Abdomen & Anterior Abdominal Wall Flashcards
Explain the function of the abdomen and its boundaries
Function: Flexible container for the abdominal organs & facilitates movement of the trunk and breathing, provides bony
protection for certain organs
Boundaries:
Anterior: Abdominal wall
Posterior: Vertebral column
Superior: Diaphragm
Inferior: Pelvic inlet
Explain the functions of the anterior abdominal wall
- Support the trunk
- Support the abdominal viscera
- Manage intra-abdominal pressure during
respiration - Move the trunk and maintain posture
Describe the organization of the greater and lesser sacs
Greater sac = main abdominal cavity
Lesser sac = omental bursa, it is a diverticulum (extension off another cavity), it is posterior to the stomach
Describe the organization of the mesenteries
- Double layer of peritoneum
- Provides conduit for neurovasculature
- Mesentery proper suspends small intestine from posterior abdominal wall
Describe the organization of the peritoneal ‘ligaments’
Greater omentum:
- gastrophrenic ligament
- gastrosplenic ligament
- gastrocolic ligament
Lesser omentum:
- hepatogastric ligament
- hepatoduodenal ligament
Liver:
- falciform ligament
- round ligament
- coronary ligament
- left and right triangular ligaments
Distinguish between intraperitoneal and retroperitoneal visceral categorization
Intraperitoneal:
- Enclosed by visceral peritoneum
- Suspended by mesenteries
Retroperitoneal:
- Having to do with the area outside or behind the peritoneum
Viscera primarily retroperitoneal
Never had mesentery, developed posterior to peritoneal cavity:
- Kidneys
- Suprarenal glands
Viscera secondarily retroperitoneal
Was previously intraperitoneal, but mesentery fused during development:
- Duodenum (descending, horizontal, ascending)
- Colon (ascending, descending)
- Pancreas
- Rectum (upper 2/3)
Explain the layers of the rectus sheath
Explain the significance of the arcuate line
Superior to the arcuate line the rectus sheath has an anterior rectus sheath and a posterior rectus sheath.
Inferior to the arcuate line the rectus sheath is one continuous aponeurotic sheath with the transversalis fascia posterior to the RA.
Inferior epigastric vessels perforate the rectus abdominis
Describe the inguinal canal including its contents in both phenotypic males and females
Passage 4 cm long, parallel to the inguinal ligament
Openings are called ‘rings’
Primarily occupied by
♂ Spermatic cord
♀ Round ligament
What are the boundaries of the inguinal canal?
Floor: inguinal ligament reinforced medially by lacunar ligament
Anterior wall: external oblique aponeurosis, reinforced laterally by internal oblique
Posterior wall: transversalis fascia reinforced by conjoint tendon
List the layers of the anterior abdominal wall from superficial to deep
Skin
Campers fascia (fatty layer)
Scarpas fascia (membranous layer)
External oblique
Internal oblique
Transversus abdominis
Transversalis fascia
Extraperitoneal adipose
Parietal peritoneum
Describe the innervation of the skin of the abdomen via T7-T12 spinal nerves
Roots > Spinal Nerve > Anterior Ramus > T7-12
- Anterior cutaneous branches of thoracoabdominal nerves (T7-T11)
- Lateral cutaneous branches of thoracoabdominal nerves (T7-T11)
- Lateral cutaneous branch of subcostal nerve (T12)
- Anterior cutaneous branch of subcostal nerve (T12)
Name the location of common abdominal wall dermatomes
T4 = nipple
T5 = xyphoid process
T10 = umbilicus
Describe the division of the abdomen into quadrants
From midline of body crossing umbilicus to transverse cut through umbilicus:
Left Upper Quarter (LUQ)
Right Upper Quarter (RUQ)
Left Lower Quarter (LLQ)
Right Lower Quarter (RLQ)
What are the contents of the LUQ
Stomach
Duodenum
Jejunum
Ileum
Spleen
Pancreas
Transverse colon
Descending colon
Left lobe of liver
Left kidney
Left adrenal gland
What are the contents of the RUQ
Stomach
Duodenum
Jejunum
Ileum
Liver
Gallbladder
Pancreas
Ascending colon
Transverse colon
Right Kidney
Right Suprarenal gland
What are the contents of the LLQ
Jejunum
Ileum
Descending colon
Sigmoid colon
Rectum
What are the contents of the RLQ
Jejunum
Ileum
Ascending colon
Cecum
Appendix
Rectum
What is an inguinal hernia? What are the risk factors? What is the consequence on an inguinal hernia?
*Inguinal Hernia: Protrusion of peritoneal sac thru weakened abdominal wall.
*Risk factors: Obesity, aging, genetics, sex (being male), certain occupations.
*Consequences: Viscera may become trapped and twisted, compromising blood supply
Describe a direct inguinal hernias
*Bowel passes medial to inferior epigastric vessels.
*Acquired.
*Least common (<33%)
Describe an indirect inguinal hernias
*Bowel passes lateral to inferior epigastric vessels.
*Congenital (patent process vaginalis).
*Most common (>66%)
Name the components of the digestive system and identify their distinguishing features as given on the Structure Information List
Oral cavity
Pharynx
Esophagus
Stomach
Liver
Gallbladder
Pancreas
Small intestine
Large intestine
Rectum
Anus
What is the function, tissue composition, and innervation of the esophagus?
Function:
*transports food to the stomach
*helps warm or cool food
*expands significantly
Tissue composition:
*thick muscular walls (longitudinal & circular layers) that produce strong peristaltic waves
*muscular walls transition from skeletal to smooth
Innervation:
*R & L vagus nerve
*Upper portion: recurrent laryngeal
*Below lung roots: esophageal plexus
Identify the distinguishing features of the stomach
Cardiac sphincter
Fundus - Left bottom
Body
Greater curvature
Lesser curvature
Pyloric sphincter
Identify the distinguishing features of the liver
Right lobe
Left lobe
Quadrate lobe
Caudate lobe
Surface features:
*Impression for gallbladder
*Porta hepatis
Internal features:
*Hepatic veins
*Portal triads
Identify the distinguishing features of the gallbladder
Divisions:
*Fundus
*Body
*Neck.
Ducts:
*Common hepatic
*Cystic
*Common bile
Identify the distinguishing features of the pancreas
Parts:
*Head
*Neck
*Body
*Tail
*Uncinate process
*Pancreatic duct
Identify the distinguishing features of the large intestine
Flexures:
*R colic (ascending)
*L colic (descending)
Other:
*ileocecal junction
*Teniae coli
*Haustra
*Appendices epiploicae (epiploic appendages)
Name the composition of the portal triad
Hepatic artery proper
Hepatic portal vein
Common bile duct
The hepatic artery proper passes ________ to the epiploic foramen
Anterior
The gastroduodenal artery passes _______ to the duodenum (first segment) and _______ to the pancreas
posterior, anterior
The splenic artery and vein pass _______ to the stomach (fundus) and are typically positioned _______-_______ to the pancreas (body and tail)
posterior, posterior-superior
The superior mesenteric artery is positioned _______ to the superior mesenteric vein and passes _______ to the duodenum (4th segment), directly _______ to the left renal vein, and _______ to the pancreas (body)
lateral (to the left), anterior, anterior, posterior
The right renal artery passes directly _______ to the inferior vena cava
posterior
The right testicular artery passes directly _______ to the inferior vena cava, the right ureter, and the psoas muscle
anterior
The right common iliac artery passes directly _______ to the left common iliac vein
anterior
The internal pudendal artery and vein, and the pudendal nerve pass _______-_______ (_______) to the sacrospinous ligament
posterior-lateral (superficial)
The external iliac vein is positioned _______-_______ to the external iliac artery
posterior-medial
The obturator artery, vein and nerve pass _______ to the superior pubic ramus
inferior
The ureter passes _______ and _______ to the uterine artery
posterior and inferior
The ureter passes _______ and _______ to the vaginal artery
superior and anterior
The left common iliac vein is positioned _______-_______ to the common iliac artery
posterior-medial
The external iliac vein is positioned _______-_______ to the external iliac artery
posterior-medial
The right ureter passes directly _______ to the right external iliac artery
anterior
The ductus deferens passes directly _______ to the obliterated umbilical artery
posterior (deep)
The obturator artery, vein and nerve pass _______ to the superior pubic ramus
inferior
