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anatomy II > Abdominal Wall And Peritoneum > Flashcards

Abdominal Wall And Peritoneum Flashcards

1
Q

The pelvic inlet is formed from

A
  • Pectin pubis (pubic bone)
  • Arcuate line (ilium)
  • Sacral promontory (sacrum)
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2
Q

Continuous with the superficial fatty layers in the thorax, thick and perineum

A

Fatty layer (Camper’s fascia)

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3
Q

Continuous with the fascia Lata in the thigh and with the deep layer of superficial perineal fascia

A

Scarpa’s fascia (membranous layer)

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4
Q

The membranous layer (scarpa fascia) is just deep to what

A

Fatty layer (Camper Fascia)

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5
Q

Superficial blood vessels run in the ____ layer of superficial fascia

A

Fatty layer (Camper fascia)

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6
Q

The membranous (Scarpa’s fascia) fuses with the ______ and is continuous over the ___ and __-

A

Fascia Lata, and is continuous over the pets and scrotum

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7
Q

Does the deep fascia of the abdominal wall follow the same pattern as the membranous layer of superficial fascia

A

No

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8
Q

There is a potential space between the the membranous layer of superficial fascia (Scarpa fascia) and the ______ of the external abdominal oblique muscle

A

Deep fascia ( note that fluid can leak into this potential space between the membranous layer of superficial fascia and the deep fascia of the external abdominal oblique muscle)

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9
Q

Abdominal midline

A

Linda Alba

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10
Q

Lateral border of rectus abdominus muscle

A

Linea semilunar is (semilunar line)

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11
Q

Transverse plane midway between the superior borders of the pubic symphysis and the manubrium

A

Transpyloric plane

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12
Q

Plane at the lowest level of the costal margin (the inferior margin of the tenth costal cartilage)

A

Subcostal plane

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13
Q

Plane passing through the summits of the iliac crests

A

Supracrestal plane

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14
Q

Plane at the level of the iliac tubercles (the iliac tubercle lies-5cm posterolateral to the nation superior iliac spine)

A

Transtubercular plane

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15
Q

Plane at the level of the anterior superior iliac spine

A

Interspinous plane

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16
Q

Contents of the RUQ (most superficial to deepest)

A

Liver, Gallbladder, Suprarenal glands and kidneys

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17
Q

Contents of the LUQ most superficial to deepest

A

Stomach and transverse colon, then Spleen, pancreas, and duodenum, Then kidneys, Suprarenal glands, and the abdominal aorta (this is slightly left of midline

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18
Q

The ascending colony with cecum and vermiform appendix is in what quadrant

A

RLQ

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19
Q

The descending colon is in what quadrant

A

LLQ

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20
Q

____ pairs of muscles, located anteriorly and laterally collectively compress and hold the abdominal organs in place. What are they.

A
  • 4
  • External obliques
  • Internal obliques
  • Transversus abdominis
  • rectus abdominis
  • note that these work together to flex and stabilize the vertebral column
  • When they unilaterally contract they laterally flex the vertebral column
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21
Q

_____ pairs located in the posterior abdominal wall flex the spin and lower limb. What are they

A
  • Iliacus
  • Psoas major
  • Psoas minor
  • Quadratus lumborum
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22
Q

The three “flat” muscles of the anterior/lateral abdominal wall end anteriorly in a strong sheet of aponeurosis called the _____-

A

Rectus sheath

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23
Q

The rectus sheath encloses the _____-

A

Rectus abdominis

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24
Q

The midline of the rectus sheath is the ____

A

Linea Alba

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25
Q

Are the layers of fascia and aponeurosis of the muscles forming the rectus sheath are arranged differently in the upper abdominal wall than they are in the lower wall

A

Yes

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26
Q

The ___ is the line where the layers of fascia and aponeurosis of the muscles forming the rectus sheath are arranged differently in the upper and lower abdominal wall

A

Arcuate line

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27
Q

The Arcuate line is located

A

About half way between the umbilicus and pubic symphysis

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28
Q

Above the Arcuate line, the aponeurosis from the _______ splits to surround ______ and the aponeurosis from the __________ runs posterior to ________

A

Above the Arcuate line, the aponeurosis from the internal oblique splits to surround rectus abdominis and the aponeurosis from Transversus abdominus runs posterior to rectus abdominis

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29
Q

Below the Arcuate line, the rectus abdominis muscle lies

A

Directly on transversal is fascia

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30
Q

What muscle has fibers that project inferomedially to form the inguinal ligament

A

External oblique

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31
Q

Bony landmarks of anterior abdominal wall

A
  • Xiphoid process
  • Costal margins
  • Ilium
  • Pubis
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32
Q

Muscles of the posterior abdominal wall

A

Iliacus, Psoas major, Psoas minor, Quadratus lumborum

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33
Q

Superficial arteries of Abdominal Wall

A
  • Superficial circumflex iliac artery
  • superficial epigastric artery
  • external pudendal artery (superficial branch, and deep branch)
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34
Q

The deep drainage of the anterior abdominal wall veins go to the

A

Subclavian vein, eternal iliac vein, lumbar, and intercostal veins

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35
Q

Anterior abdominal wall veins are within the ____ fascia and are what veins

A

Campers fascia, thoracoepigastric veins, lateral thoracic veins, and superficial epigastric veins

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36
Q

What are the dermatomes. Of the anterior abdominal wall

A

T7-L1

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37
Q

What dermatomes is at the Xiphoid region (tip)

A

T7

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38
Q

What is the dermatomes at the umbilical region

A

T10

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39
Q

What is the dermatomes at the inguinal fold

A

L1

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40
Q

What are the nerves of the anterior abdominal wall

A
  • sensory : Dermatomes (T7-L1)

- Innervated muscles (motor): Intercostal nerves (T7-T11), sub costal nerve (T12) , Lumbar nerve (L1-L4)

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41
Q

The cutaneous branches of ventral rami, intercostal nerves (T7-T11) of the anterior abdominal wall lie between _____ and ______. They pierce the _____ to innervate the rectus abdominis muscles. They supply ____. ____ and ______. and are angled _____

A

The cutaneous branches of ventral rami, intercostal nerves (T7-T11) of the anterior abdominal wall lie between internal abdominal oblique and transverse abdominis. They Pierce the rectus sheath to innervate the rectus abdomens muscles. They supply skin, muscles and parietal peritoneum. They are angled inferiomedially

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42
Q

The ilioinguinal nerve (L1) enter the ____ canal and merges through the ____. Supplies ___ and ____

A

enters the inguinal canal and emerges through the superficial inguinal ring. Supplies groin and scrotum/labium majus

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43
Q

Iliohypogastic nerve arises form the ventral rami of Nerve ____ and branches into the ____ and ____ which supplies ______ region

A

L1 (sometimes plus T12), lateral cutaneous branch and anterior cutaneous branch, supra pubic region

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44
Q

The genitofemoral nerve is a branch of ___ and ___

A

L1 and L2

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45
Q

The genital branch of genitofemoral nerve exits the ____ and innervates the

A

exits the inguinal canal through the superficial inguinal ring. Innervates the cremaster muscle or is cutaneous to the labium majus

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46
Q

The femoral branches of the genitofemoral nerve (L1, L2) is cutaneous to the

A

femoral triangle area

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47
Q

Superficial lymphatic drainage of the anterior abdomen drains superiorly from ____ to _____ and drains inferiorly form _____ to ___

A
  • Drains superiorly from umbilical region to anterior axillary and sternal nodes
  • inferiorly from umbilical region to superficial inguinal nodes
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48
Q

Deep lymphatic drainage of anterior abdomen

A
  • along posterior intercostal and lumbar vessels to deep abdominal nodes
  • from testes to deep abdominal nodes
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49
Q

Portion of the viscera protrudes through a weakened point of the muscular wall of the abdominal cavity

A

hernia

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50
Q

What is a strangulated intestinal hernia

A

When herniated portion of the intestine swells thus becoming trapped and the blood flow to the trapped segment diminishes causing that portion of the intestine to die

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51
Q

What are the two types of hernias

A
  • Inguinal hernias

- Femoral hernias

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52
Q

An _____ hernia is the most common type of hernia to require treatment

A

Inguinal hernia

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53
Q

The inguinal region is one of the ____ areas of the abdominal wall

A

weakest

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54
Q

Are males more likely to develop inguinal hernias than females

A

yes

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55
Q

What causes an inguinal hernia

A

Rising pressure in the abdominal cavity provides the force to push a segment of the small intestine into the canal

56
Q

what are the two types of inguinal hernias

A
  • Direct inguinal hernia

- indirect inguinal hernia

57
Q

What is a direct inguinal hernia

A

the loop of small intestine protrudes directly through the superficial inguinal ring, but not down the entire length of the inguinal canal, and creates a bulge in the lower anterior abdominal wall

58
Q

what is an indirect inguinal hernia

A

herniation travels down the entire inguinal canal and may even extend all the way into the scrotum

59
Q

Indirect inguinal hernias are more common in

A

younger males and may be congenital

60
Q

indirect inguinal hernias pass _____ to epigastric vessels to _____ to enter _____ and follows the path of

A

lateral to inferior epigastric vessels to enter deep inguinal ring, follows path of spermatic cord

61
Q

What type of hernia is usually acquired an happens in females as well

A

Direct inguinal hernias

62
Q

In direct inguinal hernias herniation passes ___ to inferior epigastic vessels punching though ___ and ____

A

medial to inferior epigastric vessels punching through peritoneum and transversalis fascia

63
Q

Femoral hernia occurs in the _____

A

upper thigh, just inferior to he inguinal ligmanet, originating in the femoral triangle

64
Q

The ___ part of the femoral triangle is relatively weak and prone to stress injury, allowing a loop of small intestine to protrude

A

medial

65
Q

Women more commonly develop femoral hernias because of the

A

greater width of their femoral triangle

66
Q

_____occur when a portion of intestine pushes through abdominal wall musculature in the periumbilical or umbilical region

A

umbilical hernia

67
Q

Umbilical hernias are most common in ___ but can occur in ___ as well

A

infant, adults

68
Q

Derivatives of foregut (celiac trunk)

A
  • Esophagus, stomach, duodenum, liver, gallbladder, spleen, and pancreas
69
Q

Derivatives of midgut (superior mesenteric artery)

A

Duodenum, jejunum, ileum, cecum and appendix, ascending colon, 2/3 of transverse colon

70
Q

Derivatives of hindgut (inferior mesenteric artery)

A

1/3 transverse, descending and sigmoid colon, rectum and anal canal

71
Q

serous membrane of the abdomen

A

peritoneum

72
Q

What are the subdivisions of the peritoneum

A
  • Parietal layer (lines the body wall)

- Viscer alyer (serosa)- covers viscera

73
Q

Which of the peritoneum layers has abundant pain fibers

A

Parietal layer has abundant pain fibers via nerves form the body wall. The visceral layer lacks pain fibers

74
Q

These organs have a mesentery and are completely covered by the peritoneum

A

Intraperitoneal organs

75
Q

what are the abdominal cavity intraperitoneal organs

A
  • Stomach
  • Small intestine (jejunum, ileum, some of the superior part of the duodenum)
  • Spleen
  • Liver
  • Gallbladder
  • Cecum with vermiform appendix (portions of variable size may be retroperitoneal)
  • Large intestine (transverse and sigmoid colons)
76
Q

What are the pelvic cavity intraperitoneal organs

A
  • Uterus (fundus and body)
  • Ovaries
  • Uterine tubes
77
Q

These organs either have no mesentery or lost it during development

A

Extraperitoneal organs

78
Q

Primarily retroperitoneal organs

A
  • kidneys
  • suprarenal glands
  • Uterine cervix
  • ureters
  • adrenals
  • gonads
  • aorta and inferior vena cava
79
Q

Secondarily retroperitoneal organs (became retroperitoneal during development)

A
  • duodenum (descending, horizontal, and ascending)
  • ascending and descending colon
  • pancreas
  • rectum (upper 2/3)
80
Q

What are the infra peritoneal/subperitoneal organs

A
  • urinary bladder
  • distal ureters
  • prostate
  • Seminal vesicle
  • uterine cervix
  • Vagina
  • Rectum (lower 1/3)
81
Q

Intraperitoneal organs are covered on most sides by ______ and suspended by ____ form the body wall

A

visceral peritoneum, suspended by mesentery from the body wall

82
Q

Retroperitoneal organs lie deep to the _____ and are covered by ___ on one side only

A

parietal peritoneum, parietal peritoneum

83
Q

what part(s) of the small intestine are retroperitoneal

A
  • duodenum (descending, horizontal, and ascending) note that the jejunum, ileum, and superior part of the duodenum are intraperitoneal organs
84
Q

2-layered fold of peritoneum

A

the mesenteries

85
Q

“The mesentery” attaches _____ to the posterior body wall

A

free small intestine (jejunum and ileum)

86
Q

Transverse mesocolon

A
  • mesentery of the transverse colon
  • holds the transverse colon to the posterior body wall
  • fuses with the posterior layer of the greater omentum
87
Q

The transverse mesocolon fuses with the posterior layer of the ______

A

greater omentum

88
Q

Sigmoid mesocolon

A
  • mesentery of the sigmoid colon

- holds the sigmoid colon to the posterior body wall

89
Q

Mesoappendix

A

Mesentery of the vermiform appendix

90
Q

The mesenteries of the duodenum, ascending colon, descending colon and cecum are usually lost during development. Since they are no longer suspended by a mesentery, these organs are _____

A

secondarily retroperitoneal

91
Q

peritoneal ligaments may be subdivisions of a ____ structure

A

larger

92
Q

Peritoneal ligament usually transmit ___ and ____

A

nerves and vessels

93
Q

Peritoneal ligaments usually lack ____ and are not the same as ligaments that join bones

A

Connective tissue

94
Q

Examples of peritoneal ligaments

A

Gastrosplenic ligament, splenorenal (lienorenal) ligament

95
Q

Broad, 2-4 layered sheet of peritoneum that attaches the stomach to other viscera

A

Omentum (epiploon)

96
Q

The lesser omentum develops from the ________

A

Ventral mesogastrium (mesentery)

97
Q

The lesser omentum is subdivided into two parts

A
  • hepatogastric ligament (stomach to liver)

- Hepatoduodenal ligament (liver to duodenum)

98
Q

Peritoneal reflections (adult)

A
  • Greater Omentum
  • Gastrocolic ligament
  • Gastrophrenic ligament
  • Gastrosplenic ligament
99
Q

The greater omentum develops form the

A

dorsal mesogastrium

100
Q

The Gastrocolic ligament attaches the

A

stomach to transverse colon

101
Q

The Gastrophrenic ligament attaches the

A

stomach to diaphragm (is continous with phrenicosplenic ligament)

102
Q

The Gastrosplenic ligament attaches the

A

stomach to the spleen

103
Q

What are the peritoneal ligaments that are associated with the liver

A
  • Coronary ligaments
  • Right and left triangular ligaments
  • Falciform ligaments
  • Ligamentum teres hepatis
104
Q

a ridge or elevation in the peritoneum produced by underlying vessels

A

Folds

105
Q

The fossae (fossa) or recesses are

A

depressions between folds

106
Q

Examples of abdominal fossa or recesses

A
  • superior duodenal fold and fossa (recess)
  • Paraduodenal fossa
  • inferior deuodenal fold and fossa
  • retroduodenal fossa
  • Fold is formed by inferior mesenteric vein posterior to peritoneum
107
Q

Structures coursing through the exztraperitoneal tissue form elevations on the interior abdominal wall called _____

A

peritoneal (umbilical) folds

108
Q

Median umbilical fold

A
  • Urachus

- midline from bladder

109
Q

Medial umbilical folds

A
  • 2
  • medial umbilical ligaments
  • obliterated umbilical aa.
110
Q

Lateral umbilical fold

A
  • 2
  • inferior epigastric vessels
  • Functional aa. and vv.
111
Q

supraumnbilical structures located on the internal aspect of the anterior abdominal wall

A
  • falciform ligament
112
Q

Falciform ligament

A
  • curved remnant of the ventral mesogastrium
  • ligamentum teres hepatis (round ligament of the liver) in tis lower free border
  • Obliterated umbilical vein
113
Q

The Supravesical fossa is between the ___ and ____ umbilical folds

A

median and medial

114
Q

The supravesical fossa is the site for ______

A

supravesical hernias (rare)

115
Q

The medial inguinal fossa is between the ____ and _______

A

medial and lateral umbilical folds

116
Q

The medial inguinal fossa is the site for

A

direct inguinal hernias

117
Q

The medial inguinal fossa is also called the

A

inguinal triangle

118
Q

The lateral inguinal fossa is lateral to the

A

lateral umbilical folds

119
Q

The lateral inguinal fossa is the site for

A

indirect inguinal hernias

120
Q

The _____ is most of the potential space within the abdomen

A

Greater sac

121
Q

The greater sac can be subdivided into

A

supracolic an infracolic regions by the colon and transverse mesocolon

122
Q

The supramesocolic (supracolic) region of the greater sac is superior and anterior to the ___ and the ___ and includes

A

liver and the stomach and includes hepatorenal and subphrenic spaces and fossa of the anterior wall

123
Q

The peritoneal cavity is a ____ potential space between parietal and visceral layers of peritoneum

A

closed

124
Q

recesses and fossa of the peritoneal cavity

A
  • Subphrenic recess
  • subhepatic/hepatorenal recess
  • rectovesical/rectouterine recess
125
Q

Why are the recesses and fossa of the peritoneal cavity of clinical importance

A

Because abscesses may develop and excess fluid (ascites) will pool here

126
Q

inferior and posterior part of the greater sac

A
  • Inframesocolic (infracolic) region of the greater sac of the peritoneal cavity
127
Q

The inframesocolic region of the greater sac is subdivided by

A

mesenteries and ligaments

128
Q

the upper and lower parts of the inframesocloic (infra colic) region of the greater sac is divided by _______ into right and left infra colic spaces

A

The mesentery

129
Q

What limits the spread of fluid superiorly in the inframesocolic region

A

phrenicocolic ligament

130
Q

The lesser sac (omental bursa) develops as a part of the

A

greater sac

131
Q

The lesser sac is _____ and ____ to the stomach

A

posterior and inferior

132
Q

Greater and lesser peritoneal sacs communicate through the

A

Epiploic foramen (of Winslow)

133
Q

Recesses of the lesser sac

A
  • Superior recess (posterior to the liver)
  • Inferior process (potential space between the 2 layers of the gastrocolic ligament)
  • Splenic recess (posterior to and left of the stomach)
134
Q

The lesser sac has a clinically important relationship to the

A

liver, pancreas, stomach, and spleen.

135
Q

Epiploic forament (of Winslow) (omental foramen)

A
  • opening between the greater and lesser sacs
  • anterior: hepatoduodenal ligament with the portal vein, hepatic artery and bile duct
  • posterior: IVC, diaphragm
  • Superior: liver, caudate lobe
  • Inferior: duodenum, 1st part

anatomy II (7 decks)

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