abdomen LOs Flashcards
explain the function of the abdomen and its boundaries
- function: flexible container for abdominal organs
- bony framework provides sites for muscle attachment
- bony protection to certain organs
- boundaries
- superior: diaphragm
- anterior: abdominal wall
- posterior: vetebral column
- inferior: pelvic inlet
explain the functions of the anterior abdominal wall
- no definite boundaries with muscles – anterior to lateral to posterior
- functions
- support trunk
- supper abdominal viscera (organs)
- manage intra-abdominal pressure during respiration – muscle
- move trunk and maintain posture
organization of greater and lesser sacs, mesenteries, peritoneal “ligaments”
- greater sac: main abdominal cavity
- lesser sac/onmental bursa/diverticulum: posterior to stomach, anterior to pancreas
- mesenteries: continuous set of tissues located in abdomen
- suspend peritoneal layers
- double layer of peritoneum
- provides conduit for neurovascular supply between organ and body wall
- peritoneal “ligaments:” falciform ligaments, liver to posterior of anterior abdominal wall
- A -> P, inferiorly, encloses round ligament of the liver
- splits the L and R liver lobes
distinguish between intraperitoneal and retroperitoneal visceral categorization
- intraperitoneal: enclosed by visceral peritoneum, suspended by mesentaries
- retroperitoneal: behind the peritoneum
- primarily: never had a mesentery, truly posterior to peritoneal cavity
- kidney, suprarenal glands
- secondarily: looks retroperitoneal but not really, were previously intrapertioneal but mesentery fused during development
- duodenum, colon, pancreas, upper 2/3 rectum
- primarily: never had a mesentery, truly posterior to peritoneal cavity
explain the layers of the rectus sheath
- separated by arcuate line
- above arcute line (upper 2/3 of rectus abdominis):
- anterior rectus sheath: external abdominal oblique, internal abdominal oblique
- posterior rectus sheath: internal abdominal oblique, transversus abdominis
- below arcuate line (lower1/3 of rectus abdominis): no posterior sheath
- (anterior) rectus sheath: EAO, IAO, TA
- posterior: transversalis fascia
- above arcute line (upper 2/3 of rectus abdominis):
explain the significance of the arcuate line
- demarcates transition between aponeurotic (tendon) posterior rectus sheath and transversalis fascia
- forms passage for blood from abdomen to rectus abdominis
- inferior epigastric vessels perforate RA
- 2/3 between xiphoid process, 1/2 between umbilixus and pubic symphysis
describe the anatomy of the inguinal canal including its contents in both males and females
- inguinal region: interface of LE to abdomen
- passage 4 cm long, parallel to inguinal ligament
- openings are known as “rings” – deep and superficial
- primarily occupied by
- spermatic cord
- round ligament (homolog to ductus deferens)
- – > with ilioinguinal nerve outside
- boundaries
- floor: inguinal ligament (ASIS to pubic tubercle) 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
- superficial fascia (adipose)
- muscles and fascia – 3 layers
- extraperitoneal adipose
- peritoneum
describe the innervation of the skin of the abdomen via T7-T12 spinal nerves
- peripheral NS –> spinal nerves
- dermatomal pattern
describe the division of the abdomen into quadrants
- vertical line at midline/xiphoid process
- horizontal line at umbilicus
direct vs indirect inguinal hernias
- both: protrusion of peritoneal sac through weakned abdominal wall
- predisposing factors: obesity, aging, genetics, male, certain occupations
- viscera may become trapped or twisted, compromises blood supply
- indirect: through both superficial and deep inguinal rings
- bowels passes lateral to inferior epigastric vessels, into scrotum
- congenital, most common (>66%)
- direct: only through the superficial ring
- bowel passes medial to inferior epigastric vessels
- acquired and not congenital, least common (<33%)
name the composition of the portal triad
- endclosed in lesser omentum
1. common bile duct
2. hepatic portal vein
3. hepatic artery proper
abdominal aorta arterial supply drawing
celiac trunk arterial supply drawing
superior and inferior mesenteric artery arterial supply drawing
sympathetic/thoracolumbar innervation (T1-L2)
parasympathetic/craniosacral innervation
biliary tree drawing
caval venous drainage
portal venous drainage
venous pathways involved in 4 primary portal hypertension scenarios
- L gastric: esophageal <> azygos, IVC
- IMV: superior rectal <> middle and inferior rectals to internal iliac to common iliac, IVC
- paraumbilical: <> inferior epigastric/superficial epigastric, EI/femoral, CI, IVC
- IMV: L colic <> lumbars, IVC
abdomen lymph drainage
explain the three layers of thoracolumbar fascia including what attaches to each
- 3 layers: anterior, middle, posterior
- 2 spaces containing quadratus lumborum and erector spinae
- anterior | QL | middle | ES | posterior –> latissimus dorsi
name the openings in the diaphragm and the structures that pass through them
- caval opening (T8)
- inferior vena cava
- esophageal hiatus (T10)
- esophageal hiatus, parasympathetic (vagal trunks)
- aortic hiatus (T12)
- descening aorta, thoracic duct
lumbar plexus drawing
describe arterial supply and venous drainage of the posterior abdominal wall
- arterial supply
- abdominal aorta
- celiac trunk, superior mesenteric artery, inferior mesenteric artery, suprarenal arteries (superior, middle, inferior), renal aa, gonadal aa (anterior to ureter), inferior phrenic aa, lumbar aa (4 pairs), median sacral
- venous drainage
- inferior vena cava
- inferior phrenic vv, renal and suprarenal vv, lumbar vv (4 pairs), ascending lumbar vv (parallel abd aorta), left gonadal into L renal v, R gonadal vein into IVC
review retropeitoneal structures and their relation to the posterior abdominal wall
- primary retroperitoneal: kidney, suprarenal gland
- secondarily retroperitoneal: duodenum, pancreas, spleen, upper 2/3 rectum, colon
describe external and internal features of the kidneys
define the trigone of the urinary bladder
- triangular region or tissue at the base of the urinary bladder between openings of the ureters and urethra
contrast anatomy of male and female urethra
- male
- 20 cm
- through prostatic, membranous, and spongy tissue to penis
- female
- 4 cm
- opens to outside
