Abdomen Week 1 (A) Flashcards
1
Q
Where is the abdomen located?
A
▪ Region between thorax and pelvis.
2
Q
What organs are contained in the abdomen?
A
▪ Contains organs of alimentary and urogenital
systems.
3
Q
The abdomen is the superior part of the ________cavity.
A
abdominopelvic
4
Q
▪ Walls of the abdomino(pelvic) cavity:
▪Abdominal muscles and aponeuroses ______
▪ Thoracic diaphragm ______
▪Pelvic muscles _______
A
anteriorly
superiorly
inferiorly
5
Q
Abdomen overview:
▪ _____ rings form upper and lower borders
▪ _____vertebrae form posterior skeleton
▪ Walls allow for protection and ______
A
Bony
Lumbar
Flexibility
6
Q
What is the importance of the surface anatomy? (3)
A
▪ Crucial for clinical applications
▪ Organ location
▪ Referred pain
7
Q
▪Abdominal planes cross _______.
A
landmarks
8
Q
▪ Subdivide the abdomen into: (2)
A
▪ Quadrants
▪ Regions
9
Q
▪ Contents related to specific regions and quadrants:
A
10
Q
What are the planes and landmarks?
A
11
Q
How are the quadrants of the abdomen formed? (2)
A
▪Median plane + Transumbilical line
12
Q
What are the quadrants? (4)
A
▪Left Upper Quadrant
▪Right Upper Quadrant
▪Left Lower Quadrant
▪Right Lower Quadrant
13
Q
Superficial abdominal reflex:(4)
A
- activation of anterior abdominal muscles; in response to rapid/quick of abdomen skin from lateral —> medial
- reflex: contraction, protection from incoming injury
- abdomen’s only protection is muscles
- reflex vary be decreased visible in obese + women; increased births and elderly
- find location of sc injury (older days)
14
Q
What are the contents in the right upper quadrant? (10)
A
15
Q
What are the contents in the left upper quadrant? (10)
A
16
Q
What are the right lower quadrant? (10)
A
17
Q
What are the left lower quadrant? (8)
A
18
Q
What are the borders of the regions of the abdomen? (3)
A
▪Mid-clavicular linessandgate
▪Sub-costal (or transpyloric) plane
▪Interspinous (or transtubercular) plane
19
Q
Abdomen Regions:
A
▪Left and right hypochondrium
▪ Epigastric
▪Left and right flank (lumbar/lateral)
▪ Umbilical
▪Left and right inguinal/iliac (groin)
▪ Pubic/hypogastric
20
Q
Contents in the abdominal regions:
A
21
Q
Most often used planes: (3)
A
22
Q
Other planes used: (2)
A
23
Q
What are the layers of the abdomen? (2)
A
▪Skin
▪Subcutaneous tissue
24
Q
Superficial fascia (2 layers below umbilicus) : (2)
A
▪Superficial fatty fascia (Camper’s)
▪Deep membranous fascia (Scarpa’s)
25
What are all the layers of the abdomen? (8)
26
What are the 3 horizontal/flat muscles? (3)
▪External oblique
▪Internal oblique
▪ Transversus abdominis
27
What are 2 vertical/straight muscles? (2)
▪Rectus abdominis
▪ Pyramidalis
28
What are 2 vertical/straight muscles? (2)
▪Rectus abdominis
▪ Pyramidalis
29
External oblique muscles:
Origins:
Insertions:
Innervation:
Actions:
Main Action:
30
What are myofascial trigger points? (5)
- Emotional stress
- Increased exercise
- Surgical incision
- Inflammation
- Trauma
31
Internal Oblique Muscles:
Origins:
Insertions:
Innervation:
Actions:
Main Action:
32
TRANSVERSUS ABDOMINIS Muscle:
Origins:
Insertions:
Innervation:
Actions:
Main Action:
33
RECTUS ABDOMINIS muscle:
Origins:
Insertions:
Innervation:
Actions:
Main Action:
34
Pyramidalis muscle:
Origins:
Insertions:
Innervation:
Actions:
Main Action:
35
What is the clinical significance of the pyramidalis muscle? (5)
▪ Landmark
▪ C-sections ~sample muscle
▪ Electrophysiology
▪ Sk M stem cells
▪ Various surgeries
36
What is the arcuate line?
37
What is the rectus sheath? (5)
▪ Formed by 3 flat muscle aponeurosis
▪ Between midclavicular lines
▪ Enclosing rectus
abdominis and pyramidalis
▪ Midline raphe
▪ Linea alba
▪Change in arrangement
▪→“6-pack vs 8-pack”
38
Rectus sheath:
Intramuscular exchange-
Intermuscular exchange-
39
What is the internal surface of the abdomen? (5)
▪ Covered by transversalis fascia
▪ Extraperitoneal fat ▪Parietal peritoneum
▪ Falciform ligament
▪Ligamentum teres hepatis
40
Internal surface:
▪ Folds: (3)
▪Median umbilical fold
▪ Medial umbilical fold -original
▪Lateral umbilical fold→bleed
41
Internal surface:
▪ Folds: (3)
▪Median umbilical fold
▪ Medial umbilical fold -original
▪Lateral umbilical fold→bleed
42
▪
Fossae (NB! for hernias): (3)
▪ Supravescical fossae
▪Medial inguinal fossae
43
Internal surface:
▪ Fossae (NB! for hernias): (3)
▪ Supravescical fossae
▪ Medial inguinal fossae
▪ Lateral inguinal fossae
44
Median umbilical fold: (4)
- from apex of bladder
- to umbilicus
- contains median umb. ligament
- remnant of urecus
(join foetal bladder to umb)
45
Medial umbilical fold: (2)
- contains medial umb. ligament
- orgininal umb. arteries close + become this fibrous remnant
46
Lateral umbilical cord:
Contain inferior epigastric vessels, therefore if cut via lateral fold = blood
47
Abdominal Regions: (8)
48
* 9 regions used to describe the location of abdominal organs, pains or pathologies
* Delineated by 4 planes: (2)
o 2 sagittal (vertical)
o 2 transverse (horizontal)
49
What are the abdominal planes?
50
Mid-inguinal points:
Midpoints of the lines joining the anterior superior iliac spine and the pubic tubercles on each side
51
Mid-inguinal points:
Midpoints of the lines joining the anterior superior iliac spine and the pubic tubercles on each side
52
Abdominal Quadrants:
2 planes:
o Transumbilical plane
§ Passes through the umbilicus
o Median plane
53
What are the SUPERIOR borders of the anterolateral abdominal wall? (2)
o Cartilages of 7th to 10th ribs
o Xiphoid process of sternum
54
What are the INFERIOR borders of the anterolateral abdominal wall? (2)
o Inguinalligament
o Superior margins of the anterolateral aspects of the pelvic girdle
- Iliac crests, pubic crests, pubic symphysis
55
What are the muscles of the anterolateral abdominal wall? (A + B)
56
What are the muscles of the anterolateral abdominal wall? (A + B)
57
* 3 paired flat muscles:
o External oblique (hands in pockets)
o Internal oblique (hands on tits)
o Transversus abdominis (horizontal fibres)
58
* 2 paired flat muscles:
o Rectus abdominis
o Pyramidalis
59
What are the combined sections of the anterolateral abdominal wall muscles? (5)
60
What is the External oblique aponeurosis? (3)
* Begins medially at the midclavicular line and inferiorly at the spino-umbilical line
* Fibres decussate at the linea alba
* Most fibres become continuous with tendinous fibres of the contralateral internal oblique muscle
61
* Most fibres become continuous with tendinous fibres of the contralateral internal oblique muscle
o The contralateral external and internal oblique muscles together form a digastric muscle since they share a common tendon
o e.g....
o e.g. The right external oblique and left internal oblique work together when flexing and rotating to bring the right shoulder toward the left hip
62
What is the * Inguinal ligament (Poupart ligament)? (4)
o Inferior margin of external oblique aponeurosis
o Thickened under-curving fibrous band with a free posterior edge
o Spans between the anterior superior iliac spine and the pubic tubercle
o Continuous with the deep fascia of the thigh inferiorly
63
Where is the lacunar ligament located?
o at medial end of inguinal ligament to superior pubic ramus
64
What is the Internal oblique aponeurosis?
* Fibres also become aponeurotic at the midclavicular line
65
What is the Transversus abdominis?
* Aponeurosis forms conjoint tendon with internal oblique
* Neurovascular plane is superficial to this muscle
66
External oblique
- Contribution to covering of spermatic cord:
- Contribution to rectus sheath:
External spermatic fascia
Aponeurosis- anterior layer
67
Internal oblique
- Contribution to covering of spermatic cord:
- Contribution to rectus sheath:
Cremaster muscle & fascia
Aponeurosis- both layers
68
Transversus abdominis
- Contribution to covering of spermatic cord:
- Contribution to rectus sheath:
No contribution
Aponeurosis- posterior layer
69
* Transversalis fascia contributes as internal _______ fascia
spermatic
70
Rectus abdominis
* Enclosed in the _____ sheath
rectus
71
Rectus abdominis:
* Anchored transversely by attachment to the anterior layer of the rectus sheath at 3 tendinous intersections:
o At the level of the _____ process
o Halfway between the xiphoid process and _____
o At the umbilicus
xiphoid
umbilicus
72
Rectus abdominis:
* To test action of muscle:
o Raise head while lying flat on back with out using arms
73
What are some features of the pyramidalis muscle? (2)
* Variable in size
o Larger on one side (may be double)
* Not always present (80% only)
74
What is the rectus sheath?
* Strong, incomplete fibrous compartment of the rectus abdominis and pyramidalis muscles
75
What are the contents of the rectus sheath? (4)
o Rectus abdominis and pyramidalis muscles
o Superior and inferior epigastric arteries and veins
o Lymphatic vessels
o Abdominal portions of the anterior rami of spinal nerves T7-T12 (thoraco-abdominal nerves)
76
How is the rectus sheath formed?
* Formed by the decussation and interweaving of the aponeuroses of the flat abdominal muscles
77
Rectus sheath formation
Anterior layer -
Posterior layer -
o Anteriorl ayer-external oblique and anterior lamina of internal oblique
o Posteriorlayer-transversus abdominis and posterior lamina of internal oblique
78
Levels of variation:
* Arcuate line: (2)
o One third distance from the umbilicus to the pubic crest
o Demarcates transition in composition of posterior layer of rectus sheath
79
o Above arcuate line (superior 3⁄4 of posterior layer):
§ Made from aponeuroses of transversus abdominis and posterior lamina of internal oblique
80
o Below arcuate line (inferior 1⁄4 of posterior layer): (2)
§ All 3 aponeuroses pass anterior to the rectus abdominis
§ Only the thin transversalis fascia covers the rectus abdominis posteriorly
81
* Superior to the costal margin
o Posterior layer is ______
§ Transversus abdominis continues superiorly as ____ _______ internal to costal cartilages
§ Internal oblique attaches to the costal margin
o Rectus abdominis lies directly on the ______ _____
deficient
transversus thoracis
thoracic wall
82
What is the function of the line alba? (5)
* Interlacing fibres of the anterior and posterior layers of the rectus sheath in the anterior median line
* Separates the bilateral rectus sheaths
* Narrows inferior to the umbilicus to the width of the pubic symphysis
* Widens superiorly to the width of the xiphoid process
* Transmits small vessels and nerves to the skin
83
What is the umbilical ring? (2)
* In the middle of the linea alba beneath the umbilicus
* All layers of the anterolateral abdominal wall fuse
83
What is the umbilical ring? (2)
* In the middle of the linea alba beneath the umbilicus
* All layers of the anterolateral abdominal wall fuse
