Abdominal wall Flashcards
what spinal level is the inferior vena cava located
T8
what spinal level is the esophageal hiatus located
T10
what spinal level is the aortic hiatus (abdominal aorta and celiac trunk) located
T12
what spinal level is the transpyloric plane located
L1
what is included in the transpyloric plane
1st part of the duodenum
8th intercostal space
superior mesenteric artery
what structures are located a the L2 spinal level
renal artery
left diaphragm crus attachment
what structures are located at the L3 level
subcostal plane
12th rib
inferior mesenteric arteries
what structures are located at the L4 spinal level
supracristal plane
umbilicus
abdominal aorta divides into r/l common iliac arteries
what structures are located at the L5 spinal level
intertubercular plane
inferior vena cava formed by r/l common iliac veins
what structures are in the medial sagittal plane
xiphoid process and pubic symphysis
what structures are located in the right upper quadrant
liver
duodenum
what structures are located in the left upper quadrant
stomach and spleen
what structures are located in the right lower quadrant
cecum and ascending colon
what structures are located in the left lower quadrant
descending and sigmoid colon
what is McBurney’s point
location of the base of the appendix
referral pain for appendicitis
what is the innervation of the posterior abdominal wall
dorsal rami of spinal nerves
what is the innervation of the lateral abdominal wall
intercostal nerves
lateral cutaneous branch
what nerve innervates the anterior abdominal wall
intercostal nerve
anterior cutaneous branch
what structure is located at T6 vertebra level
xiphoid process
what structure is located at T10 vertebra level
umbilicus
Where is the T12 dermatome located
anterior superior iliac spine
what level does the spinal cord stop
T12-L2
what is caput medusae
swollen veins in the abdomen
related to liver disease
what occurs with an abdominal aorta malfunction
lower extremity can get blood supply form superior epigastric artery
what can occur with an inferior vena cava malfunction
lower extremity blood can drain back to superior vena cava
what are the layers of the abdominal wall from external to internal
skin superficial fascia (fatty layer, membranous layer) external oblique internal oblique transversus abdominis transversalis fascia extraperitoneal fascia parietal peritoneum
origin of external oblique muscle
external surface of 5-12th ribs
insertion of external oblique muscle
aponeurosis attaches to Linea Alba
iliac crest
pubic tubercle
folds to form inguinal ligament
function of external oblique muscle
compression of abdominal cavity
stabilization of pelvis
ipsilateral SB and contralateral RT
trunk flexion
innervation of external oblique muscle
intercostal nerve T7-T12
what direction do the external oblique muscles run
hands in pocket
what direction do the internal oblique muscles run
oh my
origin of internal oblique muscle
inferior border of 10-12th ribs
thoracolumbar fascia
insertion of the internal oblique muscles
aponeurosis attaches to Linea Alba
anterior 2/3 iliac crest
continue in the inguinal ligament
function of internal oblique muscles
core to support abdominal contents and stabilize pelvis
ipsilateral SB and RT
trunk flexion
elevate testes
innervation of internal oblique muscles
intercostal nerves T7-T12
2 branches of L1
innervation of internal oblique muscles
iliohypogastric nerves
innervation of cremaster part
ilioinguinal nerve
origin of transverse abdominis
thoracolumbar fascia
inner surface of ribs 7-12
insertion of transversus abdominis
aponeurosis attaches to linea alba
iliac crest
pubic tubercle
folds to iningial ligament
function of transverse abdominis
increase intraabdominal pressure/compression
spinal rotation
innervation of transverse abdominis
intercostal nerve T7-T12
2 branches of L1
where are the intercostal nerves located in the abdominal muscles
between transversus abdominis and internal oblique muscles
origin of rectus abdominis
xiphoid process and 5-7th costal cartiliages
insertion of rectus abdominis
public crest, tubercle, symphysis
function of rectus abdominis
compression/stabilization of pelvis
trunk flexion
innervation of rectus abdominis
intercostal nerves T7-T12
what is the pyramidalis
small triangular muscles in the distal anterior rectus abdominis
what is the arcuate line
~1/3 distance of umbilicus to pubic symphysis of posterior rectus abdominis
what is the rectus sheath
rectus abdominis wrapped by the aponeurosis of the 3 abdominal muscles
what is above and superior to the rectus abdominis in the rectus sheath
aponeurosis of external oblique
half aponeurosis of internal abdominis
what is above and deep to the rectus abdominis in the rectus sheath
half aponeurosis of internal oblique
aponeurosis of transversus abdominis
what is below and superficial to the rectus abdominis in the rectus sheath
all aponeurosis of 3 layers of muscles
what is below and deep to the rectus abdominis in the rectus sheath
none, weakness of the abdominal wall
what is the lateral border of Hesselbach’s/inguinal triangle
medial of lateral umbilial fold
what is the inferior border of Hesselbach’s/inguinal triangle
inguinal ligament
what is the medial border of Hesselbach’s/inguinal triangle
lateral rectus abdominis
what symptoms can occur with anastomosis with rectal vein to internal vena cava
can lead to internal hemorrhoids
what can occur with anastomosis of portal vein branches to esophageal veins to superior vena cava
esophageal varices
what can occur with anastomosis with epigastric veins to INV/SVC if IVC has problems
caput medusae
what veins close after birth, but can reopen in portal hypertension
paraumbilical veins
what ligament is an external oblique aponeurosis spanning from the ASIS and public tubercle
inguinal ligament
what are the layers of the inguinal canal
external oblique aponeurosis
internal oblique muscle slip
transverse abdominis
what veins/arterys run through the inguinal canal
femoral artery and vein
hernia happens at the deep inguinal ring
most common abdominal hernia (~3/4)
abdominal contents enter the scrotum in males and into the groin for females
can be congenital or acquired
indirect inguinal hernia
hernia that happens at the superficial inguinal ring
weakness of abdominal wall at Hesselbach’s/inguinal triangle
abdominal contents never enter the scrotum
all acquired but can be predisposed
direct inguinal hernia
hernia caused by abnormal closure after birth
umbilical hernia
hernia caused after laparotomy/laparoscopy due to weakened anterior abdominal wall
post-surgical/incisional hernia
what is diastasis recti
separation of linea alba
happens in both genders equally
internal organs are pushed outward when intra-abdominal pressure increases
what can worsen hernia/diastasis recti and how can PT improve the condition
worsens with increasing intra-abdominal pressure
can be improved with core strengthening exercises
what are the layers of the thoracolumbar fascia
anterior: internal oblique, transversus abdominis
middle: quadratus lumborum
posterior: erector spinae and extrinsic back muscles
origin of quadratus lumborum
inferior border of 12th rib
lateral transverse process of L1-L4
insertion of quadratus lumborum
posterior iliac crest
iliolumbar ligament
function of quadratus lumborum
ipsilateral lumbar SB
hip lift
depress 12th rib to aid in respiration
innervation of quadratus lumborum
T12-L4 lumbar spinal nerves
origin of psoas major
T12-L5
insertion of psoas major
lesser trochanter
function of psoas major
open chain: hip flexion, external rotation, adduction
closed chain: trunk flextion and side bend
innervation of psoas major
femoral nerve (L2-L4)
what is median arcuate ligament syndrome
compression of aorta by the median arcuate ligament
symptoms: pain around stomach and afraid of eating
what is the nerve root to the subcostal nerve
T12
what is the nerve root to the iliohypogastric nerve
T12/L1
what is the nerve root to the ilioinguinal nerve
L1
what is the nerve root to the lateral femoral cutaneous nerve
L2-L3
what is the nerve root of the femoral nerve
L2-L4
what is the nerve root of the genitofemoral nerve
L1-L2
what is the nerve root of the obturator nerve
L2-L4
what is the nerve root of the lumbosacral trunk
L4-L5
what are the anterior core muscles
transversus abdominis
what are the posterior core muscles
multifidi