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GINME > Week 1: Overview of the abdomen > Flashcards

Week 1: Overview of the abdomen Flashcards

1
Q

Describe the major parts of the abdomen

A

The abdomen is composed of

  • abdominal wall
  • abdominal cavity
  • abdominal viscera
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2
Q

Describe the parts of the abdominal viscera

6 listed

A
  • GI tract and associated organs
  • liver
  • gallbladder
  • pancreas
  • spleen
  • urinary system (kidney and ureters)
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3
Q

Functions of the muscles of the abdominal wall

A
  • move trunk
  • protect viscera
  • assist in respiration
  • increase intra-abdominal pressure to facilitate micturation, defecation and parturition
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4
Q

What is micturation?

A

urination

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5
Q

What is defactation?

A

Bowel movement

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6
Q

What is parturition?

A

childbirth

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7
Q

What are the muscles of the abdominal wall?

A

external oblique

internal oblique

transverse abdominus

rectus abdominus

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8
Q

Identify

A
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9
Q

Identify and function

A
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10
Q

Identify

A
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11
Q

What is the linea alba?

A

(white line)

is where the aponeuroses from each side interdigitate in the midline between the paired rectus muscles

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12
Q

Identify

A
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13
Q

What is the tendinous intersections?

A

are transverse fibrous bands where the rectus sheath attaches to the rectus abdominus muscle

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14
Q

Identify

A
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15
Q

These muscles are often called a ‘six-pack’

A

Rectus abdominus

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16
Q

Muscles of the abdominal wall from superficial to deep

A

external oblique

internal oblique

transverse abdominus

The flat muscles end in flat tendons called aponeuroses that form a sheath around the rectus abdominus

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17
Q

What is the arcuate line?

A

the arcuate line is where the posterior rectus sheath ends, below it, the rectus abdominus muscle rests on a fascial layer called the transversalis fascia

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18
Q

Identify

A
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19
Q

What is the transversalis fascia?

A

a fascial layer that the rectus abdominus muscle rests on

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20
Q

The anterior rectus sheath is formed by?

A

the aponeurosis of the external oblique and part of the aponeurosis of the internal oblique

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21
Q

The posterior rectus sheath is formed by?

A

the rest of the aponeurosis of the internal oblique and the aponeurosis of the transverse abdominus

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22
Q

The internal oblique aponeurosis contributes to?

A

both the anterior and posterior rectus sheath

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23
Q

Describe the inferior portion of the posterior rectus sheath

A

The inferior one-third of the posterior rectus sheath is absent because all three aponeuroses go anterior to the rectus abdominus muscle

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24
Q

Identify

A
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25
Q

Describe the innervation of the anterior abdominal wall

A

anterior or ventral rami of T7-L1 spinal nerves

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26
Q

T7 - T11 abdominal nerves

A

T7 to T11 are continuations of the intercostal nerves

their accompanying vessels are continuations of the intercostal arteries and veins

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27
Q

T12 abominal nerves

A

subcostal nerve and vessels

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28
Q

L1 splits into?

A

iliohypogastric and ilioinguinal nerves

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29
Q

Neurovascular supply to the abdominal wall

A
  • T7-L1 intercostal nerves, arteries and veins
  • T12 subcostal nerve, arteries and veins
  • L1 iliohypogastric and ilioinguinal nerves
  • superior epigastric and musculophrenic arteries (terminal branches of the internal thoracic artery)
  • superior and inferior epigastric arteries run posterior to the rectus abdominus within the posterior rectus sheath
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30
Q

Identify

A
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31
Q

Describe the abdominal quadrants and their contents

A
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32
Q

Right upper quadrant contents

A
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33
Q

Left upper quadrant contents

A
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34
Q

Right lower quadrant contents

A
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35
Q

Left lower quadrant contents

A
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36
Q

epigastric pain region

A

referred pain from the foregut

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37
Q

Umbilical region pain

A

referred pain from the midgut

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38
Q

Pubic region pain

A

referred pain from the hindgut

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39
Q

Structure of the peritoneum

A

peritoneum is simple squamous (serous) epithelium lining the abdominal cavity and reflecting onto viscera

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40
Q

Location of parietal peritoneum

A

parietal peritoneum lines the internal surface of the abdominal wall

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41
Q

Visceral peritoneum location

A

visceral peritoneum covers the viscera

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42
Q

The parietal and visceral peritoneum become continuous at?

A

the mesentery

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43
Q

Function of the mesentery

A

provides a path for blood vessels, nerves and lymphatics to reach abdominal organs

44
Q

Visceral and parietal peritoneum at the mesentery

A

are continuous

45
Q

What is the peritoneal cavity?

A

The peritoneal cavity is a potential space between the parietal and visceral peritoneum that contains only serous peritoneal fluid which allows the organs to move without friction

46
Q

Does the peritoneal cavity differ among the sexes?

A

In men, the peritoneal cavity is closed

in women, the uterine tubes open into the peritoneal cavity and thus, is a potential route for spread of infection

47
Q

What does it mean to be intraperitoneal?

A

organs covered on all sides by peritoneum

48
Q

What does it mean to be retroperitoneal?

A

Organs covered only on one side of peritoneum

49
Q

Any organ that has a mesentery is?

A

intraperitoneal

50
Q

Describe how the peritoneum surrounds organs

51
Q

Describe innervation of the parietal peritoneum

A

parietal peritoneum shares sensory innervation with the abdominal wall from spinal nerves T7-L1

52
Q

Describe parietal peritoneum and referred pain

A

sharp, somatic pain localized along the T7-L1 dermatome

53
Q

Describe innervation of visceral peritoneum and referred pain

A

the visceral peritoneum shares innervation with the viscera so pain originating from the abdominal viscera or visceral peritoneum is diffuse, dull referred pain

54
Q

Pain from the foregut refers to?

A

epigastric region

55
Q

Pain from the midgut refers to?

A

umbilical region

56
Q

Pain from the hindgut refers to?

A

pubic or hypogastric region

57
Q

The peritoneal cavity is divided into?

A

greater and lesser sac

58
Q

The greater sac comprises

A

most of the peritoneal cavity

59
Q

The lesser sac comprises

A

a small compartment located posterior to the stomach and inferior to the liver

60
Q

Lesser Sac AKA

A

omental bursa

61
Q

Omental bursa AKA

A

lesser sac

62
Q

Communication between the greater and lesser sacs

A

They communicate via the entrance into the lesser sac called the epiploic foramen of Winslow

63
Q

Identify greater and lesser sac

64
Q

What is a mesentery?

A

a double layer of peritoneum reflecting from the abdominal wall to enclose viscera

65
Q

Examples of mesenteries

A
  • Mesenteries of the small intestine (Mesentery proper)
  • colic mesenteries (Transverse mesocolon, sigmoid mesocolon)
66
Q

Mesenteries of the stomach are called?

67
Q

The omenta attaches what to what?

A

the stomach to other organs and not to the abdominal wall like other mesenteries

68
Q

What is an omentum?

A

a double-layer of peritoneum passing from the stomach to another organ

69
Q

The stomach has how many omenta?

A

2

the greater omentum

the lesser omentum

70
Q

Location of the greater omentum

A

passes from the stomach to the transverse colon and then drapes over it to form an apron in the greater sac

71
Q

Location of the lesser omentum

A

passes from the stomach to the liver

the lesser omentum forms the anterior wall of the lesser sac along with the stomach

72
Q

Where is the epiploic foramen?

A

posterior to the free edge of the lesser omentum

73
Q

Mesenteric ligaments

A

ligaments are parts of mesenteries between organs or organs and the body wall and are named according to their attachments

74
Q

Identify and notice the ligaments

75
Q

Abdominal spaces and gutters

A

abdominall or peritoeal spaces and gutters allow the passage of infectious fluids between different compartments of the abdomen and pelvis

peritoneal fluid usually flows upward due to peristalsis (movement) of the intestines

When excess fluid (ascites) accumulates due to pathology, the fluid usually flows downward

Ascites flow can be limited by? the presence of mesenteries and ligaments

76
Q

Peritoneal fluid flow

A
  • peritoneal fluid usually flows upward due to peristalsis (movement) of the intestines
  • When excess fluid (ascites) accumulates due to pathology, the fluid usually flows downward
77
Q

Greater sac divisions

A

the transverse mesocolon divides the greater sac into the supracolic and infracolic compartments

78
Q

Ascites flow limitations

A
  • Ascites flow can be limited by the presence of mesenteries and ligaments
  • the transverse mesocolon divides the greater sac into the supracolic and infracolic compartments limiting fluid flow except for laterally
  • the phrenicocolic ligament restricts flow on the left
  • in the infracolic compartment fluid flows through spaces to the right and left of the colon (paracolic gutters)
79
Q

Describe peritoneal fluid flow

80
Q

Embryological origin of the GI tract

A

The GI tract can be divided into three regions based on embryological origin

Foregut (celiac trunk)

Midgut (superior mesenteric artery (SMA))

Hindgut (inferior mesenteric artery (IMA))

81
Q

Parts of the foregut

A
  • esophagus
  • stomach
  • first half of the duodenum
  • liver
  • pancreas
  • gallbladder
  • spleen
82
Q

Foregut vascular supply

A

celiac trunk

83
Q

Parts of the midgut

A
  • 2nd hald of the duodenum
  • jejunum
  • ileum
  • ascending colon
  • first 2/3 of the transverse colon
84
Q

Midgut vascular supply

A

SMA or superior mesenteric artery

85
Q

Parts of the hindgut

A
  • last 1/3 of the transverse colon
  • descending colon
  • sigmoid colon
  • rectum
86
Q

Divisions of the small intestine

A

Duodenum

Jejunum

Ileum

87
Q

Divisions of the large intestines

A
  • Ascending colon
  • transverse colon
  • descending colon
  • sigmoid colon
  • rectum
88
Q

Hindgut vascular supply

A

IMA or Inferior mesenteric artery

89
Q

Anastomoses and vascular obstruction in the gut

A

branches of unpaired visceral arteries anastomose at junctions between gut regions and can provide collateral circulation if there is a vascular obstruction

90
Q

Collateral circulation at the foregut-midgut junction

A

the superior pancreaticoduodenal artery which is a branch of the celiac trunk anastomoses with the inferior pancreaticoduodenal artery which is a branch of the SMA

91
Q

Collateral circulation at the midgut-hindgut junction

A

Near the splenic or right flexure, The middle colic artery from the SMA anastomoses with the left colic artery from the IMA

However, this watershed area is vulnerable to ischemia as the anastomosis is not robust

Anastomoses between the left, middle and right colic arteries form an arterial arch called the marginal artery

The intestinal branches of the SMA do not anastomose with branches of the celiac trunk or IMA rendering the loops of the small intestines susceptible to ischemia

92
Q

Describe the divisions of the gut and their vascular supply

93
Q

some more anastamoses

94
Q

Describe gut vascular supply

95
Q

Question 1

A
  • Duodenum
  • descending colon
  • Kidney
96
Q

Where are retroperitoneal structures and what are they covered by?

A

Posterior to the peritoneal cavity and they are covered by peritoneum on their anterior surface and do not have a mesentary

97
Q

List of retroperitoneal structures

A
  • Esophagus
  • 2nd and 4th parts of the duodenum
  • Ascending colon
  • Descending colon
  • rectum
  • aorta
  • IVC
  • Ureters
  • Kidneys
  • suprarenals
98
Q

Question 2

99
Q

The lesser omentum is made of what parts?

A
  • Hepatoduodenal ligament
  • Gastrohepatic ligament
100
Q

Question 4

A

Hepatoduodenal ligament

101
Q

What is the pringle maneuver?

A

clamping the hepatoduodenal ligament to control bleeding from the liver

102
Q

The hepatoduodenal ligament contains …

A

the portal triad

103
Q

Question 5

A

gastrocolic ligament

104
Q

The portal triad consists of what parts?

A
  • Portal vein
  • hepatic artery
  • Common? bile duct
105
Q

Question 6

GINME (63 decks)

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