B5-085 Anterior Abdominal Wall, Inguinal Canal, and Organs Flashcards
I'm so sorry :(
1
Q
name the quadrant the organ is found in
right lobe of liver
A
RUQ
2
Q
name the quadrant the organ is found in
gallbladder
A
RUQ
3
Q
name the quadrant the organ is found in
pylorus of stomach
A
RUQ
4
Q
name the quadrant the organ is found in
parts 1-3 of duodenum
A
RUQ
5
Q
name the quadrant the organ is found in
head of pancreas
A
RUQ
6
Q
name the quadrant the organ is found in
right suprarenal gland
A
RUQ
7
Q
name the quadrant the organ is found in
right kidney
A
RUQ
8
Q
name the quadrant the organ is found in
right hepatic flexure
A
RUQ
9
Q
name the quadrant the organ is found in
superior part of the ascending colon
A
RUQ
10
Q
right half of transverse colon is in what quandrant?
A
RUQ
11
Q
name the quadrant the organ is found in
left lobe of liver
A
LUQ
12
Q
name the quadrant the organ is found in
spleen
A
LUQ
13
Q
name the quadrant the organ is found in
stomach
A
LUQ
14
Q
name the quadrant the organ is found in
jejunum and proximal ileum
A
LUQ
15
Q
name the quadrant the organ is found in
body and tail of pancreas
A
LUQ
16
Q
name the quadrant the organ is found in
left kidney
A
LUQ
17
Q
name the quadrant the organ is found in
left suprarenal gland
A
LUQ
18
Q
name the quadrant the organ is found in
left splenic flexure
A
LUQ
19
Q
name the quadrant the organ is found in
left half of transverse colon
A
LUQ
20
Q
name the quadrant the organ is found in
superior part of descending colon
A
LUQ
21
Q
name the quadrant the organ is found in
cecum
A
RLQ
22
Q
name the quadrant the organ is found in
appendix
A
RLQ
23
Q
name the quadrant the organ is found in
most of ileum
A
RLQ
24
Q
name the quadrant the organ is found in
inferior part of ascending colon
A
RLQ
25
# name the quadrant the organ is found in
right ovary
RLQ
26
# name the quadrant the organ is found in
right uterine tube
RLQ
27
# name the quadrant the organ is found in
abdominal part of right ureter
RLQ
28
# name the quadrant the organ is found in
abdominal part of right spermatic cord
RLQ
29
# name the quadrant the organ is found in
sigmoid colon
LLQ
30
# name the quadrant the organ is found in
inferior part of descending colon
LLQ
31
# name the quadrant the organ is found in
left ovary
LLQ
32
# name the quadrant the organ is found in
left uterine tube
LLQ
33
# name the quadrant the organ is found in
abdominal part of left ureter
LLQ
34
# name the quadrant the organ is found in
abdominal part of left spermatic cord
LLQ
35
if the uterus or urinary bladder are enlarged, what quandrants could they be found in?
RLQ/LLQ
36
list the layers of the anterior abdominal wall as you would encounter them dissecting down
| 8
1. superficial fatty layer (camper's)
1. deep membranous layer (scarpa's)
1. external oblique
1. internal oblique
1. transversus abdominis
1. transversalis fascia
1. extraperitoneal fat
1. parietal peritoneum
37
extends into scrotum as dartos fascia and into the perineum as colle's fascia
deep membranous layer (Scarpa's)
38
what layer is fat removed from during a liposuction?
superficial fatty (camper's)
39
between what two structures do the nerves of the anterior abdominal wall run?
internal oblique
transversus abdominis
40
# descibe the orientation of the muscle fibers for each
external oblique
internal oblique
transversus abdominis
rectus abdominis
external oblique: inferiomedially (hands in pockets)
internal oblique: perpendicular to external obliques
transversus abdominis: horizontal
rectus abdominis: vertical
41
what muscle of the anterior abdominal wall prevents anterior pelvic tilit?
rectus abdominis
42
* structure of abdominal wall that is absent in 20% of people
* tenses linea alba
pyramidalis
43
aponeurosis of the external oblique meets at the midline to join the aponeurosis of the other side, forming what structure?
linea alba
44
name the muscles that make up the rectus sheath **above the arcuate line**
| differentiate posterior and anterior structures
anterior: external and internal obliques
posterior: internal oblique, transversus abdominis, and transversalis fascia
45
name the muscles that make up the rectus sheath **below the arcuate line**
| differentiate posterior and anterior structures
anterior: external obliques, internal obliques, transversus abdominis
posterior: traversalis fascia
46
is the rectus sheath stronger above or below the arcuate line?
| why?
above
| below, the only posterior structure is transversalis fascia = weak
47
vertebrae associated with nipple line
T4
48
vertebrae associated with umbilicus
T10
49
subcostal nerve is located at what vertebrae?
T12
50
L1 bifurcates into what two nerves?
1. iliohypogastric
2. ilioinguinal
51
what nerve innervates the upper inguinal and hypogastric region?
iliohypogastric
| L1
52
what nerve innervates the mons pubis, anterior scrotum/labia, and the medial thigh?
ilioinguinal
| L1
53
[vessel] will anstomose with [vessel] near the umbilicus
superior epigastric
inferior epigastric
54
external iliac a. becomes the [vessel] as it crosses the inguinal ligament
femoral a.
55
the blood vessels of the anterior abdominal wall lie between which two structures?
posterior rectus sheath and rectus abdominis
56
the internal thoracic a. gives rise to [2 vessels]
superior epigastic and musculophrenic
57
the external iliac a. gives rise to [vessel]
inferior epigastric
58
type of hernia common in newborns
umbilical
59
hernia occuring between umbilicus and xiphoid process
epigastric
60
hernia occuring along line of linea semilunaris
spigellan
61
**above the transumbilical plane**, lymphatics drain to what two structures?
axillary lymph nodes
parasternal lymph nodes
62
**below the transumbilical plane**, lymphatics drain to what structure?
superficial inguinal nodes
63
describe the flow of the deep lymphatics
| 3 structures
external iliac to common iliac to lumbar nodes
64
# umbilical folds
remnant of obliterated urachus
median umbilical fold
65
# umbilical folds
remnant of obliterated umbilical arteries
medial umbilical fold
66
# umbilical folds
covers the inferior epigastric vessels
lateral umbilical fold
67
associated with direct inguinal hernias
medial inguinal fossae
68
associated with indirect inguinal hernias
lateral inguinal fossae
69
gonad migration follows what structure?
gubernaculum
70
from what germ cell layer do testes and ovaries derive?
intermediate mesoderm
71
formed when the testis first migrates out of the abdomen and starts to go through muscular layers
deep inguinal ring
72
the testis exits through the abdominal ring forming the
superficial inguinal ring
73
# name the abdominal layers that give rise to the testicular layer
* dartos
* external spermatic fascia
* cremasteric fascia
* tunica vaginalis
* internal spermatic fascia
* dartos: Scarpa's
* external spermatic fascia: external oblique
* cremasteric fascia: internal oblique
* tunica vaginalis: peritoneum
* internal spermatic fascia: transversalis fascia
74
what nerve innervates the posterior scrotum?
posterior cutaneous of thigh
75
what nerve innervates the anterior scrotum?
genitofemoral
| ilioinguinal a bit as well
76
caused by fluid in persisent processus vaginalis
hydrocele
77
hydrocele can be detected using
transillumination
78
the spermatic cord exits the [structure]
superficial inguinal ring
79
you're killing it!
80
supplies blood to testicle
testicular a.
81
thought to help with heat reduction in some animals
pampiniform plexus of veins
82
innervates cremasteric muscle
| pulls testicle toward body to regulate temp
genitofemoral
83
pampiniform plexus of veins becomes enlarged causing scrotal fullness
| bag of worms
varicocele
84
varicocele commonly occurs on which side
left
85
what structure passes through the superficial inguinal ring?
| decribe both male and female
male: spermatic cord
female: round ligament
86
attaches from ASIS down to pubic tubercle
inguinal ligament
87
help to stabilize superficial inguinal ring to prevent splitting
| 2 structures
medial and lateral crus of the external oblique
88
the same fibers that form the inguinal ligament turn and form the [structure], then split and form the [structure]
lacunar ligament
pectineal ligament
89
internal oblique and transversus abdominis join to form what structure?
conjoint tendon
90
inguinal ligament is from what abdominal layer?
external oblique
91
pubic tract is from what abdominal layer?
transversalis fascia
92
lacunar ligament is from what abdominal layer?
external oblique
93
the cremaster muscle is from what abdominal layer?
internal oblique
94
borders of Hesselbach's triangle
inferior epigastric
rectus abdominis
inguinal ligament
95
where do direct inguinal hernias occur?
Hasselbach's triangle
(inferior epigastric vessel, inguinal ligament, and lateral aspect of rectus abdominis)
96
space below the inguinal ligament, next to femoral a. and v.
femoral canal
| site of femoral hernias
97
hernias that occur lateral to inferior epigastic a.
indirect
98
most common type of hernias
indirect
99
hernias that occur medial to inferior epigastic a.
direct
100
many times, indirect inguinal hernias will descend through the inguinal canal to the
scrotum
101
hernias that occur superior to the inguinal ligament
direct and indirect
102
* innervates scrotum
* passes through inguinal canal to scrotum
ilioinguinal nerve
103
innervates the cremaster muscle
genitofemoral
104
hernias more common in women
femoral
| present as emergency
105
hernias inferior to inguinal ligament
femoral
| present as emergency due to strangulation of bowel
106
hernias through femoral canal
femoral
| present as emergencies
107
lymph nodes affected by cancer or infection of testes/ovaries
lumbar nodes
108
lower limbs, gluteal region, scrotum, and inferolateral region of trunk drain into what lymph nodes?
superficial inguinal
109
site of cervical constriction of the esophagus
pharyingo-esophageal junction enclosed by cricopharyngus muscle
| upper esophageal spinchter
110
fundus of stomach herniates through the esophageal hiatus
para esophageal hiatal hernia
111
esophagus, cardia, and fundus all herniate through the esophageal hiatus
sliding hiatal hernia
112
* connects liver to anterior abdominal wall
* divides liver into left and right
falciform ligament
113
portal triad
portal vein
hepatic artery
bile duct
114
found at right side at 9th costal cartilage
gallbladder
115
ascending colon
descending colon
and rectum
| intra or retroperitoneal
retroperitoneal
116
most completely covered with visceral peritoneum
| retro or intra peritoneal
intraperitoneal
| have movement
117
outside of the peritoneal cavity and only partially covered with peritoneum
| intra or retro peritoneal
retroperitoneal
| don't have movement
118
structures anterior to stomach
| 3
anterior abdominal wall
diaphragm
left lobe of liver
119
connects liver to anterior abdominal wall
falciform ligament
120
what ligament contains the teres hepatis
falciform ligament
121
connects liver to duodenum
hepatoduodenal ligament
122
connects liver to lesser curvature of stomach
hepatogastric ligament
123
connects greater curvature of stomach to transverse colon
gastrocolonic ligament
124
connects greater curvature of stomach and spleen
gastrosplenic ligament
125
connects spleen to left pararenal space
splenorenal ligament
126
what ligament contains the portal triad?
hepatoduodenal
127
what ligament contains the gastric vessels?
hepatogastric
128
what ligament contains the splenic artery and vein, and tail of pancreas
splenorenal ligament
129
* lies posterior to the 1st part of duodenum and head of pancreas
* enters 2nd part of duodenum with the pancreatic duct
bile duct
130
3 places gallstones can become lodged
1. cystic duct
2. hepatic duct
3. hepaticpancreatic ampulla
131
# what part of the small intestine?
* greater vascularity
* long vasa recta
* simple vascular arcades
jejunum
132
# what part of the small intestine?
* less vascular
* short vasa recta
* compound vascular arcades
ileum
133
3 bands of longitudinal muscle on outside of colon that produce haustrae
taenia coli
134
* commonly found in the sigmoid colon
* affects middle age/elderly
* most commonly occurs on mesenteric side
| clinical correlation
diverticulosis
135
SADPUCKER
| for retroperitoneal structures
Suprarenal
Aorta and IVC
Duodenum (2-4)
Pancreas (except tail)
Ureters
Colon
Kidneys
Esophagus
Rectum
136
ligaments of the lesser omentum
| 2
hepatoduodenal ligament
gastrohepatic ligament
137
ligaments of the greater omentum
| 3
gastrophrenic
gastrosplenic
gastrocolic
138
the lesser sac communicates with the greater sac via
epiploic foramen
139
boundaries of the epiloic foramen
anterior: hepatoduodenal ligament/portal triad
posterior: IVC and rt. crus of diaphragm
superior: caudate lobe of liver
inferior: 1st part of duodenum
140
what ligament separates greater and lesser sacs on the left?
gastrosplenic
141
what ligament separates the greater and lesser sacs on the right?
hepatogastric
| may be cut during surgery to access lesser sac
142
which ligament borders the omental foramen which connects the greater and lesser sacs?
hepatoduodenal
143
layers of the gut wall
mucosa
submucosa
muscularis externa
serosa (intra) or adventitia (retro)
| MSMS
144
what layer of the gut contains the submucosal nerve plexus (Meissner)?
submucosa
145
what layer of the gut wall contains the myenteric nerve plexus (Auerbach)?
muscularis externa
146
describe the tension, innervation and vascular supply you'd encounter through a **midline** incision
tension: obliques
vascular: none
innervation: none
147
describe the tension, innervation and vascular supply you'd encounter through a **subcostal** incision
tension: some from rectus
vascular: superior epigastric
innervation: thoracolumbar nerve
148
describe the tension, innervation and vascular supply you'd encounter through a **suprapubic** incision
tension: rectus and obliques
vascular: inferior epigastric
innervation: usually no
149
describe the tension, innervation and vascular supply you'd encounter through a **paramedian** incision
tension: obliques
vascular: i dont think any?
innervation: deinervates rectus abdominis (increase risk of herniation)
150
hernia lateral to inferior epigastric vessels
indirect
151
hernia medial to inferior epigastric vessel
direct
152
hernias that occur inferior to inguinal ligament
femoral
153
what is the embryological basis of an indirect hernia?
weakening of abdominal wall due to a defect in processus vaginalis
154
what layers form the hernial sac of an indirect hernia?
peritoneal sac
external oblique (external spermatic fascia)
internal oblique (cremaster muscle)
transversalis fascia (internal spermatic fascia)
155
what gives rise to the external spermatic fascia?
external oblique
156
what gives rise to the cremaster muscle?
internal oblique
157
what gives rise to the internal spermatic fascia?
transversalis fascia
158
what layers form the hernial sac of a **direct hernia**?
parietal peritoneum
transversalis fascia
conjoint tendon
159
what two muscles make up the conjoint tendon?
internal oblique and transversus abdominis
160
what structures may be damaged during a hernia repair?
vas deferens
testicular vessels
external iliac vessels
inferior epigastric
ilioinguinal nerve
161
the ilioinguinal nerve provides sensory for
medial thigh
anterior scrotum/labia
162
the iliohypogastric provides sensory for
mons pubis
163
innervates motor to cremaster muscle
genitofemoral
164
what organs should be considered with mass in RUQ?
liver
gallbladder
right hepatic flexure
head of pancreas
right kidney
right adrenal gland
right transverse colon
pylorus of stomach
165
compression of the common bile duct result in
jaundice
166
pain illicited upon palpation under 9th rib
positive Murphy's sign
| gallbladder pain
167
elevated alkaline phosphatase indicates
billiary issue
168
what structures should be considered in surgery to remove pancreas?
portal triad
small intestine-duodenum
hepatoduodenal ligament
hepatogastric ligament
**SMA and vein**
169
narrowest part of biliary passages and common site of gallbladder obstruction
hepatopancreatic ampulla
(spinchter of Oddi)
170
obstruction of the cystic duct causes
biliary colic
(intense spasmodic pain)
| but no jaundice
171
positive Murphys sign
gallbladder pain
specifically: billiary colic and obstruction of **cystic duct**
172
the neck and uncinate process of the pancreas wrap around what two structures?
| of importance in removal of pancreatic cancer
SMA and SMV
173
the tail of the pancreas and splenic artery run in which ligament?
splenorenal
174
round ligament of the liver runs into the [...] ligament
falciform
175
diaphragmatic irritation refers pain to the
shoulder
176
C4 and 5 keep the [...] alive
diaphragm
177
passage between greater sac and lesser sac
foramen of Winslow
178
what organs are we concerned about in **posterior** stomach rupture
pancreas
kidney
**splenic artery**
left adrenal gland
179
to remove fat during liposuction in which layer is the canula placed?
Camper's subcutaneous tissue
180
extends into the scrotum as dartos fascia and into the perineum as Colle's fascia
Scarpa's fascia
181
extraperitoneal fat is located between the [...] and [...]
parietal peritoneum
transversalis fascia
182
an incision through the [...] would denervate the rectus abdominis
linea semilunaris
183
dermatomal pattern for T1-T2
upper chest
184
dermatomal pattern for T4
nipple line
185
dermatomal pattern for T4-T5
level where sternal angle projects back
186
dermatomal pattern of T10
umbilicus
187
dermatomal pattern T12-L1
hypogastric region
188
fold that contains inferior epigastric vessels
lateral umbilical fold
189
fold that contains obliterated umbilical arteries
medial umbilical fold
190
fold that contains fibrous remnant of urachus
median umbilical fold
191
forms round ligament of liver and travels in falciform ligament
umbilical vein
192
located superior to umbilicus and posterior to rectus abdominis
superior epigastric
193
the internal oblique gives rise to
| 2
cremasteric muscle
conjoint tendon
194
the external oblique gives rise to
| 5
external spermatic fascia
inguinal ligament
lacunar ligament
pectineal ligament
superficial inguinal ring
195
transversalis fascia gives rise to
internal spermatic fascia
196
the tunica vaginalis arises from the
peritoneum
197
forms the posterior wall of the medial third/superficial ring of the inguinal canal
conjoint tendon
198
forms the floor of the middle third of the inguinal canal
inguinal ligament
199
forms floor of medial third/superficial ring of inguinal canal
lacunar ligament
200
forms roof of medial third/superficial ring of the inguinal canal
medial crus of external oblique
201
forms posterior wall of the middle third of inguinal canal
transversalis fascia
202
which dermatomal level corresponds with the level of the inguinal ligament?
L1
203
which dermatomal level corresponds with the level of the nipple line?
T4
204
which dermatomal level corresponds with the level of the umbilicus?
T10
205
an indirect hernia is found in the [...] inguinal fossa
lateral
206
a direct hernia is located in the [...] inguinal fossa
medial
medial to inferior epigastric vessels
207
space located between stomach and pancreas
lesser sac
208
most inferior location of the peritoneum in pelvis
retrovesical space
209
space between rectum and bladder
rectovesicle space
210
opening to omental bursa
epiploic foramen
211
obstruction of [...] would cause enlargement of the gallbladder, but not jaundice
cystic duct
212
enlargement of the gallbladder and obstructive jaundice is cause by what being blocked?
common bile duct
213
connects jejunum and ileum to posterior abdominal wall
mesentery proper
214
* located between stomach and transverse colon
* composed of gastrophrenic, gastrosplenic, gastrocolic
greater omentum
215
* located between liver and stomach
* composed of hepatoduodenal and hepatogastric ligaments
lesser omentum
216
attaches sigmoid to posterior abdominal wall
sigmoid mesocolon
217
attaches transverse colon to posterior abdominal wall
transverse mesocolon
218
the lesser omentum is located between the [...] and [..]
liver
lesser curvature of stomach
219
the greater omentum is located between [...] and [...]
greater curvature
transverse colon
220
located between hilum of spleen and stomach
gastrosplenic ligament
221
located along superior edge of pancreas
splenic vessels
222
what ligament attaches the liver to the anterior abdominal wall
falciform
223
located on diaphragmatic side of liver
coronary ligaments
224
fibrous remnant of the fetal ductus venosus located posteriorly to liver
ligamentum venosum
225
usual source of rectal sheath hematoma
inferior epigastric vein
226
branches of the internal thoracic vein that run posterior to the rectus sheath but superior to umbilicus
superior epigastric vein
227
drain into femoral vein and anastomose with other superficial veins to form a network radiating outward from umbilicus
superficial epigastric
228
what abdominal muscles are contracting to bring right shoulder to left hip?
right internal oblique and left external oblique
229
the thoraco-abdominal nerves run between which two structures?
internal oblique, transversus abdominis
230
what nerve is responsible for the efferent limb of the cremasteric reflex?
genitofemoral
231
innervates cutaneous sensation to the skin over iliac crest, upper inguinal and hypogastric regions
iliohypogastric
232
innervates motor to internal oblique and transversus abdominis
iliohypogastric
233
supplies cutaneous sensation to the skin in T12 dermatome
subcostal nerve
234
supplies motor to the three muscles of the anterior abdominal wall and rectus abdominis
subcostal nerve
235
receive lymph from scrotum, penis, gluteal region, and lower limb
superficial inguinal nodes
236
receive lymph from testis and ovaries
lumbar nodes
237
receive lymph from pelvic viscera
internal iliac nodes
238
branch of L1 that courses between transversus abdominis and internal oblique muscles
iliohypogastric
239
branch of L1 that enters inguinal canal and emerges through superficial inguinal ring
ilioinguinal
240
which structure is likely to be defective due to a malformation of the transversalis fascia during development, resulting in a hernia?
deep inguinal ring
241
lies in the transversalis fascia, lateral to inferior epigastric vessels
deep inguinal ring
242
formed from the internal oblique and transversus abdominis muscles
conjoint tendon
243
in the aponeurosis of the external oblique muscle
superficial inguinal ring
244
formed by aponeurosis of external oblique
| 2
inguinal ligament
lacunar ligament
245
painless swollen testis that feels like a water balloon
hydrocele
246
abnormal dilation of pampiniform plexus of veins causing a "bag of worms" appearance of testis
varicocele
247
structure near free edge of lesser omentum
| 3
portal vein
bile duct
hepatic artery
| hepatoduodenal ligament
248
opening lying posterior to hepatoduodenal ligament (free edge of lesser omentum)
omental foramen
249
posterior boundary of omental foramen
IVC
right crus of diaphragm
250
anterior boundary of omental foramen
hepatoduodenal ligament
251
Pringle's maneuver
hepatoduodenal ligament is clamped to control hepatic bleeding during liver surgery
252
superior boundary of omental foramen
liver
253
can be located by tracing along gallbladder until reaching
omental foramen
254
inferior boundary of omental foramen
first part of duodenum
255
superior pole of the kidney is closely related to [...] rib
12th
256
if gallstones erode through the fundus of the gallbladder, they are likely to enter the
transverse colon
257
resides on left side, close to ribs 9-11
spleen
| rib fractures can damage
258
connects the hilum of the spleen with the left kidney and posterior abdominal wall
splenorenal ligament
259
contains splenic vessels and tail of pancreas
splenorenal ligament
260
connect diaphragmatic surface of liver to diaphragm
coronary ligament
261
composed of hepatoduodenal and hepatogastric ligaments
lesser omentum
262
composed of gastrophrenic, gastrosplenic, and gastrocolic ligaments
greater omentum
263
which omentum attaches from stomach to spleen?
greater omentum
264
which omentum attaches from liver to stomach/duodenum?
lesser omentum
265
runs from left part of greater curvature of stomach to the hilum of the spleen
gastrosplenic
