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DPT 701: Clincal Anatomy > Abdominal Wall > Flashcards

Abdominal Wall Flashcards

1
Q

What structures can be found at L1

A

Transpyloric plane: 1st part of duodenum, 8th intercostal space, superior mesenteric artery

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2
Q

What structures can be found at L2

A

Renal artery, L diaphragm crus attachment.

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3
Q

What internal structures can be found at L3

A

Subcostal plane

12th rib and inferior mesenteric arteries

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4
Q

What internal structure can be found at L4

A

Supracristal plane

Umbilicis

Abdominal aorta divides into R and L common iliac a

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5
Q

What internal structures can be found at L5

A

Intertubercular plane, IVC formed by R/L common iliac v

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6
Q

Where does the median sagittal plane run

A

Xiohoid process to pubic symphysis

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7
Q

What are the contents of the R upper and lower quadrants

A

R upper- liver and duodenum

R lower- cecum, ascending colon, McBurney’s point

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8
Q

What are the contents of the L upper and lower quadrants

A

L upper- stomach and spleen

L lower- descending and sigmoid colon

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9
Q

What is the appendix referral point

A

McBurney’s point

Referred pain from appendix

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10
Q

Where does the midclavicular plane run

A

Mid clavicle to mid inguinal ligament in the sagittal plane

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11
Q

What is the more reasonable plane for the stomach region

A

Transpyloric L1

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12
Q

What is the innervation of the posterior abdominal wall

A

Dorsal rami of spinal nerves

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13
Q

What is the innervation of the lateral abdominal wall

A

Intercostal nerves- lateral cutaneous branch

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14
Q

What is the innervation of the anterior abdominal wall

A

Intercostal nerve- anterior cutaneous branch

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15
Q

What is a common impingement of the T6-7 lateral cutaneous nerve

A

Serratus anterior can impinge

Secondary to shoulder problems

Need to work back muscles

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16
Q

What nerve level corresponds to the xiohoid process

A

T6

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17
Q

What nerve level innervates the umbilicus

A

T10

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18
Q

What nerve level innervates to ASIS

A

T12

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19
Q

How is the dermatome of the abdomen correlated

A

They are not.

Spinal cord stops at T12-L2 so nerves travel inferior to the exiting level

T9 spinal nerve innervate transversely at L3 vertebral level

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20
Q

What is the blood supply of the lateral abdominal wall

A

Posterior intercostal vessels

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21
Q

What is the blood supply of the anterior abdominal wall

A

Superior and inferior epigastric vessels, deep and superficial circumflex iliac artery

Anastomosis of superior and inferior epigastric vessels

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22
Q

What if there is an abdominal aorta malfunction

A

LE can get blood from superior epigastric artery

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23
Q

What happens if there is an IVC malfunction

A

LE can drain back to the SCV

Portal hypertension=Caput medusae

Swollen superficial veins in abdomen to compensate

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24
Q

What are the 9 layers of the abdominal wall?

A 
Skin
Superficial fascia: fatty layer and membranous layer
External oblique 
Internal oblique 
Transverse abdominus
Transversalis fascia
Extraperitoneal fascia
Parietal peritoneum
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25
Q

How are the external oblique muscle fibers oriented

A

Hands in pocket

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26
Q

What is the muscle fiber orientation of internal oblique

A

Oh my

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27
Q

What is the muscle fiber direction of transversus abdominis

A

Horizontal muscle fiber

CORE muscle

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28
Q

Why is the transverse abdominus considered a CORE muscle

A

Muscle fibers interdigitate with diaphragm

Weave together

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29
Q

Where do the intercostal nerves run in the abdominal muscles

A

Between the transverse abdominus and internal oblique

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30
Q

What is the pyramidalis

A

Small triangular muscle in the distal anterior recuts abdominis

Doesn’t exist in all people or even on both sides

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31
Q

What is significant about the attachment of the recuts abdominus

A

As it narrows down to a point and forms a weak point on the anterior abdominal wall

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32
Q

What is the rectus sheath

A

Recuts abdominus is wrapped by an aponeurosis is of 3 muscles

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33
Q

What is the arcuate line

A

1/3 distance from umbilicus to pubic symphysis of posterior rectus abdominus

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34
Q

What is above the arcuate line

A

Superficial- 1 EO, .5 IO

Deep- .5 IO, 1 TA

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35
Q

What is below the arcuate line

A

Superficial- all 3 muscles

Deep- none, weakness of abdominal wall

36
Q

What is the purpose of aponeurosis fiber crossing

A

Improves strength and functions

Weaving of both superficial and deep layers of the same aponeurosis

37
Q

What is intramuscular exchange

A

Fiber crossing between 2 layers of the same oblique

38
Q

What is the inter muscular exchange

A

Fiber crossing between 2 layers of different obliques

39
Q

What is line alba

A

Midline of aponeurosis fiber exchange

40
Q

What is the lateral umbilical fold

A

Inferior epigastric vessels

41
Q

What is the medial umbilical fold

A

Remnant umbilical artery

42
Q

What is the median umbilical fold

A

Remnant allantois (urachus), from umbilicus to suspend the urinary bladder

43
Q

What are the borders for hesselbachs triangle or inguinal triangle

A

Lateral- medial side of lateral fold

Inferior- inguinal ligament

Medial- lateral rectus abdominus

***very weak, common spot for hernia

44
Q

What stage of gestation is the placenta completed

A

3 weeks

45
Q

Functions of placenta

A

Nutrient and oxygen exchange with mothers blood

No direct contact with fetus

46
Q

What is the umbilical cord

A

Connection from fetus with placenta

Remnant structures after birth

Contains blood vessels/urachus

47
Q

What do the umbilical arteries become

A

Start: 2 internal iliac arteries

End: 2 medial umbilical ligaments/folds

48
Q

What do the umbilical veins become

A

Start: veins to the liver and then IVC (ductus venosus)

End: ligament teres and ligament venosum

49
Q

What is the allantois and what does it turn into

A

Start: fetal urine drainage

End: median umbilical ligament/ fold

50
Q

What is the ductus arteriosus and what does it become

A

Start: bridging blood vessels between the aorta and pulmonary trunk

End: ligament arteriosum

51
Q

What are the esophageal varices

A

Anastomosis of portal vein branches to the esophageal veins to SVC

52
Q

What are the causes of internal hemorrhoids

A

Anastomosis of rectal vein to IVC

53
Q

What causes caput medusae

A

Portal hypertension

Anastomosis with epigastric veins to IVC or SVC if IVC has problems too

Paraumbilical veins can reopen during portal hypertension

54
Q

What are the layers of inguinal ligament

A

External oblique
Internal oblique
Transverse abdominus

55
Q

What does the external oblique form in the inguinal ligament

A

Distal part forms inguinal ring

56
Q

What does the internal oblique form in the inguinal ligament

A

Cremaster muscle

57
Q

What does the transverse abdominis form in the inguinal ligament

A

Deep inguinal ligament- spermatic duct in males and ligament teres in females

58
Q

What is the innervation if the inguinal ligament/canal

A

Motor: genital branch of genitofemoral n

Sensory: ilioinguinal n

59
Q

What is an indirect inguinal hernia

A

Hernia happens at the deep inguinal ring

Most common hernia 75%

Abdominal contents enter scrotum in males and groin in females

Can be congenital or acquired

60
Q

What is the direct inguinal hernia

A

Hernia that happens at the superficial inguinal ring

Weakness of abdominal wall in hesselbachs triangle

Abdominal contents NEVER enter scrotum

All are required, but some individuals can be predisposed

61
Q

What is an umbilical hernia

A

Abnormal closing after birth

62
Q

What is a post surgical/incisional hernia

A

Mainly after a laparotomy or laparoscopy

Artificially weakened anterior abdominal wall

63
Q

What is the diastasis recti

A

Separation of linea alba

Happens equally in both genders

Not a hernia, but internal organs push outward when intra abdominal pressure increases but returns afterwards

**must design exercises accordingly

64
Q

What muscles attach to the anterior layer of the thoracolumbar fascia

A

Internal oblique and transverse abdominis

65
Q

What muscles attach to the middle layer of the thoracolumbar fascia

A

Quadratus lumborum

66
Q

What muscles attach to the posterior layer of the thoracolumbar fascia

A

Erector spinal and extrinsic back muscles

67
Q

What are the posterior arcuate ligament formed by

A

Tendinous structure of diaphragm, wrapping muscles, and aorta

68
Q

Where is the posterior median arcuate ligament

A

Aortic hiatus; a round abdominal aorta

69
Q

What is median arcuate ligament syndrome

A

Compression of aorta, pain around stomach, afraid to eat

70
Q

Where is the medial arcuate ligament on the posterior abdominal wall

A

Over psoas major

71
Q

Where is the lateral arcuate ligament from the posterior abdominal wall

A

Over quadratus lumborum

72
Q

Where do the ventral rami of L1-4 exit

A

Between quadratus lumborum and psoas major

73
Q

Where is the Subcostal n

A

T12, under 12th rib

74
Q

Where is the iliohypogastric n

A

T12/L1 above ASIS

75
Q

Where is the ilioinguinal n

A

L1, follows inguinal canal

76
Q

Where is the lateral femoral cutaneous n

A

L2-3 under inguinal ligament

77
Q

Where is the femoral n

A

Lateral and deep to psoas major L2-4

78
Q

Where is the genitofemoral n

A

L1-2 crossing psoas major

Genital branch follows inguinal canal

Femoral branch follows femoral triangle

79
Q

Where is obturator n

A

L2-4 medial and deep to psoas major

80
Q

Where is the lumbosacral trunk

A

L4-5 deep to obturator

81
Q

Which anterior core muscles contribute to stability of core

A

Transverse abdominis- active all the time

Possible contribution of internal oblique through thoracolumbar fascia

82
Q

Which posterior muscles contribute to core stability

A

Multifidi and psoas major

Help maintain lordosis

83
Q

What is hyperlordosis

A

Too much extension in lumbar spine

Weakness in transverse abdominis

84
Q

What causes flat back

A

Too little lordosis in lumbar

Compresses shock absorption

85
Q

What nerves innervate quadratus lumborum

A

Ventral rami spinal nerves

86
Q

What nerves innervate the internal oblique and cremaster muscle

A

IO- iliohypogastric

C- ilioinguinal

DPT 701: Clincal Anatomy (12 decks)

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