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Anatomy of the Abdomen > Abdomen > Flashcards

Abdomen Flashcards

1
Q

Muscle in lateral abdomen

A

External Oblique
Internal Oblique
Tranversus Abdomonis

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2
Q

Muscle on posterior wall

A

Psoas major- lumbar vertebrae to femur
Quadratus Lumborum- iliac crest to all lumbar veterbrae (outer)
Iliac Muscle/iliacus- iliac crest down to femur

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3
Q

Midline Structure arising from aponeurosis and where it attaches to

A

Linea alba and goes from xiphoid to pubic symphysis

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4
Q

External oblique origin and attachment, function and innervation

A

Originates from Lower 8 ribs

Attaches to ASIS, anterior half of iliac crest and lines alba

Compress abdominal contents
Bends trunk to same side contracting
And rotates trunk to opposite side contracting

T7-12

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5
Q

Internal oblique origin and attachments, function and innervation

A

Origin Lateral half of inguinal ligament, iliac crest
Attaches to inferior borders of cartilages of last 3-4 ribs, pubic crest and linea alba

Compress abdominal contents
Bends trunk to same side contracting
And rotates trunk to same side contracting

T7-12 and L1

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6
Q

Transversus Abdomonis attachments, function and innervation

A

Runs medially from costal margin at ribs 7-12
Iliac crest
Lateral third of inguinal ligament

Compresses abdominal contents

T7-12 and L1

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7
Q

Rectus abdomonis and rectus sheath

A

Muscle lies infront of transverses aponeurosis and internal’s splits it for upper 2/3 until arcuate line (at umbilicus) where all 3 run anteriorly

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8
Q

Between oblique muscles is

A

Fasica but under transversus is transveralis fascia which then has parietal peritoneum deep to it

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9
Q

Tendinous intersections of rectus abdominis

A

Xiphoid
umbilicus
inbetween

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10
Q

Blood supply rectus sheath

A

Epigastric vessel

Superior (descend from internal thoracic) and inferior (ascend from external iliac) anastomose

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11
Q

Formation of inguinal ligament

A

External aponeurosis extends from ASIS to pubic tubercle and fold back on itself to form this ligament

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12
Q

Canals

A

Femoral- carries femoral arteries and veins and inguinal from superficial to deep ring

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13
Q

Types of hernias

A

Femoral, inguinal, direct and indirect

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14
Q

Difference in indirect and direct

A

Indirect pass through the canal from one ring to another

Direct bypass one ring and enter the canal midway

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15
Q

Types of peritoneum

A

Parietal and visceral

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16
Q

Intra vs retro peritoneum and examples

A

Retro- between parietal and abdominal wall- kidneys and great vessels
Intra- suspended by mesentery- small intestine

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17
Q

Divisions of GI tract

A

Foregut- distal third of oesophagus to papilla of duodenum
Midgut- papilla to diastal third of transverse colon
Hindgut- distal third to rectum

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18
Q

Mesentery of liver

A 
Falciform ligament
Lesser omentum (between stomach and liver)
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19
Q

Splenic Ligaments

A

Gastrolienal (stomach)

Lineorenal (wall)

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20
Q

Greater omentum

A

Apron like peritoneal double fold from the stomach containing the omentum bursa separating it from the greater sac

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21
Q

Omentum bursa location

A

Posterior to liver and stomach

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22
Q

4 parts of duodenum

A

Superior
Descending- papilla
Inferior
Ascending

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23
Q

Blood supply of gut

A

Coeliac trunk- foregut and pancreas, spleen, liver
Superior mesenteric artery-midgut
Inferior mesenteric artery- hindgut

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24
Q

Coeliac trunk divisions

A

Common hepatic artery- gives rise to right gastric and gastroduodenal (which also supplies pancreas)
Left Gastric
Splenic- gives rise to short gastric

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25
Q

Branches of superior mesenteric artery

A

Middle
Right
Ileocolic

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26
Q

Branches of inferior mesenteric artery

A

Left
Sigmoid
Superior rectal

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27
Q

Portal vein forms from

A

Splenic-Inferior mesenteric branches onto this

Superior mesenteric

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28
Q

Lymphatic of gut

A

Drain into superior and inferior mesenteric nodes which go to cisterna chyli

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29
Q

Innervation of gut

A

Para- Vagus and pelvic splanchnic (S2-4)

Symp- Thoracic(greater and lesser) (T5-12) and Lumbar splanchnic (L1-2)

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30
Q

Secondary retroperitoneal structures

A

Duodenum parts 2-4
Pancreas expect tail
Colon not transverse

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31
Q

Parts of pancreas

A

Head, neck, uncinate process- lie in G of duodenum
Body
Tail- kidney to spleen

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32
Q

Liver, jejenum, stomach and spleen relations to kidneys

A

Liver is anterior to right superior part of kidney
Jejenum is anterior to left inferior part of kidney
Stomach and spleen anterior to upper part of left

Right lower than left

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33
Q

Liver lobes and area

A

Bare area at top to diaphragm

4 lobes- right left, caudate(lower), quadrate(upper)

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34
Q

Where liver is split

A

Gall bladder and IVC split from left to right

Porta of liver (carries hepatic artery, portal vein and common bile duct) serperates caudate and quadrate

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35
Q

Blood supply of liver

A

Hepatic artery from coeliac trunk

3 short hepatic veins to IVC

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36
Q

Biliary Tract

A

Right and left hepatic duct form common hepatic duct
This goes to either the cystic duct to the gall bladder or the bile duct to join the pancreatic duct to form the ampulla of vater with the sphincter of oddi controlling

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37
Q

Spleen location

A

Left side, posterior to ribs 9-11

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38
Q

9 regions of abdomen

A

R and L hypochrondrium Epigastric
R and L flank Umbilicus
R and L groin Pubic

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39
Q

Plexus and ganglia- superior to inferior

A 
Coeliac
Superior mesenteric ganglion
Renal plexus and ganglion
Inferior mesenteric ganglion
Superior hypogastric ganglion and plexus
Inferior hypogastric ganglion and plexus
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40
Q

Referred pain

A

Cerebral cortex doesn’t have a good visceral map

So if there is any pain from viscera it is referred to the dermatome of the same nerve that supplies it

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41
Q

Dermatome

A

Area supplied by a single spinal nerve(segment of that spinal nerve)

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42
Q

Referred pain- areas in abdomen

A

Foregut- epigastric region - T7/8 (stomach, proximal duodenum, pancreas, liver, gall bladder)

Midgut- Umbilical region- T10
Progress of pain in appendicitis- inflammation spreads to local peritoneum- localised to right inguinal

Hindgut- Suprapubic- T12/L1-2

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43
Q

Ligaments of hip bone

A

Sacrospinous- sacral vertebrae to ischial spine
Sacrotuberous- sacral vertebrae to ischial tuberosity

Tendinous arch- levator ani to obturator internus
Anococcygeal-attaches to coccyx and attaches levator ani of either sides

44
Q

Spines of pelvis

A 
On anterior 
ASIS
AIIS
Then on posterior 
PSIS
PIIS
Mirrors

Ischial Spine-below greater sciatic notch

45
Q

Fossa that attaches to femur

A

Acetabulum- has part of all 3 bones

46
Q

Bones of pelvis

A

Ilium
Ischium
Pubis

47
Q

Foreamen of pelvis

A

Greater sciatic
Lesser sciatic - separate by sacrospinous ligament
Obturator- mostly covered by obturator membrane giving rise to obturator canal

48
Q

Muscles on lateral wall of pelvic cavity

A

Piriformis (S1-2) and Obturator internus (L5 S1)

Both cause lateral rotation of hip

49
Q

Pelvic floor- what it is, function and what is below it

A

Formed by pelvic diaphragm and in the anterior midline the perineum membrane
Supports the main pelvic viscera (bladder, uterus, rectum)

Below the diaphragm is the perineum (fascia), containing voluntary sphincters and external genitali

50
Q

Pelvic diaphragm muscles

A

Levator ani- illiococcygeus (tendinous arch to coccyx) , pubococcygeus (anterior to coccyx) , puborectalis (around anal aperture)

Coccygeus muscle- ischial spine to sacral/coccyx

51
Q

What enters and exits the bladder

A

Ureters enter- superior posterior angles
Urethra exit- inferior angle
Form trigone at posterior of bladder

-Two ureteral orifices and the internal urethral orifice form the trigone

52
Q

Males pelvis viscera- where they sit

A

Bladder superior to prostate and they sit in a bowl shaped structured formed by levator ani

53
Q

4 parts of human urethra and size

A 
Preprostatic
Prostatic 
Membranous
Spongey
20cm
54
Q

Female pelvis viscera- where they sit

A

Uterus superior to bladder

Urethra anterior to vagina and rectum

55
Q

Urethral sphincter

A

Internal sphincter on neck of bladder- smooth muscle
Female’s isn’t as well defined

External sphincter-skeletal muscle surrounding the urethra in the deep perineal pouch

Female’s have 2 extra
Sphincter urethrovaginalis- surrounds vagina and urethra
Compressor urethrae- branches to urethra

56
Q

Expansion of bladder

A

Tetrahedral when empty

Expands between transversals fascia and peritoneum

57
Q

Sensation of rectum

A

Autonomic- filing

Somatic- pain- v sensitive

58
Q

Muscle that causes sharp angle in recto-anal junction

A

Puborectalis

59
Q

Arterial supply of pelvic organs

A

Common iliac artery branches into
External and internal iliac
Internal iliac- supplies viscera apart from ovaries, pelvic walls and buttocks

60
Q

What plane is used to find position of kidneys

A

Transpyloric- at CC9

Runs through L1

61
Q

Outline of kidney

A

Mark transpyloric plane
Both 4-5 cm from posterior midline
Superior pole- Covered by 12th rib
Inferior pole- 3-4cm above iliac crest

9-12cm long, 4-7 wide

62
Q

Difference of male and female pelvises

A

Male- heart shaped inlet
Pubic angle 50-60 degrees
Ischial spine projects medially
X:Y <1- ratio beween pubic symphysis to acetabulum to acetabulum diameter

Female- oval inlet
Pubic angle- greater than 80degrees
Ischial spine doesn’t project medially
X:Y >1

63
Q

Pathway of ductus deferens

A

From testis to inguinal canal-then anterior and over behind the ureter to enter the urethra via the prostate with the seminal vesicles (on back of bladder) opening into the deferens between ampulla (enlarged portion) and ejaculatory duct

64
Q

Openings into urethra in prostate

A

Prostatic utricle

Ejaculatory ducts- from ductus deferens

65
Q

Significance of internal urethra sphincter in males

A

Closes during ejaculation by sympathetic synthesis

Parasympathetic relaxes

66
Q

Perineum

A

Diamond shape between pubic symphysis, ischial tuberosities and coccyx

Divided into anterior (urogenital) and posterior (anal) triangles
Urogenital is different in sexes, and anal is same

67
Q

Perineum membrane

A

Thick triangular fascial structure attached to pubic arch. Posterioly free margin. Anteriorly a small gap.

68
Q

Deep perineal space

A

Above PM and below pelvic diaphragm

69
Q

Superficial perineal space

A

Below PM above superficial fascia

70
Q

Median erectile tissue

A

Corpus spongiosum- contains urethra

71
Q

Lateral erectile tissue

A

Corpora Cavernosae

Meet to form shaft and head of penis or clitoris

72
Q

Rectum blood supply

A

Inferior mesenteric artery provides the superior rectal artery
The internal iliac artery provides middle and inferior rectal arteries
All provided in pairs

73
Q

Testis

Where is sperm produced and where it passes to

A

Produced in seminiferous tubules

Goes to epididymis then vas deferens

74
Q

Parts of the penis

A

Crus of penis- attached part of corpus cavernosum
Bulb of penis- attached part of corpus spongiosum
Bulbourethral gland within pouch
Glans penis- head

75
Q

Parts of of clitoris

A

Bulb of vestibule with greater vestibular gland inferior

Crus of clitoris- attached part of corpus cavernosum

76
Q

Muscle underlying genital muscle and innervation

A

Ischiocavernosus- underlies crus of penis/clitoris
Bulbospongiosus- underlies bulb of penis/ bulb of vestibule
Superficial transverse perineal- run transversely from ischial tuberosities
All supplied by pudendal nerve

77
Q

Blood supply of penis

A

From internal pudendal artery
Deep artery of penis- corpora cavernosa
Dorsal artery of penis- skin
Artery of bulb- bulb, corpus spongiosum

78
Q

Pelvic content innervation

A

Sympathetic from lower thoracic and upper lumbar (T10 - L2) segments via hypogastric plexus

Parasympathetic from S2-4 outflow

79
Q

Nerves of perineum

A

Somatic nerve- arise from lumbosacral plexus- pudendal - arrise from S2-4

Sensory to penile headvestibule, labia minora and part of labia majora, lower vagina, clitoris, lower anal canal

Motor to perineal muscles bulbospongiosus and ischicavernosus -causing ejaculation and external urethral sphincter, anal sphincters and levator ani

80
Q

Peritoneum in the female pelvic region

A

Continues into pelvic cavity but does not reach floor

Completely covers uterine/fallopian tubes forming broad ligament

81
Q

Ovaries are suspended by

A

Mesovarium- portion of broad ligament

82
Q

Parts of female genetalia

A

Vagina
Cervix
Uterus
Uterine tube

83
Q

Ligaments of female genitals

A

Ligament of ovaries- joins ovaries to uterus
Round ligaments- 2 anterolateral attachments of uterus to inguinal canal and to labia majora (part of female genitals anterior to pubic symphysis)

Broad ligament- double fold of peritoneum from lateral pelvic wall to uterus

Suspensory ligaments- ovaries to L2 level in retroperitoneum covering ovary vessel

84
Q

Segments of uterus

A

Fundus
Body
Lower segment
Cervix

85
Q

Parts of Fallopian tube

A

Infundibulim and fimbrae
Ampulla
Isthmus

86
Q

Structure formed between vagina and cervix

A

Fornix

Posterior fornix- clinically relevant as it is very close to pouch of Douglas and rectum

87
Q

Arteries of female pelvis viscera

A

Internal iliac artery

Anterior division provides - superior vesicubules, uterine and medial rectal arteries

88
Q

Uterine Artery

A

Runs medially towards cervix
Crosses ureter around 1cm before uterus
Ascending supplies ovaries and uterine tubes
Descending supples vagina

89
Q

Contents of superficial perineal pouch

A

Median erectile tissue masses

Lateral erectile tissue masses

90
Q

Lymphatic drainage of pelvis

A

Pelvic organs drain mainly to external and internal iliac nodes (around the arteries)

Ovary and testis drain to para-aortic nodes

Perineum (including anal canal) and external genitalia drain to superficial inguinal nodes

91
Q

Pelvic brim and girdle

A

Brim is the edge of the inlet

Girdle is two hip bones joined together to sacral vertebrae

92
Q

True and false pelvis

A

False pelvis is above the pelvic brim

True is below the pelvic brim

93
Q

Parts of broad ligament

A

Mesosalpinx- most superior, suspends uterine tube
Mesovarium- posterior extension, attaches the ovary
Mesometrium- largest part, extends from lateral pelvic wall to the body of the uterus

94
Q

Inferior epigastric arrises from

A

Internal iliac artery

95
Q

Testicular/ovarian artery arrises from

A

Abdominal aorta just inferior to superior mesenteric artery
Testicular then passes down through the inguinal canal to the testes
Ovarian pass in suspensory ligaments of ovary

96
Q

Contents of spermatic cord

A

Cremasteric muscle

Testicular artery and pampiniform plexus

97
Q

Ligaments between sacral vertebrae and pelvis

A 
Anterior sacro-iliaca ligament
Lumbosacral ligament
Iliolumbar ligament
Interosseous Sacro iliac ligament
Posterior sacro iliac overlying
98
Q

Ligaments at pubic symphysis

A

Superior and inferior pubic ligament

99
Q

Divisions of pubococcygeus

A

Puboprostaticus
Pubovaginalis
Puboanalis

100
Q

Ligaments of bladder

A

Women- pubovesical

Men- Puboprostatic

101
Q

Spaces in peritoneum in pelvis

A

Recto-uterine pouch- on either side in women

Rectovesical pouch in men

102
Q

Somatic plexus

A

Sacral-sciatic, pudendal, superior and inferior glutaneal, obturator
Coccygeal- anococcygeal

103
Q

Autonomic plexuses in pelvis

A

Superior hypogastric plexus forms 2 hypogastric nerves
Which combine with pelvic splanchnic nerves to form 2 inferior hypogastric plexuses- this goes to rectal, uterovaginal, porstatic and vesicle plexuses

104
Q

Branches of internal iliac artery

A 
Umbilical
Obturator
Superior vesical 
Inferior vesical /Vaginal
Middle rectal
Uterine
105
Q

Veins in pelvis

A 
Prostatic plexus
Vesical plexus
Middle rectal
Obturator 
Go to internal iliac

Rectal plexus and its veins
Pudendal vein

106
Q

Glands of females and male

A

Vestibular

Bulbourethral- in deep perineum pouch

Anatomy of the Abdomen (1 decks)

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