Surgical Antomy Of The Abdomen Flashcards
Describe some of the functions of the abdominal wall.
Provides a firm, flexible wall which keeps the abdominal viscera in the abdominal cavity, protects the abdominal viscera. Matins the anatomical position of the viscera against gravity, assists in forceful expiration, and is involved in any action that increases the abdominal pressure
What are the layers of the abdominal wall?
Skin, superficial fascia, muscles and associated fascia, parietal periotoneum,
What are some of the features of the superfical fascia/
Consists of fatty connective tissue, above the umbilicus is a single sheet of connective tissue, and below the umbilicus is divided into two layers, a fatty superifical layer (the compers fascia) and a membranous deep layer (scapers fascia) superficial vessels run between these two layers of fascia
What are the three flat muscles of the abdominal wall?
The external oblique, the internal oblique and the transversus abdominsus.
What are some of the features of the external oblque muscle?
Largest and most superficial muscle, the fibres run inferiomedially, and apporach the midline where they form an aponeurosis.
What is the linea alba?
In the midline all the aponeurosis comes together to form a fibrous sheath, the linea alba that runs from the xiphoid process of the sternum to the pubic symphysis
What are some of the features of the internal oblique muscle?
Lies deep to the external oblique, is smaller and thinnner in structure and the fibres run superiomedially, and also contributes towards the linea alba
What are some of the features of the tranversus abdominus muscle?
Deepest of the flat muscles with transversely running fibres, contributes aponeurotic fibres towards the linea alba, and deep to this there is a layer of fascia called the transveraslis fascia
What are some of the features of the rectus abdominus muscle?
Is a vertical muscle, split in two by the linea alba, muscle is intersected by fibrous strips kknonw as tendinous intersections, and helps to stabilise the pelvis during walking,
What is the pyramiddis?
A small triangle shaped muscle found in the rectus abdominius, located inferiorly with its base on the pubis, the apex attached to the linea alba and walls to surround the linea alba
What is the rectus sheath?
Is formed by the aponeurosises of all the external oblique muscles and has an anterior and posterior wall for most of its length,
When do the aponeurosis move the the anterior wall as part of the rectus sheat?
About half way between the umbilicus and the pubic symphisis
What is the median incision?
An incision which is made through the linea alba, and can be extended down the whole length of the abdomen by curving round the umbilicus,- the linea alba is poorly vascularised by the blood losses are minimal and the major nerves are avoided
What is a paramedian incison?
Is performed laterally to the linea alba, and provides access to some of the more lateral structures.
What is a tranverse incision?
Made inferiorly and just lateral to the umbilicus, causes the least damage to the nerve supply and also heals well
What is a suprapubic incision?
5 cm superior to the pubic symphsis, used when access to the pelvic organs is needed and care must be taken not to perforate the bladder
What is a subcostal incision?
The incision is inferior to the xiphoid proccess.
What is a Mc Burney incision ?
Grid iron incision, consists of two lines which split the fibres of the muscles, and mc burneys point is 1/3 of the distance between the ASIS and the umbilicus
What is ectopia cardis?
Is an emboryoigcal defect whereby the lateral body folds fail to close in the thoaric region, and this causes the heart to lie outside the body cavity,
What is a meckels diverticulum?
Where a small portion of the vitelline duct persist and and this forms a out pocket of ileum, the meckeys divertuculum, and this does not usually cause symptoms in adults
When may a meckels divertuculum be symptomatic?
When it contains hetertopic pancreatic tissue or gastic mucosa or and it may cause bleeding
What is explhos/ omphaolcele?
A herniation of the amboimnal viserca through an enlarged amboimal ring, covered by amnion, and is caused by a failure of the bowel to return to the body after physiological herniation
What is gastrochisis?
A protustion of the abdominal contents in the body into the amniotic cavit, is lateral to the umbilicus in this region, and they is abnormal closure of the body wall against the contecting stalk, Is not voered by viserca and may be damaged by the amniotic fluid, and is more likley in babies that are born to younger mothers
What is reffered pain?
Pain percieved at a site distant from what is causing the pain.
Describe the features of somatic reffered pain?
Pain that is cause by a noxious stimula to the proximal part of a soft tic nerve that is perceived in the distal dermatome of that nerve
What is visceral reffered pain?
There are visceral pain fibres running through the body, along with somatic fibres that enter the spinal cord at the same location, and therefore the cns perceives the pain as coming from the somatic portion of the body as opposed to the visceral portion of the body
What are some of the things that can cause visceral pain?
ischameia, abnomrally strong muscle contractions, inflmation adn strecth.
Where would pain in the foregut be reffered to?
The epigastric region
Where would pain in the midgut be reffered to?
The periumbilical region
Where would pain in the hindgut be referred to?
The suprapubic region
