Abdomen Flashcards by Sophie Hay

In order of superficial to deep, name the three layers of flat muscles in the abdominal wall

External oblique
Internal oblique
Trans versus abominis

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What strap muscle lies anterior to the muscles of the abdominal wall

Rectus abdominis

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What vessels run along the deep surface of the rectus abdominus

Superior and inferior epigastric vessels

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Where do the superior epigastric arteries arise from

Internal thoracic artery

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From which larger artery do the inferior epigastric arteries arise from

External iliac artery

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Name the three main muscles which form posterior abdominal wall

Qaudratus lumborum
Psoas Major
Illiacus

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What nerve plexus can be found on the posterior abdominal wall

Lumbar plexus

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Name the two large vessels found in the posterior abdominal wall

Right and left common iliac arteries (L5)

Bifurcation at L4

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What is the position of the deep and superficial ring of the inguinal canal

Deep ring: just superior to the mid point of the inguinal ligament (ASIS-pubic tubercle)

Superficial ring: superior and slightly lateral to the pubic tubercle

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What muscle forms the deep and superficial rings ?

Deep ring: internal oblique

Superficial ring: external oblique

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How long in the inguinal canal?

Approx 4cm in adults

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What somatic nerves are found in the inguinal canal?

Ilionguinal nerve & genital branch of the genitofemoral nerve

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Main structures found in the premature cord?

Testicular artery, cremasteric artery, testicular veins, genital branch of genitofemoral nerve, vas deferents (transports sperm from the epididymis to ampulla) lump vessls,

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In females what structure is transmitted in the inguinal canal

Round ligament of the uterus

Helps anchor the uterus

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State whether the flowing organs are intra or retro peritoneal

Liver, caecum, kidneys, stomach, jejunum, descending colon

Liver -I
Caecum - R
Kidneys - R
Stomach - I
Jejunum - I
Descending colon - R

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What do the greater and lesser sacs communicate via?

Omental (epiploic) foramen

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What structures are found in the hepatoduodenal ligament

Portal triad : portal born, hepatic artery, bile duct

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At what vertebral level does the IVC, oesophagus and aorta penetrate the diaphragm

IVC -T8
Oesophagus -T10
Aorta - T12

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At what vertebral level do the renal arteries branch ?

L1-2

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What are the 3 main branches of the coeliac trunk?

Splenic artery
Common hepatic artery
Left epigastric artery

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Para-aortic lymph nodes receive lymph from which organs ?

Kidneys, suprarenal glands, testes, ovaries, uterus

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What are the three types of preaortic lymph nodes?

Celiac lymph nodes (foregut organs)
Superior mesenteric lymph nodes (midgut organs)
Inferior mesenteric lymph nodes ( descending colon, sigmoid colon, upper part of rectum)

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Where does the lymph of the preaortic lymph nodes pass to

Cisternia chyli

Dilated sac of the thoracic duct

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What is the root value of the lumbar plexus?

L1-L4

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Which muscle is closely associated with the lumbar plexus and it’s branches ?

Psoas Major

Which cranial nerve is present in the abdomen?

Vagus nerve

What are the surface markers of the kidneys?

Posterior, bilateral, 3cm lateral from the median plane, between the 11th thoracic spine and the 3rd lumbar spine

Where does the hilum of the kidneys lie and what 3 structures exit/enter the hilum

``` Transpyloric plane (L1) Vessels, nerves & ureter ```

Of the 3 structure of the hilum of the kidney which is most anterior and which is posterior ?

Renal vein is most anterior, then renal artery and the ureter is post posterior

Where do the suprarenal gland lie in relation to the kidneys ?

Superior medial aspects of the kidneys

What is the difference between direct and an indirect inguinal hernia

Direct: protrudes forward alongside the dermatitis core (medial to inferior epigastric artery) Indirect: more oblique route, downwards to the scrotum and defends along the spermatic cord (Lateral to the inferior epigastric artery)

Why is inguinal hernia more common in men?

Men have a weak spot in abdominal wall where spermatic cord enters the scrotum

Which part of the small intestine is foregut and which parts are midgut?

Foregut: 1st & 2nd part of the duodenum Midgut: 3rd & 4th part of the duodenum, jejunum & ileum

Describe the peritoneal relationship of the duodenum

Initial and terminal parts of duodenum are in the peritonemun, the rest is retroperitoneal

What region of the abdomen is the spleen in?

Left hypochondriac

What lies anterior to the pancreas

Stomach (pylorus)

How do secretions from the pancreas empty into the duodenum

Sphincter of Oddi

What are the four lobes of the liver?

Right, left, caudate, quadrate

Below which surface landmark is the gallbladder located ?

Tip of the right 9th rib

What is released through the hepatopancreatic ampulla (ampulla of vater)

Pancreatic juice and bile

What landmark identifies the transition from the foregut to the midgut?

Above the major duodenal papilla there is a prominent mucosal fold forming a hood

Where would you locate McBurney’s point ?

Point on the lower right quadrant of the abdomen | Two thirds from the the umbilicus to the ASIS

What are the three external features of the colon?

Taenia coil:longitudinal ribbons of smooth muscle Haustra: small segmented ouches of bowel separate by haustral folds Epiplioc appendices: small pouches of peritoneum filled with fat

At which point does the midgut become the hindgut?

Proximal 2/3 of transverse colon

At what level does the rectus begin

What is the vasculature of the rectum

Proximal part of the rectum: superior rectal arteries (branch of inferior mesenteric artery) Distal parts of rectum and the anal canal: middle and inferior rectal arteries arising from internal iliac artery

Which branch of the nervous system inner area the internal and external anal sphincters ?

Internal : autonomic | External: somatic

At what vertebral levels does each of these arteries branch at? Coeliac trunk SMA IMA

Coeliac trunk: T12 SMA: L1 IMA: L3

What is the lines Alba ? What functions does it form?

Midline of aponeurosis formed dram the fascia of the abdominal muscles. Separates the left and right sides of the rectus abdominis

Which bones form the posterior abdominal wall

Bodies of the lumbar vertebrae posterior costal margin and ilium

How would you distinguish the lower thoracic vertebrae from the lumbar vertebrae

Thoracic vertebrae will have articular facets on the transverse processes and body for articulation with the ribs

What are the attachments of the inguinal ligament

Pubic tubercle and ASIS

Which nerve supplies the internal oblique muscle on each side

Segmental spine nerves from T6-L1

What dermatome overlies the inguinal ligament

What structure forms the floor of the inguinal canal

Inguinal ligament

Which abdominal region lies superior to the umbilical region

Epigastric region

What are the lateral branches of the abdominal aorta

Gonadal arteries, suprarenal arteries, renal arteries and lumbar arteries

At which level does the oesophagus pass through the diaphragm

T10

Where does the thoracic duct drain

Into the left brachiocephallic vein at the union of the internal jugular and the subclavian

In a healthy individual what lies within the peritoneal cavity

A small amount of serous fluid

What is an omentum

Double layer of peritoneum

What are the anterior branches of the abdominal aorta

Coeliac trunk, superior mesenteric artery, inferior mesenteric artery

To which group of lymph nodes for the lymph of the appendix drain

Pre-aortic around the toot of the superior mesenteric artery

What do the contents of the cistern chyli drain into

Thoracic duct

Is the duodenum a retroperitoneal organ?

The duodenum is almost entirely retroperitoneal apart from the first but

What veins unite to form the hepatic portal vein

Splenic vein and superior mesenteric vein

Explain the pathway of bile through the biliary tree to the duodenum ?

Bile produced by the liver passes into the left and right hepatic ducts. These unite to form the common hepatic duct. This exits the liver and joins the cystic duct from the gallbladder to form the common bile duct which unites with the pancreatic duct forming the ampulla of vater to enter the duodenum

What is the first structure you will encounter upon opening the peritoneum and what is its function

Greater omentum | Fat deposition, immune contribution and infection and wound isolation

What is the falciform ligament

2 folds of peritoneum that go from the liver to the anterior abdominal wall