Abdomen, Pelvis, and Perineum anatomy Flashcards
Linea Semilunaris
a curved line defining the lateral border of the rectus abdominin
Layers of the anterior abdominal wall
- Skin
- Superficial fascia
- Camper (fatty)
- Scarpa (fibrous)
- External oblique
- Internal oblique
- Transversus abdominis
- Transversalis fascia
- Extraperitoneal
- Parietal peritoneal
Inguinal ligament extends
between the anterior superior iliac spine and pubic tubercle
Lacunar ligament forms
the medial border of a femoral hernia
Transversalis fascia forms
A continuous lining of the entire abdominalopelvic cavity
Major arterial blood supply to the anterior wall is derived from
- Superior epigastric branch of the internal thoracic artery
- Inferior epigastric and deep circumflex iliac branches of the external iliac artery
Deep inguinal ring located
Lateral to the inferior epigastric vessels and immediatly superior to the midpoint of the inguinal ligament
Content of the female inguinal canal
- Round ligament of the uterus
- Ilioinguinal nerve (L1)
Content of male inguinal canal
- Ilioinguinal nerve
- Spermatic corda
Spermatic cord contains
- Testicular artery
- Pampiniform venous plexus
- Vas deferens
- Autonamic Nerves
- Lymphatics
Lymphatics drainage of the testis
Drain into the lunber (aortic) nodes of the lumber region
What nerve intervates the cremasteric muscle
Genitofemoral N
Congenital indirect inguinal hernia is usually due to
Persistent process vaginalis
Hydrocele is fluid in
Tunica vaginalis
Direct herinas are found
medial to the inferior epigastric vessels
Indirect hernias are found
lateral to the inferior epigastric vessels
Indirect hernias follow
the route taken by the testis and are found within the spermatic cord
Which is the only hernia that pass through the deep ring
Indirect hernia
What are the borders of the Inguinal (Hasselbach’s) triangle
- Lateral: inferior epigastic vessels
- Medial: rectus abdominis muscle
- Inferior: Inguinal ligament
The primitive gut tube is formed by
Incorporation of the yolk sac into the embryo
Foregut artery
Celiac
Foregut PSNS
Vagus
Foregut SNS
Preganglionic: Thoracic splanchnic N T5-T9
Postganglionic: Celiac ganglion
Foregut referred pain
Epigastrium
Derivatives of the foregut
- Esophagus
- Stomach
- Duodenum (first and second)
- Liver
- Pancreas
- GB
Midgut artery
Superior Mesenteric
Midgut PSNS
Vagus
Midgut SNS
Preganglionic: Thoracic splanchnic nerves T9-T12
Postganglionic: Superior mesenteric ganglion
Midgut referred pain
Umbilical
Derivatives of the midgut
- Duodenum (second, third, and forth)
- Jejunum
- Ileum
- Cecum
- Appendix
- Ascending colon
- Transverse colon (proximal 2/3)
Hindgut artery
Inferior Mesenteric
Hindgut PSNS
Pelvic splanchnic nerve
Hindgut referred pain
Hypogastrium
Derivatives of hindgut
- Transverse colon (distal 1/3)
- Descending colong
- Sigmoid colon
- Rectum
- Anal canal (above pectinate line)
What develops from endodermal outgrowth of the foregut
- Lower respiratory tract
- Liver
- Pancrease
Where is the lesser sac formed
Posterior to the stomach and the lesser omentum
What is the only communication between the greater sac and lesser sac
Epiploic foramen of Winslow
Major intraperitoneal organs (suspended by a mesentery)
- Stomach
- Liver and GB
- Spleen
- Duodenum (1st part)
- Tail of pancreas
- Jejunum
- Ileum
- Appendix
- Transverse colon
- Sigmoid colon
Major Secondary Retroperitoneal organs (lost a mesentery during development)
- Duodenum (2nd and 3rd parts)
- Head, neck, and body of pancreas
- Ascending colon
- Descending colon
- Upper rectum
Major Primary Retroperitoneal organs (never had a mesentery)
- Kidenys
- Adrenal glands
- Ureters
- Aorta
- IVC
- Lower rectum
- Anal canal
Boundaries of the epiploic foramen (of Winslow)
- Anterior: Hepatoduodenal ligament and hepatic protal vein
- Posterior: IVC
- Superior: Caudate lobe of the liver
- Inferior: First part of the duodenum
Falciform ligament contains
Ligamentum teres of liver
Lesser omentum contains
Hepatogastric ligament
Hepatoduodenal ligament
Helpatoduodenal ligament contains
- Common bile duct
- Proper hepatic A
- Hepatic Portal V
Gastroschisis is due to
Defect in the closure of the lateral body folds and a weakness of the anterior wall at the site of absorption of the right umbilical vein
Ileal (Mechel) Diverticulum is due to
a remnant of the vitelline duct persists forming a blind pouch
Portal triad are located in
Hepatoduodenal ligament
Head of pancreas recieves blood supply from
Superior and inferior pancreaticoduodenal branches of the gastroduodenal and superior mesenteric arteries
The spleen is beneath what ribs
9th, 10th, and 11th
What travels in the splenorenal ligament
Splenic artery and vein
What connects lesser curvature of stomach to the liver
Lesser omentum (hepatogastric ligament)
What descends posterior to the first part of duodenum
Gastroduodenal artery and common bile duct
What nerve intervates the external anal sphincter
Pudendal n
Where does lymph from above the pectinate line drain to
Iliac LN
What is the origin above pectinate line
Endoderm
What is the origin below pectinate line
Ectoderm
Lymph below pectinate line drains to
Superficial inguinal nodes
Where does Abdominal Aorta bifucate
L4 vertebral level
Celiac artery located
L1
Renal arteries located
L2
Inferior mesenteric locatated
L3
What supplies the lesser curvature of the stomach
Left gastric artery
Ulcer on posterior wall of stomach can erode
Splenic artery
Uler of the lesser curvature of stomach may erode
Left gastric artery
Ulcer of the posterior wall of the first part of duodenum may erode
gastroduodenal artery
Branches of SMA
- Inferior pancreaticoduodenal artery
- Anastomose with superior pancreaticoduodenal branches
- Intestinal arteries
- Ileocolic artery
- lower right quadrant to supply the distal ileum and cecum
- Right colic artery
- ascending colon
- Middle colic artery
- proximal 2/3 of transverse colon
Branches of IMA
- Left colic artery
- Distal third of transverse colon and descending colong
- Sigmoid arteries
- Superior rectal artery
- Superior aspect of the rectum and anal canal
Most common sight of bowl ischemia
Splenic flexure
Hepatic portal vein formed by
Union of the superior mesenteric and splenic veins posterior to the neck of the pancreas
Umbilical anastomoses
Paraumbilical v => superficial v of the anterior abdominal wall
Rectal anastomoses
Superior rectal v (IMV) => Inferior rectal V (Internal iliac v)
Pronephros forms
Nephric tubes then disappear with no function
Medial end of Mesonphros enlarge to form
Bowman’s capsule
Lateral end of the mesonephros become
Mesonephric (Wolffian) duct
What is the fate of the mesonphric tubes in males
Becomes Ductus epidiymidis, ductus deferens, and ejaculatry duct
Metanephros AKA
Permanent kidney
What two sources develop into Metanephros
Uretric bud and metanephric mass
What does the urorectal septum seperate
Anorectal canal and urogenital sinus
Lumen of the allantois becomes
Urachus
Urachus becomes
Medial umbilical ligament
Renal agenesis is due to
Early degneration of the ureteric bud
Drainage of urine through umbilicus is due to
Patent urchus due to failure of the allantois to be obliterated
Kidneys are in contact with
Diaphragm
Psoas major
Quadratus lumborum
Detrusor muscle inervated by
Pelvic Splanchinic (S2, 3, 4)
PSNS
Internal urethral sphincter inervated by
Lumbar splanchnics (T11-L2)
SNS
External urethral sphincter is inervated by
Pudendal N
What cuases rectal incontinence
Weakness of the puorectalis part of the levator ani muscle
Gonads + TDF
Testes
Seminiferous tubules
Rete testes
Gonads - TDF
Ovary
Follicles
Rete Ovarii
Paramesonephric ducts - MIF
Addenix of testes
Paramesonephri ducts + MIF
Uterine tubes
Uterus
Cervis
Upper part of vagina
Mesonephric ducts + Testosterone
Epididymis
Ductus deferens
Seminal vesicle
Ejaculatory duct
Mesonephric ducts - Testosterone
Duct of Gartner
Genital tubercle in males
Glans and body of penis
Genital tubercle in females
Clitoris
Urogenital folds in males
Ventral aspect of penis
Urogenital folds in females
Labia minora
Labioscrotal swellings in males
Scrotum
Labioscrotal swellings in female
Labia majora
Congenital adrenal hyperplasia leads to
Female Pseudointersexuality