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General Anatomy Sem1 > Ch 4 Abdomen (Conceptual) > Flashcards

Ch 4 Abdomen (Conceptual) Flashcards

1
Q
  • hepatic portal vein
  • hepatic sinusoids
  • hepatic veins
A
  • venous blood from digestive tract, pancreas, gallbladder, spleen enters inferiorly
  • vascular exchange network of liver
  • drain into inferior vena cava
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2
Q

Portcaval anastomoses

  • round ligament of the liver
  • other regions of interconnect
A

overlap between portal and caval systems
-inferior end of esophagus
-inferior part of rectum
(will enlarge)

*connects the umbililicus of ant abdominal wall w/ the left branch of the portal vein as it enters the liver

*liver - diaphragm
gastrointestinal tract - posterior abdominal wall
posterior surface of pancreas

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3
Q
  • Portal hypertension

- caput medusae

A
  • esophageal varices and hemorrhoids at the esophageal and rectal ends of gastrointestinal sys
  • systemic vessels radiate from para-umbilical veins enlarge and become visible on the abdominal wall
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4
Q

-Prevertebral plexus

A

-innervation of the abdominal viscera,associated mainly w/ anterior and lateral surfaces of aorta

  • contains:
    • sympathetic from T5-L2
    • parasympathetic from [X] and S2 to S4

-visceral sensory fibers

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5
Q

9-region organizational pattern

-Planes (4)

A
  1. subcostal- superior horizontal plane, is inferior to the costal margins, lower rib X, posterior through LIII
  2. intertubercular-inferior horizontal plane, connects tubercles of iliac crests, passes through LV
    3/4. Right/left midclavicular planes-pass inferiorly to anterior superior iliac spine and pubic symphysis
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6
Q

Name the 9 regions

A
  1. right hypochondrium
  2. left hypochondrium
  3. epigastric region
  4. right groin
  5. left groin
  6. right flank
  7. left flank
  8. umbilicus region
  9. pubic region
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7
Q

Superficial fascia:

  • superficial fatty layer
  • dartos fascia
  • deeper membranous layer
  • fascia lata
  • superficial perineal fascia (Colle’s fascia)
  • superficial fascia of the penis
  • fundiform ligament of penis
A
  • Camper’s fascia: continuous over inguinal ligament, with the superficial fascia of the thigh and w/ a similar layer in the perineum
  • in men, this layer continues over penis, losing fat, fusing w/ superficial fascia, continues into scrotum, containing smooth muscle fibers. In women, retains fat, and is part of labia majora
  • Scarpa’s fascia: thin, contains little or no fat
  • deep fascia of the thigh
  • anterior part of perineum, firmly attached to ischiopubic rami and to posterior margin of the perineal membrane.
  • in men, the deeper membranous layer of superficial fascia blends w/ the superficial layer as they both pass over the penis (before forming the dartos fascia)
  • in men, extensions of the deeper membranous layer of superficial fascia (attached to the pubic symphsis) pass inferiorly onto the dorsum and sides of the penis. in women, membranous layer goes into the labia majora and the ant part of perineum.
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8
Q

3 major arteries from anterior ab aorta that supply abdominal gastrointestinal system(liver, pancreas, gallbladder):

  1. celiac artery
  2. superior mesenteric artery
  3. inferior mesenteric artery
A
  1. foregut-upper LI
  2. midgut-lower LI
  3. hindgut-LIII
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9
Q
  • gonad descend from __ and into __:
  • gubernaculum
  • processus vaginalis
  • inguinal canal
  • spermatic cord
  • tunica vaginalis
  • round ligament of uterus
A
  • posterior abdominal wall, pelvic cav-girl, scrotum-boy
  • cord of tissue passes through anterior abdominal wall, connects inferior pole of each gonad to scrotum or labia majora
  • tubular extension of peritoneal cavity and muscular layers of ant ab wall project along gubernaculum on each side into labioscrotal swellings
  • passage through anterior abdominal wall created by processus vaginalis
  • tubular extension of layers of ab wall into the scrotum that contains all structures passing between testis and abdomen.
  • the distal sac-like terminal end of the spermatic cord on each side contains the testis, associated structures, and the now isolated part of the peritoneal cavity.
  • in women, derivative of gubernaculum that passes through the inguinal canal. because the gonads descend to a position just inside the pelvic cavity and never pass through the ant ab wall.
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10
Q

Transpyloric plane

A
  • horizontal at LI
  • midway between jugular notch and pubic symphysis
  • crosses through opening of stomach into duodenum (pyloric orifice
  • crosses through body of pancreas
  • approx. position of kidney hila:
    • left kidney higher than right kidney
    • crosses inferior left hilum and superior right hilum
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11
Q
  • The ant rami of thoracic spinal nerves T7 to T12 follow the inferior slope of lateral parts of ribs and cross costal margin to enter ab wall.
  • skin and muscle of abdominal wall
  • external oblique
  • skin over xiphoid
  • inguinal, suprapubic regions of ab wall
A
  • Intercostal T7 to T11, subcostal T12
  • Intercostal T5 and T6
  • T6
  • L1
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12
Q

Structures passing between ab and thigh

A
  • IVC
  • aorta
  • LIV and LV
  • inguinal ligament
  • psoas major muscle
  • iliacus muscle
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13
Q

-Structures that pass through aperture of Lower limb:

  • vessels passing inferior to inguinal ligament:
  • external iliac artery
  • vein of abdomen
A
  • major artery/vein
  • fermoral nerve: extends the knee
  • lymphatics
  • distal psoas major and iliacus: flex the thigh
  • -femoral artery
  • vein of thigh
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14
Q

Pelvic inlet

A
  • sacrum post
  • pubic symphysis ant
  • bony rib of pelvic bone, laterally

*pelvic cavity projects posteriorly and inlet opens anteriorly

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15
Q

Diaphragm:

  • a muscular extension firmly anchors the diaphragm to the anterolateral surface of the vert column
    • LIII
    • LII
  • cross muscles of posterior ab wall and attach to vertebrae, the transverse processes of LI and rib XII
  • crosses aorta and is continuous w/ the crus on each side
A
  • musculotendinous
  • crus
    • right
    • left
  • medial/lateral arcuate ligaments
  • median arcuate ligament
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16
Q

Margins of superior aperture of ab/inferior thoracic aperture (closed by diaphragm)

A
  • TXII
  • rib XII
  • rib XI
  • costal margin
  • xiphoid process of sternum
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17
Q

Abdominal cavity:

  • thin sheets of tissue
  • proximal regions of gut tube
  • entire length of system
  • lines abdominal wall
  • covers suspended organs
  • epithelial-like single layer of cells
  • suspended from abdominal wall by mesenteries
  • are not suspended in ab cavity by a mesentery and that lie bet parietal peritoneum and ab wall
A
  • mesenteries
  • ventral (anterior) mesentery
  • dorsal (posterior) mesentery
  • parietal peritoneum
  • visceral peritoneum
  • mesothelium
  • intraperitoneal
  • retroperitoneal
    • kidneys, ureter
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18
Q

Abdominal Wall:

-Skeletal elements

A
  • 5 lumbar vertebrae
  • pelvic bones
  • costal margin
  • rib XII
  • end of rib XI
  • xiphoid process
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19
Q 
Abdominal Wall:
Muscles
-Lateral to vertebral column(posterior aspect)
-Lateral abdominal wall
-anteriorly, segmented
  • aponeuroses
  • fascial layer of varying thickness separates the ab wall from the peritoneum, which lines the ab cavity.
A
  • quadratus lumborum, psoas major-flex hip, iliacus muscles-flex hip
  • transversus abdominis, internal oblique, external oblique
  • rectus abdominis, pyramidalis

*flat tendious sheets derived from muscles of the lateral wall

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20
Q

Breathing of abdominal wall:

  • inspiration
  • expiration
A
  • relaxes, contracts diaphragm

- contracts, relaxes diaphragm

21
Q

-contraction of abdominal walls

A
  • increases intra-abdominal pressure

- for micturition, defecation, parturition

22
Q

Abdomen viscera (under domes of diaphragm)

*those not under, are protected by muscular walls of abdomen

A
  • liver
  • gallbladder
  • stomach
  • spleen
  • colon
  • parts of urinary system
  • small intestine
23
Q

Abdomen viscera (by mesenteries or musculoskeletal wall)

A
  • caudal end of esophagus
  • stomach
  • small/large intestines
  • pancreas
  • gallbladder
  • spleen
  • kidneys and ureters
  • suprarenal glands
  • major neurovascular structures
24
Q
  • Pelvic inlet:

- Peritoneal cavity:

A
  • the deep abdominal wall is continuous with the pelvic wall

- chamber enclosed by the ab wall, freely communicates w/ pelvic cavity.

25
Q

Venous shunts from left to right:

A
  • left renal vein: drains kidney, suprarenal gland, and gonad
  • left common iliac vein at LV: drains lower limbs, pelvis, perineum, parts of ab wall
  • left lumbar veins: drain back and posterior abdominal wall
26
Q
  • common large ab incision, from xiphoid process to symphysis pubis, which provides wide access to the whole ab contents and allows an exploratory procedure to be performed
  • removal of gallbladder
  • removal of appendix
A
  • central craniocaudad incision (laparotomy)
  • cholecystectomy
  • appendectomy
27
Q
  • 3 flat muscles
  • Associated ligaments
  • Transversalis fascia->parietal pelvic (endopelvic) fascia
A
  1. external oblique: inferomedial direction
    - form linea alba in center
    - inguinal ligament
    - lacunar ligament
    - pectineal (Cooper’s) ligament
  2. internal oblique: superomedial direction
  3. transversus abdominis
    - deep to transversus abdominis, lines ab cavity, and continues into pelvic cavity
28
Q

-2 vertical muscles

A
  1. rectus abdominis: intersected by tendinous intersections

2. pyramidalis: anterior to rectus, small, triangular-shaped, which maybe absent

29
Q

Rectus sheath:

  • upper three-quarters
    • anterior wall
    • posterior wall

-lower one-quarter (between umbilicus and pubic symphysis)

A
  • aponeurosis of external oblique and half internal oblique
  • aponeurosis of other half internal oblique and transversus abdominis
  • all of aponeurosis move anterior to rectus muscle, theres no posterior wall of rectus sheath
  • it becomes directly in contact w/ transversalis fascia
30
Q

-separates transversalis fascia from peritoneum and is abundant on posterior ab wall

A

-extraperitoneal fascia

  • preperitoneal
  • retroperitoneal
31
Q

Arterial/Venous supply and drainage:

  • Superficially
  • Deeper
A
  • musculophrenic artery(internal thoracic artery), superficial epigastric artery (femoral artery), superficial circumflex iliac artery
  • superior epigastric artery, 10th/11th intercostal arteries, subcostal artery, inferior epigastric artery, deep circumflex iliac artery (external iliac artery)
32
Q

Direct inguinal hernias

A
  • peritoneal sac enters medial end of inguinal canal through a weakened posterior wall
  • acquired, in mature men
  • bulging occurs in the inguinal triangle (Hesselbach’s triangle)
    • bounded by inferior epigastric artery(lateral), rectus abdominis(medial), inguinal ligament(inferior)
  • may exit through the superficial inguinal ring
  • thickening of transversalis fascia(iliopubic tract)
  • lateral to inferior epigastric vessels
33
Q

Indirect inguinal hernias

A
  • most common. and more in men.
  • congenital
  • peritoneal sac enters inguinal canal by passing through deep inguinal ring (lateral to inferior epigastric vessels) because part or all of embryonic processus vaginalis remains open.
  • if open, can exit superficial inguinal ring, and into scrotum or labia majora (transversing entire length of canal)
  • lateral to inferior epigastric vessel
34
Q

Inguinal hernia

A

-protrusion or passage of a peritoneal sac, w/ or w/o abdominal contents, through a weakened part of the abdominal wall in the groin

35
Q

-a cord-like structure that passes from the uterus to the deep inguinal ring where it enters the inguinal canal, and exits through superficial inguinal ring.

A

-Round ligament of uterus

36
Q
  • Contents of Spermatic Cord

* and Fascia enclosing it

A
  • ductus deferens
  • artery to ductus deferens
  • testicular artery
  • pampiniform plexus of veins
  • cremasteric artery and vein
  • genital branch of genitofemoral nerve
  • sympathetic and visceral afferent nerve fibers
  • lymphatics
  • remnants of the processus vaginalis

*external spermatic fascia-superficial
cremasteric fascia
internal spermatic fascia

37
Q

Contents of inguinal canal

  • in men
  • in women
A
  • spermatic cord
  • round ligament of uterus and genital branch of the genitofemoral nerve in women
  • ilio-inguinal nerve (L1)
38
Q
  • formed by the medial one-half of the inguinal ligament

- a gutter or trough on which the contents of the inguinal canal are positioned

A

-the floor

39
Q

-formed by the arching fibers of the transversus abdominis and internal oblique muscle

A

-roof

40
Q

Inguinal canal

A
  • slit-like passage that extends downward and medial direction, just above and parallel to the lower half of the inguinal ligament
  • begins at deep inguinal ring
    • internal spermatic fascia
  • ends at superficial inguinal ring
    • external spermatic fascia
41
Q

inguinal ligament

A

-passes between anterior superior iliac spine laterally and pubic tubercle medially

42
Q
  • passes through the femoral canal and into the medial aspect of the anterior thigh
  • acquired
  • middle-aged and elderly
  • more common in women
A

-femoral hernia

43
Q
  • rare
  • congenital
  • result from failure of the small bowel to return to the ab cavity from the umbilical cord during dev’t
  • incomplete closure of umbilicus
A
  • umbilical hernias

* para-umbilical: in adults, around umbilicus and often have small necks, so need surgery

44
Q
  • occur through defect in a scar of a previous ab operation
  • wide
  • do not strangulate vicera
A

-incisional hernias

45
Q
  • passes upward through the arcuate line into the lateral border at the lower part of the posterior rectus sheath
  • present as a tender mass on one side of the lower ant ab wall
A

-spigelian hernia

46
Q

Anterior wall of inguinal canal

A
  • aponeurosis of external and internal oblique
  • cremasteric fascia
  • cremasteric muscle
  • provides additional covering of weakness at the deep inguinal ring
47
Q

Posterior wall of inguinal canal

A
  • transversalis fascia
  • reinforced by conjoint tendon (inguinal falx)
  • provides additional support to weakness of ant ab wall
48
Q

lymphatic drainage

A
  • axillary nodes
  • superficial inguinal nodes
  • parasternal nodes
  • lumbar nodes
  • external iliac nodes
49
Q
  • exploratory procedure
  • removal of gallbladder
  • removal of appendix
A
  • laparotomy
  • cholecystectomy
  • appendectomy

*central craniocaudad incision

General Anatomy Sem1 (12 decks)

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