Anatómía abdomen og pelvis Flashcards
Innihald rectus sheath (5):
- The rectus abdominis muscle
- The pyramidalis muscle
- The superior epigastric vessels
- The inferior epigastric vessels
- The ventral primary rami of T7-T12 nerves
Hvaða tvö lög eru fyrir ofan rectus sheath?
- Camper’s fascia (anterior part of the superficial fascia)
- Scarpa’s fascia (posterior part of the superficial fascia)
Hvaða 3 lög eru fyrir neðan rectus sheath?
- Transversalis fascia
- Extraperitoneal fat
- Parietal peritoneum
Úr hverju er rectus sheath?
The rectus sheath is formed by the aponeurosis of the three flat muscles: transversus abdominis and the external and internal oblique muscles.
Í hvaða 3 lög skiptist rectus sheath og úr hverju eru þau?
- An anterior layer consisting of the aponeurosis of the external oblique and internal oblique
- A posterior layer consisting of the fused aponeurosis of the internal oblique and transversus abdominis
- A cresenteric line of transition called the arcuate line between the tranversalis fascia and the aponeurotic posterior wall of the rectus sheath
Í hvaða tvo hópa skiptast abdominal lymph nodes?
The abdominal lymph nodes can be broadly divided into pre-aortic and para-aortic groups, depending upon their relationship to the aort
Hvar liggja pre-aortic hópur abdominal eitla?
The pre-aortic nodes lie anterior to the aorta and lie around the origins of the visceral (anterior) arteries.
Hvað drenera pre-aortic abdominal eitlar?
- gastrointestinal tract
- and its accessory viscera (liver, spleen and pancreas).
Pre-aortic eitlar eru annar hópur abdominal eitla. Í hvaða 3 undirhópa skiptast þeir svo?
- Coeliac lymph nodes
- Superior mesenteric lymph nodes
- Inferior mesenteric lymph nodes
Hvert drenera pre-aortic eitlar í abdomen?
Í intestinal trunk, sem drenerar svo í cisterna chlyi.
Hvað drenera Coeliac lymph nodes sem eru hluti af pre-aortic eitlum? (5)
- Stomach
- Most of the duodenum
- Liver and biliary tree
- Pancreas
- Spleen
Hvað drenera superior mesenteric lymph nodes, sem eru hluti af pre-aortic eitlum? (5)
- Part of the duodenum
- Jejunum and ileum
- Caecum and appendix
- Ascending colon
- Transverse colon
Hvað drenera inferior mesenteric lymph nodes, sem eru hluti af pre-aortic eitlum? (3)
- Descending colon
- Sigmoid colon
- Upper rectum
Hvað heita ligamentin fjögur í symphysis pubis?
Anterior pubic ligament
Posterior pubic ligament
Superior pubic ligament
Inferior (arcuate) pubic ligament
Hvaða tvö ligament í symphysis pubis eru sterkari en hin?
The anterior and posterior pubic ligaments are weaker than the superior and inferior pubic ligaments, which provide most of the joint’s stability.
Hvaða ligament í symphysis pubis er stærst og þykkast og hvernig liggur það?
The inferior (arcuate) pubic ligament is the largest and thickest of the pubic ligaments. It is triangular in shape and connects the two pubic bones inferiorly, forming the upper border of the pubic arch. It attaches to the fibrocartilage superiorly and the inferior pubic ramus of the pubic bones laterally.
Í hvaða 4 svæði skiptist maginn?
- The cardia – which is around the opening of the oesophagus
- The fundus – which is the dilated superior portion lying beneath the left dome of the diaphragm
- The body – which is the large central position lying between the fundus and the pylorus
- The pylorus – which is the lower portion that facilitates the emptying of its contents into the duodenum
Hvaðan koma greater og lesser omentum?
Frá greater og lesser curvatures maga, respectively.
Hvar er angular notch?
Á maga á lesser curvature - milli pylorus og body.
Í hvaða hluta skiptist duodenum og hvernig liggja þeir?
- The superior (first) part:
This superior part is short (around 5 cm long) and lies anterior to the body of L1. It is connected to the liver by the hepatoduodenal ligament. The first 2 cm is mobile and is referred to as the duodenal cap. Duodenal ulcers are most likely to occur in this part of the duodenum.
- The superior (first) part:
- The descending (second) part:
This is the longest part (around 7-10 cm long) and descends long the right side of the L1-L3 vertebrae. This part curves inferiorly around the head of the pancreas.
- The descending (second) part:
- The inferior (third) part:
This part is around 6-8 cm long and passes laterally to the left crossing the body of L3. This part crosses anteriorly over the inferior vena cava and aorta and is located inferiorly to the pancreas.
- The inferior (third) part:
- The ascending (fourth) part:
The ascending part is short (around 5 cm long). It begins to the left of L3 and ascends to the level of the superior border of L2. During its ascent is curves anteriorly at a sharp turn referred to as the duodenojejunal flexure.
- The ascending (fourth) part:
Hvaða hluti duodenum er tengdur við lifur með hepatoduodenal ligamenti?
Fyrsti hlutinn.
Hvað er duodenal cap?
Fyrstu 2 cm í fyrsta hluta duodenum. Þetta er mobill partur duodenum.
Hvaða partur duodenum er lengstur og fer inferiort kringum höfuð pancreas?
Annar partur.
Hvaða partur duodenum fer anteriort yfir inferior vena cava?
Þriðji partur.
Hvaða líffæri sjáum við á T11 á CT?
Þind, lifur, aortu, milta, maga, hrygg.
Hvaða líffæri sjáum við í hæð við T12 á CT?
Þind, lifur, aortu, milta, maga, hrygg.
Bætist svo við vinstra nýra.
Inferior vena cava sást á T11 líka en betur hér.
Hvaða líffæri sjáum við í hæð við L1 á CT?
Þind, lifur, aortu, milta, maga, hrygg, bæði nýru, gallblöðru, oft pylorus og upphaf duodenum. Pancreas.
Upphaf superior mesenteric artery.
Portal vein.
Hvaða líffæri sjáum við í hæð við L2 á CT?
Þind, lifur, aortu, maga, hrygg, bæði nýru og nú nýrnaslagæðarnar, gallblöðru. Pancreas.
Superior mesenteric artery.
Portal vein.
Miltað horfið.
Hvaða líffæri sjáum við í hæð við L3 á CT?
Aortu, maga, hrygg, bæði nýru og nú nýrnaslagæðarnar, gallblöðru. Pancreas.
Superior mesenteric artery.
Portal vein.
Inferior mesenteric artery kemur inn.
Psoas vöðvinn.
Hvaða líffæri sjáum við í hæð við L4 á CT?
Aorta skiptist í hæ og vi common iliaca, maga, hrygg, neðri hlutann á nýrum. Pancreas.
Superior mesenteric artery.
Portal vein.
Inferior mesenteric artery.
Psoas vöðvinn.
Hvort nýrað er lægra?
Hægra, út af lifrinni þar fyrir ofan.
Coeliac artery og superior mesenteric artery eru greinar frá…
…aortu.
Í hæð við L3 ganga tvær æðar út frá aortu…
…hægri og vinstri nýrnaslagæðar
Rétt fyrir neðan nýrnaslagæðar gengur hvaða æð út frá aortu?
Testicular arteries (langar mjóar æðar sem fara niður)
Aorta skiptist í hæð við…
…L4
Hægra megin við hana í svipaðri hæð renna iliaca æðarnar saman og mynda inferior vena cava.
Tveir þrengstu staðirnir í ureterum:
- Pelvic uritary junction
- Þar sem ureter fara anteriort við iliaca æðarnar.
Meðallengd botnlangans:
11cm
Hvernig þekkjum við ristilinn á rtg?
Haustrae fara ekki alla leið yfir ristilinn.
Utan um nýrun eru 4 lög af fitu og fasciu. Telja þau upp í röð frá superficial til deepest:
- Pararenal fat
This lies external to the renal fascia and is mostly located on the posterolateral aspect of the kidney. - Renal fascia
This encloses the kidney and sends bundles of collagen through the fat, which assist in holding the kidney in position. It ascends to envelop the adrenal glands superiorly. - Perirenal fat
This is continuous with the fat in the renal sinus at the hilum of the kidney. - Renal capsule
This is the tough fibrous capsule that surrounds the kidney. It provides a limited amount of protection against trauma and damage.
Hvers vegna eru fasciulögin kringum nýrun mikilvæg? Hvar festist renal fascian við kviðvegginn?
The attachments of the renal fascia are clinically important as they prevent the extension of perinephric abscess pus. The renal fascia is attached to the posterior abdominal wall inferiorly and to the renal vessels and ureter at the hilum. These attachments serve to prevent the extension of pus.
2 algengustu staðirnir fyrir sár í efri hluta meltingarvegar sem valda blæðingu og hvaða æðar eru þar?
The two most common sites of ulcers that cause haemorrhage are
- the posterior duodenum, eroding the gastroduodenal artery
- the lesser curvature of the stomach, eroding branches of the left gastric artery.
Small intestine mesentery: hvað er það, hvernig er það í laginu og hvar festist það?
- The small intestine mesentery is a large, broad, fan-shaped mesentery that is attached to the jejunum and ileum, connecting them to the posterior wall of the abdominal cavity.
- Superiorly the root of the mesentery is attached to the duodenojejunal junction just to the left of the L2 vertebra.
- It runs obliquely downwards, from left to right, to attach inferiorly to the ileocaecal junction close to the right sacroiliac joint.
7 lög kviðveggjarins, frá dýpsta að ysta:
- Parietal peritoneum (deepest)
- Extraperitoneal fat
- Transversalis fascia
- Aponeurosis of transverse abdominis and internal oblique
- Rectus abdominis muscle
- Aponeurosis of internal oblique and external oblique muscles
- Superficial fascia (most superficial)
Superficial fascian sem er yst í kviðveggnum skiptist í tvennt:
- Camper’s fascia (anterior part of the superficial fascia)
- Scarpa’s fascia (posterior part of the superficial fascia)
Hvað og hvar er dentate línan (pectinate línan) og
The dentate line (pectinate line) is a line that divides the upper two-thirds and the lower third of the anal canal. It represents the line of division between the embryonic hindgut-proctodeum junction. As a general rule, the neurovascular supply and lymphatics of the anal canal differ above and below this line.
Ítaugun anal canal fyrir ofan dentate línu:
Above the dentate line, the anal canal has visceral innervation provided by the inferior hypogastric plexus and is, therefore, sensitive to stretch only.
Ítaugun anal canal fyrir neðan dentate línu:
Below the dentate line, the anal canal has somatic innervation provided by the inferior anal nerves (also referred to as the inferior rectal nerves), which are branches of the pudendal nerve. It is, therefore, sensitive to pain, touch, temperature and pressure.
Anal reflexinn: hvernig og hvaða taugarætur:
The anal reflex is the reflexive contraction of the external anal sphincter that occurs when the skin around the anus is stroked. The tactile stimulus of the skin triggers a reflex arc that is carried via the pudendal nerve to the S2-S4 spinal segments. This is often utilised in neurological assessment, and the absence of the reflex can indicate damage to the spinal cord.
Hvaða 3 lög af kviðveggnum eru fyrir neðan rectus sheath?
Transversalis fascia
Extraperitoneal fat
Parietal peritoneum
Hvaða 5 atriði eru inni í rectus sheath?
The rectus abdominis muscle The pyramidalis muscle The superior epigastric vessels The inferior epigastric vessels The ventral primary rami of T7-T12 nerves
Hver er algengasta ástæða pneumoperitoneum?
The most common cause of pneumoperitoneum is a perforated peptic ulcer, and the most frequent perforation site is the anterior wall of the first part of the duodenum.
Í hvaða hæð hryggjarliða er nafli?
The umbilicus lies at L3/L4.
Hvar er lægsti punktur thoracic cage?
The subcostal plane (the lowest point of the thoracic cage) lies at L2.
Hvar er efsti punktur lifrarinnar?
The upper border of the liver lies at T6.
Í hvaða hæð er suprasternal notch?
The suprasternal notch lies at T2/T3.
Í hvaða 4 hluta skiptist þvagblaðran anatómískt:
- The apex – which is located superiorly and points towards the superior edge of the pubic symphysis
- The body – the large central portion located between the apex and the fundus
- The fundus (base) – which is triangular in shape and located posteroinferiorly
- The neck – which is the point where the fundus and inferolateral surfaces converge
Hvar eru inguinal lymph nodes og hvað eru þeir margir?
The inguinal lymph nodes are located in the upper aspect of the femoral triangle. There can be up to twenty of these lymph nodes present in this area.
Hvert fer lymphan úr testes og scrotum?
The lymph from the testes drains into the para-aortic lymph nodes, whilst that from the scrotum drains into the superficial inguinal lymph nodes.
Í hvaða tvo hluta skiptast inguinal lymph nodes og hvað drenera þeir?
- The deep inguinal lymph nodes:
- These are located medial to the femoral vein and under the cribriform fascia. There are usually between three and five nodes in this area.
- The most superior of these nodes is called Cloquet’s node and is located under the inguinal ligament.
- They drain the deep parts of the lower limbs, the penis in the male, and the clitoris in the female.
- The deep inguinal lymph nodes drain superiorly into the external iliac lymph nodes, then to the pelvic and para-aortic lymph nodes. - The superficial inguinal lymph nodes:
- These form a chain immediately below the inguinal ligament and lie deep to Camper’s fascia. There are usually around ten nodes in this area.
- They drain into the deep inguinal nodes. There are broadly speaking three groups of superficial inguinal lymph nodes:
- Inferior: lie inferior to the saphenous opening and receive drainage from the lower legs
- Superolateral: lie on the side of the saphenous opening and receive drainage from the buttocks and the lower abdominal wall
- Superomedial: lie in the middle of the saphenous opening and receive drainage from the perineum, the outer genitalia (including the scrotum), and the anus below the pectinate line.
5 atriði sem þreifast anteriort í rectum hjá kk:
The prostate gland The seminal vesicles The rectovesical pouch The bulbourethral glands The full bladder
5 atriði sem þreifast anteriort per rectum hjá kvk:
The vagina The cervix The pouch of Douglas The broad ligaments The uterine tubes and ovaries
2 atriði sem þreifast lateralt og 3 sem þreifast posteriort í rectum:
Lateralt:
- The ischial tuberosity and spine
- The sacrotuberous ligament
Posteriort:
- The sacrum
- The coccyx
- anococcogyal ligament
Leiðin sem gallið fer frá lifur út gegnum sphincter of Oddi.
The biliary tract begins as the interlobular bile ducts form the right and left hepatic ducts. These two ducts merge to form the common hepatic duct, which is situated alongside the hepatic vein.
The common hepatic duct exits the liver and joins with the cystic duct from the gallbladder to form the common bile duct. The common bile duct is sometimes referred to as the ‘trunk of the biliary tree’ and, together with the hepatic artery and hepatic portal vein, forms the central axis of the portal triad.
The common bile duct passes downwards posteriorly to the proximal duodenum and joins with the pancreatic duct from the pancreas to form the ampulla of Vater. The ampulla of Vater opens into the duodenum, and the release of bile at this point is controlled by a muscular valve called the sphincter of Oddi.
3 atriði sem eru anteriort við ascending colon:
Anterior abdominal wall
Small intestine
Greater omentum
5 atriði sem eru posteriort við ascending colon:
Quadratus lumborum Iliacus Right kidney Iliohypogastric nerve Ilioinguinal nerve
2 atriði sem eru anteriort við transverse colon:
Anterior abdominal wall
Greater omentum
4 atriði sem eru posteriort við transverse colon:
Duodenum
Jejunum
Ileum
Head of pancreas
3 anteriort við descending colon:
Anterior abdominal wall
Small intestine
Greater omentum
5 atriði sem eru posteriort við descending colon:
Quadratus lumborum Iliacus Left kidney Iliohypogastric nerve Ilioinguinal nerve
3 atriði sem eru anteriort við sigmoid colon:
Urinary bladder
Uterus (females)
Upper vagina (females)
2 atriði sem eru posteriort við sigmoid colon:
Rectum
Sacrum
Hvernig liggur anterior hluti sacroiliac ligamentsins:
The anterior sacroiliac ligament consists of numerous thin bands that pass from the anterior surface of the lateral part of the sacrum to the margin of the auricular surface of the ilium.
Posterior sacroiliac ligamentið - hvar liggur það og hvernig liggja efri og neðri hlutar þess:
The posterior sacroiliac ligament is situated in the depression between the sacrum and the ilium. It is a strong ligament that forms the main bond of union between the two bones. It can be divided into an upper and a lower part:
- The upper part passes horizontally from the 1st and 2nd transverse tubercles on the back of the sacrum to the tuberosity of the ilium
- The lower part passes obliquely from the 3rd transverse tubercle on the back of the sacrum to the posterior superior iliac spine
