Jan29 M3-Anatomy Lecture 1 Flashcards

1
Q

extraperitoneal fatty tissue location

A

between peritoneum and transversalis fascia

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2
Q

7 layers of the anterior abdomen

A

skin, superficial fascia, deep fascia, anterolateral wall muscles, transversalis fascia, extraperitoneal fatty tissue, peritoneum

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3
Q

superficial fascia components

A

Camper’s fascia (superficial fatty)
Scarpa’s fascia
(deep membranous)

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4
Q

deep fascia def

A

fascia coating/covering every muscle in the body

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5
Q

external oblique runs in what direction

A

hands in pockets.

starts on rib cage.

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6
Q

external oblique: 2 target places where it joins in the bottom

A
  1. inguinal ligament (free lower edge), connected to legs fascia
  2. anterior superior iliac spine (ASIS)
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7
Q

external oblique: midline extensions + name

A

beyond midclavicular line, going to midline is only deep fascia. aponeurosis

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8
Q

pubic tubercle location

A

bottom of linea alba (midline)

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9
Q

where 2 bands of external oblique fascia end up going

A

extend to pubic tubercle

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10
Q

bump on the hip: what it corresponds to

A

anterior superior iliac spine

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11
Q

internal oblique muscle limited to where and extensions

A

muscle doesn’t go medially under the ribs (between the costal margins (infrasternal angle)) and is mostly on the side
still aponeurosis

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12
Q

transversus abdominis direction and fascia

A

horizontal. fascia extending to midline

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13
Q

rectus abdominis covers name and origin

A

rectus sheath: formed by fascias of external oblique, internal oblique and transversalis abdominis

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14
Q

rectus abdominis origin and insertion and direction

A

starts on costal cartilage of costal margin. goes down to pubic crest (near pubic tubercles and pubic symphysis)

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15
Q

how many pubic tubercles and pubic crests and where

A
  • inguinal ligament extends to pubic tubercle

- pubic crest is from pubic tubercle to midline

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16
Q

3 non muscular delineations of the rectus abdominis

A
  • linea alba (middle forward extension of sheaths)
  • linea semilunaris (sides)
  • tendinous intersections
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17
Q

tendinous intersections attach to what structure anteriorly

A

rectus sheath

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18
Q

composition of the rectus sheath right below the xiphoid process (at costal margin level)

A

deep fascia of EO (external oblique) goes on top of rectus abdominis and makes anterior rectus sheath

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19
Q

rectus sheath composition in the middle of the abdomen

A

anterior: EO + half IO deep fascia
posterior: half of IO, TA, transversalis fascia (TF)

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20
Q

lower sheath (low abdomen) composition

A

anterior: EO + all IO + TA (transversus abdominis)
posterior: TF (transversalis fascia)

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21
Q

vessels feeding the rectus abdominis: location in relation to rectus sheath

A

between rectus abdominis and posterior rectus sheath

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22
Q

arcuate line def

A

(lower edge of posterior rectus sheath) transition line below umbilicus where no more posterior rectus sheath

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23
Q

below arcuate line, what is posterior to rectus abdominis

A

transversalis fascia

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24
Q

blood supply to the rectus abdominis

A
  • superior epigastric arteries (from internal thoracic arteries)
  • inferior epigastric arteries (from external iliac artery)
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25
Q

branchings after abdominal aorta

A

2 common iliacs. each gives external iliac (becomes femoral artery in the leg) and internal iliac (to the pelvis)

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26
Q

blood supply to side of the abdominal wall and origin (2)

A
  • lumbar arteries (L1, L2, L3 and L4) from aorta. as if we had rib cage
  • deep circumflex iliac artery (from external iliac)
27
Q

link between superior and inferior epigastric artery

A

they anastomose in the rectus abdominis

28
Q

how inferior epigastric a. reaches the rectus abdominis

A

pierces through the transversalis fascia and reaches rectus from below arcuate line

29
Q

3 folds visible when looking at abdomen from inside and what causes them/origin

A
  • median umbilical ligament (remnant of embryonic urachus
  • medial umbilical ligament (remnant of embryonic umbilical artery)
  • lateral umbilical folds (inferior epigastric vessels)
30
Q

blood supply to abdomen: structure after deep circumflex ilieac

A

ascending branch of the deep circumflex iliac

31
Q

blood supply to abdomen: branch originating from the femoral artery

A

superficial epigastric artery

32
Q

venous drainage: 4 deep vessels

A
  • superior epigastric v (to internal thoracic v)
  • inferior epigastric v (to external iliac v)
  • superficial CIRCUMFLEX iliac v (to femoral v)
33
Q

venous drainage: 3 superficial vessels

A
  • superficial epigastric v (to iliac v)
  • thoraco epigastric v
  • axillary v
34
Q

2 (groups of) lymph nodes important for the abd wall

A
  • axillary lymph nodes

- superficial inguinal lymph nodes

35
Q

thoracic innervation to abd wall and what type of innervation

A

motor and sensory. anterior and lateral cutaneous branches of lowest five throacoabdominal (or intercostal) nerves (T7-T11) + subcostal nerve (T12)

36
Q

landmark for T10

A

belly button

37
Q

two L1 level innervation of abdominal wall and position relative to each other

A

Iliohypogastric nerve (L1) and Ilioinguinal nerve (L1), which is lower than the iliohypogastric n

38
Q

iliohypogastric nerve motor innervation to where and sensory to where

A
  • motor to muscles of abd wall

- sensory to suprapubic region + lateral aspects of the buttocks

39
Q

ilioinguinal nerve motor innervation to where and sensory to where

A
  • motor to muscles of abd wall

- sensory to upper medial part of the thigh, anterior part of the scrotum, mons pubis and labium majus

40
Q

iliohypogastric nerve: how reaches the skin

A

pierces the EO 3-5 cm above the superficial inguinal ring

41
Q

ilioinguinal nerve: how reaches the skin

A

emerges from superficial inguinal ring and passes on the surface of the spermatic cord

42
Q

inguinal canal def

A

canal developed for spermatic cord to get through (since spermatic cord, testes and scrotum are made of layers of abd wall)

43
Q

testes push against which abd layers in development

A

all layers except TA

so transversalis fascia, internal abd oblique, external abd oblique, Scarpa’s fascia, skin

44
Q

how peritoneum relates to the testes

A

gets sucked in the testes during development even though they don’t push on it

45
Q

name of descent of the testes (whole process)

A

processus vaginalis

46
Q

diff abdo layers names once in the testes (inside to outside)

A
  • obliterated processus vaginalis (perit): descent part
  • visceral and parietal tunica vaginalis (perit)
  • internal spermadic fascia (TF)
  • Cremaster muscle (IO muscle)
  • External spermadic fascia (EO aponeurosis)
  • Dartos (Scarpa’s fascia)
  • skin
47
Q

deep inguinal ring def and location

A

where inguinal canal starts to form and stuff first starts to get through. halfway between ASIS and pubic tubercle

48
Q

superficial inguinal ring def

A

where we see the spermatic cord coming off

49
Q

3 structures important in hernial repair

A

conjoint tendon
lacunar ligament
Cooper’s ligament

50
Q

conjoint tendon def

A

fusion of aponeuroses of TA and IO. Inserts on pubic crest in continuity with pectinal line (middle of pelvis anteriorly) Reinforcement of posteror wall of the inguinal canal

51
Q

lacunar ligament def

A

backward and lateralward posterior projection of the inguinal ligament on the pectinal line, after it reaches the pubic tubercle

52
Q

Cooper’s ligament def

A

extension of the lacunar ligament that runs on the pectineal line

53
Q

conjoint ligament position relative to rectus abdominis

A

is where fascias come together in front of rectus

54
Q

inguinal canal content in females

A

round ligament of the uterus

55
Q

direct hernia def

A

direct bulging out of the front wall, medially to the inferior epigastric artery, through Hesselbach’s triangle

56
Q

indirect hernia def

A

intestine pushing down into the scrotum (lateral to inferior epigastric artery)

57
Q

3 borders of inguinal triangle or Hesselbach’s triangle

A

medial: lateral margin of rectus abdominis muscle/sheath
superlateral: epigastric vessels
inferior border: inguinal ligament

58
Q

what is the weakness in the inguinal triangle

A

no transversalis fascia

59
Q

condition where indirect hernia more likely to happen and explanation

A

patent processus vaginalis. no closure of the processus vaginalis (which comes from peritoneum)
can also have partial closure of the processus vaginalis

60
Q

femoral hernias: occur where

A

below inguinal ligament, through the femoral canal/ring

61
Q

mnemonic on structures near the femoral canal/ring

A

NAVEL. nerve, artery, vein, empty, lymphatics

62
Q

condition where an artery sits right in front of the hernial canal (where femoral herniation might happen)

A

abberant obturator artery

63
Q

abdominal hernias occur where and who can check for these

A

anterior abdominal wall. phys exam or CT

64
Q

other name for femoral canal

A

femoral ring