Anterior Abdominal Wall and Abdominal Organs Flashcards
Boundaries of abdominal wall
Superior - xiphoid process and costal margin
posterior - vertebral column
inferior - superior portions of the pelvic bone
Pelvis components and brief function
Fusion of three bones: 1. Ilium 2. Ischium 3. pubis This bone serves as a site of attachment for abdominal muscles and ligaments
pelvic osteology
see lab notes
three flat muscles of anterolateral abdominal wall and what/how do they end
- external oblique
- Internal oblique
- Transverse abdominis
end anteriorly in a stong sheetlike aponeurosis
what does the aponeurpses of the three flat muscles of the anterolateral wall form/interlace at
aponeuroses interlace at the linea alba (LA)
what is an aponeurosis
what the muscle fibers are replaced by anteriorly and it is a sheet-like fibrous membrane
external oblique muscle
attachments
innervation
action
Attachments: Ribs 5-12
LA (linea Alba), pubic tubercle, iliac crest
innervation: segmental thoracoabdominal nerves
actions:
compress, support abdominal viscera
flex and rotate to OPPOSITE SIDE
Fibers are running superior lateral to inferior medial
lower border of the external oblique forms…
ingual ligamentum - which passes between the ASIS and the pubic tubercle
inguinal ligament
thickened, underturned, INFERIOR margin of the aponeurosis of the external oblique
from the ASIS and the pubic tubercle
forms boundaries of the inguinal canal
ingual canal function and its openings
develops in posterior abdominal cavity
oblique, inferiormedially directed passage (4 cm long) through inferior part of anterolateral abdominal wall
how the testis were able to be externalized
1. deep internal inguinal ring - entrance to the canal
2. superficial (external) inguinal ring - exit from the inguinal canal
contents of the inguinal canal
Spermatic cord: ductus deferens, testicular artery, sympathetic nerve fibers
Round Ligament of uterus (female) - ‘tether’ to uterus
inguinal Hernia
more common in males than females because wider canal
intestines passes into the scrotum or the groin
could occur if there is too much pressure in the abdominal
internal oblique muscle
attachment, innervation, and action
Attachments:
Thoracolumbar fascia, iliac crest, inguinal ligament
ribs 10-12, LA
innervation: segmental thoracoabdominal nerves
action: compress, support abdominal viscera, flex and rotate trunk to SAME SIDE
Transversus Abdominis (TA) Muscle
Attachments
Innervation
Action
Internal to the internal oblique muscle
Attachment : Ribs 7-12 costal cartilage, iliac crest, thoracolumbar fascia to LA, pubic crest (part of symphysis)
Innervation: Segmental thoracoabdominal nerves
Action: Compress, support the abdominal viscera
These are horizontal and meant to protect
Transversailis fascia
Each of the three flat muscles is covered on its anterior and posterior surface by this layer of fascia
which layer of the transversalis fascia can we see? what is it continuous with?
layer deep to the transversus abdominus and is continuous with the fascia on the internal aspect of the abdominal wall (endoabdominal (EA) fascia)
what is deep to the transversalis fascia?
Extraperitoneal fascia which is a connective tissue and contains varrying amounts of fat
what is deep to the extraperitoneal fascia?
the peritoneum
Peritoneum
this is deep to the extraperitoneal fascia and is a thin serous membrane lining the abdominal walls and some viscera of the abdominal cavity
‘TEP’
Transversalis fascia - deep to the transversus abdominous
Extraperitoneal fascia - deep to transversalis fascia
Parietal peritoneum - serous membrane lining abdominal cavity - deep to the extraperitoneal
Layers of fascia
Superficial layer :fatty and membranous
Deep (investing) layers: envelop muscle layers
Transversalis fascia: Underlies (deep) to the TA muscle which is continous with the endoabdominal (EA) fascia
Extraperitoneal fascia
Peritoneum
Rectus Abdominus Attachment Innervation Action , Direction of fibers
Vertical
Attachments: Pubic symphysis and pubic crest to xiphoid process and costal cartilages 5-7
Innervation: segmental thoracoabdominal nerves
Action: compress, support abdominal viscera. flex trunk
what is significant about the rectus abdominal muscle?
IT IS SEGMENTED so it can contract in smaller units
it is segmented by the tendinous intersection
arcuate line
where we see a change in the direction of the fascia in the abdominal muscles (rectus sheath then transversalis fascia)
rectus sheath
fascia surrounding the rectus abdominus muscle
above arcuate line?
rectus abdominus is covered on both sides by the rectus sheath
below the arcuate line?
posterior surface of the rectus muscle is in direct contact with the transversalis fascia
Superior Abdominal wall vasculature
Superior epigastric artery- terminal branch of the internal thoracic artery
Lateral abdominal wall vasculature
10th and 11th posterior intercostal arteries - coming off aorta
subcostal arteries
Inferior abdominal wall vasculature
inferior epigastric artery (from internal iliac artery)
Veins of abdominal wall
same as the arteries
where do the superior and inferior epigastric vessels
the superior and inferior epigastric vessels enter the rectus sheath - so go in a vertical manner
but they are posterior to the rectus muscle throughout their course
what do you have to do to see the inferior epigastric vessels?
they are posterior to the rectus abdominus - so have to lift it up and look at the inferior aspect
what is significant about the diaphragm being highly arched?
some of the abdominal cavity can be deep to the ribs and thus protected like the liver and spleen
peritoneum
continuous BILAYER transparent serous membrane - lining the abdominopelvic cavity and invests the viscera (organs)
parietal peritoneum
lining the internal surface of the abdominopelvic wall (body cavity)
visceral peritoneum
around the viscera/organs such as the stomach and intestines
retroperitoneal organs
these do NOT possess a mesentary. Organs lie within the extraperitoneal layer of the abdominal wall
SADPUCKER
mesentery
a double layer of peritoneum that suspends some abdominal organs
from posterior coming forward
omentum
double-layered extension or fold of peritoneum that passes between the stomach/duodenum and adjacent organs
lesser omentum
connects the lesser curvature of the stomach and the proximal part of the duodenum to the liver
BETWEEN THE STOMACH/DUODENUM AND LIVER
greater omentum
prominent peritoneal fold fold that hangs down like an apron from the greater curvature of the stomach and proximal part of the duodenum
where does the greater omentum attach as it descends
anterior surface of the transverse colon and its mesentary
esophagus
pass through where
terminate where
continuous with the pharynx
passes through the esophogeal hiatus at the level of T10 vertabra
terminates by entering stomach at the cardiac region of the stomach
stomach regions
abdominal esophagus enters at cardia fundus body pyloric region
pyloric region
pylorus is thickened to form the pyloric spinchter into the duodenum
small intestine
duodenum(digestion) - jejunum - ileum(absorption)
T/F there are no gross anatomical features which distinguishes the three regions of the small intestine
True
large intestine function and regions
Colon
Function- absorb salt and water
Regions- cecum - ascending colon - transverse colon- descending colon - sigmoid colon
hepatic plexure
superior to transverse colon where liver would be right above on the RIGHT SIDE
splenic plexure
superior to the transverse colon before descending because spleen is right above - on the LEFT SIDE
teniae coli
begin where? and split to what?
thickened bands of smooth muscle representing most of the longitudinal muscle coat
begin at the base of the appendix and split into three bands
run the length of the large intestine and merge again at the rectosigmoid junction
haustra
teniae are shorter than the intestine, the colon becomes sacculated between the tenia and form the haustra
like pouches in the large intestine
omentum appendages
fatty omentum-like projections are unique to large intestine
appendix and where does it arise
(veriform appendix)
extends from the intestines and contains masses of lymphoid tissue
arises from the posteromedial aspect of the cecum inferior to the ileocecal junction
liver : function and location
endocrine and exocrine functions
location: normally on the right side and deep to ribs 7-11 (small portion will cross the midline)
under the ribs but still in the abdominal cavity because of the arch of the diaphragm
four lobes of liver
right, left, caudate, and quadrate
porta hepatis
on the posterior aspect- point of entry for hepatic arteries and portal vein and point of exit for hepatic duct
caudate and quadrate lobe
caudate is superior on the posterior surface
quadrate is inferior of posterior surface - adjacent to the gallbladder
coronary ligament
connecting the liver to the inferior surface of the diaphragm
hepatoduodental ligament
thick free edge of the lesser omentum - between the porta hepatis of liver and the duodenum
what does the hepatoduodenal ligament enclose?
portal triad, few lymph nodes, lymphatic vessels, and the hepatic plexus of nerves
hepatogastric ligament
sheetlike remainder of the lesser omentum, extends between the liver and the lesser curvature of the stomach
portal vein
main channel of portal venous system as it collects poorly oxygenated blood but NUTRIENT RICH BLOOD from the abdominal part of the GI tract, including the gall bladder, pancreas, and spleen - carrying them to liver
hepatic vein
carries filtered blood from the liver to the IVC - inferior vena cava
hepatic artery
the parenchyma (functional tissue) of the liver is supplied by the hepatic artery
portal triad
portal vein and hepatic artery enter the liver and the hepatic vein leaves to go into the IVC
portal vein is formed by the union of what?
splenic and superior mesenteric veins
also divides into right and left before entering the liver
portal vein is final common pathway for what organs?
spleen (splenic vein contributing), pancreas, gall bladder, GI tract
gall bladder; function and location
functionally - stores and concentrations bile
location: lies in the gallbladder fossa on the visceral surface of the liver
pancreas
Function
location
regions of pancreas
function: enzyme production
Location: NECK of pancreas overlies 1st and 2nd lumbar vertebrae
HEAD is to the right and inferior to this plane
BODY AND TAIL are to the left and superior to this level (1&2nd lumbar vertebrae)
ducts related to dueodenum
R+L hepatic duct to form common
cystic duct - bile from gall bladder
common bile duct from cystic and common hepatic
pancreatic- from pancreas to dueodenym
kidneys
function
location
function: remove water, salt, etc. from the blood
location : superior poles of the kidney lie deep to the 11th and 12th ribs
also pretty far posterior
T/F the right kidney is lower than the left?
TRUE
hilum of kidney
concave medial border where the nerves and vessels enter and exit
ureter from kidney
expands at the hilum and forms renal pelvis
how many pyramids in a typical renal medulla
6-18 medullary pyramids
renal papilla
apex/tip of the pyramid and points towards the hilum - it is perforated by openings of collecting ducts
where do collecting ducts empty into
minor calyces
what forms the major calyx?
several minor calyces coming together
renal pelvis
major calyces come together to form this - it is the expanded end of the ureter
suprarenal (adrenal) gland
gland that is surrounded by a dense, fibroelastic capsule of connective tissue
parenchyma of gland (functional tissue) is divided into two histologically and functionally different regions -cortex & medulla
looks like a fatty mass on top of the kidneys
spleen; function and location
largest lymph organ with B and T lymphocytes
Filters blood - digest bacteria and depleted red blood cells
Location: deep to left 9th through 11 ribs (doesnt usually descend inferior to the costal margin
spleen receives blood via?
splenic artery - sill bring you to trunk of vessels
branches of abdominal aorta
anterior visceral to unpaired organs (GI and spleen)
lateral visceral (paired organs - reproductive and kidneys)
posterior parietal - paired lumbar and sacral regions
anterior visceral arteries
Celiac trunk - foregut
superior mesenteric-midgut
inferior mesenteric - hindgut
celiac trunk comes off?
supplies what
comes off the abdominal aorta and supplies foregut - esophagus, stomach, duodenum, liver, gall bladder, pancreas, spleen
superior mesenteric artery
supplying the midgut - jejunum, ileum, cecum, ascending and 2/3 transverse colon
inferior mesenteric artery
supplying the hindgut- 1/3 transverse colon, descending colon, sigmoid colon, rectum
major branches of the celiac trunk
left gastric artery
splenic artery
common hepatic artery
where does the right gastric artery arise from?
from the hepatic artery
superior mesenteric artery branches
inferior pancreatiocoduodenal artery jejunal and ileal arteries middle colic artery right colic artery ileocolic artery
inferior mesenteric artery branches
left colic artery
sigmoid arteries
superior rectal artery
lateral visceral arteries
inferior phrenic
suprarenal
renal
reproductive
inferior vena cava begins where and by the union of what?
begins anterior to L5 vertebra by the union of the common iliac veins
