Abdomen LO's Flashcards
Name the Boundaries of the Abdomen ?
ANT (the abdominal wall), POST (veterbral column), SUP (diaphragm) INF (pelvic inlet)
Where is the pelvic inlet?
Plane that extends from pubic symphysis to the lumbar spine
Are there definite boundaries for the wall of abdomen?
no, they are INDEFINITE
What are the functions of the ANT abdominal wall?
support trunk, support abdominal viscera, manage intra-abdominal pressure during respiration, moves trunk, maintains posture.
Layers of ANT wall sup to deep
Skin -> superficial adipose/fascia -> muscles and facia -> extraperotoneal adipose -> peritoneum.
What spinal levels innervate the skin of the abdomen?
T7-T12
What spinal level innervates skin of the umbilical
T10
What are the two layers of superficial fascia beneath the skin ? SUP to DEEP
Campers (thick and fatty), Scarpa: (thin and can suture it.)
Name the 4 abdominal muscles from SUP to DEEP and its orientation
1) EXT abdominal oblique (SUP-LAT to INF medial)
2) INT abdominal oblique (INF-LAT to SUP-Medial)
3) Transverse abdominis (Transverse)
4) Rectus abdominis (6 pack)
Function of the 4 abdominal muscles
EAO= lateral flexion and increase intra-abd-pressure
IAO= Lateral flexion/rotation & compress/support abdominal viscera
TA= compress/support abdominal viscera
RA= flexion of trunk & compress/support abdominal viscera
Innervation of External Abdominal Oblique
T7-T11 & T12 (subcostal)
Innervation of Internal Abdominal Oblique
T7-T11 & T12 (subcostal) & L1 spinal nerve
Innervation of Transverse abdominis
T6-T11 & T12 (subcostal) & L1 (spinal nerve)
Innervation of Rectus Abdominis
T6-T11 & T12 (subcostal)
What is the “bulk” or main abdominal cavity known as?
Greater sac
What is the smaller portion of the peritoneal cavity known as
Lesser Sac
Where is the lesser sac
posterior to the stomach
Which is a diverticulum greater or lesser sac?
Lesser sac
What is also called the “omental bursa”
Lesser sac
Where is the Greater and lesser omentum located?
Greater: hangs off the greater curvature over all the intestines
Lesser: is near lesser curvature of stomach
Gastrophrenic ligament attaches where?
stomach to diaphragm
Gastrosplenic ligament attaches where?
Stomach to spleen
Gastrocolic ligament attaches to?
stomach to transverse colon
Hepatogastric ligament attaches to?
liver to stomach
Hepatodueodenal ligament attaches to ?
liver to duodenum
Where is the falciform, round, coronary and L/R triangular ligaments found?
Liver
What is the peritoneal cavity filled with
Serous fluid
What is intraperitoneal organs
organs that develop inside the peritoneal cavity
What two things classify intraperitoneal organs?
enclosed by visceral peritoneum & its suspended by mesentery
Name two types of retroperitoneal
Primary and secondary retroperitoneal
Define Primary retroperitoneal and what organs are they?
Kidneys & suprarenal glands; because they developed posterior to peritoneal cavity “retro” behind.
What never had a mesentery ?
kidneys and suprarenal glands (primary retroperitoneal)
Define secondary retroperitoneal? & the organs
were previously intra, but messentary fused during development. (Duodenum, ascending and desending colon, pancreas, rectum)
Where is a possible site for infections to develop? And what type of organs can get them.
parabolic gutters of (secondary retroperitoneal)
Above Arcuate line is there a posterior rectus sheath?
Yes
below Arcuate line is there a posterior rectus sheath?
NO
What does arcuate line delineate?
transition between the posterior rectus sheath & the transversalis fascia
(Between unbilucus and Pubic symphysis and it’s where post rectus sheath ends and all we have behind rectus and absominis is transversalis fascia)
Why do we need an arcuate line? passageway?
for the inferior epigastric vessel
Is the inguinal canal SUP of INF to inguinal ligament?
INF and more medial
Whats in the inguinal canal ?
Male: spermaticord
Female: Round ligament
What is homolog to ductus deferens?
round ligament
What landmark does inguinal canal attach to ?
ASIS
What is the center point for the 4 quadrants of the abdomen?
The Umbilicus
What are the two types of hernias?
Indirect and direct hernia
What is the most common type of hernia ?
Indirect
What is a direct inguinal hernia?
where abdominal contents protrude through weakened abdominal wall. Pass through the deep inguinal ring but NOT superficial inguinal ring
Which is non-congenital, indirect or direct hernia ?
Direct
Which is congenital indirect or direct hernia?
in-direct hernia
What is an indirect hernia?
When contents pass through the deep inguinal ring, then into scrotum.
What 3 organs don’t aid in digestion?
Spleen, kidneys and adrenal glands
List flow of food though digestive system
Oral cavity -> pharynx -> esophagus -> Stomach -> Dueodenum -> Jejunum -> ilium -> Accending colon -> transverse colon -> decending colon -> sigmoid colon -> rectum -> anus
What nerves innervate the esophagus
recurrent laryngeal nerve (between trachea and esophagus) innervates upper portion then post vagal trunk innervates lower part of esophagus
What does stomach do
stores food, HCL to disinfect and denature protein, pepsin released, and food turns to chyme.
What does small intestine do
enzymatic digestion and absorption of nutrients
What goes into the Duodenum “C shaped”
pancreatic duct and common bile duct
Function of liver
receives blood from digestive system, detoxes, stores glucose, produces bile.
Gallbladder does what?
stores bile, which emulsifies fat and enhances digestion and absorption
Function of pancreas?
produces enzymes helps neutralize acidic chyme.
Does digestion occur in the large intestine?
NOPE BITCH
What is most proximal part of Large intestine
Cecum
function of Large intestine
Absorb water and minerals
What are the components of the portal triad?
Common bile duct, Hepatic Artery Proper, Hepatic Portal Vein.
Where can you find the Portal Triad?
Enclosed in the lesser omentum
Name the three layers of thoracolumbar fascia
ANT, Middle, Posterior
What is between the ANT and Middle layer of thorocolumbar fascia?
QL
What is between the middle and posterior layer of thoracolumbar fascia?
Errector spinae
What does middle layer of thoracolumbar fascia also serve as an attachment site to?
TA, IAO & EAO
Where does Psoas Minor attach ?
lumbar spine to pelvis
Where does Psoas Major attach
Lumbar spine to lesser trochanter
Where does iliacus attach
lesser trochanter with Psoas major
Where does QL attach
12th rib to iliac crest
The diaphragm has two “legs” whats the name
L & R Crus,
Name the three arcuate ligaments of post abdominal wall
Median, middle and lateral arcuate ligaments
What passes through the median arcuate ligament?
forms the Aortic Hiatus, point where thoracic aorta turns into abdominal aorta
what passes through the medial arcuate ligament?
Psoas
What passes through the lateral arcuate ligament?
QL
Where is the subcostal nerve?
INF to the 12th rib
What segment is subcostal nerve?
T12
What nerve pierces the Psoas Major
Genitofemoral nerve (L1,L2)
When Genitofemoral nerve splits, where do Genito and femoral go.
Genital goes medial, Femoral goes lateral.
Where does lateral femoral cuteaneous nerve of thigh pass
ANT to iliacus
what nerves traverse the QL
iliohypogastric N and iliinguinal nerve
Which side of body does most of venous drainage go directly into?
R, goes into IVC
Where is the suprarenal gland? Both A lil diff
SUP aspect of kidneys. L suprarenal gland is sup but more medial. R is just superior
What is the Renal Hilum?
passage way where renal A & V and ureter go through
What is the renal cortex?
outer most part of internal kidney
Where are renal pyramids located?
in medulla
Where is urine collected in the kidneys
Major/Minor Calyx
Where does urine leave the kidney from ____ then to _____
Renal pelvis then Ureter
Where are the renal columns
between the renal pyramids
Renal arteries are what type of arteries?
“END arteries”, so if there is a blockage it will result in death of that part of kidney, since there is no anastomoses.
Majority of abdominal viscera will have innervation from the ___ nerve?
Vagus
What systems do plexuses use for innervation?
Sympatetic and parasynpatetic
What nerves do the sympathetic system use for kidney function?
lesser or least splanchnic nerves
What nerve innervates parasympathetic system of. kidneys?
POST vagal trunk
Contraction of urinary bladder (release of urine) uses what system?
Parasympathetic
Filling of urinary bladder (relaxation) uses what part of nervous system?
Sympathetic
Where is the Testicular artery in relation to the body?
ANT to the Ureter (testis drop through development, then descend with vasculature ANT to Ureter)
Where is the urinary bladder
POST to the pubic symphysis
Describe the flow of urine
Minor Calycx -> Major calycx -> Renal pelvis -> Ureter -> urinary bladder.
How long is the Male Urethra?
20 CM
How long is the Female Urethra
4 CM
What are the two holes on post aspect of inside of urinary bladder called?
2 Ureteric orifices
What is beginning of Urethra called
Urethral offices (inf aspect of bladder)
What is the union of the three orifices of the bladder called?
Trigone
What two vessels form the common hepatic duct?
L and R hepatic duct (come off liver)
What 2 vessels form the common bile duct?
The common hepatic duct and the cystic duct
In regards to hernias which; direct or indirect is a protrusion of abd wall medial to inf epigastric vessels.
Direct
In regards to hernias which; direct or indirect is a protrusion of abd wall lateral to inf epigastric vessels.
Indirect
What innervates thoracic and abdominal viscera?
CN X vagus
What ganglion/plexus targets the foregut?
celiac ganglion
What ganglion/plexus targets the midgut?
SM ganglion
What ganglion/plexus targets the kidney?
aorticorenal ganglion
What ganglion/plexus targets the hindgut?
IM ganglion
What ganglion/plexus targets the pelvic viscera?
Sup hypogastric plexus & Inf hypogastric plexus
Is blood supply to Midgut CT, SMA or IMA
SMA
Is blood supply to Hindgut CT, SMA or IMA
IMA
Is blood supply to Foregut CT, SMA or IMA
CT
organs of the foregut?
liver, spleen, stomach, duodenum, pancreas, gallbladder
organs of the midgut?
cecum, appendix, small intestine, ascending colon, transverse colon
Organs of Hindgut?
descending colon, transverse colon, sigmoid colon, rectum.
