Abdomen Week 1 (A) Flashcards
Where is the abdomen located?
▪ Region between thorax and pelvis.
What organs are contained in the abdomen?
▪ Contains organs of alimentary and urogenital
systems.
The abdomen is the superior part of the ________cavity.
abdominopelvic
▪ Walls of the abdomino(pelvic) cavity:
▪Abdominal muscles and aponeuroses ______
▪ Thoracic diaphragm ______
▪Pelvic muscles _______
anteriorly
superiorly
inferiorly
Abdomen overview:
▪ _____ rings form upper and lower borders
▪ _____vertebrae form posterior skeleton
▪ Walls allow for protection and ______
Bony
Lumbar
Flexibility
What is the importance of the surface anatomy? (3)
▪ Crucial for clinical applications
▪ Organ location
▪ Referred pain
▪Abdominal planes cross _______.
landmarks
▪ Subdivide the abdomen into: (2)
▪ Quadrants
▪ Regions
▪ Contents related to specific regions and quadrants:
What are the planes and landmarks?
How are the quadrants of the abdomen formed? (2)
▪Median plane + Transumbilical line
What are the quadrants? (4)
▪Left Upper Quadrant
▪Right Upper Quadrant
▪Left Lower Quadrant
▪Right Lower Quadrant
Superficial abdominal reflex:(4)
- 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)
What are the contents in the right upper quadrant? (10)
What are the contents in the left upper quadrant? (10)
What are the right lower quadrant? (10)
What are the left lower quadrant? (8)
What are the borders of the regions of the abdomen? (3)
▪Mid-clavicular linessandgate
▪Sub-costal (or transpyloric) plane
▪Interspinous (or transtubercular) plane
Abdomen Regions:
▪Left and right hypochondrium
▪ Epigastric
▪Left and right flank (lumbar/lateral)
▪ Umbilical
▪Left and right inguinal/iliac (groin)
▪ Pubic/hypogastric
Contents in the abdominal regions:
Most often used planes: (3)
Other planes used: (2)
What are the layers of the abdomen? (2)
▪Skin
▪Subcutaneous tissue
Superficial fascia (2 layers below umbilicus) : (2)
▪Superficial fatty fascia (Camper’s)
▪Deep membranous fascia (Scarpa’s)
What are all the layers of the abdomen? (8)
What are the 3 horizontal/flat muscles? (3)
▪External oblique
▪Internal oblique
▪ Transversus abdominis
What are 2 vertical/straight muscles? (2)
▪Rectus abdominis
▪ Pyramidalis
What are 2 vertical/straight muscles? (2)
▪Rectus abdominis
▪ Pyramidalis
External oblique muscles:
Origins:
Insertions:
Innervation:
Actions:
Main Action:
What are myofascial trigger points? (5)
- Emotional stress
- Increased exercise
- Surgical incision
- Inflammation
- Trauma
Internal Oblique Muscles:
Origins:
Insertions:
Innervation:
Actions:
Main Action:
TRANSVERSUS ABDOMINIS Muscle:
Origins:
Insertions:
Innervation:
Actions:
Main Action:
RECTUS ABDOMINIS muscle:
Origins:
Insertions:
Innervation:
Actions:
Main Action:
Pyramidalis muscle:
Origins:
Insertions:
Innervation:
Actions:
Main Action:
What is the clinical significance of the pyramidalis muscle? (5)
▪ Landmark
▪ C-sections ~sample muscle
▪ Electrophysiology
▪ Sk M stem cells
▪ Various surgeries
What is the arcuate line?
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”
Rectus sheath:
Intramuscular exchange-
Intermuscular exchange-
What is the internal surface of the abdomen? (5)
▪ Covered by transversalis fascia
▪ Extraperitoneal fat ▪Parietal peritoneum
▪ Falciform ligament
▪Ligamentum teres hepatis
Internal surface:
▪ Folds: (3)
▪Median umbilical fold
▪ Medial umbilical fold -original
▪Lateral umbilical fold→bleed
Internal surface:
▪ Folds: (3)
▪Median umbilical fold
▪ Medial umbilical fold -original
▪Lateral umbilical fold→bleed
▪
Fossae (NB! for hernias): (3)
▪ Supravescical fossae
▪Medial inguinal fossae
Internal surface:
▪ Fossae (NB! for hernias): (3)
▪ Supravescical fossae
▪ Medial inguinal fossae
▪ Lateral inguinal fossae
Median umbilical fold: (4)
- from apex of bladder
- to umbilicus
- contains median umb. ligament
- remnant of urecus
(join foetal bladder to umb)
Medial umbilical fold: (2)
- contains medial umb. ligament
- orgininal umb. arteries close + become this fibrous remnant
Lateral umbilical cord:
Contain inferior epigastric vessels, therefore if cut via lateral fold = blood
Abdominal Regions: (8)
- 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)
What are the abdominal planes?
Mid-inguinal points:
Midpoints of the lines joining the anterior superior iliac spine and the pubic tubercles on each side
Mid-inguinal points:
Midpoints of the lines joining the anterior superior iliac spine and the pubic tubercles on each side
Abdominal Quadrants:
2 planes:
o Transumbilical plane
§ Passes through the umbilicus
o Median plane
What are the SUPERIOR borders of the anterolateral abdominal wall? (2)
o Cartilages of 7th to 10th ribs
o Xiphoid process of sternum
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
What are the muscles of the anterolateral abdominal wall? (A + B)
What are the muscles of the anterolateral abdominal wall? (A + B)
- 3 paired flat muscles:
o External oblique (hands in pockets)
o Internal oblique (hands on tits)
o Transversus abdominis (horizontal fibres)
- 2 paired flat muscles:
o Rectus abdominis
o Pyramidalis
What are the combined sections of the anterolateral abdominal wall muscles? (5)
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
- 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
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
Where is the lacunar ligament located?
o at medial end of inguinal ligament to superior pubic ramus
What is the Internal oblique aponeurosis?
- Fibres also become aponeurotic at the midclavicular line
What is the Transversus abdominis?
- Aponeurosis forms conjoint tendon with internal oblique
- Neurovascular plane is superficial to this muscle
External oblique
- Contribution to covering of spermatic cord:
- Contribution to rectus sheath:
External spermatic fascia
Aponeurosis- anterior layer
Internal oblique
- Contribution to covering of spermatic cord:
- Contribution to rectus sheath:
Cremaster muscle & fascia
Aponeurosis- both layers
Transversus abdominis
- Contribution to covering of spermatic cord:
- Contribution to rectus sheath:
No contribution
Aponeurosis- posterior layer
- Transversalis fascia contributes as internal _______ fascia
spermatic
Rectus abdominis
* Enclosed in the _____ sheath
rectus
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
Rectus abdominis:
* To test action of muscle:
o Raise head while lying flat on back with out using arms
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)
What is the rectus sheath?
- Strong, incomplete fibrous compartment of the rectus abdominis and pyramidalis muscles
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)
How is the rectus sheath formed?
- Formed by the decussation and interweaving of the aponeuroses of the flat abdominal muscles
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
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
o Above arcuate line (superior 3⁄4 of posterior layer):
§ Made from aponeuroses of transversus abdominis and posterior lamina of internal oblique
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
- 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
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
What is the umbilical ring? (2)
- In the middle of the linea alba beneath the umbilicus
- All layers of the anterolateral abdominal wall fuse
What is the umbilical ring? (2)
- In the middle of the linea alba beneath the umbilicus
- All layers of the anterolateral abdominal wall fuse
