APP Flashcards by Galvin Chiam

Posterior abdominal wall muscles and action

Iliacus and psoas major: hip flexion

Quadratus lumborum: lateral flexion of lumbar spine

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Anterolateral abdominal wall muscles

Rectus abdominis
External oblique
Internal oblique
Transversus abdominis

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Features of rectus abdominis

Wide at top, narrow at bottom
Divided by tendinous intersections
Enclosed by rectus sheath where posterior layer ends between umbilicus to pubic symphysis(arcuate line)

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Inguinal canal contents

Male: spermatic cord, ilioinguinal nerve

Female: round ligament, ilioinguinal nerve

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Blood vessels of anterior abdominal wall and which artery the branch from

Superior epigastric artery(from internal thoracic)

Inferior epigastric artery(from external iliac)

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Indirect vs direct inguinal hernia

Indirect: herniation at scrotum, abdominal defect

Direct: weakness in abdominal muscles, potrudes anteriorly when standing up

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Stomach curvatures and attachments

Lesser curvature->lesser omentum ->contains gastrohepatic ligament and diaphragm attachment

Greater curvature->greater omentum ->contains gastrocolic ligament

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Which parts of the duodenum are retroperitoneal

All except first part

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What does epiploic foramen lead to

Omental bursa formed by lesser omentum

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Duodenum ligaments

Suspensory ligament holds distal part of duodenum

Hepatoduodenal ligament

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Difference between proximal and distal jejunoileum

Proximal: single arcade
Distal: multiple arcades

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What attaches small bowel to posterior abdominal wall

Mesentary

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Colon longitudinal muscle

Not continuous
Divided into 3 strips called teniae coli
Outer bulges called haustra

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Colon attachments

Ascending: peritoneum
Transverse: transverse mesocolon, gastrocolic ligament
Sigmoid: sigmoid mesocolon

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What is perineal flexure

Curve between rectum and anal canal

Maintained by forward pull of puborectalis

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What makes up anal sphincter

Internal(involuntary): continuation of smooth muscle, present in proximal 2/3 of anus

External(voluntary): annular fibres(upper) and fibres that go back to front(lower)

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External anal sphincter attachments

Posterior: anococcygeal ligament
Anterior: perineal body

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Liver ligaments

Falciform(attach to ant abdo wall, divides liver into left and right lobes)
Triangular(superior lateral edges)
Coronary(attach to inf diaphragm)
Lesser omentum(attach to stomach and diaphragm)

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Liver lobes

Right
Left
Quadrate(inferior)
Caudate(superior)

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What is ligamentum teres

Remnant of umbilical vein

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Bile pathway

Right/left hepatic duct->cystic duct(spiral)->gall bladder->common bile duct

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Structures posterior to pancreas

Body of L1
IVC
Aorta
Superior mesenteric artery
Left kidney

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Parts of pancreas that are retroperitoneal

Head, neck, body

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Spleen ligaments

Gastrosplenic: left gastroepiploic artery and short gastric arteries
Lieno-renal: splenic artery&vein and tail of pancreas

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Kidney internal structure

3-4 major calyces drain into renal pelvis Renal papilla attach to each end of calyx Renal cortex is outer Renal medulla is inner

Ureter in relation to psoas major

Ureter is anterior

Testicular/ovarian vessels inrelation to ureter

Ureter is posterior

Male glands near bladder

Prostate is inferior Vas deferens travels close to midline and widens to form ampulla Lateral to ampulla is seminal vesicle

Bladder entry and exit

Entry: ureteric ostium Exit: internal ureteric meatus

Coeliac trunk branches

Left gastric Common hepatic Splenic

Common hepatic artery branches

Hepatic: right gastric, right hepatic, left hepatic Gastroduodenal: right gastroepiploic, pancreaticoduodenal

Stomach blood supply

Lesser curve: right and left gastric Greater curve: right and left gastroepiploic

Where does left gastroepiploic artery branch from

Splenic artery

What does superior mesenteric artery supply

Distal duodenum Jejunoileum Ascending colon Part of transverse colon

Vessels surrounding superior mesenteric artery

Anterior is splenic vein | Posterior is left renal vein

Colon blood supply

Ascending colon: right colic(SMA) Transverse colon: middle colic(SMA) and left colic(IMA) Descending colon: left colic(IMA) Upper rectum: superior rectal(IMA)

Lower rectum blood supply

Internal iliac artery

What forms portal vein

``` Superior mesenteric veins(right and middle) Splenic vein(left) ```

Bones of pelvis

Ilium Ischium Pubis

What forms greater and lesser sciatic foramina

Sacrotuberous ligament | Sacrospinous ligament

Bones that form obturator foramen

Ischium | Pubis

Ligaments between sacrum and ilium

Anterior sacroiliac ligament | Posterior sacroiliac ligament

Pelvic wall muscles and attachment

Piriformis Obturator internus Both attach to greater trochanter of femur

Pelvic diaphragm muscles and origin&attachment

Coccygeus: ischial spine to coccyx Levator ani: body of pubis and ischial spine to meet fibres on contralateral side External anal sphincter(continuous with levator ani)

Levator ani muscles

Puborectalis Iliococcygeus Pubicoccygeus

Urogenital hiatus of levator ani

Urethra Rectum Vagina(female)

Arteries that pass through greater sciatic foramen and origin

Superior and inferior gluteal arteries(internal iliac)

Internal pudendal artery origin and pathway

Branch of internal iliac | Passes through GSF, looping around sacrospinous ligament, entering LSF

What does internal pudendal artery supply

Anal sphincter Pelvic diaphragm External genitalia(female) Penis(male)

What does pudendal nerve supply

Anal aphincter Muscles of urogenital diaphragm External genitalia

Layers of penis

Tunica vaginalis Tunica albuginea Seminiferous tubules

What makes up the spermatic cord

Vas deferens | Testicular blood vessels

Tissue in penis

``` 2 corpus cavernosa(erectile) Corpus spongiosum(contains urethra) ```

Penis ligaments

Suspensory ligament->holds penis superiorly Triangular ligament->holds penis to pubic symphsis

Penis muscles

Ischiocavernosus->surrounds each corpus cavernosum Bulbospongiosus->surrounds corpus spongiosum

4 parts of male urethra

Prostatic Membranous Bulbar Penile

Female perineal fossae

Rectouterine pouch(Douglas) Vesicouterine pouch Post. Fornix of vagina

What is the foramen of cervix called

Ostium/external os

Uterus ligaments

Broad ligament attaches uterus laterally Mesosalpinx attaches fallopian tube to broad ligament Mesovarium attaches ovaries to broad ligament Suspensory ligament provides ovarian artery Round ligament attaches uterus anteriorly

Vagina folds

Outer: labia majora Inner: labia minora

Female genital muscles

Labia minora contains bulbospongiosus Ischiocavernosus is parallel to ischiopubic ramus

What is the clitoris

Erectile tissue | Contains 2 crura that unite at midline to form body of clitoris

Recurs sheath borders

``` Linea alba (midline) Linea semilunaris (lateral) ```