Anatomy week 1 Flashcards

1
Q

Name the 4 quadrants of the abdominal cavity

A

RUQ
LUQ
RLQ
LLQ

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2
Q

What 2 imaginary lines (vertical and horizontal) divide the abdomen into 4 quadrants

A

Vertical - median line

Horizontal - trans umbilical line

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3
Q

Name the 4 imaginary lines that divide the abdomen into 9 regions

A

Right and left midclavicular lines
Transtubercular line
Subcostal line

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4
Q

Level of transpyloric plane

A

L1

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5
Q

Name the 9 regions of the abdominal cavity

A

Right hypochondrium
Epigastric
Left hypochondrium

Right lumbar
Umbilical
Left lumbar

Right iliac/inguinal
Hypogastric/suprapubic
left iliac/inguinal

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6
Q

Name 2 structures present in the right hypochondrium

A

Liver (extends down to right lumbar)

Gallbladder (Extends down to right lumbar)

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7
Q

Name 3 structures present in the epigastric region

A

Liver
Stomach
Pancreas

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8
Q

Name 3 structures present in the left hypochondrium

A

Spleen

Stomach
Pancreas

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9
Q

Name 3 structures present in the right lumbar region

A

Ascending colon
Liver
Right kidney

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10
Q

Name 3 structures present in the umbilical region

A

Transverse colon
Small intestine - duodenum, jejunum, ileum
Aorta

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11
Q

Name 3 structures present in the left lumbar region

A

Descending colon
Left kidney extends down from left hypochondrium
Jejunum + ileum extends here too

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12
Q

Name 3 structures present in the right iliac region

A

Caecum
Appendix
Terminal ileum

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13
Q

What valve exists between the terminal ileum and caecum

A

Ileo-caecal valve

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14
Q

Name 3 structures present in the hypogastric region

A

Urinary bladder
Sigmoid colon
Uterus

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15
Q

Name 2 structures present in the left iliac region

A

Descending colon

Sigmoid colon

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16
Q

The anterolateral abdominal wall is composed of what 3 flat muscles and what 2 vertical muscles

A

External oblique
Internal oblique
Transversus abdominis

Rectus abdominis
Pyramidalis

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17
Q

2 actions and innervation (2) of external oblique

A

Compress + support abdominal viscera
Flex + rotate trunk

Anterior rami of T7-T12
Subcostal nerve

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18
Q

2 actions and innervation (3) of internal oblique

A

Compress + support abdominal viscera
Flex + rotate trunk

Anterior rami of T7-T12
Subcostal nerve
1st lumbar nerve

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19
Q

Action and innervation (3) of transversus abdominis

A

Compress + support abdominal viscera

Anterior rami of T7-T12
Subcostal nerve
1st lumbar nerve

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20
Q

3 actions and innervation of rectus abdominis

A

Flex trunk in lumbar region
Compress abdominal viscera
Stabilises + controls tilt of pelvis

Anterior rami of T7-T12

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21
Q

What artery supplies rectus abdominis

A

Inferior epigastric a

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22
Q

What muscle is superficial to the rectus abdominis and what is its function

A

Pyramidalis - small triangular muscle

Tenses the lines alba

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23
Q

What is the lines alba

A

Vertical fibrous white structure that runs down the midline of the abdomen from the xyphoid process to the pubic symphysis

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24
Q

What is the rectus sheath + what is it made up of

A

Fused aponeurosis of the 3 flat abdominal muscles

Aponeuroses of the external oblique, internal oblique and transversus abdominis

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25
Q

What is an aponeurosis

A

Flat sheet of tendinous tissue

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26
Q

How does the rectus sheath differ above and below the umbilicus

A

Above - internal oblique splits into 2 layers, so a layer above and below the umbilicus

Below - all 3 aponeurosis of the flat muscles pass anterior to the rectus abdominis

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27
Q

Order of layers pierced above the umbilicus (11)

A
Skin 
Fat
External oblique fascia
Anterior part of internal oblique fascia
Rectus abdominis
Posterior part of internal oblique fascia
Transversus abdominis fascia
Transversalis fascia
Parietal peritoneum
Peritoneal cavity
Visceral peritoneum
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28
Q

What 2 layers is the transversals fascia found between

A

Transversus abdominis and parietal peritoneum

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29
Q

Vertebral level of umbilicus (not dermatomal level)

A

L3/4

dermatome is T10

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30
Q

What 2 landmarks is the umbilicus in the middle of vertically

A

Xiphoid process and pubic symphysis

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31
Q

What thoracic segments innervate anterior abdominal wall

A

Anterior rami of T7-T12

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32
Q

How is the inguinal canal formed during foetal development

A

Relocation of the gonads

Layers of the anterior abdominal wall push through the wall obliquely to form a canal

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33
Q

What ligament does the inguinal canal lie parallel to (and above)

A

Medial half of inguinal ligament

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34
Q

What tubercles are found in the pubic bone of the pelvis

A

Pubic tubercles

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35
Q

The inguinal ligament is attached to which 2 bony points of the pelvis (pelvic bone)

A

Anterior superior iliac spine

Pubic tubercle

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36
Q

What 3 things makes up the anterior wall of the inguinal canal

A

External oblique aponeurosis
Lowermost fibres of internal oblique muscle
Superficial inguinal ring

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37
Q

What 3 things makes up the posterior wall of the inguinal canal

A

Transversalis fascia
Inguinal falx (conjoint tendon)
Deep inguinal ring

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38
Q

What 3 things makes up the roof of the inguinal canal

A

Aponeurosis of internal oblique and transversus abdominis

Transversalis fascia

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39
Q

What makes up the floor of the inguinal canal

A

Inguinal ligament

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40
Q

What is the inguinal falx

A

Pubic attachments of internal oblique and transversus abdominis aponeuroses

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41
Q

The inguinal canal has an opening at each end - what are they and which is superior/inferior

A

Deep inguinal ring superiorly

Superficial inguinal ring inferiorly

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42
Q

Relationship of the deep inguinal ring to the inferior epigastric vessels

A

Ring is lateral to the inferior epigastric vessels

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43
Q

Relationship of superficial inguinal ring to the pubic tubercle

A

Superolateral to the tubercle

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44
Q

What muscle are the superior and inferior epigastric vessels deep to

A

Rectus abdominis

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45
Q

Superior epigastric vessels are branches of what a

A

Internal thoracic a

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46
Q

Inferior epigastric vessels are branches of what a

A

External iliac a

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47
Q

5 contents on the male inguinal canal

A
Spermatic cord
Ductus deferens
Genitofemoral nerve
Ilio-Inguinal nerve
Lymphatics
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48
Q

4 contents of the female inguinal canal

A

Round ligament of uterus
Genitofemoral nerve
Ilio-Inguinal nerve
Lymphatics

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49
Q

Which inguinal ring is the terminal end of the inguinal canal

A

Superficial inguinal ring

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50
Q

What fascia forms the deep inguinal ring

A

Transversalis fascia

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51
Q

What muscle forms the superficial inguinal ring

A

External oblique muscle

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52
Q

Inguinal hernias classified into what 2 types + which is more common

A

Direct and indirect

Indirect more common

53
Q

Cause of indirect hernia

A

Congenital weakness in the deep inguinal ring, allowing abdominal contents to enter inguinal canal

54
Q

Cause of direct hernia

A

Abdominal contents don’t herniate through the deep inguinal ring but push through a weak spot in the muscles making up the posterior wall of the inguinal canal, allowing contents to enter canal

55
Q

The inguinal canal transmits what inferiorly in males

A

Spermatic cord

56
Q

Direct hernia is medial or lateral to the inferior epigastric vessels

A

Medial

57
Q

Indirect hernia is medial or lateral to the inferior epigastric vessels + herniates through which ring

A

Lateral

Deep inguinal

58
Q

Does direct hernia herniate through the superficial/deep inguinal ring or something else

A

Pushes through weak spot in the muscles making up the posterior wall of the inguinal canal, allowing contents to enter canal and herniate out superficial ring

59
Q

Femoral hernias occur below what ligament

A

Inguinal

60
Q

What happens in a femoral hernia

A

Abdo contents pass into weak area at posterior wall of femoral canal medial to the inferior epigastric vessels

61
Q

What are umbilical hernias + are they acquired or congenital in adults

A

Abdo contents pass through weakness at the umbilicus

Acquired

62
Q

4 layers of the gut tube from inside to outside

A

Mucosa - epithelium, lamina propria, muscularis mucosae
Submucosa
Muscularis externa
Adventitia/serosa (if in abdo cavity)

63
Q

3 layers of the mucosa

A

Epithelium
Lamina propria
Muscularis mucosae

64
Q

What is the peritoneum

A

Transparent serous membrane that lines the abdo wall and abdo organs

One continuous layer but named differently depending of what it lines

65
Q

2 subdivisions of the peritoneum

A

Parietal - lines the body wall

Visceral - lines organs

66
Q

What are the 3 things that the peritoneum can fold to form

A

Mesentery
Omentum
Ligament

67
Q

Where is the peritoneal cavity

A

Between parietal and visceral peritoneum

68
Q

The abdominal cavity is divided in what 2 sacs

A

Greater and lesser

69
Q

Through which passage does the greater and lesser sac communicate via

A

Epiploic foramen

70
Q

Which sac is behind the stomach

A

Lesser sac

71
Q

Where is the epiploic foramen

A

Posterior to the free margin of the lesser omentum

72
Q

If an organ is intraperitoneal, what does it mean about its peritoneum

A

Completely surrounded by visceral peritoneum

73
Q

If an organ is retroperitoneal, what does it mean about its peritoneum

A

Only covered by visceral peritoneum on the anterior surface, stuck to posterior abdominal wall

74
Q

Name retroperitoneal organs/structures (SAD PUCKOR)

A
2nd - 4th part of duodenum
Kidneys
Pancreas
Ascending + descending colon
Adrenal gland (suprarenal gland)
Ureter
75
Q

Name 9 intraperitoneal organs/structures

A
Stomach
Spleen
Liver
1st part of duodenum
Jejunum
Ileum
Caecum
Transverse colon
Sigmoid colon
76
Q

Name an extraperitoneal organ/structure

A

Rectum

77
Q

What does extraperitoneal mean

A

Structures in the abdominopelvic cavity not covered in peritoneum

78
Q

Which layer of peritoneum more sensitive to pressure, pain and temp

A

Parietal

79
Q

What is the lesser sac also known as

A

Omental bursa

80
Q

What does the lesser omentum connect

A

Liver to lesser curvature of stomach

81
Q

What does the greater omentum connect

A

Greater curvature of stomach to transverse colon

82
Q

What is often referred to as the abdominal policeman + why

A

Greater omentum
The lower margin and right & left margins of the greater momentum are free so moves about when there’s peristaltic movements
In infection, inflammatory exudate causes the greater momentum to stick to the site of infection, therefore wrapping itself around the infected organ, thus localising the infection to a small area

83
Q

What protective function does the greater momentum have

A

localises infection so preventing diffuse peritonitis

84
Q

What is parietal peritoneum innervated by + so what does this mean for pain coming from the parietal peritoneum

A

T7-L1

Parietal pain is somatic so is precisely localised, extremely sensitive to stretch (Rebound tenderness)

85
Q

What is visceral peritoneum innervated by + so what does this mean for pain coming from the visceral peritoneum

A

Autonomic nerves
Visceral pain is often referred so dull and poorly localised
Pain from the visceral peritoneum often referred to midline (i.e. pain could be coming from visceral peritoneum laterally but felt in the midline)

86
Q

What actually is the greater and lesser sac

A

Greater sac - general space/cavity that forms the majority of the abdomen

Lesser - cavity in the abdomen posterior to the stomach and lesser omentum

87
Q

Name 4 muscles of the posterior abdominal wall

A

Psoas major
Psoas minor
Iliacus
Quadratus lumborum

88
Q

What is bilateral action of psoas major

A

Flexion

89
Q

What vertebral level is the transtubercular line

A

L5 (body of L5)

90
Q

Name 2 vessels stuck to the posterior abdominal wall

A

Abdominal aorta

IVC

91
Q

Nerve plexuses in the posterior abdominal wall + other nerves

A

Lumbar plexus - L1-L4
Sacral plexus - L5-S4
Sympathetic trunk/chain

92
Q

3 major openings in the diaphragm + the vertebral level of the opening

A

IVC - T8
Oesophagus - T10
Aorta - T12

93
Q

3 main branches of the abdominal aorta which supple blood to gut tube

A

Coeliac trunk
Superior mesenteric a
Inferior mesenteric a

94
Q

What vertebral level does the aorta divide into common iliac arteries

A

L4

95
Q

What joins to form the IVC

A

Right and left common iliac veins

96
Q

What vertebral level does the coeliac trunk branch off the aorta

A

T12

97
Q

What vertebral level does the superior mesenteric artery branch off the aorta

A

L1

98
Q

What vertebral level does the inferior mesenteric artery branch off the aorta

A

L3

99
Q

After emerging from the aorta, the coeliac trunk extends approximately 1cm before dividing into what 3 major branches - 2 go left and 1 go right

A

Left gastric a
Splenic a

Common hepatic a

100
Q

Name the structures of the foregut (3)

A

oesophagus, stomach, upper duodenum

101
Q

Name the structures of the midgut (7)

A

distal part of duodenum, jejunum, ileum, caecum, appendix, ascending colon, proximal 2/3rds of the transverse colon

102
Q

Name the structures of the hindgut (5)

A

distal 1/3rd transverse colon, descending colon, sigmoid colon, rectum and upper part of the anal canal

103
Q

Arterial supply of the foregut/midgut/hindgut

A

Foregut - coeliac trunk
Midgut - superior mesenteric a
Hindgut - inferior mesenteric a

104
Q

What 2 veins unite to form the hepatic portal vein + at what vertebral level

A

Superior mesenteric and splenic v

L2

105
Q

Blood from the abdominopelvic GI tract drains via a what system to what organ

A

Portal system to the liver

106
Q

What does the inferior mesenteric vein drain into

A

Splenic vein

107
Q

What is the portal venous system

A

Vascular arrangement in which blood from capillaries of one organ is transported to capillaries of another organ by a vein(s)
Deoxygenated blood from GI tract and GI organs transported to liver

108
Q

Blood from the gut tube superior to diaphragm or inferior to pelvic floor drains via what system + where does this system drain into

A

Systemic venous system

IVC carries deoxygenated blood into RA of heart

109
Q

What is a portocaval/portosystemic anastomosis

A

Collateral communication between the portal and systemic venous system

110
Q

Importance of the portocaval/portosystemic anastomosis

A

Provide alternative routes of circulation when there is a blockage in the liver or portal vein.
Ensures that venous blood from the GI tract still reaches the heart through the IVC without going through the liver

111
Q

List 4 sites of portocaval/portosystemic anastomosis

A

Distal oesophagus
Anorectal junction
Paraumibilical
Retroperitoneal

112
Q

Sympathetic innervation to abdominal viscera is via what 3 things

A

Abdominopelvic splanchnic nerves (greater, lesser and least)
Prevertebral sympathetic ganglia
Abdominal aortic plexuses

113
Q

Parasympathetic innervation of abdominal viscera is via what 2 things

A

Vagus nerve

Pelvic splanchnic nerves (S2-S4)

114
Q

Parasympathetic stimulation increases or decreases:
GI secretion
Peristalsis/motility

A

Increases

115
Q

Sympathetic stimulation increases or decreases:
GI secretion
Peristalsis/motility

A

Decreases

116
Q

Sympathetic stimulation of blood vessels causes what

A

Vasoconstriction

117
Q

Parasympathetic stimulation of blood vessels causes what

A

Vasodilation

118
Q

Effect of vagotomy (removing part of vagus nerve) on gastric secretion

A

Decrease rate of gastric secretion

119
Q

Functional difference between greater, lesser and least splanchnic nerves (abdominopelvic splanchnic) and the pelvic splanchnic nerves

A

Pelvic splanchnic nerves are parasympathetic and vice versa

120
Q

Arrangement of ganglia in relation spinal cord in sympathetic and parasympathetic nervous system

A

Sympathetic - ganglia close to spina cord as short pre-ganglionic fibre

Parasympathetic - ganglia close to target organ as long pre-ganglionic fibre

121
Q

Vertebral level range of kidneys

A

T12 - L3

122
Q

Right kidney lies slightly lower than left kidney, why?

A

Liver pushes down on right kidney

123
Q

3 main structures entering/leaving the hilum of the kidney

A

Renal vein
Renal artery
Pelvis of the ureter

124
Q

Anterior to posterior arrangement of the 3 tubes at the hilum of the kidney

A

Renal vein
Renal artery
Pelvis of the ureter

125
Q

Where is the adrenal gland + what kind of gland is it

A

Superior to kidney

Endocrine

126
Q

What is the ureter

A

Muscular duct carrying urine from kidneys to urinary bladder

127
Q

What is the expanded upper part of the ureter called

A

Pelvis of ureter

128
Q

Name the 3 locations that the ureter is constricted during its course from the kidney to the bladder

A

At the junction of the ureters and renal pelvis (pelveureteric junction)
Where it crosses external iliac artery (pelvic brim)
Just before it enters the bladder (vesico-ureteric junction)