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DIGESTIVE > LECTURE 2- abdominal wall and peritoneum > Flashcards

LECTURE 2- abdominal wall and peritoneum Flashcards

1
Q

superior boundary of the abdomen

A

inferior thoracic apeture and diaphragm

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2
Q

inferior boundary of the abdomen

A

iliac crest, inguinal ligament, pelvic inlet

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3
Q

posterior boundary of the abdomen

A

lumbar vertebral column, psoas maj, quadratus lumborum

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4
Q

lateral and anterior boundary of abdomen

A

abdominal wall muscles

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5
Q

what are the 9 regions of the abdomen

A

down the middle: epigastric- umbilical- pubic

the sides: hypochondrium- flank- groin

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6
Q

what are the layers of the abdominal wall from superficial to deep

A

skin- superficial fascia- ext oblique- int oblique- transversus abdominis- transversalis fascia- extraperitoneal fascia- parietal peritoneum

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7
Q

fibre direction of rectus abdominis

A

longitudinal

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8
Q

function of recuts abdominus

A

flex trunk

support/ compress abdominal wall

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9
Q

innervation of rectus abdominus

A

anterior rami of thoracic spinal nerves

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10
Q

external oblique aponeurosisi

A

from xyphoid process to pubic symphysis (lower border forms inguinal lig)

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11
Q

external oblique action

A

flex trunk
bend trunk to same side
turn to opposite side

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12
Q

innervation of external oblique

A

anterior rami of thoracic spinal nerves

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13
Q

fibre direction of external oblique

A

infero medial (hands in pockets)

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14
Q

internal oblique action

A

flex trunk

bend and turn to same saide

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15
Q

internal oblique innervation

A

anterior rami of thoracic spinal nerves

and some L1

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16
Q

internal oblique fibre direction

A

superomedial ( up to boobs)

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17
Q

transversus abdominus action

A

supports abdominal wall

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18
Q

transversus abdominus innervation

A

anterior rami of thoracic spinal nerves

some L1

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19
Q

what divides the rectus sheath into 3/4 and 1/4

A

the arcuate line (which is halfway along the line from the umbilicus to the pubic bones)

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20
Q

what happens in the upper 3/4 of the rectus sheath

A

all 3 abdominal wall muscles surround rectus abdominis
external oblique above
internal oblique splits
transversus abdominus below

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21
Q

what happens below the arcuate line in the lower 1/4 of the rectus sheath

A

rectus sheath is in front of rectus abdominis only

behind is transversalis fascia and parietal peritoneum

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22
Q

what is the arcuate line

A

halfway along the line from the umbilicus to the pubic bones

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23
Q

what is the arterial supply of the rectus sheath

A 
superior epigastric (from internal thoracic)
inferior epigastric (from external iliac)

both these arteries run underneath rectus abdominus (on top of transversalis fascia) and within the rectus sheath and ANASTAMOSE together

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24
Q

what dermatomes supply the skin, muscle and parietal pertoneum of teh abdomen

A

t7-12 and L1

all of these nerves are anterior rami

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25
Q

where do the anterior rami run in the neurovascular plane

A

run between transversus abdominis and internal oblique (analogous to the intercostal neurovascular plane)
before piercing the muscular wall to reach the skin

26
Q

nerves that supply rectus sheath

A

lower 6 intercostal nerves t7-12 and L1 (iliohypogastric)

27
Q

between which 2 muscles do the nerves travel though

A

in between internal oblique and transversus abdominis

28
Q

what are the 2 pathways of venous tdrainiabe in the abdomen

A

axillary vein superiorly

femoral vein inferiorly

29
Q

what is the lymphatic drainage of the abdomen

A

superior abdomen- axillary nodes

inferior abdomen- groin and superior inguinal nodes

30
Q

do the superficial lymphatics and deepy lymphatics follow the arteries or veins

A

superficial lymphatic= arteries

deep lymphatics= veins

31
Q

what does the visceral peritoneum cover

A

abdominal organs

32
Q

what does the parietal peritoneum cover

A

lines the body wall

33
Q

what supplies the parietal peritoneum

A
  • somatic nerves to the body wall (thoracic and lumbar nerves)
  • phrenic nerves- up by diaphragm
  • obturator nerve- down in pelvis
    SOP
34
Q

what is the parietal peritoneum sensitive to

A

touch, pain, temperature, pressure

35
Q

what type of pain is felt in the parietal peritoneum

A

localised pain

36
Q

what is the nervous supply of the visceral peritoneum and the mesenteries

A

afferent fibres of the autonomic nervous system

37
Q

what is the visceral peritoneum and the mesenteries sensitive to

A

stretch eg when you eat too much

38
Q

what kind of pain is felt in the visceral peritoneum and the mesenteries

A

de-localised pain

39
Q

what is mesentery

A

when visceral perotneum comes back around on itself

anchors viscera to the body wall

40
Q

what mesentery(s) suspends the midgut and hindgut

A

only one mesentery- the DORSAL

41
Q

what mesentery(s) susupends the foregut

A

by both DORSAL and VENTRAL mesenteries

42
Q

which organs in the abdomen are retroperitoneal

A

SAD PUCKER
S(adrenal gland)
aorta/ ivc
duodenum (distal 2/3)

Pancreas (except tail
Ureters
Colon (ascending and descending)
Kidneys
Esophagus
Rectum
43
Q

acronym for retroperitoneal organs

A

SAD PUCKER

44
Q

where is the lesser sac located

A

behind the lesser omentum, liver and the stomach

45
Q

how was the lesser sac created

A

created due to rotation of the foregut strucutres (drags lesser omentum round to create a pocket)

46
Q

where is the greater omentum derived from

A

the dorsal mesentery

big dick

47
Q

where is the lesser omentum derived from

A

ventral mesentery

v=L

48
Q

what is the opening to the lesser sac called

A

the omental foramen
foramen of winslow
epiploic foramen

49
Q

what is in the free edge of the lesser omentum

A

the portal triad

50
Q

what is the hepatoduodenal ligament

A

part of the lesser omentum

extending between the porta hepatis of the liver –> superior part of the duodenum.

51
Q

what is the hepatogastric ligament

A

connects the liver –> lesser curvature of the stomach.

It contains the right and the left gastric arteries.

In the abdominal cavity it separates the greater and lesser sacs on the right.

52
Q

which 2 ligaments make up the lesser omentm

A

hepatogastric (medial) and hepatoduodenal (lateral) ligaments

53
Q

what does the greater omentum attach to

A

the greater curvature of the stomach

54
Q

what suspends the jejenum to the terminal ileum

A

mesentery

55
Q

what suspends the transverse colon

A

transverse mesocolon

56
Q

what suspends the sigmoid colon

A

sigmoid mesocolon

57
Q

what are paracolic gutters

A

peritoneal sulci to the lateral and ascending colons

58
Q

what is the function of the paracolic gutters

A

create a pathway for peritoneal fluid, pus, bile, blood etc to migrate around the abdomen

59
Q

why is the right paracolic gutter more clinicallly significant than the left

A

the right side is a bit larger
(the left is limited by the phrenico-colic ligament)
the right side of the peritoneum = continusous with the peritoneum of the hepatic recess and lesser sac

60
Q

what is the clinical significance of the paracolic gutter

A

migration of fluids can cause pain to present in sites that are distant from the site of the affected organ

eg if sitting fluid migrates downwards and presents as acute appendicitis
but if standing it migrates into the lesser sac and collects there

DIGESTIVE (6 decks)

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