WEEK 6 Flashcards
Thoracic Wall Layers
- Skin
- superficial fascia
- external intercostals
- intermediate intercostals
- VAN
- Innermost intercostals
- lateral innermost
- anterior transverse thoracis
- posterior subcostals
- Endothoracic fascia
- parietal pleura
- pleural cavity
- visceral cavity
- lung
Abdominal Wall Layers
- Skin
- Superficial fascia
- External Abdominal Oblique
- Internal Abdominal oblique
- VAN
- Transverse abdominus
- transversalis fascia
- parietal peritoneum
- peritoneal cavity
- viceral peritoneum
- gut tube
Spermatic Chord Layers + Abdominal Wall structures
- Ductus Deferens/ Testicular Arteries and Nerves Tunica vaginalis = Parietal Peritoneum
- Internal spermatic fascia = Transversalis fascia
- SKIPS THE TRANSVERSE ABDOMINUS
- Cremastor muscle = Internal abdominal oblique
- External spermatic fascia = External abdominal oblique
What is the nervous innovation and embryology of the Diaphgram?
Innovated by the phrenic nerve C3,4,5
Embryology: Myotome in the cervical hypomere, hypaxial muscle, ventral medial lip, ventral primary ramus
Thoracic Hypomeres: Thoracic Body wall Overview
Outer: External intercostals
Intermediate: Internal intercostals
(N.V.PLANE)
Inner: innermost intercostals , Transverse thoracis, Subcostals
Thoracic Hypomere: Abdominal Body wall overview
Outer longitudinal layer - Linear Alba - Midclavicular line - Rectus abdominus - Pyramidalis Outer - External oblique Intermediate - internal oblique (N.V.PLANE) Inner - Transverse abdominis
Name the 5 peritoneal folds
- x 1 Median umbilical fold
- x 2 Medial umbilical folds
- x 2 Lateral umbilical folds
Inguinal Ligament
Not a true ligament but a fold in the aponeurosis of the external abdominal oblique Subinguinal space contains muscles and nerovasuclar structures Males: Spermatic chord layers Females: round ligament ilioingual nerve in both sexes
Lumbar Hypomeres - Lumbar prevertebal muscles
Quadratus lumborum psoas major
Sacral Hypomeres: Pelvic Wall Muscles + perineum
Pelvic Wall muscles:
- Obturator internus
- Piriformis
Perineum
- Urogenital
- Anal
Sacral Hypomeres: Pelvic floor muscles
Pelvic flood muscles: - Levator ani puborectalis - levator ani pubococcygeus - levator ani illiococcygeus - ischiococcygeus
Pelvic flood muscles
Thoracic apetures of the diaphram
Vena caval appature (T8)
Oesophageal hiatus (T10)
Aortic hiatus (T12)
Thoracic appature attachements of the diaphragm
Anterior: Xiphoid process
Posterior: medial and lateral acruate ligaments
Inferior: lumbar vertebral bodies via medial acrute ligmanents
Lateral: Inferior 6 costal cartilages
Attachments of the Centeral tendon of the Diaphragm
Superior attachement: parietal pericardium
Inferior attachement: ligaments of the liver/ coranary ligament
What are the Ligaments of the Diaphragm?
Median arcuate ligament: Arches over aorta and unites the left and right crus
Medial arcuate ligament: Arches over psoas major, L1,L2 VB and L1 TVP
Lateral arcuate ligament: Arches over quadratus lumborum. Tip of 12th rib
Functions of the Diaphragm
Containment
Changes pressure within the thoracic and abdominal cavities
Respiration
Circulation
Sneezing, coughing, crying, urinating, defacating.
Outer Thoracic Body Wall: External intercostals
Origin: Inferior border of the 1-11th rib
Insertion: Superior border of the ribs below origin site. Sloped inferomedially when viewed anteriorly.
Nervous Innovation: anterior rami of thoracic nerves (intecostal nerve)
Action: Elevate ribs and support
Incompleate incompleate anteriorly continuation of the external intercostal membrane that connects the sternum/costal margin.
How can we distinguish the innermost intercostals from the external and internal intercostals?
- Innermost intercostals are connected to the parietal plura via the endothoracic fascia.
- Fibre direction
- Innermost intercostals originate on the internal surface of the inferior borders of the ribs
What ligmanents span over the psoas mj and quadratus lumborum?
Medial arcuate ligament passes over the psoas major. Lateral archuate ligament passes over the quadratus lumborum
Which embryological section of the embryo do the abdominal flank muscles belong?
Hypaxial. prevertebral muscles.
Which fascial structures separates the posterior layer of the rectus sheath from the peritoneum?
Transversalis fascia
Features of the Median Umbilical ligament
only one
most medial
obliterated urachus
fiberous reminant of canal connecting fetal bladder to umbilicus
Features of the Medial Umbilical ligament
Two
Contains left and right umbilical ligaments
reminance of umbilical arteries
Features of Lateral umbilical folds
Two
contain inferior epigastric artery, branch of external illiac
most latera of the 3
What is the fascia of the abdominal body wall?
Posterior + laterally : thoracolumbar fascia
Anteriorly: rectus sheath
Thoracic hypomeres: OUTER LAYER: External abdominal oblique (EAO)
Origin: Lower 8 ribs
Insertion: anterior, superior iliac spine. half of the iliac creast, pubic tubercle, linear alba.
becomes apponurotic in the MCL
Direction of fasicles: lateral to medial, superior to inferior
Abdominal hypomere: Abdominal Body wall: INTERMEDIATE LAYER Internal abdominal Oblique (IAO)
Deep to the EAO
Origin: thoracolumbar fascia. iliac creast. inguinal ligament
Insertion: Lower 4 ribs. Linear alba. pubic creast via conjoint tendon
contributes to the cremastor muscle.
directions of the fibers: inferior to superior, lateral to medial.
Thoracic hypomers: Abdominal wall: INNER LAYER: Transversus abdominis
Deepest of lateral abdominal body wall
lies deep to NV PLANE
Origin: Thoracolumbar fascia, costal margin, illiac crest, inguinal ligament
Insertion: linear alba, pubic crest via conjoint tendon
Becomes apponurotic in the MCL
Fascial direction: transversely orientated.
Thoracic hypomeres: Abdominal body wall VENTRAL LONGITUDINAL LAYER: Rectus Abdominus
Origin: pubic symphasis. pubic crest
Insertion: Xiphoid process. costal cartilages
Muscle fibers are interupted by tendenous sections
Abdominal body wall: VENTRAL LONGITUDINAL LAYER: Pyramidalis:
Present in 80% of people
tenses linear alba
lies within the rectus sheath anterior to inferior fibers of rectus abdominus
Is the Inguinal Ligament a true ligament?
Not a true ligament but a fold in the apponurosis of EAO
What runs through the inguinal cannal in females?
Round ligament
illioinguinal nerve
genitofemoral nerve
blood and lymphatic vessles
whats runs through the inguinal ligament in males?
Illioinguinal nerve
genitofemoral nerve
lympatics and blood vessles
Spermatic chord
What are the spermatic chord layers
Ductus deferins
tunica vaginalis
intenal spermatic fascia
cremastor muscle
external spermatic fascia
skin
What structures pass through the superficial inguinal ring?
no
What structures makes up the inguinal canal?
Floor: inguinal ligmanent
Roof: EAO, IAO, TA
Sides: Transversalis fascia and EAO (wrapped around)
What forms the deep and superficial rings?
Hiatus in the transversalis fascia forms the deep inguinal ring
Hiatus in the EAO forms the superficial inguinal ring
Name the 2 pelvic floor walls
obturator internus (lateral wall)
Piraformis (posteriorsuperior wall)
Name the pelvic floor
ischio coccygeus
levator ani puborectalis (medial)
levator ani pubococcygeus (intermediate)
levator ani illiococcygeus (lateral)
Name the two pelivic floor hiatus
Urogenital
Anorectal
What are the are the 3 muscles that form the levator ani
- levator ani puborectalis
- levator ani pubococcygeus
- levator ani illiococcygeus
What are the external surfaces that make up the two perineum triangles?
Anterior: pubic symphysis
Posterior: coccyx
Lateral: ishial tuberosities
