Unit 3 Exam Flashcards
What occurs into the potential space between scarpa’s fascia and deep fascia of the abdomen?
Extravasaion of urine
Can extravasation of urine spread inferiorly into the thigh?
NO, due to the firm adhesion of scarpa’s fascia and the fascia lata
What innervates the external oblique muscle?
Anterior primary rami of the Lower 6 thoracic nerves
What is the origin of the internal oblique muscles?
Lumbar fascia, iliac crest, and lateral two-thirds of inguinal ligament
Transverus abdominis muscle
“Acts as an internal backbone”
Or: lower 6 costal cartilages, lumbar fascia, iliac crest, lateral third of inguinal ligament
In: into línea alba by aponeurosis
Nerve: anterior primary rami of Lower 6 thoracic and first lumbar nerves
Function of the rectus abdominis muscle?
Compresses the abdomen, supports abdominal viscera, anterior flexor of the trunk
Anterior layer of the rectus sheath?
Composed of the aponeurosis of the external and internal oblique muscles
Median umbilical fold?
Extends form the APEX of the bladder and contains the obliterated umbilical artery
Ligamentum Teres?
Lies above the umbilicus and contains the obliterated umbilical vein. Free edge of the falciforme ligament, which is attached to the liver
Blood supply to the anterior abdominal wall?
- Superior epigastric A (from internal thoracic A)
- Inferior epigastric A (from external iliac A)
- Lumbar A (from Abdominal aorta)
- Deep Circumflex iliac A (from external Iliac A)
Inguinal ligament
Formed by the lower edge of the external oblique aponeurosis
Conjoint tendon (Inguinal Falx)?
Formed by the fusion of the aponeurosis of the internal oblique and trans versus abdominis muscles as they insert into the pubic crest and pecten.
Boundaries of the inguinal canal?
Anterior wall - aponeurosis of the external oblique muscle
Posterior wall - conjoint tendon and transversalis fascia
Roof - internal oblique and transversus abdominis muscles
Floor - inguinal and lacunar ligaments
Direct inguinal hernia
Passes medial to the inferior epigastric vessels, through the inguinal triangle
25% of inguinal hernias
Indirect inguinal hernias
Passes through the deep inguinal ring, inguinal canal, and superficial ring
75% of inguinal hernias
Ductus deferens
The muscular duct that transports sperm from the epidiymis to the ejaculatory duct
Ilioinguinal Nerve
Runs through the inguinal canal and superficial ring accompanying the spermatic cord BUT IS NOT PART OF IT
Layer of the anterior abdominal wall that is continues with the cremasteric fascia and cremaster muscle?
Internal oblique muscle
Layer of the scrotum that is continuous with the internal oblique muscle?
Cremasteric fascia and cremaster muscle
Two muscles that function in temperature regulation in the scrotum?
Dartos (smooth muscle)
Cremaster (skeletal muscle)
Cryptochidism
Testes are undescended at birth
3% of full term babies
30% of premies
Ascites (FIB)
The accumulation of fluid within the peritoneal cavity
Causes Malnutrition CHF Liver failure Kidney failure Peritonitis
Parietal peritoneum
Very sensitive to pain
Visceral peritoneum
Insensitive to pain
Omental bursa
Irregular shaped space which lies POSTERIOR to the liver, lesser momentum, and stomach
Right paracolic gutter
Longitudinal depression lateral to the ASCENDING colon
R-A
Left paracolic gutter
Longitudinal depression lateral tot he DESCENDING colon (L-D)
What structures pass through the porta hepatis?
Bile duct
Hepatic Artery
Portal Vein
Blood supply for the midgut
Superior mesenteric A
Blood supply for the foregut
Celiac trunk
Blood supply for the hind gut?
Inferior mesenteric Artery
Sympathetic innervation of the Foregut?
Greater splenetic nerves (T5-T9) and Lesser splanchnic nerves (T10-T11)
Sympathetic innervation of the midgut?
Greater splanchnic nerves (T5-T9) and lesser splanchnic (T10-T11)
Sympathetic innervation of the hindgut?
Lumbar splanchnic nerves (L1-L2)
Parasympathetic innervation of the foregut?
Vagus N.
Parasympathetic innervation of the midgut?
Vagus
Parasympathetic innervation of the hindgut?
Pelvic splanchnic nerves (S2-S4)
What makes up the Enteric Nervous System?
Submucosal plexus & myenteric Plexus
Submucosal plexus?
Supply muscularis mucosal and mucus secreting glands
Myenteric plexus
Supply smooth muscle and stimulate peristalsis
Congenital hypertrophic pyloric stenosis?
A tumor like increase in the size of the pyloric sphincter which reduces the size of the pyloric canal… Require surgery
Pylorospasm
Spasmodic contraction of the pyloric sphincter. Subluxation of T5-T9
Gastric ulcer
A crater like depression in the mucosa of the stomach
-Secretes a alkaline mucus which is “Sticky”
What are the branches of the splenic artery?
Pancreatic branches
Short gastric A.
Left gastro-omental A
Other name for the ascending (4th) part of the duodenum?
Intraperitoneal
Blood supply tot he duodenum?
Superior pancreaticoduodenal A
Supraduodenal A.
Inferior pancreaticoduodenal A
Duodenal ulcer?
Erosion of the gastroduodenal A by a perforated duodenal ulcer can result in severe hemmoraging
Vas a Recta?
Straight terminal branches of the A. That travel through the mesentery to supple small intestines
Peyer’s patches?
Aggregation of lymphoid tissue found within the walls of the smal intestine
Color of the jejunum?
Dark red
Color of the ileum?
Pale pink
Ilegal (meckel’s) diverticulum?
Remnant portion of the embryonic Vitelli needs duct
- finger like pouch that projects from the distal ileum
- *mimics Appendicitis**
Crohn’s disease
FIB
Inflammatory bowel disease which most commonly affects the distal ileum and adjacent colon.
produces cobblestone radiographic appearance
Cecum
Blind pouch below the ileso el al junction within the RIGHT iliac fossa
Ilegal fold
Two flaps which surround the ileal orifice
prevents backflow of feces into the SI
Most common position of the appendix
Retrocecal
Second most common position of the appendix?
Pelvic
Appendicitis?
- Inflammation of the appendix
- Symptoms are umbilical pain localized to the lower right quadrant
4 parts of the colon?
Ascending colon = ileocecal junction to right Colic (hepatic) flexure retroperitoneal
Transverse colon = Right colic (hepatic) flexure to the Left colic (Spenic) flexure
Descending colon = Left colic (splenic) flexure to the pelvic brim retroperitoneal
Sigmoid colon = pelvic brim to the front of the sacrum diverticulosis
What two parts of the colon are in the retroperitoneal space?
Ascending and descending colon
Diverticulosis
Herniation of the mucosa of the colon through the muscular layer
40+
Ulcerative colitis
Severe inflammation and ulceration of the rectum and lower colon
Appears on the radiograph
Irritable bowel syndrome
- Spastic Colon
- abnormal muscular contractions of the colon
Vasa recta (LI)
Straight terminal branches from the marginal A to the LI
Bowel infarction
Complete occlusion of the intestinal vessel by lipid plaque
What forms the inferior mesenteric plexu and hypogastric plexus?
Left 1/3 of the transverse colon to the upper part of the anal canal
Portal venous system
Drains the gastrointestinal tract, spleen, pancreas and gall bladder
NOT THE KIDNEY
Tributaries of the Portal vein
SLIP-LSS
Short gastric V Left gastro -omental V Inferior mesenteric V Pancreatic veins Left colic V Sigmoid V Superior Rectal V
Cirrosis of the liver
Characterized by the destruction of hepatic cells and their replacement by fibrous tissue and fat
Portal hypertension
Abnormal elevation of pressure within the portal system often due to cirrosis of the liver
-Blood backs up in tot he caval system
Caput medusa
Pronounce snake like veins radiating around umbilicus only present in severe cases
What are ALWAYS due to hypertension?
Caput medusa and Esophageal Varices
Quadrate lobe
Lies between the L and R lobes anterior to the porta hepatis
supplied by the Left branches
Blood supply to the liver?
75-80% portal vein
20-25% hepatic A
What does the gallbladder do?
Stores bile and concentrates it by absorbing water.
-it contracts to expel the bile into the duodenum (initiated by CCK)
Hepatopancreatic Ampulla (ampulla if Vater)
Formed by the union for he bile duct and the pancreatic duct
Gallstones
Hard masses formed by the solidification of bile constituents
MOST COMMON @ DISTAL END OF THE HEPATOPANCREATIC AMPULLA
Chiropractic note to Gallstones
30% of Patients have pain in the Right subscapular region of the back
Pancreatic duct
Drains the NECK BODY AND TAIL
Empties into the major duodenal papilla
Accessory pancreatic duct
Drains the HEAD AND UNCINATE PROCESS
** allows pancreatic enzymes to enter the duodenum with gallstones present**
What are the 3 subdivisions of the visceral surface of the Spleen?
Gastric surface
Colic surface
Renal surface
Blood supply for the spleen?
Splenic A
Splenic Vein
What is derived from the transversalis fascia?
Internal spermatic fascia
What nerve causes hiccups?
Phrenic Nerve in peritonitis
What is the abdominal policeman?
And what are its 3 parts
Greater momentum
- Gastrophrenic lig.
- Gastrosplenic lig.
- Gastrocolic lig.
Two parts of the Lesser omentum?
Hepatogastric lig.
Hepatoduodenal Lig.
Functions of the liver
Bile secretion
Metabolism of proteins, fats & Carbs
Storage of Glycogen, Vit, and iron
Detoxification