Abdomen Flashcards
1
Q
What is the abdomen in relation to the trunk?
A
The part between thorax and pelvis
2
Q
True/False: The abdomen is a flexible, dynamic container housing most of the organs of the alimentary system and part of the urogenital system.
A
True
3
Q
Through what type of contraction is the muscular roof, anterolateral wallsm and floor that raises internal pressure to aid air expulsion or substances?
A
Voluntary, reflexive contraction
4
Q
What covers the anterolateral wall and organs against the posterior wall?
A
Periotneum
5
Q
What is formed between the viscera and the abdominpelvic cavity?
A
Peritoneal cavity
6
Q
What structure “separates” the abdominal and pelvic cavities?
A
Pelvic inlet
7
Q
What is the name of the two sagittal planes?
A
Midclavicular to midinguinal
8
Q
What does the transverse plane cross through?
A
The coastal cartilages of 10th row (also called subcostal plane)
9
Q
What is the plane that passes through the iliac tubercles and L5?
A
Transtubercular
10
Q
What plane passes through the ASIS on each side?
A
Interspinous
11
Q
What plane passes halfway between the manibrium and pubic symphysis?
A
Transpyloric
12
Q
What are the nine region used to describe the location of organs, pains, and pathologies?
A
Right Hypochondriac, Right Flank , Right Inguinal, Epigastric, Umbilical, Hypogastric, Left Hypochondriac, Left Flank, Left Inguinal
13
Q
What planes intersect to create the Right Hypogastric region?
A
R MCL x transtubercular
14
Q
What planes intersect to create the epigastric region?
A
Transtubercular and MCLs
15
Q
What planes intersect to create the Left Hypochondriac region?
A
L MCL x transtubercular
16
Q
What planes intersect to create the Left flank region?
A
R MCL x interspinous x subcostal
17
Q
What planes intersect to create the umbilical region?
A
MCLs x subcostal x Interspinous
18
Q
What planes intersect to create the left flank region?
A
L MCL x subcostal x interspinous
19
Q
What planes intersect to create the right inguinal region?
A
L MCL x interspinous
20
Q
What planes intersect to create the hypogastric region?
A
MCLs x interspinous
21
Q
What planes intersect to create the Left Inguinal region?
A
Interspinous x L MCL
22
Q
What are the four quadrants that are created by the median plane and transumbilical plain?
A
RUQ, LUQ, RLQ, LLQ
23
Q
What are the organs of the RUQ?
A
R lobe liver, Gallbladder, Pylorus of stomach, Duodenum, Head of pancreas, R suprarenal gland, R kidney, R colic flexure, ascending colon sup, 1/2 Transverse colon
24
Q
What are the organs of the LUQ?
A
L lobe liver, Spleen, stomach, jejunum, proximal ileum, body and tail of pancreas, L kidney, L suprarenal gland, L colic flexure, Half transverse colon, Descending colon sup
25
What are the organs of the RLQ?
Cecum, appendix, ileum, ascending colon inf, R ovary, R uterine tube, R ureter, R spermatic cord
26
What are the organs of the LLQ?
Sigmoid colon, Descending colon inf, L ovary, L uterine tube, L spermatic cord
27
To what structures does the anterolateral abdominal wall extend to?
Thoracic cage -> pelvis
28
What are the components of the anterolateral abdominal wall?
Skin, SubQ tissue: Camper -> scarpa, deep fascia, muscles, extraperitoneal fat, parietal peritoneum
29
What are the muscles of the anterolateral wall?
External oblique, internal oblique, Rectus Abdominus, Transverse Abdominus, Pyramidalis
30
What structure forms between the aponeuroses of the anterolateral abdominal muscles?
Rectus sheath
31
What structure runs down the midline of the abdomen wall?
Linea alba
32
Between what two structure does the linea alba run between?
Xiphoid process and pubic symphysis
33
What is the arcuate line?
demarcates the transition between the aponeurotic posterior wall of the sheath covering the superior three quarters of the rectus and trasversalis fascia covering the inferior quarter
34
What structures are also found in the rectus sheath?
Superior and inferior epigastric arteries and veins, lymphatic vessels, and distal portions of thoraco-abdominal nerves
35
All the layers of the rectus sheath fuse to what structure?
Umbilicus
36
What is the OINA of the external oblique?
O: ribs 5-12
I: Linea alba, pubic tubercle, anterior 1/2 of iliac crest
N: Thoraco-abdominal nerve (T7-11) and subcostal nerve (T12)
A: Compress and support viscera, Flexion of trunk, Rotation of trunk
37
Where do the fibers of the EO become aponeurotic?
MCL and spino-umbilical line
38
What is the OINA of the internal oblique?
O: thoracolumbar fascia, ant 2/3s of iliac crest, connective tissue of lateral 1.3 of inguinal ligament
I: Inf borders of 10-12 ribs, linea alba, pecten pubis
N: T6-12 and L1 ant rami
A: compress and rotate viscera, Flexion of trunk, Rotation of trunk
39
What is the OINA of the tranverse abdominus?
O: Internal surfaces of 7-12 costal cartilages, thoracolumbar fascia, iliac crest, connective tissue deep to lateral 1/3 of inguinal ligament
I: linea alba, pubic crest, pecten pubis
N: T6-12 and L1 anterior rami
A: compress and support the viscera
40
What is the OINA of the rectus abdominus?
O: pubis symphysis, pubic crest
I: Xiphoid process and 5-7 costal cartilages
N: T6-12 anterior rami
A: flexes trunk, Compresses viscera, Stabilizes and controls tilt of pelvis (antilordosis)
41
What are the paired rectus muscles separates by?
Linea abla
42
What structure exists within the rectus abdominus?
Tendinous intersections
43
What is the pyramidalis muscle?
abest in 20% of people, small, insignificant triangular muscle. Lies anterior to the inferior part of RA and attaches to anterior surface of pubis and anterior pubic ligament
44
What supplies the majority of the abdominal wall?
Anterior rami of T7-T12
45
What are they and what structures do the thoraco-abdominal nerves supply?
anterior rami of T7-11, supply the abdominal skin @ and IO, TA muscles
46
What are they and what structures do the lateral cutaneous branches of nerves supply?
T7-9 or t10, supply skin supply the skin of the L and R hypochondriac regions
47
What are they and what structures do the anterior cutaneous branches of nerves supply?
T7-9, supply the skin abobe umbilicus, T10, supplies the skin around umbilicus, T11+T12+ iliohypogastric + Ilioinguinal, supply the skin below umbilicus
48
What is the subcostal nerve and what does it supply?
Anterior ramus of T12, supplies muscles of the anterolateral abdominal wall and overlying skin superior to iliac crest but inf to umbilicus
49
What is the Iliohypogastric nerve and what does it supply?
Anterior ramus of L1, supplies skin over iliac crest, upper inguinal, hypogastric regions, IO and TA muscles
50
What is the ilioinguinal nerver and what does it supply?
Anterior ramus of L1, supplies skin of lower inguinal region, mons pubis, anterior scrotum/labium, medial thigh, inferiormost IO and TA
51
What is the origin, course, and distribution of the musculophrenic artery?
O: Internal thoracic artery
C: descends along costal margin
D: hypochondriac region, anterolateral diaphragm
52
What is the origin, course, and distribution of the superior epigastric artery?
O: Internal Thoracic artery
C: Descends in rectus sheath deep to RA
D: RA, epigastric and upper umbilical regions
53
What is the origin, course, and distribution of the intercostal arteries?
O: Aorta
C: beyond ribs to descend abd. wall between IO and TA
D: Lumbar/Flank region
54
What is the origin, course, and distribution of the subcostal artery?
O: Aorta
C: beyond ribs to descend abd. wall between IO and TA
D: Lumbar/Flank region
55
What is the origin, course, and distribution of the inferior epigastric artery?
O: External Iliac artery
I: runs superiorly and enters rectus sheath, runs deep to RA
D: RA, pubic and umbilical regions
56
What is the origin, course, and distribution of the deep circumflex iliac artery?
O: Exteral Iliac artery
C: runs Deep aspect of abd. wall, parallel to inguinal ligament
D: Iliacus, inguinal region, iliac fossa
57
What is the origin, course, and distribution of the Superficial circumflex artery?
O: Femoral Artery
C: Runs in subQ tissue along inguinal ligament
D: Superifcial wall of inguinal regions and adj. anterior thigh
58
What is the origin, course, and distribution of the superificial epigastric artery?
O: femoral artery
C: Runs in subQ tissue toward umbilicus
D: Superficial wall of pubic and inferior umbilic region
59
What is a surgical method for removing unwanted subcutaneous fat using a suction tube and high vacuum pressure?
Liposuction
60
Which fascia provides a plane that can be opened, enabling a surgeon to approach structures without entering the peritoneal sac?
Endoabdominal fascia
61
Describe an abdominal protrusion.
Anything that causes the abdomen to protrude, can be food, feces, fetus, flatus, fat, fluid, ascites (serous fluid), Large mass (tumor, enlarged organ)
62
What is an umbilical hernia?
A hernia in umbilical ring due to failure to normally close, common in neonates
63
What is an epigastric hernia?
A hernia through the linea alba. typicall just lobules of fat
64
What is a Spligelian hernia?
Occur along semilunar line.
65
Describe a longtiduinal incision.
Midline/ paramedian incisions, good for exploratory operations due to best exposure to viscera, can extend as necessary with minimal complications
66
Describe a median incision.
Any part of the linea alba, won't cut any major muscles, BVs, or nerves.
67
Describe an oblique incision.
(McBurney) 2.5 cm superomedial to the ASIS on the spino-umbilical line
68
Describe a suprapubic incision.
Horizontal with a slight convexity along pubic hairline (c-section)
69
Describe a subcostal incision.
parallel but at least 2.5 cm inf to costal margins to avoid the 7th and 8th spinal nerves, access to gallbladder and biliary ducts on R side and spleen on the :
70
What is a pararectus incision?
Along the lateral border of the rectus sheath
71
Why is the pararectus incision so high risk?
Risk to cutting nerve supply to RA
72
Describe an endoscopic procedure.
Minimally invasive, tony perforations, allow entry of instruments (laparoscope)
73
What makes up the internal surface of the anterolateral abdominal wall?
Transversalis fascia, extraperitoneal fat, parietal peritoneum
74
What "structure(s)" are exhibited in the infra-umbilical part of the internal surface?
Umbilical folds
75
How many umbilical fold are there?
5. Two median, two lateral, one medial
76
What are the depressions lateral to the umbilical folds?
Peritoneal fosse
77
What supra-umbilical structure extends between the superior anterior abdominal wall and liver?
Falciform ligament
78
What is another term for the inguinal region?
Groin
79
The inguinal region is a passage from what cavity?
Abdominal
80
What is the dense band constituting the inferiormost part of the EO aponeurosis?
Inquinal ligament
81
What structure forms the medial boundary of the subinguinal space, between the superior pubic ramus to tubercle?
Lacunar ligament
82
What structure runs along the pectin pubis?
Pectineal ligament
83
What structure is formed by the bypassing of the pubic tubercle and crossing the linea alba to blend with the lower fibers of the EO aponeurosis?
Reflected inguinal ligament
84
What structure is the thickened inferior margin of the transversalis fascia, appearing as a fibrous band running parallel to posterior to inguinal ligament?
Iliopubic tract
85
What is the weak area in the inguinal region that is the site of direct and indirect hernias?
Myopectineal orifice
86
Describe the difference between direct and indirect hernias.
Direct hernias form in the abdominal canal, indirect ones do not
87
What is formed in relation to the relication of the testis during fetal development?
Inguinal canal
88
What is the main occupant of the inguinal canal?
Spermatic cord/round ligament of uterus
89
What muscle aponeourosis forms the inguinal canal?
EO
90
What are the superficial inguinal rings?
exit by the spermatic cord/round ligament
91
What are the deep inguinal rings?
Entrance to inguinal canal
92
What other structures does the inguinal canal contain?
Inguinal nerve, blood and lymphatic vessels
93
What is a hydrocele in the inguinal region?
Excess fluid in a persistent processus vaginialis, testis, spermatic cord - detection by transillumination
94
What is a hermatocele of the testis?
Collection of blood in the tunica vaginalis that results from trauma
95
What is a spermatocele?
Retention cyst in the epidymis
96
What is an epidymal cyst?
Collection of fluid anywhere in the epidymis
97
What is a variocele?
varicose vein plexus
98
What is a thoraco-epigastric vein?
Formed between superior epigastric vein and lateral thoracic vein
99
What are the two layers of the peritoneum?
Parietal and visceral
100
What does the parietal peritoneal line?
Abdominal wall
101
What does the visceral peritoneal line?
Visceral organs
102
True/False: The peritoneum has separate neurovasculature than the wall lining it.
False, same
103
What is created in the potential space between the peritoneal layers?
Peritoneal cavity
104
What surrounds the peritoneal cavity?
peritoneal fluid
105
What is the double layer of peritoneum that encloses the abdominal organs?
Mesentery
106
What does the mesentery function to connect?
Organs and body wall
107
What is the double layer extension/fold of peritoneum that passes from stomach and proximal duodenum to organs in the abdominal cavity?
Omentum
108
What is the greater omentum?
Prominent, four layered peritoneal fold that connects the stomach to transverse colon
109
What is the lesser omentum?
Much smaller, double layered peritoneal fold that connect the lesser curvature of the stomach and proximal part of duodenum to the liver
110
What is the double layer of peritoneum that connect an organs with another to the abdominal wall?
Peritoneal ligament
111
What connects the liver to the anterior abdominal wall?
Falciform ligament
112
What connects the liver to the stomach?
Hepatogastric ligament
113
What connects the liver to the duodenum?
Hepatoduodental ligament
114
What connects the stomach to the inferior surface of the diaphragm?
Gastrophrenic ligament
115
What connects the stomach to the spleen?
Gastrosplenic ligament
116
What connects the stomach to the transverse colon?
Gastrocolic ligament
117
What is the inflammation of peritoneum?
Peritonitis
118
Describe peritoneal adhesions.
damage or infection fill with fibrin which changes to fibrous tissue
119
What is the surgical separation of peritoneal separations?
Adhesiolysis
120
What is the surgical puncture of the peritoneal cavity for the aspiration or drainage of fluid?
Paracentesis
121
What is the removal of soluble substances and excess water by the transfer across the peritoneum?
peritoneal dialysis
122
What is a circumscribed collection of pus in the subphrenic recess?
Abscess
123
How does an abscess form?
From a perforation of a duodenal ulcer, rupture of gallbladder, or perforation of appendix
124
What results from an inflamed/injured pancreas in the passage of pancreatic fluid into the bursa?
Pancreatic pseudocyst
125
What is the removal of the gallbladder?
Cholecystectomy
126
What is the sac-like cavity that lies posterior to the stomach, lesser omentum, and adj. structures?
Omental bursa
127
What is the communication point for the omental bursa with the greater sac?
Omental foramen
128
What is the muscular tube that extends from the pharynx to stomach?
Esophagus
129
Approximately, how long and how wide is the esophagus?
25 cm, 2 cm
130
What is the function of the esophagus?
Transport of food through peristaltic action from the oral cavity to stomach
131
Where are the three constrictions to aid in food propellant?
Cervical (upper esophageal sphincter), thoracic (broncho-aortic), diaphragmatic constriction
132
What does the esophagus follow the curvature of?
Vertebral column
133
What structure does the esophagus pass through in the right crus of the diaphragm?
Esophageal hiatus
134
What structure does the esophagus terminate at by entering the stomach at?
Cardial orifice
135
What two layers of muscles makes up the esophagus?
Circular and external longitudinal
136
Describe the makeup of muscle in the esophagus.
Exterior: striated voluntary. Inferior 1/3: smooth muscle. Middle 1/3: combo
137
What is the expandable part of the digestive tract between the esophagus and small intestine?
Stomach
138
What is the function of the stomach?
Accumulate ingeted food, enzymatic digestion, and transport into duodenum
139
Gastric juice converts food to what for easier passage through the intestine?
Chyme
140
how many liters is the stomach capable of holding?
2-3 L
141
What are the four parts of the stomach?
Cardia, fundus, body, pylorus
142
What is the part of the stomach that surrounds the opening of the esophagus?
Cardia
143
What is the part of the stomach that dilates related to the dome of the diaphragm?
Fundus
144
What structure separates the cardiac and fundus?
Cardial notch
145
What is the body of the stomach?
The center, between the fundus and pylorus
146
What is the funnel-shaped outflow region of the stomach?
Pylorus
147
Describe the pathway through the pylorus.
Pyloric antrium -> pyloric canal -> pylorus -> pyloric orifice
148
What is the specific piece of the pyloric part of the stomach that is the sphinctric region controlling the discharge of stomach contents?
Pylorus
149
Through which structure does chyme flow through in the stomach to enter the duodenum?
Orifice
150
What is the primary site for absorption of nutrients from ingested materials?
Small intestine
151
What are the three parts of the small intestine?
Duodenum, jejunum, ileum
152
Rank the size order of the three parts of the small intestine.
ileum > jejunum > duodenum
153
What is the first portion of the small intestine?
Duodenum
154
What is the middle portion of the small intestine?
Jejunum
155
What is the bottom portion of the small intestine?
Ileum
156
Which portion of the small intestine is c shaped and has biliary and pancreatic ducts that enter into it?
Duodenum
157
Which portion of the small intestine begins at duodenal flexure, where the GI resumes?
Jejunum
158
Which portion of the small intestine ends and meets the cecum?
Ileum
159
What is the approximate length of the jejunum and ileum together?
6-7 m
160
What attaches the small intestine to the body wall?
Mesentery
161
Between jejunum and ileum: which has a deeper red vs paler pink?
Jejunum
162
What is the approximate length of jejunum vs ileum?
2-4cm, 2-3 cm
163
Between jejunum and ileum: which has greater vascularity?
jejunum
164
Between jejunum and ileum: which has a longer vasa recta?
Jejunum
165
Between jejunum and ileum: which has large, tall folds vs low sparse, absent folds?
Jejunum
166
Between jejunum and ileum: which has many lymph nodes over the other?
Ileum
167
Between jejunum and ileum: which has few, large arcade loops vs many short arcade loops?
Jejunum
168
What is the first 2 cm of duodenum?
Ampulla
169
What structure is the entrance between the duodenum and the ducts leading to it?
Papilla
170
What is the water absorption site from the ingestible residues of liquid chyme, coverting them to solid waste?
Large intestine
171
What are the parts of the large intestine?
cecum, appendix, colon, rectum and anal canal
172
What are the distinguishable parts of the large intestine?
omental appendices (small, fatty projections), teniae coli (3 bands: mesocolic tenia, omental tenia, free tenia), haustra (sacculations of the wall of the colon between the teniae)
173
What structure connects the ileum and cecum?
Ileocecal valve
174
What is the blind intestinal pouch that lies in the iliac fossa of RLQ?
cecum
175
What is the blind intestinal diverticulum containing masses of lymphoid tissue?
Appendix
176
What part of the large intestine encircles the small intestine and functions to move fluid from fecal matter?
Colon
177
What are the four parts of the colon?
Ascending colon (passes from R side of abd @ cecum ro R lobe of liver, turning at the R colic flexure ~ 9-10 ribs) -> Transverse colon (R colic flexure to L colic flexure) -> descending colon (L colic flexure and L iliac fossa) -> Sigmoid colon (S-shaped loop linking descending colon to rectum)
178
What is the fixed terminal part of the small intestine, continuous with the sigmoid colon ~ S3?
Rectum
179
What continues after the rectum to the outside?
Anal canal
180
What condition results from increased BP causing esphogeal varices?
Portal hypertension
181
What condition can increase the likelihood of portal hypertension?
Cirrhosis
182
What is pyrosis?
Heartburn - burning sensation usually resulting from regurgitation of food/gastric fluid (GERD)
183
Is pyrosis common?
Yes
184
What can pancreatic pseudocysts and abscesses in the omental bursa do to the stomach?
Push it anteriorly
185
What is a hiatal hernia?
A protrusion pf part of the stomach into the mediastinum through the esophageal hiatus
186
Describe the difference between a para-esophageal hiatal hernia and sliding hiatal hernia?
Para-esophageal: cardia remains in position but fundus extends, sliding: esophagus, cardia, and fundus extend through eso. hiatus
187
What is the results of the failure of smooth muscle fibers encircling the pyloric canal to relax nomrally?
Pylorspasm
188
What is the marked thickening of smooth muscle of the pylorus?
Congenital hypertrophic pyloric stenosis
189
What is the surgical treatment of congential hypertrophic pyloric stenosis?
Pyloromyotomy
190
What is the removal of the stomach?
Gastrectomy
191
What results from an infection of H. pylori?
Gastric ulcers
192
True/False: An anterior gastric ulcer may erode the stomach wall into the pancreas, resulting in back pain.
False, posterior gastric ulcer may do this
193
How can you distinguish between organic pain and visceral pain?
organic - poorly localized, visceral - epigastric region
194
What type of ulcers can cause peritonitis?
Dudoneal ulcers
195
How does ischemia of intestine occur?
By emboli, thrombus, or plague (atherosclerotic occulsion) - can result in necrosis
196
What is the acute inflammation of the appendix?
Appendicitis
197
What is the surgical removal of the appendix?
Appendectomy, through McBurney's incision
198
What is the condition resulting in chronic inflammation/ulceration of the colon/rectum?
Colitis (Chrohn's)
199
What is the removal of the colon?
Colectomy
200
What is the surgical operation in which part of the ileum is diverted to an artificial opening to allow egress of contents?
Ileostomy
201
What surgical procedure creates an artificial cutaneous opening in the colon for egress of contents?
Colostomy
202
What procedure utilizes a long, flexible, fiberoptic endocscope to enter the colon through the anus and rectum for view of colon?
Colonoscopy
203
Where do most intestinal tumors occur?
Sigmoid colon, rectum, or ascending colon
204
What is the disorder in the which multiple external invaginations develop alone the intestine?
Diverticulosis
205
What is the condition in which diverticulum rupture?
Diverticulitis
206
Volvulus of the sigmoid colon can lead to what?
Ischemia and obstipation -> necrosis
207
What is the ovoid, purplish, pulpy lymphatic organ?
Spleen
208
What is the approximate size of the spleen?
Shape of fist
209
What are the functions of the spleen?
Defense system as a site of lymphocyte proliferation/elimination of old, damaged RBCs and immune surveillance
210
True/False: You cannot live without your spleen.
False, you can, it is not vital to sustain life
211
Where does the spleen rest?
L colic flexure ~ 9-11th ribs
212
What is the elongated, accessory digestive gland?
Pancreas
213
What is the approximate location of the pancreas?
~ L1, L2, posterior to stomach between spleen and duodenum
214
What are the functions of the pancreas?
Produce exocrine secretion (pancreatic juice), supply body with insulin and glucagons from the Islets of Langerhans
215
How does pancreatic juice flow to the duodenum?
Main and accessory pancreatic ducts
216
What are the components of the pancreas?
Head, neck, body, and tail
217
What is the largest gland, and, second to skin, organ?
Liver
218
True/False: All nutrients absorbed are initially conveyed to the liver by the portal venous system.
True
219
What are the functions of the liver?
Metabolic activities, stores glycogen, secrete bile, processes the products of digestion and exo/endogenous substances (drugs, toxins) that enter circulation
220
Describe the passage of bile from the liver.
via bile duct to join w/ cystic ducts to form the common hepatic duct -> hepatic artery
221
What is the storage site of bile?
Gallbladder
222
What is the approximate size of the gallbladder?
7-10 cm
223
What causes release of bile from the gallbladder?
fat enters the duodenum via cystic duct to bile duct
224
True/False: The spleen, pancreas, liver can be ruptured.
True
225
What is the removal of the spleen?
Splenectomy
226
What is the removal of the pancreas?
Pancreatectomy
227
What is a lobectomy?
Removal of part of the liver
228
what is the removal of the gallbladder?
Cholecystectomy
229
What is cholelithiasis?
Gallstones - crystallized concretion in GB, cystic duct, or bile duct
230
What is inflammaton of the pancreas?
pancreatitis
231
What does a whipple procedure do?
Removal of pancreatic cancer
232
What is a subphrenic abscess and how is it "treated"?
Collection of pus, drained by incision
233
What is the enlargement of the liver due to increased blood?
Hepatomegaly
234
What is the destruction of hepatocytes becoming replaced with fat and fibrous tissue?
Cirrhosis
235
What is the surgical procedure in which portal hypertension is reduced by connecting the hepatic portal vein and IVC?
Portosystemic shunt
236
What is the function of the kidneys?
remove excess water, salts, and wastes of protein metabolism converting it to urine
237
Where is the location of the kidneys?
Approx. T12-L3 along posterior wall
238
What are the muscular ducts that carry urine from the kidney to the bladder?
Ureters
239
What do the ureters "run" over?
Common iliac arteries
240
What are the yellowush hormone and steroid producing glands?
Supradrenal
241
Where are the supradrenal glands located?
Above the kidney, below the diaphragm
242
What is the hollow pouch with strong, distensible muscular walls that serves as a temporary reservoir for urine?
Bladder
243
What is the muscular tube that converys urine from the bladder?
Urethra
244
True/False: the urethra is longer in females.
False, it is longer in males
245
What is the female reproductive organ that produces ova/oocytes and estrogen?
Ovaries
246
What is the female reproductive organ that transports ovum from ovary to uterus?
Fallopian (uterine) tube (one pair)
247
What is the female reproductive hollow organ that is thick walled prividing the environment for embryonic/fetal development?
Uterus
248
What is the female reproductive organ that serves as the passageway from uterus?
vagina
249
What is the extension of the vagina that dilates to allow for fetal passage?
Cervix
250
What is the male reproductive organ that is one of two reproductive glands too produce spermatozoa and testosterone?
Testis
251
What is the male reproductive organ that lies between the bladder and rectum that secretes a thick, alkaline fluid that mixes with sperm?
Seminal vesicle
252
What is the male reproductive organ that begins in the epididmysis and eventually joins with duct of seminal vesicle?
Vas deferens
253
What is the male reproductive organ that is a slender tube that arises by the union of the Seminal vesicle and the vas deferens?
Ejaculatory duct
254
What is the male reproductive organ that is an accessory gland that secretes seminal fluid?
Prostate
255
What is a collection of pus around the kidney?
perinephric abscess
256
What is the term given to a dropped kidnye?
Nephroptosis
257
What is a congenitally misplaced kindey?
Ectopic kidney
258
What is the preferred treatment of renal failure,, removing the defective kidney and replacing it with another without damaging surrounding/supporting structures?
Renal transplant
259
What is a renal cyst?
A cyst in the kidney - can be polycystic disease
260
What is renal vein entrapment syndrome?
Compression of Left renal vein
261
What are the signs/symptoms of renal vein entrapment syndrome?
Hematuria, proteinuria, flank pain, nausea, vomiting, L testicular pain (in males)
262
What is the term given to an additional kidney developed by the separation of blastomas?
Supernumerary kidney
263
What is a retrocaval ureter?
a rare congenital anomaly with the ureter passing posterior through the IVC
264
What is the term given to a fused, U-shaped kidney?
horseshoe kidney
265
How does a horseshoe kidney form?
Mesentaric artery fails to normally relocate the kidneys
266
True/False: A horseshoe kidney can cause an array of symptoms.
False, generally produce no symptoms or problems
267
What is the official term of a kidney, ureter stone?
Renal, ureteric calculus
268
What is the double-domed, musculotendinous partition that separates the thorax and abdomen?
Diaphragm
269
True/False: The diaphragm is the major muscle for respiration.
True
270
What are the compositions of the diaphragm?
Central tendon, sternal portion, costal portion, lumbar portion
271
What is the central tendon?
Boomerang shape insertion point for peripheral muscular portions of the diaphragm.
272
What is the sternal portion of the diaphragm?
Two muscular slips that arise from the xiphoid process and insert to central tendon
273
What is the costal portion of the diaphragm?
Wide muscular slips arise from the interior surfaces of lower 6 ribs and costal cartilage to CT
274
What is the lumbar portion of the diaphragm?
Arises from the medial and lateral ligaments ~ LV1-3 to CT
275
What does the lumbar portion form?
R and L muscular crura that ascend to CT
276
What is a crura?
musculotendinous band that arises from the anterior surfaces of the bodies of L1-3, ALL, and IV discs.
277
Is the right or left crus larger?
R
278
What LV does the R crus arise from?
L1-3 maybe 4
279
What LV does the L crus arise from?
L1-2 or 3
280
What are the four openings in the diaphragm that permit passage of structures between the thorax and abdomen?
IVC foramen (caval opening), Esophagea hiatus, Aortic hiatus, Stenocostal hiatus (triangle, foramen)
281
What is the caval opening?
The passage between the IVS and R phrenic nerve
282
Where is the caval opening located?
to R of median plane @ central tendon junction ~ IV disc between T8&9
283
What is the esophageal hiatus?
The passage between the esophagus and vagal trunks
284
Where is the esophageal hiatus located?
located superior to and left of the aortic hiatus ~ T10
285
What is the aortic hiatus?
Passage of aorta and thoracic ducts
286
Where is the aortic hiatus located?
passes between crura to MAL
287
What is the sternocostal hiatus?
between sternal and costal attachments of the diaphragm, transmit lymphatic, epigastric vessels
288
What are the five components of the posterior abdominal wall?
Five lumbar vertebrae and IV discs, wall muscles, diaphragm, fascia, lumbar plexus, and fat, nerves, and lymph nodes.
289
What fascia exists between the parietal peritoneum and muscles?
Endoabdominal fascia
290
What is the extensive fascial complex that attaches the muscles to the VC?
Thoracolumbar fascia
291
What are the muscles of the posterior abdominal wall?
Psoas, iliacus, quadaratus lumborum
292
What is the OINA of the psoas major?
O: Transverse processes of LV bodies and discs of T12-L5
I: Tendon to lesser trochanter of femur
N: anterior rami of L1-3
A: Thigh flexion, Trunk flexion, Trunk Lateral flexion
293
What is the OINA of the psoas minor?
O: Bodies and IV discs of T12-L1
I: pubic bone
N: anterior ramus of L1
A: Pelvic and trunk flexion
294
What is the OINA of the iliacus?
O: iliac fossa, ala of sacrum, anterior sacroiliac ligaments
I: Lesser trochanter of psoas major
N: Femoral Nerve
A: Thigh flexion, Hip stabilization
295
What is the OINA of the quadratus lumborum?
O: Iliac crest, Iliolumbar ligament
I: Rib 12, transverse processes of upper lumbar vertebrae
N: Subcostal and upper lumbar (L1-4) anterior rami
A: Trunk lateral flexion, Trunk Extension, Hip elevation, stabilization of 12th rib during inspiration
296
Where do the subcostal nerves arise, course, and distribute?
In the thorax, pass posterior to LCLs into abdomen and run inferiolaterally on the anterior surface of QL passing through TA and IO to supply EO and skin
297
Where do the lumbar spinal nerves arise and course?
Pass from SC through IV foramina inferior to the corresponding vertebrae, where they split into posterior and anterior rami
298
What does the posterior rami of lumbar spinal nerves supply?
Muscles of back and overlying skin
299
What does the anterior rami of lumbar spinal nerves supply?
SKin and muscles of the inferiormost trunk and lower limb
300
Where is the lumbar plexus of nerves formed?
Anterior to the lumbar tranverse processes, within the proximal attachment of psoas major
301
What is the lumbar plexus of nerves composed of?
Anterior rami of L1-4, Femoral nerve branch, obturator nerve branch
302
What and where is the femoral nerve?
L2-L4, emerges @ inf psoas major and innervates the iliacus and passes deep to inguinal ligament/IT to anterior thigh, supplying the hip flexors and knee extensors
303
What and where is the obturator nerve?
L2-L4, emerges @ med psoas major and passes into lesser pelvis, passing through obturator foramen to pubic ramus to medial knww, supplying the adductor muscles
304
What and where is the Ilioinguinal nerve?
ant rami of L1, emerges from lateral psoas major and passes across QL and IL, supplying the scrotum, labia, mons pubis, medial thigh, Io and TA
305
What and where is the Iliohypogastric nerve?
ant rami of L1,received fibers from T12, innervates the skin over the lateral gluteal region and IO and TA
306
What and where is the Genitrofemoral nerve?
L1-2, pierces psoas major and runs inferior on anterior surfacem deep to psoas fascia, divides laterally to the common and external iliac arteries into femoral and genital branches
307
What and where is the lateral cutaneous femoral nerve of thigh?
L2-3, runs inferiolaterally oniliacus and enters the thing deep to inguinal ligaemt/IT just medial ASIS, supplies the skin on anterolateral surface of thigh
308
Describe the passage of blood through the posterior abdominal wall.
Descending thoracic aorta enters abdomen and becomes abdomional aorta @ abdominal hiatus ~T12-L4. -> divides into R and L common iliac arteries that diverge and run inferiolaterally to medial psoas major to pelvic brim -> divides into Internal and External Arteries, internal supplies viscera, external follow iliopsoas) External iliac divides into inferior epigastric and deep circumflex arteries that supply the anterolateral abdominal wall
309
Describe the venous pattern of the posterior abdominal wall.
Common iliac veins unionize to form IVC ~L5, which returns deoxygenated blood from lower extremities, anterolateral abdominal wall and abdominal pelvic viscera, ascends through caval opening in the diaphragm and continues to the heart. Major veins from the IVC to body = Renal veins, common iliac veins, suprarenal veins, lumbar veins
310
What structures fuse to form the pelvic girdle?
ilium, ischium, pubis
311
At what structure does the pelvic girdle fuse together?
Acetabulum
312
What is the name given to the fused hip bones?
Ox coxae
