Anatomy Topic 4 Case 1 Flashcards
Describe the protective role of the abdomen
- Abdomen houses elements of the GI tract, spleen and urinary system
- Much of the viscera is under the diaphragm and is protected by the thoracic wall
Describe the abdomen’s role in inspiration
- Abdominal muscles relaxes
- To accommodate expansion of the thoracic cavity
- To cause inferior displacement of abdominal organs during contraction of diaphragm
Describe the abdomen’s role in expiration
- Abdominal muscles contract
- To assist in elevating the domes of the diaphragm
- Reducing thoracic volume
How is intraabdominal pressure increased and what is the purpose of this.
- Contraction of abdominal wall muscles
- Assisting in voiding the contents of the bladder, rectum and in giving birth
Which planes form the four-quadrant pattern
- Transumbilical plane passing through umbilicus at the level of L3/L4
- Vertical median plane passing in the mid-sagittal plane
Which planes form the nine-quadrant pattern?
- Subcostal plane at the level of L3 / rib 10
- Intertubercular plane connecting tubercles of iliac crests and L5
- Midclavicular planes passing in the sagittal plane between the midpoint of the clavicle and
Identify the nine regions of the abdomen
- Right and left hypochdonrium, separated by epigastric region
- Right and left flank, separated by umbilical region
- Right and left groin, separated by the pubic region.
Where is a craniocaudal incision performed and what is the purpose?
- Incision from xiphoid process to pubic symphysis
- Provides access to whole of abdominal contents for an exploratory procedure
What is laparoscopic surgery? Identify an advantage of this type of surgery
- Keyhole surgery through small incisions no more than 2cm in length
- Less postoperative pain and shorter recovery times
What are the palpable landmarks used to delineate the extent of the abdomen?
- Costal margin above
- Pubic tubercle and ASIL above
A line between which structures marks the position of the inguinal ligament? What is the purpose of the inguinal ligament?
- Pubi tubercle and ASIL
- Separates anterior abdominal wall above from thigh below
What is the superficial inguinal ring and where is it located?
- Triangular defect in aponeurosis of external oblique
- External opening of inguinal canal
- In lower medial aspect of anterior abdominal wall
What passes through the superficial inguinal ring in men?
- Spermatic cord
What passes through the superficial inguinal ring in women?
- Round ligament of uterus
What is the deep inguinal ring and where is it located?
- Internal opening to inguinal canal
- Superior to inguinal ligament midway between ASIL and pubic symphysis
Where can the femoral pulse be felt?
- Inferior to inguinal ligament
- Midway between ASIL and pubic symphysis
Where is the transpyloric plane located?
- L1 / rib 9 level
- Transverse plane
- Midway between jugular notch and pubic symphysis
Where is the supracristal plane located
- L4
- Transverse plane
- Through highest point of iliac crests
Identify structures found at the level of L1 / transpyloric plane
- Upper limit of end of duodenum
- Hila of kidneys
- Neck of pancreas
- Origin of superior mesenteric artery
Which major blood vessel originates at the upper border of L1?
- Celiac trunk
Which major blood vessel originates at the lower border of L1?
- Superior mesenteric artery
Which major blood vessel originates at the lower border of L2?
- Renal arteries
Which major blood vessel originates at the lower border of L3?
- Inferior mesenteric artery
Which major blood vessel originates at the lower border of L4?
- Common iliac arteries
Which major blood vessel originates at the lower border of L5?
- Inferior vena cava from right and left common iliac veins
Which organs are in the right upper quadrant?
- Liver and gallbladder
Which organs are in the left upper quadrant?
- Stomach and spleen
Which organs are in the right lower quadrant?
- Cecum and appendix
Which organs are in the left lower quadrant?
- Descending and sigmoid colon
How can the inferior of the liver be palpated?
- Just below right costal margin when patient breathes in deeply
- Can be felt slipping under palpating fingers
Where is McBurney’s point and what is it used to identify?
- One-third the way up a line from right ASIL to umbilicus
- Common surface projection of the appendix
The superior poles of the kidneys reach as high as which ribs?
- Left: 11
- Right: 12
At which vertebral level are the inferior poles of the kidneys?
- L3/L4
At which vertebral level are the hila of the kidneys?
- L1
With relation to surface anatomy where is the spleen located?
- Left side and back in the area of ribs 9 to 11
- Follows the counter of rib 10 and extends from the superior pole of the left kidney to just posterior to the midaxillary line