Abdomen - Lecture 1 Flashcards

1
Q

Superior Border of the Abdominal Cavity?

A

Diaphragm

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2
Q

Inferior Border of the Abdominal Cavity?

A

Continuous with the Pelvic Cavity

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3
Q

Posterior Border of the Abdominal Cavity?

A

Vertebral Column and Abdominal Wall

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4
Q

Lateral and Anterior Border of the Abdominal Cavity?

A

Abdominal Wall with ribs in Superior Portion

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5
Q

Because of the dome shape of the diaphragm…

A

Many abdominal organs (stomach, spleen, liver) are protected by thoracic wall and diaphragm.

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6
Q

Orientation of Abdomen and Pelvis

A

Abdomen- vertical

Pelvis- diagonal tilt backwards

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7
Q

What is the Serous Membrane of the Abdomen?

A

Peritoneum (has a visceral and parietal layer) and continues into the pelvis

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8
Q

Mesentery

A

Double layer of Peritoneum that folds over onto itself and suspends organs in the abdominal cavity by anchoring them to the POSTERIOR Abdominal Wall

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9
Q

4 Quadrants of the Abdominal Cavity (Clinically preferred)

A

Right Upper, Left Upper, Right Lower, Left Lower

SS Abdomen 1

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10
Q

Planes that make the 4 Quadrants of the Abdominal Cavity (Clinically preferred)

A
Horizontal/Transumbilical Plane (ventrally it goes through the umbilicus and dorsally passes between L3 and L4)
Vertical Plane (from Xiphoid Process to Pubic Symphysis)
(SS Abdomen 1)
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11
Q

9 regions of the Abdominal Cavity (Anatomist preferred)

A
  1. Right Hypochondrium
  2. Epigastric Region
  3. Left Hypochondrium
  4. Right Flank (Lumbar)
  5. Umbilical
  6. Left Flank (Lumbar)
  7. Right Groin (Inguinal)
  8. Pubic
  9. Left Groin (Inguinal)
    (SS Abdomen 2)
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12
Q

Planes that demarcate the 9 Abdominal Cavity Regions

A
Subcostal Plane (Horizontal; lower border of Rib 10 Costal Cartilage and L3)
Intertubercular Plane (Horizontal; connects tubercles of Iliac Crests)
Midclavicular Planes (Vertical; go from midpoint of clavicles to the a point between pubic symphysis and anterior superior iliac spine)
(SS Abdomen 2)
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13
Q

Components of Abdominal Wall

A
  1. Bony Components
  2. Muscular Components (Majority)
  3. Fascial Components
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14
Q

Bony Components of Abdominal Wall

A
  1. Lumbar Vertebrae
  2. Upper wings of Pelvic Bones
  3. Costal Margin
  4. Floating Ribs (11 and 12)
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15
Q

Muscular Components of Abdominal Wall

A
  1. Anteriorly: Rectus Abdominus
  2. Laterally: External Oblique, Internal Oblique, and Transversus Abdominis
  3. Posteriorly: Quadratus Lumborum and Iliopsoas
    (SS Abdomen 3)
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16
Q

Quadratus Lumborum

A

Bilateral (either side of the Lumbar Vertebrae) flat muscle that makes up a good amount of posterior abdominal wall; kidney sits on part of this
(SS Abdomen 3)

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17
Q

Iliopsoas

A

Hip flexors; combination of the muscles Iliacus and Psoas Major since they have a common origin
(SS Abdomen 3)

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18
Q

Superficial Fascia layers of Abdominal Cavity

A

Above Arcuate Line:
Camper’s Fascia
Below Umbilicus:
1. Camper’s Fascia (most superficial fatty layer)
2. Scarpa’s Fascia (deeper membranous layer

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19
Q

Campers Fascia

A

Most Superficial fatty, protective layer of Abdominal Cavity Superficial Fascia

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20
Q

Scarpas Fascia

A
  1. Deepest Layer of Abdominal Cavity Superficial Fascia below the Umbilicus
  2. MEMBRANOUS
  3. Fuses with Fascia Lata in the thigh
  4. Becomes Colles Fascia in the Perinuem
  5. Becomes Dartos Fascia in the Penis/Scrotum
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21
Q

Dartos Muscle

A

A Smooth Muscle continuation of the deep layer of Superficial Fascia present in the Penis and Scrotum
Side Note: Scarpas- in the Abdomen below the Umbilicus
Colles- in Perinem
Dartos- Penis and Scrotum

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22
Q

External Oblique

A
  1. Most SUPERFICIAL of Lateral Muscles Abdominal Cavity
  2. Hands in pockets Orientation (Inferomedial)
  3. Aponeurosis (thick flat tendinous insertion that attaches to Linea Alba (midline)
  4. Twists
  5. Compresses Abdomen (supports abdominal components and posture)
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23
Q

Aponeurosis

A

Thick flat membranous insertion of an Abdominal muscle such as the Internal or External Oblique or Transversus Abdominus that attaches to the Linea Alba (midline)

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24
Q

Inguinal Ligament

A
  1. Formed by External Ligament Aponeurosis

2. Originates from ASIS (Anterior Superior Iliac Spine) and Inserts at Pubic Tubercle

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25
Q

Internal Oblique

A
  1. Deep to External Oblique
  2. Same Plane as Rectus Abdominus
  3. Fibers run Superomedially (OPPOSITE of hands in pockets)
  4. Ends at Linea Alba (midline)
  5. Compresses Abdomen & Twists
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26
Q

Linea Alba

A

Midline of Abdominal Cavity that runs from Xiphoid Process down to Pubic Symphysis

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27
Q

Rectus Abdominus

A
  1. Long, flat, vertical muscle
  2. Bilateral; each pair separated at Linea Alba
  3. Origin: Pubic Crest (Symphysis and Tubercle)
  4. Insertion: Costal Margin
  5. 4 or 5 Tendinous Intersections perpendicular to muscle fibers (prevent over-contraction)
  6. Enclosed in Rectus Sheath (Aponeurosis of abdominal wall muscles and Transversalis Fascia)
  7. Compresses Abdomen and Flexes Trunk
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28
Q

Rectus Sheath

A

Aponeurosis of the abdominal muscles that surround the Rectus Abdominus.

ABOVE Arcuate Line:

  1. Anterior Side: External Oblique, Internal Oblique
  2. Posterior Side: Internal Oblique and Transversus Abdominus

BELOW Arcuate Line:

  1. Anterior Side: External Oblique, Internal Oblique, and Transversus Abdominus
  2. Posterior Side: Transversalis Fascia
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29
Q

Transversus Abdominus

A
  1. Deepest Abdominal Muscle
  2. Fibers run horizontally
  3. Insertion at Linea Alba
  4. Compresses Abdomen
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30
Q

Deep Fascia Layers of Abdominal Cavity

A
  1. Transversalis Fascia

2. Extraperitoneal Fascia

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31
Q

Transversalis Fascia

A
  1. Deep to Transversus Abdominus
  2. Continuous Layer of Deep Fascia that lines Abdominal and Pelvic Cavities
  3. Continuous with Inferior Diaphragm Surface and Posterior Muscles
  4. Superficial to Peritoneum
  5. Direct Contact with Rectus Abdominus posteriorly below Arcuate Line
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32
Q

ABOVE Arcuate Line the Rectus Abdominus is surrounded by…

A

Rectus Abdominus surrounded by:

  1. Anterior Rectus Sheath (Internal and External Oblique Aponeuroses)
  2. Posterior Rectus Sheath (Internal Oblique and Transversus Abdominus Aponeuroses)
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33
Q

BELOW Arcuate Line the Rectus Abdominus is surrounded by…

A

Rectus Abdominus surrounded by:

  1. Anterior Rectus Sheath (Internal and External Oblique AND Transversus Abdominus Aponeuroses)
  2. Transversalis Fascia
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34
Q

Extraperitoneal Fascia

A
  1. Deep to Transversalis Fascia separating it from Peritoneum
  2. Lines Abdominal and Pelvic Cavities
  3. Abundant on Posterior Wall
  4. Houses the Vasculature
  5. Organs in Extraperitoneal Fascia are Retroperitoneal
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35
Q

Retroperitoneal Organs

A

Organs located in the POSTERIOR portion of the deep Extraperitoneal Fascia layer (eg. Kidneys, parts of pancreas and duodenum) between Parietal Peritoneum and Abdominal Wall

36
Q

List Layers of the Abdominal Cavity from Superficial to Deep

A

Skin > Campers Fascia (fatty) > Scarpas Fascia (membranous) > External Oblique Muscle > Internal Oblique Muscle > Transversus Abdominus > Transversalis Fascia > Extraperitoneal Fascia > Parietal Peritoneum

37
Q

Preperitoneal

A

Structures located in the ANTERIOR portion of the deep Extraperitoneal Fascia layer

38
Q

Skin, muscles, and parietal peritoneum of the Abdominal Cavity are innervated by…

A

Ventral Rami of Spinal Nerves T7-L1

39
Q

Anterior Wall Muscle(s)

A

Rectus Abdominus

40
Q

Lateral Wall Muscle(s)

A
  1. External Oblique
  2. Internal Oblique
  3. Transversus Abdominis
41
Q

Posterior Wall Muscle(s)

A
  1. Quadratus Lumborum

2. Iliopsoas (Iliacus & Psoas Major)

42
Q

Intercostal Nerves branch off into…

A

Lateral Cutaneous Branches that wrap around and end anteriorly

43
Q

Innervation of Abdominal Wall Muscles is…

A

SEGMENTAL. Spinal Nerve travels where its same name Vertebra is found, following the patterns of Dermatomes

44
Q

Overall Vasculature of Abdominal Cavity

A
  1. Musculophrenic Artery (SF Superior)
  2. Superficial Epigastric Artery (SF Inf Med and Deep Superior)
  3. Superficial Circumflex Artery (SF Inf Lat)
  4. 10th and 11th Intercostal Arteries (Deep Lat)
  5. Subcostal Arteries (Deep Lat)
  6. Inferior Epigastric Artery (Deep Inf)
  7. Deep Circumflex Iliac Artery (Deep Inf Lat)
45
Q

Musculophrenic Artery

A
  1. Superficial Superior Abdomen Vasculature
  2. Runs down Costal Margin
  3. Branch of Internal Thoracic Artery (comes off and goes down)
46
Q

Superficial Epigastric Artery

A
  1. Superficial Inferior MEDIAL Vasculature
  2. Deep Superior Vasculature
  3. Branch of Femoral Artery (comes off and goes up)
47
Q

Superficial Circumflex Artery

A
  1. Superficial Inferior LATERAL Vasculature

2. Branch of Femoral Artery (comes off and goes up and lateral)

48
Q

Provide Vasculature for Deep Lateral Abdomen

A
  1. 10th and 11th Intercostal Muscles

2. Subcostal Arteries

49
Q

Inferior Epigastric Artery

A
  1. Deep Inferior MEDIAL Epigastric Vasculature

2. Branch of External Iliac Artery

50
Q

Deep Circumflex Iliac Artery

A
  1. Deep Inferior LATERAL Vasculature

2. Branch of External Iliac Artery

51
Q

Lymphatics of Anterolateral Abdominal Wall: Superficial and Superior to Umbilicus drain to…

A

Axillary Nodes

52
Q

Lymphatics of Anterolateral Abdominal Wall: Superficial and Inferior to Umbilicus drain to…

A

Superficial Inguinal Nodes

53
Q

Lymphatics of Anterolateral Abdominal Wall: Deep drain to…

A

Parasternal Nodes (along Trachea)

54
Q

Inguinal Region (Groin)

A

Region between Anterior Abdominal Wall and the Thigh (Where thigh attaches to your trunk)

55
Q

Descent of Testes in Male Fetus

A

Testes develop inside abdominal cavity and descend through abdominal wall out into the scrotum pulling all of the layers superficial to them along creating Inguinal Canal

56
Q

Inguinal Canal

A
  1. A not so clear Anatomical Passageway in the anterior abdominal wall formed by folding of fascia from Abdominal Muscles in the Inguinal Region during Descent of Testes
  2. More prominent in men than in women
  3. Weak Spot in Abd
57
Q

Start and end of Inguinal Canal

A

STARTS at the more lateral Deep (Internal) Inguinal Ring (Invagination of Transversalis Fascia)
ENDS at more medial Superficial (External) Inguinal Ring (Invagination of External Oblique Fascia

58
Q

What passes through Inguinal Canal?

A

In Men: Spermatic Cord

In Women: Round Ligament of the Uterus

59
Q

Spermatic Cord Layers (Outermost to Innermost)

A

External Spermatic Fascia (EOM > Cremasteric Fascia (IOM) > Internal Spermatic Fascia (TF) > Parietal Layer of Tunica Vaginalis > Cavity of Tunica Vaginalis > Visceral Layer of Tunica Vaginalis

60
Q

Inguinal Triangle

A

Spot where DIRECT Inguinal Hernias Push through

61
Q

Inguinal Triangle Borders:

A

Lateral: Inferior Epigastric Vessels
Inferior: Inguinal Ligament
Medial: Lateral Edge of Rectus Abdominus

62
Q

Inguinal Hernia

A
  1. Protrusion of Peritoneal Sac through a weakened part of the abdominal wall
  2. Can be DIRECT or INDIRECT
63
Q

Indirect Inguinal Hernia

A
  1. Parts of intestine go down into the scrotum through the Deep Inguinal Ring
  2. Lateral to Inferior Epigastric Vessels
  3. Most Common
64
Q

Direct Inguinal Hernia

A
  1. Goes through the posterior wall of the Inguinal Canal
  2. Medial to Inferior Epigastric Vessels
  3. Directly pushes on the Inguinal Triangle
65
Q

Peritoneum layers

A
  1. Parietal Peritoneum (Outermost)
  2. Peritoneal Cavity- potential space
  3. Visceral Peritoneum (covers organs)
66
Q

Parietal Peritoneum

A

Lines the inside of the Abdominal Wall

67
Q

Visceral Peritoneum

A

Covers organs suspended in the Peritoneal Cavity

68
Q

Peritoneal Cavity

A

Potential Space between the Parietal and Visceral Peritoneum

69
Q

Abdominal Peritoneum is continuous with…

A

Pelvic Peritoneum

70
Q

Intraperitoneal Organs

A

Organs Suspended in abdominal cavity by Mesentery (thin tissue composed of reflected peritoneal double layer)

71
Q

Intraperitoneal Structures vs. Retroperitoneal Structures

A
  1. Intraperitoneal Structures can move FREELY within mesentery
  2. Retroperitoneal Structures are more CONFINED to their position
72
Q

Peritoneal folds form:

A
  1. Mesentery
  2. Ligaments
  3. Omentum
73
Q

List the Retroperitoneal Structures

A
  1. Urinary System (Kidney, Ureter, Bladder)
  2. Adrenal Glands
  3. Aorta
  4. Inferior Vena Cava
  5. Abdominal Esophagus
  6. Rectum
  7. Most of Pancreas (except tail)
  8. Most of Duodenum (except for segments 1 and 4)
  9. Ascending and Descending Colon
74
Q

Greater Omentum

A

Protective fatty “apron” formed from layers of peritoneum that hangs from the greater curvature of the stomach and/or duodenum

75
Q

Lesser Omentum

A
  1. Layers of Peritoneum that connect lesser curvature of stomach and the duodenum to the liver
  2. Seperates the Omental Bursa (small pocket) from the Greater Sac
76
Q

Omental Bursa

A
  1. Small pocket of open space behind the stomach and liver that is formed by the Lesser Omentum
  2. AKA Lesser Sac
77
Q

Greater Sac

A

the Peritoneal Cavity of the Abdomen

78
Q

Omental Foramen

A

Opening on the right side that makes the Greater Sac and Omental Bursa continuous
(reach your hand in to get to Omental Bursa from Greater Sac)
AKA Epiploic Foramen

79
Q

Mesentery Proper

A

Anchors Small Intestine to each other and the posterior abdominal wall

80
Q

Transverse Mesocolon

A

Fold of Peritoneum (Mesentery) that connects the Transverse Colon to the posterior body wall

81
Q

Sigmoid Mesocolon

A

Inverted V shaped Peritoneal Fold (Mesentery) that attaches Sigmoid Colon to Abdominal Wall

82
Q

Clinically Important Structure in: Right Upper Quadrant

A
  1. Liver
  2. Gall Bladder
  3. Pancreas
  4. Small Intestine
83
Q

Clinically Important Structure in: Left Upper Quadrant

A
  1. Stomach
  2. Spleen (Posterior)
  3. Pancreas
  4. Small Intestine
84
Q

Clinically Important Structure in: Right Lower Quadrant

A
  1. Appendix
  2. Ascending Colon
  3. Small Intestine
85
Q

Clinically Important Structure in: Left Lower Quadrant

A
  1. Descending Colon
  2. Sigmoid Colon
  3. Small Intestine