The abdomen

Question 1

important thing about quadrants

Answer 1

-know where to auscultate, percuss, and palpate the patients and to record the locations of findings during a physical exam

Question 2

what is the division between the upper and lower quadrants?

Answer 2

umbilical

Question 3

RUQ

Answer 3

Right upper Quadrant

• liver; right lobe
• gallbladder
• stomach; pylorus
• duodenum: parts 1-3
• pancreas: head
• right suprarenal gland
• right kidney
• right colic (hepatic)
• ascending colon; superior part
• transverse colon; right half

Question 4

LUQ

Answer 4

Left upper quadrant

• Liver; left lobe
• spleen
• stomach
• jejunum and proximal ileum
• pancreas; body and tall
• left kidney
• left suprarenal gland
• left colic (splenic) flexure
• transverse colon: left half
• descending colon: superior part

Question 5

RLQ

Answer 5

right lower quadrant

• cecum
• appendix
• most of ileum
• ascending colon: inferior part
• right ovary
• right uterine tube
• right ureter: abdominal part
• right spermatic cord: abdominal part
• uterus (if enlarged)
• urinary bladder (if very full)

Question 6

LLQ

Answer 6

left lower quadrant

• sigmoid colon
• descending colon: inferior part
• left ovary
• left uterine tube
• left ureter: abdominal part
• left spermatic cord: abdominal part
• uterus (if enlarged)
• urinary bladder (if very full)

Question 7

what are other regions of clinical significance?

Answer 7

• epigastric region
• hypogastric region
• umbilical region
• right and left iliac regions

Question 8

epigastric region

Answer 8

the upper central region of the abdomen. It is located between the costal margins and the subcostal plane

Question 9

hypogastric region

Answer 9

region of the abdomen located below the umbilical region. The pubis bone constitutes its lower limit

Question 10

umbilical region

Answer 10

area centralized on the umbilicus (naval)

Question 11

Right and Left iliac and regions

Answer 11

region of the abdomen, on either side of the hypogastric regions, and below the lumbar regions

Question 12

wings on the pelvis

Answer 12

iliac crest

Question 13

abdominal skin

Answer 13

loosely attached except at the umbilicus where the scar tissue makes a strong attachment. Skin collagen runs in the natural lines of cleavage that mimic the dermatomes pattern

Question 14

lines of cleavage

Answer 14

skin collagen runs in these natural lines that mimic the dermatomes pattern. In surgery, they cut in horizontal lines BC it scars less

Question 15

cutaneous nerve supply

Answer 15

• anteriorly from the anterior rami of the spinal nerves of the lower 6 thoracic vertebrae and 1st lumbar vertebrae
• the thoracic nerves are the lowest 5 intercostals and the subcostal nerve
• the 1st lumber is the iliohypogastric and the ilioinguinal nerve

Question 16

T-12 nerve

Answer 16

subcostal nerve

Question 17

L-1

Answer 17

branches into iliohypogastric nerve and ilioinguinal nerve

Question 18

What dermatome is the epigastric area?

Answer 18

T7, near the xiphoid process

Question 19

What dermatome is near umbilicus?

Answer 19

T10

Question 20

What dermatome is near the inguinal canal?

Answer 20

L1

Question 21

Fatty layer (Campers fascia)

Answer 21

the fat that no one likes. superficial to the membranous layer (Scarpa’s fascia)

Question 22

Skin blood supply at midline

Answer 22

-superior and inferior epigastric artery

Question 23

What does the superior epigastric artery arise from?

Answer 23

internal throacic artery

Question 24

what doe the inferior epigastric artery arise from?

Answer 24

external iliac artery

Question 25

superior and inferior epigastric artery

Answer 25

they anastomose near the epigastric area

Question 26

inguinal region blood supply for skin

Answer 26

superficial epigastric - superficial circumflex iliac - superficial external peddle arteries

Question 27

Lateral abdominal cutaneous branches of nerves

Answer 27

come off of the costal nerves and loop around

Question 28

anterior abdominal cutaneous branch

Answer 28

comes off the front of the costal nerves and loops back

Question 29

venous drainage of the skin: superiorly

Answer 29

lateral thoracic into the axillary vein (armpit)

Question 30

venous drainage of the skin: inferiorly

Answer 30

superficial epigastric and the great saphenous vein into the femoral vein

Question 31

Lymph drainage of the skin of abdomen

Answer 31

- above the level of the umbilicus is upward to the anterior axillary (pectoral) group of nodes. - Below the level of the umbilicus, the lymph drains downward and laterally to the superficial inguinal nodes

Question 32

Fascia

Answer 32

a thin sheath of fibrous tissue enclosing a muscle or organ

Question 33

superficial fascia

Answer 33

- a loose fatty layer (Campers) - continuous with fat found all over the body. Found just below the skin -A tough membranous layer (Scarpa's) that lies beneath the fatty layer and just precedes the muscular layer of the abdomen.

Question 34

Deep fascia

Answer 34

a thin layer of fascia that envelopes the muscles of the abdominal wall

Question 35

Muscles of the abdomen

Answer 35

External oblique internal oblique transversus rectus abdominus

Question 36

external oblique

Answer 36

mose external muscle found laterally | runs anterior-inferiorly (forward and down)

Question 37

internal oblique

Answer 37

lies below the external oblique muscle fibers run anterior-superiorly (forward and up) Fibers run at 90 degrees from the external oblique

Question 38

transversus

Answer 38

lies below the internal oblique | deepest abdominal wall muscle

Question 39

rectus abdominus

Answer 39

- long strap muscle that extends along the whole length of the anterior abdominal wall. - broader above and lies close to the midline, being separated from its fellow by the linea alba

Question 40

rectus sheath

Answer 40

"tendon" for broad thin muscles

Question 41

rectus sheath

Answer 41

- long fibrous sheath that encloses the rectus abdominis muscles and contains the anterior rami of the lower six thoracic nerves - formed by the aponeuroses of the three later abdominal muscles - multilayered, tough

Question 42

Aponeurosis

Answer 42

a sheet of pearly white fibrous tissues that takes the place of a tendon in sheet-like muscles having a wide area of attachment

Question 43

thickness of abdominal muscles

Answer 43

- muscles have different thicknesses depending on where you look at them - the 3 abdominal muscles tun laterally and taper near the midline where it becomes the aponeurosis, or the rectus sheath

Question 44

What nerves have cutaneous branches?

Answer 44

intercostals

Question 45

Fascia transversalis

Answer 45

thin layer of fascia that lines the transverses abdominis muscles and is continuous with a similar layer lining the diaphragm and the iliac muscle

Question 46

inguinal canal

Answer 46

- allows structures to pass to and from the testis to the abdomen in males - in females, it allows the round ligament of the uterus to pass from the uterus to the labium majus

Question 47

anterior wall of inguinal canal

Answer 47

external oblique aponeurosis

Question 48

posterior wall of inguinal canal

Answer 48

conjoint tendon medially, fascia transversalis laterally

Question 49

roof or superior wall of inguinal canal

Answer 49

arching lowest fibers of the internal oblique and transverses abdominus muscles

Question 50

floor or inferior wall of inguinal canal

Answer 50

upturned lower edge of the inguinal ligament and, at its medial end, the lacunar ligament

Question 51

spermatic cord

Answer 51

structures that pass through the inguinal canal to and from the testis -begins at the deep inguinal ring lateral to the inferior epigastric artery and ends at the testis

Question 52

superficial inguinal ring

Answer 52

internal oblique and transverse oblique aponeuroses wraps around inside of this and sticks it like tape to the top

Question 53

inguinal ligament

Answer 53

very strong attachment from the iliac spine to the pubic tubercle