Abdomen Flashcards
Motor supply of diaphragm
Phrenic
Sensory supply of diaphragm
Central- phrenic
Peripheral- intercostal
Level of Caval hiatus
T8
Level of esophageal hiatus
T10
Level of aortic hiatus
T12
Pass caval hiatus
IVC and Right phrenic
Pass aortic hiatus
Aorta, thoracic duct, azygous vein
Pass esophageal hiatus
Esophagus and vagus
Thoracic duct empty to
Left brachiocephalic vein
Level of umbilicus
L3
Runs obliquely downward and medially
External oblique
Runs upward and medial
Internal oblique
Formed by aponeurosis of int oblique and transversus abdominis
Conjoint tendon
Marking inferior limit of posterior recrus sheat. Midway of umbilicus and pubic crest
Arcuate line/linea semicircularis
Forms linea alba
EO, IO, TA
Lymph from lower abdominal wall, buttocks, penis, scrotum, labia mahora, lower vagina and anal canal drains to
Superficial inguinal LN
Lymphatic drainage of anterior abdominal wall
Above umbilicus- AXILLARY LN
BELOW- superficial inguinal lymph nodes
Borders of HESSELBACH triangle
Superolateral- inf epigastric artery
Medial- rectus abdominis
Inferior- inguinal ligament/poupart ligament
Walls of INGUINAL CANAL
Ant- external spermatic
Post- transversalis fascia and conjoint tendon
Floor- inguinal lig
Roof- io and Ta
Pass through inguinal canal
Male-spermatic cord
Female- round ligament
ILIOINGUINAL nerve
Structures within spermatic cord
3- testicular, cremasteric, artery of vas deferens
2- autonomic and genital branch of genitofemoral nerve
2- vas deferens and processus vaginalis
1- testicular vein
1- lymph of testis
Hernia
Congenital; patent processus vaginalis, children, sac LATERAL to inferior Epigastric vessels, covered by peritoneum and spermatic cord
Indirect hernia
Hernia
Acquired, weak abdominal wall, elderly, MEDIAL to inferior epigastric, covered only by external spermatic fascia
Direct hernia
Cremaster muscle derived from
Internal oblique
Afferent limb of cremasteric reflex
Femoral branch of Genitofermoral nerve
Efferent of cremaateric reflex
Genital branch of Genitofemoral nerve
Peritoneum
Pain is localized
Parietal
Peritoneum
Insensitive, pain is poorly localized
Visceral
Retroperitoneal organs
Suprarenal glands Abdominal aorta/ IVC Duodenum (2nd and 3rd) Pancreas (except tail) Ureters Colon (ascending and descending) Kidneys Esophagus Rectum (middle)
Peritoneal cavity
Main and larger
From
Diaphragm to pelvis
Greater sac
Peritoneal cavity
Smaller
Post to stomach and lesser omentum
Super and inferior recess
Lesser sac/ Omental bursa
boundaries of foramen of winslow
A: hepatoduodenal lig, portal vein, hepatic artery, bile duct
P: IVC
S: caudate lobe
I: superior duodenum
Formed by hepatoduodenal lig and hepatogastric lig
Connects lesser curvature
Lesser omentum
Portal triad
Portal vein posterior
Cbd anterior and right
Hepatic artery anterior and to the left
* in relation to hepatoduodenal lig
Abdominal entry of Paracentesis
2cm below umbilicus midline
4cm superior and midline to ASIS in either side
Ant unpaired branch of AA
Celiac
SMA
IMA
AA
Lateral paired visceral
Suprarenal
Renal
Gonadal
AA
Lateral paired abdominal
Inferior phrenic
Lumbars
AA
terminal branches
Common Iliac and median sacral
Supply of foregut
Celiac trunk
Supply of midgut
SMA
Supply of hindgut
IMA
Primitive gut of duodenum
Fore and mid
Primitive gut of transverse colon
Mid and hind
Primitive of anal canal
Upper- hindgut
Lower- ectoderm
Level of celiac artery
T12
Branches of Celiac artery
Left gastric (terminal) Splenic: left gastroepiploic and short gastric Common hepatic: right gastric, r and l hepatic, gastroduodenal (right gastroepiploic and superior pancreaticoduodenal)
Level of SMA
L1
Level of IMA
L3
Branches of SMA
Inferior Pancreaticoduodenal Middle colic Right colic Ileo-colic Jejunal-ileal
Branches of IMA
Left colic
Sigmoid
Superior rectal
Marginal artery of Drummond
Common site of aortic aneurysm
Bifurcation of AA
Level of IVC
L5
Drains to left renal vein
Left suprarenal
Left gonadal
Forms portal vein
Union of splenic and SMV
Tributaries of portal vein
Smv Imv Splenic vein Left gastric v Paraumbilical v
Collateral circulation that bypass liver
Left gastric and azygous veins
Block in esophageal branch of left gastric blocks esophageal of azygous causes
Esophageal varices
Block in superior rectal that blocks middle and inferior rectal veins causes
Internal hemorrhoids
Block in paraumbilical veins bloacks superficial veins of ant abdominal wall
Causes
Caput medusae
Block in collic veins block retroperitoneal veins causes
Internal hemorrhage
Drains directly to IVC
Right and left hepatic veins
Right suprarenal and right gonadal veins