Test 2 Flashcards
Layers of the abdominal wall
Skin. Steve Camper fascia. Cooked Scarpa fascia. Six External oblique. Eggs Internal oblique. In Transversus abdominis The Transversalis fascia. Tiny Extraperitoneal fat. Evil Parietal peritoneum. Pot
Superior to arcuate line, the ant. Ab. Wall layers are organized how
1.5/1.5
Inferior to arcuate line, the ant. Ab. Wall is organized how
3 in front, only transversalis fascia in back
What do the median, medial and lateral umbilical folds contain?
Median - median umbilical ligament (uracus)
Medial - portions of umbilical artery
Lateral - inferior epigastric vessels
What are the two vessels in the campers fascia
Superficial Circumflex a./v.
Superficial Epigastric a./v.
Between what layers does the deep circumflex iliac a./v. Run?
Between IO/TÁ
Where does the inferior epigastric a./v. Enter the rectus sheath?
Arcuate line
What vessels supply the upper rectus abdominus mm.
Superior epigastric vessels
Where does the musculophrenic a./v. Run?
Costal cartilages
Nerves of abdominal wall
Ventral Rami (efferent, motor) of T7-L1 spinal nn.
T7-T9 supply what region
T10 supplies what region
T11-L1 supply what region
Region above umbilicus
Umbilicus
Region below umbilicus
What does the inguinal ligament come from, where does it extend to/from
Folded inferior border of the EO aponeurosis
From ASIS to pubic tubercle
What does the male inguinal canal contain? Female?
Male: vas deferens, testicular nn. /vessels, cremasteric m./fascia
Female: round ligament of uterus
Superficial ring is an opening in what
Deep ring is opening in what
EO aponeurosis
Transversalis fascia
Where are the superficial and deep ring located?
S: lateral to pubic tubercle
D: lateral to inferior epigastric vessels
4 walls of inguinal canals
Anterior: EO aponeurosis
Posterior: transversalis fascia and conjoint tendon
Roof: IO/TA muscles
Floor: inguinal ligament
3 layers of hernial sac
Peritoneum, extraperitoneal fat, transversalis fascia
Indirect vs. direct hernia
I: through inguinal canal both deep and superficial rings, lateral to inferior epigastric vessels
D: Through inguinal (Hesselbach’s) triangle, medial to inferior epigastric vessels, through conjoint tendon, not in scrotum/labia
3 other types of hernias
Femoral, umbilical, epigastric
What are the functions of the greater omentum? Why are adhesions bad?
It can wall off infections and inflammation sites
Can strangulate
What are the parts that make up the greater omentum
Gastrocolic ligament
Gastrosplenic ligament
Gastrophrenic ligament
What does the lesser omentum attach to?
What are the two portions that connect the lesser omentum to the liver?
Lesser curvature of stomach, liver, and duodenum
Hepatogastric ligament, hepatoduodenal ligament
Where is the portal triad contained
Hepatoduodenal ligament
What are the three parts of the portal triad
Hepatic a.
Portal v.
Bile duct
What does the mesentery proper do?
Anchors most of the small intestine to posterior abd. Wall
What anchors the duodenum to the posterior abd. Wall, where is it and why does it do that
Suspensory ligament of treitz
Descends from R. Crus of diaphragm
Prevents duodenojejunal jxn. From sagging
Transverse mesocolon divides abdominal cavity into two compartments. What is in the superior compartment? The inferior compartment?
Stomach, liver, spleen
Small intestine, ascending/descending colon (mesentery of small intestine divides inferior into L and R)
What did the umbilical vein do
Delivered oxygenated blood to fetus
Falciform ligament divides liver into L/R lobes and does what else?
What does it contain?
Anchors liver to diaphragm and anterior body wall
Round ligament of the liver
What was the round ligament of the liver? What is it’s alternate name
Left umbilical vein
Ligamentum teres hepatis
What is the anterior/posterior coronary ligament, what does it do
Reflection of peritoneum around the bare area of the liver
Attaches liver to inferior surface of the diaphragm
What did the urachus used to be, how does it form and where does it extend
Allantois
It constricts and becomes the thick fibrous cord
Extends from the apex of the bladder to the umbilicus
Medial umbilical folds cover what?
What did they used to be?
Medial umbilical ligaments
Occluded portions of umbilical aa.
Lateral umbilical folds cover the ____ ____ ____
Inferior epigastric vessels
The peritoneal pouches are the_____ and _____ pouches.
Women also have the ____ pouch
Hepatorenal and rectovesical (rectouterine) pouches
Vesicouterine
Other name for hepatorenal pouch is the pouch of _____
Pouch of Morrison
The hepatorenal pouch is lower on the ____ side because ___
R
The celiac trunk supplies ____ ____ ____ ____ ____ ____
The 3 main branches of the celiac trunk are ___ ___ ___
Liver, gb, esophagus, stomach, pancreas and spleen
Common hepatic, L. Gastric, splenic aa.
Common hepatic a. Branches off to ____ and ____
Proper hepatic a.
Gastroduodenal a.
Proper hepatic a. splits into the ____ and _____ ______ aa.
Right and Left hepatic arteries
Gastroduodenal aa. Branches into the ___ and ____ arteries
Superior pancreaticoduodenal aa
R gastroepiploic aa
The splenic artery branches to the ____ and the ____
Short gastric artery
L gastroepiploic artery
How common are variations of the hepatic AA
40% mostly involving L/R hepatic
Cystic aa. Usually arises from ___ ___ ___ . What variations can the cystic a. Have?
R hepatic aa.
Usually runs posterior to common hepatic duct but 24% of the time can run ant. To common hepatic duct
Double cystic is 1% of the population
R gastric a. can arise from what 3 places
Proper hepatic (normal)
Common hepatic
Gastroduodenal
The duodenum is ____ and immobile and the jejunum and ileum are _______ but very mobile
Fixed
Tethered
Plicae circularis are more _____ distally
Diffuse (less in #)
Proximal to distal: Vasa recta \_\_\_\_ in length Plica circularis \_\_\_\_ in number Arterial arcades \_\_\_\_\_ in number and size Lymphatics and fat \_\_\_\_\_
Vasa recta decreases in length
Plica circularis decrease in number
Arcades increase in number and size
Lymphatics and fat increase
Meckels diverticulum is a remnant of the _____ _____ ____ or the ___ ____
Embryonic yolk sac
Vitelline duct
The vermiform appendix is located at the ____ level
T10
The SMA supplies from the distal part of the ___ to the ____ ____ of the ____ ____
Duodenum
Proximal 2/3 of the transverse colon
SMA branches to the (from 11:00 counterclockwise) _____ _____, _____ _____, _____ _____ and _______ arteries
Ileocolic, R colic, middle colic, pancreaticoduodenal arteries
The ___ ____ ____ and the ___ ____ join to form the bile duct
Common hepatic duct
Cystic duct
The ___ ___ ___ and the ___ ___ ___ join and empty into the major duodenal papilla
Common bile duct
Main pancreatic duct
The ___ ___ ___ empties into the minor duodenal papilla
Accessory pancreatic duct
5 parts of the pancreas
Head, neck, body, tail and uncinate process
The ____ ____ connects the spleen to the stomach and contains the ___ ___ and ___ vessels
Gastrosplenic ligament
Short gastric
Gastroomental vessels
The IMA branches to the ___ ___, ___ and ___ ___ arteries
Left colic, sigmoid and superior rectal
Main branches off the abdominal aorta
Celiac Trunk -T12 SMA. -L1 L/R Renal -L1 Testicular/Ovarian-L2 IMA. -L3 Bifurcation. -L4 CSR GIB
The ____ and ___ ___ veins come together to form the portal vein
Splenic
Superior mesenteric
4 portal-caval anastomoses
Gastric - Esophageal
Paraumbilical - Epigastric
Superior rectal - Middle & inferior rectal
Colic - Retroperitoneal
GE
PE
SM
CR
Portal venous system has how many valves
None
Esophageal varices come from dilated ___ veins
Caput medusae come from dilated ____ veins
Hemorrhoids come from dilated ___ and ___ ___ veins
Esophageal veins
Epigastric veins
Inferior and middle rectal
Sympathetic fibers originate from ___-___-___, parasympathetic fibers originate from ___ ___ ___ and ___-___
T5-T12-L2
CN X and S2-S4
Preganglionic splanchnic nn synapse in ___ ___
Paravertebral (collateral) ganglia
Thoracic Splanchnic Nerves:
Greater splanchnic nerve comes from ___-___
Lesser splanchnic nerve comes from ___-___
Least splanchnic nerve comes from ___
T5-T9
T10-T11
T12
4 major autonomic ganglia
Celiac ganglion
Superior mesenteric ganglion
Aorticorenal ganglion
Inferior mesenteric ganglion
Phrenic nerve originates at levels ___-___
C3-C5
Median arcuate ligament arches over ____
Medial arcuate ligaments arch over ___ ___
Lateral arcuate ligaments arch over ___ ___
Aorta
Psoas major
Quadratus lumborum
____ and ___ ___ arteries supply superior surface of diaphragm
___ ___ supplies inferior surface
___ supplies periphery of diaphragm
Pericardiacophrenic superior phrenic
Inferior phrenic
Musculophrenic
Superior pole of L kidney is at the ___ rib, superior pole of R kidney is at the ___ rib
11th
12th
The renal ___ is anterior to the renal ___ which is anterior to the renal ___
Vein, artery, pelvis
The ___ renal artery is longer and the ___ renal vein is longer because the IVC sits ___ to the abdominal aorta
Right
Left
Right
The first constriction in the urinary system is at the ___ ___, the second constriction is at the ___ ___, the third constriction is at the entrance to the bladder
Ureteropelvic junction
Pelvic inlet
Ureter arteries arise from 4 sources
Renal artery
Gonadal artery
Abdominal aorta (or common iliac)
Internal iliac artery
To visualize the urinary system, an _ _ _ is performed
IVU
___ is the most common cause of kidney stones, ___ is the second most common cause
Dehydration, pharmaceuticals
The ___ adrenal gland is more triangular and the ___ is more semilunar
Right, Left
The superior suprarenal artery comes from the ___ ___ artery. The middle suprarenal artery comes from the ___ ___. The inferior suprarenal artery comes from the ___ artery.
Inferior phrenic artery
Abdominal aorta
Renal artery
Nerves of the posterior wall
Subcostal (T12) Iliohypogastric (L1) Inioinguinal (L1) Genitofemoral (L1, L2) Lateral cutaneous nerve of thigh (L2, L3) Femoral Nerve (L2-L4) Obturator Nerve (L2-L4)
Six Inspiring Insects Got Lunch From Oprah
The ___ ___ separates the false pelvis from the true pelvis
Pelvic brim
Features of female pelvis \_\_ pubic symphysis \_\_ pubic arch More \_\_ iliac wings Ischial tuberosities \_\_\_ \_\_\_ Sacrum is \_\_ and less curved
Shorter pubic symphysis Wider pubic arch More flared iliac wings Ischial tuberosities farther apart Sacrum is shorter and less curved
The interosseous ligament is between the anterior and posterior ___ ligaments
Sacroiliac
The __ ligament connects the sacrum and the spinous process of the ischium
Sacrospinous
The piriformis attaches at the ___ and the ___ ___
Sacrum
Greater trochanter
The obturator internus attaches from the ___ ___ to the ___ ___
Obturator foramen
Greater trochanter
The ___ ___ nerve travels above the piriformis in the greater sciatic foramen
Superior gluteal nerve
The ___, ___ ___, ___ ___ ___ and ___ ___ nerves and vessels travel beneath the piriformis through the greater sciatic foramen
Sciatic
Inferior gluteal
Posterior femoral cutaneous
Quadratus femoris
The muscles of the pelvic floor (pelvic diaphragm) are the ___ ___ and the ___
Levator ani
Coccygeus
The levator ani is made of the ___ ___ and the ___ muscles
Iliococcygeus
Pubococcygeus
Puborectalis
In males, the ___ ___ crosses the ureter and in females, the ___ ___ crosses the ureter
Ductus deferens
Uterine a.
The four parts of the male urethra are the ___ part, the ___ part, the ___ part, and the ___ part of the urethra.
Preprostatic, prostatic, membranous, spongy
