Anatomy I (Abdo Walls) Flashcards
Name the layers from external to innermost
Skin>superficial fascia(fatty/membranous)>ext oblique>int oblique>transversus abdominus>transversalis fascia>extraperitoneal fascia>parietal peritoneal fascia
What is mesentery?
double fold of visceral peritoneum
How to the follow attach to the costal margins?
- external oblique
- internal oblique
- transversus abdominus
- overlaps
- edge to edge
- underlaps
3 layers of abdomen are _____laterally and ________medially?
fleshy
aponeurotic
describe the external oblique attachment inferiorly?
free inferior edge = inguinal ligament, from ASIS to pub tub with a triangular opening
Describe the external oblique’s posterior edge?
free
Describe the external oblique’s superior edge?
aponeurotic medially
attaches to pec major and serratus
What is the middle of the abdomen where the external oblique called?
raphe interdigitate
What are the conjoined tendons in the abdomen?
internal oblique and transversus abdominus insert together into the pubic crest
where do the lowermost fibres of internal oblique arise from?
lateral 2/3 of inguinal ligament
Transversus abdominus: how does it attach to costal margins?
underlaps, continuous plane with diaphragm
internal oblique posterior origin?
thoracolumbar fascia
Where do the lowermost fibres of Transversus abdominus arrise from?
lateral 1/2 inguinal ligament
Transversus abdominus does what to insert inferiorly?
arches and joins with internal oblique conjoined tendon and inserts into public crest
the linea alba is in the centre of the abdomen, what lineas are on either side of the rectus abdominals?
linea semilunaris
Where is a marker of the gall bladder on the abdomen?
where the linea semilunaris and external oblique intersects
Where is the arcuate line?
2.5 cm below umbilicus
Whats different in an upper and lower transverse section of abdominal muscles?
upper-internal oblique splits around rectus abdominus
lower-int oblique and TA both run over the rectus abdominus
Which nerves and Where do the nerves of the abdomen run between?
T7-12 and run between internal oblique and transversus abdominus
the nerves of the abdomen: Umbilus is around?
T10
What nerves of the abdomen are between umbilicus and groin?
T11-12
Arteries of anterior abdominal wall?
internal thoracic
superior epigastic
inferior epigastric
superficial epigastric
venous drainage of anterior abdominal wall?
IVC and portal
Where does the teste develop?
in the extraperitoneal fat
How long does it take the teste to traverse into the scrotum?
3 days
Describe the route of the teste:
Start at the extra peritoneal fat in the poster lumbar region inside the abdominal cavity
Travel to the deep ring which is located in the aponeurosis of the transversis abdominis, half way between the ASIS and the pubic tubercle, a finger’s width above the inguinal ligament
Enter the inguinal canal
Travel down the canal and out the superficial ring (the triangle structure)
Go into the scotum
What are the 4 major muscles in the posterior abdomen?
quadratus lumborum
psoas major
Psoas minor
iliacus major
Where is psoas major located in term of near the vertebrae?
between bodies and transverse processes of vertebrae
What is the lateral edge of psoas major like?
straight but oblique
Can you see the lateral edge of the psoas major on x-ray?
yes, abdominal x-ray
Which vertebrae is psoas major originate?
inferior border of T12 to upper L5
Along T12 to L5, psoas major also attaches to what along the way?
discs and the vertebral bodies
Where does psoas major insert?
with iliacus via conjoined tendon into the lesser trochanter
What are located behind the psoas? within the psoas? and in front of the psoas?
behind: lumbar vessels off of aorta
within: lumbar plexus, L1-4 ventral ramus
in front: sympathetic trunks
how many people have psoas minor?
2/3rds of population
Where is the origin and insertion of psoas minor?
origin: T12/L1
inserts with periosteum of pelvis
Where does QL originate?
tip of lumbar transverse processes, inferior aspect of T12
Where does QL insert?
top of iliac crest
What does QL do?
stabilizer and flexor of spine
iliacus fills in what?
fills in the smooth iliac fossa
Where does is insert?
converges with psoas into the lesser trochanter
Does iliacus psoas and QL all have their own fascia?
Iliacus and psoas does
QL does not
Where is QL’s fascia?
within anterior compartment of thoracolumbar fascia
How many compartments in thoracolumbar fascia?
3
anterior
middle
posterior
Where does the posterior thoracolumbar fascia extend?
neck to sacrum
Where does the anterior and middle thoracolumbar fascia extend?
only in thoracolumbar region
how do you get a psoas abcess?
from TB when it’s in the bone, it can burst through but wont’ pierce lumbar fascia, it just runs down the psoas fascia and presents in the hip.
thoracolumbar fascia is origin for what muscles?
internal oblique
transversus abdominis
where in the peritoneum is the kidney?
retroperitoneal
Kidneys are on which muscle?
QL
kidneys are in the paravertebral gutter between which vertebrae?
T12 to L3
Which kidney is lower? why?
right due to liver pushing down on it
what’s the best approach surgically to get to kidneys?why?
posterior or lateral approach both extraperitoneal
Dimensions of kidney?
10x5x2.5cm
Which adrenal gland is a party hat/pyramidal?
right
what is surrounded by its own fibrous capsule, surrounded by fat, then enclosed by peri-renal fat, then extra peritoneal fat?
kidney
outer cortex of kidney is continuous or discontinuous?
continuous
inner medulla of kidney is continuous or discontinuous?
discontinuous medullary pyramids with apex towards hilum
Describe vessels front to back at the hilum of kidney.
renal vein
renal artery
uretery pelvis
nerves&lymphatics
What’s in the renal sinus?
fat
would you want an artery in front of a vein?
nope, it will compress it otherwise
renal artery path from aorta?
behind the IVC
Renal artery divides into how many segments?
5 functional segments so surgical resection is possible if needed
Can you have more than one artery supplying the kidney?
in rare cases if in utero development, it doesn’t shed the accessory arteries as it moves, it could persist into adulthood
Where do the renal veins drain?
IVC
What is path of right and left renal veins into IVC?
Right: straight in
Left: over the aorta, with superior mesenteric artery
Trace the main pathway of structures from cortex to ureter
Cortex>medulla>minor calyces>major calyces>renal pelvis>ureter
how long are ureters and are they muscular?
yes muscular
25-30cm long
Which muscle does the ureters it on?
psoas major
how do ureters get blood supply?
pick up arteries along the way
Where are the 3 places you can get kidney stones stuck in the ureter?
- uretopelvic junction
- crossing of iliac artery
- uretero-vesical junction