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GI > Abdominal Wall Anatomy > Flashcards

Abdominal Wall Anatomy Flashcards

1
Q

Abdominal communication with the thoracic and pecliv cavity

A

Thoracic connection to abdominal cavity- holes in the diaphragm

Communication to pelvis- open communication

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2
Q

Extent of the abdominal cavity superiorly and inferiorly and posterior

A

Superior- diaphragm, coastal margin, xiphoid

inferior- lilac crest, anterior superior iliac spine, inguinal ligament, pubic symphysis

posterior-lumbar vertebrae, muscle and fascia

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3
Q

Rectus abdominus is?

A

The msucle that connects the ribs to the pelvis (six pack)

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4
Q

Tendinous insertions?

A

Interruptions in the rectus abdominus that allows you to control each rectus abdominus muscle

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5
Q

What is the linea alba

A

white line in cadavers where the aponeurosis of the lateral muscles come over and meet. Nothing there expect muscle so makes a good point of incision because there are no blood vessels or nerves.

Right in line with the umbilicus

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6
Q

Linea semilunaris line

A

The lateral edge of the rectus abdominus. Good point of surgurical access and you avoid structures that you should incise through

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7
Q

Umblicus is

A

The entrance of the umbilical cord. Usually at the 10th thoracic level

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8
Q

What is in the right upper quadrant?

A

Most anteriorly- liver, small part of stomach, tranverse colon, small intestine

Middle- gallbladder,top portion of ascending colong, duodenum, pancrease

posteriorly- right kidney and suprarenal gland

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9
Q

What is in the right lower quadran

A

Anterior- small intestine

Middle Ascending colon and appendix

Posteriorly ureters and half of urinary bladder

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10
Q

What is in the left upper quad

A

Anterior- Stomach, transverse colon, and SI (jejunum and ileum)

Middle- Spleen, pancreas, top of descending colon, small bit of duodenum

Posterior- Left kidney, suprarenal and abdominal aorta

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11
Q

What is in the left lower quadrant

A

Anterior- jejunum and ileum

Middle- descending colon

Posterio- half of urinary bladder, left ureters

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12
Q

How to divide into the 9 quad system

A

Vertical- Line at the midclavicular line

Two horizontal lines- one under the costal margin and one extending between the iliac crest

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13
Q

Name the nine zones

A
  1. Right hypochondrium, 2. epigastric,
  2. left hypochondrium
  3. right flank, umblical region, left flank, right groin, pubic (hypogastric) region, left groin
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14
Q

Match the three regions to foregut, midgut and hindgut pain

A

Foregut- epigastric
MId- umbilical
Hind- pubic (hypogastric) region

The pain associated with these areas can compartmentalize it so this one is useful

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15
Q

What structures are by the transpyloric plane and where is it?

A

Half way between the jugular notch and the pubic symphsis

Pylorus of the stomach, fundus of the gallbladder, neck and body of the pancreas, hila of the kidneys, 1st part of duodenum, and the origin of the superior mesenteric artery

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16
Q

Structures in the foregut

A

Artery- celiac

esophagus, stomach, duodenum, liver, pancrease, biliary appartus, gallbladder

17
Q

Structures in the midgut (umblical region

A

Atery- superio mesenteric

Duodenum (2-4th part), jejunum, ileum, cecum, appendix, ascending colon, transverse colon

18
Q

Structures in the hind gut (hypogastric/pubic region)

A

Artery- inferior mesenteric

transverse colon
Descending colon
sigmoid colon
rectum
anal canal
19
Q

What thoracic nevce is the umblical associated with

A

T10- important neural landmark especially when determing spinal injury

20
Q

What innervates the thoracic wall

A

The intercostal thoracic nerves from T7-T12

21
Q

Explain blood supply to abdominal wall

A

Main the superior epigastric artery which is a continuation to the internal thoracic artery

The Superior epigastric anastomoses with the inferior epigastric which is a branch of the external iliac artery

Other blood supplies- lower posterior intercostal arteries
Lumbar arteries
Branches of the femoral artery

Veins follow the artery

22
Q

Explain the layers of superficial fascia of the abdominal cavity

A

It’s uniform in thickness around the umblicus

Camper- outer fatty
Scarpas- deeper fibrous (tough) layer- always there

The scarpas extends to the inguinal ligament and adheres to the fascia lata of the thigh

23
Q

Layers of the deep fascia

A

Rectus muscle with its aponeurosis and below that is the transversalis fascia (can’t be dissected out)

24
Q

Scarpas fascia range

A

Stops at the inguinal ligament and in a male contiunes covers the scrotum over the penis and stops before the head of penis and

Female covers clit and covers the labia majora

So injecting bacteria under the scapas fascia can infiltrate the entire area

Urine would flow into the space contained by the scapas fascia if the pelvis is crushed and the ureter is cut, so swelling would begin

25
Q

Muscles of the abdominal cavity

A 
Outer Layer
Rectus abdomnius
External oblique
Internal oblique
Transversus abdominus
26
Q

Rectus Sheath difference below the ___ line

A

Arcuate line

Anterior rectus above is the external and internal oblique

Posterio– rectus sheath above the arcuate line is the internal and transversus

Below the line all three layers are anterior

27
Q

Expalin how the layers work around the rectus abdominus

A

External is always superficial to the rectus abdominus

The deepest layer always stay deep to the rectus abdominus

The middle layer splits to enclose the rectus

At the arcuate line all three sheaths are anterior so that they don’t miss the pubic smpyhsis

28
Q

Inferior epigastric artery

Location

A

Lie within the lateral umbliical folds and associated with the arcuiate line.

29
Q

Structures inside the abdominal wall

3 folds and what lies in them?

Know this!

A

Median umbliical fold that relates to the urchus which is part of the developing urinary bladder

Medial umbilical fold contains obliterated umbilical artery

Laterl umblical fold- inferior epigastric artery

30
Q

Inguinal region
Where?
Shape?

male vs female

A

Where- Under the inguinal ligament; two creases between the abdomen and the thigh
Shaped like- oblique tubes

Two rings- the deep (opening to pelvic cavity) and superficial (proximal opening to scrotum or labia majora)

31
Q

Contents of inguinal canal in males and femal

A

Females- through the canal is the round ligmanet exteds from uterus and inserts onto the labia majora and the illioinguinal nerve (off L1)

Males- through the inguinal canal is the spermatic cord that extend to the scrotum and the illioinguinal nerve

Illioinguinal nerve is lateral to the other parts

32
Q

Content of the spermatic cord (5)

A
  1. Testicular artery
  2. Pampiniform venous plexus
  3. Vas deferens and its artery
  4. Autonomic nerves
  5. Lymphatic
33
Q

Parts of the inguinal ligament

Where does it extend from?

A

Lateral crus fibers
Medical Crus fibers
Intercrural fibers

Anterior superior iliac spine to the pubic tubercle

34
Q

Fascia covering the spermatic cord and where do they come from?

A

External spermatic fascia from external oblique
Cremasteric fascia from internal oblique
Internal spermatic fascia from transversalis fascia

35
Q

What layer of spermatic cord fascia is most important? Why

A

The cremasteric fascia (from the internal oblique) and it has skeletal muscle. So stroking the inside of the thigh will cause the testes to go up. Good assessment for neural activity.

36
Q

Explain the descend of testis

A

They start in the abdominal cavitiy in utero and are guided down into the scrotum as you grow by the gubernaculum.

Important because of the path

37
Q

key factor of direct and indirect inguinal hernias

A

Lateral is the deep inguinal ring (indirect– often due to defect in descent of testis)

Medical is the anterior abdominal wall (direct)

38
Q

Hydrocele

A

abnormal accumulation of fluid in the cavity of the tunica vaginalis

39
Q

Vasectomy

A

Cutting the vas deferens so disconneting the testis from the penis

GI (27 decks)

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