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GI > Lect 3: Anterior Abdominal Wall, Inguinal Region, and Peritoneum > Flashcards

Lect 3: Anterior Abdominal Wall, Inguinal Region, and Peritoneum Flashcards

0
Q

Transumbilical Plane (Location)

A

@ L3/L4 separates 4 quadrants of abdomen (along with median plane - vertical)

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1
Q

Lesser vs. Greater curvature of stomach

A

Lesser - faces right Greater - faces left

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2
Q

Subcostal Plane (Location)

A

L3

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3
Q

Transtubercular plane (location)

A

L5

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4
Q

Transpyloric plane (location, intersections)

A

@ L1 and 9th costal cartilage *Intersects: - pyloric sphincter of stomach - funds of gallbladder - duodenojejunal junction - neck of pancreas - hiatus of kidneys

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5
Q

Umbilicus (location)

A

L3-L4

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6
Q

Linea semilunaris

A

depression at lateral edge of each rectus abdominus muscle

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7
Q

Lowest level of costal margin

A

L3

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8
Q

Iliac crest (location)

A

L4

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9
Q

2 types of superficial fascia of abdomen

A
  1. Camper’s 2. Scarpa’s
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10
Q

Camper’s fascia

A
  • fatty, superficial fascia - continuous with tunica dartos in the scrotum (muscle that contracts when cold)
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11
Q

Scarpa’s fascia

A
  • membranous, superficial fascia - blends with fascia of thigh (although can be separated) - continuous with Colles’ fascia of perineum
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12
Q

Superficial Arteries of Abdomen

A
  1. Anterior perforating arteries (from superior and inferior epigastric A. - inferior epigastric from the external iliac A) 2. Lateral cutaneous arteries (from lower intercostal, subcostal, and lumbar A)
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13
Q

Superficial Arteries of Inguinal Region

A

From femoral A: 1. superficial epigastric (to lower abdomen) 2. superficial circumflex iliac (to lower abdomen above inguinal ligament) 3. superficial external pudendal (to pubic region)

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14
Q

Anterior perforating veins drain to the

A

superior and inferior epigastric VV

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15
Q

Lateral cutaneous veins drain to the

A

thoracoepigastric V (then will travel up to axillary vein or down to femoral vein)

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16
Q

Superficial inguinal vein drain to the

A

femoral V

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17
Q

Paraumbilical vein drain to the

A

portal V –> umbilical V (along the falciform ligament)

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18
Q

Caput medusae

A

portal drainage obstructed –> build-up of pressure –> drainage to tributaries of umbilical vein (distinctive pattern of visible superficial veins results)

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19
Q

Superficial lymphatics of abdomen

A
  • above umbilicus –> anterior axillary nodes - below umbilicus –> superficial inguinal nodes
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20
Q

Deep lymphatics of abdomen

A
  • parasternal (follows internal thoracic A) - lumbar (follows abdominal aorta) - external iliac nodes (follows external iliac A)
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21
Q

Cutaneous Nerves to abdomen (lateral, anterior, and pubic)

A
  1. lateral and anterior –> from T7 - T12 2. L1: - iliohypogastric N (lower hypogastric region) - ilioinguinal N (inguinal region)
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22
Q

Key features at T7, T10, and L1 dermatomes

A

T7 - just below xiphoid process T10 - umbilicus L1 - inguinal ligament and pubic symphysis

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23
Q

External spermatic fascia

A
  • from external oblique aponeurosis and fascia - outermost fascia of spermatic cord
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24
Inguinal canal (deep and superficial rings and contents)
\*deep \*ring: evagination of transversalis fascia - lateral to inferior epigastric A and V \*superficial \*ring: b/w lateral and medial crura of external oblique Contains: 1. ilioinguinal N 2. (males) - spermatic cord (females) - round ligament of uterus
25
Cremaster fascia (and muscle)
- from internal oblique - middle layer of fascia for spermatic cord
26
Internal spermatic fascia
- from transversalis fascia - innermost fascia of spermatic cord
27
Tunica vaginalis
- serous sac that covers testis - parietal and visceral layers
28
Scrotum (contents)
- end of spermatic cord - epididymis - testis
29
Scrotum (layers)
1. skin 2. tunica dartos (smooth muscle that is a continuation of camper's fascia of lower anterior abdomen)
30
Epididymis
- stores sperm - receives sperm from seminiferous tubules of testis via efferent ductules - epididymus --\> vas deferens (begins at tail of epididymus)
31
Vas deferens
- thick-walled muscular tube - conveys spermatozoa - passes with spermatic cord and externally to peritoneum in the pelvic cavity - expands to form ampulla which forms an ejaculatory duct with the seminal vesicle
32
3 arteries of scrotum
1. testicular A - supplies testis and epididymis (from abdominal aorta) 2. artery of vas deferens - from inferior vesical artery 3. cremasteric artery - from inferior epigastric artery
33
Pampiniform plexus
- venous drainage of testis and epididymis - surround testicular artery to allow for cooling (needed for spermatogenesis) - combines into 1 testicular vein at inguinal canal - \*varicocele - due to obstruction of vein
34
Testicular veins terminates as
(right) - IVC (left) - left renal V.
36
3 Inguinal nerves
1. Genitofemoral N (L 1 and 2) - 2 branches: genital - enters spermatic cord via deep inguinal ring; motor to cremaster muscle femoral - enters thigh; sensory to thigh 2. Ilioinguinal N (L1): bw internal oblique and transversus abdominus, through inguinal canal but does NOT pierce deep inguinal ring - sensory to anterior scrotum/labia majora and to thigh 3. Iliohypogastric N (L1) - b/w I.O. and T.A. muscles - NOT within inguinal canal
37
Descent of gonads by
processus vaginalis (guided by gubernaculum) - obliterated in females; becomes tunica vaginalis in males
38
Gubernaculum remnants become
- males: scrotal ligament - females: superior - ligament of ovary, inferior - round ligament of the uterus
39
Hydrocele and Hematocele
- accumulation of fluid or blood (respectively) in the tunica vaginalis via distention - can lead to inguinal hernias
39
Femoral hernias
- more common in females - pass posterior to inguinal ligament in thigh
40
Direct vs. Indirect Hernias
- DIRECT: push out though the Hesselbach's (inguinal) triangle (usually don't reach testis) - INDIRECT: pass through deep inguinal ring (and the entire inguinal canal); may reach scrotum \*\* BOTH pass through superficial inguinal ring
41
Lymph drainage of scrotum
superficial inguinal --\> deep inguinal --\> external iliac nodes
42
Lymph drainage of testis
along testicular arteries --\> lumbar (para-aortic) nodes posteriorly
43
Ligament (peritoneal reflection)
suspends/supports abdominal organ
44
Mesentery (peritoneal reflection)
encloses an organ AND conveys blood and nerves and stores fat
45
Falciform ligament
b/w diaphragm and anterior abdominal wall & liver
46
Coronary ligament and R/L triangular ligaments
b/w diaphragm and liver
47
Mesentery proper
b/w posterior abdominal wall and coils of jejunum/ileum
48
Sigmoid mesocolon
b/w posterior abdominal wall and sigmoid colon
49
transverse mesocolon
b/w pancreas and transverse colon
50
ligament of Treitz
suspensory ligament of duodenum (made from right crus of diaphragm) junction of retroperitoneal duodenum and intraperitoneal jejunum
51
Retroperitoneal organs
1. Kidneys (ureters, adrenal glands) 2. Aorta and IVC 3. Duodenum (except 1st part) 4. Colon (except transverse) 5. Pancreas (except tail)
52
Median umbilical fold covers
fetal urachus (median umbilical ligament)
53
Medial umbilical fold covers
obliterated umbilical artery
54
Lateral umbilical fold covers
inferior epigastric vessels
55
Omental bursa (lesser peritoneal sac)
- posterior to stomach and lesser omentum - hepatogastic and hepatoduodenal ligaments
56
Epiploic foramen
- communication b/w greater and lesser peritoneal sacs - extends to hilum of spleen (gastrosplenic and lienorenal ligaments) - anteriorly: portal vein, hepatic artery, and bile duct - posteriorly: IVC
58
Greater omentum
- hangs from greater curvature of stomach - can move - prevents spread of fluid and infection - fusion with omental bursa = gastrocolic ligament
58
Hepatogastric ligament
- prat of the lesser omentum - at lesser curvature of stomach - fuses with liver
59
Hepatoduodenal ligament
- Part of lesser peritoneal sac - from upper border of duodenum and porta hepatis
60
Paracolic gutters
- pathways that allow flow of fluid/infection - helps prevent spread into other areas - four of them: R lateral, R medial, L medial, and L lateral

GI (40 decks)

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