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IKK - Anatomy Exam 2 > Anterior Abd. Wall > Flashcards

Anterior Abd. Wall Flashcards

1
Q

Abdominal cavity boundaries (superior/inferior)

A 
Superior = diaphragm
Inferior = Pelvic inlet
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2
Q

Quadrants of abdominal cavities and what separates them

A

4 quadrants (R/L upper quadrant, R/L lower quadrant) separated by median plane and transumbilical plane

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3
Q

Region breakdown of abdominal cavity and what separates them

A

Going across:

  1. Rt hypochondrium - epigastric region - lft hypochondrium
  2. Rt. flank - umbilical region - left flank
  3. Rt. groin - pelvic region - left groin

separated by midclavicular planes, subcostal plane and intertubercular plane

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4
Q

Name the 9 layers from superficial to deep on abdominal cavity antero-laterally

A
  1. Skin
  2. Camper’s fascia (fatty subcutaneous)
  3. Scarpa’s fascia (deep membraneous)
  4. External oblique muscle
  5. Internal oblique muscle
  6. Transversus abdominins muscle
  7. Transversalias Fascia
  8. Extraperitoneal fat
  9. Parietal Peritoneum

*there is INVESTING FASCIA surrounding all of the muscular layers (investing = surrounding)

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5
Q

External Oblique Muscle

A

Lateral sides of abdomen, fibers go from high lateral to low anterior (fingers in pocket)

Has aponeurosis connecting two lateral sides

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6
Q

Linea Alba

A

Midline of aponeuroses of external oblique, internal oblique, and transversus abdominins.

Part of anchoring for all three of these layers.

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7
Q

Aponeurosis definition

A

tendinous sheet connecting two opposing muscles

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8
Q

Rectus Abdominins

A

Covered by aponeurosis of external oblique, paired, central muscles.

Has dense connective tissue anterior and posteriorly - these tissues coming together is called RECTUS SHEATH

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9
Q

Rectus Sheath

A

The connective tissues of the rectus abdominins (posteriorly and anteriorly) together is the rectus sheath. Changes superiorly to inferiorly at ARCUATE LINE.

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10
Q

Internal Oblique Muscle - fibers

A

Deep to external oblique muscle
Fibers directed opposite than external
Thumbs “up” in pocket to horizontal but hard to tell where the fibers change because they become interdigitated

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11
Q

Transversus Abdominins Muscle - fibers

A

Fibers are horizontal (transverse)

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12
Q

Arcuate Line

A

~midpoint between umbilicus and pubic symphysis, can only be seen posteriorly

denotes when rectus sheath structure changes (different superiorly and inferiorly)

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13
Q

Rectus sheath superior arcuate line

A

@ or above the umbilicus

Anterior: External oblique, 1/2 internal oblique

Posterior: 1/2 internal oblique, transversus abdominins, transversalias fascia and parietal peritoneum

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14
Q

Rectus sheath inferior to arcuate line

A

Closer to pubic symphysis

Anterior: external oblique, internal oblique, transversus abdominins

Posterior: transversalias fascia, parietal peritoneum

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15
Q

Which half of the rectus sheath is more translucent? Why?

A

Rectus sheath inferior to arcuate line

Because the posterior aspect of the rectus sheath only consists of transversalius fascia/parietal peritoneum which is thin therefore it becomes transclucent

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16
Q

Mesentery vs. Fold definition

A

Mesentery = 2 layers of mesothelium together

Fold = single layer of mesothelium

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17
Q

Name the 3 infraumbilical folds on the peritoneal

A
  1. Median Umbilical Fold (1)
  2. Medial Umbilical Folds (2)
  3. Lateral Umbilical Folds (2)
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18
Q

Median Umbilical Fold details

A

Only 1 - at midline

  • From urinary bladder to umbilicals
  • Covers median umbilical ligament (aka fibrous ligament also called remnant of the urachus)*

*results from embryonic atlantois that in late fetal is called urachus

IN ADULTHOOD ONLY CALL THIS THE REMNANT OF THE URACHUS OR THE UMBILICAL LIGAMENT

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19
Q

Medial Umbilical Folds details

A

R / L on either side of median umbilical fold

Covers medial umbilical ligament (occluded portion of umbilical artery)

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20
Q

Lateral Umbilical Folds

A

R / L on either side of medial umbilical folds

Covers inferior epigastric vessel (active!!! as opposed to remnants of other fold coverings)

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21
Q

What 2 structures can be seen in relation to the median/medial/lateral umbilical folds? Where are they found?

A

Deep Inguinal Ring: found just superior to lateral umbilical folds

Hesselbach’s triangle: found just superior to medial umbilical folds

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22
Q

Abdominal Wall Vasculature Summary (6)

A
  1. Superficial epigastric a. & v.
  2. Superficial circumflex a. & v.
  3. Deep circumflex iliac a. & v.
  4. Deep Inferior epigastric a. & v.
  5. Deep Superior epigastric a. & v.
  6. Deep Musculophrenic a. & v.
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23
Q

Superficial Circumflex Iliac a. & v. (branching and supply)

A

SUPERFICIAL VESSELS

  • branch of femoral artery
  • supplies/drains region of inguinal ligament
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24
Q

Superficial Epigastric a. & v. (branching and supply)

A

SUPERFICIAL VESSELS

  • branch of femoral artery
  • supplies/drains abdomen inferior to umbilicus
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25
Q

Deep Circumflex a. & v. (branching, supply, location)

A

DEEP VESSEL

  • branch of external iliac
  • runs between internal oblique and transversus abdominins
  • Supplies inferior lateral abdominal musculature
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26
Q

Inferior Epigastric a. & v. (branching, supply, location)

A

DEEP VESSEL

  • branch of external iliac
  • enters posterior rectus sheath @ arcuate line
  • supplies lower rectus abdominus musculature
  • anastomose with superior epigastric a. & v.
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27
Q

Superior Epigastric a. & v. (branching, supply, location)

A

DEEP VESSEL

  • branch of internal thoracic (mammary)
  • enters posterior rectus sheath lateral to sternum (on either side)
  • supplies upper rectus abdominus musculature
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28
Q

Musculophrenic a. & v. (branching, supply, location)

A

DEEP VESSEL

  • branch of internal thoracic (mammary)
  • runs along costal cartilage
  • Supplies upper abdominal musculature

phrenic = diaphragm

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29
Q

Dermatome vs. Myotome innervation locations

A

Myotomes: innervate deeper muscles
Dermatomes: innervate cutaneous sections IN PATTERNS

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30
Q

Is the abdominal wall innervated by dermatomes or myotomes?

A

Dermatomes - because abdominal wall is CUTANEOUS. Follow PATTERN.

31
Q

Define the innervation of the abdominal wall

A

Ventral Rami of T7-L1

T7, T8, T9 = supply region above umbillicus
T10 = supplies umbillicus region
T11, T12, L1 = supplies region below umbillicus

32
Q

Ventral Rami T7-L1 innervate cutaneous surface. How do they get there?

A

T7, T8, T9, T10, T11, T12, L1 all run between internal oblique muscle and transversus abdominins muscle as they come up to innervate cutaneous surface

33
Q

Injury to T7, T8, T9 results in _____

A

weakening to 1/2 of musculature. Makes this region weak but still functional

34
Q

Injury to T11, T12, L1 result in ____

A

total weakening of inguinal region

35
Q

Weakened sensation in region 3 inches below umbilcus is a result of ____

A

innervation problems with T12

36
Q

Inguinal region:

Location in reference to abdominal region, thigh, ilum, pubic bone?

A

Inguinal region is

  • inferior lateral to abdominal region
  • Superior to thigh
  • Medial to ilium
  • Lateral to pubic bone
37
Q

Inguinal region extends between _____ and _____.

A

Inguinal region extends between anterior superior iliac spine and pubic tubercle

38
Q

What does the inguinal region contain?

A

Inguinal ligament, inguinal canal, superficial and deep rings, walls of canal

39
Q

Vessels change name when passing through inguinal ligament. What’s the name before/after passing?

A

External iliac artery/vein becomes femoral artery/vein when passing through inguinal ligament

40
Q

Inguinal Ligament definition

A

folded inferior border of external oblique aponeurosis (ie this is superficial)

extends from ASIS to pubic tubercle

41
Q

Inguinal Canal definition

A
  • Runs parallel to inguinal ligament
  • Obliquely set tunnel 3-5cm long
  • Transverses anterior abdominal wall (think: rungs traverse from inside abdominal cavity
42
Q

MALE inguinal canal

A

Contains Spermatic cord and Ilioinguinal Nerve (@ L1)

Spermatic cord contains Vas Deferens, Testicular nn and vessels, Cremasteric muscle and fascia

Deep ring: opening to abdominal/pelvic cavity goes through structure and out superficial ring

43
Q

FEMALE inguinal ring

A

Contains round ligament of uterus and Ilioinguinal Nerve (@L1)

44
Q

Are spermatic cord and round ligament of uterus similar?

A

Spermatic cord and round ligament of uterus are derived from same embryological structure.

Both are contained in male/female inguinal canals respectively

45
Q

Superficial Inguinal Ring

A

Opening in External Oblique Aponeurosis

Obvious triangular opening just LATERAL to pubic tubercle

46
Q

Deep Inguinal Ring

A

Opening in Transversalias Fascia

Subtle piercing just lateral to inferior epigastric.
(think: deep inguinal ring found just lateral to umbilical folds which cover inferior epigastric)

47
Q

What compose the anterior/posterior walls of the inguinal canals? What compose the roof/floor of inguinal canals?

A

Anterior wall: EO aponeurosis
Posterior wall: transversalias fascia, conjoint tendon
Roof: Internal oblique and transversus abdominus m (superior)
Floor: inguinal ligament (inferior)

48
Q

Conjoint tendon defintion

A

Fusion of Internal Oblique, Transversus Abdominus aponeuroses medially.

Part of the posterior wall of the inguinal canal

49
Q

Hernia definition

A

Hernia is an outpocketing of viscera within a sac

50
Q

Abdominal hernia definition

A

Out-pocketing of abdominal viscera within a sac.

51
Q

What is a hernial sac composed of?

A

Hernial sac composed of 3 layers

- Peritoneum, extraperitoneal fat, transversalias fascia

52
Q

Are hernias common in inguinal region?

A

90% of hernias occur in inguinal region because we have a CANAL here

53
Q

Indirect Inguinal Hernia definition

A

Most common type of hernia (male>female)

  • extends thru entire inguinal canal
  • lateral to inferior epigastric vessel (bc exits thru deep ring which is lateral to lateral umbilical fold which contains inferior epigastric vessel)
54
Q

Indirect inguinal hernia commonly enters the ____ in male, and the ___ in females.

A

Indirect inguinal hernia commonly enters the scrotum in male, and the labia majora in females.

55
Q

In males, indirect inguinal hernia is usually caused by _______.

A

In males, indirect inguinal hernias are usually caused b persistent processus of vaginalus (which connects peritoneum with descended testes)

56
Q

In females, we can refer to indirect inguinal hernias as _____.

A

In females, we can refer to indirect inguinal hernias as CANAL OF NUCK.

57
Q

Direct Inguinal Hernia definition

A

extends through inguinal triangle (Hesselbach’s triangle)

emerges through conjoint tendon by or at the superficial ring

doesn’t enter scrotum/labia majoria because so medial and superficial

associated with weakened abdominal wall (beer belly)

58
Q

Where is hesselbach’s triangle?

A

Hesselbach’s triangle/inguinal triangel=

between inferior epigastric aa., rectus abdominus m., inguinal ligament

AKA THIS IS MEDIAL TO INFERIOR EPIGASTRIC (think back in relation to medial umbilical folds)

59
Q

Femoral Hernia

A

-Through femoral ring and canal
= medial compartment of sheath
-More common in male than female because males have wider femoral ring

60
Q

Umbilical Hernia

A

Through umbilical ring
most common in newborns/obese individuals
more common in male

61
Q

Epigastric Hernia

A

through linea alba

most common in over 40 and severe obesity

62
Q

Pathway for accessory pancreatic duct

A

May enter duodenum as well

~2cm above major papilla at the minor duodenal papilla

63
Q

Ascites

A

fluid (from peritoneum during herniation)

64
Q

What are the branches of the celiac trunk?

A
  1. Common hepatic (right branch)
  2. Left gastric (superior branch)
  3. Splenic branch (left branch)
65
Q

what does the celiac trunk solly?

A

FOREGUT: Liver, gallbladder, esophagus, stomach, pancreas, spleen

66
Q

What does the common hepatic branch supply?

A

Liver and gall bladder

67
Q

What are the terminal branches of the common hepatic bramch?

A
  1. Proper hepatic artery (superior)

2. Gastroduodenal artery (inferior)

68
Q

What does the proper hepatic supply?

A

Runs towards liver and medial to bile duct

69
Q

Proper hepatic terminal branches?

A
  1. Right gastric artery

2. Proper hepatic bifurcates into right and left hepatic arteries

70
Q

Gastroduodenal artery terminal branches?

A
  1. Superior anterior pancreaticoduodenal artery
  2. Superior posterior pancreaticoduodenal artery
  3. Right gastroepiploic (right gastro-omental)
71
Q

Superior anterior/posterior pancreaticoduodenals arteries supplies what?

A

Pancreas and duodenum

*after anastomes with inferior anterior/posterior pancreaticoduodenal arteries

72
Q

what does the left gastric artery supply?

A

runs towards lesser curvature supplies stomach and esophagus

73
Q

What does the splenic artery supply?

A

pancreas and spleen

IKK - Anatomy Exam 2 (13 decks)

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