Anterior Abd wall and Neurovascular Supply Flashcards
Explain the function of the abdomen and its boundaries
A flexible container for the abdominal organs
Boundaries: posterior=spinal column, anterior=abdominal wall, Lateral=Tra, obliques, superior=diaphragm, inferior=pelvic inlet
Explain the functions of the anterior abdominal wall
Regulate intra abdominal pressures. Support the trunk. Support the abdominal viscera. Move the trunk and maintain posture.
Describe the organization of the peritoneal ‘ligaments’
Gastrophrenic ligament (diaphragm to greater curvature of the stomach), Gastrosplenic (spleen to gr. curvature of the stomach), Gastrocolic (around the small intestine), Hepatogastric, hepatoduodenal. Falciform lig. Round lig of liver.
Describe the organization of the mesenteries
a. Mesentery proper- surrounds branches of the superior mesenteric vessels
b. Sigmoid mesocolon- surrounds branches of the inferior mesenteric vessels
c. Transverse mesocolon- surrounds branches of the middle colic vessels
Draw the layers of the rectus sheath including the arcuate line
Draw
Why is the arcuate line significant?
Demarcates the transition between the aponeurotic posterior rectus sheath and the transversalis fascia. Where the inferior epigastric vessels perforate the rectus abdominis.
Describe the anatomy of the inguinal canal including its contents in both males and females
About 4cm long and runs parallel to the inguinal ligament. Has deep and superficial rings.
Boundaries: Floor=inguinal lig, reinforced medially by lacunnar lig. Ant wall=external oblique aponeurosis reinforced laterally by internal oblique. Post wall=transversalis fascia reinforced by conjoint tendon
Male: spermatic cord (A annd V of ductus deferens, ilioinguinal n., genital br of genitofemoral n., testicular a, cremasteric a and v., pampiniform plexus, testicular plexus nn.)
Female: round ligament
List the layers of the anterior abdominal wall from superficial to deep
Skin, Camper’s fascia, scarpas fascia, rectus femoris sheath, RF, posterior rectus sheath. Laterally, external oblique, internal oblique, TrA, transversalis fascia, extraperitonneal adipose, parietal peritoneum.
Describe the innervation of the skin of the abdomen via T7-T12 spinal nerves
Innervate via the lateral cutaneous brr and anterior cutaneous brr of the T7-12 costal nn.
Distinguish between direct and indirect inguinal hernias
Direct inguinal hernias press directly through the abdominal wall, medial to the inferior epigastric vessels and potentially through the superficial inguinal ring
Indirect hernias the bowel passes lateral to the inferior epigastric vessels, through the deep and potentially superficial inguinal rings. Most common >66%
Name the composition of the portal triad
The common bile duct, the hepatic portal vein, and the hepatic artery proper. The omental foramen runs directly posterior to this.
Draw the abdominal aortic brr
Draw!
Draw the celiac trunk and brr
Drraw!
Draw the SMA and brrr
Draw ✍️
Draw the IMA and brr
✍️
Draw the sympathetic innervation
✍️
Draw the parasympathetic innervation
✍️
Draw the brr of the biliary tree
✍️
Describe the caval and portal venous drainage of the abdomen from peripheral veins to the right atrium
Hepatic portal vein drains into liver > Sinusoid v > central v. > hepatic vv. (3) > IVC
Draw the portal venous system
✍️
Explain the venous pathways involved in each of the four primary portal hypertension scenarios
A: blockage at L gastric
B: blockage at superior rectal
C: blockage at superficial epigastric or inferior epigastric
D: Blockage at L colic
Name the groups of lymph nodes that drain the abdomen including the territory they drain and their pattern of drainage
Deep inguinal > external iliac + Internal iliac»_space; common iliac > lateral aortic via the lumbar trunk to the cisterna chyli @ L2
Preaortic and retroaortic»_space;cisterna chyli
Structures of the foregut
liver, spleen, stomach, duodenum, pancreas, gall bladder
Structures of the midgut
cecum, small intestine, appendix, ascending and transverse colon
Structures of the hindgut
Descending, transverse, sigmoid colon and rectum
