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Anatomy > Exam 3 Abdomen, Pelvis > Flashcards

Exam 3 Abdomen, Pelvis Flashcards

0
Q

Interspinous plane

A

goes through ASIS

promontory of sacrum

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1
Q

Transpyloric plane

A

L1,2 disc

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2
Q

boundaries of abdominal region

A

superior: diaphragm
ant & lat: abdominal muscles
post: lumbar verteb, quadratus muscle
inf: iliac crests, sup iliac spine, inguinal lig, pubic tubercle, pubic crest, pubic symphysis

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3
Q

6 planes that pass through abdomen

A
  1. Transpyloric: disc L1,2
    - pylorus of stomach
  2. subcostal: disc L2,3
    - lowest level of costal cartilage
  3. Transumbilical: disc L3,4
    - umbilicus
  4. supracrestal: body of L4
    - highest border of iliac crest
  5. Transtubercular: body of L5
    - iliac tubercles
  6. interspinous: sacral promontory
    - ASIS
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4
Q

epigastric region

A
  • between midclavicular lines
  • superior to subcostal plane (disc L2,3)
  • liver, stomach, gallbladder, transverse colon, pancreas
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5
Q

L Hypochondriac region

A

*upper row, left column
inferior border: subcostal plane (disc L2,3)
medial border: L midclavicular line

organs: stomach, spleen, pancreas, splenic flexure of large intestine (sharp bend between transverse/descending colon)

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6
Q

relation of spleen to midaxillary line

A

majority of spleen is posterior to midaxillary line (ribs 8-11)

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7
Q

9 abdominal regions

A

Upper row: (superior to subcostal plane L2,3)
1.R Hypochondriac (right of R midclavicular line)
2.Epigastric (between midclavicular lines)
3.L Hypochondiac (left of L midclavicular line)
Middle Row: between subcostal (L2,3) & transtubercular (L5)
4.R lumbar
5.Umbilical
6.L lumbar
Lower Row: inferior to Transtubercular plane (L5)
7.R iliac
8.Hypogastric
9.L iliac

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8
Q

4 areas of abdominal region

A
  1. Ant, Lat abdominal walls (abdominal mms)
  2. inguinal (inguinal lig, canal)
  3. Post abdominal wall (lumbar spine, plexus)
  4. abdominal cavity (organs, vessels)
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9
Q

boundaries of anterior abdominal wall

A

anterior: rectus abdominis
lateral: ext/int obliques, transverse abdom

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10
Q

rectus sheath

A

*part of ant abdominal wall

epigastric region: ext obliques split–>A/P sheath
umbilical region: *int oblique splits into A/P
-ant: aponeurosis of ext,int obliques
-post:aponeurosis of int oblique, transverse abdom

hypogastric region:

  • ant:aponeuroses from ext & int obliques, transverse abdom
  • meet ventrally, form sleeve around each rectus muscle
  • post: fascia transversalis–thin layer of CT
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11
Q

Linea Alba

A
  • found in anterior abdominal wall
  • abdominal fibers pass from superficial–>deep (& vice versa)
  • interwinding of L/R rectus sheath in midline
  • xiphoid process to pubic symphysis
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12
Q

external abdominal oblique

A

N:

  • intercostal N T6-T11
  • subcostal N
  • iliohypogastric N
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13
Q

Internal Obliques & Transverse Abdominis

A

N:

  • intercostal N T6-T11
  • subcostal N
  • iliohypogastric N
  • ilioinguinal N
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14
Q

blood vessels to abdominal wall

A
  1. superior epigastric A (from internal thoracic A)
    - to region above umbilicus
  2. inferior epigastric & deep circumflex iliac A (from external iliac A)
    - to region below umbilicus

IN ADDITION:
Posterior intercostal A from T10,11, Subcostal A & Lumbar A (from aorta)
-travel central and anastomose with sup/inf epigastric A

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15
Q

pathway of blood vessels to abdominal wall

A

Aorta->subclavian A->internal thoracic A->super epigastric A –>above umbilicus

Aorta->common iliac A->external iliac A->inferior epigastric A & deep circumflex iliac A–>below umbilicus

Aorta->posterior intercostal A, subcostal A, lumbar A–>umbilicus

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16
Q

veins to abdominal wall

A

*accompany each of the arteries

superior epigastric V->internal thoracic V->brachiocephalic V–> superior vena cava

inferior epigastric & deep circumflex iliac V ->external iliac V -> common iliac V–>inf vena cava

lumbar V –>inf vena cava

post intercostal & subcostal V –>azygos V & hemiazygos V–> superior vena cava

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17
Q

inguinal canal

A

Males:

  • ilioinguinal N
  • spermatic cord
    • vas deferens, testicular A, pampiniform venous plexus of testicular V, genital branch of genitofemoral N

Females

  • Round L of uterus
  • ilioinguinal N
  • genital branch of genitofemoral N
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18
Q

inguinal region: hernias

A

Indirect inguinal hernia: (most common)
-herniation of small intestine into DEEP inguinal ring through inguinal canal, out the SUPERFICIAL inguinal ring

Direct inguinal hernia:
-herniation of small intestine through conjoint tendon (int oblique & transverse abdom) and directly out superficial inguinal ring

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19
Q

aponeurosis of external obliques

A

becomes inguinal ligament

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20
Q

what structure in females does round ligament of uterus go through?

A

deep inguinal ring

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21
Q

posterior abdominal wall boundaries

A

posterior boundaries:

  • lumbar vert
  • QL
  • psoas major
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22
Q

lumbar plexus

A

*post abdominal wall

  • ventral rami of L1-5 spinal nerves
  • L2-4 divide as they pass through psoas
    • ant division: obturator N, part of genitofemoral N, part of lumbosacral trunk
    • post division: lat femoral cutaneous N, femoral N, (accessry obturator N)
  1. iliohypogastric N: L1
  2. ilioinguinal N: L1
  3. genitofemoral N: L1, ant div L2
  4. lateral femoral cutan N: post div L2,3
  5. femoral N: post div L2,3,4
  6. obturator N: ant div L2,3,4
  7. lumbosacral trunk: ant div L4,5
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23
Q

iliohypogastric N

A

L1
sensory to skin: lateral glutes, hypogastric region
motor: ext/int obliques, transverse abdom

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24
Q

ilioinguinal n

A

L1
sensory: skin pubic symphysis, inguinal region, anterior scrotum, labia majora

motor: internal oblique, transverse abdom

25
Q

genitofemoral N

A

L1,L2

sensory: femoral branch, genital branch

26
Q

dermatomes in the thigh

A

lateral femoral cutaneous N (L2,3): lateral thigh
ant femoral cutaneous N (L2,3): ant/medial thigh
posterior femoral cutaneous N (S1,2,3): posterior thigh
posterior division of L1,2,3: mid gluteal region
posterior division of S1,2,3: medial gluteal region
lumboinguinal L1,2: near femoral triangle
ilioinguinal L1: proximal medial thigh (crotch area–>medial to femoral triangle)

27
Q

organs in upper half of abdominal cavity

A
  1. liver
  2. gallbladder
  3. stomach
  4. spleen
  5. pancreas
  6. kidneys
28
Q

organs in lower half of abdominal cavity

A

large, small intestines

29
Q

blood supply to abdominal organs

A
  • Arteries off abdominal aorta to organs
  • venous system (2 routes) to inferior vena cava
    1. venous hepatic portal system
      - stomach, pancreas, spleen, SI, LI –>liver (processing) –> inferior vena cava
    2. venous systemic system
      - liver, kidneys, suprarenal glands, testes, ovaries, lumbar vertebrae, muscles of abdomen return DIRECTLY to inferior vena cava
30
Q

Liver

A
  • heaviest organ
  • 4 lobes: R,L, caudate, quadrate
  • metabolic function:
    • glucose conversion, storage, release
    • amino acid conversion to glucose
    • bile salt formation
    • storage of minerals, iron
  • excretory organ
31
Q

inferior surface of liver

A
  • gallbladder, IVC, hepatic triad, quadrate, caudate
  • hepatic A, hepatic portal V enter near superior end of gallbladder
  • common hepatic duct joints w/ cystic duct to form common bile duct
  • hepatic triad:
    • hepatic A, portal V, bile duct
32
Q

blood supply of the liver

A

2 sources:

1. hepatic A: delivers oxygenated blood from general circulation
2. hepatic portal V: delivers deoxygenated blood from small intestine containing nutrients

*blood drains out of the liver via hepatic V

33
Q

blood flow from abdominal aorta to gallbladder

A

abdominal aorta–>celiac trunk–>common hepatic A–>proper hepatic A–>R,L hepatic A–>cystic A–>gallbladder

34
Q

hepatic portal vein

A

formed by union of:

  1. splenic V (spleen, stomach, pancreas)
  2. superior mesenteric V (stomach, SI, ascending colon, R half transverse colon)
  • inf mesenteric V drains into splenic V –>portal V
    • drains L half of transverse colon, descending colon, sigmoid colon, rectum
35
Q

function of gallbladder

A

stores bile

36
Q

which plane does pancreas sit?

A

transpyloric plane: disc L1,2

37
Q

pancreas arterial blood supply

A
  1. pancreatic A: off splenic A
  2. superior pancreaticoduodenal A: off gastroduodenal A (off common hepatic A)
  3. inferior pancreaticoduodenal A: off superior mesenteric A (off abdominal aorta)

*venous blood enters hepatic portal vein–>liver

38
Q

spleen

A
  • largest lymphoid organ
  • located behind stomach at L posterior abdominal wall
  • laterally @ ribs 9-11

blood supply:

  • abdominal aorta–>celiac A–>splenic A
  • splenic vein joins w/ superior mesenteric V–>hepatic portal V
39
Q

esophagus

A
  • oral cavity through esophageal hiatus-T10
  • ends @ cardiac portion of stomach
  • Receives blood from:
    • thoracic aorta
    • L gastric A (off celiac trunk)
    • L inferior phrenic A (off abdominal aorta)
  • venous blood–>L gastric V–>portal system
40
Q

stomach

A
  • cardiac region: esophagus to stomach
  • fundus: superior dome
  • pylorus: tubular inferior end to duodenum
  • lesser curvature: short sup-medial
  • greater curvature: long inferior-lateral
41
Q

stomach arterial blood supply

A
  1. L gastric A (from celiac trunk–>L part of lesser curvature)
  2. R gastric A (from Common or Proper Hepatic A –> R part of lesser curvature)
  3. L gastroepiploic A (from splenic A–>L part of greater curvature)
  4. R gastroepiploic A (from gastroduodenal A–>R part of greater curvature)
  5. Short gastric A (from splenic A –>fundus of stomach)
42
Q

stomach venous supply

A

*venous blood–>hepatic portal system

  • R, L gastric V–>portal V
  • short gastric V, L gastroepiploic V–>splenic V
  • R gastroepiploic V–>superior mesenteric V
43
Q

Small Intestines: duodenum blood supply

A
  1. Duodenum (from pylorus–>jejunum)
    * Arterial blood (5 arteries)
    • supraduodenal (off gastroduodenal A)
    • superior pancreaticoduodenal (off gastroduodenal A)
    • inferior pancreaticoduodenal (off sup mesenteric A)
    • branches from R gastroepiploic (off gastroduodenal A)
    • branches from R gastric (off common/proper hepatic A)
44
Q

small intestines: jejunum & ileum blood supply

A

jejunum: ~2.5 meters (mainly in umbilical region)
ileum: ~3.5 m (to cecum of ascending colon–mainly in hypogastric & R iliac regions)

  • superior mesenteric A –>jejunal, ileal A
  • veins–>superior mesenteric V–>portal system
45
Q

Intestines: quadrants

A

RUQ: ascending colon, duodenum, jejunum, transverse colon
LUQ: jejunum, transverse colon, descending colon
LLQ: descending colon, a little jejunum, ileum, sigmoid
RLQ: cecum, ascending colon, ileocecal junction, appendix, ileum, a little jejunum

46
Q

Large intestines

A
  • begins @ R iliac region: cecum, appendix post
  • ascending colon: hepatic (R colic) flexure @ liver
  • transverse colon: splenic (L colic) flexure @ spleen
  • descending colon:
    • sigmoid colon (in pelvis)
    • rectum in midsagittal plane
    • anal canal
47
Q

transverse mesocolon

A

mesentery that suspends the transverse colon from the posterior abdominal wall

48
Q

Large intestines blood supply

A
  1. superior mesenteric A: MIDGUT
    * iliocolic A: ileocecal jcn, cecum, appendix, inf ascending colon
    * R colic A: ascending colon
    * middle colic A: to hepatic fixture, R half transverse colon
  2. inferior mesenteric A: to remaining parts (HINDGUT)
    * Lt colic A
    • L sup colic: L half of transverse colon
    • L inf colic: descending colon
      * sigmoid A
      * superior rectal A

3.superior/inferior mesenteric V–>portal V

49
Q

Pelvic Arteries

A
  1. External Iliac (off abdominal aorta)
  2. internal iliac A
    • posterior div
      • iliolumbar A
      • superior gluteal A
      • lateral sacral A
    • anterior division (differ by gender)
      • common:
        • umbilical A
        • obturator A
        • middle rectal A
        • internal pudendal A
        • inferior gluteal A
        • median sacral A
        • vaginal A (female) = inferior vesical A (male)
        • uterine A (female)
50
Q

Kidneys: boundaries

A

Ant:
-L: spleen, stomach, pancreas, L colic (splenic) flexure, jejunum
-R: liver, R colic (hepatic) flexure, duodenum
Post:QL, diaphragm (common site of referred pain)
Lateral: transverse abdominis (common site of referred pain)
medial: psoas major (common site of referred pain)
superior: suprarenal gland

L kidney: T11-L2
R kidney: T12-L3

51
Q

renal cortex

A

glomerulus, bowman’s capsule, prox/distal convoluted tubule

52
Q

Renal pyramids (medulla)

A

papillary duct (collecting tubule), loop of henle (between prox & dist convoluted tubules)

53
Q

suprarenal glands

A

-medial superior pole of kidney
-cortex
*cortisol, aldosterone, corticosterone, estrogen, progesterone
-medulla
*epinephrine, norepinephrine
Blood supply:
-superior suprarenal A (off inferior phrenic A)
-middle suprarenal A (off abdominal aorta)
-inferior suprarenal A (off renal A)
-suprarenal V

54
Q

referred pain site for kidney/ureter

A

inguinal region, ant thigh

55
Q

referred pain site for gallballder, liver

A

R shoulder, scapula area

56
Q

pancreas referred pain site

A

L shoulder, midback

57
Q

stomach/duodenum

A

R shoulder, upper trap, lower thoracic

58
Q

abdominal arteries (9)

A
  • inferior phrenic A: level of aortic hiatus (T12)
  • celiac trunk A: T12
  • superior mesenteric A: L1
  • middle suprarenal A: L1
  • renal A: L2
  • testciular/ovarian A: below renal
  • inferior mesenteric A: L3
  • lumbar A: side of aorta @ L1-4 level
  • common iliac A: disc L4,5
59
Q

celiac trunk

A
  1. common hepatic A:
    * R gastric A
    * proper hepatic–>L hepatic A
    * proper hepatic–>R hepatic A–>cystic A
    * gastroduodenal A
    • supraduodenal
    • superior pancreaticoduodenal
    • R gastroepiploic
  2. L gastric A
    - esophageal A
  3. splenic A
    - pancreatic A
    - short gastric A
    - L gastroepiploic A
60
Q

common iliac A

A
  1. internal iliac A
    - pelvic organs, muscles, perineum
  2. external iliac A (becomes femoral A when it passes deep to inguinal Lig)
    - deep circumflex A
    - inferior epigastric A: abdominal wall

Anatomy (10 decks)

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