GI session 1

Question 1

Abdominal wall constituents

Answer 1

Sheets of muscle and sheets of tendon (aponeuroses)

Question 2

Aponeuroses functions

Answer 2

Hold abdominal viscera in cavity. Rotate body. Respiration, coughing, sneezing, micturition, defecation, childbirth

Question 3

How do aponeuroses carry out functions

Answer 3

By contracting to increase intra-abdominal pressure

Question 4

Hernia definition and cause

Answer 4

bowel or other organs protruding out of abdomen. weaknesses in muscle wall.

Question 5

Muscles on side of midline

Answer 5

Pair of muscles on each side of midline - rectus abdominis muscle

Question 6

Rectus abdominis muscle attachments

Answer 6

Superiorly - sternum and costal margin
Inferiorly - pubis
Surrounded by - rectus sheath

Question 7

Lateral to rectus sheath

Answer 7

3 sheets of muscle w/ fibres running in different directions.

Question 8

Directions of 3 muscle fibres

Answer 8

External oblique: obliquely downwards and inwards
Internal oblique: Obliquely upwards and inwards
Transvesus abdominis: transversely

Question 9

Aponeuroses of muscle layers

Answer 9

Become aponeurotic as they pass towards rectus sheath

Question 10

Aponeurosis of external oblique

Answer 10

Lowest most extent is aponeurotic throughout length.

Question 11

Attachments of external oblique

Answer 11

Laterally: anterior superior iliac spine
Medially: pubic tubercle
Inguinal ligament

Question 12

Inguinal canal

Answer 12

above inguinal ligament. In males, it transmits structures to and from testes - spermatic cord

Question 13

Bony landmarks of the abdomen

Answer 13

Xiphisternum
Costal margin
Iliac crest
anterior superior illiac spine
pubic tubercle
pubic symphysis

Question 14

deliniation of 9 abdominal regions

Answer 14

2 vertical and 2 horizontal lines

Question 15

Vertical line

Answer 15

extends from mid-clavicular pint to mid-inguinal point

Question 16

mid-inguinal point

Answer 16

midway between pubic symphysis and anterior superior iliac spine

Question 17

Lower transverse line

Answer 17

between tubercles of iliac crests

Question 18

upper transverse line

Answer 18

subcostal plane (line joining lowest part of costal margins on both sides)

Question 19

3 central regions

Answer 19

epigastric, umbilical and suprapubic (superior to inferior)

Question 20

3 lateral regions

Answer 20

hypochondrium, flank and iliac fossa

Question 21

extensions from fossa

Answer 21

towards back: loin, lumbar region

Question 22

Transpyloric plane of Addison

Answer 22

passes horizontally across epigastrium and reaches costal margin at most lateral part of rectus abdominis muscle. Tip of 9th costal cartilage, where mid-clavicular line crosses costal margin

Question 23

Organs lying on transpyloric plane of Addison

Answer 23

gall bladder, pancreas, plyorus of stomach and duodeno-jejunal flexure

Question 24

sub-costal plane

Answer 24

lies at lowest points of costal margin

Question 25

McBurney’s point

Answer 25

2/3 of way along line joining umbilicus to right anterior superior iliac spine. Marks usual site of base of appendix. Position of caecum.

Question 26

Umbilicus

Answer 26

insertion of umilical cord during embryonic life and level of L3 vertebra

Question 27

intertubercular plane

Answer 27

level of tubercles of iliac crests. position of bifurcation of abdominal aorta.

Question 28

Intercristal plane

Answer 28

highest point of pelvis.

Question 29

Foregut innervation and pain

Answer 29

Greater sphlanic nerve arising from T5 to T9 spinal level. Anteriorly in midline (epigastrum).

Question 30

Midgut innervation and pain

Answer 30

Lesser sphlanic nerve from T10 and T11 (periumbilical area)

Question 31

Hindgut innervation and pain

Answer 31

lowest sphlanic nerve from T12 (suprapubic area)

Question 32

Peritoneum innervation and pain

Answer 32

same sensory nerve supply as skin overlying abdominal wall

Question 33

Diaphragm innervation and pain

Answer 33

Phrenic nerve, C3, C4 and C5.
Diseases irritating diaphragm - cholecystitis (inflammation of gall bladder) - pain in C3,4,5 distribution. Pain felt in shoulder.

Question 34

Cholecystitis

Answer 34

Inflammation of gall bladder

Question 35

Kidney innervation and pain

Answer 35

Sensory innervation is via sympathetic plexus accompanying renal artery (T10,11,12) (same as gonad).
Pain referred along cutaneous nerves of T10, 11, 12(most common). Radiates from loin to groin.