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Digestive System > Abdominal Wall & Peritoneum > Flashcards

Abdominal Wall & Peritoneum Flashcards

1
Q

Boundaries of the abdomen?

A

Superior: diaphragm, inferior thoracic aperture
Inferior: Iliac crest, inguinal lig. , pelvic inlet
Posterior: Lumbar vertebral column, psoas major, quadratus lumborum (abdominal wall muscles)
Anterior/lateral: Abdominal wall muscles

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2
Q

What is the inferior thoracic aperture?

A

Bottom of the ribcage

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3
Q

4 division?

A

RUQ, LUQ, RLQ, LUQ

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4
Q

9 divisions

A

Right hypochondrium, epigastric region, left hypochondrium, right flank, umbilical region, left flank, right groin, pubic region, left groin

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5
Q

the three planes of the abdomen?

A

midclavicular, subcostal and intertubecular plane

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6
Q

From SF to deep, what are the layers of the abdominal wall?

A 
skin
SF fascia (x2) -camper's
                       - Scarpa's
Muscle (x3)     - Ext oblique
                        - Int oblique
                        - Transversus Abdominis
Tranversalis Fascia
Extraperitoneal Fascia
Parietal Peritoneum
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7
Q

When does the SF fascia divide?

A

at umbilicus

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8
Q

What are the two layers of SF below umbilicus and how are they different?

A 
Camper's = SF and fatty
Scarpa's = deep and membranous ( thinner with little fat)
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9
Q

Where do the blood vessels lie?

A

In the SF fascia

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10
Q

What is the Rectus Abdominis

A

A paired abdominal muscle separated in the midline by ‘linea alba’. Along its course, it’s intersected by 3-4 tendinous insertions.

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11
Q

O/I and action of Rectus Abdominis?

A

O: Pubic tubercle, crest & symphysis
I: Costal cartilages of ribs 5-7 and xiphoid procress
Action: Flex trunk, support/compress the abdominal wall
*also secondary resp muscle for forced expiration

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12
Q

Nerve supply and fibre direction of rectus abdominis?

A

Nerve: Anterior rami of thoracic spinal nerves
Fibres: extend longitudinally upwards

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13
Q

External Oblique O/I and actions?

A

O: ribs 5-12
I: iliac crest & linea alba via aponeurosis
action: flex trunk (both)
bends trunk to same side
turns trunk to opposite side

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14
Q

External Oblique Nerve supply and fibre direction

A

Nerve: Anterior rami of thoracic spinal nerves
fibres: inferomedial

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15
Q

The ext obliques aponeurosis…

A

Extends from xiphoid process to pubic symphysis

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16
Q

Internal Oblique O/I and actions?

A 
O:  thoracolumbar fascia, inguinal lig, and iliac crest 
I: ribs 9-12
Action: flex trunk
             bends trunk (single)
             turns to same side
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17
Q

Internal Oblique Nerve supply and fibre direction

A

Nerve: Anterior rami of thoracic spinal nerves (and some L1)
Fibres: superomedial

18
Q

How do the internal and external obliques work together

A

the internal work antagonistically with the opposites sides external oblique

19
Q

Transversus abdominis O/I and action

A 
O: thoracolumbar fascia
     iliac crest
     inguinal ligament
     costal cartilage rib 7-12
I: linea alba, pubic crest pectineal line
Action: Supports the abdominal wall
20
Q

Transversus Abdominis nerve and fibre direction

A

Nerve Supply: anterior rami of thoracic spinal nerves (and L1)
Fibres: Transverse

21
Q

What is the rectus sheath?

A

an aponeurotic tendinous sheath formed by internal oblique, external oblique and tranversus abdominis that surrounds rectus abdominis.

22
Q

The upper 3/4 of the rectus sheath

A

all 3 muscles surround rectus abdominis

23
Q

The lower 1/4 of the rectus sheath

A

Only supports and travels in front of rectus abdominis. At the back of rectus abdominis is transversalis fascia and parietal peritoneum (weak and allows BVs to pass through)

24
Q

The Arcuate Line is?

A

The point where all of the aponeuroses are anterior to RA and there in no posterior wall of rectus sheath.
Happens approx halfway between umbilicus and pubic bones
Allows arterial supply (IE) to get through

25
Q

Whats the arterial supply of the abdomen? How does it travel?

A 
Superior Epigastric (from internal thoracic) 
and Inferior Epigastric (from external iliac)
-These both run under RA (atop transversalis fascia and within the rectus sheath) and anastamose together
26
Q

What other arteries apart from the two main also supply the abdomen

A
  • deep circumflex
  • musculophrenic
  • intercostal
  • lumbar
  • iliolumbar
27
Q

Venous drainage of the abdomen?

A

Thoracoepigastric veins > drain to axillary

Superficial epigastric veins > drain to femoral

28
Q

Nervous supply to the abdomen?

A

Lateral cutaneous branches 7-12 intercostal nerves + iliohypogastric nerve (L1)
All anterior Rami
These travel in the neurovascular plane between int. oblique and transversus abdominus before piercing the muscular wall to reach the skin

29
Q

What dermatome/ spinal nerve is umbilicus at?

A

T10

30
Q

The lymphatic drainage of the abdomen?

A

Anterior axillary
Superficial Inguinal
Posterior axillary

31
Q

Visceral peritoneum

A

Covers abdominal organs

  • sensitive to stretch - ANS - afferent nerve fibres
    eg) stretching/ distension (when you eat too much/ gas)

BUT no somatic pain sensation

32
Q

Mesentery

A

visceral peritoneum can come back around on itself, forming a mesentery and anchoring viscera (organs) to the posterior body wall

33
Q

Parietal Peritoneum

A

Lines body wall
-sensitive to pain, touch, temperature & pressure
Nervous supply:
- somatic nerves to body wall (thoracic and lumbar nerves)
- Phrenic Nerve (up by diaphragm)
- Obturator nerve (down in pelvis

34
Q

Midgut and hindgut mesentery?

A

Suspended by only one dorsal mesentery

35
Q

Foregut mesentery?

A

Suspended in both a dorsal and a ventral mesentery. This is due to veins and umbilical cord coming in higher up

36
Q

Intra-peritoneal?

A

Completely contained in visceral peritoneum and suspended in mesentery
eg) stomach, liver, gall bladder, spleen, proximal duodenum, SI, appendix, transverse colon, sigmoid colon

37
Q

Retro-peritoneal?

A

Lies between peritoneum and body wall. only has an anterior covering of peritoneum.
eg) kidneys, pancreas, distal duodenum, asc/desc colon, upper 2/3 rectum

38
Q

Greater Sac

A

peritoneal cavity proper

39
Q

lesser sac

A

behind lesser omentum and stomach. Created due to rotation of foregut structures where LO is dragged around to create a pocket)

40
Q

What is the opening to the lesser sac, the free end called?

A 
Omental foramen (foramen of Winslow)
Bound anteriorly by lesser omentum, posteriorly by IVC
41
Q

Paracolic Gutters

A

a peritoneal sulci (groove) lateral to the asc./desc. colons. They create a pathway for peritoneal fluid OR pus, bile, blood to migrate, and sometimes collect within the abdomen.
migration of fluids can cause pain to present in sites distant from affected (leaky organ)
sitting: fluid migrates down, presents as appendicitis
supine: fluid can migrate into lesser sac … abscess

Digestive System (27 decks)

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