Overall test 3 review Flashcards
What is the major point of muscle origination on the pubis?
- iliac fossa on the ilium
What occurs at the obturator foramen?
- the obturator forament allows for the passage of nerves and vessels from the pelvis to the thigh
Which muscle is absent in 20% of the population?
- psoas minor muscle (not very relevant)
What is the function of the psoas major?
- to act in the motion of hip flexion, this is the most important flexor muscle of the joint
What is the origin of the psoas major?
– on the transverse process of the lumbar vertebrae in front of the quadratus lumborum
What is the origin for the Quadratus lumborum?
- the inferior aspect of the 12th ribs and to the lateral aspect of the transverse processes
What is the function of the quadratus lumborum?
- when acting in a unilateral motion lateral flexion to the ipsilateral side occurs
- when acting bilaterally extension of the back will occur
- during respiration will act to increase the volume of the thorax to aid in inspiration
What does the subcostal nerve innervate?
- it acts similar to ventral rami, somatic senorsy, somatic motor, and postganglionic sympathetic
Where does the subcoastal nerve exit from?
- it exits just beneath the 12th rib similar to an intercostal nerve
Where does the ilohypogastric nerve innervate?
- it innervates the lateral and anterior thoracic wall and into the thing
Where does the genitofemoral nerve exit the vetebral column?
- it exits at the L1/L2 rami, and runs in front of the psoas major
What is unique about the lateral femoral cutaneous nerve regarding its innervation?
- it does not contain somatic motor units just somatic sensory, not typical ventral rami nerve
Where does the lateral femoral cutaneous nerve exit the pelvis?
- it exits through space under the anterior superior illiac space and over inguina ligament
What is the largest nerve, and what is its function?
- the femoral nerve and it comes from L2-L4 rami, responsible for the motion needed to kick a ball, contains sypical somatic motor, sensory and post ganglionic sympathetics
- also acts in knee extension and hip flexion
Where does the obturator nerve pass?
- through the obturator foramen
What is unique about the sensory innervation of the obturator nerve?
- it stops at the knee
What is the lumbrosacral trunk?
- the connection between lumbar plexus and the sacral plexus and it is the pathway to the sciatic nerve
What are the layers of the anterior abdominal wall from superficial to deep?
- skin
- campers fascia
- scarpas fascia
- 3 layers of muscle
- transversalis fascia
- parietal peritoneum
- abdominal organs
What is the function of the sympathetic trunk?
- to act as the paravetebrbral ganglion
- it is medial to everything
Where is insertion for the rectus abdominus?
- on costal cartilages and the xiphoid process
Do the fibers of rectus abdominus run laterally or vertically? Where are they wider?
- vertical and are wider more superiorly
How many tendinous insertions are there for the rectus abdominus and where are they attached?
- 4 insertions that insert to the superficial divisions of the rectus sheath
Where is the origin of the rectus abdominis and what is its function?
- it originates at the pubis and functions to flex the trunk and aid in forceful expiration
True or false the internal and external oblique muscles’ fibers run in the same direction?
- False they run at right angles to one another
What is the aponuerosis?
- It is a flat sheet like membrane that is avascular
What is the boarder of the external and internal oblique on?
- the inguinal ligament
What is the shape of the internal abdominal oblique?
- it is a fan shaped muscle
What is the function of the internal oblique?
- to twist the torso
Where is the origin of the internal oblique?
- on the iliac crest and the iliac spine
What is the name of the line that divide the upper 3/4 from the lower 1/4 of anterior abdominal wall?
- the arcuate line also in the lower portion there is not deep fascia between the rectus abdominis and the TF
Which epigastric artery supplies most of the rectus abdominus with blood and what does it arise from?
- the inferior gastric artery and comes from the external iliac artery
What is the function of the falciform ligament?
- it anchors the organs such as the liver to the anterior abdominal wall and it is made of peretienion (sic)
What is the ligamentum teres derives from?
-from the umbilical vein
What connects the bladder to the umbilical cord?
The median umbilical ligament (urachus)
What does the obliterated umbilical artery turn into after birth?
- the umbilical ligament it drapes over part of the umbilical
What is another name for the lateral umbilical ligament?
- the inferior epigastric artery
- it drapers the lateral umbilical ligament
What type of muscle contraction causes rotation?
- unilateral to the ipsilateral side
T/F the abdominal wall muscles aid in intraabdominal pressure changes?
- True
- Stabilization of the trunk during strenous physical effort to hold breath and tighten abs called Valsalva’s manuever
- forceful expiration
- coughing and sneezing, also during urination and defecation, labor and delivery
Where does the sensory innervation to the skin come from and motor innervation to the anterior abdominal wall muscles come from?
- Ventral rami from the ower 5 intercostal nerves (T7-11)
- subcostal (T12)
- ilohypogastric/iloinguinal nerves (L1)
Are the testes inside or outside the body cavity?
- outside
What are the contents of the spermatic cord?
- ductus deferents
- testicular artery
- pampiniform plexus of vein and testicular vein
- genitofermoral nerve (for the cremaster muscle)
- autonomic nerves
- lymphatics
Where do the gonads begin their journey?
- on posterior abdominal wall
What do the gonads pass through?
- they pass through the inguinal hole which is too small for its passage so it takes some of the surrounding muscle with it
What is the gubernaculum
- it is the cord that attaches to the gonads that pull them forward and eventually to the outside of the body
Are the gonads always at the same vertebral level?
- no they begin at the same height as the kidneys and descend to their present level
Do the gonads move through the abdominal cavity?
- no they begin at the back and move along the wall and move forward and down
What anchors the gonads to the scrotum?
- the gubernaculum
What is the female counterpart to the scrotum in males?
- the skin of the labia majorum because it attaches to the gubernaculum
What are the 3 inguinal rings?
Deep
Middle
superficial
What does the internal spermatic fascia come from?
- at the deep inguinal ring there is a transition between the transveralis fascia and becomes the internal spermatic fascia
Which abdominal muscle is not in the spermatic cord?
- the transveris abdominus
What does the internal abdominal oblique turn into?
- the cremaster muscle
What is the external spermatic fascia derived from?
- It is derived from the external abdominal oblique
What is more likely to occur if there is not proper closure of these rings?
- hernias
What is the name of the gap that these testes fit through?
- Sub-muscular gap
Is it common for the loop of bowel to extend into the scrotum in a direct inguinal hernia?
- no it usually does not pass into the scrotum but it does pass medial to both the deep and middle rings and exits through the deep ring
Does a direct inguinal hernia impede on the inferior epigastric artery?
- no because it passes medial to it
In an indirect inguinal hernia where does the loop of bowel pass?
It passes down the processus vaginalis and medial to the inferior epigastric
How many rings does the indirect hernia pass through?
- all 3 rings
What is the most common inguinal hernia in males and in females?
- in males the indirect is the most common type and in females they are equal with a 1:1 ratio
What is an incarcerated hernia?
- it is when the intestine is trapped in the scrotum then it can become necrotic
What is the vitelline duct?
- it is found in the fetus and it is the entry from the umbilicus where all nutrients enter the gut tube
How is innervation and blood supply supplied to the gut tube?
- when the gut tube is divided into foregut, midgut, and hindgut the nerves and vessels attach at this point and maintain their segments
What are the parts of the foregut?
- esophagus
- stomach
- 1st half of duodenum
- liver
- gall bladder
- pancrease
- spleen
What organs are derived from the midgut?
- 2nd half of duadenum
- jejunum
- ileum
- cecum and appendix
- ascending colon
- 2/3 of transverse colon
What organs make up the hindgut?
- 1/3 transverse colon
- descending colon
- sigmoid colon
- rectum
What arteries supply the foregut derivatives?
- celiac artery
What supplies the midgut and hindgut?
- superior mesenteric artery and inferior mesenteric artery
What path do the postganglionic nerves take in the gut?
- they follow the vessels that supply them
Do blood vessels travel through the paritoneal cavity?
- No, when the gut tube descends to the middle of the peritoneal cavity it takes with it a mesentery
- the blood vessels follow these mesenteries
What does it mean when an organ is said to be secondarily retroperitoneal?
-It is when an organ begins in the middle of the cavity then through development it falls back to the dorsal wall of the cavity, and becomes associated with the wall and loses half of its visceral peritoneal.
Which part of the stomach is the greater curvature?
-It is the outer side of the stomach that has the longer wall and is on the left side of the body, which is also site of blood supply and attachment to the mesentery.
Which area of the stomach is radiographically visible?
- the fundus because it is air filled and appears dark on a radiograph
Which ligament attaches the stomach to the liver?
the hepatogastric ligament (part of the lesser omentum)
What is the epiploic/omental foramen?
- passageway between the omentum and the body wall
What does the heptoduadenal ligament connect?
- the liver and the duadenum
Which parts of the duodenum is mesenteric and which part is secondarily retroperitoneal?
- The 1st section is mesenteric and sections 2-4 are retroperitoneal
What is the lesser sac?
- It is an area posterior to the lesser omentum and entered through the omental foramen?
What is the greater omentum, and what importance does it have?
- It is the flap of mesentery that suspends the transverse colon from greater curvature, and divides the cavity so there is a greater sac, and when the internal organs are injured it will adhere to the organ and form a seal around the lesion so healing can occur, it is also movable with body movements,
What does the linorenal ligament connect?
- the kidneys to the spleen
How soon after the aorta enters the abdomen does it give rise to the celiac?
- as soon as it passes through the diaphragm and enters the abdomen
Does the splenic artery pass posterior or anterior to the stomach?
- posterior
Which arteries does the splenic artery give rise to?
- the left gastroomental artery
- short gastric aa.
When the common heptatic a. branches it gives rise to two major arteries, what are they?
- the hepatic artery proper
- gastroduodenal
What arteries supply the gall bladder?
- the cystic artery
What does the right gastric artery branch off of?
- off of the hapatic artery proper
Which omentum do the right and left gastroomental aa. Anastamose?
- the greater ommentum on the inferior side of the stomach
Where do the left and righ gastric aa. anastamose?
- the lesser omentum