Abdomen Flashcards
where does the abdominal cavity extend to*
from thoracic cage to the 5th intercostal space in the supine position
what is the falciform ligament
attaches to anterior abdominal wall and divides liver into L and L lobes
Umbilicus level
L3 L4
linear semilunaris extension*
from 9th costal cartilage to pubis
it is 5-8 cm from medial plane ( represents lateral border of rectus abdominis muscle)
Where is the pubic tubercle *
2.5 cm laterally of the pubic symphysis
where is the Iliac tubercle located *
6 cm posterior to ASIS
Where is the subcostal plane located *
inferior margin of 10th costal cartilage thru L2-L3
where is the Transtubercular plane located *
through the iliac tubercles through body of L5
Where is the transpyloric plane located *****
midway between xiphosternal joint an the umbilicus through the inferior borders of L1*
many abdominal viscera are related to it*
Trans umbilical plane location *
through umbilicus L3 L4
The abdomen is divided into 4 quadrants by which horizontal plane
Trans umbillical plane L3 L4
the abdomen is divided into 9 regions why which horizontal planes
Subcostal plane L2/L3
trans tubercular plane L5
contents of RUQ
right lobe of liver, gall bladder pylorus of stomach duodenum part 1-3 right suprarenal land right kidney right colic flexure superior part of ascending colon and right half of transverse colon
contents of LUQ
left lobe of liver spleen stomach jejunum, proximal ileum pancreas body and tail left kidney left suprarenal gland left colic flexure transversecolon left half descending colon superior part
content RLQ
cecum vermifrom appendix most of leum ascending colon- inferior part R uterine tube, R ureter r spermatic cord uterus ( if enlarged) urinary bladder
Content LLQ
sigmoid colon desceding colon left ovary left uterine tube uterus ( enlarged) urinary bladder- if full
Fascia of anterior abdominal wall
superficial ( fatty– campers, membranous –scarpas) deep ( thin strong layer over superficial muscles)
campers fascia continuous with scarpas fascia is continuous with/ deep fascia continuous with
campers– superficial fascia of thigh scarpas– with fascia lata of leg deep layer– continuous with colle’s fascia of perineum
O I external oblique
O - external surface of 5th - 12th ribs I- linea alba, pubic tubercle, anterior half of iliac crest
N F external oblique
inferior six thoracic and subcostal nerves F- flex rotate trunk, support compress abdominal viscera
O I internal obliqu
O- thoracolumbar fascia anterior 2/3 of iliac crest and lateral half of inguinal ligament I- inferior border of ribs 10 11 12 and lined alba via the conjoint tendon
N F internal oblique
inferior 6 thoracic nerves F- flex rotate trunk, compress and support abdominal viscera
O I transversus abdominis
O- internal surfaces of costal cartilages 7-12, lateral 1/3 of inguinal ligament
N F internal oblique
inferior 6 thoracic nerves F- compress and support abdominal viscera
O I rectus abdominis
O- pubic symphysis I- typhoid process CC 5 6 7
N F rectus abdominis
N- inferior 6 thoracic nerves F- flexes trunk and compresses abdominal viscera
the EOM forms what inferiorly?
the INGUINAL LIGAMENT (axis to pubic tubercle) and superficial inguinal ring
borders of superficial inguinal ring
Lateral- lateral crus medial- medial crus inferior- pubis
lateral crus inserts on*
pubic tubercle
medial crus inserts on*
pubic symphysis
contents of superficial inguinal ring
spermatic cord- Male round ligament- female ilioinguinal nerve
function of ilioinguinal nerve*
Supplies skin over superomedial aspect of thigh, also skin of lower inguinal region , mons pubis, scrotum and labia majora
Cremasteric muscle is formed by what?*
Internal oblique muscle=
the spermatic chord passes thru these fibers forming the spermatic chord
the inguinal canal passes through and is formed in part by IOM
what is the conjoint tendon*
it is the insertion of IOM and transversus abdominis onto the pubic symphysis
The rectus sheath is made by
aponeurosis of EOM, IOM and transversus abdominis as they insert into the linea alba
Upper 2/3 rectus sheath made by ( between costal margins and ASIS
EOM anteriorly
IOM - splits one part anteriorly, one part posteriorly
transversus abdominus posteriorly
Lower 1/3 rectus sheath made by ( from ASIS to pubic symphysis)
Aponeurosis of all three abdominal muscles go anteriorly
the posterior part of rectus sheath is ONLY the transversalis fascia
The internal spermatic fascia of spermatic cord is derived from what*
from the fascia transversalis
Iliohypogastric nerve*
L1
skin over the upper inguinal region, skin over iliac crest in between internal and external oblique
Ilioinguinal nerve *
L1 skin over the superomedial aspect of thigh
skin over lower inguinal region mons pubis and labia majora
NOT a content of the spermatic chord *
Superior epigastric artery*
where it comes from and where it goes
branch of internal thoracic artery
enters rectus sheath superiorly and inferior to 7th CC
Inferior epigastric artery*
comes from and where it goes
runs superiorly on transversalis fascia and enters arcuate line to get into rectus sheath
What peritoneal folds are superior to umbillicus
Large median fold- contains falciform ligament
the free edge of falciform ligament is called the round ligament or ligamentum teres
what does the ligamentum teres contain
the remnant of umbillical vein
Peritoneal folds inferior to umbillicus and their contents *
Median umbillical fold- Urachus - (drains urine in fetus- )
medial umbilical fold- umbillical artery
lateral umbillical fold- inferior epigastric artery - patent
Hesselbacks triangle*
inguinal triangle
medial border- rectus abdominis muscle
lateral border- inferior epigastric vessels
inferior border- inguinal ligament
Hernias male v female
Female more likely to have femoral hernias due to their anatomy
males more likely to have inguinal hernias
contents of inguinal canal
spermatic chord Male
round ligament female
ilioinguinal nerve
Deep inguinal ring*
slit like opening in the fascia transversalis
superficial inguinal ring
triangular opening of EOM
indirect inguinal hernias*
More common*
leave abdominal cavity LATERAL to inferior epigastric vessels
transverse deep inguinal ring, inguinal canal and superficial inguinal ring
(follow same path as spermatic chord- so they would have the similar coverings)
indirect is within the spermatic chord*
Direct inguinal hernias*
pass through hesselbachs triangle
leave abdominal cavity MEDIAL to inferior epigastric vessels
protrude ateriorly to posterior wall of inguinal canal
Direct parallels the spermatic cord*
Contents of the spermatic cord*
Vas deferens
testicular artery
testicular veins that from the pampinifrom plexus*
genital branch of genitofemoral nerve ( supplies cremaster muscle)
arteroes to vas deferens
remnant of processus vaginalis
lymphatic vessels -
autonomic sympathetic nerves
Where does the right testicular vein drain into*
leaves panpiniform plexus as a single vein and drains directly into IVC at L1
Where does right testicular vein drain into
drains into left renal vein at L1
more chance of back up
what should you know about the ilioinguinal nerve
its a content of inguinal canal but NOT a content of the spermatic chord
cremasteric abdominal reflex
absence indicates corticospinal injury - strike the thigh- causes that testicle to rise
From genitofemoral nerve (L1- L2)
femoral branch (afferent)- supplies skin of thigh
genital branch ( efferent) supplies cremaster muscle
