Abdomen Flashcards
Rectus Abdominus is intersected horizontally by ____ and vertically by ____
Tendinous interection
Linea Alba
Formed by the free inferior border of the external oblique aponeurosis
Inguinal Ligament
Layers of anterior abdominal wall, out > in
Skin
Sub Q Fat, "Camper's Fascia"
Deep Membranous Sub Q Tissues, "Scarpa Fascia"
Rectus Fascia *Separated by *Investing Fascia*
- External Oblique
- Internal Oblique
- Transverse Oblique
Endoabdominal Transversalis Fascia
Extraperitoneal Fat
Parietal PeritonealThree layers of muscles of anterolateral abdominal wall (Out > In)
External Oblique - attaches to Iliac Crest
Internal Oblique
Transverse Abdominus
Rectus Abdominus
A horizontal line that demarcates the lower limit of the posterior layer of the rectus sheath. It is also where the inferior epigastric vessels perforate the rectus abdominis.
Arcuate Line
Where do nerves of abdominal wall travel
Between Internal Oblique and Transversus Abdominis muscles
5 nerve groups that innervate abdominal wall
Thoracoabdominal nerves (T7 - T11) **Anterior cutaneous branches and lateral cutaneous branches**
Subcostal nerve, lateral and anterior cutaneous branch, (T 12)
Iliohypogastric nerve (L1)
Iliolingual nerbe (L1)
Abdominal Wall Arteries
Superior Epigastic (where does it come from? Internal Thoracic Artery?)
Inferior Epigastric
Superficial Epigastric
External Iliac (leads to above two arteries?)
Femoral (leads to external iliac)
Pros of Midline Vertical Incision
More surgical visibility
Incision is extendable
Lower risk of infection, especially if patient is obese
Cons of Midline Vertical Incision
Higher risk of Dehiscence
Cosmetic
Pros of Low Transverse Incision
Cosmesis
Lower risk of Dehiscence
Abdominal folds
Lateral - Inferior epigastric artery
Medial - Obliterated fetal umbilical artery
Median - Obliterated fetal urachus
Where is the internal inguinal ring and what travels through it?
Lies near Lateral Abdominal Fold
Indirect Inguinal Hernias Testis Ductus Deferens Testicular artery and vein Spermatic cord
Where is the external inguinal ring and what travels through it?
Just anterior to the Medial Fold (fetal umbilical a.)
Direct inguinal hernias
Recesses in the peritoneal cavity between the anterior part of the liver and the diaphragm, separated into R and L by the falciform ligament
Subphrenic Space
Lesser Sac
Lesser omentum, between liver and stomach
Omental foramen
Omental bursa
Celiac trunk and Pancreas? inside
Where do lower and middle esophagus blood supply drain?
Azygous system
Where do middle and lower rectum blood supply drain?
Pudendal Vein > Internal Iliac System > Inferior Vena Cava
Two venous detours used when there’s Portal Hypertension
Iliac System (rectum)
Azygous System (lower esophagus)
Branches off abdominal aorta, top-down
Celiac Trunk Superior Mesenteric Renal Inferior mesenteric Common Iliac External Iliac Internal Iliac Femoral
At what area of the spine does the aorta bifurcate
L4
3 Main branches of the Celiac Trunk
Left Gastric
Splenic
Common Hepatic
Common Hepatic branches / organs
Left Hepatic
Right Hepatic
Cystic
Right Gastric
Pancreato-duodenal
Supplies:
Liver, gallbladder, stomach, duodenum, pancreas (head and neck)
Left Gastric Branches / organs
Gastric artery branches
Esophageal branches
Supplies:
Stomach and esophagus
Splenic branches / organs
Pancreatic
Short gastric
Splenic
Supplies:
Spleen, stomach, pancreas (neck body tail)
Branches of the Superior Mesenteric Artery
Inferior Pancreatoduodenal (head of panc, lower duod)
Intestinal (ileum and jejunum)
Ileocolic (last part ileum, cecum, appendix)
Right Colic (ascending colon)
Middle Colic (transverse colon)
Branches of Inferior Mesenteric Artery
Left colic artery (descending colon)
Sigmoid branches
Superior rectal artery (terminal IMA)
