiorly into the thigh
because of the membranous layer fuses with the deep layer of the thigh (fascia lata)
43
what is an
| important part for surgery
fat filled space between the endoabdominal fascia
44
the kidney's and the lumbar vertebrae can be reached by
cutting through the endoabdominal fascia and accessing the extraperitonel fat
45
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
46
the space between the transversalis fascia and the parietal peritoneum
the space of Bogros
47
what is the space of Bogros used for
placing a prostheses for example when repairing inguinal hernias
48
what are the three flat muscles in the abdomen
- external oblique
- internal oblique
- transverse abdominal
49
which muscles run from the side and are the deepest ones
the transverse abdominal muscles
50
the three flat muscles are so strong why
because they fuse together
51
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!!
52
what encloses the rectus abdominis muscle
the rectus sheath ( aponerous of three muscles)
53
where is the linea alba?
in the middle of the abdomen, extending from the midclavicular line to the pubic symphysis
54
the two vertical muscles un the abdomen wall that are under the rectus sheath are called?
rectus abdominis and pyramidalis
55
where does the spinoumbilical line run
from umbilicus to the anterior superior illiac crest
56
the inguinal ligament is continuos with what
the deep fascia of the thigh
57
the inguinal ligament serves as what
a retaining band for the structures underneath of the thigh
| fixes structures where they should be
58
the internal oblique muscles has thoracolumbar fascia but what doesn't
the external oblique muscles
59
what are the long, broad, strap-like muscles
rectus abdominis
60
what is the principle vertical muscle
rectus abdominis
61
rectus abdominis are seperated by what
linea alba
62
what is broad and thin superiorly and thick inferiorly
rectus abdominis
63
what kind of hernia can happen in the rectus abdominis muscle that are closer to the top
epigastric hernia
64
rectus abdomins are separated by
3 or more tendinous sheaths
65
when tensed in muscular people the stretches of rectus abdominis muscle between the tendons do what
bulge out
66
the pyramidalis is absent in how many people
20%
67
what is the strong compartment of the abdomen that is made up of incomplete fibers that covers the rectus abdominis
rectus sheath
68
external oblique contributes to what portion of the rectus sheath
the anterior wall
69
what splits into two laminae that go anteriorly and posteriorly to the rectus abdominis
the internal oblique
70
below umbilicus the rectus sheath stops making the wall what
deficient
71
warm hands are important when palpating the abdominal wall why
because cold hands will make the muscles tense, causing spasm to occur
72
intense guarding across things like the appendix when what is happening
when there is inflammation ( the aim is to isolate that portion)
73
involuntary muscular spasms attempt to do what
protect the viscera from pressure
74
what is the good postion for abdomen palpation
supine with knees and thighs semiflexed (enables relaxation)
75
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
76
what is the only protection that most of abdomen wall have
abdominal wall
77
superficial ABDOMINAL reflex is elliceted how
by horizontally stroking the abdomen wall
78
in what people will you might not feel contractions
obese people
79
you cannot dissect things in what area
umbilical area (ring) all muscles are fused here so we avoid it
80
why are prominent abdomen common in infants and children
because they have more air in there GI tract
81
liver and spleen are big in who
infants and kids, causing prominent belly
82
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)
83
organomegaly
organ enlargement
ex: like splenomegaly)
- if you can palpate enlargement then it is pathological
84
three places hernias are likley to happen
- inguilanl (MAX) 90%
- umbilical
- epigastric
85
what hernias are common in kids
umbilical (umbilical ring)
due to pressure, especially in low birth babies
86
acquired umbilical hernias occur most in?
women and obese people
87
usually what do you see in umbilical hernia
extra peritoneal fat
88
line along which the fibers of abdomen aponeruoses is a good spot for
herniation
89
gaps in aponeruouis can be ...
congenital
or due to the stress of obese and aging people
ALSO SURGERY
90
epigasttric hernia occurs where
between xiphoid and umbilicus
91
spigelian hernias?
this happens where the muscles become aponeurotic
92
spigelian hernia occur in who
people over 40 and obese people
93
if the hernia is small then what? if big?
small- fat
| big- might have intestine
94
all nerves for the abdomen run how
anteriorinferiorly
95
injury of abdomen nerve during surgery can cause
herniation and weakness of muscles
96
planned incisions for abdomen should not be
vertical
97
it is ideal to follow what when making incisions
Langer's Lines
98
high risk incisions include what
- pararectus ( along lateral border of rectus sheath) and inguinal incisions
99
incisions on pararectus is unadvised why
because you may cut the nerve supply
100
during inguinal incisions to repair hernia you may harm the
ilioinguinal nerve
101
incisional hernia
hernia due to incision ( protrusion or organ or omentum(fold of peritoneum)
102
incisional hernia can result from
muscular and aponeurotic layers not healing properly
103
factors that can lead to incisional hernia are
- age
- obesity
- postoperative wound infection
104
many abdominal procedures are performed how today?
endoscope
