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Anatomy (MPAS) > Lecture 17: Abdomen I > Flashcards

Lecture 17: Abdomen I Flashcards

1
Q

What are the boundaries of the abdomen?

A

Superior: The diaphragm (fifth intercostal space)

Posterior: Lumbar vertebrae and quadratus lumborum muscles

Anterolateral: The muscles of abdominal wall

Inferior: The pelvic brim

See figure

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2
Q

What are the planes that divide the abdomen into quadrants?

A

Median plane (midline)

Transumbilical plane

See figure

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3
Q

What are the abdominal quadrants?

A

Right upper quadrant

Left upper quadrant

Right lower quadrant

Left lower quadrant

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4
Q

What are the planes that divide the abdomen into 9 parts?

A

Midclavicular planes

Subcostal planes

Transtubercular plane

See figure

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5
Q

What are the 9 abdominal regions?

A

Right hypochondriac region

Epigastric region

Left hypochondriac region

Right lumbar region

Umbilical region

Left lumbar region

Right iliac (inguinal) region

Hypogastric (pubic) region

Left iliac (inguinal) region

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6
Q

What are the layers of the anterolateral abdominal wall (superficial to deep)

A

skin

superficial fascia (fatty layer)

deep fascia (scrape fascia)

muscles

transversalis fascia,

extraperitoneal fat/fascia

peritoneum

See figure

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7
Q

Clinical significance of the scarpa fascia

A

Used to hold sutures when abdominal surgery is done, another layer of sutures in the skin

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8
Q

What happens if you move deep to the peritoneum?

A

In the abdominal cavity

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9
Q

What are the functions of the abdominal muscles?

A
  1. Protection of abdominal viscera
  2. Movement of the trunk
  3. Allow expansion of abdominal cavity
  4. Compressing the abdominal viscera
  5. Expelling abdominal contents (micturition, defecation, parturition, vomiting) – increase intra-abdominal pressure
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10
Q

What are the muscles of the anterolateral abdominal wall?

A

External oblique

Internal oblique

Transversus abdominis

Rectus abdominus

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11
Q

What is the outermost layer of abdominal muscles?

A

External oblique

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12
Q

How do the fibres of the external obliques run?

A

Down and toward the midline

“Hands in your pockets”

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13
Q

Actions of external oblique muscles

A

Flexion and rotation of trunk

Compression of viscera

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14
Q

Where are the internal obliques?

A

Middle layer of abdominal muscles

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15
Q

How do the fibres of the internal obliques run?

A

down and away from midline (perpendicular to external obliques)

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16
Q

Actions of internal obliques?

A

Flexion and rotation of trunk

Compression of viscera

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17
Q

Location of the transverses abdominus

A

Deepest and thinnest layer of abdominal muscle

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18
Q

How do the fibres of the transverses abdomens run?

A

Horizontally

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19
Q

Actions of transverses abdominus

A

Compression of viscera only!

No trunk movement (“suck it in”)

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20
Q

Appearance and location of rectus abdominus?

A

Pair of long, straplike muscles

extend vertically from the pelvis to the ribs

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21
Q

What separates the rectus abdominus muscles?

A

Linea alba (midline)

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22
Q

What are the rectus abdominus muscles enclosed within?

A

rectus sheath (aponeuroses of obliques)

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23
Q

How are divisions of rectus abdominus separated? How many divisions are there?

A

tendinous intersections

8 pack

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24
Q

Actions of rectus abdominus

A

Flexion of the trunk

Compression of viscera

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25
Q

Shape and origin of quadrates lumborum

A

Square-shapedmuscle originating on the pelvis

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26
Q

Action of quadrates lumborum

A

Powers lateral flexion of the lumbar spine

Stabilizes the 12th rib against the action of the diaphragm during inspiration

27
Q

What does psoas major combine with?

A

Combineswithiliacus to form iliopsoas

28
Q

Action of psoas major

A

Powers hip flexion and can also flex the trunk laterally

29
Q

Innervation of psoas major

A

Femoral nerve

30
Q

Abdominal muscles - cross section

A

See figure

31
Q

Innervation of anterolateral abdominal wall

A

Mixed sensory and motor nerves

Anterior rami of spinal nerves T7 to L1

Includes intercostal nerves (T7-T11), subcostal nerve (T12), iliohypogastric and ilioinguinal nerves (L1)

See figure

32
Q

What are the primary blood vessels of the anterolateral abdominal wall?

A

Superior epigastric vessels and branches of the musculophrenic vessels from the internal thoracic vessels.

Inferior epigastric and deep circumflex iliac vessels from the external iliac vessels.

See figure

33
Q

What is the inguinal canal?

A

4 cm long tube-like space within the lower part of the anterior abdominal wall

Begins at the deep inguinal ring and ends at the superficial inguinal ring

34
Q

What gender has the inguinal canal?

A

Present in males and females

35
Q

Importance of inguinal canal in males

A

where the testis, which develop in the abdominal cavity, descend down into the scrotum

36
Q

What are the boundaries of the inguinal canal?

A

Floor: inguinal ligament

Anterior wall: external oblique aponeurosis

Roof: formed by arched fibres of internal oblique and transversus abdominis muscles

Posterior wall: transversalis fascia (laterally) and conjoint tendon (medially)

37
Q

Rings (openings) of the inguinal canal

A

Superficial inguinal ring: triangular opening in the external oblique aponeurosis

Deep inguinal ring: opening in the transversalis fascia.

38
Q

Contents of the inguinal canal in males and females

A

Males: the spermatic cord and its coverings + the ilioinguinal nerve.

Spermatic cord contains: vas deferens, testicular artery and vein, genital branch of the genitofemoral nerve, lymphatic vessels

Females : the round ligament of the uterus + the ilioinguinal nerve.

See figure

39
Q

What is the peritoneum?

A

Transparent membrane that covers most (BUT NOT ALL!) abdominal organs

See figure (white lines are peritoneum)

40
Q

2 layers of peritoneum

A

Parietal – lines the abdominal wall

Visceral – covers the viscera

41
Q

Role of peritoneum

A

Secretes peritoneal fluid that lubricates the organs and prevents friction

42
Q

2 main divisions of peritoneal cavity

A

Greater sac (green): largest part of the cavity

Lesser sac (blue): smaller part, situated posterior to the stomach and liver

See figure

43
Q

When are the divisions of the peritoneal cavity formed?

A

During embryonic development

44
Q

Greater sac

A

See figure

45
Q

What is the greater omentum?

A

Double layer of peritoneum, impregnated with fat and blood vessels

46
Q

What does the greater momentum attach to?

A

stomach and transverse colon, inferior border is free

Hangs down like an apron, covering the abdominal viscera

47
Q

Role of greater omentum

A

Prevents organs from sticking to the anterior abdominal wall

48
Q

Mobility of greater omentum

A

Very mobile!

Can sense, migrate and wrap itself around an inflamed or infected organ!

Will also wrap itself any foreign object (clinical significance)

49
Q

What are the parts of the greater omentum?

A

Gastrophrenic ligament

Gastroplenic ligmament

Gastrocolic ligament

See figure

50
Q

Lesser sac

A

aka mental bursa

See figure

51
Q

What is the lesser sac?

A

A pouch found posterior to the stomach

52
Q

How does the lesser sac communicate with the greater sac?

A

Via the epiploic foramen (behind the stomach)

See figure

53
Q

Clinical significance of lesser sac

A

The inferior recess of the lesser sac extends a considerable distance

Infectious material from abscesses can collect here!

54
Q

Composition of lesser sac

A

Double layer of peritoneum

Made up of hepatoduodenal and hepatogastric ligaments

55
Q

What does the hepatoduodenal ligament contain?

A

important blood and bile
vessels going to and from the liver

See figure (parts of greater omentum)

56
Q

Composition of the peritoneal ligaments

A

Double layer of peritoneum

57
Q

Role of the falciform ligament

A

Peritoneal ligament

Attaches the liver to anterior wall of abdomen

See figure

58
Q

What is the mesentery?

A

Double layer of peritoneum that attaches organs to the posterior abdominal wall (mainly small intestine)

Now considered an organ itself!

59
Q

What does the mesentery contain?

A

Blood/lymph vessels

Fat

Nerves

60
Q

Role of mesentery

A

Makes the organs mobile

Suspends the small intestine

Carries nerves, lymph and blood vessels to small intestine

(see peritoneum figure)

61
Q

Difference between intraperitoneal and retroperitoneal organs

A

Intraperitoneal organs are covered by visceral peritoneum

Retroperitoneal organs lie between the parietal peritoneum and the posterior abdominal wall

62
Q

What are the intraperitoneal organs?

A

Stomach

Spleen

Liver and gallbladder

Small intestine (jejunum, ileum, and small part of duodenum)

Large intestine (transverse colon, sigmoid colon)

63
Q

What are the retroperitoneal organs?

A

Kidneys and suprarenal glands

Pancreas

Most of duodenum

Large intestine (ascending and descending colon)

See figure (+peritoneum figure)

Anatomy (MPAS) (22 decks)

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