Gross Anatomy of the Abdomen and Pelvis Flashcards
what bounds the anterolateral abdominal wall superiorly and inferiorly
Superiorly:
- 7th through 10th costal cartilages and xiphoid process
Inferiorly:
- Inguinal ligaments and the pelvic bones.
what will cause a narrow scar and what will cause a wide scar in relation to incisions made along or across a cleavage line
An incision along a cleavage line will heal as a narrow scar, while one that crosses the lines will heal as a wide scar
what is the cutaneous nerve supply of the anterolateral abdominal wall
Is derived from the anterior rami of the lower six thoracic and first lumbar nerves
what is the blood supply of the skin near the midline of the anterolateral abdominal wall
Skin near the midline is supplied by branches of the superior epigastric artery (br. of internal thoracic artery) and the inferior epigastric artery ( br. of external iliac artery)
what is the blood supply of skin of the flanks of the anterolateral abdominal wall
Skin of the flanks is supplied by branches from the intercostal, lumbar, and deep circumflex arteries
describe the two layers of superficial fascia of the anterolateral abdominal wall
Fatty layer or fascia of camper is continuous with the superficial fat over the rest of the body and may be extremely thick in obese patients
The membranous layer or scarpa’s fascia is thin and fades out laterally and above - this is located under the camper fascia
External oblique: origin insertion innervation action
- external surfaces of 5th-12th ribs (lower 8)
- linea alba, pubic tubercle, and iliac crest
- thoracic-abdominal nerves (T7-11 spinal nerves) and subcostal nerve
- compresses and supports abdominal viscera and flexes and rotates trunk
Internal oblique: origin insertion innervation action
- thoracolumbar fascia, iliac crest
- Linea alba, pubis, last 3 ribs
- thoraco-abdominal nerves (anterior rami of T6-T12 spinal nerves) and first lumbar nerve
- compresses and supports abdominal viscera and flexes and rotates trunk
Transversus abdominis: origin insertion innervation action
- Inguinal ligament, thoracolumbar fascia, cartilage of last 6 ribs, iliac crest
- Linea alba, pubis
- thoraco-abdominal nerves (anterior rami of T6-T12 spinal nerves) and first lumbar nerve
- Compress abdominal contents
Rectus abdominis: origin insertion innervation action
- Pubis
- Xiphoid process, costal cartilages of ribs 5-7
- thoraco-abdominal nerves (anterior rami of T6-T12 spinal nerves)
- trunk flexion
function of the Muscles of Anterolateral Abdominal Wall
Compress abdominal organs:
- raise intra-abdominal pressure: defecation, childbirth, micturition,flatulence, vomiting
- raise intra-thoracic pressure: laughing, coughing, shouting
Stabilize back (posture)
what type of tendon allows the internal oblique and transverses abdominis to insert together on the pubis
a conjoint tendon
Pyramidalis: origin insertion innervation action
what is abnormal about this muscle
pubis
linea alba
T12
tense linea alba
absent in 1/5 people
what are the contents of the rectus sheath
- Rectus abdominis
- Pyramidalis
- Anterior rami of T7-12
- Superior & inferior epigastric vessels
what intercostal nerves make up the thorax-abdominal nerves
T7-11
what makes the subcostal nerve
T12
at what level does the abdominal aorta divide into the L & R Common iliac arteries
L4
what forms the two lateral umbilical folds
due to underlying inferior epigastric vessels
what forms the two medial umbilical folds
ue to underlying medial umbilical ligaments (remnants of fetal umbilical arteries)
what forms the median umbilical fold
due to underlying median umbilical ligament
remnant of fetal urachus which drained urine from the bladder –> umbilicus
describe the Superficial lymphatic drainage of lymphatics above and below the umbilicus
above = axillary nodes
below = superficial inguinal nodes
describe the Deep lymphatic drainage of the abdomen
drain to deeper nodes and then drain to the cisterns chyli
what are the anterior border, posterior border, roof and floor of the inguinal canal
Anteriorly: Aponeurosis of External Oblique
& laterally reinforced by Internal Oblique lying superficial to the deep ring
Posteriorly: Transversalis fascia
& medially reinforced by the conjoint tendon lying posterior to the superficial ring
Roof: The arching fibers of the internal oblique & transversus abdominis
Floor: Inguinal ligament
how might an indirect inguinal hernia occur in males
Just before birth, the testes are pulled through the abdominal wall carrying with them a sac-like extension of the abdominal wall called the processus vaginalis
The connection between the abdomen & the sac surrounding the testicle should disappear - if NOT - Indirect inguinal hernia may result
what are the contents of the inguinal canal
Spermatic cord (♂)/ Round Ligament of the Uterus (♀)
Genital branch of the Genitofermoral nerve
Ilioinguinal nerve
what is the difference between an indirect (congenital) and direct inguinal hernia
Indirect:
The intestine goes through the deep ring and into the INguinal canal, & may emerge at the superficial ring
Direct:
The intestine goes through a weak area/tear in the abdominal wall (e.g. Hesselbach’s triangle a.k.a. medial inguinal fossa, which is directly posterior to the superficial ring
what are the boundaries of Hesselbach’s inguinal triangle a.k.a medial inguinal fossa
inferior epigastric vessels
rectus abdominis (lateral edge)
inguinal ligament
see L36
S 35
define peritoneal cavity
The peritoneal cavity is the fluid-filled space between these 2 layers it contains peritoneal fluid that reduces friction between the wall/organs & immune cells to prevent infection.
define visceral peritoneum and parietal peritoneum
Peritoneum is a mesothelium (like the pericardium & pleura) that consists of 2 continuous layers:
• Parietal peritoneum lines the walls of the abdominopelvic cavity
• Visceral peritoneum lines most of the abdominal organs
define retroperitoneal (primarily and secondarily)
see lecture 37 slide 3
Primarily Retroperitoneal: Organs on posterior wall, covered by peritoneum only on anterior surface
Secondarily Retroperitoneal: Initially intraperitoneal but was pushed against posterior wall during development & fused to the posterior abdominal wall
what does Intraperitoneal mean
see lecture 37 slide 3
Intraperitoneal: covered by visceral peritoneum, and suspended by a mesentery/ligament
at what level does the oesophagus perforate the diaphragm
t10
what is the differences between the jejunum and the ileum
see lecture 37 slide 11
what ligament if found between the liver and diaphragm
coronary ligament
what is the name of the ligament between the liver an anterior abdominal wall
falciform ligament
what are the boundaries of the mental foramen
lecture 37
slide 19
name three functions of the greater omentum
- fat storage
- insulation and protection
- passively moves and adheres to inflamed organs to isolate inflammation
what is contained within the portal triad
- Common Bile Duct
- Hepatic Artery (proper)
- Hepatic Portal Vein
what is jaundice and what are some of the causes
Bilirubin buildup in tissues
Causes:
- Liver disease
- Blockage of bile duct
- Excess RBC breakdown
- Newborn jaundice - Caused by increased RBC turnover & insufficient bilirubin clearance by the immature liver
a patient experiences Intermittent intense spasmodic right upper quadrant pain after a meal. The pain relieves after a while.
what is the most likely cause of this
Gallstones:
Intermittent intense spasmodic right upper quadrant pain after a meal (biliary colic). This happens when the gallbladder tries to contract against a temporarily blocked duct. The pain relieves when gallbladder relaxes and stone falls away from duct
If the common bile duct is blocked & inflamed (cholangitis) it can cause: • Jaundice if bile cannot
be excreted
• Pancreatitis if blockage
where do the veins of the spleen, stomach and intestine drain to
the hepatic portal vein
what is the function of the thoracolumbar fascia
- Separate muscle into compartments
- Stabilization of trunk when flexed
Which spinal nerves form the phrenic nerves?
C 3, 4, 5 keep the diaphragm alive!
at what level are the kidneys found
T12-L3
why does the right kidney lie slightly more inferiorly compared to the left
The Right kidney lies slightly more inferiorly due to the liver
describe the blood supply and blood drainage of the Adrenal (aka Suprarenal) Glands
Blood supply: 3 suprarenal arteries supply each gland:
- Superior (from inferior phrenic a)
- Middle (from aorta)
- Inferior (from renal a)
Blood Drainage: 1 suprarenal vein
(on the R this drains to the IVC, on the L it drains to the L renal vein)
what are the Three structures are attached to the cornu
- round ligament anteriorly,
- uterine tube centrally,
- ovarian ligament posteriorly.
what are the three subcomponents of the broad ligament in females
Mesometrium - the mesentery of the uterus; the largest portion of the broad ligament.
Mesosalpinx- the mesentery of the Fallopian tube.
Mesovarium - the mesentery of the ovaries.
where do the right and left testicular veins drain to
Right testicular vein drains to inferior vena cava
Left testicular vein drains to left renal vein
