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_Anat./GIE #2 > Anterolateral Abdominal Wall & Inguinal Region > Flashcards

Anterolateral Abdominal Wall & Inguinal Region Flashcards

1
Q

Name the site into which the thoracic duct drains.

A

Usually empties into the venous system near the union of the left internal jugular and subclavian veins, but may open into the left subclavian vein.

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2
Q

What body regions/structures drain blood into the superior vena cava?

A

Returns blood from all structures superior to the diaphragm, except the lungs and heart.

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3
Q

What is the aortic knob/knuckle?

A

the contour of the aortic arch protruding from the mediastinal silhouette in an anteroposterior (AP) radiograph of the chest

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4
Q

What is the ligamentum arteriosum?

A

it is the remnant of the fetal DUCTUS ARTERIOSUS and passes from the root of the left pulmonary artery to the inferior surface of the aortic arch.

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5
Q

Describe the relationship of the aortic arch with the recurrent laryngeal nerve.

A

The left recurrent laryngeal nerve branches from the left vagus nerve at the aortic arch and passes under it (posterior to ligamentum arteriosum) and back up superiorly behind the aortic arch.

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6
Q

List three branches of the aortic arch.

A

brachiocephalic trunk; left common carotid; left subclavian

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7
Q

Name the 3 thoracic plexuses formed by branches of the right and left vagus nerves.

A
  1. right pulmonary plexus (at root of right lung)
  2. left pulmonary plexus (at root of left lung)
  3. esophageal plexus
  4. also contributes fibers to cardiac plexus
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8
Q

What are the contents of the posterior mediastinum?

A
  1. thoracic aorta
  2. thoracic duct and lymphatic trunks; lymph nodes
  3. azygos and hemiazygos veins
  4. esophagus and esophageal nerve plexus
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9
Q

What is the cisterna chyli?

A

The origin of the thoracic duct.

It is a dilated sac at the lower end of the thoracic duct into which lymph from the intestinal trunk and two lumbar lymphatic trunks flow. It receives fatty chyle from the intestines and thus acts as a conduit for the lipid products of digestion. It is the most common drainage trunk of most of the body’s lymphatics. The cisterna chyli is located posterior to the abdominal aorta on the anterior aspect of the bodies of the FIRST AND SECOND LUMBAR VERTEBRAE.

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10
Q

Name the 7 branches of the thoracic aorta.

A

4 visceral branches, 3 parietal branches

VISCERAL:

  1. pericardial arteries
  2. bronchial arteries
  3. esophageal arteries
  4. mediastinal arteries

PARIETAL:

  1. posterior intercostal arteries
  2. subcostal arteries
  3. superior phrenic
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11
Q

What are the body regions that drain into the thoracic duct?

A

all lymph except for that of the right superior quadrant drains into the thoracic duct (right superior quadrant drains into the right subclavian)

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12
Q

What are the 3 + 3 + 3 = 9 layers of the abdominal wall? (from superficial to deep)

A

3 associated with skin
3 associated with muscle
3 associated with internal layer

skin
Camper’s fascia (fatty)
Scarpa’s fascia (membranous)

external abdominal oblique muscle
internal abdominal oblique muscle
tranversus abdominus

transversalis fascia
extraperitoneal fascia
parietal peritoneum

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13
Q

What are the arteries, muscles, and nerves found within the rectus sheath?

A

superior and inferior epigastric arteries
lymphatic vessels
thoracoabdominal nerves (T7 - T12)
rectus abdominus muscle

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14
Q

What is the main constituent of the inguinal canal in males and in females?

A

Males: spermatic cord

Females: round ligament

(note that in both sexes the inguinal canal also contains the ilio-inguinal nerve as well as blood and lymphatic vessels)

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15
Q

Name the 9 regions and 4 quadrants of the abdomen.

A

URQ, ULQ, LRQ, LLQ

right and left hypochondriac, right and left lateral, right and left inguinal, epigastric, umbilical, pubic

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16
Q

What are the components of the thoracic diaphragm?

A

skeletal muscle + tendinous portion (central tendon)

17
Q

What are the apertures through the diaphragm?

A

in central tendon: caval opening

in skeletal muscle: esophageal hiatus, aortic hiatus

18
Q

What passes through the caval opening of the diaphragm?

A

inferior vena cava

19
Q

What passes through the esophageal hiatus of the diaphragm?

A

esophagus, right and left vagal trunks

20
Q

What passes through the aortic hiatus of the diaphragm?

A

aorta, thoracic ducts, azygos vein, hemiazygos vein

21
Q

What are the origins, insertions, and innervation of the external abdominal oblique muscles?

A

origin: ribs 5-12
insertion: linea alba, pubic tubercle, ASIS, anterior iliac crest
innervation: ventral rami of spinal nerves T7-T12

22
Q

What are the origins, insertions, and innervation of the internal abdominal oblique muscles?

A

origin: thoracolumbar fascia, iliac crest, lateral inguinal ligament
insertion: ribs 10-12, linea alba, pectin pubis via conjoint tendon
innervation: ventral rami of spinal nerves T7-T12, L1

23
Q

What are the origins, insertions, and innervation of the transversus abdominalis muscle?

A

origin: costal cartilages 7-12, thoracolumbar fascia, iliac crest, lateral inguinal ligament
insertion: linea alba, pubic crest, pectin pubis via conjoint tendon
innervation: ventral rami of spinal nerves T7-T12

24
Q

What are the origins, insertions, and innervation of the rectus abdominus muscle?

A

origin: pubic symphysis, pubic crest
insertion: xyphoid process, costal cartilages 5-7
innervation: ventral rami T7-T12

25
Q

Describe the location & function of the pyramidalis muscle.

A

Present in about 80% of people, it is a small triangular muscle anterior to the rectus abdominus. It extends from pubis to linea alba and tenses the linea alba.

26
Q

Describe the spermatic cord and compare it with the round ligament.

A

Spermatic cord: a layered tube of fascia and muscle derived from the abdominal wall during the descent of the testis. Begins at the deep inguinal ring, traverses the inguinal canal, exits the superficial inguinal ring, ends at the posterior border of the testis.

Round ligament: passes through the inguinal canal and attaches to the subcutaneous tissue of the labium majus.

27
Q

What is the scrotal raphe?

A

Externally, the scrotal raphe marks the fusion of the labioscrotal folds.

28
Q

What is the tunica albuginea?

A

A fibrous layer that adheres to the testicular surface

29
Q

What is the tunica vaginalis?

A

A serous sac derived from the peritoneum that contains a capillary of fluid

30
Q

What structures pass through the diaphragm on their own (not through a hiatus)?

A

sympathetic chain

thoracic splanchnic nerves

31
Q

Describe the structure of the rectus sheath above the arcuate line.

A

Rectus abdominus muscle is within the split aponeurosis of the internal oblique muscle (so some rectus sheath is anterior to muscle, some is posterior)
246N5

32
Q

Describe the structure of the arcuate sheath below the arcuate line.

A

All the layers of the rectus sheath pass anteriorly to rectus abdominus muscle; none are posterior

33
Q

Name the anterolateral abdominal nerves.

A

Thoraco-abdominal (T7-T11)
7th-9th lateral cutaneous branches
Subcostal (T12)
Iliohypogastric (superior terminal branch of L1)
Ilio-inguinal (inferior terminal branch of L1)
p. 194 COA7

34
Q

Describe the structures supplied by the thoraco-abdominal nerves of the anterolateral abdominal region.

A

Muscles of anterolateral abdominal wall and overlying skin. (dermatomes T7-T11!)

35
Q

Describe the structures supplied by the 7th-9th lateral cutaneous branches of the anterolateral abdominal region.

A

Skin of right and left hypochondriac regions.

36
Q

Describe the structures supplied by the subcostal nerve of the anterolateral abdominal region.

A

Muscles of anterolateral abdominal wall and overlying skin, superior to iliac crest and inferior to umbilicus. (dermatome of T12!)

37
Q

Describe the structures supplied by the iliohypogastric nerve.

A

Skin overlying superior part of L1 dermatome; internal oblique and transversus abdominus muscles

38
Q

Describe the structures supplied by the ilioinguinal nerve.

A

Skin overlying inferior part of L1 dermatome; inferiormost internal oblique and transversus abdominus muscles

39
Q

What are the landmark dermatomes for block 2?

A

T4: nipples
T10: umbilicus
L1: inguinal groove

_Anat./GIE #2 (18 decks)

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