Abdomen intro Session 9 Flashcards

Session 9

1
Q

what is a hernia

A

weakness in the muscle wall that causes organs to protrude out of the abdomen

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2
Q

role of abdominal muscles (at least 5)

A
rotate body
respiration
coughing
sneezing
increase intra-abdominal pressure for defecation, micturition and childbirth
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3
Q

where is the rectus abdominus located

A

either side of midline

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4
Q

what are the attachments of rectus abdominus

A

superiorly: attached to sternum and costal margin
inferiorly: pubic
surrounded by rectus sheath

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5
Q

what r the 3 muscle sheets lateral to rectus sheath

A

external oblique
internal oblique
transversus abdominus

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6
Q

direction of external oblique layers

A

down and in

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7
Q

direction of internal oblique fibres

A

up and out

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8
Q

direction of transversus abdominus

A

transverse

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9
Q

what contributes to the abdominal aponeurosis

A

3 muscle layers all form aponeurosis

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10
Q

explain the external oblique aponeurosis

A

Inferiorly

the lowest most extent of the external oblique muscle is aponeurotic throughout its length

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11
Q

what is the inguinal ligament made of and where does go to and from

A

made from the aponeurosis of external oblique

from anterior superior iliac spine laterally and the pubic tubercle medially

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12
Q

what r the 6 bony landmarks of the abdomen

A
  1. Xiphisternum
  2. Costal margin
  3. Iliac Crest
  4. Anterior Superior Iliac Spine
  5. Pubic Tubercle
  6. Pubic Symphysis
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13
Q

how many regions is the abdomen divided into

A

9

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14
Q

vertical lines to split up the abdomen

A

mid-clavicular point to mid inguinal point

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15
Q

what is the mid-inguinal point

A

midway between pubic symphysis and anterior superior iliac spine

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16
Q

transverse lines that separate the 9 anatomical regions of the stomach

A
upper= subcostal plan (line joining lowest part of costal margins) 
lower= intertubercular line (between tubercles of the iliac crests)
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17
Q

name the nine regions of the stomach (go left to right and down rows)

A

right hypochondrium, epigastric, left hypochondrium
right flank, umbilical, left flank
right iliac region, suprapubic/ hypogastric, left iliac region

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18
Q

where is the transpyloric plane of Addison with:

  1. regards to the regions of the stomach
  2. regards to the costals
A

horizontal across epigastrium

tip of 9th costal cartilage

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19
Q

What 4 structures lie on the plane of addison

A

gallbladder, pancreas, pylorus, duodenal-jejunal flexure

20
Q

what is Mcburney’s point and on what side of the body is it

A

2/3 of the way along a line joining the umbilicus to the anterior superior iliac spine
only on right side

21
Q

what is located at mcburney’s point

A

appendix

22
Q

what does the umbilicus mark and what level is it

A

location of umbilical cord during embryonic life at the level of the L3 vertebra

23
Q

what is the intertubercular plane

A

line that joins the tubercles of the iliac crest

24
Q

what vertebral level is the intertubercular plane and what important structure is found at this level

A

L5 bifurcation of IVC

25
Q

what is the intercristal plane and why is is significant

A

line joining the iliac crest together

highest point of the pelvis

26
Q

what is the foregut innervated by

A

greater splachnic nerve (arises T5-9)

27
Q

where is pain felt that is in the foregut

A

anteriorly in midline ie epigastric

28
Q

what is the midgut innervated by

A

lesser splachnic nerve (T10-11)

29
Q

where is pain from the midgut felt

A

periumbilical area

30
Q

what is the hindgut innervated by

A

lowest splachnic nerve T12

31
Q

where is pain from the hindgut felt

A

suprapubic area

32
Q

what innervates the under surface of the diaphragm

A

phrenic nerve (C3,4,5)

33
Q

what is the sensory innervation of the kidney

A

symapathetic plexus (T10-12)

34
Q

what is ‘loin to groin’

A

the way pain form the kidney is described as radiating from the loin to the groin

35
Q

which of the three abdominal muscle layers pass over the costal margin

A

external oblique

36
Q

which of the three abdominal muscle layers interdigitate with serratus anterior

A

external oblique

37
Q

what do the lower posterior fibres of the external oblique attach to?

A

iliac crest

38
Q

what is the linea alba

A

‘white line’ in taht runs down midline of anterior abdominal wall formed by fusion of layers of rectal sheath medially

39
Q

what is underneath the medial external oblique aponeurosis

A

anterior layer of rectus sheath

40
Q

typical history for appendicitis

A

dull central abdominal pain that becomes sharp and located above the appendix

41
Q

explain the history of pain for appendicitis

A

dull vague pain= lesser splachnic nerve via sympathetic nervous system
sharp pain= inflammation rubs on inside of abdominal wall which is relayed by cutaneous nerves

42
Q

where can an aortic auneurysm be felt and what level is this

A

above the intertubercular point

L5

43
Q

what is shingles

A

viral infection of the sensory dorsal root ganglia that produces rash and blisters on skin

44
Q

what r all the layers of the abdomen from outer to inner (lateral)

A
  1. skin
  2. superficial fascia
  3. 3 muscles- external and internal oblique and transversalis abdominus
  4. transversalis fascia
  5. extra peritoneal fascia
  6. parietal peritoneum
45
Q

what r all the layers of the abdomen from outer to inner (medial) before the arcuate line

A
  1. skin
  2. superficial fascia
  3. aponeurosis of external and internal oblique (anterior layer of rectus sheath)
  4. rectus abdominus
  5. aponeurosis of internal oblique and transversalis abdominus (posterior layer of rectus sheath)
  6. transversalis fascia
  7. extra peritoneal fascia
  8. parietal peritoneum
46
Q

what is the arcuate line’s alternative name, where is it roughly located and what is the structure below this line?

A

semicircular line of douglas
found at 1/3 distance from pubic crest to umbilicus
below arcuate line= aponeurosis from three lateral muscles goes anterior to rectus sheath