Lecture 7: Abdomen Flashcards
Landmarks of Abdomen (6)
- Rectus Sheath
- Linea Alba
- Semilunar line
- Tendinous intersections
- Umbilicus
- Iliac crest
Rectus sheath
fascial sheath containing rectus abdominis muscle
Linea Alba
“white line”
Semmilunar line
lateral border of rectus abdominus muscle in rectus sheath
tendinous intersections
transverse skin grooves
iliac crest
about L4
RUQ components (6)
- liver
- gallbladder
- pylorus
- duodenum
- hepatic flexure of colon
- head of pancreas
LUQ components (5)
- spleen
- splenic flexure of colon
- stomach
- body and tail of pancreas
- transverse colon
LLQ components (3)
- sigmoid colon
- descending colon
- left ovary
RLQ components (4)
- cecum
- appendix
- ascending colon
- right ovary
Transumbilical plane
separates upper quadrants from lower quadrants
Anterolateral ABD wall muscles ** (5)
- external oblique
- internal oblique
- transverse abdominis
- rectus abdominis
- rectus sheath
External oblique **
3 movements
Anterolateral ABD wall muscles
- flexes trunk
- rotates trunk
- supports abdominal viscera
Internal Oblique **
3 movements
Anterolateral ABD wall muscles
- flexes trunk
- rotates trunk
- supports abdominal viscera
Transverse abdominis **
movement
anterolateral ABD wall muscle
- compresses and supports abdominal viscera
Rects abdominis**
movement (2)
anterolateral ABD wall muscle
- compresses abdominal viscera
- flexes trunk
Posterior abdominal wall muscles (4)**
- quadratics lumborum
- psoas major
- iliacus
- iliopsoas
Hernia
- profusion of peritoneal contents (mesentery, fat, and/or portion of bowel) through abdominal wall muscles
Umbilical hernia
usually seen up to age 3 and after age 40
inguinal region hernia
- Hesselbach’s triangle**
A. medial border: rectus sheath
B. lateral border: inf/ epigastric artery
C. inferior border: inguinal ligament
Hessebach’s triangle **
boarders
- medial: rectus sheath
- Lateral: inferior epigastric artery
- Inferior: inguinal ligament
Direct Hernia (3)
Inguinal
- medial to inferior epigastric vessels
- acquired due to weakness later in life
- pass through Hesselbach’s triangle
Indirect Hernia (2)
Inguinal
- lateral to the inferior epigastric vessels
- congenital due to weak processus vaginalis
Inguinal hernia classification
classified by relationship to inferior epigastric vessels
- direct
- indirect
Abdominopelvic Cavity (7)***
- esophagus and stomach
- greater and lesser momentum - small instestine
- large intestine
- liver
- gallbladder
- pancreas
- spleen
Peritoneal cavity (2)
- parietal peritoneum
2. visceral peritoneum
Parietal peritoneum (2)
- lines abdominal wall sin double layer of peritoneum and mesentery
- localized afferent nerves of anterior rami of spinal nerves
Visceral peritoneum (2)
- surrounds organs
- poorly localized pain
- referred pain from visceral afferent fibers sympathetic/parasympathetic
Esophagus (3)
- muscular tube that connects the pharynx to the stomach
- approx 8” long
- runs behind trachea and heart and in front of spine
Stomach Areas (6)
- cardia
- fundus
- body
- pylorus
- greater curvature
- Lesser curvature
Small intestine (4 components)
- connected stomach to large intestines
- 3 parts
- duodenum
- jejunum
- ileum - ligament of treitz
- jejunum and ileum suspended in mesentery
Ligament of Treitz
purpose
tethers duodenum ar duodenojejunal flexure
-suspensory muscle fo the duodenum
ligament of small intestine
Jejunum
5 components
- LUQ of abdomen
- larger in diameter (than ileum)
- thicker walls
- mesentery with less fat
- mucosal folds are higher and more numerous
- increased surface area for absorption***
Large intestine 2 components
- Teniae coli
2. Haustra
Teniae Coli
description
function
part of large intestine
- 3 longitudinal bands of smooth muscle that are visible on the cecum and colon’s surface
- assist in peristalsis
Haustra
part of large intestine
-sacculations of the colon created by the contracting teniae coli
Appendix (2)
- end of cecum
2. no known function
Appendicits and radiating pain (3)
- initially pain is felt by peri-umblical
- as appendix becomes more inflamed, it irritated the parietal peritoneum
- becomes localized in RLQ
McBurney’s Point location
2/3 of the way from the umbilicus to the anterior supers iliac spine
-apendicitis
Crohn’s Disease (4)
- inflammation seen anywhere from lips to anus
- s/sx: abdominal pain and intestinal obstruction
- on imaging: inflammation occurs in patches
- skip lesions - thick bowel wall with cobblestone appearance
Ulcertive colitis (4)
- inflammation localized to colon only *
- s/sx: cause crampy abdominal pain, diarrhea, and blood in stool
- inflammation is continuous
- thin bowel wall
Liver (2 pts, 4 lobes)
- four lobes
- right
- left
- caudate
- quadrate - anatomist consider caudate and quadrate as part of left lobe
Falciform ligament
separates left and right lobes of liver
Liver functions (7)
- removes potentially toxic byproducts of certain medications
- metabolizes or breaks down nutrients from food to produce energy when needed
- helps body fight infection, removes bacteria from the blood
- prevents shortages of nutrients by storing vitamins, minerals, and sugar
- produces most proteins needed by body
- produces bile, compound needed to digest fat and absorb vitamin A, D, E, K
- produces most of the substances that regulate blood clotting
Gallbladder
beneath liver, joined via hepatic duct
Pancreas (2, 4 parts)
- 4 parts
- head in RUQ
- Neck-anterior to aorta and IVC
- body
- tail- LUQ - endocrine and exocrine functions
- produces insulin
Spleen (3 pts, 7 functions)
- size of a fist
- LUQ
3. functions A. lymphocyte proliferation B. immunize surveillance and response C. blood filtration D. destruction of old/damages RBCs & platelets E. recycling of iron and globing F. recevoir for blood G. source of RBCs in fetal life
Arteries of abdominal aorta *** (7)
- cephalic trunk
- anterior phrenic arteries
- adrenal arteries
- renal arteries
- gonadal arteries
- lumbar arteries
- common iliac arteries
Cephalic trunk (3)**
- L gastric artery
- Splenic artery
- Common hepatic artery
T12*
L gastric artery **
supplies (2)
- part of cephalic trunk
a. stomach
b. adjacent portion of esophagus
Spleenic artery**
supplies (3)
Part of cephalic trunk
- spleen
- stomach
- pancreas
Common hepatic artery **
supplies (5)
Part of cephalic trunk
- liver
- stomach
- gallbladder
- duodenum
- pancreas
Superior Mesenteric Artery **
supplies (4)
branch of abdominal aorta
- pancreas
- small intestine
- appendix
- first 2/3 large intestine
L1*
Inferior mesenteric artery**
Supplies (1)
branch of abdominal aorta
last third of large intestine
L3*
Inferior phrenic arteries
supplies (2)
branch from abdominal aorta
- diaphragm
- inferior portion of esophagus
Adrenal arteries
supply (1)
branch from abdominal aorta
adrenal glands
Renal arteries
supply (1)
branch form abdominal aorta
kidneys
L renal @ L1*
Gonadal arteries
supplies
branch from abdominal aorta
testes/ovaries
Lumbar arteries
supplies (4)
branch from abdominal aorta
- vertebrae
- spinal cord
- abdominal wall
- lumbar region
common iliac arteries
branch from abdominal aorta
Bifourcation of abdominal aorta
L4*
AAA
- bulge in artery wall
- etiology
- FHx
- HTN
- artherslcerosis
- breakdown of collagen and elating - s/sx
- abdominal pain
- back pain
Veins of abdomen (7)
- common iliac
- lumbar veins
- renal veins
- right testicular/ovarian vein
- right suprarenal vein
- inferior phrenic veins
- hepatic veins
Common iliac vein
drain lower limbs and gluteal region
lumbar veins
drain the posterior abdominal wall
renal veins
drain kidneys, left adrenal gland and left testis/ovary
Right testicular/R ovarian
- drain the right testes or ovary respectively in men and women
- left testicular/ovarian vein drains into left renal vein
Right suprarenal vein
drains R adrenal gland and left adrenal vein drains into the left renal vein
inferior phrenic veins
drain the diaphragm
hepatic veins
drain the liver
Hepatic portal system**
- splenic vein
- superior mesenteric vein
- inferior mesenteric vein
- portal vein
Splenic vein**
drains (3)
-part of hepatic portal
drains blood from spleen, stomach fundus, part of pancreas
Superior Mesenteric vein **
drains (3)
- Part of hepatic portal
- drains blood from small intestines, jejunum, and ileum
inferior mesenteric vein **
drains (1)
- part of hepatic portal
- drains blood from large intestines
Portal vein**
drains (3)
-part of hepatic porta
drain blood from gallbladder, pancreas, spleen
Sympathetic Abdominal innervation (2)
- thoracic splanchnic
2. lumbar splanchnic
Thoracic splanchnic nerve
sympathetic
- to abdominal pervertebral ganglia
- celiac and superior mesentery ganglia
Lumbar splanchnic nerve
sympathetic abdominal innervation
abdominal viscera
Parasympathetic Abdominal innervation
- vagus
2. pelvic splanchnic
vagus nerve
parasypathetic innvervation of abdomen
distal esophagus to proximal 2/3 of transverse colon
Pelvic splanchnic nerve
parasympathetic innervation of abdomen
inferior hypogastric plexus