Abdominal Wall and Cavity Flashcards
What is the inferior border of the abdominal cavity?
the pelvic outlet
What is the superior border of the abdominal cavity?
the diaphragm
The inguinal ligament connects what two structures?
the anterior superior iliac spine and the pubic tubercule
What is the iliac crest?
the superolateral margin of the greater pelvis
What is the lower segment of the sterum called?
the xiphoid process
What is the linea alba?
a fibrous structure that runs down the midline of the abdominal wall
What is the semilunar line?
a tendenous intersection on either side of the rectus abdominis
What vertebral level does the transumbilical plane lie at?
a horizontal plane between the level of L3/L4
At what vertebral level is the umbilicus?
L3/L4
The abdomen is divided into four quadrants by what two planes?
the median plane and transumbilical planes create what clinical tool?
The abdomen can be divided into 9 regions using what vertical planes?
either the semilunar lines or midclavicular planes
What two horizontal lines can be used to divide the abdomen into 9 regions?
transpyloric plane with transtubercular plane
The interspinous plane intersects what structure?
the anterior superior iliac spine
Where is the transtubercular plane?
line that passes through the iliac tubercles
The transpyloric plane sits at what vertebral level?
L1
The semilunar line serves as the lateral border to what muscle group?
the rectus abdominus muscle
The lateral abdominal wall has what three muscle layers?
- external oblique
- internal oblique
- transversus abdominus
The superficial fascia that lies on the abdominal wall can be divided into what two portions?
- Camper (fat)
- Scarpa (membranous)
Where is Scarpa’s fascia found?
halfway between the umbilicus and pubic crest and down
The external oblique muscles originate from where?
the external surfaces of ribs 5-12
Which lateral abdominal wall muscles run superior-lateral to inferior-medial?
the external oblique muscle
The rectus abdominis sheath is formed by what structures?
the aponeurosis of the lateral wall muscles
The inguinal ligament is formed by what?
the inferior edge of the external oblique muscle aponeurosis
The internal oblique muscle runs in which direction?
- inferior-lateral to superior-medial in the superior region
- almost perfectly lateral-medial in the middle and inferior region
How do the external and internal oblique muscles work together?
the contralateral external and internal muscles work to bring one’s shoulder toward the opposite hip
In which direction do the transverse abdominis muscles run?
horizontally
The rectus abdominis muscles originate from whree?
the pubic symphysis and pubic tubercle
The rectus abominis muscles are used to perform what primary function?
bring the thorax toward the pelvis
The thoracic artery gives rise to what vessels in the abdominal wall?
a few superior epigastric arteries
Inferior epigastric arteries arise from what major artery?
the external iliac artery
What is the arcuate line?
the line formed by all three lateral muscle aponeuroses moving anterior to the rectus abdominis
What layers of tissue do you need to go through when positioned over a superior rectus abdominis muscle?
- superficial fascia
- rectus sheath
- rectus muscle
- rectus sheath
- transversalis fascia
- extraperitoneal fat
- parietal peritoneum
The inguinal canal is formed by what?
the descending of testis or the round ligament of the uterus
The external oblique muscle aponeurosis gives rise to what inguinal ring?
the superficial
What is the conjoint tendon?
combination of the internal oblique and transverse abdominal muscles which forms the anterior wall of the medial inguinal ring
Where is the deep ring of the inguinal canal located?
lateral to the inferior epigastric artery and vein
The superficial inguinal ring is bordered by what structures?
the medial and lateral crus as well as intercrural fibers
What are the inguinal canal contents in males?
spermatic cord
What are the inguinal canal contents in females?
round ligament of uterus
What nerves run in the inguinal canal?
- ilioinguinal (sensory)
- genital branch of genitofemoral nerve (motor)
What are the two types of inguinal hernia?
direct and indirect
Which type of inguinal hernia is congenital?
an indirect hernia
How do direct and indirect inguinal hernias differ?
indirect hernias pass through the deep inguinal ring while direct hernias do not
Direct inguinal hernias enter the inguinal canal through what structure?
Hesselbach’s triangle
Women are most at risk for what type of hernia?
groin hernia between the ages of 60 and 75
Caput medusa is dilation of what blood vessels?
superficial veins that are anastomosed with deep veins
The internal thoracic artery gives rise to what superficial abdominal artery?
superior epigastric
Where do superior epigastric arteries run?
inside the rectus sheath, behind the rectus abdominus
Superficial arteries that branch off the aorta run where?
between the internal oblique and transverse abdominal muscles
Inferior epigastric arteries branch off what larger arteries?
external iliac and femoral arteries
The aorta bifurcates into what two arteries?
the right and left common iliac arteries
The femoral artery has what origin?
the external iliac artery
What are the thoracoabdominal nerves?
the distal portion of intercostal nerves T7-T11
The thoracoabominal nerves innervate what structures?
- T7-T9 serve the epigastrium
- T10 serves the umbilical region
- T11 serves the upper hypogastric region
What is the subcostal nerve?
T12 nerve that runs beneath the last rib
The upper hypogastric region is innervated by what nerve?
the T11 thoracoabdominal nerve
The middle hypogastric region is innervated by what nerve?
the subcostal nerve (T12)
The genital area and thigh are innervated by what superficial nerve?
the ilioinguinal (L1) nerve
The ilioinguinal nerve has what vertebral origin and serves what structures?
- L1
- the genital area and thigh
What is the neurovascular plane?
the nerves and vessels running between the internal oblique and transverse abdominal muscle
Why does the loss of one dermatome not result in anesthesia, but in hypothesia?
because the dermatomes overlap
The umbilical vein gives rise to what adult structure?
the round ligament of the liver
The round ligament of the liver is found where?
as part of the falciform ligament
What three folds are found below the umbilicus on the internal surface of the anterior abdominal wall?
the median umbilical fold, the medial umbilical fold, the lateral umbilical fold
The median umbilical fold is raised by the ____.
obliterated urachus
The medial umbilical fold is raised by the ____.
obliterated umbilical arteries
The lateral umbilical fold is raised by the ____.
inferior epigastric arteries
Which layer of the peritoneum is closer to the exterior?
the parietal
Which peritoneum senses pain in a well localized manner?
the parietal peritoneum because it is served by the nerves in the region it is adjacent to
The visceral peritoneum is served by the blood, lymph, and nerves of what ___.
the organ it covers
Which is more sensitive, the parietal or visceral peritoneum?
the parietal
The visceral peritoneum is only sensitive to what sensations?
stretch and chemical irritation
The peritoneum is formed by a layer of what kind of cells?
squamous epithelial cells
What is the mesothelium?
the epithelium that lines the peritoneal cavity
What embryonic cavity becomes the peritoneum?
the intraembryonic coleum
The peritoneum has what embryonic tissue origin?
mesoderm
Which gender has a peritoneal cavity that is not completely sealed?
females
Peritoneal folds are typically found on what surface?
on the anterior abdominal wall
What is a mesentery?
a double layered peritoneum connecting intraperitoneal organs with the abdominal wall
What are the three major mesenteries?
- the mesentery (small intestine)
- transverse mesocolon
- sigmoid mesocolon
The greater omentum connects what structures?
the greater curvature of the stomach to the transverse colon
The lesser comentum connects what structures?
the lesser curvature of the stomach and duodenum to the liver
What are the functions of the greater omentum?
- store excess calories
- cushion against trauma
- insulate against heat loss
The lesser omentum has what two divisions?
the hepatogastric ligament and the hepatoduodenal ligament
The portal triad runs into the liver within what CT?
the hepatoduodenal ligament of the lesser omentum
What ligament runs between the stomach and spleen?
gastrosplenic
What ligament runs between the stomach and transverse colon?
the gastrocolic ligament
The stomach and transverse colon are connected by what two structures?
the greater omentum and gastrocolic ligament
What ligament runs between the spleen and kidney?
splenorenal
What ligament runs between the diaphragm and colic flexure?
the phrenicocolic ligament
On which side of the body is the phrenicocolic ligament?
the left
When standing, what two peritoneal recesses will fluid collect in?
- rectouterine pouch in females
- rectovesicle pouch in males
What peritoneal recesses will fluid collect in while someone is lying supine?
the hepatorenal pouch
What is the hepatorenal pouch?
the peritoneal recesses most inferior when lying supine
Where are the paracolic gutters?
to the right of the ascending colon and left of the descending colon
The peritoneal cavity is divided into what two compartments?
the lesser and greater sac
What is the lesser sac?
the space posterior to the lesser omentum and sotmach
What are the two comparements of the greater sac?
the supracolic and infracolic
What structure divides the greater sac?
the transverse colon
What structure connects the space of the lesser and greater sacs?
the omental foramen
What is the omental foramen?
space created behind the hepatoduodenal ligament that connects the lesser and greater sacs of the peritoneum
The lesser sac is also known as the what?
omental bursa
Describe the pathway of fluid spread inside the peritoneal cavity from the omental bursa
- lesser sac
- hepatorenal recess
- right paracolic gutter
- rectouterine or rectovesicle pouch
What are the signs of peritonitis?
- fever
- guarding
- gas under diaphragm
- no bowel sounds
Peritoneal dialysis can be used to help patients suffering from what?
renal failure
Peritoneal adhesions are caused by what?
the healing process of the periotenum which leaves fibrous/scar tissue
