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GI - A > Wet Room 1 > Flashcards

Wet Room 1 Flashcards

Covers abdominal wall, regions, surface landmarks, Inguinal canal and some histology. Suitable for all except Ben Grey

1
Q

What structures form the “walls” of the abdominal cavity?

A
  1. The dynamic musculo-aponeurotic abdominal walls enclose anterolaterally.
  2. The diaphragm separates the abdominal cavity from the thoracic cavity superiorly and the posterior thoracic vertebrae also.
  3. Under cover of the thoracic cage superiorly extending to the 4th intercostal space.
  4. Continuous inferiorly with the pelvic cavity
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2
Q

How is the abdominal cavity divided by clinicians?

A

Either:
Right Upper Quadrant, Left upper quadrant, Right lower quadrant and left lower quadrant.
OR
Right and left hypochondriac, Right and left lateral, right and left inguinal, epigastric, umbilical and pubic (hypogastric)

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3
Q

What are the names of the 4 planes which divide the abdominal cavity into 9 regions?

A

Subcostal plane: passing through the inferior border of the 10th costal cartilage on each side.
Transtubular Plane: passing through the iliac tubercles and the body of the L5 vertebrae.
2 Verticle Midclavicular planes: Midpoint of clavicle to the midlinguinal points

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4
Q

What are the names of the 2 planes which divide the abdominal cavity into 4 quadrants?

A

Transumbilical plane: passing through the umbilicus and intervertebral disc between L3 and L4.
Median Plane: running longitudinally.

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5
Q

Name the 3 flat muscles in the anterolateral abdominal wall from outer to inner layer

A
  1. External oblique: fibres run inferomedially.
  2. Internal oblique: fibres fan out. Lateral with external obliques towards the pelvis and perpendicular to obliques superiorly towards thoracic cage.
  3. Transversus abdominis: Fibres run horizontally

All three end anteriorly in a strong aponeurosis.

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6
Q

What do the aponeurosis of the external oblique, internal oblique and transverses abdominis between the midclavicular line and the midline form?

A

The rectus sheath which encloses the rectus abdominis

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7
Q

Name the 2 vertical muscles of the anterolateral abdominal wall

A
  1. Rectus abdominis: Enclosed in the rectus sheath. Fibres run between three or more tendinous intersections
  2. Pyramidalis: small triangular muscle that lies in the rectus sheath anterior to the inferior part of the rectus abdomens. Arises from the pubic crest and attaches along the lines alba.
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8
Q

What is the action of the obliques?

A

Compress and support abdominal viscera

Flex and rotate trunk

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9
Q

What is the action of the transverses abdominis?

A

Compresses and supports abdominal viscera

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10
Q

What is the action of the Rectus abdominis?

A 
Flexes trunk (lumbar vertebrae) and compresses abdominal viscera.
Stabilises and controls tilt of the pelvis
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11
Q

How does the rectus sheath differ above and below the umbilicus?

A

Below: Sheath is anterior to the rectus abdominis
Above: Sheath is both anterior and posterior to the rectus abdominis

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12
Q

What organs and structures are present in the right hypochondriac region?

A 
Liver
Gall Bladder
Small intestine
Ascending colon
Transverse colon
Right kidney
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13
Q

What organs and structures are present in the Epigastric region?

A 
Oesophagus
Stomach
Pancreas
small intestine
Transverse colon
Liver
Right and left adrenal glands
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14
Q

What organs and structures are present in the left hypochondriac region?

A 
Stomach
Left kidney
Spleen
small intestine
Transverse colon
descending colon
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15
Q

What organs and structures are present in the right lumbar region?

A

Gall bladder
Right kidney
Ascending colon
Small intestine

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16
Q

What organs and structures are present in the umbilical region?

A 
Cisterna chyli
Stomach
Pancreas
small intestine
Transverse colon
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17
Q

What organs and structures are present in the left lumbar region?

A

Small intestine
Descending colon
Left kidney

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18
Q

What organs and structures are present in the right inguinal region?

A

Small intestine
Appendix
Caecum and ascending colon
Right ovary

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19
Q

What organs and structures are present in the hypogastric region?

A 
Small intestine
Sigmoid colon
Rectum
right and left ureters
Urinary bladder
uterus
Vas deferens
Prostate (unless its seamus' das which extends up to his throat)
20
Q

What organs and structures are present in the left inguinal region?

A

small intestine
descending colon
sigmoid colon
Left ovary

21
Q

At what vertical level is the umbilicus and what dermatome supplies it?

A

L3-L4

T10

22
Q

Which thoracic spinal segments innervate the anterior abdominal wall?

A

Ventral Rami

23
Q

How is the inguinal canal formed?

A

The inguinal canal is formed during the relocation of the gonads during metal development. It is formed from layers of the anterior abdominal wall as these layers push through the wall obliquely, thus forming a canal.

The canal is approximately 4cm long and lies parallel to and above the medial half of the inguinal ligament.

24
Q

The lateral border of the rectus abdominis and the rectus sheath is formed by what? (Surface anatomy point of view)

A

Semilunar lines.
Visible in individuals with good muscle definition these grooves extend from the inferior costal margin near the 9th costal cartilages to the pubic tubercles.

25
Q

What groove indicates the position of the inguinal ligament in terms of surface anatomy?

A

Inguinal groove

26
Q

Name the two surface landmarks of the iliac pelvis bone

A

Iliac crest and anterior superior iliac spine

27
Q

The inguinal ligament is attached to which two bony points if the hip?

A

Pubic tubercle and the anterior superior iliac spine

28
Q

The inguinal ligament is attached to which two bony points if the hip?

A

Pubic tubercle and the anterior superior iliac spine.

29
Q

What is the inguinal region?

A

Where structures exit and enter the abdominal cavity.
The migration of the testes from the abdomen into the perineum accounts for many of the structural features of the region.

30
Q

Where does the inguinal canal lie in relation to the inguinal ligament?

A

The inguinal canal lie parallel to and just superior the medial half of the inguinal ligament.

31
Q

What passes through the inguinal canal?

A

The main structure passing through is the spermatic cord (conveys the vas deferens in males, vestigial round ligament of uterus in females).

Blood and lymphatic vessels

  • Testicular artery
  • Cremasteric artery (cremaster muscle)
  • Deferential artery (Vas deferens)
  • Pampiniform venous plexus

Ilio-inguinal nerve

32
Q

What are the two openings to the inguinal canal?

A 
The deep (internal) ring: internal entrance
The superficial (external) inguinal ring: Slit like opening in the aponeurosis of the external oblique superolateral to the pubic tubercle.
33
Q

What are the two openings to the inguinal canal?

A 
The deep (internal) ring: internal entrance (superiorly)
The superficial (external) inguinal ring: Slit like opening in the aponeurosis of the external oblique superolateral to the pubic tubercle. (inferiorly)
34
Q

What forms the anterior wall of the inguinal canal?

A

The external oblique aponeurosis throughout the length of the canal

35
Q

What forms the posterior wall of the inguinal canal?

A

Trasversalis fascia.
Reinforced medially by merging of internal oblique and transverses abdomens aponeurosis into a common tendon (inguinal falx)

36
Q

What forms the roof of the inguinal canal?

A 
Laterally = transversalis fascia
centrally = musculo-aponeurotic arches of internal oblique
Medially = medial crus and intercrural fibres
37
Q

What forms the floor of the inguinal canal?

A

Inguinal ligament

38
Q

What is the relationship of the deep inguinal ring to the inferior epigastric vessels?

A

Deep inguinal ring lies laterally

39
Q

Where does the superficial ring lie in relation to the pubic tubercle?

A

Superolateral

40
Q

What is an indirect hernia?

A

An indirect hernia is the most common inguinal hernia.
It results from a weakness in the deep inguinal ring, allowing abdominal contents to enter into the inguinal canal lateral to the inferior epigastric vessels.

41
Q

What is a direct hernia?

A

Direct hernias account of 1/3 of inguinal hernias.
Abdominal contents do not pass through the deep inguinal ring, but simply push through a weak spot in the muscles making up the posterior wall of the inguinal canal, allowing contents to enter the canal and, again, even pass through the superficial inguinal ring.

42
Q

What is a femoral hernia?

A

These occur below the inguinal ligament, when abdominal contents pass into the weak area at the posterior wall of the femoral canal medial to the inferior epigastric vessel;s.
These (unlike indirect hernias) are more common in females.
The risk of strangulation is high

43
Q

What is an umbilical hernia?

A

Abdominal contents pass through a weakness at the site of the passage of the umbilical cord through the abdominal wall.
In adults umbilical hernias are acquired rather than congenital.
Abnormal fibres at the line alba may also contribute to the weakness of the wall.

44
Q

What does the external oblique form in the scrotum?

A

External spermatic fascia

45
Q

What does the internal oblique form in the scrotum?

A

Cremasteric fascia

46
Q

What does the transversalis fascia form in the scrotum?

A

Internal spermatic fascia

GI - A (8 decks)

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