Abdominal Walls and Peritoneum Flashcards
Central landmark of the surface anatomy of the abdomen?
Umbilicus
What is the superior boundary of the abdomen ?
Diaphragm (5th intercostal)
A tendinous line that extends from the xiphoid process to the pubic symphysis.
Linea alba
How many regions are in the abdominal cavity?
9
What makes up the superficial fascia of the abdominal wall?
Camper’s fascia
Scarpa’s fascia
Cutaneous nerves
Superficial vessels
What lies underneath the superficial fascia of the abdominal wall?
Deep fascia
Nerves that innervate the anterior abdominal wall
Lower 6 thoracic nerves
Lumbar Plexus (L1)
(Illioinguinal + Iliohypogastric = L1)
Innervation of the Abdominal Wall
- Thoracoabdominal Nerves (T7-T11)
- Lateral Cutaneous Branch of Subcostal Nerve (T12)
- Anterior Cutaneous Branch of Subcostal Nerve (T12)
- Lumbar Plexus (L1)
Where does the L1 plexus arise from?
Anterior Rami of L1
What two nerves make up L1
Illioinguinal
Iliohypogastric
Skin near the midline is supplied by what?
Superior and Inferior Epigastric Arteries
What arteries supply the skin of the flanks?
Intercostal a.
Lumbar a.
Deep Circumflex Iliac a.
What arteries supply skin in the inguinal region?
Superficial Epigastric a.
Superficial Circumflex Iliac a.
Superficial External Pudendal a.
Two branches of the internal thoracic artery (that we need to know)
Musculophrenic a.
Superior Epigastric a.
Musculophrenic Artery
branches to the aortic intercostal a.
Supplies:
- pericardium
- diaphragm
- abdominal muscles
Superior Epigastric Artery
- enters the sheath of the rectus abdominus
- pierces the rectus abdominus muscle
- anastomoses with the inferior epigastric artery
What are the branches of the external iliac artery?
Inferior Epigastric a.
- External Spermatic a. or Cremasteric
Deep Iliac Circumflex a.
What are the branches of the femoral artery?
Superficial Epigastric a.
Superficial External Pudendal a.
What artery is the dominant vascular supply to the anterior abdominal wall?
Inferior Epigastric
What is the most common cause of portal hypertension?
Cirrhosis
Blockage of what vein causes Caput Medusa?
Paraumbilical Vein
Blockage of what veins causes esophageal varices?
Esophageal Veins
Blockage of what veins causes hemorrhoids?
Rectal Veins
Where does lymph from above the umbilicus drain into?
Pectoral Lymph Nodes in the Axilla
Where does lymph from below the umbilicus drain into?
Superficial Inguinal Lymph Nodes
What are the muscles of the anterior abdominal wall?
External Oblique
Internal Oblique
Transversus Abdominis
External Oblique Aponeurosis
Internal Oblique Aponeurosis
What is the name of location where the inferior epigastric vessels enter the rectus sheath?
Arcuate Line
Where is the arcuate line located?
5 cm below the umbilicus
What separates the rectus sheath into superior and inferior portions?
Arcuate Line
Name of the location where the abdominal cavity ends?
Sacral Promontory
What muscle forms lateral half of the inguinal canal, the rectus sheath, and inguinal falx?
Internal Oblique
What structure covers the upper 3/4 of the rectus abdominus, but only covers the anterior portion of the lower 1/4 of the rectus abdominus?
Rectus Sheath
What type of hernia is usually seen up to the age of 3 and after the age of 40?
Umbilical Hernia
What type of hernia is often seen in the epigastric region, are more common in males, and rarely contain visceral structures?
Linea Alba Hernia
What type of hernia usually occurs in midlife and develops slowly?
Linea Semilunaris (spigelian) Hernia
What type of hernia occurs at the site of a previous laparotomy scar?
Incisional Hernia
Remnant attachment of the the umbilical cord
Umbilicus
Name the umbilical ligaments
Median
Medial (paired)
Lateral (paired)
Name the 5 muscles of the posterior abdominal wall
Iliacus
Psoas Major
Psoas Minor
Qudratus Lumborum
Diaphragm
What muscle allows for flexion of the thigh at the hip and lateral flexion of the vertebral column?
Psoas Major
Flexion of the vertebral column
Only present in 60% of people
Psoas Minor
Fan shaped muscle that allows flexion of the thigh at the hip joint
Iliacus
Nerve that innervates the anterior and lateral thigh muscles, as well as medial leg and ending at the foot.
- Most important nerve from the lumbar plexus
Femoral Nerve
What else does the femoral nerve innervate
Quadratus femoris
Iliopsoas
Sartorius muscle with motor coordination
What plexus is formed by the ventral rami of L1-L4?
Lumbar Plexus
What are the peripheral branches of the lumbar plexus?
Iliohypogastric
Ilioinguinal
Genitofemoral
Lateral Femoral Cutaneous
Femoral
Obturator
Space between the parietal and visceral layers
Peritoneal Cavity
Peritoneum that lines that abdominal wall
Parietal
Peritoneum that lines the viscera
Visceral
What are the two layers of the peritoneum?
Parietal
Visceral
Functions of the peritoneum
Location of blood and lymph vessels
Lubrication
Serous fluid production
Suspension of organs
Limits infection spread
Adhesions
Double layer of peritoneum connecting the viscera to the abdominal wall
Mesentery
Double layer attached to the stomach
Omentum
Layers that connect viscera to the the abdominal wall
Peritoneal Ligament
Blinds sacs with a single opening into the peritoneal cavity
Recess
What is the lowest point in the peritoneal cavity when lying supine?
Hepatorenal Recess
(Morrison’s Pouch)
Inflammation generates a sticky fluid containing fibrin that glues the greater omentum to the inflamed areas.
Peritonitis
What is referred pain?
Organ itself doesn’t hurt, the nerve it touches does.
