Abdomen Flashcards
Organs and abdominal viscera are protected by
Fat and muscles, no bony protection
Left upper quadrant structures
The tip of the medial liver lobe, spleen, stomach, left kidney, pancreas, splenic flexure, and parts of the transverse and descending colons
Right upper quadrant structures
Liver, duodenum, pyloris, right kidney, hepatic flexure, portions of ascending and part of the transverse colon
Left lower quadrant structures
Sigmoid colon, descending colon, bladder, left ovary, uterus, left spermatic cord, and left ureter
Right lower quadrant structures
Appendix, cecum, ascending colon, bladder, right ovary, uterus if enlarged, right spermatic cord, and right ureter
Under the skin in the abdominal region we have fat to serve as
Thermal insulation and protection from trauma. Also a large band of fascia which runs up and down and connects to the rectus abdominis and will be continuous with the thoracolumbar fascia in the back
Rectus abdominis
Origin: ribs 5,6,7
Inserts: pubic tubercle
Action: trunk flexion, compresses and supports the abdominal viscera
Innervated by ventral rami from T8-T12
Global muscle - its superficial and produces large movement
External abdominal oblique
Origin: lower 8 ribs
Insertion: ASIS and pubic tubercle via the inguinal ligament; interdigitate (connect) with the serratus anterior
Action: contralateral trunk rotation
External oblique runs down and forward (hands in pockets)
Also a global muscle
Internal oblique
Origin: inguinal ligament
Insertion: linea alba, lower 4 or 5 ribs
Action: ipsilateral trunk rotation
Will connect to the back of the thoracolumbar fascia, fibers will run down and backwards
Called a local muscle, meaning its deeper, one of the “core” muscles
Transverse abdominis
Comes from the deepest layers of the thoracolumbar fascia and will come forward to pass deep to the rectus abdominis
Action: compresses and supports the abdominal viscera
Will fire first during trunk flexion and extension for stabilization
Also a local muscle
Patients with lower back pain (or SI pain or during/post pregnancy) have
Motor control issues of the muscles around the lumbopelvic hip complex. Not a strength issue, its about firing at the appropriate time
Abdominal cavity is lined with
Peritoneal lining
Organs that are behind the lining are called
Retroperitoneal (i.e. kidneys, and most of your duodenum (first part of small intestine))
Omenta
Two: greater and lesser omen, associated with the stomach
Mesocolon
Associated with the large intestine
Mesenteries: associated with with the small intestine
Ligaments
Peritoneal duplications between the two organs (i.e. pancreato-splenic ligament)
Omenta, mesocolon, and ligaments function
Give the abdominal organs support and help connect one abdominal organ to another abdominal organ
Food pathway after we swallow
Food travels through our esophagus and through the cardiac sphincter to the stomach. Stomach has two parts: fundus is first, body is second. From the stomach food will pass through the pyloric sphincter to the small intestine, specifically the duodenum. From the duodenum we hit the jejunum and then we go to the ileum. From the ileum we heads to the first part of the large intestine, the cecum. Then it goes to the ascending colon to the transverse colon to the descending colon to the sigmoid colon to the rectum and out.
Duodenum
C-shaped organ with 4 parts: superior, descending, transverse, and ascending.
It is a double chamber with 2 functions: receives input from the pancreas and liver.
It will have a connection to the pancreas (LUQ) via the common pancreatic duct
Liver
Left lobe in the left upper quadrant but is primarily in the right upper quadrant.
The liver is the breakdown for everything that comes into our system.
The function of the liver is also to produce bile
Gallbladder
Functions to store bile.
Sits on top of liver.
Can be removed if it becomes problematic
Pancreas
Organ of digestion (exocrine gland that secretes enzymes to go to the duodenum to start digestion), and is also an organ of the endocrine system (secretes hormones).
It has 2 types of cells alpha and beta. Alpha cells release glucagon and beta cells release insulin. Insulin will lower blood glucose sugar by taking glucose from the blood to cells. Glucagon will increase blood sugar by doing the opposite.
First sign of pancreatic cancer can be lower thoracic pain. There is no screening test for pancreatic cancer
Large intestine
Function is water reabsorption.
Has 5 parts: ascending colony, transverse colon, descending colon (LLQ), S-shaped or sigmoid colon, rectum
Appendix
In the RLQ right off the cecum. People who have right lower quadrant pain and rebound tenderness (when you go to push into the belly it hurts but as soon as the hands let go it hurts even more – rebound guarding) this is a sign of peritoneal inflammation, might have appendicitis and it may need to be removed. Only a 20-minute operation if you get to it before it ruptures, if you get to it after it ruptures there’s bacteria all over the place and you get very sick and you’re in the hospital for 3 or 4 days minimum
Spleen
Above the duodenum and pancreas in the LUQ.
Organ of the circulatory system - produces and destroys red blood cells
Kidneys
Retroperitoneal. Function to filter blood and pass urine out through the body. Kidneys are a long term regulator of blood pressure.
Lymphatic fluid drains through the
Groin (inguinal lymph nodes) and the axilla (axillary lymph nodes)
Posterior abdominal wall
We see the posts major, the quadratus lumborum (attaches to the 12th rib and give us hip hiking - works with opp glut med), and the femoral and obturator nerves roots L2-L4
