The abdominal wall and the intestines Flashcards

1
Q

What is the costal margin?

A
  • The lower edge of the thorax

- Formed by the bottom edge of the rib cage (ribs 7-10)

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2
Q

Where does the umbilicus lie?

A

Dermatome 10

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3
Q

Where is the trans-pyloric plane of the abdomen and what does it cross?

A
  • At the level of the 9th costal cartilage
  • At L1
  • Crosses the pyloric part of the stomach (where the stomach enters into the duodenum)
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4
Q

Where is the trans-tubercular plane of the abdomen and what does it cross?

A

At L5

Crosses the tubercule of the pelvis

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5
Q

What is the tubercule of the pelvis?

A
  • Prominent forward projecting part of the pelvis
  • Upper border of the medial portion
  • Where the inguinal ligament attaches to
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6
Q

Where are the imaginary vertical lines drawn from, which split the abdomen into its parts?

A

The mid-clavicular lines

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7
Q

What are the 2 imaginary horizontal lines which split the abdomen into its 9 regions?

A

Trans-pyloric plane

Trans-tubercular plane

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8
Q

What are the 9 regions of the abdomen and where are they in relation to each other?

A

Umbilical – central region

Epigastric – Above the umbilical region and just below the sternum

Hypochondriac – Either side of the epigastric

Lumbar – Either side of the umbilical

Hypogastric – Below the umbilical

Iliac – either side of the hypogastric

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9
Q

Which region does the appendix lie?

A

In the RIGHT iliac region

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10
Q

What are the muscle layers of the abdominal wall?

A

External oblique

Internal oblique

Transverse abdominus

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11
Q

Where do the external oblique muscles originate and where do they connect to?

  • Which direction do they travel?
A
  • 5th to 12th rib
  • Anterior iliac crest, linear alba, pubis
  • Travel down and medially
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12
Q

What do the external oblique muscles help the trunk to do?

A

Rotate (to the opposite side)

Both help to flex forwards

Bend (to that side)

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13
Q

What does the external oblique become inferiorly?

A

The inguinal ligament

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14
Q

Where do the internal oblique muscles originate and where do they connect to?

  • Which direction do they travel?
A
  • Inguinal ligament, iliac crest
  • Posteriorly to the lumbar fascia
  • To inferior border of ribs 9-12
  • Upwards and medially
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15
Q

What is the function of the transverse abdominis?

A

Thoracic and pelvic stability

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16
Q

Where do the transverse abdominis arise from?

A
  • Ribs 7-12 (interdigtates with the diaphragm)

- Lumbar fascia posteriorly

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17
Q

Where is the insertion of the transverse abdominsis?

A

Linear alba and pubis

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18
Q

What is the function of the internal oblique muscles?

A
  • Flex trunk forwards

Each muscle:

  • Bend to the same side
  • Rotate front of abdomen to the same side
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19
Q

What is the origin of the rectus abdominis?

A

5-7 costal cartilages and xiphoid

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20
Q

What is the insertion of the rectus abdominis?

A

1inch into the pubis crest

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21
Q

What is the function of the rectus abdominis?

A
  • Flexes abdominal column

- Tenses anterior abdominal wall

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22
Q

What is the function of ALL of the abdominal muscles?

A

Compress abdominal contents

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23
Q

What happens to the aponeurosis of each muscle ABOVE the arcuate line?

A
  • External oblique and anterior internal oblique makes the anterior rectus sheath
  • Posterior internal oblique aponeurosis and the aponeurosis of the transverse abdominis forms the posterior sheath
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24
Q

What happens to the aponeurosis of each muscle BELOW the arcuate line?

A
  • All aponeurosis pass infront of the rectus - forming the anterior sheath
  • Posterior sheath made of transversalis fascia and the peritoneum below this
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25
Q

What is the arcuate line of Douglas?

A

Horizontal line - sets the boundary of the lower limit of posterior layer of recuts sheath

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26
Q

What is the aponeurosis of the muscle?

A
  • Flattened sheet
  • Made of connective tissue and collagen
  • Envelope the muscle and connect them together
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27
Q

What does the peritoneum do?

A

Form the lining of the abdominal cavity

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28
Q

What is the greater omentum and where does it lie?

A
  • Apron-like fold of visceral peritoneum, which hangs down in front of the stomach
  • Lies over the transverse colon and small intestine
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29
Q

What is the small intestine split into?

A

Duodenum

Jejunum

Ileum

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30
Q

Does the colon have vili?

A

No - has crypts

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31
Q

Where does most the absorption take place?

A

In the jeujunum of the small intestine

32
Q

What is the shape of the duodenum?

A
  • C shaped around the head of the pancreas

- 4 distinct sections

33
Q

Where does the duodenum lie?

A

Adjacent to the stomach

34
Q

What is the blood supply to the duodenum?

A
  • Superior pancreaticoduodenal artery (from the gastroduodenal artery)
  • Inferior pancreaticoduodenal artery (from the superior mesenteric artery)
35
Q

What are PLICAE CIRCULARIS?

A

Large valvular flaps projecting into the lumen of the small intestine - has villi

36
Q

Where does the jejunum lie in the body?

A

In the umbilical region

37
Q

What are the differences between the jejunum and the ileum?

A

Ileum has thinner walls and a smaller diameter

Ileum has more fat (mesentery) than the jejunum

Ileum has more peyers patches

Ileum is supplied by shorter and more numerous arcades of the mesenteric vessels

(ileum 3-5 arcades. jejunum 1-2 arcades)

38
Q

What does the ileum absorb?

A

Vitami B12

39
Q

Where does the ileum lie?

A

In the suprapubic and pelvic region

40
Q

What can be identified where the ileum joins to the caecum?

A
  • Ileocecal fold
  • Appendix
  • Mesoappendix
41
Q

What is the ileocaecal fold?

A

Fold of peritoneum

42
Q

What is the ileocaecal junction?

A

Where the ileum meets the caecum of the large intestine

43
Q

What is the ileo-caecal valve?

A

Spinchter muscle valve which separates the ileum from the caecum

44
Q

What are the parts of the large intestine?

A
  • Caecum
  • Ascending colon
  • Hepatic flexure
  • Transverse colon
  • Splenic flexure
  • Descending colon
  • Sigmoid colon
  • Rectum
  • Anal canal
45
Q

Where is the rectum located in the body?

A

Anterior to the 3rd segment of the sigmoid colon

46
Q

Where does fluid get absorbed in the body?

A

In the colon

47
Q

What are the aterial branches from the aorta?

A
  • Celiac trunk
  • Supra renal
  • Renal
  • Superior mesenteric
  • Inferior mesenteric
48
Q

What are the arterial branches from the celiac trunk and which direction do they travel?

A
  • Left gastric (to the left)
  • Splenic (to the left)
  • Common hepatic (to the right)
49
Q

What are the branches from the splenic artery?

A
  • Short gastric

- Left gastroepiploic

50
Q

What are the branches from the common hepatic?

A
  • Propper hepatic

- Gastrodueodenal

51
Q

What are the branches from the propper hepatic?

A
  • Left and right hepatic

- Right gastric

52
Q

Where does the cystic artery branch from?

A

The right hepatic artery

53
Q

What are the branches of the gastroduodenal artery?

A
  • Right gastroepiploic
  • Supraduodenal
  • Superior pancreaticoduodenal
  • Pre pancreatic
54
Q

What are the branches from the superior mesenteric aretery?

A
  • Inferior pancreaticoduodenal
  • Middle colic
  • Right colic
  • Jejunal arteries
  • Ileocolic
55
Q

What are the branches from the inferior mesenteric artery

A
  • Left colic
  • Superiror and inferior rectal arteries
  • Sigmoid
56
Q

What are the branches from the ileocolic?

A
  • Ileal arteris

- Appendicular arteries

57
Q

What do the colic arteries supply?

A

The colon

58
Q

What does the terminus of the abdominal aorta split into?

A

The right and left common iliac arteries

59
Q

What do the right and left common iliac arteries split into?

A

Internal and external iliac arteries

60
Q

What are the 3 main features of the large intestine?

A

1) Appendices epiploicae
2) Haustrations
3) Taenia coli

61
Q

What are appendicies epiploicae?

A

Fatty tags

62
Q

What are taenia coli and how do that cause haustrations to form?

A
  • 3 bands of longitudinal smooth muscle
  • Shorter than the rest of the layers of the large intestine
  • When contract the cause the small bunches - haustrations
63
Q

Which parts of the colon are completely peritonealised and which are attached directly to the posterior abdominal wall?

A
  • Transverse colon and sigmoid - peritonealised

- Ascending and descending - attached to wall

64
Q

Where does the the appendix arise from?

A

The posteriomedial aspect of the caecum

65
Q

Where does the ceoliac axis arise from the aorta?

A

T12

66
Q

Where does the superior mesenteric artery arise from the aorta?

A

L1

67
Q

Where does the inferior mesenteric artery arise from the aorta?

A

L3

68
Q

What does the ileocolic artery supply?

A
  • The terminal ileum
  • Caecum
  • Start of ascending colon
69
Q

What does the right colic artery supply?

A

The ascending colon

70
Q

What does the middle colic artery supply?

A

The transverse colon

71
Q

What does the left colic artery supply?

A

The descending colon

72
Q

Which structures are intraperitoneal?

A

Stomach

Jejunum

Ileum

Transverse colon

Liver

Gallbladder

73
Q

Which structures are RETROPERITONEAL?

A
  • Pancreas
  • Duodenum
  • Ascending colon
  • Descending colon
  • Oesophagus
  • Rectum
74
Q

Where does the blood supply for the oesophagus come from?

A

The coeliac trunk

75
Q

What is Merckel’s diverticulum and where is it found?

A

Remains of the embryonic vitello-intestinal duct

  • On the anti-mesenteric border of the bowel (small intestine)
  • 2ft away from the ileocaecal junction