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Z N Anatomy > Abdomen > Flashcards

Abdomen Flashcards

1
Q

What is the subcostal line?

A

an imaginary horizontal line across the lower margin of the costal cartilages; it crosses the descending duodenum

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2
Q

What is the transumbilical plane?

A

a horizontal line passing through the umbilicus and the L3-L4 intervertebral disc

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3
Q

What is the ranstubercular plane?

A

passes through the iliac tubercles of the iliac crest and corresponds to the body of the 5th lumbar vertebra

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4
Q

How are the quadrants decided?

A

visualizing an imaginary vertical (median) plane from the xiphoid process to the pubic symphysis and a horizontal (transumbilical) plane

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5
Q

What are the four quadrants?

A

right upper quadrant, left upper quadrant, right lower quadrant, and left lower quadrant

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6
Q

Where does external oblique muscle arise?

A

by fleshy digitations from the external surfaces and inferior borders of the lower 8 ribs

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7
Q

Where does the external oblique attach?

A
  • The muscle attaches to the anterior half of the iliac crest, to the anterior superior iliac spine, and into a broad aponeurosis along a line from the 9th costal cartilage to the anterior superior iliac spine.
  • The aponeurosis inserts into the midline linea alba
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8
Q

What is the action of the external oblique?

A
  1. Compresses the abdominal contents
  2. Contracting bilaterally, the muscles flex the vertebral column or trunk
  3. Acting alone, the muscle bends the vertebral column laterally and rotates it so as to bring the shoulder of the same side forward
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9
Q

What is the innervation of the external oblique?

A

Supplied by intercostal nerves T7-T11 and the subcostal nerve (T12)

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10
Q

How big is the external oblique?

A

largest and most superficial of the 3 flat abdominal muscles

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11
Q

What are the different fascia?

A
  1. fatty (Camper’s) fascia

2. underlying membranous (Scarpa’s) fascia of the abdominal wall

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12
Q

Why are these fascia important?

A
  • These fascial planes are important in the spread of infection
  • Fluid from the perineal region (e.g., ruptured urethra) can spread into the abdominal wall between Scarpa’s fascia and the underlying investing (deep) fascia of the external abdominal oblique muscle and aponeuros
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13
Q

Where does the internal oblique muscle arise from?

A

from the lateral half of the inguinal ligament, the iliac crest, and the thoracolumbar fascia

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14
Q

Where does the internal oblique attach to?

A

Attaches to the inferior borders of the cartilages of the last 3 or 4 ribs, the linea alba, the pubic crest, and the pectineal line

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15
Q

What is the action of the internal oblique?

A
  • Compresses the abdominal contents
  • Contraction of both internal abdominal oblique muscles flexes the vertebral column
  • Contraction on one side only bends the vertebral column laterally and rotates it, moving the shoulder of the opposite side anteriorly
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16
Q

What is the innervation of the internal oblique?

A

By the intercostal nerves T7-T11, subcostal nerve (T12), and iliohypogastric and ilioinguinal nerves (L1)

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17
Q

How does the internal oblique help form the conjoint tendon?

A

In the inguinal region, the aponeuroses of the internal abdominal oblique and transverse abdominal muscles fuse to form the conjoint tendon

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18
Q

What can lead to hernia?

A

A weakness in the anterior abdominal wall can lead to hernias, where underlying viscera and fat may protrude anteriorly and cause a bulge or rupture of the anterior muscle layers

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19
Q

What are the most common types of abdominal wall hernias?

A
  1. inguinal hernias
  2. umbilical hernias,
  3. linea alba hernias (usually occurring in the epigastric region)
  4. incisional hernias (occurring at the site of a previous surgical scar)
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20
Q

Where does the rectus abdonomis arise

from?

A
  • arises inferiorly by 2 tendons
    1. The lateral tendon is attached to the pubic crest
    2. The medial tendon interlaces with the tendon of the opposite side to arise from the pubic symphysis.
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21
Q

What is the insertion of the rectus abdominis?

A

Attaches into the cartilages of the 5th, 6th, and 7th ribs and the xiphoid process

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22
Q

What is the action of the rectus abdonomins?

A

Flexes the vertebral column or trunk, tenses the anterior abdominal wall, and depresses the ribs

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23
Q

What is the innervation of the rectus abdonomins?

A

Intercostal nerves (T7-T11) and the subcostal nerve (T12)

24
Q

Where is the rectus abdonomis contained within?

A

The rectus abdominis muscle is contained in the rectus sheath and is separated from the rectus abdominis on the other side by the linea alba

25
Q

What is the rectus abdonmis crossed by?

A

The muscle is crossed by fibrous bands, which are the 3 tendinous intersections; this gives the appearance of “6-pack abs.”

26
Q

What is the guarding reflex?

A
  • If abdominal pain is present, especially if the affected visceral structure (e.g., bowel, appendix) comes in contact with the inner aspect of the peritoneal wall, the patient may present with a guarding reflex
  • The patient will contract the abdominal wall muscles when palpated (rebound tenderness) because of the abdominal pain, and the abdomen will become rigid
27
Q

Where does the thin cremaster muscle arise from?

A

arises from the middle of the inguinal ligament and is a continuation of the internal oblique muscle

28
Q

What is the insertion of the thin cremaster muscle?

A

Attaches by a small tendon to the pubic tubercle and crest

29
Q

What is the action of the thin cremaster muscle?

A

Draws the testes upward

30
Q

What is the innervation of the thin cremaster muscle?

A

Genital branch of the genitofemoral nerve (L1 and L2)

31
Q

What happens for the cremaster muscle after passing through the inguinal ring?

A

the muscle fibers of the cremaster form a series of loops that are embedded in the cremasteric fascia (surrounding the spermatic cord in a male)

32
Q

What is the spermatic cord covered by?

A

by 3 fascial layers derived from the abdominal wall

33
Q

What is the external spermatic fascia derived from?

A

external oblique aponeurosis

34
Q

What is the middle spermatic (cremastric) fascia dervied from?

A

internal oblique muscle

35
Q

What is the internal spermatic fascia derived from?

A

trasversalis fascia

36
Q

What do the testes do after brith?

A
  1. The testes normally descend into the scrotum shortly before birth
  2. This is necessary for viable germ cell division and future sperm production
  3. The human testes will not produce sperm if the testis is not cooled to several degrees below that of the body’s normal temperature (37°C [98.6°F])
37
Q

What happens above the arcuate line?

A
  1. the anterior layer of the rectus sheath comprises the fused aponeuroses of the external and internal oblique muscles
  2. The posterior layer comprises the fused aponeuroses of the internal oblique and transversus abdominis muscles
38
Q

What happens below the arcuate line?

A

the aponeuroses of all 3 muscles fuse to form the anterior layer of the sheath; and the rectus abdominis muscle rests only on the thin transversalis fascia

39
Q

What forms the lateral umbilical fold?

A

inferior epigastric vessels

40
Q

What do inferior epigastric vessel anastomose with?

A

with the superior epigastric vessels, which are continuous with the internal thoracic (mammary) vessels

41
Q

What is the arterial vascular anastomosis important in?

A

providing blood to the abdominal wall, because these arteries have connections all along their route with intercostal arteries (in the thorax) and segmental lumbar branches in the abdomen

42
Q

Where does the quadratus lumborum muscle arise from?

A

from the transverse processes of L3-L5, the iliolumbar ligament, and the iliac crest

43
Q

Where does the quadratus lumborum muscles attach?

A

Attaches to the lower border of the last rib and the transverse processes of L1-L3 vertebrae

44
Q

What does the quadratus lumborum muscles action?

A
  • With the pelvis fixed, the quadratus lumborum muscle laterally flexes the lumbar vertebral column (trunk)
  • It also fixes the 12th rib during inspiration
  • When both quadratus lumborum muscles act together, they can help extend the lumbar vertebral column
45
Q

What is the innervation of the quadratus lumborum muscle?

A

Subcostal nerve (T12 and L1-L4 nerves)

46
Q

What does the diaphragm form superiorly?

A

the lateral arcuate ligament (lumbocostal arch) where it passes over the quadratus lumborum

47
Q

What is the lumbcostal triangle?

A
  1. The lumbocostal triangle (located just lateral and superior to the lateral arcuate ligament) is a nonmuscular area between the costal and lumbar portions of the diaphragm
  2. During trauma or with increased abdominal pressure, this portion of the diaphragm can become weakened and viscera can herniate into the thorax superiorly
48
Q

Where does the respiratory diaphragm arise from?

A

The respiratory diaphragm is a dome-shaped musculofibrous septum that arises from the circumference of the thoracic outlet, with fibers arising from a sternal portion (xiphoid process), a costal portion (lower 6 costal cartilages), and a lumbar portion (L1-L3 vertebrae).

49
Q

Where does the respiratory diaghrgam muscle insert?

A

The muscles converge and insert into the central tendon

50
Q

What inaction of muscular diaphragm?

A
  • Attached to the ribs and lumbar vertebrae, the muscular diaphragm draws the central tendon downward and forward during inspiration
  • This increases the volume of the thoracic cavity and decreases the volume of the abdominal cavity
51
Q

What is the innervation of the muscular diaphragm?

A

Phrenic nerve (C3, C4, and C5)

52
Q

What are the 3 large opening of the diaphragm?

A
  1. the caval hiatus for the inferior vena cava (at the level of the T8 vertebra)
  2. the esophageal hiatus (at the level of the T10 vertebra)
  3. the aortic hiatus (in front of the T12 vertebra)
53
Q

What happens as the diaphragm passes over the aorta?

A

it forms an arch called the median arcuate ligament

54
Q

What happens as the diaphragm passes over the psoas major muscle?

A

it forms the medial arcuate ligament

55
Q

What happens as the diaphragm passes over the quadratus lumborum?

A

forms the lateral arcuate ligament

56
Q

What is an example of referred pain?

A
  1. If an inflamed visceral structure (e.g., gallbladder) contacts the underside of the diaphragm, the parietal peritoneum may become inflamed and the pain will be passed along the sensory axons of the phrenic nerve (C3-C5) on the right side to the corresponding dermatomes in the lower neck and shoulder region
  2. This is an example of referred pain from the abdomen to a somatic region of the body.

Z N Anatomy (35 decks)

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