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Abdominal muscles, peritoneum & mesenteries, GI tract

1
Q

What is the origin and insertion of the rectus abdominis muscle?

A

Origin: pubic crest, tubercle and symphysis
Insertion: 5th, 6th & 7th costal cartilages, xyphoid process

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2
Q

What are the 4 muscles of the anterolateral abdominal wall? (sup to deep)

A

External oblique
Internal oblique
Rectus abdominis & transversus abdominis

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3
Q

What are the 4 muscles of the posterior abdominal wall?

A

Quadratus lumborum
Iliacus
Psoas major
Psoas minor

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4
Q

Which muscles make up the iliopsoas muscle group, and what is their action?

A

Psoas major and iliacus
Main flexors of hip joint

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5
Q

Which arteries supply the anterolateral abdominal wall? (Which arteries do they arise from?)

A

Superior epigastric (internal thoracic)
Inferior epigastric (external iliac)

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6
Q

What is the difference between an indirect and direct inguinal hernia? Which one is more common?

A

INdirect - goes through INguinal canal
Direct - goes through abdominal wall
Indirect are more common (85%)

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7
Q

What is the blood supply to the posterior abdominal wall?

A

A: abdominal aorta
V: inferior vena cava

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8
Q

Which organs/structures are intraperitoneal? (9)

A

Stomach
Jejunum
Ileum
Caecum
Transverse colon
Sigmoid colon
Liver
Gallbladder
Spleen

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9
Q

Which organs/structures are retroperitoneal? (9)

A

Duodenum (except first part)
Pancreas (except tail)
Ascending colon
Descending colon
Superior rectum
Kidneys & ureters
Adrenals
Aorta
IVC

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10
Q

At what spinal level does the oesophagus enter the abdomen?

A

T10

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11
Q

At what spinal level does the IVC enter the abdomen?

A

T8

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12
Q

At what spinal level does the thoracic aorta enter the abdomen?

A

T12

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13
Q

At what spinal level does the coeliac trunk emerge from the abdominal aorta?

A

T12

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14
Q

At what spinal level does the SMA emerge from the abdominal aorta?

A

L1

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15
Q

At what vertebral level does the spinal cord end?

A

L2

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16
Q

At what vertebral level do the renal arteries emerge from the abdominal aorta?

A

L2

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17
Q

At what vertebral level does the IMA emerge from the abdominal aorta?

A

L3

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18
Q

At what spinal level does the abdominal aorta bifurcate?

A

L4

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19
Q

Which nerve roots does the greater splanchnic nerve have?

A

T5-T9

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20
Q

Which nerve roots does the lesser splanchnic nerve have?

A

T10-T11

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21
Q

What nerve roots does the lumbar splanchnic nerve have?

A

L1-2

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22
Q

Which nerve roots does the least splanchnic nerve have?

A

T12

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23
Q

Describe how the route of the gonadal arteries differ on the right and left

A

L: comes directly from abdominal aorta
R: comes off R renal artery

24
Q

What does the coeliac trunk split into?

A

Splenic artery
Left gastric artery
Common hepatic artery

25
Which arteries supply the lesser curvature of the stomach?
Left and right gastric arteries
26
Which arteries supply the greater curvature of the stomach?
Left and right gastro-omental arteries
27
What is the first branch of the SMA and what does it supply?
Inferior pancreatico-duodenal artery Supplies head of pancreas and 2/3 of duodenum
28
What are the three major branches of the IMA?
Left colic artery Sigmoid arteries Superior rectal arteries
29
What levels of the spinal cord does the sympathetic nervous system originate from?
T1-L2 | Thoracolumbar outflow
30
Where are the preganglionic cell bodies of the sympathetic nerve cell found in the spinal cord?
Lateral horn
31
Describe the route of the sympathetic nervous system from spinal cord to the target organ
1. preganglionic cell body in lateral horn 2. white ramus communicans 3. ganglion 4. sympathetic chain (if target organ not between T1-L2)
32
Where does the parasympathetic nervous system originate from?
CN 3, 7, 9 and 10 S2-4 | Craniosacral outflow
33
What is the name of the parasympathetic nerve arising from S2-4? What is its function?
Pelvic splanchnic nerve Parasympathetic Hindgut innervation Pelvis innervation
34
What is the innervation of the foregut? | Sympathetic and parasympathetic, which ganglia
Sympathetic: greater splanchnic nerve via coeliac ganglion Para: vagus nerve
35
What is the innervation of the midgut? | Sympathetic and parasympathetic, which ganglia
Sympathetic: lesser splanchnic nerve via superior mesenteric ganglion and aorticorenal ganglion Para: vagus nerve
36
What is the innervation of the hindgut? | Sympathetic and parasympathetic, which ganglia
Sympathetic: lumbar splanchnic nerve via inferior mesenteric ganglion Para: **pelvic splanchnic nerves**
37
What are the nerve roots for the pelvic splanchnic nerve?
S2-4
38
What is the innervation of the kidneys and ureters?
Sympathetic: lesser and least splanchnic nerves via renal plexus Ureters: take innervation from different locations as they move down | Renal plexus receives input from coeliac and aorticorenal ganglia
39
What is the innervation of the adrenal glands? Describe the course
Only sympathetic Greater splanchnic straight to adrenal medulla, synapse on chromaffin cells | Chromaffin cells release adrenaline and noradrenaline
40
Describe the innervation of the parietal and visceral peritoneum | How does this affect pain?
Parietal: somatic nervous system, pain very sharp and localised Visceral: visceral nervous system, pain poorly localised, dull
41
What plexuses does the inferior hypogastric plexus give rise to? (3)
Rectal plexus Uterovaginal/prostatic plexus Vesical plexus
42
What nerves form the inferior hypogastric plexus?
Pelvic splanchnic nerves Hypogastric nerves
43
What are the sympathetic functions of the inferior hypogastric plexus? | What nerve roots?
Constriction of smooth muscle of internal urethral and anal sphincters SMC contraction of reproductive and accessary organs Moving secretions during ejaculation | T10-L2
44
What are the parasympathetic functions of the inferior hypogastric plexus? | What nerve roots?
Innervation of hindgut Vasodilatory (erection) Contraction of bladder | S2-4
45
What spinal levels provide somatic **sensory** innervation of the perineum? | What nerve is used?
S3-S5 | Pudendal nerve
46
What spinal levels provide somatic **motor** innervation to the perineum? | What nerve is involved?
S2-S4 | Pudendal nerve
47
What does the gastroduodenal artery supply? (3) Clinical relevance | Where does it lie in relation to the duodenum?
Pylorus of stomach Superior duodenum Head of pancreas Source of GI bleeding in peptic ulcer disease | Posterior to duodenum
48
What is SMA syndrome?
SMA branches off at too acute of an angle from AA Compresses duodenum, causing bowel obstruction
49
What is Nutcracker syndrome?
Acute angled SMA compressing left renal vein Causes backflow obstruction in left gonadal vein
50
What is portosystemic anastamosis? Why does it occur? Why is it useful? Why can it be dangerous?
Anastamoses between portal venous system and systemic venous system Occurs because of portal hypertension e.g. from liver cirrhosis Useful in allowing blood from GIT to bypass blockage Bypassed blood doesn't get detoxified by liver
51
Which systemic vein does the left gastric vein most most commonly anastamose to? What clinical condition can occur if this bursts?
Lower oesophageal Oesophageal varices
52
Which systemic vein does the superior rectal vein most commonly anastamose to? What is the clinical significance?
Inferior and middle rectal veins Rectal varices (internal haemorrhoids)
53
Which systemic vein does the paraumbilical vein most commonly anastamose to? What is the clinical condition that can form?
Epigastric vein Caput medusae
54
Describe the origin and route of the uterine artery
Branch of the anterior division of the internal iliac artery Passes superiorly to ureter (water under the bridge)
55
What does the internal pudendal artery supply? What is the clinical significance?
Perineum, vestibule, clitoris Avoid in episiotomies
56
What are the branches of the internal iliac artery? (proximal to distal)
Umbilical Obturator Inferior vesical/uterine Middle anorectal Internal pudendal Inferior gluteal

Y2 Anatomy (8 decks)

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