Outline 11: the abdomen Flashcards
What is the superior border of the abdomen
diaphragm
What is the inferior border of the abdomen
pelvic inlet
what is the anterior and lateral borders of the abdomen
muscle
basically a muscular wall with no bones
What is the posterior border of the abdomen
lumbar verterbrae
what are the contents of the abdomen
most of the unpaired (stomach, spleen, pancreas, intestines) and paired (kidneys, adrenal glands) viscera
What are the 4 major layers of fascia?
Superficial, Deep, Transversalis, and Peritoneum
What are the two types of Superficial fascia
Camper’s Fascia and Scarpa’s Fascia
What is Camper’s Fascia
The more superficial, outer layer of the superficial fascia and it is primarily adipose tissue
what is scarpa’s fascia
it is the more internal of the superficial fascia, It is under Camper’s fascia and it is more membranous,
What is the transversalis fascia analogous to
endothoracic fascia
Where is the transversalis fascia
interior to the deep fascia and lines the abdominal wall
What are the two layers of the peritoneum
Parietal and visceral
Where is the parietal peritoneum
it is the more superficial peritoneum and clings to the transversalis fascia
where is the visceral peritoneum
it is the more interior layer of the peritoneum and surround organs in different ways
What is analogous to the pleura of the lungs
the peritoneum
What are the four anterior muscles of the abdomen?
external abdominal oblique, internal abdominal oblique, transversus abdominus, and rectus abdominus
How is the external abdominal oblique analogous to the external intercostals?
inferomedial fibers
go from being muscular posteriorly to membranous anteriorly
where do the external abdominal obliques originate? insert?
Originate from lower ribs and insert at the external oblique aponeurosis and iliac crest
What is the linea alba
the line where the two external oblique aponeurosis sheets meet
what do the most inferior fibers of the external oblique aponeurosis form
the inguinal ligament
How is the internal abdominal oblique analogous to the internal intercostals
-superomedial fibers
go from being membranous posteriorly to being muscular anteriorly
What is the inguinal ligament
it is a specialization of the external abdominal obliques that connects the ASIS with the public tubercle
it forms the base of the iguinal canal
where does the internal abdominal oblique originate and insert
thoracolumbar aponeurosis and iliac crest to the ribs
what is the transversus abdominus
it is the deepest layer and has transversely oriented fibers
T/F Like the innermost intercostals, the transversus abdominus is the same muscle as the internal abdominal oblique
False
What are the actions of the anterior abdominal muscles
supports abdominal viscera, compresses abdomen, and moves the trunk(not transversus abdominus)
For abdominall compression action, costal attachment is the ____. so external obliques is _____ action and internal obliques is _____ action .
ORIGIN , Normal, Reverse
For moving the trunk, costal attachment is the _____ so external obliques is _____ action and internal obliques is _____ action
INSERTION Reverse, Normal
Unilateral contraction of the external oblique in reverse action will result in
contralateral rotation
unilateral contraction of the internal oblique in normal action is result in
ipsilateral rotation
Name two ways the rectus abdominus muscle is unusual
The origin (pubis) is inferior to the insertion (xiphoid process) the fibers don't run the full length of the muscle. Tendinous intersections break up the muscles and the fibers run from one point of connection to the next
What is the rectus abdominus covered by
the rectus sheath
What is the nerve supply for the abdominal muscles
ilioinguinal and iliohypogastric nerves (L1)
anterior rami of T7-T11 and subcostal nerves
what is the nerve supply for the abdominal skin
continuation of the anterior rami of T7-11 (posterior intercostal nerves) and subcostal nerves
What is the blood supply for the flat anterior abdominal muscles
lower posterior intercostal A, and subcostal A
deep circumflex iliac A
What is the blood supply for the rectus abdominus
the superior and inferior epigastric A
The deep circumflex artery is a branch of?
External Iliac A
The superior epigastric A is a continuation of _____ and the landmark is the _____
Internal thoracic A
diaphragm
The inferior epigastic A is the second branch off of which artery?
external iliac A
What contributes to the sheath of the rectus abdominus
Transverse fascia, transversus abdominus, internal obliques, external obliques
What is the lateral boundary of the rectus abdominus sheath?
linea semilunaris
Why is abdominal herniation more likely is the distal abdomen than the proximal abdomen?
The components contributing to the rectus abdominus move anteriorly as you go more distal on the abdomen, leading to a thinner posterior sheath.
What does the inguinal canal carry in men? in women?
spermatic cord
round ligament of the uterus
What is the role of the inguinal canal
The testes are in the posterior abdomen in early male development, they travel to the scrotum by travelling through the inguinal canal
What does the cremaster reflex do
In response to cold or touch, the cremaster reflex elevates the testes closer to the body in the scrotum
what nerve carries the sensory information in the cremaster reflex?
what nerve carries the motor information?
ilioinguinal nerve
genital femoral nerve
what is the floor of the inguinal canal
inguinal ligament
what is the superficial wall of the inguinal canal
external oblique
what is the deep wall of the inguinal canal
transversalis fascia
what is the roof of the inguinal canal
internal oblique and transversalis abdominus
what are the two openings of the inguinal canal
deep ring and superficial ring
what does the deep ring of the inguinal canal occur in
the transversalis fascia
what does the superficial ring of the inguinal canal occur in
it is an opening in the external oblique muscle
where does the deep ring of the inguinal canal occur
in the transversalis fascia
Describe the pathway of the testes
from the posterior abdominal wall it moves through the deep ring into the inguinal canal and through the inguinal canal and through the superficial ring into the scrotum
25% of abdominal herniations are ____ 75% of abdominal herniations are____.
direct
indirect
Describe the indirect hernia?
When the deep ring isn’t sealed tightly enough, the intestines can travel the path of the testes and cause a bulge in the scrotum.
describe a direct hernia
a tear in the transversalis fascia internal to the superficial ring causes intestines to travel out of fascia,out of the superficial ring into the scrotum
What are the 4 posterior muscles of the abdomen
quadratus lumborum
psoas major
psoas minor
iliacus
What is the innervation of quadratus lumborum
T12, L1-4
what are the actions of quadratus lumborum
bilaterally, respiration
unilaterally, bending
reverse action* - pelvic elevation= hip hike
what is the innervation of psoas major
L2-L3
what is the origin and insertion
very close to the body of the lumbar spinae
trochanter of the femur
where is psoas minor
superficial to psoas major and doesn’t insert of femur so it only contributes to lumbar flexion
What are the two most powerful flexors
psoad major and iliacus
what muscle has the same insertion as psoas major
iliacus
what is the blood supply of the posterior abdominal muscles
lumbar A (4 pairs) and the subcostal A
What is the primary muscle of inspiration
diaphragm
what are the two compartments of the diaphragm
contractile
non-contractile central tendon
why is the diaphragm an unusual muscle
because although it originates peripherally, it inserts on itself (central tendon of diaphragm)
What are the three regions of the diaphragm
sternal
costal
lumbar
where does the sternal region of the diaphragm attach
the xiphoid process
where does the costal region of the diaphragm attach
ribs 7-12
What does the lateral arcuate ligament go over
quadratus lumborum
what does the medial arcuate ligament go over
psoas major
____ and _____ arcuate ligaments are part of the costal region
____ arcuate ligament is part of the lumbar region
lateral and medial
median
what does the median arcuate ligament go over
the aorta to form the aortic hiatus
what do the crura do
they are the base attachment for the median arcuate ligament
Name the apertures of the diaphragm and the respective vertebrae from most superior to most inferior
vena caval hiatus (T8) esophageal hiatus (T10) aortic hiatus (T12)
What is the motor innervation of the diaphragm
the Phrenic Nerves (C3-C5)
What is the sensory innervation of the central diaphragm? the peripheral diaphragm?
phrenic nerves
inferior 6-7 intercostal and subcostal nerves
What happens if you injure your spinal cord above C3
You cannot breathe because you have injured the innervation from the respiratory control center of the brainstem that activates the phrenic nerves
what happens if you injure your spinal cord below C6
although you are paralyzed you can still breathe
what is the blood supply of the diaphragm
superior and inferior phrenic A’s
describe the difference between the superior and inferior phrenic A
although both come off of the aorta the superior phrenic A is above the diaphragm
and the inferior phrenic A branches off below the diaphragm.
what supplies the abdomen
subcostal A and abdominal aorta
what are the 4 types of abdominal aorta
anterior visceral unpaired
lateral visceral paired
posterior parietal paired
terminal branches
what are the 3 anterior visceral unpaired arteries and what do they supply
celiac trunk - all other paired organs like stomach and spleen
superior mesenteric - goes to rest of intestine
inferior mesenteric - goes to colon
what are the 4 lateral visceral paired arteries and what do they suuply
inferior phrenic - diaphragm
middle suprarenal - adrenal glands
renal- kidneys
reproductive- testes/ ovaries
what is an aneurysm
it is a bulge in the blood vessel and commonly in the abdominal aorta. It will cause turbulent flow and plaque formation
What are the posterior parietal paired Arteries
4 lumbar
1 median sacral (unpaired but functions like lumbar)
what is the lumbar arteries analogous to
the posterior intercostal arteries
what happens at L4/L5 to the abdominal aorta
it ends and becomes the 2 common iliac arteries
what happens at S1 to the common iliac arteries
they act like a trunk and become the internal iliac artery and the external iliac artery
what are branches off the internal iliac artery
superior gluteal
inferior gluteal
obturator
what are the branches off of the external iliac arteries
deep circumflex iliac
inferior epigastric
what does the external iliac artery become after crossing the inguinal ligament
femoral A
what is the main vein in the abdomen
inferior vena cava (L5)
what does the superior gluteal supply
gluteus maximus, medius and minimus. tensor fascia latae
what does the inferior gluteal supply
gluteus maximus, obturator internus, quadratus femoris, superior hamstrings
what does obturator supply
obturator internus and externus, hip joiny
what do the deep circumflex arteries supply
lower abdominals
what do the inferior epigastric supply
rectus abdominus
