Abdomen & Anterior Abdominal Wall Learning Objectives Flashcards by Lauren Wolfe

Explain the function of the abdomen and its boundaries

Function: flexible container for the abdominal organs

Boundaries
- Anterior: abdominal wall
- Posterior: vertebral column
- Superior: diaphragm
- Inferior: pelvic inlet

How well did you know this?

Not at all

Perfectly

Explain the functions of the anterior abdominal wall

Functions:
- Support the trunk
- Support the abdominal viscera
- Manage intra-abdominal pressure during respiration
- Move the trunk and maintain posture

How well did you know this?

Not at all

Perfectly

Describe the organization of the greater and lesser sacs

Greater sac: “main abdominal cavity”

Lesser sac: “omental bursa”; diverticulum
- Posterior to stomach

How well did you know this?

Not at all

Perfectly

Describe the organization of the mesenteries

Mesentery = double layer of peritoneum; provides conduit for neurovascular supply b/t organ and body wall

Peritoneal layers:
- visceral (innermost)
- parietal

How well did you know this?

Not at all

Perfectly

Peritoneal ligaments of the greater omentum

Gastrophrenic ligament
Gastrosplenic ligament
Gastrocolic ligament

How well did you know this?

Not at all

Perfectly

Peritoneal ligaments of the lesser omentum

Hepatogastric ligament
Hepatoduodenal ligament

How well did you know this?

Not at all

Perfectly

Falciform ligament

Peritoneal ligament

Attaches liver to posterior surface of anterior abdominal wall

Inferiorly encloses the round ligament of the liver

How well did you know this?

Not at all

Perfectly

Intraperitoneal

Enclosed by visceral peritoneum
Suspended by mesenteries

How well did you know this?

Not at all

Perfectly

Primarily retroperitoneal

Kidneys
Suprarenal glands

never had mesentery, posterior to peritoneal cavity

How well did you know this?

Not at all

Perfectly

Secondarily retroperitoneal

Duodenum (desc, horiz, ascend)
Colon (ascend, desc)
Pancreas
Rectum (upper 2/3)

were previous intraperitoneal, but mesentery fused during development

How well did you know this?

Not at all

Perfectly

Explain the layers of the rectus sheath above the arcuate line

upper 2/3

Anterior rectus sheath: external oblique and internal oblique

Posterior rectus sheath: internal oblique and transversus abdominis (and transversalis fascia however not RS)

How well did you know this?

Not at all

Perfectly

Explain the layers of the rectus sheath below the arcuate line

lower 1/3

Anterior rectus sheath: external oblique, internal oblique, transversus abdominis

Posterior (not considered rectus sheath): transversalis fascia

How well did you know this?

Not at all

Perfectly

Explain the significance of the arcuate line

Demarcates the transition b/t the aponeurotic posterior rectus sheath (internal oblique and transversus abdominis) and the transversalis fascia
- When IO and TA transition to anterior rectus sheath

Inferior epigastric vessels perforate the rectus abdominis

How well did you know this?

Not at all

Perfectly

Describe the anatomy of the inguinal canal including its contents in both males and females

4 cm long, parallel to inguinal ligament

Openings:
Deep inguinal ring
Superficial inguinal ring

Contents:
- ilioinguinal n.
- male: spermatic cord
- female: round ligament of uterus

How well did you know this?

Not at all

Perfectly

Inguinal canal boundaries

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

How well did you know this?

Not at all

Perfectly

List the layers of the anterior abdominal wall from superficial to deep

Skin
Camper’s fascia (fatty layer)
Scarpa’s fascia (membranous layer)
External abdominal oblique m.
Internal abdominal oblique m.
Transversus abdominis m.
Transversalis fascia
Extraperitoneal adipose
Parietal peritoneum

How well did you know this?

Not at all

Perfectly

Describe the innervation of the skin of the abdomen via T7-T12 spinal nerves

Innervation corresponds with dermatomal striping pattern; no plexus

T7-11: thoracoabdominal nn.
T12: subcostal n.

T4: nipple
T6: xyphoid process
T10: umbilicus

How well did you know this?

Not at all

Perfectly

Describe the division of the abdomen into quadrants

Vertical: midline
Horizontal: through umbilicus

Right upper quadrant (RUQ)
– superior border is costal margin
Left upper quadrant (LUQ)
– superior border is costal margin
Right lower quadrant (RLQ)
Left lower quadrant (LLQ)

Direct hernia

Acquired
Medial to inferior epigastric vessels
Least common (<33%)

Indirect hernia

Congenital
Lateral to inferior epigastric vessels
Enters scrotum
Most common (>66%)

Name the composition of the portal triad

Hepatic artery proper
Hepatic portal vein
Common bile duct

Components of digestive system

Oral cavity
Pharynx
Esophagus
Stomach
Small intestine
- duodenum
- jejunum
- ileum
Large intestine
- cecum/appendix
- ascending colon
- transverse colon
- descending colon
- sigmoid colon
- rectum
- anus

Stomach: surface and internal features

Surface features:
o Fundus
o Body
o Greater and lesser curvatures

Internal features:
o Folds
o Cardiac and pyloric orifices
o Cardiac and pyloric sphincters

Small intestine function

enzymatic digestion of food; absorption of nutrients

Small intestine features

Duodenum o Superior o Descending -- Duodenal papillae (major and minor) o Horizontal o Ascending Jejunum o Duodenojejunal flexure Ileum

Large intestine features

Surface features: o Teniae coli o Haustra o Appendices epiploicae Cecum o Ileocecal junction o Vermiform appendix Ascending colon o Right colic flexure Transverse colon Descending colon o Left colic flexure Sigmoid colon Rectum Anus

Explain the three layers of the thoracolumbar fascia including what attaches to each

Anterior layer: (not considered thoracolumbar fascia) - Anterior to quadratus lumborum Middle layer: - Between quadratus lumborum and erector spinae - Attachment for external/internal obliques Posterior layer: - Posterior to erector spinae - Attachment for latissimus dorsi

Muscles of posterior abdominal wall

Psoas major/minor Iliacus Quadratus lumborum

Attachments for psoas major/minor

from transverse processes of T12-L4 to lesser trochanter of femur

Attachments for iliacus

from iliac fossa to lesser trochanter of femur

Attachments for quadratus lumborum

from 12th rib & transverse processes of L1-4 to iliolumbar ligament & iliac crest

Attachments for diaphragm

from xiphoid process, inner surface of the lower ribs & costal cartilages, medial & lateral arcuate ligaments & lumbar vertebrae via the crura to the central tendon

Name the openings in the diaphragm and the structures that pass through them

Left crus (“leg”) Right crus Median arcuate ligament - Aortic hiatus passes through here Medial arcuate ligament - Psoas major/minor pass through here Lateral arcuate ligament - Quadratus lumborum passes through here

Parasympathetic innervation of kidney

Vagus > Esophageal plexus > Post vagal trunk > Celiac ganglion and plexus > Renal nerve plexus > Kidney

Sympathetic innervation of kidney

Lesser/least splanchnic (T10-11; T12) > Aorticorenal ganglion (synapse) > Renal nerve plexus > Kidney

Parasympathetic innervation of urinary bladder

S2-4 > Pelvic splanchnic > Inferior hypogastric plexus > Wall (synapse; contraction)

Sympathetic innervation of urinary bladder

T10-12, L1-2 > Lumbar splanchnic > Superior/inferior hypogastric plexus > Inferior hypogastric plexus (synapse) > Wall relaxation

Define the trigone of the urinary bladder

Triangular surface at base of bladder - Shaped by openings of ureter and urethra to form triangle Urinary stones can form here

Contrast the anatomy of the male and female urethra

Male urethra - 20 cm in length - Prostatic, membranous, spongy segments Female urethra - 4 cm in length

Portal hypertension pathways

A) HPV > L gastric > esophageal > azygos > IVC B) HPV > IMV > superior rectal > mid/inf rectal > internal iliac > common iliac > IVC C) HPV > paraumbilical > sup/inf epigastric > IVC D) HPV > splenic > IMV > L. colic > lumbars > IVC

Foregut

Liver, gallbladder, spleen, stomach, pancreas, duodenum

Midgut

Supplied by SMA Small intestine, cecum, appendix, ascending colon, transverse colon

Hindgut

Supplied by IMA transverse colon, descending colon, sigmoid colon, rectum