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Clinical Anatomy II > LOs abdomen > Flashcards

LOs abdomen Flashcards

1
Q

boundaries of abdomen

A

anterior: abdominal wall
posterior: vertebral column
superior: diaphragm
inferior: pelvic inlet (pubic tubercle to lumbar spine)

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2
Q

functions of anterior abdominal wall

A
  1. support trunk
  2. support abdominal viscera
  3. manage intra-abdominal pressure during respiration
  4. move trunk and maintain posture
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3
Q

greater versus lesser sac

A

greater sac: main abdominal space
lesser sac: omental bursa, posterior to stomach, diverticulum (extension) of greater sac

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4
Q

mesentery

what vessels do these mesenteries cover?
1. mesentery proper
2. sigmoid mesocolon
3. transverse mesocolon

A

double layer of peritoneum, conduit of neurovascular supply between organ and body wall

  1. superior mesenteric vessels – since mesentery proper is connected to small intestine (midgut)
  2. inferior mesenteric vessels – since sigmoid mesocolon is connected to sigmoid (hindgut)
  3. middle colic vessels – since transverse colon is innervated by middle colic of SMA
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5
Q

ligaments of greater omentum

A

gastrosplenic
gastrocolic
gastrophrenic

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6
Q

ligaments of lesser omentum

which one contains the portal triad?

A

hepatoduodenal – contains portal triad
hepatogastric

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7
Q

intraperitoneal

A

organs fully enclosed by visceral peritoneum and suspended by mesenteries; organ developed within peritoneal cavity

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8
Q

retroperitoneal

A

organs enclosed only by parietal peritoneum; organ developed posterior to peritoneal cavity

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9
Q

primarily retroperitoneal

A

developed posterior to peritoneal cavity, never had mesentery

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10
Q

intraperitoneal organs

A

superior/1st segment of duodenum
jejunal, ileum
transverse colon
liver
gallbladder

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11
Q

retroperitoneal organs: primary

A

primary:
1. kidney
2. suprarenal glands

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11
Q

retroperitoneal organs: primary and secondary

A

primary:
1. kidney
2. suprarenal glands

secondary
1. duodenum (2nd/desc, 3rd/horz, 4th/ascend)
2. colon (asc, desc)
3. rectum (upper 2/3)
4.

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12
Q

retroperitoneal: secondarily

A
  1. descending (2nd seg) duodenum
  2. horizontal (3rd seg) duodenum
  3. ascend (4th seg) duodenum
  4. ascend colon
  5. descend colon
    rectum (upper 2/3)
  6. pancreas
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13
Q

secondarily retropertioneal

A

previously intraperitoneal but moved posteriorly to peritoneal cavity during development

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14
Q

inguinal canal content female

A

round ligament of uterus (homolog to ductus deferens)
ilioinguinal nerve

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15
Q

components of rectus sheath above vs. below arcuate line

A

above arcuate line
1. anterior rectus sheath: EAO, IAO
2. posterior rectus sheath: IAO, TA

below arcuate line
1. anterior rectus sheath: EAO, IAO, TA
2. posterior to RA: transversalis fascia

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16
Q

significance of arcuate line

A

provides passageway for INFERIOR EPIGASTRIC VESSELS to innervate RA

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17
Q

arcuate line

A

demarcates transition between posterior rectus sheath and transversalis fascia

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18
Q

inguinal canal boundaries

A

floor: inguinal ligament
posterior: transversalis fascia
anterior: EAO aponeurosis

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19
Q

inguinal canal content male

A

spermatic cord
1. ductus deferens
2. ductus deferens a. and v.
3. testicular a. and v. (pampinform plexus)
4. ilioinguinal nerve
5. genital branch of genitofemoral n.

covered by: cremaster muscle, its fascia, and vessels

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20
Q

superficial fascia: camper vs. scarpa

A

camper = more superficial, fatty layer right under skin

scarpa = deep to camper, membranous layer directly superficial to EAO. where sutures happen

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21
Q

innervation of anterior abdominal mm

A

RA: T6-T12
EAO: T7-T12
IAO and TA: T6-L1

T6-T11 = thoracoabdominal nerve
T12 = subcostal nerve

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22
Q

landmarks for abdominal skin

A

T4 = xiphoid process
T5/6 = nipple
T10 = umbilicus

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23
Q

indirect inguinal hernia

A
  1. more common 66%
  2. congenital
  3. protrusion is LATERAL to inferior epigastric vessels
  4. protrusion passes through deep and superficial inguinal ring
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24
Q

direct inguinal hernia

A
  1. less common
  2. acquired
  3. protrusion is MEDIAL to inf epigastric vessels
  4. passes only through superficial inguinal ring
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25
Q

stomach quadrant and functions

A

LUQ, RUQ
1. store food
2. HCl disinfects food and denatures protein
4. activates protease pepsin
3. produces chyme

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26
Q

esophagus functions

A
  1. transports food from mouth to stomach
  2. warms or cools food
  3. muscles enable peristalsis of foods – transitions from skeletal to smooth muscle (voluntary –> involuntary)
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27
Q

small intestine quadrant and function

A

LUQ, RUQ
1. enzymatic digestion of food
2. absorption of nutrients

28
Q

liver quadrant and function

A

RUQ
1. produces bile and plasma proteins
2. detoxifies
3. stores glycogen

29
Q

gallbladder quadrant and function

A

RUQ
1. stores and releases bile – bile emulsifies fats and enhances digestion/absorption
2. consists of bilirubin, cholesterol, water, ions

30
Q

major duodenal papilla: location and function

A

on superior duodenum; all bile comes through this from gallbladder via common bile duct

31
Q

portal triad

A

within lesser omentum (primarily hepatoduodenal ligament); all are anterior to omental foramen

consists of:
1. hepatic artery proper
2. hepatic portal vein
3. common bile duct

32
Q

pancreas quadrant and function

A

RUQ, LUQ
1. makes enzymes
2. makes bicarbonate to neutralize chyme

an endocrine gland

33
Q

large intestine function

A

NO digestion
1. absorbs water and minerals
2. has lots of bacteria
3. incomplete longitudinal layer

34
Q

foregut arterial main supply and content

A

arterial: celiac trunk
contents (6):
1. stomach
2. pancreas
3. duodenum
4. spleen
5. gallbladder
6. liver

35
Q

midgut arterial main supply and content

A

arterial: SMA
contents (5):
1. cecum
2. appendix
3. ascending colon
4. transverse colon
5. small intestine

36
Q

hindgut arterial main supply and content

A

arterial: IMA
contents (4)
1. transverse colon
2. descending colon
3. sigmoid
4. rectum

37
Q

retroperitoneal: secondarily

A
  1. descending (2nd seg) duodenum
  2. horizontal (3rd seg) duodenum
  3. ascend (4th seg) duodenum
  4. ascend colon
  5. descend colon
    rectum (upper 2/3)
  6. pancreas
37
Q

caput medusae

A

HPV –> paraumbilical –> superficial and inferior epigastric vv –> IVC

EPIGASTRIC

38
Q

esophageal varicies

A

HPV –> L gastric –> esophageal –> azygos –> SVC

39
Q

rectal varicies

A

IMV –> superior rectal –> middle and inferior rectal –> internal iliac –> IVC

40
Q

retroperitoneal dilated veins

A

IMV –> L colic –> lumbars –> IVC

41
Q

lymph nodes in abdomen

A

preaortic (anterior of abdomen) –> cisterna chyli
retroaortic (posterior) –> cisterna chyli
lateral aortic (within AA) – drains into lumbar trunk –> cisterna chyli

42
Q

lymph nodes in pelvis

A

external iliac
internal iliac
common iliac

43
Q

what LE lymph node drains into external iliac?

A

deep inguinal

44
Q

psoas major attachments

A

origin: T12-L5 transverse processes
insertion: lesser trochanter of femur

45
Q

QL attachments

A

origin: 12th rib, L1-L4
insertion: iliac crest

46
Q

iliacus attachments

A

origin: iliac fossa, iliac crest, sacroiliac lig
insertion: lesser trochanter femur

47
Q

what passes through median arcuate ligament?

A

aortic hiatus

48
Q

aortic hiatus

A

T12
contents:
1. descending aorta
2. thoracic duct

aortic hiatus marks transition of thoracic aorta into abdominal aorta

49
Q

what passes through medial arcuate ligament?

A

psoas

50
Q

what passes through lateral arcuate ligament?

A

QL

51
Q

caval opening

A

T8
contents: IVC

52
Q

esophageal hiatus

A

T10
contents:
1. parasymp vagal trunk
2. esophagus

53
Q

pelvic inlet boundaries

A

sacral promontory
arcuate line of ilium
pectineal line of ischium
pubic symphysis

function: divides pelvis into lesser and greater

54
Q

pelvic outlet boundaries

A

coccyx
sacrotuberous and sacrospinous ligament
ischial tuberosity
pubic arch (inf pubic ramus –> pubic symphysis)

55
Q

lesser (true) pelvis

A

bounded superiorly by pelvic inlet, inferiorly by pelvic outlet

56
Q

greater (false) pelvis

A

above pelvic inlet

57
Q

SI joint stabilizers (3)

A
  1. sacrospinous: sacrum –> ischial spine
  2. sacrotuberous: sacrum –> ischial tuberosity
  3. anterior sacroiliac: sacrum –> ilium
58
Q

male vs. female pelvis

A

male:
1. subpubic angle 70 deg
2. heart shaped inlet (due to greater prominence of sacral promontory)
3. narrower outlet and cavity
5. narrower sacrum and more convex

female:
1. subpubic angle 90-100 deg
2. oval shaped inlet
3. wider outlet and cavity
4. wider sacrum (ala) and more flat

59
Q

ischioanal fossa boundaries

A

ceiling: levator ani
lateral wall: obturator internus
medial-inferior: rectum

60
Q

ischioanal fossa contents

A
  1. fat pads
  2. connective tissue
  3. pudendal canal:
    -pudendal nerve
    -internal pudendal a/v

outside of canal, these become inferior rectal a,v,n

61
Q

features of scrotum (deep –> superficial)

A

testis visceral
testis parietal
internal spermatic fascia
cremasteric muscle
external spermatic fascia
tunica dartos (deep layer)
superficial fascia
skin

62
Q

functions of pudendal nerve and branches

A
  1. defecation
  2. urination/micturition
  3. parturition (childbirth)
  4. erection
  5. ejaculation
63
Q

erection innervation

A

parasympathetic S2-S4

pelvic splanchnic nn. –> prostatic plexus –> cavernous nerves –> corpus cavernosum relax and enlarge

64
Q

ejaculation innervation

A

sympathetic L1-L2

lumbar splanchnic –> superior and inferior hypogastric plexus –> muscles contract

65
Q

most commonly injured artery due to pelvic fracture?

A

internal/external iliac artery
obturator artery

66
Q

pelvic viscera sympathetic innervation

A
  1. sympathetic trunk
    > gray rami: postganglionic nerves that synapsed within trunk
    > sacral splanchnic: preganglionic nerves that synpases outside of trunk
    > ganglion impar: end of sacral sympathetic trunks that unite at coccyx tip
  2. periarterial plexus – vasoconstricts arteries starting at internal iliac
  3. hypogastric plexus: superior and inferior (inf is mixed)
67
Q

inferior hypogastric plexus

A

mixed innervation!

parasympathetic: pregang pelvic splanchnic
sympathetic: pregang sacral splanchnic

Clinical Anatomy II (8 decks)

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