GI Class 1 - Wet Lab Flashcards
name 1 and 2
1 - xiphoid process
2 - right and left costal margins
name 3 and 4
3 - 12th rib
4 - iliac crest
name 5 and 6
5 - anterior superior iliac spine
6 - pubic tubercle
name 7 and 8
7 - pubic crest
8 - pubic symphysis
name 9 and 10
9 - body of lumbar vertebrae
10 - sacroiliac joint
name the 4 quadrants of the abdomen
1 - right upper
2 - left upper
3 - right lower
4 - left lower
what are the two imaginary lines used to divide the abdomen into 4 quadrants?
name A and B
A - transumbilical line
B - medial line (midsagittal)
what are the lines used to divide the abdomen into 9 regions?
name 1, 2 and 3
1 - right and left midclavicular lines
2 - trans tubercular line
3 - subcostal/transpyloric line
name the 9 regions of the abdomen
right hydrochondriac, epigastric, left hydrochondriac
right lumbar, umbilical, left lumbar
right iliac/inguinal, hypogastric/suprapubic, left iliac/inguinal
what organs or structures may be present in the right hypochondriac region of the abdomen
liver
gallbladder
right kidney
what organs or structures may be present in the epigastric region of the abdomen
adrenal glands
part of the duodenum
most of the stomach
what organs or structures may be present in the left hypochondriac region of the abdomen
left kidney
pancreas
part of the stomach
what organs or structures may be present in the right lumbar region of the abdomen
gallbladder
ascending colon
right kidney
what organs or structures may be present in the umbilical region of the abdomen
umbilicus
transverse colon
many parts of the small intestine e.g. duodenum, jejunum, illeum
what organs or structures may be present in the left lumbar region of the abdomen
descending colon
left kidney
part of the spleen
what organs or structures may be present in the right iliac region of the abdomen
caecum
appendix
right iliac fossa
what organs or structures may be present in the hypogastric region of the abdomen
bladder
anus
part of the sigmoid oclon
what organs or structures may be present in the left iliac region of the abdomen
sigmiod colon
part of the descending colon
left iliac fossa
the antero-lateral abdominal wall is constituted by ______ flat muscles and ____ vertical muscles
the antero-lateral abdominal wall is constituted by three flat muscles and two vertical muscles
what is the action of the external oblique?
compress and support abdominal viscera
flex and rotate trunk
(functions to pull the chest downwards and compress the abdominal cavity, which increases the intra-abdominal pressure as in a valsalva maneuver. It also performs ipsilateral (same side) side-bending and contralateral (opposite side) rotation)
what is the innervation of the external oblique?
thoraco abdominal nerves (anterior rami of T7-11) and subcostal nerve
The external oblique muscle is supplied by ventral branches of the lower six thoracoabdominal nerves and the subcostal nerve on each side
what is the action of the internal oblique?
compress and support abdominal viscera
flex and rotate the trunk
(This muscle supports the abdominal wall, assists in forced respiration, aids in raising pressure in the abdominal area, and rotates and turns the trunk with help from other muscles)
what is the innervation of the internal oblique?
thoraco-abdominal nerve (anterior rami T7-11), subcostal nerve and the first lubar nerve
(Thoracoabdominal nn. (T7-T11), Subcostal n. (T12), Iliohypogastric n. (L1) and Ilioinguinal n. (L1))
what is the action of the transversus abdominis?
compress and supports abdominal viscera
(support for the abdominal wall
role in maintenance of posture
trunk movements: flexion, extension, lateral flexion
raise intra-abdominal pressure e.g. for forced expiration, defaecation, micturition and parturition
via the conjoint tendon, to support the posterior wall of the inguinal canal)
what is the innervation of the transversus abdominis?
thoraco-abdominal nerve (anterior rami T7-11), subcostal nerve and the first lubar nerve
(innervated by the anterior primary rami of T7 to T12. The conjoint tendon is supplied by the ilioinguinal nerve (L1))
what is the action of the rectus abdominis?
flexes trunk and compresses abdominal viscera
stabilizes and controls tilt of the pelvis
(The action of this muscle pulls the rib cage and the pelvic bone towards the middle of the abdomen, just like the movement when a person performs a sit-up or crunch)
(Flexion of the lumbar spine)
what is the innervation of the rectus abdominis?
thoraco-abdominal and sub-costal nerves (anterior rami of T7-12 spinal nerves)
(segmentally by thoraco-abdominal nerves (T7 to T11) and subcostal (T12))
A
transversus abdominis
B
internal oblique
C
external oblique
D
rectus abdominis
is the following pictures from above or below the umbilicus?
left - below level of umbilicus
right - above level of umbilicus
what is the rectus abdominis muscles action on the trunk?
flexes trunk and compresses abdominal viscera, stabilizes and controls tilt of the pelvis
what is the rectus sheath?
contains the rectus abdomins and pyramidalis muscles
The rectus sheath, also called the rectus fascia, is formed by the aponeuroses of the transverse abdominal and the internal and external oblique muscles. It contains the rectus abdominis and pyramidalis muscles
what is the rectus sheath made up of?
the aponeuroses of the transverse abdominal muscle, external oblique muscle and the intenral oblique muscle
what is an aponeurosis?
fibrous tissue that takes the place of a tendon in flat muscles having a wide area of attachment
how does the rectus sheath differ above and below the umbilicus?
above umbilicus: the external oblique runs above the rectus abdominis, transverse abdominis goes behind and the internal oblique splits into 2 and goes above and below
below umbilicus: the rectus sheath only runs on top of the rectus abdominis
arcuate line = a horizontal line that demarcates the lower limit of the posterior layer of the rectus sheath
at what vertebral level is the position of the umbilicus on the abdominal wall?
L3/4
is the umbilicus a good surface landmark?
yes
easily visible
20mm off aortic bifurcation
may be used to estimate the position of the aortic bifurcation however, clinicians must be aware that excessive abdominal wall fat may render this landmark inaccurate
which thoracic spinal segments innervate the anterior abdominal wall?
T7-12
L1
what dermatome supplies the level of the umbilicus?
T10
the inguinal canal is formed during the……
relocation of the gonds during fetal development
it is formed from layers of the anterior abdominal wall as these layers push through the wall obliquely, thus forming a canal
what is the size and location of the inguinal canal?
the canal is approximatley 4cm long and lies parallel to and above the medial half of the inguinal ligament
the inguinal ligament is attached to which two bony points of the hip bone?
anterior superior iliac crest of the iliac
pubic tubercle of the pubic bone
the inguinal canal has what?
2 walls
floor
roof
what makes up the anterior wall of the inguinal canal?
aponeurosis of the external obliques reinforced by the internal oblique muscle laterally
what makes up the posterior wall of the inguinal canal?
transversalis fascia
(a thin aponeurotic membrane which lies between the inner surface of the transverse abdominal muscle and the parietal peritoneum)
what makes up the roof of the inguinal canal?
transversalis fascia
internal oblique and transverus abdominis (muscle and apponeurosis)
what makes up the florr of the inguinal canal?
inguinal ligament
what are the 2 openings of the inguinal canal?
deep inguinal ring superiorly
superficial inguinal ring inferiorly
what is the relationship of the deep inguinal ring to the inferior epigastric vessels?
lateral to them
inferior epigastric vessels lie immediately medial to the deep inguinal ring
where does the superficial ring lie in relation to the pubic tubercle?
just superior (lateral) to it
The superficial (external) ring marks the end of the inguinal canal, and lies just superior to the pubic tubercle
what are the superior and inferior epigastric vessels (deep to the rectus abdominis) branches of?
superiorly - internal thoracic artery
inferiorly - external iliac artery
what are the contents of the male inguinal canal?
spermatic cord
ilioinguinal nerve (a branch of the first lumbar nerve (L1))
blood and lymphatic vessles
what are the contents of the female inguinal canal?
round ligament of the uterus
ilioinguinal nerve (a branch of the first lumbar nerve (L1))
blood and lymphatic vessles
name 3 abdominal hernias
inguinal hernia
femoral hernias
umbilical hernias
what is an inguinal hernia?
most common form of hernias
inguinal hernias can be classified as direct or indirect
what are indirect inguinal hernias
most common
results from congenital weakness in the deep inguinal ring, allowing abdominal contants to enter into the inguinal canal lateral to the inferior epigastric vessles, and even out of the deep inguinal ring
(Indirect inguinal hernias occur when abdominal contents protrude through the deep inguinal ring, lateral to the inferior epigastric vessels; this may be caused by failure of embryonic closure of the processus vaginalis)
what are direct inguinal hernias
direct hernias account for 1/3 of inguinal hernias
abdominal contents do not pass through the deep inguinal ring, but simply push through weak spot in the muscles making up the posterior wall of the inguinal canal, allowing contents to enter the canal and, again, even pass through the superficial inguinal ring
what are femoral hernias?
occur below the inguinal ligament, when abdominal contents pass into weak area at the posterior wall of the femoral canal medial to the inferior epigastric vessels
these are more common in females
the risk of strangulation in a femoral hernia is high
what are umbilical hernias?
occurs when the abdominal contents pass through a weakness at the site of the passage of the umbilical cord through the abdominal wall
in adults umbilical hernias are aquires, rather than congenital
abnormal fibres at the linea alba may also contribute to weakness of the wall
what are the layers of the GI tract?
- mucosa: made of 3 layers
a) epithelium
b) lamina propria
c) muscularis mucosae - submucosa
- muscularis externa/propria
- serosa (or adventitia)
what are the 4 basic mucosal types found in the GI tract and in what locations are they found?
depending on their function
protective - oral cavity, pharynx, oesophagus and anal canal
secretory - seen only in the stomach
absorptive - typical of entire small intestine
absorptive/protective - lines the whole of the large intestine
describe the featues of each image
1 - villi with short glands
2 - stratified squamous epithelium
3 - simple columnar epithelium with tubular glands
4 - closely packed straight glands with goblet cells
