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Phase 1 - Anatomy > Anatomy - The Abdominal Wall > Flashcards

Anatomy - The Abdominal Wall Flashcards

1
Q

What 2 vertical lines divide the abdomen into it’s 9 nine regions?

A

Mid-clavicular lines that extend to the mid-inguinal point.

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2
Q

What 2 horizontal lines divide the abdomen into it’s 9 nine regions?

A

transpyloric: joins lower coastal margins.

Intertubercular: connects the iliac crests.

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3
Q

How would you draw the transpyloric plane?

A

Half way between the suprasternal notch and the pubic symphysis.

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4
Q

What vertebral level is the transpyloric plane found?

A

L1.

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5
Q

Name 5 structures found on the transpyloric plane.

A
  1. Pylorus of stomach. 2. Fundus of gall bladder. 3. Pancreas. 4. Hilum of Kidneys. 5. Duodenojejunal flexure.
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6
Q

How would you draw the transtubercular plane?

A

Joins the iliac crests of the pelvis.

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7
Q

What vertebral level is the transtubercular plane found at?

A

L4. (Same level as the bifurcation of the abdominal aorta).

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8
Q

What is the intercristal plane?

A

It joins the highest points of the pelvis at the back.

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9
Q

What vertebral level is the intercristal plane found at? Why is this important?

A

Between the L4 and L5 vertebrae. This is important for lumbar punctures and epidurals.

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10
Q

What is the subcostal plane and at what vertebral level does it lie?

A

It joins the lower points of the costal margins and lies at the L2 level.

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11
Q

What can the subcostal plane (L2) be a marker for?

A
  • The end of the spinal cord. - The superior mesenteric artery.
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12
Q

What is McBurney’s point?

A

2/3 of the way along a line extending from the umbilicus to the right anterior superior iliac spine.

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13
Q

What is the significance of McBurney’s point?

A

Marks the base of the appendix and can act as a guide for the location of the caecum.

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14
Q

Name the 3 flat muscles of the Abdominal wall.

A
  1. External Oblique. 2. Internal Oblique. 3. Transversus Abdominis.
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15
Q

In what direction do the fibres of the flat muscles run in?

A
  1. External oblique - inferiorly and medially (down and in). 2. Internal oblique - superiorly and medially (up and in). 3. Transversus abdominis - transversely.
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16
Q

What is the origin of external oblique?

A

Lower 8 ribs and thoraco-lumbar fascia.

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17
Q

What is the insertion of external oblique?

A

Pubic crest, pubic tubercle, iliac crest and linea alba.

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18
Q

What is the origin of internal oblique?

A

Thoraco-lumbar fascia, iliac crest, lateral 1/2 of the inguinal ligament.

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19
Q

What is the insertion of internal oblique?

A

Linea alba, pubic tubercle.

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20
Q

What is the origin of transversus abdominis?

A

Thoraco-lumbar fascia, iliac crest, lateral 1/3 of the inguinal ligament.

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21
Q

What is the insertion of transversus abdominis?

A

Linea alba, pubic tubercle.

22
Q

What are the fibrous intersections of the rectus abdominis called?

A

Tendinous intersections.

23
Q

What are the attachments of rectus abdominis?

A

Rectus sheath, pubis, costal cartilages.

24
Q

Name 5 structures contained within the rectus sheath.

A
  1. Rectus Abdominis. 2. Sup and inf epigastric arteries. 3. Sup and inf epigastric veins. 4. Nerves. 5. Lymphatics.
25
Q

What is the inferior epigastric artery a branch of?

A

The external iliac artery.

26
Q

What is the internal thoracic artery a branch of? And what does it supply?

A

It is a branch of the subclavian artery and it supplies the anterior chest and abdominal wall and also the breasts.

27
Q

Define dermatome.

A

An area of skin supplied by nerves from a single spinal root.

28
Q

What are the dermatomes of the abdominal wall?

A

T7 to L1.

29
Q

If a disease process involves the peritoneum of the abdominal wall, then the pain is localised. Why is this?

A

The peritoneum covering the inside of the abdominal wall has the same sensory nerve supply as the overlying skin.

30
Q

What are the four main functions of the abdominal wall?

A
  • firm yet flexible boundary, that keeps the abdominal viscera in anatomical positions against gravity
  • protect the abdominal viscera from injury
  • assist enforceable exploration by pushing the abdominal viscera inwards
  • involved in any action that increases the intra-abdominal pressure eg coughing
31
Q

Name the four main layers of the abdominal wall (externally to internally)?

A
  • skin
  • superficial fascia
  • muscles and associated fascia
  • parietal peritoneum
32
Q

Describe the difference in the superficial fascia Above the umbilicus below the umbilicus?

A
  • above - single sheet connective tissue continuous with other regions
  • below - divided into two layers: fatty superficial layer (camper’s fascia) and membranous deep layer (scarpa’s fascia)
  • superficial vessels and nerves run in between these two layers
33
Q

Describe the two Muscle groups on the anterior lateral abdominal wall?

A
  • Flat muscles - three situated laterally on either side of the abdomen
  • vertical muscles - two situated near the midline of the body
34
Q

Describe how the three flat must are positioned?

A
  • fibres running different directions crossing each other
    • strengthening the wall and decreasing the risk of abdominal contents her negating through
35
Q

Where is the abdominal aponeurosis formed?

A
  • broad flat tendon
  • on the anterior medial aspect of the abdominal wall each muscle forms an aponeurosis
  • Covers the vertical rectus abdominis muscle
36
Q

What occurs when the aponeurosis intertwine?

A
  • entwine at the midline
  • forms linea alba
  • fibrous structure that extends from the xiphoid process of the stone into the pubic symphysis
37
Q

Describe the external oblique muscle? attachments function and innervation?

A
  • largest most superficial flat muscle
  • run inferomedially ( hands in pocket)
  • originates from ribs 5 to 12, inserts of the iliac crest and pubic tubercle
  • Contralateral rotation of the torso
  • innervated by T7-T11 and T12
38
Q

Describe the internal oblique muscle? Attachments function innervation?

A
  • Lies deep to the external oblique, smaller and thinner
  • Runs superomedially
  • Originates from the inguinal ligament, iliac crest and lumbodorsal fascia
  • Insert into ribs 10 to 12
  • bilateral contraction compresses the abdomen, while unilateral contraction ipsilaterally rotates the torso
  • Innervation is T7-T11 and T12 and branches of the lumbar plexus
39
Q

Describe the transversus abdominis Muscle? attachments function and innervation?

A
  • deepest muscle, runs transversely
  • deep to this is a well formed layer of fascia, called transversalis fascia
  • Originates from the inguinal ligament, costal cartilages 7-12, the iliac crest and thoracolumbar fascia
  • inserts onto the conjoint tendon, xiphoid process, linea alba and pubic crest
  • Compression of the abdominal contents
  • Innervation by T7-11, T12 and branches of the lumbar plexus
40
Q

Describe the vertical abdominal muscle rectus abdominis?

A
  • paired muscle found each side of the midline (4 in total)
  • Split into by the linea alba
  • create surface markings known as linea semilunaris
  • Intersected by fibrous strips, known as tendinous intersections
  • Originates from the crest of the pubis before inserting into xiphoid process of the sternum and costal cartilages of ribs 5-7
  • Compresses the abdominal viscera, stabilises the pelvis during walking and depresses the ribs
  • innervation from T7-11
41
Q

Describe the vertical abdominal muscle pyrimidalis?

A
  • small triangular muscle found superficially to rectus abdominis
  • Located inferiorly with base on the pubis bone, apex of the triangle attaches to the linea alba
  • originates from the pubic crest and pubic symphysis for inserting into the linea alba
  • axed to tense the linea alba
  • T12
42
Q

Describe the location of the umbilicus?

A
  • roughly halfway between the xiphoid process and pubic symphysis
43
Q

What indicates the lateral and medial borders of the rectus abdominis?

A
  • linea semilunaris
    • curved line running from the ninth rib to the pubic tubercle
  • linea alba
  • Visible as a virtual groove extending inferiorly from the xiphoid process
44
Q

Describe the 2 horizontal and 2 vertical planes that split the abdomen into nine regions?

A
  • horizontal planes:
    • transpyloric - halfway between the jugular notch and pubic symphysis ( at the level of L1)
      • the gallbladder, the pancreas, the pylorus of the stomach and duodenal-jejunal flexure all lines plain
    • intertubercular - runs between the superior aspect of the right and left iliac crest (Bifurcates the abdominal aorta)
    • (Sub coastal plane - lowest point the costal margin)
    • (Intercristal plane - Lies across the highest point of the pelvis)
  • vertical planes
    • mid-clavicular to mid inguinal points
45
Q

Describe the rectus sheath?

A
  • the fascial covering of the rectus abdominis and pyramidalis muscles
  • formed by aponeuroses of the three flat muscles
  • Anterior wall is formed by - external oblique and half of internal oblique
  • posterior wall is formed by - half of internal oblique and transversus abdomis
  • halfway between the umbilicus and pubic symphysis, all muscle is the anterior wall
    • at this point there is no posterior wall so the rectus abdominis is in direct contract with the transversalis fascia
    • this is called the arcuate line
46
Q

What is aponeurosis?

A
  • Takes place of a tendon in a flat muscle that has a wide area attachment (sheet)
47
Q

Describe the inguinal ligament? What is found just above it?

A
  • the lowest most extent of the external oblique muscle inferiorly is attached to the anterior superior iliac spine laterally and the pubic tubercle medially
  • inguinal canal, Transmits all structures to and from the testes
48
Q

Name the six bony landmarks of the abdomen?

A
  • xiphisternum
  • Coastal margin
  • iliac crest
  • Anterior superior iliac spine
  • pubic tubercle
  • pubic symphysis
49
Q

Describe McBurney’s point?

A
  • Perpendicular line, point is two thirds of the way along between the umbilicus and right anterior superior iliac spine
  • base of the appendix
  • a guide to the position of the caecum
  • Splits the fibres of the muscle without cutting them
50
Q

Describe the positioning of the umbilicus?

A
  • often unreliable
  • around the level of L3
51
Q

What is the upper extent of the abdominal cavity?

A
  • anteriorly the under surface of the diaphragm reaches the 5th intercostal space
52
Q
A

Phase 1 - Anatomy (29 decks)

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