Anterior Abdominal Wall Flashcards
Right upper quadrant organs
Liver-right lobe Gallbladder Pylorus of stomach Duodenum parts 1-3 Head of pancreas Right suprarenal gland Right kidney Right colic flexure Ascending colon- superior part Transverse colon- right half
Left upper quadrant organs
Liver- left lobe Spleen Stomach Jejunum and proximal ileum Body and tail of pancreas Left kidney Left suprarenal gland Left colic flexure Transverse colon- left half Descending colon- superior part
Right lower quadrant organs
Cecum Appendix Most of ileum Ascending colon- inferior Right ovary Right uterine tube Right ureter- abdominal part Right spermatic cord- abdominal part Uterus (if enlarged) Urinary bladder (if full)
Left lower quadrant organs
Sigmoid colon Descending colon- inferior part Left ovary Left uterine tube Left ureter- abdominal part Left spermatic cord- abdominal part Uterus (if enlarged) Bladder (if full)
Transpyloric plane level/organs
L1 level Gall bladder fundus Pyloris Pancreatic neck Hepatic portal vein Root of transverse mesocolon Hila of kidneys
Subcostal plane level/organs
Passes inferior border of 10th costal cartilage
Level of transverse colon
Transtubercle plane level/organs
B/w iliac tubercles
Level of ileocecal junction
Interspinous plane level/organs
B/w ASIS
Level of appendix, sigmoid colon
Abdominopelvic cavities
Includes abdomen and pelvis
B/w thoracic diaphragm and pelvic diaphragm
Can extend as high as 4th intercostal space
Abdomen separated from pelvis by imaginary border of pelvic inlet
Walls are mostly bone, muscle and CT
Lined by peritoneum
Anterolateral abdominal wall
Mostly muscle and aponeurosis
Boundaries- upper 7-10 costal cartilages – lower inguinal ligament and pelvic bones
Outer layer- skin, campers fascia and Scarpas fascia
Campers fascia
Fatty layer of superficial fascia
Scarpas fascia
Membranous fascia underlying CT layer of superficial fascia
Continuous with Colles fascia of perineum but fused with fascia lata of lower limb
Fluid cannot go from abdominal wall into leg but can flow into or out of superficial perineum (colles fascia is superficial perineal fascia)
External oblique muscle OINA
O- outer surface of lower 6 ribs
I- anterior iliac crest and pubic tubercle
Lower portion rolled under to make inguinal ligament from ASIS-pubic tubercle- makes opening of superficial inguinal ring
N- Ventral rami of T7-12 intercostal nerves
A- compresses abdomen and increase intra-abdominal pressure, move trunk/retain posture
Internal oblique muscle OINA
O- iliac crest and some thoracolumbar fascia
I- Lower 10-12 ribs, aponeurosis, linea alba and pubic crest
Some fibers follow spermatic cord to make cremasteric muscle
N- T7-12/L1 intercostal nerves
A- compresses and supports viscera, laterally flexes and rotates
Transversus abdominis muscle OINA
O- Lower 7-12 ribs, thoracolumbar fascia, iliac crest
I- linea alba, pectin pubis and pubic crest
N- T7-L1 intercostal nerves
A- compresses and supports viscera
Rectus abdominis muscle OINA
O- pubic symphysis and pubic crest I- xiphoid process and outer surface of 5-7 intercostal cartilages Forms part of rectus sheath N- T7-12 ventral rami intercostal nerves A- flexes abdomen and compresses it
Linea semilunaris
Lateral border of rectus abdominis muscle
Rectus sheath
Made of fascia and aponeurosis of muscles encompassing RA
External oblique aponeurosis is always anterior
Internal oblique aponeurosis splits in upper 3/4 but is anterior in lower 1/4
Transversus abdominis is posterior except in lower 1/4
Arcuate line
Sharp transition where all EO, IO and TA aponeurosis become anterior to rectus abdominis muscle
So below this line the rectus abdominis is in contact with transversalis fascia
Thoracoabdominal nerves
T7-T11 continuation of intercostal nerve
Both motor and sensory
Run b/w TA and IO muscles
Subcostal nerve
T12
Runs along inferior 12th rib
Motor; sensory is superior to iliac crest
Iliohypogastric nerve
L1
Runs b/w 2nd/3rd muscle layers
Motor to IO and TA, sensory to upper inguinal/hypogastric region
Ilioinguinal nerve
L1
Motor to lower IO and TA muscles
Sensory to lower inguinal, anterior scrotum/labia, near medial thigh
Lumbar arteries origin
Abdominal aorta
