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2020 MHS Anatomy unit 1 > anterolateral abdominal wall > Flashcards

anterolateral abdominal wall Flashcards

1
Q

What is the top of the abdominal cavity?

this structure has a difference between its right and left side…

A

Diaphragm

  1. Right dome rise as high as th 5th rib
  2. Left dome rises as high a 5th intercostal spcae (between 5-6)
    1. remember the heart is here, taking up space n stuff
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2
Q

what is protected by the lower ribs and costal cartilages?

A

upper abdominal organs:

  1. liver and spleen
  2. may be injured by fractures of the lower ribs
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3
Q

define the abdominal wall

A
  1. 5 lumbar vetebrae
  2. wings of the ilia
  3. skeletal muscle and aponeurosis
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4
Q

list the conents of the RUQ

A
  • Live:righ lobe
  • gall bladder
  • stomach: pylorus
  • duodenum: pats 1-3
  • pancreas head
  • right suprarenal gland
  • right kidney
  • right colic(hepatic) flexture
  • ascending colon: superior part
  • transverse colon: right half
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5
Q

List the contents of the LUQ

A
  • Liver: left lobe
  • spleen
  • stomach
  • jejunum and proximal ileum
  • pancreas: body and tail
  • left kidney
  • left suprarenal gland
  • left colic(splenic) flexure
  • transverse colon: left half
  • descending colon: superior part
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6
Q

List the contents of the right lower quadrant

A
  • cecum
  • verimorm 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 full)
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7
Q

list the contents of the 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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8
Q

describe the 9 regions of the abdomen

A
  1. subcostal plane
  2. intertubercular plane
  3. midclavicular planes
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9
Q

list the utaneous nerves of the suerficial fascia along the anterolateral abdominal wall

A
  1. thoracoabdominal nerves
    1. T7-T11
      1. note T10 innervates the umbilical
    2. pan from the lower thracic wall
      1. due to pleurisy
  2. subcostal nerve
    1. T12
  3. ilihypogastric and iliolingual nerves
    1. L1
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10
Q

what are the two lines the generate the four quadrants of the abdomen?

A

median plane + transumbilical plane

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11
Q

list the location and, if given, names ofthe thoracic nerves.

A
  • T7-T11
    • thoracoabdominal nerves
  • T12
    • subcostal nerve
  • L1
    • iliohypogastic/ilioinguinal nerves
      • provided to skin of the groin
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12
Q

list the arteries of the abdominal wall

  1. deeper vessels
A
  1. inferior epigastric artery
    1. external iliac
    2. anastomosis is potential source of collateral circulation
  2. suerior epigastric artery
    1. internal thoracic
    2. anastomosis is a potential source of collateral ciculation
  3. deep circumflex iliac artery
    1. from the external iliac artery
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13
Q

compare superficial fascia superior and inferior to umbilical

A
  1. superior
    1. single fatty layer
  2. inferior
    1. two layers
      1. campers fascia
        1. superficial fatty layer
      2. scarpas fascia
        1. deep membranous layer
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14
Q

contrast males and the multipurpose of the scarpa;s fascia.

A
  • scarpas fascia
    • continuous fascia with the testes and perineum
    • this may prevent movement of infection
      • males
        • scrotum and perineum have loose fascia and may permit the movement of infection into the scarpas fascia via the fluid upward.
          *
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15
Q

list the 5 important mosucles of the the abdomen= 3 horizontal. 2 vertical

A
  • 5 muscles
    • external oblique
    • internal oblique
    • transversus abdominus
    • rectus abdominus
    • pyramidals
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16
Q

external obliques muscle

  1. arises and travels
    2.
A
  1. arises from the lower 8 ribs and courses inferomedially
  2. posterior fibers inserting into the iliac crest and broad external oblique aponeurosis
    1. anteriorly that helps form the anterior layerof the rectus sheath
    2. midline linea alba aponeurotic fibers intersect with those of the other side
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17
Q

List the important superficial arteries of the the anterolateral abdominal wall

A
  1. superficial epigastric artery
  2. superficial circumdflex iliac artery

both branch from th femoral artery.

18
Q

what superficial veins of the abdomen are used when a blockage occurs in the superior or inferior vena cava?

A

if the inferior or superior vena cava is obstructed include, the superficial collateral routes for venous return to the heart through anstamosis to form the

  1. thoracoepigastric vein- has a superior and inferior component
    1. Lateral Thoracic vein
      1. arises from the axillary vein
    2. superficial epigsastric vein
      1. arises from the femoral vein
19
Q

discuss the flow of lymph fluid in the abdomen. compare superficial to deep

A

Lymphatic drainage in the anterolateral abdominal can use the umbilical as a land mark

superficial lymphatic vessels

  1. superior to the umbilicus
    1. superficial lympahatic vessels above the umbilicus drain mainly upward to axillary lymph nodes
  2. inferior to the umbilicus
    1. below the umbilicus lymph flows downward to the superficial inguinal lymph nodes

deep lymphatic vessels

  1. travel with deep veins of the abdominal wall
20
Q

internal oblique

  1. arises from-3 spots
  2. fibers traverse
    1. foms and intersects
A
  1. arises from
    1. thoracolumbar fascia
    2. iliac crest
    3. 1/2 of inguinal ligament
  2. fibers course superomedially
    1. right angle to the external oblique and continuing into the internal obliqueaponeurosis
      1. internal oblique aponeurosis helps form the rectus sheath and intersects at the linea alba
21
Q
A
22
Q

external oblique muscle

  1. arises from
  2. travels
  3. inserts into…helps to form…
  4. specific fibers continue to meet other side at the
  5. continues inferior to become _____ _____ _____.
    1. define and describe area termination
A
  1. arises from the lower 8 ribs
  2. travels iferiomedially
  3. posterior fibers insert into the iliac crest and broad external oblique aponeurosis** anterior that helps form the layer of the **rectus sheath
  4. aponeurotic fibers intersect with those of the other side at the linea alba
  5. external oblique aponeurosis
    1. between anterior superior spine** and **pubic tubercle
    2. has rolled-under inferior free margin that forms the inguinal ligament
23
Q

a surgeon cuts through the spermatic cord of a male (same location as the round ligament of the uterus per female) What tendon did he cut through with respects to the abdomenal muscles?

A
  • Conjoint tendon = faux inguinalis
    • inferior fibers of the internal oblique joins those of the deeper transversus abdominus arrching over the spermatic cord (round ligament of the uterus)
24
Q

transversus abdominis muscle

  1. originates
  2. runs
    1. explain the joint tendon
A
  1. originates from
    1. costal cartilages 7-12
    2. thoracolumbar fascia
    3. iliac crest
    4. lateral 1/3 of the inguinal ligament
  2. runs
    1. transversely mainly
    2. lowest tendinous fibers arching downward to help form the conjoint tendon
      1. ​aka Falx inguinalis= inferior fibers of internal oblique + transversus abdominis
25
Q

rectus abdominis

  1. originates and inserts
  2. 6 pack formation
  3. explain the CT
  4. vertical seperation
  5. lateral attachment
A
  1. ascends vetically from the pubic crest** to the **costal cartilages 5-7
  2. three or more tendinous intersection cause the 6 pack design
  3. rectus abdominis is enclosed in rectus sheath
    1. ​rectus sheath formed by external oblique +internal oblique + transversusabdominus
  4. linea alba
    1. formed by the decussation of aponeurotic fibers of the obliques and transversus muscles
      1. no major nerves or blood vessels cross the linea alba
  5. linea semilunaris, shallow convex groove
26
Q
  1. compare the upper 3/4 and lower 1/4 of the rectus sheath
A
  1. compare
    1. upper 3/4 = completely encloses rectus abdominis
      1. anterior wall
        1. external oblique aponeurosis + 1/2internal oblique aponeurosis
      2. posterior wall =other 1/2 of internal oblique aponeurosis + transversus abdominis aponeurosis
    2. lower 1/4 = covers anterior surface, leaving the posterior in contact with the transversalis fascia
      1. this begins midway between the umbilicus and the pubic symphysis
      2. all three aponeuroses move to the anterior side of the rectus abdominis, leaving the muscle directly on transcersalis fascia
      3. check point of transition is the arcuate line
27
Q

compare and explain the upper

A
28
Q

what is the point of transition from the upper 3/4 -> lower 1/4 of the rectus sheath?

A

arcuate line

  1. inferior epigastric artery lies here and is the land mark for the arcuate line
29
Q

what are the contents of the rectus sheath?

A
  1. rectus abdominis
  2. pyramidalis
  3. superior epigastric artery and vein
  4. inferior epigastric artery and vein
  5. distal portions of anterior rami
    1. T7-T12 spinal nerves
  6. lymphatic vesels
30
Q

pyramidalis

  1. location
  2. function
A
  1. second vertical muscle of the anterolateral abdominal wall
    1. present anterior to rectus abdominis base on pubis.apex attached superiorl ya ndmedially to linea alba
  2. tenses linea alba
31
Q

important funtions of anterolateral abdominal wall muscles-3

A
  1. support and protect abdominal organs
    1. rigidity, caused by inflammation
    2. gaurding, colds hands during palpation
  2. relaxation during inspiration and contraction during FORCED EXPIRRATION
  3. Increase intra-abdominal pressue
    1. micturation, coughing, sneezing, emesis, parturition
32
Q

explain the imporance between bilateral and unilateral contraction of anterolateral abdominal wall muscles

  1. what is contracted to cause rotation of the trunk
A
  1. bilateral contraction
    1. flexion of the trunk
  2. unilateral
    1. flexion of the trunk to the ipsilateral side
    2. 1 internal oblique + contralateral external obliqu = rotation of the trunk
33
Q

describe the oblique passage through the abdominal wall and its contents

A

inguinal canal

  1. lies superior to the medial half of the inguinal ligament
  2. extend inferomedially from the deep inguinal ring** to the **superficial inguinal ring
    1. deep inguinal ring
      1. begining of inguinal canal and midway between anterior superior iliac spine** and **pubic symphysis
      2. just above inguinal ligament and immediately lateral to inferior epigastric vessels
      3. aka begining of evagination of transversalis fascia forming 1 of 2 coverings of sperm cord -or-round lig
    2. superficial inguinal ring = external inguinal ring
      1. split in the external oblique aponeurosis
      2. end of the inguinal canal
      3. superior to the pubic tubercle
34
Q

describe the triangle of rthe external inguinal ring

A

triangular opening inaponeurosis of the external oblique

  1. apex
    1. pointing superiolaterally
    2. intercrural(crossing) fibers hold onto medaial and lateral crus, prevent widening of the ring
  2. base
    1. pubic crest
  3. two sides
    1. medial crus
      1. attached to the pubic symphysis
    2. lateral crus
      1. attached to the pubic tubecle
35
Q

describe the boundaries of the inguinal canal

  1. anterior
  2. posterior
  3. roof
  4. floor
A
  1. anterior wall
    1. external oblique aponeurosis
    2. internal oblique aponeurosis- reinforcment
  2. posterior wall
    1. transversalis fascia
    2. conjoint tendon - reinforcment
  3. roof
    1. internal oblique
    2. transversus abdominis
  4. floor
    1. inquinal ligament
36
Q

list the three hernias associated with the abdominal wall

A
  1. inquinal
  2. umbilical
  3. epigastric
37
Q

protrusions of viscera from the abdominal cavity throuugh the inguinal region.

  1. %
  2. types-define
A
  1. 75%
  2. types
    1. indirect inguinal hernia
      1. follow the path of descent of the testes
    2. directt inguinal hernia
      1. push directly through a weak area of abdominal wall
38
Q

define indirect inguinal hernia

  1. demographic
  2. pathway
A

may follow the path of descent of the the testes

  1. most common in both sexes at all ages
  2. passes lateral to inferior epigastric vessels to enter deep inguinal ring
    1. leaves abdominal wall lateral to the inferor epigastric artery
    2. commonly exits the superficial inguinal ring to descend into the scrotum or labium majus
  3. at significant risk of becoming entrapped (incarceration)** with bowel obstruction and possible loss of its blood supply(**strangluation)
    1. surgery is usually recommended to repari the hernia
39
Q

direct inguinal hernia

  1. demographic
  2. pathway
    3.
A
    1. herniating bowel passes MEDIAL to inferior epigastric vessels, puushing through peritoneum and transversalis fascia in inguinal triangle to enter inguinal canal
    2. leaves the abdominal cavity medial to the inferior epigastric artery
    3. Pusches directly** into the inguinal canal through or around a **weak conjoint tendon
    4. les likely to decend into the scrotum than an indirect inguinal hernia
  2. inguinal triangle
    1. formed by
      1. inferior epigastric artery-LATERALLY
      2. rectus abdominis- MEDIALLY
      3. inguinal ligament-INFERIORLY
    2. protrudes through the inguinal (hesselbach’s) triangle
40
Q

Which hernia type is most likely to descend into the scrotum?

A

Indirect -follows the path of embryonic descent of the testis from the posterior abdominal wall through the inguinal canal

2020 MHS Anatomy unit 1 (6 decks)

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