Abdomen Flashcards
Layers of anterolateral wall of abdomen
Skin Camper fascia (fatty) Scarpa fascia (membranous) External oblique + investing fascia Internal oblique + investing fascia Transversus abdominis + investing fascia Transversalis fascia Extraperitoneal fat Parietal peritoneum
3 major unpaired branches of the abdominal aorta
Area they supply
Celiac trunk (foregut) Sup mesenteric (midgut) Inf mesenteric (hindgut)
Branches of celiac trunk
Left gastric
Splenic
Common hepatic
Branches of left gastric a (from celiac trunk from aorta)
Esophageal
Branches of splenic a (from celiac trunk from aorta)
Post gastric Short gastric aa Left gastro-omental artery Splenic branches Dorsal pancreatic
Left gastric from…
Right gastric from…
Left from celiac trunk
Right from Hepatic Artery proper from Common Hepatic from Celiac Trunk
Left gastroomental from…
Right gastroomental from…
Left from splenic from celiac trunk
Right from gastroduodenal from common hepatic from celiac trunk
Branches of Common Hepatic
Hepatic artery proper
Gastroduodenal artery
Branches of hepatic artery proper (from common hepatric from celiac trunk)
Right gastric
Right and left branches to liver
Cystic artery
Branches of gastroduodenal artery (from common hepatic from celiac trunk)
Supraduodenal
Right gastro-omental
Sup pancreaticoduodenal
Branches of sup mesenteric artery
Ileocolic Right colic Middle colic Inf pancreaticoduodenal aa Jejunal aa Ileal aa
Name of vessel that is anastamosis b/w sup and inf mesenteric aa
Marginal a
Branches of inf mesenteric artery
Left colic
Sup sigmoid aa
Sigmoid aa
Sup rectal
Parasym nerves of abdomen come from…
Sym nerves of abdomen come from…
Parasym: vagus
Sym: splanchnic
Where does vagus end?
left colic flexure
Path of splanchnic nerves from thorax to abdomen
Travel in front of aorta through hole in diaphragm for aorta
Ganglionic plexi of abdomen
Celiac
Sup mesenteric
Inf mesenteric
Parasympathetic innervation below the left colic flexure come from what nerves?
pelvic splanchnic nerves
Parasym nerves originate…
Sym nerves originate
Parasym: head and pelvis
Sym: thoracolumbar area
Muscles of anterolateral wall
External oblique
Internal oblique
Transversus abdominis
Quadratus lumborum
External oblique
Origin
Insertion
Origin: ribs 5-12 Insertion: --Linea alba --Pubic tubercle --Ant half of iliac crest
Internal oblique
Origin
Insertion
Origin: --Thoracolumbar fascia --Iliac crest --Inguinal ligament Insertion --Ribs 10-12 --Linea alba --Pecten pubis via conjoint tendon
Transversus abdominis
Origin
Insertion
Origin: --Costal cartilages 7-12 --Thoracolumbar fascia --Iliac crest --Inguinal ligament Insertion: --Linea alba w/ aponeurosis of internal oblique --Pubic crest Pecten pubis via conjoint tendon
Rectus abdominus
Origin
Insertion
Origin: pubic symphysis and pubic crest
Insertion: Xiphoid process and 5th-7th costal cartilages
Fascia surrounding oblique muscles originated from
Thoracolumnar fascia
Deep inguinal ring
entrance to inguinal canal
Superficial inguinal ring
exit by which spermatic cord/round ligament emerges from inguinal canal
Subinguinal space
Located below inguinal canal and above the hip bone
Passage for things to move from pelivis –> leg (femoral NAV)
Inguinal canal formed by…
Inguinal ligament
Fascia of obliques and transversus abdominis
Lateral and medial crus come from…
Ext oblique aponeurosis
Inguinal falx (conjoint tendon)
Where aponeuroses of int oblique and transversus abdominus fuse to form back wall of inguinal canal
Ant wall of inguinal canal formed by…
External oblique aponeurosis
Post wall of inguinal canal formed by…
Inguinal falx (conjoint tendon) Transversalis fascia
Floor of inguinal canal formed by…
Inguinal ligament
Muscles near inguinal canal
Iliopsoas made by:
Iliacus and
Psoas major
Iliopsoas allows for what movement
Main flexor hip
Parts of lumbar plexus
Iliohypogastric (sensory)
Ilio-inguinal (sensory)
Common iliac aa from…
Branch into…
From descending aorta
Branch into ext and int iliac
Branches of ext iliac a
Superficial epigastric (in front of rectus abdominus) Inferior epigastric (behind rectus abdominus)
Branches of int thoracic a
Musculophrenic (also supplies diaphragm)
Superior epigastric
Arcuate line
point where rectus sheath goes entirely in front of rectus muscle (lower part of rectus)
Median umbilical fold
Location
Remnant of…
Location: comes off bladder in midline of abdominal wall
Remnant of urachus (outgrowth of gut called allantois)
Medial umbilical fold
Location
Remnant of…
Location: located lateral the median umbilical cord
Remnant of umbilical aa (go toward umbilicus, took deox blood from fetus out to placenta to be oxygenated)
Round ligament of liver
Remnant of…
Umbilical vein
Gonads begin near…then descend
the kidneys
Gubernaculum
Connects testis/ovaries to ant abdominal wall
Shortens to pull gonads down
Spermatic cord includes
Testicular a and v
Vas deferens
Layers of scrotum
- External spermatic fascia (from ext oblique muscle)
- Cremasteria fascia (from int oblique muscle)
- Internal spermatic fascia (from transversalis fascia)
- Tunica vaginalis (from peritoneum)
Ligament of ovary from…
Round ligament of uterus from…
Ligament of ovary from upper gubernaculum
Round ligament from lower gubernaculum
What passes through inguinal canal in males?
Females?
Males: Spermatic cord
Females: Round ligament of uterus
Testicular vein AKA
pampiniform plexus
What connects testis and epididymis?
Rete testis
2 spaces of peritoneal cavity
Greater sac Lesser sac (omental bursa)
Greater sac Lesser sac (omental bursa)
Greater: everything outside the lesser omentum
Lesser: space below liver and behind stomach
Everything behind the lesser omentum
Retroperitoneal
structures that are external to the peritoneum
Secondarily retroperitoneal
Start off as intraperitoneal, then fuse to post body wall to become retroperitoneal
Intraperitoneal
structures that are internal to the peritoneum
Retroperitoneal organs
Kidneys
Ovaries
Testis
Secondarily retroperitoneal organs
Ascending colon Descending colon Duodenum Pancreas Rectum
Mesentery
Double layer of peritoneum
that occurs as a result of the invagination of the peritoneum by an organ and constitutes a continuity of the visceral and parietal peritoneum
–Connects intraperitoneal organ to the body wall
Greater omentum
Developed from what mesentery?
- -4-layered peritoneal fold
- -hangs down from the greater curvature of the stomach and duodenum
- -after descending, folds back and attaches to ant surface of the transverse colon and its mesentery
- -Developed from dorsal mesentery
Lesser omentum
Developed from what mesentery?
- -2-layered peritoneal fold
- -connects lesser curvature of stomach and duodenum to liver
- -Developed from ventral mesentery
Dorsal mesentery
Ventral mesentery
Dorsal: anchors gut to post wall
Ventral: anchors top part of gut to parietal peritoneum; surrounds liver, pancreas, duodenum
Ligaments of greater omentum
Gastrophrenic ligament
Gastrosplenic ligament
Gastrocolic ligament
Ligaments of lesser omentum
Gastrohepatic ligment
Hepatoduodenal ligament
Indirect inguinal hernia
loop of small intestine exits into inguinal canal via deep inguinal ring
Direct inguinal hernia
breaks straight through post wall of inguinal canal
Femoral hernia
gut passes under inguinal canal and comes out with femoral a and v
Umbilical hernia
gut comes out into umbilicus (newborns
External iliac goes to…
Internal iliac goes to…
Ext: exits pelvis and becomes femoral a
Int: stays in pelvis
Hepatic portal sys
all blood from gut goes to liver via hepatic portal vein
Hepatic portal sys is confluence of what vv?
Splenic v
Inf mesenteric v (branch of splenic)
Sup mesenteric v
Branches of sup mesenteric vein
Ileocolic
Right colic
Middle colic
Branches of inf mesenteric vein
Left colic
Sigmoid
Recto-sigmoid
Parts of stomach (external surface)
Cardia Fundus Body Pyloric antrum Pyloric canal
Internal surface of stomach
Gastric folds (rugae) Angular incisure (notch in lesser curvature) Pyloric sphincter
What side of the body are these organs?
Spleen
Liver
Spleen: left
Liver: right
What organ is behind the stomach, nestled into the C shape of the duodenum?
Pancreas
3 parts of small intestine
Intra, retro, or sec retro?
Duodenum: sec retro
Jejunum: intra
Ileum: intra
Compare jejunum and ileum based on... Location Inside surface Arterial arcades Vasa recta Windows Encroaching fat
Jejunum
- -L upper quadrant
- -many ridges inside
- -few, large arterial arcades
- -long vasa recta
- -larger windows
- -less encroaching fat
Ileum
- -R lower quadrant
- -Becomes progressively smoother
- -many, short arterial arcades
- -short vasa recta
- -smaller windows
- -more encroaching fat
Windows
spaces b/w vasa recta
Layers of wall of small intestine
Visceral peritoneum (serosa) --> from mesentery Subserosa Muscularis externa --with myenteric plexus (Auerbach) Submucosa --with submucosal plexus (Meissner) Muscularis mucosae Mucosa
Pancrease releases…
Digestive enzymes (carb and protein digestive enzymes) Bicarbonate soln
Blood supply of pancreas
Sup pancreatocoduodenal aa (from common hepatic from gastroduodenal)
Inf pancreaticoduodenal aa (from sup mesenteric)
Dorsal pancreatic a (from splenic)
Parts of duodenum
Sup
Desc
Horiz
Asc
First part of sup part of duodenum is …peritoneal
Second part
Rest of duodenum
First part: intraperitoneal
Second part: retroperitoneal
Rest of duodenum: sec retroperitoneal
Exit from what organs into duodenum?
Pancreas
Liver (bile)
Hepatopancreatic ampulla
Confluence of bile duct and main pancreatic duct
Enter duodenum via major duodenal papilla
Minor duodenal papilla
opening where accessory pancreatic duct enters duodenum
Parts of large intestine
Cecum Asc Transverse Des Sigmoid Rectum Anal canal
outer longitudinal muscle arranged as strips on outside of large intestine
Tenuae coli
subdivisions/segments of large intestine; correspond with semilunar folds
Haustra
folds on inside of large intestine that correspond with haustra
Semilunar folds
Ileocecal junction
where ileum of SI and cecum of LI join
–1st named branch of sup mesenteric a is here
Appendix attached to what part of large intestine?
Cecum
Subinguinal space
Below aponeurosis of ext oblique
Conduit for femoral NAV
Superficial inguinal ring located b/w…
lateral and medial crus
Lateral crus attaches to…
Medial crus…
Lateral: pubic tubercle
Medial: pubic crest
Upper gubernaculum forms…
Lower gubernaculum…
Upper: ligament of ovary
Lower: round ligament of uterus
Where are sperm produced?
Seminiferous tubercles
What kind of nerves run along with splanchnic nerves?
Sensory
When contract…
Longitudinal muscle…
Circular muscle…
Long: shortens
Circular: squeezes
Function of muscles of SI…
Muscularis externa
Muscluaris mucosae
Externa: peristalsis
Mucosae: regulates blood flow
What is the joining of the bile duct and main pancreatic duct?
Hepato-pancreatic ampulla
What is the opening into the duodenum for the hepato-pancreatic ampulla?
Major duodenal papilla
Opening for accessory pancreatic duct into duodenum?
Minor duodenal papilla
