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GI I Exam 1 > Anterior Abdominal Wall > Flashcards

Anterior Abdominal Wall Flashcards

1
Q

Right Upper Quadrant

A 
Liver: right lobe
gallbladder
stomach: pylorus
duodenum: parts 1-3
pancreas: head
right suprarenal gland
right kidney
right colic flexure
ascending colon: superior part
transverse colon: right half
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2
Q

Left upper quadrant

A 
liver: left lobe
spleen
stomach
jejunum and proximal ileum
pancreas: body and tail
left kidney
left suprarenal gland
left colic flexure
transverse colon: left half
descending colon: superior part
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3
Q

Right lower quadrant

A 
cecum
appendix
most of ileum
ascending colon: inferior part
right ovary
right uterine tube
right ureter: abdominal part
right spermatic cord: abdominal part
uterus (if enlarged)
urinary bladder (if very full)
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4
Q

Left lower quadrant

A 
sigmoid colon
descending colon: inferior part
left ovary
left uterine tube
left ureter: abdominal part
left spermatic cord: abdominal part
uterus (if enlarged)
urinary bladder (if very full)
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5
Q

Transpyloric plane

A

L1 level
level of gallbladder fundus, pylorus, pancreatic neck, SMA origin, hepatic portal vein, root of transverse mesocolon, hila of kidney

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6
Q

Subcostal plane

A

passes inferior border 10th costal cartilage
level of transverse colon
L3

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7
Q

transtubercle plane

A

L5
between iliac tubercles
level of iliocecal junction

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8
Q

interspinous plane

A

S2
between ASIS
level of appendix, sigmoid colon

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9
Q

Abdominopelvic cavity

A

includes abdomen and pelvis
-between thoracic diaphragm and pelvic diaphragm
-can extend as high as 4th ICS
-abdomen separated from pelvis by imaginary border of pelvic inlet (greater pelvis is above pelvic inlet)
-walls mostly bone, muscle, CT
lined by peritoneum

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10
Q

Anteriolateral Abdominal Wall

A

mostly muscle and aponeurosis

  • boundaries: upper 7-10 costal cartilage and lower inguinal ligament/pelvic bone
  • outer layer: skin, camper’s fascia, and scarpa’s fascia
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11
Q

Aponeurosis

A

tough, relatively thick because it’s made of several layers (overlies/envelopes rectus abdominis forming rectus sheath)

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12
Q

Camper’s and Scarpa’s fascia

A

integument

  • campers fascia: fatty layer of superficial fascia
  • scarpa’s fascia: membranous underlying CT layer of superficial fascia
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13
Q

Scarpa fascia

A

It is continuous with colle’s fascia of perineum but fused with fascia lata of lower limb
-fluid cant go from abdominal wall into leg but could flow into or out of superficial perineum

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14
Q

External oblique muscle

A

runs in downward medial direction (hands in pocket)
-interdigitates w/ serratous anterior
O: outer surface of lower 6 ribs
I: aponeurosis and linea alba, ant iliac crest and pubic tubercle (the lower portion rolls to make inguinal l. which is attached to ASIS and pubic tubercle) it also makes the opening of superficial inguinal canal, some reflected under to make lacunar lig.
-innervated by ventral rami of T7-12 of intercostal nerves
action- compress abdomen (forceful exhale), increase intrabdominal pressure, move trunk and retain posture

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15
Q

Internal oblique muscle

A

runs 90 degree from external oblique m.
O: iliac crest and some of thoracolumbar fascia
I: lower 10-12 ribs, aponeurosis, linea alba and pubic crest, lower part makes part of conjoint tendon (some fibers follow spermatic cord to make cremasteric muscle)
-aponeurosis part splits to encompass rectus m. in upper 3/4s, otherwise all go in front in lower 4th
-innervated by T7-12 and L1
-action: compresses and supports viscera, lateral flexes and rotates.

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16
Q

Transversus Abdominus Muscle

A

runs transverso-medially except for some running toward pubic crest (to contribute to conjoint tendon)

  • originate of lower 7-12 costal cartilages, thoracolumbar fascia, iliac crest, and some even off upper inguinal ligament
  • insert on linea alba, pecten pubis, and pubic crest
  • aponeurosis contributes to rectus sheath
  • innervated by T7-L1
  • action: compresses and supports visceral
17
Q

Rectus Abdominus Muscle

A

paired muscle of anterior abdominal wall; wider at top than bottom
-O: pubic symphysis and pubic crest
-I: xiphoid process and outer surface of 5-7th intercostal cartilage
-tendinous intersections form part of rectus sheath at umbilical, xiphoid and midway levels
-innervated by ventral rami of T7-T12
-action: flexes abdomen and compresses it
linea semilunaris: lateral border of rectus abdominus m.
pyramidis m: missing in 20% (pubic symphsis to linea alba)

18
Q

Rectus Sheath

A

made of fascia and aponeurosis of muscles encompassing RA

  • EO aponeurosis is always anterior
  • IO aponeurosis splits in upper 3/4 but is all ant lower 1/4
  • TA apon. is post except in lower 1/4
  • arcuate line, sharp transition where all 3 become ant
  • below line, the RA is in contact w/ transversalis fascia(which is beneath TA)
19
Q

Thoraco-abdominal n

A

T7-T11
continuation of intercostal n. both motor and sensory innervation
run btwn TA and IO m

20
Q

Subcostal n

A

T12

runs along inferior 12th rib; motor, sensory is superior to iliac crest

21
Q

Iliohypogastric n

A

L1

runs between 2nd and 3rd muscle layers, motor to IO and TA, sensory to upper inguinal and hypogastric region

22
Q

Ilioinguinal n

A

L1

motor lower IO and TA, sensory to lower inguinal, anterior srotum/labia, near medial thigh

23
Q

Abdominal wall arteries

A

continuation of intercostal arteries

lumbar artery: off abdominal aorta

24
Q

Superficial epigastric a

A

off femoral a

25
Q

superficial circumflex iliac a

A

off femoral a (runs along inguinal ligament

26
Q

deep circumflex iliac a.

A

off external iliac a./ runs deep along inguinal ligament

27
Q

inferior epigastric a.

A

off external iliac a.
runs posterior to rectus abdominus m
anastomosis w/ superior epigastric a.
runs anterior to posterior layer of rectus sheath

28
Q

superior epigastric artery

A

terminal branch of internal artery

29
Q

Umbilical folds

A

median umbilical fold: due to obliterated urachus
medial umbilical fold: due to obliterated umbilical arteries
lateral umbilical fold: due to inferior epigastric a

30
Q

Fossas

A

supravesicular fossa: gutter on either side of upper bladder

  • medial inguinal fossa: gutter lateral to medial umbilical folds
  • lateral inguinal fossa: gutter lateral to lateral umbilical folds
31
Q

Lymph Drainage

A

superficial vessels superior to umbilical drain into axillary nodes w/ a few going to parasternal nodes
-superficial vessels below umbilicus drain to superficial inguinal nodes
-deep lymph vessels accompany deep veins of abominal wall (ex/int iliac v)
the transumbilical plane is the cut off!!!!!

32
Q

Subcostal incision

A

about 2.5 cm inferior from margin, access to gall bladder and biliary tract and spleen

33
Q

midline incision

A

can be made rapidly. there are few blood vessels and nerves

34
Q

paramedian incision

A

open anterior sheath, push rectus muscle aside laterally and enter peritoneum

35
Q

Gridline (McBurney’s point)

A

muscle splitting; typical of appendectomy

36
Q

suprapubic

A

used mostly in gynecological/obstetrical surgeries

GI I Exam 1 (4 decks)

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