Abdomen Flashcards
what are the borders of the abdomen
roof= diaphragm
floor= none- continuous with pelvic cavity
abdominal contents= fixed but considerable vartion
what are the subdivision of the abdominal wall
- anterior abdominal wall
- right lateral wall
- left lateral wall
- posterior wall
what does you call the anterior and lateral walls
anterolateral walls
– this is because they do not have specific boundaries
what are the boundaries of the anterolateral wall
superior= right and left costal margina inferior= inginal ligament
what is the inginal ligament
a lien connecting each anterior superior iliac spine to pubic tubercle/spine ( close to pubic symphysis )
what is the alba
divides the anterior abdominal wall into right and left
what is the linea semilunaris
cured line or groove from the 9th costal cartilage to the pubic tubercle
what are the abdominal wall layers
skin superficial fascia muscles deep fascia subserous fascia parietal peritoneum
what is the superficial fascia
this is where you will find the fat and can be very thick in this area of the body. which contains subcutaneous fasica
what is subserous fascia
also called visceral fascia
-layer of loose connective tissue that hold the peritoneum to the deep fascai of abdominal wall
what is parietal peritoneum
this is serous membrane that lines the abdominal cavity
what fascia can be found above the umbilicus
superficial subcutaneous fascia and it is only a single layer of connective tissue with a variable amount of fat
what fascia can be found below the umbilicus
the superficial subcutaneous fascia is divided into 2 layers
- a fatty superficial layer
- deep membranous layer
what is the fatty superficial subcutaneous layer
this is called campers fascia
what is the deep membranous layer
scarpa’s fascia
what is the divers analogiy
superficial layer = skin divers suit w/ 1/2 of swim trunks
divers suit=campers fasica
1/2 pair of swim trunks= scarpa fascia
skin= deep fasica
what does the deep membranous layer do
reinforces the superficial fascia with collagen and elastic fibers
what is the deep fascia
this is the skin of the diver
** this is continuous as the other deep fascia in other areas
- this fascia covers the abdominal muscles of the anterolaeral wall
- contains endoabdominal fascia (transversalis)
what is endoabdominal fascia
a thin layer beneath the muscles of the anterior abdominal wall and parietal peritoneum ( line the wall)
how is the endoabdominla fascia named
they are named for according to the muscles or aponeurosis it is lining
what does he endoabdominal fascia separate
the deep surfaces for transverse and rectus abdominis from the underlying extraperitoneal fat and peritoneum
what are the flat muscles of the anterolateral wall
external oblique
internla oblique
transverse abdomins
what do the flat muscles combine to form
a strong sheet of aponuerosis and fuse at the midline the linea alba
what is the straplike vertical muscles of the anterolaeral wall
rectus abdominis
what is the rectus abdominis enclosed in
rectus sheath and anchored transversly by 3 or more tendinous intersections
what does the tendinous intersections of the rectus abdominis do
they aid in forward flexion
what is the pyramindalis
this is in 80% of people
–tense the llinea alba
O: pubic symphysis and pubic crest
I: linea alba
what does the inferior margins of the external oblieque m form
they form the inguinal ligaments
what happens above the arcuate line
internal oblique splits to surround rectus abdominis
what happens below the arcuate line
inferior oblique and transverse abdominis combine and pass superficial to rectus abdominis
*rectus abdominis rest directly on transversalis fascia
What is the arcuate line
makes the transition form aponeurotic posterior wall to transversalis fascia
- this is where the inferior epigastric a. pierces rectus abd m.
- an arched line wher a change in the thickness of the sheath occurs
what is the rectus sheath
this acts like plywood
– the different of the muscles directions give it its toughness
what are the nerves of the anterolateral wall formed by
anterior and lateral cutaneous branches of lower 5 intercostal nerves T7-T11
and T12 is formed by subcostal n
and the 1st lumbar n.
what are the thoracoabdominal nerves
the continuation of lower intercostal n.
what does the thoracoabdominal n. innervate
the abdominal m.
T7-12
what does the T7-T9 n supply
skin superior and lateral to the umbilicus
what does the T10 n supply
skin around the umbilicus
what does the n T11 and T12 supply
skin inferior lateral to the umbilicus
what nerve supplies the inferior part of anterior wall
1st lumbar n
what are the branches of the 1st lumbar n
- iliohyposgastric n (L1)
- ilioinguinal n ( L1)
what does the iliohyposgastric n (L1) supply
skin over theupper inguinal region, iliac crest, hypogatric region
what does the ilioinguinal n ( L1) supply
skin over the lower inguinal region, genetalia, the medial aspect of the thigh
how does the cutaneous veins of the anterolateral wall drain
1 upward to the thoracoepigastric and lateral thoracic vein
2 downward to the great saphenous vein
what happens with the subcutaneous veins near the umbilics anastomose with
they anastomose with the portal vein
wahta re the major arteries of the anterolateral wall
- (2) Internal thoracis a from above
- (2) external iliac a from below
what are the branches of the internal thoracic a
from the subclavian
- superior epigastric a
- musculophrenic a
what are the branches of the external iliac a
from the femoral a.
- inferior epigastric a
- deep circumflex iliac a
what are the superior feeds ( arteries ) of the anterolateral wall
- superior epigastric a
- musculophrenic a
- 10th and 11th posterior intercostal arteris
- subcostal artery
where is the musculophrenic a coming from
internal thoracis artery
where is the musculophrenic a going
superficial and deep abdominal wall, hypochondriac region; anterolateral wall, diaphragm
where is the superior epigastric a coming from
continuation of internal thoracic artery
where is the superior epigastric a going
rectus abdominis and upper umbilical region
where is the 10th and 11th posterior intercostal arteris coming from
from aorta
where is the 10th and 11th posterior intercostal arteris going
superficial and deep lateral abdominal wall
where is the subcostal artery coming from
from aorta
where is the subcostal artery going
superficial and deep lateral abdominal wall
what are the inferior feeds ( arteries ) of the anterolateral wall
- inferior epigastric artery
- deep circumflex iliac artery
- superficial circumflex iliac artery
- superficial epigastric artery
where is the inferior epigastric artery coming from
from external iliac
where is the inferior epigastric artery going to
rectus abdominis and medial abdominal wall
where is the deep circumflex iliac artery coming from
from external iliac
where is the deep circumflex iliac artery going to
iliacus m, inferior anterloateral wall
where is the superficial circumflex iliac artery coming from
femoral artery
where is the superficial circumflex iliac going to
abdominla wall of inguinal region and adjacent anterior thigh
where is the superficial epigastric artery coming from
femoral artery
where is the superficial epigastric artery going to
skin lower abdominal wall
what is the inguinal ligament
thickening of aponeurosis of exernal oblique
where is the inguinal ligament located
from anterior superio iliac spine to pubic tubercle
what is the inguinal canal
this is about 4 cm long through the inferiro anterio abdominal wall
what are the main sturctures of the inguinal canal
spermatic cord in males
round ligament of uterus in females
ilioinguinal n. in both
where is the inguinal canal open
superficial and deep inguinal rings
what is the deep ring of the inguinal canal
internal entrance to the inguinal canal
where can the deep ring of the inguinal canal be found
slit in the trnsverse fascia
- just lateral to the inferior epigastric a.
- just superior to the midpoint of the inguinal ligament
what is superficial ring of the inguinal canal
exit from the canal
where can the superficial ring of the inguinal canal be found
trinagular aperture in the aponeurosis of external oblique
what is the posterior wall like
this is more dense and more rigid and protective
what is the posterior wall composed of
centrally= bodies of lumbar v and IV discs lateral= psoas, quadratus lumborum, iliacus, transverse abdominal, oblique superior= diaphragm
what are the nerves of the lumbar plexus
- obturator n
- femoral n
- ilioinguinal
- iliohypogastric
- genital brach
- femoral b.
- lateral cutaneous n of the thigh
- the lumbosacral trunk
What is the spinal segment of the obturator n
L2-4
What does the obturator n supply
innervates adductor muscles of thigh and skin
What is the spinal segment of the femoral n
L2-4
What does the femoral n supply
in abdomen; suppies iliacus
in thigh: nerve of the extensor muscles of knee
What is the spinal segment of the iliohypogastric n.
L1
What does the iliohypogastric n. supply
skin of gulteal region
What is the spinal segment of the ilioinguinal n.
L1
What does the ilioinguinal n. supply
skin of groin and scrotum or labium majus
What is the spinal segment of the genital branch n.
L1-L2
What does the genital branch n. supply
skin of external genitalia in both sexes in males ot cremaster muscle
What is the spinal segment of the femoral b. n.
L1-L2
What does the femoral b. n. supply
small area of skin belwo the inguinal ligament
What is the spinal segment of the lateral cutaneous n of the thigh
L2-3
What does the lateral cutaneous n of the thigh supply
suppies skin of the latera surface of thigh passes superficial to sartorius m.
What is the spinal segment of the lumbosacral trunk n.
L4-L5
What does the lumbosacral trunk n.supply
not a branch of lumbar plexus– connects lumbar and sacral plexuses
what are the subcostal a.
they are the last branches of thoracic aorta
what are the terminal branches of the abdominal aorta
internal ilia- enters pelvis
external iliac
what are the branches of the external iliac
- inferior epigastric
- deep circumflex iliac
what are some other branches of the abdominal aorta
unpaired visceral
- celiac trunk
- superior mesentreric artery
- inferior mesenteric artery
where does the celiac trunk arise
T12
bowels
where does the superior mesentreric artery arise
L1
middle of intestine
where does the inferior mesenterci artery arise
L3
what are some other branches of the abdominal aorta
paired visceral
- suprarenal arteries
- renal arteries
- gonadal arteries
where does the suprarenal arteries arise
L1
where does the renal arteries arise
L1
where does the gonadal arteries arise
L2
offspring
what are some other branches of the abdominal aorta
paired parietal
- subcostal arteries
- inferior phrenic arteries
- lumbar arteries
where does the subcostal arteries arise
L1
where does the inferior phrenic arteries arise
T12
diaphragm
where does the lumbar arteries arise
L1-4
what are some other branches of the abdominal aorta
unpaired parietal
median sacral artery
what are the veins of the posterior wall
tributaries of inferior vena cava ( minus hte testicular or ovarian veins which enter renal veins )
how is the inferior vena cav formed
junction of the common iliac veins at L5
what is the path of the vena cava
ascend the posterior wall immediately to the right of the aorta
what are the sympathetic splanchnic nerves of the abdominopelvic
- thoracis
- lumbar
what is the thoracic splanchnic nn.
this is from the abdomiopelvic
- lower thoracic and abdominopelvic sympathetic trunk
- greater T5-9 or 10
- *lesser T10, 11
- least T12
what are the abdominal aortic autonomic plesuses
- celiac plexus
- intermesenteric plexus
- superior hypogastrci plexus
- perivascular plexuses
- sympathetic trunks
where does the greater thoracic splanchnic n go to
the T5-9 nn. go to the celiac gaglion near suprarenal glands
where does the lesser thoracic splanchnic n go to
the T10-11 go to the superior mesenteric ganglion - near the origin of superior mesenteric artery
where does the least thoracic splanchnic n go to
T12 goes to the aorticorenal ganglion
– postganglionic fiver to abdominal viscera
where does the lumbar splanchni nn go to
inferior mesenteric ganglion
- provide pre ganglonic fibers to the above ganglia
- post ganglionic fibers to pelvic vescera
look at slide
44
what surrounds abdominla aorta and major brnahes
the nerve networks with both SNS and PNS which is formed by sumpathetic postganglionic axons and parasymapthetic preganglionic axon and some visceral sensory axons
what happens after snapsing in ganglia
postgangliionic sns fiver join preganglionic pns fibers to pari arterial plexuses to the viscera
what is the autonomic plexes
- celiac plexus
- intermesenteric plexus
- superior mesenteric plexus
- inferior mesenteric plexus
- superior hypogastric plexus
- inferiro hypogastric plexus
what feed the celiac plexus
( greater splanchnic nn. )
what feed the intermesenteric plexus
(lumbar spalnchnic nn.)
what feed the superior mesenteric plexus
(lesser splanchnic nn)
what feed the inferior mesenteric plexus
(lumbar spalnchnic nn.)
what feed the superior hypogastric plexus
(lumbar spalnchnic nn.)
what feed the inferior hypogastric plexus
(lumbar spalnchnic nn.)
what is in the parasympathetic system
- vagus
- pelvic splanchnic nn.
what are the branches of vagus n. of the parasympathetic system
Right=posterior vagal trunk
Left=anterior vagal trunk
where is the pelvic splanchnic nn. from of the parasympathetic system
s2-4 spinal nn.
