Lecture 43 - Abdominal Wall Flashcards
Right Upper Quadrant (RUQ)
Gall bladder, right kidney, right lobe of liver
Left upper quadrant (LUQ)
Left lobe of kidney, spleen, stomach
Right lower quadrant (RLQ)
Cecum, appendix, most of ileum
Left lower quadrant (LLQ)
Left ovary, sigmoid colon, left uterine tube
Medial plane
Vertical line from xiphoid process to pubic bone
Separates left and right side
Trans umbilical plane
Horizontal plane through umbilicus and intervertebral disc of L3/L4
Separates inferior and superior abdomen
Bony elements of abdominal walls
Lumbar vertebrae (L1-5) + IV discs
Superior expanded iliac crests
Costal margin (ribs 11 and 12, costal cartilage, xiphoid process
muscular elements of abdominal wall
Held together with thick fascia and tendinous sheets
Mostly for posture and compression of abdominal cavity
Protect and support viscera best when well-toned
When weak or stretched (i.e. during pregnancy) abdomen can become pendulous (pot belly)
posterior abdominal wall
Muscles lateral to the vertebral column extending to and through the pelvis
lateral abdominal wall
Three layers of obliquely oriented mm
anterior abdominal wall
Vertical mm extending from thorax to pelvis
Understand the anatomical arrangement of the layers of abdominal fascia and muscular aponeuroses
o Superficial fascia
2 layers: fatty connective tissue (caper’s fascia)
Deeper membranous layer (Scarpa’s fascia)
o Rectus sheath
Layering of the aponeuroses of the abdominal mm
Encloses the rectus abdominis
o Transversalis fascia
Deep fascia separating the abdominal wall and the abdominal contents
o Peritoneum
Lining of the abdominal wall that surround the visceral organs
rectus sheath
Sheath-like tendons of external oblique, internal oblique and transverse abdominus that encloses rectus abdominus
Sheaths meet at midline to form linea alba
inguinal ligament
Dense band interior most aponeurosis of external oblique
Attach at ASIS (anterior superior iliac spine) and pubic tubercle
inguinal canal
Oblique passage (4cm long) parallel and superior to inguinal ligament
Formed in relation to relocation of gonads during fetal development
Contains spermatic cord (males) or round ligament of uterus (females), and neurovascular structures that serve the pelvis
Describe the features of the abdominal cavity
Cylindrical space contained within the abdominal wall
Contains visceral organs surrounded by peritoneum
Contains neurovascular structures passing from the thorax into the pelvis and lower limb
Describe the features of the peritoneum
Similar to pleura of lungs
Parietal peritoneum lines abdominal wall
Visceral peritoneum covers visceral organs
Peritoneal cavity – potential space created between parietal and visceral peritoneum
Understand the difference between peritoneal and retroperitoneal
o Some organs positions behind peritoneum – retroperitoneal
o Intraperitoneal = enveloped in peritoneum, reflections of peritoneum form mesenteries that attach the gut tube to the abdominal wall
o Retroperitoneal = organs passing between peritoneum and posterior abdominal wall (anterior surface lined with peritoneum, posterior surface lined with other types of protective fascia)
Blood supply of abdominal wall
o Superior
Superficial = branch of the internal thoracic artery (musculophrenic)
Deep = branch of internal thoracic artery (superior epigastric)
o Inferior
Superficial = branches of the femoral artery (superficial epigastric and superficial circumflex iliac arteries)
Deep = branches of the external iliac artery (inferior epigastric artery and deep circumflex artery)
o Lateral wall
Intercostal artery from ribs 10 and 11 and subcostal artery
Venous drainage of abdominal wall
Venous drainage is matched to blood supply
Innervation of abdominal wall
Anterior (ventral) rami of T7 to L1 spinal nerves
