Abdominal walls, cavities, regions and planes Flashcards
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Serosa covering the abdominal cavity and reflects on the abdominal viscera
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Peritoneum
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The potential space lined by the peritoneum
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Peritoneal cavity
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Contents of the peritoneal cavity
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ECF
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The abdominal cavity extend superiorly into the thoracic cage up to which intercostal space?
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4th
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Abdominal organs protected by the thoracic cage
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Spleen, part of kidneys, liver, stomach
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Which planes divide the abdominal cavity into 4 quadrants?
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Median plane and transumbilical plane
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The transumbilical plane passes through which level of the vertebra?
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Level of IV disc between L3 and L4
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In which quadrant: jejunum
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Left upper
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In which quadrant: ileum
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Right lower
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In which quadrant: pylorus
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RIght upper
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In which quadrant: gall bladder
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Right upper
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Planes that divide the abdominal cavity into nine regions
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Right and left midclavicular plane, subcostal plane (sometimes, transpyloric plane), and transtubecular plane (sometimes, interspinous plane)
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The midclavicular planes pass from which points to which points?
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From clavicle to midinguinal point
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The subcostal plane is on which level of the vertebra?
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L3
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The subcostal plane is marked by which costal cartilage?
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10th
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The transtubecular plane is on which vertebral level?
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L5
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The transtubecular plane extends from to which points?
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Iliac tubercles
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Plane marked by the 10th costal cartilage
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Subcostal plane
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Horizontal plane on L5
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Transtubecular plane
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Vertebral level of the transpyloric plane
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L1
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Structure that mark the interspinous plane
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ASIS
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Horizontal plane on L3
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Subcostal plane
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Horizontal plane that stretches from iliac tubercle to iliac tubercle
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Transtubecular plane
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Horizontal plane that stretches from ASIS to ASIS
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Interspinous plane
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Horizontal plane on L1
Transpyloric plane
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Horizontal planes of the abdominal cavity
Subcostal and transtubecular plane Transpyloric and interspinous plane Transumbilical plane
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Regions between the right and left midclavicular plane (superior to inferior)
Epigastric, umbilical, pubic regions
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Regions lateral to the midclavicular plane (superior to inferior)
R. and L. hypochondrium, R. and L. lateral, R. and L. inguinal regions
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Superior border of the anterolateral abdomiinal wall
Cartilages of 7-10th ribsa and xiphoid process
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Inferior border of the anterolateral abdominal wall
Inguinal ligament and anterolateral aspects of the pelvic girdle (iliac crest, pubic crest, pubic symphysis)
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Layers of the anterolateral abdominal wall (outer to inner)
Skin, subcutaneous tissue, muscles, extraperitoneal fat, parietal peritoneum
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Layers of the anterolateral abdominal wall's subcutaneous tissue (superficial fascia)
Superficial fatty layer (Camper fascia), deep membranous fatty layer (Scarpa fascia)
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Major site of fat storage in the anterolateral abdominal wall of males
Superficial fascia
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The skin of the anterolateral abdominal wall attaches losely to the subcutaneous tissue except at which area?
Umbilicus
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The parietal epithelium is how many layer of epithelial cells?
One
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Muscles of the anterolateral abdominal wall (outer to inner)
External oblique, internal oblique, transversus abdominis
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Fascia covering the surface of the EO
Superficial investing fascia
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Fascia between EO and IO
Intermediate investing fascia
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Fascia between IO and TA
Deep investing fascia
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Fascia lining the deep surface of TA
Transversalis fascia
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Five (bilaterally paired) muscles of the anterolateral abdominal wall
EO, IO, TA, rectus abdominis, pyramidalis
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Aponeuroses of the RA muscle
Rectus sheath
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The midline raphe formed by the interweaving aponeurosis of the RA
Linea alba
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The linea alba extends from which point superiorly to which point inferiorly?
Xiphoid process to pubic symphysis
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Largest most superficial flat muscle of the AAW
EO
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Direction of EO fibers
Inferomedial (fingers in pocket)
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Direction of IO fibers
Superiomedial (hand on chest)
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Direction of TA fibers
Mostly transverse Inferiormost superomedial
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Above the costal margin, the rectus sheath is formed by which aponeurosis?
EO aponeurosis anterior the RA
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What is the arcuate line?
The crescentic demarcation of the transition between the aponeurosis make up the rectus sheath
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Aponeurosis making up the rectus sheath above the arcuate line
Anterior rectus sheath = aponeurosis of EO and IO Posterior rectus sheath = aponeurosis of IO and TA
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Aponeurosis making up the rectus sheath below the arcuate line
Anterior rectus sheath = aponeurosis of EO, IO, and TA No posterior rectus sheath
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Which part of the rectus sheath does not span the RA?
Posterior rectus sheath
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The posterior rectus sheath is only present on which parts of the rectus sheath?
Below the costal margin, above the arcuate line
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The posterior rectus sheath is composed of which aponeurosis?
Aponeurosis of TA and posterior lamina of IO aponeurosis
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At which point does the IO aponeurosis split into an anterior and posterior lamina?
Below the costal margin, above the arcuate line
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Contents of the rectus sheath
Superior and inferior epigastric vessels RA, pyramidalis Lymphatic vessels Distal thoraco-abdominal nerves (abdominal parts of anterior rami of spinal nerves)
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All layers of the AAW fuse at which point?
Umbilicus
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When does the skin around the umbilicus ring become raised and the umbilicus becomes depressed?
7-14 days after birth, when the atrophic umbilical corf "falls off."
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Dermatome of the umbilicus
T10
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Which are the thoracoabdominal nerves?
T7-T11
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Which is the subcostal nerve?
T12
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What are the five umbilical peritoneal folds of the AAW?
Median umbilical fold (1) Medial umbilical folds (2) Lateral umbilical folds (2)
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Which umbilical fold extends from the umbilicus to the apex of the urinary bladder?
Median umbilical fold
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The median umbilical fold is a remnant of which embryonic structure?
Urachus
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Which umbilical folds are occluded parts of the umbilical arteries?
Medial umbilical folds
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Which umbilical fold is the fibrous remnant of the urachus?
Median umbilical fold
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Which umbilical folds cover the inferior epigastric vessels?
Lateral umbilical fold
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What is the urachus?
An embryonic structure that once joined the apex of the urinary bladder to the umbilicus
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The lateral umbilical fold bleeds when cut. Why is that?
Underneath it is the inferior epigastric vessels
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The peritoneal fossa are potential sites for hernia. T/F
T
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The median umbilical fold extends from which structure to which structure?
From umbilicus to apex of urinary bladder
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Which umbilical fold bleeds when cut?
Lateral umbilical folds
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The peritoneal fossae
Lateral inguinal fossae, medial inguinal fossae, supravesical fossae
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Which fossae lies between the median and medial umbilical folds?
Supravesical fossae
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Which fossae lies lateral to the medial umbilical folds?
Medial inguinal fossae
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Which fossae lies lateral to the lateral umbilical folds?
Lateral inguinal fossae
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Sites for indirect hernia
Lateral inguinal fossa
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Sites for direct hernia
Medial inguinal fossa/ inguinal triangles/ Hesselback triangles
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What lies underneath the medial umbilical folds?
Occluded parts of the umbilical arteries
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Two layers of the peritoneum
Parietal and visceral peritoneum
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Membranous lining of the viscera
Visceral peritoneum
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Membranous lining of the abdominopelvic wall
Parietal peritoneum
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Peritoneal layer with poorly localized pain sensation
Visceral peritoneum
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Peritoneal layer which share the nerve supply of the overlying skin
Parietal peritoneum
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Visceral peritoneum stimulus
Stretching, chemical irritation
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Parietal peritoneum stimulus
Pressure, pain, heat, cold, laceration
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Intraperitoneal organs are only partially covered by peritoneum. T/F
F They are almost completely covered by peritoneum.
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Intraperitoneal organs are located in the peritoneal cavity. T/F
F The peritoneal cavity does not contain organs, but is filled with a thin film of peritoneal fluid.
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The stomach and spleen are extraperitoneal organs. T/F
F They are intraperitoneal.
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The kidney is subperitoneal. T/F
F It is retroperitoneal.
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The urinary bladder is extraperitoneal. T/F
F It is subperitoneal.
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The peritoneal cavity is completely closed in males. T/F
T
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Omentum and mesentery are double layered. T/F
T
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A double layer of peritoneum that occurs as a result of the invagination of the peritoneum by an organ, and constitutes a continuity of the visceral and parietal peritoneum
Mesentery
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A double-layered extension or fold of peritoneum that passes from stomach to proximal parts of the duodenum to adjacent organs in the abdominal cavity
Omentum
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A prominent, four-layered peritoneal fold that hands down like an apron from the greater curvature of the stomach, proximal the duodenum
Greater omentum
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A much smaller double-layered peritoneal fold that connects stomach to a triad of structures that run between duodenum and liver
Lesser omentum
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The parts of the greater omentum
Gastrohepatic ligament, gastrosplenic ligament, gastrocolic ligament
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The parts of the lesser omentum
Hepatogastric ligament, hepatoduodenal ligament
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Connects intraperitoneal organs to the body wall: omentum or mesentery
Mesentery
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The supracolic and infracolic compartments of the greater sac is divided by which structure in abdomen?
Transverse colon
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Organs of the supracolic compartment
Stomach, liver, pancreas
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Organs of the infracolic compartment
Small intestine, ascending and descending colon
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Which mesentery is known as 'the mesentery'?
The mesentery of the small intestines
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In the suprapubic area, the posterior rectus sheath is formed by A. External oblique aponeurosis B. Internal oblique aponeurosis C. Transversus abdominis aponeurosis D. AOTA E. NOTA
E
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The outermost covering of the spermatic cord within the inguinal canal? A. cremaster muscle B. external spermatic fascia C. internal spermatic fascia D. processus vaginalis
B
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Hernia is due to the weakness of which border of the inguinal canal? A. Anterior Wall B. Posterior Wall C. Roof D. Floor
B
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Which demarcates the suprapubic area from the umbilical region? A. Transpyloric plane B. Transumbilical plane C. Transtubercular plane D. Subcostal plane
C
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What is the remnant of the umbilical artery? A. Median umbilical ligament B. Medial umbilical fold C. Medial umbilical ligament D. Median umbilical fold
C
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The limits of the pelvic outlet includes the following except? A. Ischial tuberosity B. Coccyx C. Pubic arch D. Arcuate line
D
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These ligaments do not provide support for the urinary bladder: a. pubovesical ligaments b. median umbilical ligaments c. middle umbilical folds d. puboprostatic ligaments
C
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The omental sac communicates with the greater sac through which opening?
Omental (epiploic) foramen
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The cremasteric fascia is made of: A. External oblique B. Transversusabdominis C. Internal oblique D. Transversus fascia
C
