Module 9A - Abdomen Flashcards
1
Q
Abdominal cavity location
A
Between thoracic diaphragm and pelvic inlet
2
Q
What protects the abdominal organs?
A
Lower ribs
Muscular abdominal wall
Pelvis
3
Q
Transtubercular plane location
A
Level of iliac tubercles and body of L5
4
Q
Subcostal plane location
A
Level of inferior borders of 10th costal cartilage on each side
5
Q
9 region system of abdomen
A
Hypochondriac (R/L) Lumbar (R/L) Inguinal (R/L) Epigastric Umbilical Hypogastric
6
Q
Two horizontal planes of abdomen (9 region system)
A
Transtubercular
Subcostal
7
Q
Two vertical planes of abdomen (9 region system)
A
R/L midclavicular planes
8
Q
Horizontal plane of abdomen (quadrant system)
A
Transumbilical plane
9
Q
Transumbilical plane location
A
Level of umbilicus and L3-L4 disc space
10
Q
Vertical plane of abdomen (quadrant system)
A
Median plane
11
Q
RUQ contents
A
- Liver/gallbladder
- Pylorus of stomach, duodenum, ascending/R half of transverse colon
- Head of pancreas
- R kidney
12
Q
LUQ contents
A
- L lobe of liver, jejunum, ileum, descending/L half of transverse colon
- Spleen
- Body & tail of pancreas
- L kidney
13
Q
RLQ contents
A
- Cecum, inferior portion of ascending colon, appendix
- R ureter, bladder (if distended)
- R ovary, R uterine tube, uterus (if enlarged)
- Spermatic cord - abdominal part
14
Q
LLQ contents
A
- Sigmoid colon, inferior portion of descending colon
- L ureter, bladder (if distended)
- L ovary, L uterine tube, uterus (if enlarged)
- Spermatic cord - abdominal part
15
Q
Abdominal superficial fascia is composed of 2 layers:
A
- Camper’s fascia (fatty)
- Scarpa’s fascia (membranous, inner layer)
16
Q
Transverse fascia of abdominal wall
A
- Lines inner portion of transverse abdominal wall
- Continous with linea alba
17
Q
Anterolateral abdominal wall is composed of:
A
- Skin
- Superficial fascia (Camper’s, Scarpa’s)
- Deep fascia
- Muscles
- Transverse fascia
- Extraperitoneal fat
- Parietal and visceral peritoneal layers
18
Q
Muscles of anterolateral abdominal wall
A
External oblique Internal oblique Transverse abdominal Rectus abdominis Pyramidalis
19
Q
External oblique attachments
A
Ribs 5-12 + linea alba/anterior half of iliac crest
20
Q
External oblique innervation
A
Thoracic nerves (T5-T12) *NOTE: T12 nerve is called subcostal nerve
21
Q
External oblique actions
A
Flex and rotate trunk
Compress viscera (assists w/expiration)
Support viscera/spine
22
Q
Inguinal ligament is formed by:
A
Inferior aponeuroses of external oblique (fold back on itself)
23
Q
Internal oblique attachments
A
Thoracolumbar fascia/anterior iliac crest/lateral inguinal ligament + ribs 10-12/linea alba
24
Q
Internal oblique innervation
A
Thoracic nerves (T6-12) and first lumbar nerves
25
Internal oblique actions
Flex and rotate trunk
Compress viscera (assists w/expiration)
Support viscera/spine
26
Transverse abdominal attachments
Costal cartilage 7-12/TL fascia/iliac crest + linea alba
27
Transverse abdominal innervation
Thoracic nerves (T6-12) and first lumbar nerves
28
Transverse abdominal actions
```
Compress viscera (assists w/expiration)
Support viscera/spine
```
29
Rectus abdominis attachments
Costal cartilages 5-7/xiphoid process + pubic symphysis/crest
30
Rectus abdominis innervation
Thoracic nerves (T6-T12)
31
Rectus abdominis actions
Flexes trunk
Compress viscera (assists w/expiration)
Support viscera/spine
32
Rectus sheath is formed by aponeuroses of:
External oblique
Internal oblique
Transverse abdominal
33
Rectus sheath encloses:
Rectus abdominis
34
Arcuate line location
Between level of umbilicus and pubic symphysis
35
Above the arcuate line:
Posterior portion of rectus sheath covers rectus abdominis
36
Below the arcuate line:
Rectus sheath travels anterior to rectus abdominis
37
Linea alba
Fibrous band of connective tissue located between the R/L rectus abdominis muscles
38
Linea alba is attachment for:
Oblique and transverse abdominal muscles
39
Inguinal ligament extends between:
ASIS and pubic tubercle
40
Inguinal ligament is formed by:
Folded aponeurosis of external oblique
41
Inguinal canal contents
Males: spermatic cord, ilioinguinal nerve
Females: round ligament of uterus, ilioinguinal nerve
42
Inguinal canal - anterior/posterior/superior/inferior borders
- Anterior: aponeurosis of external & internal oblique
- Posterior: transverse fascia
- Superior: Fibers of transverse abdominal and internal oblique
- Inferior: inguinal ligament (formed by inferior fold of external oblique)
43
Two openings to the inguinal canal:
Superficial (external) ring
| Deep (internal) ring
44
Superficial ring of inguinal canal formed by:
An arch in external oblique aponeurosis
45
Deep ring of inguinal canal formed by:
Transverse fascia
46
Indirect inguinal hernia
Bowel protrudes through deep ring and descends through inguinal canal
47
Direct inguinal hernia
Bowel protrudes through defect in anterior abdominal wall
48
MC site of direct inguinal hernia
Hesselbach's triangle
49
Hesselbach's triangle borders
Lateral border of rectus abdominis
Inguinal ligament
Inferior epigastric artery/vein
50
Mesentary
- Double layered fold of peritoneum
- Suspends or connects organ to posterior abdominal wall
- Contains blood vessels, lymph vessels, nerves
51
Greater omentum
- Peritoneal fold that hangs down from greater curvature of abdomen
- Loops back up to attach to transverse colon
52
Lesser omentum
-Double layer of peritoneum that attaches to stomach and proximal duodenum and then attaches to liver
53
Peritoneal ligament
Doubled layer of peritoneum that attaches an organ to the abdominal wall or another organ
54
Two examples of peritoneal ligament
```
Falciform ligament (liver to anterior abdominal wall)
Gastrosplenic ligament (spleen to stomach)
```
55
Intraperitoneal organs
- Suspended and covered anteriorly/posteriorly by peritoneum
| - Did not invaginate into peritoneum during development
56
Retroperitoneal organs
- Covered anteriorly by one layer of peritoneum
| - Did not invaginate into peritoneum during development
57
3 divisions of abdominal viscera
Foregut
Midgut
Hindgut
58
Foregut - boundaries and blood supply
Oropharynx to hepatopancreatic ampulla
| Celiac trunk
59
Midgut - boundaries and blood supply
Hepatopancreatic ampulla to distal 1/3 transverse colon
| Superior mesenteric artery
60
Hindgut - boundaries and blood supply
Distal 1/3 transverse colon to anus
| Inferior mesenteric artery
61
Esophagus definition
Muscular tube connects pharynx to stomach
62
Esophagus passes through diaphragm in _____
Esophageal hiatus
63
Upper esophageal sphincter location and muscles
- Junction of pharynx and esophagus
| - Inferior pharyngeal constrictors and cricopharyngeus muscles
64
Lower esophageal sphincter location and muscles
- Junction of esophagus and stomach
| - Smooth muscle
65
Divisions of stomach
Cardia
Fundus
Body
Pylorus
66
Muscular layers of stomach
Oblique
Circular
Longitudinal
67
Rugae
- Gastric folds
- Large longitudinal in mucosal folds of stomach
- Will flatten out with food in stomach
68
Pyloric sphincter
Connects stomach to small intestine
69
Divisions of small intestine
Duodenum
Jejunum
Ileum
70
Duodenum
- Proximal portion has mesenteric attachments and is "intraperitoneal"
- Becomes "retroperitoneal"
71
Major landmark of internal surface of duodenum
Hepatopancreatic ampulla
72
Pancreas function
Secrete digestive enzymes
73
Gallbladder function
Secrete bile
74
Ligament of Treitz
- Loops over esophageal hiatus in diaphragm
| - Peritoneal fold at junction of duodenum and jejunum
75
Jejunum
-Loops tend to be found in the LUQ
76
Ileum
- Loops tend to be fuond in RLQ
| - Terminates at ileocecal valve
77
Ileocecal valve
Connection of ileum to cecum of large intestine
| -Site of Vit B12 absorption
78
External wall of large intestine comprised of:
Taeniae coli
| Haustra
79
Taeniae coli
3 bands of longitudinal muscle - converge at appendix
80
Haustra
Sacculations of the large intestine formed by contractions oft he taeniae coli
81
Divisions of large intestine (proximal to distal)
```
Appendix
Cecum
Ascending
Transverse
Descending
Sigmoid
Rectum
```
82
Appendix location
RLQ at McBurney's point
83
McBurney's point
Approx. halfway between ASIS and umbilicus
84
Cecum
Junction of ileum and large intestine separated by ileocecal valve
85
Ascending colon
Retroperitoneal
86
Transverse colon
Intraperitoneal
87
Descending colon
Retroperitoneal
88
Sigmoid colon
Intraperitoneal
89
Diverticula
Abnormal sacs or pouches
90
Diverticulitis
Inflammation or rupture (perforation) of diverticula
91
Primary function of sigmoid colon
Storage of feces
92
Spleen location and protected by?
LUQ - intraperitoneal - near tail of pancreas
lower ribs 9-12
*Difficult to palpate if WNL
93
If enlarged, what position can the spleen be palpated?
R lateral decubitus
94
Functions of spleen
Filter RBCs - removes old or abnormal
Storage of platelets
Lymphatic/immune functions
95
Divisions of pancreas
Head, neck, body, tail
96
Location of pancreas
Retroperitoneal
Crosses midline of abdomen
Head in close contact with duodenum
Tail in close contact with spleen
97
Ducts of the pancreas
```
Main pancreatic duct (Wirsung)
Accessory duct (Santorini)
```
98
Main pancreatic duct
- Joins with bile duct to form hepatopancreatic ampulla
| - Opens into descending duodenum via major duodenal papilla
99
Functions of pancreas
Endocrine - Islets of Langherhans releases hormones
| Exocrine - digestive enzymes
100
Liver location
Intraperitoneal
| RUQ and LUQ
101
Liver is attached in peritoneal cavity via:
Falciform ligament
| Lesser omentum
102
Falciform ligament
Peritoneal fold attaches to anterior abdominal wall
103
Lesser omentum
Peritoneal fold attaches to lesser curvature of stomach
104
Surfaces of the liver
Diaphragmatic
| Visceral
105
Diaphragmatic surface of liver
Dome shaped to match contour of diaphragm
| *Anterior, superior, posterior portions of liver
106
Visceral surface of liver
Primarily posterior and inferior portions of liver
107
T/F: R and L portions of liver operate independently of each other
True
108
Cantlie's line
- Imaginary line between gallbladder and IVC
- Marks functional divisions of liver
- Each division has its own blood supply, portal system, bile drainage system
109
Anatomical lobes of the liver
Left lobe
Caudate lobe
Quadrate lobe
Right lobe
110
Functional right lobe of liver
Anatomical right lobe
111
Functional left lobe of liver
Anatomical left + caudate + quadrate lobes
112
Functions of liver
```
Filter circulating toxins/drugs/hormones
Active role in metabolism of macros
Endocrine
Activation of vit D
Synth and secretion of bile
```
113
Hepatic portal system - what does "portal" mean?
Vein located between 2 capillary beds
114
Hepatic portal system capillary beds
GI tract and liver
115
How does hepatic portal system work?
- Blood travels from heart to GI tract
- O2 delivered to GI structures, nutrients picked up from GI
- Nutrients go directly to liver via portal vein
- After filtering through liver, blood leaves via hepatic veins and eventually drain into IVC
116
How does the liver receive oxygen?
Direct arterial supply from heart via hepatic artery
- 30% is from direct arterial supply
- 70% is via oxygen-poor blood from portal vein
117
What is porta hepatis?
- Exit/entrance for portal vein, hepatic ducts, hepatic artery
- Located on visceral surface of liver
118
What is cirrhosis?
Destruction of hepatocytes and replacement with fibrous tissue
119
What is portal hypertension?
Blood flow will "reverse" and flow into IVC via 3 anastomoses (gut, butt, caput)
120
Where are the anastomoses that reverse blood flow in portal hypertension?
- Esophagus (forms varices, can bleed)
- Rectum (forms hemorrhoids)
- Epigastric veins in anterior abdominal wall (forms "caput medusae")
121
Caput medusae
Dilated superficial veins of abdomen
122
What is ascites?
Accumulation of fluid within peritoneal cavity due to portal hypertension
123
Gallbladder location
- Gallbladder fossa of visceral surface of liver
| - Close proximity to proximal duodenum
124
Cystic duct
Leaves gallbladder to merge with common hepatic duct
125
Bile pathway
Gallbladder > cystic duct > common bile duct > main pancreatic duct > hepatopancreatic ampulla > main duodenal papilla
126
Hepatopancreatic ampulla opens into duodenum via:
Main duodenal papilla
127
Sphincter of bile duct is located:
Distal end of bile duct
128
If sphincter of bile duct is contracted:
Bile is unable to flow to small intestine and backs up into gallbladder for storage
129
Retroperitoneal organs
```
Duodenum (except proximal)
Ascending, Descending colon
Rectum
Pancreas (except tail)
Adrenal glands
Kidneys
Ureters
Abdominal aorta and IVC
```
130
Intraperitoneal organs
```
Stomach
Prox. duodenum
Jejunum
Ileum
Transverse, Sigmoid colon
Liver and gallbladder
Tail of pancreas
Spleen
```
131
Abdominal aorta branches from superior to inferior
```
Celiac trunk
Superior mesenteric artery
Renal arteries
Gonadal arteries
Inferior mesenteric artery
Common iliac
```
132
Name branches of celiac trunk
Common hepatic artery
Splenic artery
Left gastric artery
133
Gonadal arteries pass through:
Inguinal canal with ductus deferens/round ligament of uterus
134
Common iliac arteries are ____ branches of abdominal aorta
Terminal
135
Common iliac arteries bifurcate at:
L4
136
Inferior mesenteric artery supplies:
Hindgut
137
Superior mesenteric artery supplies:
Midgut
138
Celiac trunk supplies:
Foregut
