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2. HLTH 109 > Trunk wall II > Flashcards

Trunk wall II Flashcards

1
Q

diaphragm: features

A
  • seals inferior thoracic aperture
  • post attachment more inferior than ant (coz of angulation of aperture)
  • R dome high than L
  • muscle fibres arise radially, converge to central tendon
  • diaphragm contracts, height of dome decreases, increase volume of thorax
  • pericardium attached to middle part of central tendon
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2
Q

diaphragm: list all attachments

A
  • xiphoid
  • costal margin of thoracic wall
  • rib 11-12 ends
  • ligaments across post ab wall
  • lumbar vertebra
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3
Q

diaphragm: post attachment

A
  • crura: anchors to anterolateral surface of vertebral column
  • L3 (R), L2 (L)

arcuate ligs:

  • median arcuate lig (btw crura)
  • medial arcuate lig (TP L1)
  • lateral arcuate lig (rib 12)
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4
Q

diaphragm: openings

A

inf vena cava:
- in central tendon

oesophagus:
- muscular part

aorta:
- posteriorly

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5
Q

respiration: general features

A
  • pressure difference btw lungs + atmosphere

inhalation (inspiration): decrease alveolar pressure (increase lung size, contract diaphragm, elevation/outward of ribcage, intercostals)

exhalation (expiration): opposition, increase alveolar pressure

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6
Q

respiration: accessory muscles of inspiration

A
  • sternocleidomastoid
  • scalene
  • pec minor
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7
Q

respiration: role of abdomen in inspiration

A
  • relaxes
  • accomodate expansion of thoracic cavity
  • inferior displacement of abdominal viscera during diaphragm contraction
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8
Q

respiration: role of abdomen in expiration

A
  • contracts
  • assist in elevating domes of diaphragm
  • reduce thoracic volume
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9
Q

Valsalva manoeuvre:

A
  • contraction of ab muscles increase intra-abdominal pressure when diaphragm is in a fixed position
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10
Q

abdominal wall: consists of

A
  • skin
  • superficial (subcutaneous) fascia
  • muscles
  • deep fascia
  • extraperitoneal fascia
  • parietal fascia
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11
Q

abdominal wall: skeletal elements

A
  • 5 lumbar vertebra + IV discs
  • superior parts of pelvis
  • inferior parts of thoracic cage
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12
Q

abdominal wall: muscle elements parts

A
  • posterior
  • lateral
  • anterior
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13
Q

abdominal wall: post muscle elements

A
  • lateral to vertebral column
  • quadratus lumborum
  • psoas major
  • iliacus
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14
Q

abdominal wall: lateral muscle elements

A
  • transverse abdominus
  • internal oblique
  • external oblique
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15
Q

abdominal wall: anterior muscle elements

A

rectus abdominus

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16
Q

what continues btw posterior, lateral and anterior parts of ab wall:

A
  • fascia posteriorly

- aponeurosis from muscles in lateral wall

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17
Q

anterior abdominal wall: features

A

flat muscles, posterolateral -> replaced by aponeurosis towards midline

  • external oblique
  • internal oblique
  • transversus abdominus

vertical muscles near midline -> enclosed in tendinous sheath from aponeurosis of flat muscles

  • rectus abdominus
  • pyramidalis
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18
Q

external oblique: sup attach

A
  • muscular slips from outer surfaces rib 5-12
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19
Q

external oblique: inf attach

A
  • lateral lip of iliac crest

- aponeurosis ending in linea alba (midline raphe)

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20
Q

external oblique: innervation

A

anterior rami of lower 6 thoracic spinal nerves (T7-T12)

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21
Q

external oblique: action

A
  • compress abdominal contents
  • flex trunk together
  • each ipsilateral bend -> turning ant part of abdomen to opposite side
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22
Q

internal oblique: sup attach

A
  • thoracolumbar fascia
  • iliac crest
  • inguinal lig (lateral 2/3)
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23
Q

internal oblique: inf attach

A
  • lower 3/4 ribs

- aponeurosis ending in linea alba/ pubic line/ pectineal line

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24
Q

internal oblique: innervation

A
  • anterior rami of lower 6 thoracic spinal nerves (T7-T12)
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25
Q

internal oblique: action

A

compress ab contents

  • flex trunk together
  • each mm bends trunk to same side, turning ant part of abdomen to same side
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26
Q

transversus abdominis: sup attach

A
  • thoracolumbar fascia
  • iliac crest
  • inguinal lig (medial 1/3)
  • costal cartilage of lower 6 ribs
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27
Q

transversus abdominis: inf attach

A

aponeurosis ending in linea alba/ pubic crest/ pectineal line

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28
Q

transversus abdominis: innervation

A

anterior rami of lower 6 thoracic spinal nerves (T7-T12)

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29
Q

transversus abdominis: action

A

compress abdominal contents

30
Q

rectus abdominis: sup attach

A

costal cartilages of ribs 5-7

- xiphoid process

31
Q

rectus abdominis: inf attach

A
  • pubic crest
  • pubic tubercle
  • pubic symphysis
32
Q

rectus abdominis: innervation

A

T7-T12

33
Q

rectus abdominis: action

A

flexes vertebral column

- compress abdominal content

34
Q

pyramidalis: sup attach

A

linea alba

35
Q

pyramidalis: inf attach

A

anterior pubis and pubic symphysis

36
Q

pyramidalis: innervation

A

T7-T12

37
Q

pyramidalis: action

A

tenses linea alba

38
Q

rectus sheath: features

A
  • encloses rectus abdominis + pyramidalis
  • layering of aponeuroses of EO/ IO/ TA
  • encloses 3/4 of RA
  • covers ant surface of lower 1/4
  • post surface of lower 1/4 direct contact w transversalis fascia
39
Q

rectus sheath: upper 3/4

A

anterior wall: aponeurosis of

  • external oblique
  • 1/2 internal oblique (splits at lateral margin of rectus abdominis)

posterior wall: aponeurosis of

  • other 1/2 internal oblique
  • transversus abdominis
40
Q

rectus sheath: lower 1/4

A
  • midway btw umbilicus and pubic symphysis: all aponeuroses anterior to rectus muscle (arcuate line)
  • no post sheath
  • ant sheath: EO/ IO/ TA
  • rectus abdominis direct contact with transversalis fascia
41
Q

inguinal region: features

A
  • junction btw abdomen and thigh
  • ab wall is weakened -> testes/ ovaries descend from initial high position of post abdominal wall
  • peritoneal outpouching (processus vaginalis) forms protruding through layers of ant abdominal wall
42
Q

inguinal canal: initially, features

A
  • processus vaginalis acquires coverings from
  • transversalis fascia (deepest)
  • musculature of internal oblique
  • aponeurosis of ext oblique (superficial)

becomes tubular structure w multiple layers - basic structure of inguinal canal

43
Q

inguinal canal: final development

A
  • descent of testes into scrotum/ ovaries into pelvic cavity

men:
- descend with assoc. ducts/vessels/nerves which also pass through inguinal canal -> same fascial layers of ab wall

women:
- become assoc. w developing uterus, round lig (remnant of gubernaculum)

44
Q

inguinal canal: concludes

A
  • vaginalis obliterates

- if not, potential weakness and hernia may occur

45
Q

inguinal canal: definition

A
  • slit like passage downwards medially
  • parallel to lower half of inguinal lig
  • begins at deep inguinal ring -> superficial inguinal ring
46
Q

inguinal canal: contents

A
  • genital branch of genitalfemoral nn
  • spermatic cord (men) round lig (women)
  • ilioinguinal nn
47
Q

inguinal canal: deep inguinal ring

A
  • beginning of inguinal canal
  • midway btw ASIS and pubic symphysis
  • above inguinal lig, lateral to inferior epigastric vessels
48
Q

inguinal canal: superficial inguinal ring

A
  • end of inguinal canal
  • superior to pubic tubercle
  • triangular opening in aponeurosis of the external oblique with apex: pointing superolaterally and base formed by pubic crest
  • medial/ lateral crus (remaining sides of triangle) attached to the pubic symphysis and pubic tubercle
49
Q

inguinal canal: anterior wall

A
  • aponeurosis of ext oblique
  • reinforced laterally by lower fibres of internal oblique (potential site weakness)
  • internal oblique mm covers deep inguinal ring contributing layer (cremasteric fascia) to covering structures tranversing inguinal canal
50
Q

inguinal canal: posterior wall

A
  • transversalis fascia
  • reinforced along medial 1/3 by conjoint tendon
  • conjoint tendon also supports superficial inguinal ring
51
Q

inguinal canal: superior wall (roof)

A
  • arching fibres of transversus abdominis and IO fibres

- from lateral points of origin from inguinal lig -> common medial attachment at conjoint tendon

52
Q

inguinal canal: inferior wall (floor)

A
  • medial half of inguinal lig
  • this free margin of lowest part of EO forms gutter which contents of inguinal canal are positioned
  • lacunar lig reinforces medial part of gutter
53
Q

inguinal hernia: indirect

A
  • most common
  • more men vs women
  • some/ all of processus vaginalis remaining
  • peritoneal sac to enter inguinal canal passing deep inguinal ring
  • peritoneal sac can traverse entire canal, exit superficial ring and continue into scrotum/ labia majus
54
Q

inguinal hernia: direct

A
  • peritoneal sac enters medial end of inguinal canal: weakened post wall
  • common in mature men
  • bulging occurs: medial/ inferior epigastric vessels
  • does NOT traverse inguinal canal but may exit through superficial inguinal ring
55
Q

posterior abdominal wall: muscles

A
  • psoas major and minor
  • quadratus lumborum
  • iliacus
56
Q

psoas major: origin

A

bodies/ transverse process T12-L5 + IV discs

57
Q

psoas major: insertion

A

lesser trochanter

58
Q

psoas major: innervation

A

anterior rami: L1,2,3

59
Q

psoas major: action

A

flex the hip

60
Q

psoas minor: origin

A

bodies of T12 + L1 IV discs

61
Q

psoas minor: insertion

A

pectineal line, iliopubic eminence

62
Q

psoas minor: innervation

A

anterior rami of L1

63
Q

psoas minor: action

A

weak flexion of lumbar spine

64
Q

iliacus: origin

A

iliac fossa

65
Q

iliacus: insertion

A

lesser trochanter

66
Q

iliacus: innervation

A

femoral n

67
Q

iliacus: action

A

flexion of hip

68
Q

quadratus lumborum: origin

A

TP of L1-L4

- rib 12

69
Q

quadratus lumborum: insertion

A

TP of L5

- iliac crest

70
Q

quadratus lumborum: innervation

A
  • depresses and stabilises rib 12

- laterally flexes vertebral column

71
Q

iliacus: features

A
  • fills iliac fossa
  • passes inferiorly, joins psoas major and attaches to lesser trochanter (iliopsoas)
  • flexes thigh at hip when trunk is stabilised

2. HLTH 109 (29 decks)

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