Abdominal wall, inguinal region, general relationships of abdominal viscera, peritoneum Flashcards
Dissection 13
What is anatomical name for “belly button”?
Umbilicus
How to locate transpyloric plane?
Transverse plane midway between xiphoid process and umbilicus
How to locate subcostal plane?
Transverse plane between bilateral 10th costal cartilages at respective midaxillary lines
Location of interiliac plane?
Transverse plane between bilateral iliac crests
What connects pubis to ischium?
Ischiopubic rami
Where does lacunar ligament attach?
Pecten pubis
What are dermatomal landmarks for the anterior trunk?
Xiphoid: T7
Umbilicus: T10
Inguinal: L1
What could pain to the lower right quadrant of the abdomen indicate?
Pneumonia in the lower lobe of the right lung is affecting local parietal plura - referring pain to the local abdominal wall (may simulate appendicitis) via the thoracoabdominal intercostal nerves
From superficial to deep, what are the layers of the anterior abdominal wall?
- Camper’s fatty fascia
- Scarpa’s membranous fascia (continuous with perineum fascia)
- External abdominal oblique muscle
- Internal abdominal oblique muscle
- Transversus abdominis
- Rectus abdominis
- Transversalis fascia
What does distention of superficial anterior abdominal veins indicate (caput medusae)?
An obstruction of one or more of the following:
- Superior vena cava
- Inferior vena cava
- Portal vein
What is special about the membranous fascia of he abdomen?
It is continuous with fascia of the perineum
How can a ruptured urethra be diagnosed?
Released urine is palpable as a fluid mass in the lower abdomen; continuity between Scarpa’s membranous fascia and Colles’ perineum fascia prevents urine from descending to lower limb
How is the abdomen divided into quadrants?
Transverse and sagittal planes intersecting at the umbilicus
What nerve supplies L1 dermatome?
Ilioinguinal nerve
What is external abdominal oblique aponeurosis continuous with?
- Inguinal ligament
- Lacunar ligament
- Superficial inguinal ring
- External spermatic fascia
What does internal abdominal oblique muscle join with?
Joins transversus abdominis muscle as inguinal falx tendon
Where does ilioinguinal nerve run?
Pierces internal abdominal oblique muscle near anterior superior iliac spine and runs medially to exit superficial inguinal ring
What encapsulates the abdominal viscera?
- Parietal peritoneum
2. Visceral peritoneum
What is arcuate line?
Above: rectus sheath completely surrounds rectus abdominis
Below: rectus sheath only covers anterior surface of rectus abdominis
What muscles form the rectus sheath?
- External abdominal oblique tendon (anterior)
- Internal abdominal oblique tendon (posterior)
- Transversus abdominis tendon (anterior/posterior)
What is the significance of the rectus sheath?
Encloses rectus abdominus
What is the linea alba?
Where the left and right rectus sheaths meet at the midline; it is a common surgical incision site; it is a weak point of the abdomen where a hernia can occur
What makes up the deep inguinal ring?
Transversalis fascia
What makes up the superficial inguinal ring?
- External oblique
2. Lateral and medial crura
What is a test for the L1 spinal nerve for males?
Cremasteric reflex: scratch skin of medial thigh or lower abdomen and look for cremaster muscle to elevate testes
What are the components of the spermatic cord?
- Ductus deferens (take spermatozoa from epididymis within scrotum to ejaculatory duct); is a thick muscular cord
- Testicular artery
- Pampiniform plexus of veins
- Testicular lymphatics
- Testicular plexus of autonomic nerves
- Vessels to ductus deferens
What is the female homolog of spermatic cord?
Round ligament
What are the symptoms of varicocele?
Varicose veins of the pampiniform plexus of veins; chronic, aching pain in groin; palpable, large, dilated, worm-like structures in scrotum; infertility
What are the boarders of Hesselbach’s triangle?
Medial: rectus abdominus
Lateral: inferior epigastric vessels
Inferior: inguinal ligament
What is a femoral hernia?
Part of inguinal peritoneum (and intestine) passes through femoral canal
Where are the semilunar lines located?
They are the lateral boarders of rectus abdominus
What abdominal, visceral organs are completely peritonealized?
- Stomach
- Duodenum, first part
- Jejunum
- Ileum
- Transverse colon
- Sigmoid colon
- Spleen
- Appendix
What abdominal, visceral organs are partially peritonealized?
- Colon, ascending
2. Colon, descending
What abdominal, visceral organs are retroperitoneal?
- Kidneys
- Ureters
- Adrenals
- Pancreas
- Duodenum (second, third, and fourth parts)
What is peritonealization?
Surrounded by visceral peritoneum
What is retroperitoneal?
Posterior to peritoneum; not surrounded
Where is parietal peritoneum?
Lining the entire internal abdominal cavity
Where is visceral peritoneum?
Lining peritonealized organs
What are the four components of greater omentum mesentery?
- Gastrocolic ligament (stomach to diaphragm)
- Gastrosphlenic ligament (stomach to spleen)
- Splenorenal ligament (stomach to left kidney and spleen)
- Gastrocolic ligament (stomach to transverse colon)
What are the components of lesser omentum ligament?
- Hepatogastric ligament (stomach to liver)
2. Hepatoduodenal ligament (stomach to common bile duct, proper hepatic artery, and portal vein)
What are the attachments of the inguinal ligament?
- Pubic tubercle
2. Anterior superior iliac spine
What nerves innervate external oblique muscle?
- Lower intercostal nerves
2. Subcostal nerve
What nerves innervate internal oblique muscle?
- Lower intercostal nerves
- Subcostal nerve
- L1 spinal nerve
What are the functions of internal oblique muscle?
- Rotation
- Lateral flexion of trunk (ipsilaterally)
- Compressor of abdomen (antagonist to diaphragm)
What are the functions of external oblique muscle?
- Rotate vertebral column to opposite side
- Bend trunk to same side
- Expiration by compressing lower thoracic cavity
- Flexion of trunk
What nerves innervate rectus abdominis?
- Lower intercostal nerves
2. Subcostal nerve
What nerves innervate transversus abdominis?
- Lower intercostal nerves
- Subcostal nerve
- L1 spinal nerve
What are the functions of transversus abdominis?
- Flexion of trunk
- Lateral flexion of trunk
- Rotation of trunk
What are the actions of rectus abdominis?
- Compression of abdomen
2. Flexion of trunk
What nerve innervates cremaster muscle?
Genital branch of genitofemoral nerve
What are the four components of greater omentum?
(Connected to greater curvature of stomach)
- Gatrophrenic ligament (connects to diaphragm)
- Gastrosplenic ligament (connects to spleen)
- Splenorenal ligament (connects to left kidney and spleen)
- Gastrocolic ligament (attaches to anterior aspect of transverse colon)
What are the two components of lesser omentum?
(Connected to lesser curvature of stomach)
- Hepatogastric ligament (connects to porta of liver)
- Hepatoduodenal ligament (contains common bile duct, proper hepatic artery, and portal vein) (forms anterior boarder of omental foramen)
What is the location of falciform ligament of liver?
From anterior abdominal wall in midline (umbilicus) to the dome of the diaphragm (runs between lobes of liver)
What is the location of coronary ligament of liver?
The top of the “T” found at the superior end of the falciform ligament; runs on the superior surface of the liver
What is the location of triangular ligaments of liver?
- Where the left inferior and superior coronary ligaments join (forming a triangle)
- Where the right inferior and superior coronary ligaments joint (forming a triangle)
What vein drains the testicles?
Testicular pampiniform venous plexus
What passes through deep inguinal ring?
- Cremaster artery
- Cremaster vein
- Testicular artery
- Testicular vein
- Testicular lymph vessels
- Ductus deferens
Where can round ligament be found?
Attached to falciform ligament
What is contained within round ligament?
Obliterated umbilical vein
What are the ligaments of the liver?
- Falciform
- Coronary
- Triangular
What mesentery holds small intestine?
Mesentery of small intestine
What mesentery holds the transverse colon?
Transverse mesocolon
What mesentery holds the sigmoid colon?
Sigmoid mesocolon
What mesentery holds the appendix?
Mesoappendix
In males, what is found between the rectum and bladder?
Rectovesical pouch
In females, what is found between the rectum and uterus?
Rectouterine pouch
In females, what is found between the blatter and uterus?
Vesicouterine pouch
What connects omental bursa to peritoneal cavity?
Omental (epiploic) foramen; found under hepatic triad