Abdomen Flashcards
Pass the Boards!
Pain from the 3 segments of the ureter is referred to which areas?
Upper - back behind kidney
Middle - inguinal region
Lower - Penis or clitoris
Branches of the celiac artery
Left Gastric Artery
Splenic Artery
Hepatic Artery
Branches of the splenic artery
Pancreatic branches
Left Gastroepiploic Artery
Short Gastric Artery
Branches of the hepatic artery
Right Gastric Artery
Gastroduodenal Artery
Right Hepatic Artery - Cystic Artery
Left Hepatic Artery
Branches of the gastroduodenal artery
Right Gastroepiploic Artery
Superior Pancreaticoduodenal Artery
Branches of the superior mesenteric artery
Inferior Pancreaticoduodenal Artery Middle Colic Artery Inferior Colic Artery Ileocolic Artery Jejunal Branches Ileal Branches
Branches of the inferior mesenteric artery
Left Colic artery
Sigmoid Artery
Superior Rectal Artery
Three main openings of the diaphragm, vertical location, and their contents
Aortic Opening (T12) - aorta, azygos vein, thoracic duct Esophageal Opening (T10) - Esophagus, right and left vagus nerve, esophageal vessels, lymphatics Caval Opening (T8) - inferior vena cava, right phrenic nerve
Shape of the adrenal glands?
Right - pyramid
Left - crescent
Blood supply of adrenal gland
Aorta, Inferior phrenic artery, renal artery
Venous drainage of adrenal gland
Right - IVC
Left - renal vein
The aorta bifurcates to the common iliac arteries at what level?
L4
Campers and Scarpa’s fascia - which is fatty layer which is membranous? which is deep which is superficial
Camper - superficial, fatty later
Scarpa’s - deep membranous
Anterior abdominal wall fascia continuous with the superficial fascia of the back and thorax?
Scarpa’s fascia
Membranous fascia in the scrotum
Colles’ Fascia
Thin layer of smooth muscle in the scrotum, which is analogue of the Camper’s fascia
Dartos muscle
Rupture of penile urethra may be followed by extravasation of urine into which structures?
Scrotum, perineum, penis, lower part of anterior abdominal wall deep to Scarpa’s fascia
Triangular shaped defect in the external oblique aponeurosis immediately above and medial to pubic tubercle
Superficial inguinal ring
Structure passing through the superficial inguinal ring?
Spermatic cord - male
Round ligament of the uterus - female
Between the ASIS and the pubic tubercle, the lower border of the external oblique aponeurosis folds backward on itself, forming what?
Inguinal ligament
Ligament extending backward and upward from medial end of inguinal ligament to the pectineal line?
Lacunar ligament
The free crescentic edge of the lacunar ligament forms the medial margin of which structure?
Femoral ring
The fascia lata is attached to the inferior border of which structure?
Inguinal Ligament
Which side of the conjoint tendon is a free border?
Lateral
Muscle found in the spermatic cord
Cremaster
Posterior border of which of the following is attached to the lumbar vertebrae by the lumbar fascia?
A. External Oblique
B. Internal Oblique
C. Transversus
B and C.
A has a free posterior border
Curved ridge seen when the rectus abdominis contracts
Linea semilunaris
Three tendinous intersections of the rectus sheath?
- Level of xiphoid process
- Level of umbilicus
- Halfway between 1 and 2
Small muscle in the lower part of the rectus abdominis which is often absent
Pyramidalis
Anterior and posterior wall of the rectus sheath above the costal margin
Anterior - External oblique aponeurosis
Posterior - 5th - 7th costal cartilage and intercostal space
Anterior and posterior wall of the rectus sheath between costal margin and ASIS
Anterior - External + Internal oblique aponeuroisis
Posterior - Internal oblique + Transversus aponeurosis
Anterior and posterior wall of the rectus sheath below the ASIS
Anterior - Aponeurosis of all 3 muscles
Posterior - free. connected with fascia transversalis
Free curved lower border of the posterior wall of the rectus sheath?
Arcuate Line
What vessels enter the rectussheath at the arcuate line?
Inferior epigastric vessels
The rectus abdominis is wider above or below the umbilicus?
Above
Blunt trauma to the abdominal wall may cause midline abdominal pain associated with an acutely tender mass confined to one rectus sheath may cause rectus sheath hematoma. Which structure is the source of bleeding?
Inferior epigastric vein (more common)
artery, rarely
The femoral sheath is formed from which fascia?
Fascia transversalis
A middle aged woman with poor abdominal muscles from multiple pregnancies is often incapable of supporting her abdominal viscera. The lower part of the wall protrudes forward. What condition is this?
Visceroptosis
Innervation of the skin, musclks, and parietal peritoneum of anterior abdominal wall
Anterior rami of T7-T12
Iliohypogastric + Ilioinguinal nerve (L1)
Dermatome over the xiphoid process?
T7
Dermatome over the pubis
L1
Main arteries of anterior abdominal wall
Superior Epigastric Inferior Epigastric Deep Circumflex Iliac Lower two posterior intercostal artery branches of aorta
The superior epigastric artery is a terminal branch of which artery?
Internal thoracic artery
The inferior epigastric artery and deep circumflex artery are branches of which larger artery?
External iliac
Paraumbilical veins connect the veins of the anterior abdominal wall to which major vein
Portal vein
If the vena cava is blocked, trace the collateral pathway passing through the abdominal wall
Axillary vein - lateral thoracic vein - superficial epigastric vein - great saphenous vein - femoral vein
Lymph drainage of anterior abdominal wall
Above umbilicus, front - anterior axillary lymph nodes
Above umbilicus, back - posterior axillary lymph nodes
Below umbilicus - Superficial inguinal nodes
Length of inguinal canal in the adult
1.5 in (4 cm)
Margins of the deep inguinal ring provide attachment for this fascia
Internal Spermatic Fascia
The crura, or margin of the superficial inguinal ring provide attachment for this fascia
External Spermatic Fascia
Vessels located medial to the deep inguinal ring?
Inferior epigastric vessels
Weakest part of the inguinal canal?
Superficial and Deep Inguinal Ring
Contents of the spermatic cord?
Vas deferens Testicular artery Testicular veins Testicular lymph vessels Autonomic Nerves Remains of processus vaginalis Genital branch of genitofemoral nerve
Venous plexus draining the testis
Pampiniform plexus
The testicular veins drain differently on the left and right side. What are they?
Left - left renal vein
Right - IVC
Lymphatic drainage of testis meet at what nodes?
Para-aortic lymph nodes
Innervation of cremaster
Genital Branch of Genitofemoral nerve
Coverings of the Spermatic Cord are derived from layers of the abdominal wall. Match them
External spermatic fascia - External oblique aponeurosis
Cremasteric fascia - internal oblique muscle fascia
Internal spermatic fascia - fascia transversalis
Afferent fibers of the cremasteric reflex
L1 and L2 (medial thigh)
Innermost wall of the scrotum directly covering the testes
Tunica Vaginalis
Which testes is lower, left or right?
Left
Tough fibrous capsule surrounding testis
Tunica Albuginea
Trace path of sperm from lobule to epididymis
Lobule - Seminiferous tubule - rete testis - efferent ductules - epididymis
The epididymis is located ___ to the testis
Posterior
A tuberculous disease from the vertebrae may spread to the upper thigh by passing under the fascia of this muscle?
Psoas Major
A patient was stabbed lateral to the rectus sheath. What structures in the anterior abdominal wall are hit by the knife?
Skin, Campers Fascia, Scarpa's Fascia, Deep fascia, external oblique internal oblique transversus abdominis fascia transversalis extraperitoneal connective tissue, parietal peritoneum
A patient was stabbed anterior to the rectus sheath. What structures in the anterior abdominal wall are hit by the knife?
Skin, Campers Fascia, Scarpa's Fascia, Deep fascia, Anterior rectus sheath Rectus abdominis posterior rectus sheath fascia transversalis extraperitoneal connective tissue, parietal peritoneum
A patient was stabbed in the midline. What structures in the anterior abdominal wall are hit by the knife?
Skin, Campers Fascia, Scarpa's Fascia, Deep fascia, Linea alba fascia transversalis extraperitoneal connective tissue, parietal peritoneum
The peritoneal cavity is divided into two, greater sac and lesser sac. The two sacs communicate with each other through what structure?
Epiploic foramen (Foramen of Winslow)
TRUE OR FALSE. Intraperitoneal organs are those found inside the peritoneal cavity
FALSE. There is no organ inside the peritoneal cavity. Intraperitoneal means it is covered by visceral peritoneum on all sides.
Fold of peritoneum connecting the greater curvature of the stomach to the transverse colon?
Greater Omentum
Fold of peritoneum connecting the stomach to the hilum of the spleen
Gastrosplenic Omentum
Fold of peritoneum suspending the lesser curvature of stomach from the fissure of the ligamentum venosum and porta hepatis on the undersurface of the liver?
Lesser omentum
Borders of the epiploic foramen (A, P, S, I)
Anterior - free border of lesser omentum, bile duct, hepatic artery, portal vein
Posterior - IVC
Superior -Caudate lobe of liver
Inferior - D1
Parietal and Visceral peritoneum are sensitive to which sensations?
Parietal - pain, temperature, touch, pressure
Visceral - stretch and tearing only
Lowest areas of the peritoneal cavity on the supine position
Right subphrenic peritoneal space and pelvic cavity
Volume of ascites required for it to be recognized clinically?
1500 mL
Anterior and posterior relations of the abdominal esophagus
Anterior - Left lobe of liver
Posterior - Left crus of diaphragm
Arterial Supply of Esophagus
Left gastric artery
Lymph Drainage of Esophagus
Left gastric nodes
The gastroesophageal sphincter is
A. Anatomic
B. Physiologic
C. Both
B. Physiologic only
Parasympathic plexus in the wall of the esophagus
Auerbach’s plexus
Portal-systemic venous anastomosis in the esophagus is between which two vessels
Left gastric vein and azygos vein
Capacity of the adult stomach in mL
1500 mL