Exam III - General Information Flashcards
The liver lies mostly in what abdominal regions?
Right Hypochondrium and epigastric regions
What vertebral level is the Transtubercular plane found?
L.V. 5
Identify the 9 regions of the abdomen
Right Hypochondrium, Epigastric, Left Hypochondrium
Right Flank, Umbilical, Left Flank
Right Groin, Pubic, Left Groin
The spleen and the fundus and body of the stomach can be found in which abdominal regions?
Left Hypochondrium
The umbilical lies between what vertebral levels?
L.V. 2 and L.V. 5
Which layer of fascia is fatty and continuous with the superficial fascia of perineum and thigh?
Superficial Layer (Camper’s Fascia)
Which layer of abdominal fascia is firmly fastened to the fascia lata of the thigh?
Deep Layer (Scarpa’s Fascia)
What is the largest raphe in the body?
Linea Alba
The Linea Alba connects _____ to _____?
xiphoid process to pubic symphysis
What muscle acts as an internal back-brace?
Transversus Abdominis Muscle
What forms the lateral edge of the 6-pack?
Linea Semilunaris
What runs transversely across the rectus abdominis and fuses with the rectus sheath?
Tendinous intersections
What muscle is often absent and lies anterior to the rectus abdominis?
Pyramidalis
The anterior abdominal wall muscles are active in what 6 body functions?
- Coughing
- Sneezing
- Vomiting
- Micturition (urinating)
- Pooping (defication)
- Parturition
What structures make up the rectus sheath?
Aponeuroses of the external oblique, internal oblique, and transversus abdominis muscles
What is enclosed within the rectus sheath?
- Rectus abdominis
- Pyramidalis Muscle (When present)
- Superior Epigastric Artery and Vein
- Inferior Epigastric Artery and Vein
- Anterior Primary Rami of Lower 6 T. Nerves
What is the crescent-shaped line in the posterior layer of the rectus sheath midway between the umbilicus and pubic crest?
Arcuate Line
What are the five folds on the posterior surface of the anterior abdominal wall?
- Median Umbilical Fold
- Medial Umbilical Fold (bilateral)
- Lateral Umbilical Fold (bilateral)
Which fold runs from the apex of the bladder to the umbilicus?
Median Umbilical Fold
Which fold extends from the side of the bladder to the umbilicus?
Medial Umbilical Fold
Which fold contains the obliterated umbilical artery?
Medial Umbilical Fold
Which fold runs from the deep inguinal ring to the arcuate line?
Lateral Umbilical Fold
Which fold contains the inferior epigastric vessels?
Lateral Umbilical Fold
The Median and Medial Umbilical folds form what fossa?
Supravesical Fossa
The Medial and Lateral umbilical folds form what fossa?
Medial Inguinal Fossa
The two lateral umbilical folds combine to form what fossa?
Lateral Inguinal Fossa
What structure above the umbilicus contains the obliterated umbilical vein?
Ligamentum Teres
What is the blood supply to the anterior abdominal wall?
- Superior Epigastric A.
- Inferior Epigastric A.
- Lumbar Arteries
- Deep Circumflex Iliac A.
What is the innervation of the Anterior Abdominal Wall?
- Lower 6 Thoracic Nerves
What is formed by the lower edge of the external oblique aponeurosis?
- The Inguinal Ligament
The inguinal ligament extends from the _____ to the _____.
- Anterior superior iliac spine; pubic tubercle
What are the most medial fibers of the inguinal ligament and insert into the superior pubic ramus?
- Lacunar Ligament
what is the lateral extension of the lacunar ligament?
- Pectineal Ligament
What is the 3-5 cm canal through the anterior abdominal wall?
- Inguinal Canal
The inguinal canal begins at the _____ and ends at the ______.
- Deep inguinal ring; superficial inguinal ring
What is transmitted in the inguinal canal?
- Spermatic Cord
- Round Ligament of the Uterus
- Ilioinguinal Nerve
What is formed by the fusion of the aponeuroses of the internal oblique and transversus abdominis muscles?
- Conjoint Tendon (Inguinal Falx)
What strengthens the posterior wall of the medial half of the inguinal canal?
- Conjoint Tendon (Inguinal Falx)
What are the boundaries of the inguinal canal?
- Ant. Wall: aponeurosis of the external oblique muscle
- Post. Wall: conjoint tendon and transversalis fascia
- Roof: internal oblize and transversus abdominis
- Floor: inguinal and lacunar ligaments
What is the triangular opening in the external oblique aponeurosis?
- Superficial Inguinal Ring
What is transmitted in the superficial inguinal ring?
- Spermatic Cord (male)
- Round ligament of the uterus (female)
- ilioinguinal nerve
The superficial inguinal ring is formed by the splitting of the external oblique aponeurosis into two crura…
- Lateral Crus (pubic tubercle)
- Medial Crus (pubic crest)
The deep inguinal ring is an opening within which fascia?
- Transversalis Fascia
What are the boundaries of the inguinal triangle?
- Med: lateral edge of the rectus abdominis muscle
- Lat: inferior epigastric vessels
- Inf: inguinal ligament
Where do direct inguinal hernias mostly occur?
Inguinal Triangle
T/F) During childhood development, the inguinal canal shortens and moves into a more vertical position.
False; It LENGTHENS and becomes more OBLIQUE
What muscles, upon exertion, may force abdominal contents into the inguinal canal?
Anterior abdominal muscles (coughing & straining)
What two anatomical adaptations function to strengthen the inguinal canal?
- Its oblique positioning
- The conjoint tendon
A ______ is an abnormal protrusion of tissue through an opening.
- Hernia
What organ is most commonly involved in hernias?
- Small Intestine
T/F) Inguinal hernias are more common in males than females.
True
1) Large diameter of inguinal canal (spermatic cord))
2) Scrotum creates a large potential space
What in the female is homologous to the male scrotum?
- Labia Majora
What are the types of hernias?
- Direct, Indirect, Femoral, and Umbilical
Which hernia accounts for 75% of inguinal hernias?
- Indirect Hernias
What is a processus vaginalis?
- An embryological outpouching of peritoneum which forms the inguinal canal and tunica vaginalis that does not obliterate
Trace the path of an indirect inguinal hernia.
Deep inguinal ring -> inguinal canal -> superficial inguinal ring -> scrotum/labia majora
(lateral to the inferior epigastric vessels)
Trace the path of a direct inguinal hernia.
Posterior wall of inguinal canal -> scrotum/labia majora
medial to the inferior epigastric vessels
Which type of hernia is ALWAYS acquired?
- Direct Hernia
What kind of hernia is more common in females?
- Femoral Hernia
Umbilical Hernias usually result from defects in what structures?
- Anterior abdominal wall (incomplete closure)
- Linea Alba
What are the layers of fascia that cover the spermatic cord?
- External Spermatic Fascia (external oblique apo)
- Cremasteric Fascia (internal oblique apo)
- Internal Spermatic Fascia (transversalis fascia)
What is the bundle of muscle fibers within the cremasteric fascia referred to as?
- Cremaster Muscle
What structures are contained within the spermatic cord?
- Ductus Deferens
- Testicular A.
- Pampiniform Plexus of Veins (bulk of spermatic cord)
- Artery to the Ductus Deferens
- Cremasteric A.
- Genital Branch of Genitofemoral N.
- Remnant of Processus Vaginalis
- Autonomic N.
- Lymphatics
What accompanies the spermatic cord in the inguinal canal?
Ilioinguinal Nerve
T/F) The ilioinguinal nerve is part of the spermatic cord.
False; it is not
What branch of the ilioinguinal nerve supplies the upper medial part of the thigh?
Femoral Branch
What branch of the ilioinguinal nerve supplies the root of the penis and anterior part of the scrotum?
Anterior Scrotal or Anterior Labial Nerve
What structures are contained within the scrotum?
- Testes
- Epididymis
- Lower part of the spermatic cord
What is the function of the dartos muscle?
Temperature regulation (firmly adhered to the scrotum)
What are the function of the testes?
- Production of spermatozoa
- Secretion of androgens
What is the tunica albuginea?
- Fibrous outer covering of the testis
- Lies deep to the tunica vaginalis
What is the fibrous compartment in the posterior part of the testis where the septa converge?
- Mediastinum Testis
What is the functional, sperm-producing part of the testis?
- Seminiferous Tubules
How many seminiferous tubules are contained in each lobule?
- 2 or 3
What is the network of canals within the mediastinum testis?
- Rete Testis
What connects the rete testis to the head of the epididymis?
- Efferent Ductules
What is the C-shaped structure attached to the superior and posterior aspect of the testis?
- Epididymis
What is the function of the epididymis?
- Store sperm until they mature
Where does lymphatics from the testis drain?
- Lumbar Nodes
Where does lymph from the scrotum drain?
- Superficial Inguinal Nodes
What structure in the fetus connects the testis to the scrotum?
- Gubernaculum Testis
With what does the peritoneal cavity communicate with the exterior?
- Infections spread through the uterine tubes
While testing for patency of the uterine tube, what does it mean when the dye does not enter the peritoneal cavity?
- There is an obstruction
What are the functions of the peritoneum?
- Minimize Friction between organs
- Resist infection
- Fat storage
What is the innervation of the peritoneum?
- Phrenic N.
- Intercostal N.
- Subcostal N.
- Iliohypogastric N.
- Ilioinguinal N.
What are the three parts of the greater omentum?
- Gastrophrenic Lig. (stomach -> diaphragm)
- Gastrosplenic Lig. (stomach -> spleen)
- Gastrocolic Lig. ( stomach -> transverse colon) (largest)
Because of its ability to restrict the spread of infection, what is the AKA for the greater omentum?
- Abdominal Policeman
What are the two parts of the lesser omentum?
- Hepatogastric Lig. (liver -> lesser curve of stomach)
- Hepatoduodenal Lig. (liver -> duodenum)
What is the general definition of mesentery?
- Any double layer of peritoneum which connects a portion of intestine to the body wall
What is the “mesentery proper”?
- Double layer of peritoneum which connects jejunum and ileum to body wall
What connects the left colic flexure to the diaphragm?
- Phrenicocollic Lig.
What is the irregularly shaped space posterior to the liver, lesser omentum, and stomach?
- Omental Bursa (Lesser Sac)
What connects the Lesser Sac to the Greater Sac?
- The omental foramen
What are the subdivisions within the Greater sac?
- Right Subphrenic Space (below diaphragm, above liver, right of falciform ligament)
- Left Subphrenic Space (below diaphragm, above liver, left of falciform ligament)
- Subhepatic Space (between liver and transverse colon)
- Right Paracolic Gutter (lateral to ascending colon)
- Left Paracolic Gutter (lateral to descending colon)
What is the posterosuperior extension of the subhepatic space, between the liver and right kidney?
- Hepatorenal Recess
What are the boundaries of the omental foramen?
- Liver
- First part of the duodenum
- Free edge of the lesser omentum
- Peritoneum covering the inferior vena cava
What passes through the porta hepatis?
- Bile Duct
- Hepatic Artery Proper
- Portal Vein
What structures make up the Foregut?
- Distal esophagus -> stomach -> second part of duodenum, entrance of the bile duct
What structures make up the Midgut?
- Entrance of bile duct -> right 2/3 transverse colon
What structures make up the Hindgut?
- left 1/3 transverse colon -> upper part of anal canal
What is the blood supply of the GI tract?
- Foregut: celiac trunk
- Midgut: Superior Mesenteric Artery
- Hindgut: Inferior Mesenteric Artery
What is the sympathetic innervation of the GI tract?
- Foregut : greater (T5-T9) and lesser splanchnic nerves (T10-T11)
- Midgut: greater and lesser splanchnic nerves
- Hindgut: lumbar splanchnic nerves (L1-L2)
What is the parasympathetic innervation of the GI tract?
- Foregut: Vagus Nerve
- Midgut: Vagus Nerve
- Hindgut: Pelvic splanchnic Nerves (S2-S4)
What are the autonomic effects on the GI tract?
- Sympathetic: decreases motility and tone; contracts sphincters
- Parasympathetic: increases motility and tone; relaxes sphincters
What are the four major layers of the gut wall?
- Mucosa
- Submucosa
- Muscularis Externa
- Serosa/Adventitia
Where is the muscularis mucosae contained?
- Mucosal layer
Where are blood vessels and lymphatics of the gut wall contained?
- Submucosal Layer
What layer of the gut wall is responsible for peristalsis?
- Muscularis Externa
Where is the submucosal plexus of the enteric nervous system contained?
- Within the submucosa, near the muscularis externa
Where is the myenteric plexus located?
- Between the longitudinal and circular layers of muscularis externa (stimulates peristalsis)
What organ is located in the left hypochondrium, epigastric, and umbilical regions of the abdomen?
- The stomach
What notch is between the body and the pyloric part?
- Angular Incisure
What opening of the stomach is located between the esophagus and the stomach?
- Cardial Orifice
What opening of the stomach connects it with the duodenum?
- Pyloric Orifice
What are the three subdivisions of the pyloric part of the stomach?
- Pyloric Antrum (wide proximal part)
- Pyloric Canal (narrow distal part)
- Pylorus (distal termination; marked externally by the pyloric constriction)
What are the longitudinal folds of mucous membrane within the stomach?
- Gastric Folds (Rugae)
What is the blood supply of the stomach?
- Celiac Trunk
What is the innervation of the stomach?
- Sympathetic: Greater splanchnic nerves
- Parasympathetic: Vagus N.
What is the first unpaired branch off the abdominal aorta?
- Celiac Trunk
What is the smallest branch of the celiac trunk?
- Left Gastric A.
What is the largest branch of the celiac trunk?
- Splenic A.
The small intestine extends from the ______ to the ______.
- pyloric orifice; ileocecal junction
What are the four parts of the duodenum?
- Superior Part (Duodenal Cap/Ampulla)
- Descending Part (bile & pancreatic ducts empty)
- Inferior part (longest)
- Ascending Part (terminates at the duodenojejunal flexure)
What is the blood supply to the duodenum?
- Superior Pancreaticoduodenal A.
- Supraduodenal A.
- Inferior Pancreaticoduodenal A.
What is the fibromuscular band that extends from the diaphragm to the duodenojejunal flexure?
- Suspensory Muscle of the Duodenum
What is the innervation of the duodenum?
- Celiac and Sup. Mesenteric Plexuses
What absorbs fat soluble vitamins?
- Ileum
What segment of the GI tract is most involved with nutrient absorption?
- Jejunum
What are the aggregations of lymphoid tissue within the small intestine?
- Peyer’s Patches
The large intestine extends from the ______ to the ______.
- Ileocecal Junction; anus
What is the primary function of the large intestine?
- convert liquid contents of ileum into feces (absorb water)
Are the ascending and descending colon intraperitoneal or retroperitoneal?
- Retroperitoneal
What is drained in the Portal Venous System?
- GI tract, Spleen, Pancreas, Gallbladder
What drains the kidney and suprarenal gland?
- Caval Venous System
What blood vessels accompany the ligamentum teres to the umbilicus?
- Paraumbilical Veins
Review Portal-Caval Anastomoses
- Page 133
What are the main functions of the liver?
- Bile Secretion
- Metabolism of proteins, fats, and carbs
- Storage of glycogen, vitamins, and iron
- Detoxification
What is contained within the porta hepatis?
- Common Hepatic Duct
- Hepatic Artery Proper
- Portal Vein
The gallbladder lies over which lobe of the liver?
- Right Lobe
What lobe of the liver is anterior to the porta hepatis?
- Quadrate Lobe
What lobe of the liver is posterior to the porta hepatis?
- Caudate Lobe
How is the liver split into functional halves?
- A line is drawn from the inferior vena cava through the gall bladder
T/F) The inferior vena cava lies within the bare area.
True
As the falciform ligament passes posteriorly, it splits to become what?
- Sup. & Inf. Coronary Ligament
What is formed at the junction of the superior and inferior layers of the coronary ligament?
- Right and Left Triangular Ligaments
The ligamentum venosum is the remnant of what embryological structure?
- Dectus Venosum
Name the fissures of the liver.
- Fis. for Lig. Teres (left lobe -> quadrate lobe)
- Fis. for Lig. Venosum (left lobe -> caudate lobe)
- Fossa for Gallbladder (right lobe and quadrate lobe)
- Fis. for Inf. Vena Cava (right lobe -> caudate lobe)
- Porta Hepatis (forms crossbar of “H”)
What is the blood supply of the liver?
- Portal Vein (75-80%)
- Hepatic Artery (20-25%)
The gallbladder drains into what?
- Cystic Duct
Contraction of the gallbladder is initiated by what?
- Cholecystokinin
What is the blood supply of the gallbladder?
- Right hepatic A.
What is formed by the union of the bile duct and pancreatic duct?
- Hepatopancreatic Ampulla
What is the narrowest part of the billiary system?
- Sphincter of Ampulla
What functions to back-fill the gallbladder?
- Sphincter of bile duct
What is the weakest sphincter of the billiary system?
- Sphincter of pancreatic duct
The pancreas is drained by what?
- Pancreatic Duct (neck, body, tail)
- Accessory Pancreatic Duct (head and uncinate process)
What is the blood supply to the pancreas?
- pancreatic branches of splenic A.
- Superior pancreaticoduodenal A.
- Inferior Pancreaticoduodenal A.
What are the functions of the spleen?
- Produce lymphocytes in the newborn
- Remove worn out RBC
- Store RBC
The autonomic plexuses are named for what?
- The artery they lie upon